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NY Times:

Early in his career, a scientist named Mario J. Molina was pulled into seemingly obscure research about strange chemicals being spewed into the atmosphere. Within a year, he had helped discover a global environmental emergency, work that would ultimately win a Nobel Prize.

Now, at 70, Dr. Molina is trying to awaken the public to an even bigger risk. He spearheaded a committee of the American Association for the Advancement of Science, the world’s largest general scientific society, which released a stark report Tuesday on global warming.

Primary Colors:
The Primary Colors algorithm was created primarily to identify low-value Democrats in safe districts for primary challenges — but it can show us other things as well.

When we assign each member of Congress an expected score, it’s based on their colleagues’ scores in districts with similar partisan profiles.

Obviously we’d expect Democratic politicians to vote more conservative the more conservative their district gets, and more liberal the more liberal their district gets. And by-and-large, they do.

But Republicans don’t really follow that trend, as you can see in red on the graph below:

expected vs actual R and D House members in terms of ideology
If you only take away one thing from this graph, it should be that the expected value for Republicans is nearly a perfect horizontal line. Translated into plain English, that means Republicans vote conservative almost no matter what. It doesn’t matter what type of districts they represent.
More policy and politics below the fold.

NBC News:

U.S. headache sufferers are racking up nearly a $1 billion a year on brain scans — and the vast majority of them are probably unnecessary, a new analysis finds.

About one in every eight visits to a doctor for an uncomplicated headache or migraine from 2007 to 2010 resulted in the patient getting an MRI or a CT scan, according to a study published Monday in JAMA Internal Medicine.

And the number of imaging procedures is going up, not down, nearly tripling from 5.1 percent to 14.7 of all visits, despite national guidelines that recommend against routine use. Experts say that brain scans detect serious problems in only a fraction — 1 percent to 3 percent — of all headache cases.

And you ask why US health care costs so much?

Phil Plait:

Jenny McCarthy Asks; the Internet Slam Dunks

By now you know about anti-vaccination mouthpiece Jenny McCarthy. I’ve written about her many times: how she claims vaccines cause autism (they don’t), how she “cured” her son of autism with a gluten-free diet (she didn’t), how she rails about vaccines being full of toxins (they aren’t) while literally injecting her face with the single most toxic protein known to science.

Yeah, that Jenny McCarthy. It’s possible she’s more well-known in the general public for being a comedian, host of the The View, and of course a Playboy model, but on the ‘Net she’s widely understood to be a voice for frankly dangerous anti-vax nonsense.

On Thursday, McCarthy asked a question of her fans on Twitter to see what they’d say. What she got was a dose of the reality she helped spawn.

Alexandra Sifferlin:
Measles has made a comeback, at least in New York City, where as many as 19 cases have been confirmed.

New York City isn’t an anomaly, though. Diseases that are and have been avoidable in the U.S. thanks to vaccines, are resurfacing all across the country. Measles, for instance, was considered wiped out in 2000, but there have been several outbreaks in the past few years. This map shows outbreaks of vaccine-preventable diseases since 2008 (click on “Map” and select which diseases and regions you want to see).

Alec MacGillis:
When there is still snow on the ground past St. Patrick’s Day, thoughts turn longingly to the beach. Say, the Jersey Shore. Which in turn brings to mind the extreme yet comically ham-handed efforts of Governor Chris Christie’s administration to keep secret the process that led to the controversial selection exactly one year ago of a firm to run a $25 million ad campaign for last summer’s tourist season touting the Shore’s comeback from Superstorm Sandy.
Paul Mulshine:
Chris Christie pulls the plug on Tesla - and his political career
Toast? He's burnt toast.
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Comment Preferences

  •  Great roundup, Greg, can't wait to dig into (25+ / 0-)

    some of these articles--particularly the Jenny and Christie ones.

    This anti-vax stuff is not only stupid, it's dangerous.

    "Religion is what keeps the poor from murdering the rich."--Napoleon

    by Diana in NoVa on Wed Mar 19, 2014 at 04:38:41 AM PDT

    •  Anti-vaxxers threaten us (10+ / 0-)

      a person's rights end at the tip of someone else's nose

    •  Why don't they redirect their anti-chemical (14+ / 0-)

      rants against real toxic threats? High on my list would be lawn chemicals (which also affect everyone, even the people who choose not to use them, but they leach into everyone's water supply), coal ash, fracking chemicals, that pile of tar sands slag or whatever it is that the Koches have piled along the Detroit riverfront, and just about every type of plastic and cosmetic that's ever been invented. Oh, and the little microbeads in cosmetics. And antibiotics in farm animals/meat. And GMO crops.

      So much to be angry about and terrified of -- we are being poisoned and hormone-disrupted every minute of every day, with no recourse -- but no, they have to focus on vaccines.

      •  GMO's are not a toxic threat. (3+ / 0-)
        Recommended by:
        nicteis, kfunk937, BelgianBastard

        They may be unwise but they are not toxic to humans. There is literally about as much reliable science behind that assertion as the "science" that asserts there is no anthropogenic global warming.

        Voting is the means by which the public is distracted from the realities of power and its exercise.

        by Anne Elk on Wed Mar 19, 2014 at 08:38:14 AM PDT

        [ Parent ]

        •  Strongly agreed (3+ / 0-)
          Recommended by:
          kfunk937, BelgianBastard, Anne Elk

          GMOs are a mixed bag, but as you say, none constitute a toxic threat to human beings. Still, most of the volume of GMOs out there consist of Bt genes - which appear to be toxic to some degree to pollinators, which are already in trouble. And of herbicide reistance genes, like Roundup-ready, which encourage the heavy application of chemicals that may have toxic implications for people.

          We need GMOs in our kit bag, though; as climate change progresses, it will be one of our best tools in developing heat-resistant and drought-resistant crops. People are dying of communicable diseases because of the anti-vax nonsense. The day may come when people are dying of hunger because of anti-GMO nonsense.

          Otherwise, rugbymom has put together a dead-on list. The jury is still out on most plastics, but that may well be only because most of them have never been tested, at least for things like hormonal effects.

          •  Agreed (0+ / 0-)

            One thing that is interesting is how Companies (and Universities) are using high throughput sequencing to identify plant variants with desirable traits. That's turning out to be extremely valuable.

            Voting is the means by which the public is distracted from the realities of power and its exercise.

            by Anne Elk on Wed Mar 19, 2014 at 01:22:12 PM PDT

            [ Parent ]

      •  What worries me more about GMO is (2+ / 0-)
        Recommended by:
        kfunk937, Diana in NoVa

        that they get into the wild and crossbreds with non-GMO crops, finally permeating all seed stores.

        Next thing you know Monsanto is getting patent royalties from everyone.

        "Drudge: soundslike sludge, islike sewage."
        (-7.25, -6.72)

        by gougef on Wed Mar 19, 2014 at 08:58:21 AM PDT

        [ Parent ]

  •  graph (16+ / 0-)

    So for Republicans, "representative democracy" obviously refers to representing their own self-interests, rather than the wishes and values of their constituents. To some of us, this is not new news.

    •  their self interests are their sponsors n/t (17+ / 0-)

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Wed Mar 19, 2014 at 04:50:30 AM PDT

      [ Parent ]

    •  For the most part, they do represent them. (9+ / 0-)

      There are some exceptions of course, where a GOP rep is far more conservative than their districts. But for most of these people, their districts are just like them. Bunch of crazy ass white folks. Ever been to North Georgia? Jesus Christ. Like another nation completely. Most of these GOP districts are just a decade or so away from open Klan rallies. And they will be the moderates.

      •  wait, what? (1+ / 0-)
        Recommended by:
        skohayes

        When I look at that graph, I see a lot of Republican representatives in purple districts (with single-digit negative PVIs) and very conservative voting records.

        Maybe PVI isn't the right way to look at this. But just what are you saying, and why do you think it's true?

        "Democracy is a political system for people who are not sure they are right." —E. E. Schattschneider

        by HudsonValleyMark on Wed Mar 19, 2014 at 05:33:37 AM PDT

        [ Parent ]

      •  Oh yeah. Atlanta's nothing but crazy-ass white (1+ / 0-)
        Recommended by:
        skohayes

        folks.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Wed Mar 19, 2014 at 05:37:07 AM PDT

        [ Parent ]

      •  to North Georgia (1+ / 0-)
        Recommended by:
        brooklynbadboy

        Yes. I was lectured about the importance of keeping black people off welfare. And introduced to the local version of political correctness. Because they spend a lot of time talking about black people there, and don't want others to think they are predudiced, they refer to the black people in code, as "Democrats".

        You will not be punished for your anger. You will be punished by your anger.

        by mstep on Wed Mar 19, 2014 at 06:57:54 AM PDT

        [ Parent ]

      •  I disagree (3+ / 0-)
        Recommended by:
        Josiah Bartlett, Stude Dude, Odysseus

        I live in an R+27 in western Kansas. You'd think people would be thrilled with our representation in the US and state legislatures, for example, my idiotic teabagger congressman, Tim Huelskamp, or our right wing governor, Sam Brownback.
        But when they can't get anything done because they vote no on everything (Huelskamp represents the largest agricultural district in the country and got kicked off the Agriculture Committee) or even deliberately hurt people to push their agenda (Brownback refusing Medicaid expansion), people get fed up with it.
        It would be near impossible for Huelskamp's challenger to win, but Brownback is going to lose. To a Democrat. In Kansas.

        Your beliefs don't make you a better person. Your behavior does.

        by skohayes on Wed Mar 19, 2014 at 07:20:36 AM PDT

        [ Parent ]

        •  It seems... (3+ / 0-)
          Recommended by:
          Geenius at Wrok, Stude Dude, skohayes

          that while sometimes a district may be conservative, it's not the same conservative as the politicians.

          The republicons moan, the republicons bitch. Our rich are too poor and our poor are too rich. Ferguson Foont

          by Josiah Bartlett on Wed Mar 19, 2014 at 07:53:16 AM PDT

          [ Parent ]

          •  Exactly! (1+ / 0-)
            Recommended by:
            Josiah Bartlett

            These are FARMERS out here-they need to plan on what they're planting next year, they need to know what their insurance is going to cost, etc.
             They figured out really quickly who is on their side when the Tea Party in the House delayed the Farm Bill for months. Huelskamp got hammered pretty hard for that in a few town halls.

            Your beliefs don't make you a better person. Your behavior does.

            by skohayes on Wed Mar 19, 2014 at 01:08:35 PM PDT

            [ Parent ]

        •  All these folks (2+ / 0-)
          Recommended by:
          Stude Dude, skohayes

          have to do is vote for a Dem and they'd likely get the representation they want - conservative and get action they need.

          Now if they could only wrap their heads around that graph.

          "I'm not left wing because i'm ideological, or passionate, or angry. I'm left wing because I'm informed." - Mikesco

          by newfie on Wed Mar 19, 2014 at 07:56:19 AM PDT

          [ Parent ]

          •  LOL (1+ / 0-)
            Recommended by:
            newfie

            They do have a different breed of Democrat than I'm used to out here (I'm originally from Philly), but even the worst is thousands of times better than the current crack pots we have.

            Your beliefs don't make you a better person. Your behavior does.

            by skohayes on Wed Mar 19, 2014 at 01:04:01 PM PDT

            [ Parent ]

            •  Oh Philly born eh?! (0+ / 0-)

              What do you do for your hockey fix?  No orange and black is not good for your soul.

              "I'm not left wing because i'm ideological, or passionate, or angry. I'm left wing because I'm informed." - Mikesco

              by newfie on Thu Mar 20, 2014 at 12:20:07 PM PDT

              [ Parent ]

    •  But isn't representing (1+ / 0-)
      Recommended by:
      I love OCD

      their constituents' wishes and values the same thing we criticize blue dog Democrats like Sen Manchen for?

      •  I guess representing their constituents (1+ / 0-)
        Recommended by:
        Geenius at Wrok

        now means voting against providing healthcare to their constituents.

        We criticize Blue Dogs for being the corporate sellouts they are, putting the interests of large wealthy corporations which are lining their pockets well above the interests of their constituents.

        In Joe Manchin's case it's big Coal and the mining interests.  Because voting to gut environmental regulations and allowing them to do whatever the fuck they want which results in toxic undrinkable water is really you know representing your constituents best interests.  

        This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

        by DisNoir36 on Wed Mar 19, 2014 at 06:40:35 AM PDT

        [ Parent ]

        •  Two different things. (0+ / 0-)

          The original poster said the "constituents' wishes and values", which is what I addressed. The constituents' best interests may be completely contrary to their wishes and values. In red states, I believe that's usually the case.

          •  Sorry I don't buy it (0+ / 0-)

            Wishes and values are not so different than interests.  

            You ask anyone in a red state whether they wish to have universal, easily accessible, affordable and quality healthcare and I GUARANTEE you they'll say yes.

            You ask anyone in a red state whether they value clean and safe drinking water and I GUARANTEE you they'll say yes.

            You ask anyone in a red state whether they would be interested in a quality job that pays them a decent wage working at a place where their life won't be put at risk by their bosses and I GUARANTEE you they'll say yes.

            This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

            by DisNoir36 on Wed Mar 19, 2014 at 06:33:33 PM PDT

            [ Parent ]

  •  2012- Dems defined GOPers by their stupidest (14+ / 0-)

    comments, most intolerant members, and most damaging economic programs. It wasn't quite enough to overcome severe GOPer gerrymandering, but it was a good , effective strategy- there are NO "moderate" GOPers.

     A vote for ANY GOPer needs to be defined as a vote for the Richest 1%, a vote against access to birth control, a vote for gun manufacturers, a vote against minimum wage, a vote against civil rights, and a vote against tax fairness

    •  More important, a vote for TP/GOP control of the (8+ / 0-)

      agenda through majority status.

      If Bernie Sanders or Elizabeth Warren changed their label to (R) and voted that one time in the (R) column for majority ship the damage is done regardless of voting with (D) on every other matter. That puts Issa in the chair instead of Cummings. It puts anti-science idiots in the chairs and control of committees on science. It puts the agenda, which things will be brought to a vote when in the hands of a Bohner or worse.

      From this comment a few days ago:

      Every time I hear someone, even here, say "I vote for the person, not the party" or "I have to sit this one out because there is no choice" I see a person that failed Civics 100. You have those choices when we have fairly benign political times and some national unity of view and purpose. When polarized and fighting for the nation's "soul" we don't have that luxury.

      We do not, and all this chatter about eventual "demographics" and such is chatter. People sitting out 2010 gave us the legacy of gerrymandered House seats and state legislative seats until 2021. If we turn over the Senate in 2014 and then lose 2016 by the time "demographics" change those demographics may face rigged elections enshrined in law rivaling Jim Crow days. Anyone really want to go back to the 1960s civil rights wars?

      If people supposedly on our side keep failing basic civics, once at least middle school level civics, then by 2021 they may find themselves as voiceless as the black college professor in 1950 Alabama or Mississippi who failed the literacy test. Then it is a long and hard uphill clime while the nation spirals to ruin in the hands of a regressive gang in the clutch of the 1% and religious nutters and racists.

      The only foes that threaten America are the enemies at home, and those are ignorance, superstition, and incompetence. [Elbert Hubbard]

      by pelagicray on Wed Mar 19, 2014 at 05:50:49 AM PDT

      [ Parent ]

      •  Civics is not taught in public schools anymore (1+ / 0-)
        Recommended by:
        pelagicray

        in elementary, middle or high school, unless it's mentioned in a section of a "social studies" class.  I don't know about charter schools, but I doubt the sponsors of those schools want the students knowing much about civics.

        "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

        by SueDe on Wed Mar 19, 2014 at 10:29:32 AM PDT

        [ Parent ]

        •  Yeah, and how I know! It is obvious even in many (0+ / 0-)

          discussions on this site that many are pretty clueless at how things work at the most basic level.

          Since the citizens are responsible for maintaining the workings of government, its owners, this is a bit like having car or computer owners so ignorant (as many are) of the very basic workings of the things they cannot even competently choose a garage or technical service and get screwed right and left by "ya gotta spend $1,000 fixing the doo hickey that makes the little red light go away"—suckers.

          Citizens don't have to be experts at all the sausage making, but when they don't even have a clue as to how things work or the basic roles of Legislative, Executive and Judicial branches they are indeed suckers for all sorts of political fraud and chicanery.

          The only foes that threaten America are the enemies at home, and those are ignorance, superstition, and incompetence. [Elbert Hubbard]

          by pelagicray on Wed Mar 19, 2014 at 05:43:57 PM PDT

          [ Parent ]

  •  Voting Conservative, Voting Wrong (12+ / 0-)

    The Primary Colors graph shows the rigidity of Republicans, who don't compromise to represent their constituents, rather they stick to their strict ideology. And it's an ideology that's strictly wrong:

    Wrong on climate change, wrong on "trickle-down" economics, wrong on voting access, wrong on healthcare, wrong on education, wrong on women's rights, wrong on gun control, wrong on immigration, wrong on separation of church and state, wrong on economic safety nets... wrong, wrong, wrong.

    And the visual of their voting trend on that graph reminds us of the direction that they are taking this country; a flat line.

    "One of the more serious temptations which stifles boldness and zeal is a defeatism which turns us into querulous and disillusioned pessimists, sourpusses." ― Pope Francis

    by GoodGod on Wed Mar 19, 2014 at 04:50:58 AM PDT

    •  I used to split the ticket and vote for a few Rs (2+ / 0-)
      Recommended by:
      skohayes, Stude Dude

      Not anymore.  Republicans are so idiotic on the national ticket that now I will not even vote for local Republicans who I know and consider to be friends. Republicans vote in lockstep so I have to, in response.

      Voters should select people to represent them in their government. People in government should not select people who may vote!

      by NM Ray on Wed Mar 19, 2014 at 07:19:22 AM PDT

      [ Parent ]

      •  30 years ago there were some Republicans (2+ / 0-)
        Recommended by:
        NM Ray, Calamity Jean

        worth voting for.  In Oregon we had Tom McCall, Norma Paulus, even Bob Packwood, who was a leader of the pro-choice caucus.  None of them would stand a chance in today's GOP, where their candidates are a pediatric surgeon who hates the ACA and a whack-a-doodle rogue scientist who wants us to send him urine samples.  Believe it or not, these two are a step up from previous candidate, three of whom ended up in jail for financial shenanigans.

  •  Interesting piece on headaches/brain scans (8+ / 0-)

    Further along in the article was this:

    “The number one reason physicians give for ordering the scans is patient reassurance,” said Dr. Brian Callaghan, the University of Michigan Health System assistant professor of neurology who led the study. “A billion dollars is a lot for patient reassurance.”
    Interesting piece.

    As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them. John F. Kennedy

    by JaxDem on Wed Mar 19, 2014 at 04:59:36 AM PDT

    •  And representative of one of the best-known (5+ / 0-)
      Recommended by:
      Ohkwai, DRo, salmo, wintergreen8694, Stude Dude

      reasons for the high cost of health care in the US:

      Doctors doing things because they can (get paid for them).

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Wed Mar 19, 2014 at 05:38:15 AM PDT

      [ Parent ]

      •  mistaken idea (1+ / 0-)
        Recommended by:
        BelgianBastard

        docs don't get paid more for ordering a scan. They mistakenly order way too many for defensive or patient satisfaction purposes, but getting paid to order is not the reason (in fact, it's illegal and falls afoul of kickback laws).

        The Anti-Kickback Statute is a criminal statute which prohibits the giving, accepting, soliciting (i.e., asking for) or arranging items of value in any form (gifts, certain discounts, cross-referrals between parties), either directly or indirectly for the purpose of inducing or rewarding another party for referrals of services paid for by a federal government health care program. The statute is very broad and, in addition to the obvious referrals of residents or services residents need, it also covers purchasing, ordering, leasing or arranging for or recommending the purchase, leasing or ordering of services paid for by a federal health care program in exchange for any item of value.

        Because this statute is criminal in nature, violations of it can result in jail time, criminal money penalties and exclusion from federal health care programs, including Medicare and Medicaid. These penalties can apply to anyone involved in a prohibited transaction, including the giver or receiver of prohibited benefits for referrals. Complying with the statute is also a condition of participation under Medicare. Because of this, a facility which claims payment for a transaction prohibited by the Anti-Kickback Statute can also be violating a separate civil statute, the federal False Claims Act, which permits payment only for items and services which are reasonable, necessary and provided consistent with federal law.

        http://www.ahcancal.org/...

        "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

        by Greg Dworkin on Wed Mar 19, 2014 at 09:21:07 AM PDT

        [ Parent ]

      •  Conservatives insist that doctors order so (1+ / 0-)
        Recommended by:
        dinotrac

        many tests in order to to defend against medical malpractice lawsuits and to lower malpractice insurance costs, hence the need for tort reform.  Funny, that here in Texas, where tort reform was enacted over 10 years ago, if there were any decline in the cost of doctors' insurance it sure wasn't passed on to patients.  The number of tests doctors order hasn't dropped either.

        "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

        by SueDe on Wed Mar 19, 2014 at 10:40:05 AM PDT

        [ Parent ]

        •  important point (2+ / 0-)
          Recommended by:
          dinotrac, BelgianBastard

          insurance co's. pocket the money. See FL:

          A blow against “tort reform” in Florida
          Even after seeing a huge spike in profits, the insurance industry, the court notes, continued to price-gouge doctors for malpractice insurance, charging OB-GYNs in Miami-Dade County more than $190,000 a year for $1 million in insurance coverage that it charged $98,000 for in other parts of the state.
          Stephanie reports the courts found that net income rose for the insurance companies by 4300% from 2003 to 2010, after “tort reform” was passed.

          For those of you who are interested, a similar thing happened in Missouri two years ago. Here’s a boatload on the Texas experience with tort reform.

          I continue to agree that the malpractice system needs fixing. I continue to hold that tort reform, meaning capping damages, is a particularly ineffective way to do it.

          http://theincidentaleconomist.com/...

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Wed Mar 19, 2014 at 10:48:50 AM PDT

          [ Parent ]

          •  Which the leaves the question: (0+ / 0-)

            If so many scans are a bad thing -- and they are -- why do they get ordered?

            I'm quite certain that butt-covering is part of it, because that's human nature and even prudent.

            I do not, however, buy your argument that federal anti-kickback statutes prevent the practice of performing procedures that aren't needed or of ordering scans that are not needed.

            First, there are no kickback considerations for services to be provided by your own practice.

            Second, referrals are a necessary part of the business and tend to have an expectation that referral partners will refer back to you, even in the absence of a rigid quid-pro-quo that would constitute a violation of federal law. Check in with business owners in your area. I'm sure you will find a number of them in referral groups. It's something the feds aren't likely to outlaw because it's something you need to do to practice medicine.

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Wed Mar 19, 2014 at 11:25:34 AM PDT

            [ Parent ]

            •  your point that docs get reimbursed or paid (0+ / 0-)

              for ordering CT scans in some way (the original comment) is simply flat out untrue. I didn't say it stops the practice of ordering unneccessary scans, I said that "docs get money for ordering" is wrong (ie doesn't happen). And it is illegal, to boot.

              Radiologists make a lot of money and so do hospitals but they don't order the tests. Docs ordering the tests don't make the money.

              And you can't self refer (see Stark laws) to a facility you own.

              As my original note states, the law is strict and we all have yearly compliance reviews to make sure we don't get cute about it.

              To continue to state that "it must be true because it makes sense to me" misses the point entirely of what the real world actually does.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Wed Mar 19, 2014 at 12:53:49 PM PDT

              [ Parent ]

              •  I didn't say that docs get paid for CT scans, (0+ / 0-)

                though the practices performing them certainly do.
                I said that a major component of high prices is that doctors (and hospitals) do procedeures they can justify regardless of whether they are actually appropriate.  I know you are aware of heart bypass rates in the US. You can't know that information and tell me that I'm wrong.

                As to referrals for scans,  everybody knows that referrals are good for business.  If you can't get paid for something directly, it's not bad to pass referrals along to people who will refer back if they find something.

                LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                by dinotrac on Wed Mar 19, 2014 at 01:04:16 PM PDT

                [ Parent ]

            •  so the reason CT scans get ordered (0+ / 0-)

              is docs and patients don't want to miss anything. It's that simple.

              That's where evidence based medicine and rule guidelines save money.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Wed Mar 19, 2014 at 12:55:06 PM PDT

              [ Parent ]

              •  Evidence based medicine can help that so long (0+ / 0-)

                as it is tied to somebody getting paid.

                LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                by dinotrac on Wed Mar 19, 2014 at 01:04:57 PM PDT

                [ Parent ]

                •  not really (0+ / 0-)

                  as shocking as it sounds, docs really want to do the right thing and if there's data to show the way, that's what they will do.

                  "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

                  by Greg Dworkin on Wed Mar 19, 2014 at 01:14:37 PM PDT

                  [ Parent ]

                  •  Yes really. Everybody wants to do the right thing (0+ / 0-)

                    We really do.
                    Even people who work for oil companies want to do the right thing.

                    HL Menken had it right, though: Don't ask the opinion of somebody whose paycheck depends on the answer.

                    I'm glad that we have human doctors.  Medicine is a calling that requires a certain humanity to practice well.

                    But humans are humans even when they're doctors.

                    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                    by dinotrac on Wed Mar 19, 2014 at 01:21:02 PM PDT

                    [ Parent ]

    •  Little to do with patient reassurance, IMO (5+ / 0-)

      and a lot to do with doctors buying scanner machines and then looking for opportunities to bill for their use.

      Or it may be "doctor reassurance," as in, "I want to make sure I haven't missed something, so it won't bite me later."

      Patients only "demand" fancy scans when the doctor suggests it would be a good idea, "just to be sure." If the doctor didn't mention it as an option, very few patients would even know it existed.

    •  Not all scans are frivolous... (3+ / 0-)
      Recommended by:
      skohayes, Stude Dude, kfunk937

      My CT scan after months of persistent headaches led to diagnosis of a brain tumor.  And I am alive today as a result.  

      •  this is really the key, isn't it? (0+ / 0-)

        If you can save 1% - 3% of headache sufferers from dying of brain tumors (or the like) is the investment worth it?

        Where do you draw that line?

        •  no, that's not it at all (1+ / 0-)
          Recommended by:
          BelgianBastard
          When are the tests warranted for headache?

          They might be considered if you get an abnormal result from a neurological exam or your doctor can’t confidently diagnose your headache based on your symptoms and exam. And call your doctor if you have headaches that are:

          Sudden or explosive.

          Different from other headaches you’ve had in the past, especially if you’re 50 or older.

          Brought on by exertion.

          Accompanied by fever, seizure, vomiting, a loss of coordination, or a change in vision, speech, or alertness.

          http://www.choosingwisely.org/...

          certain things make you get one, including consistent symptoms that don't go away, but it's not for everyone.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Wed Mar 19, 2014 at 10:14:02 AM PDT

          [ Parent ]

  •  The good news on the graph for Dems (6+ / 0-)

    Is that theres a lot more dots on the right end of it. There was a time when that line was a lot flatter and more centered.

  •  Ha! Huge LOL from #JennyAsks (2+ / 0-)
    Recommended by:
    Bill in Portland Maine, skohayes

    Responses to her question "What is the most important personality trait you look for in a mate?"

    As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them. John F. Kennedy

    by JaxDem on Wed Mar 19, 2014 at 05:06:04 AM PDT

    •  It sounds as if they were talking (0+ / 0-)

      about buying a dog-
      "I would make sure they are vaccinated"
      "Current on all vaccines"

      LOL. And now McCarthy is shocking her followers by doing ads for electronic cigarettes.

      Your beliefs don't make you a better person. Your behavior does.

      by skohayes on Wed Mar 19, 2014 at 07:28:39 AM PDT

      [ Parent ]

  •  My take on primary colors. (7+ / 0-)

    Is that the Republican party realizes the power of being identified with an overarching political philosophy.
     As the graph shows, they routinely vote more conservatively than their district, and I defy you to find an elected Republican who doesn't proudly wave the Conservative flag. That works for them because they realize that being part of a movement or a cause like Conservatism, is a powerful motivator for people to come out.
     That's why they routinely out perform Democrats as far as turnout.
     The Democrats have given up on being identified with progressive populism, because you can't really paint yourself as a populist while your grabbing for the corporate dollars with both fists.
     Especially since poll after poll shows that most citizens support progressive populist policies such as raising the minimum wage, and cracking down on the financial industry, I think the Democrats would do well to re-brand themselves as  progressive populist party.
     They would have to give up much of that sweet sweet corporate cash to do so however, so I doubt they ever will.

    •  I have a different take on why conservatives (1+ / 0-)
      Recommended by:
      kfunk937

      are more motivated to vote than Democrats.  The conservative message is all about what's wrong - with the country, with the economy, with the employment outlook, with the minorities, with our foreign policy, with our defenses - and who's to blame.  Criticism, fear, hatred are always more effective triggers for action.  People are more likely to write letters of complaint than praise; they're more likely to bitch about conditions than fight to change them and much more motivated to follow leaders who play on their fears than those who advocate positive policies.  Change is frightening and anathema to them.  Negative emotions are an enormous motivator.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Mar 19, 2014 at 10:58:00 AM PDT

      [ Parent ]

  •  Hoorey for global warming, not to mention a nice (9+ / 0-)

    piece by the Times.

    First: kudos for actually using the term "global warming" instead of the current mushmouth darling "climate change", which only confuses matters.  There's all kinds of climate change going on.  Climate changes. Always has.  The problem that's trying to kill us, along with much life on this planet, is anthropogenic global warming.  Good thing, too, because that's one we can do something about.

    Second, kudos for this, even with the gratuitous swipe:

    Global warming has been much harder to understand, not least because of a disinformation campaign financed by elements of the fossil-fuel industry.
    Yes, people who make money from fossil fuels have been waging war against the overall truth, but environmental crusaders don't exactly help the cause with their limited classifications of deniers and fools.  The issue really is a lot harder than many progressives will admit or even understand.  It's hard, and it's especially hard to solve in a way that considers the needs of the nation and its people.  People who get to vote, by the way -- so you might as well start thinking about including them in solutions.
    The issue of how much to spend on lowering greenhouse gases is, in essence, a question about how much insurance we want to buy against worst-case outcomes.
    Yes.  Precisely.
    It is not a debating club.
    It is not a blank sheet.

    People are invested in things.
    People do care about the planet.  More than you might think.
    People also have lives and families and aspirations and things that are very important to them.

    Scientists cannot decide that for us
    Bravo.  They can't, and it's wrong to expect that from them.

    But -- Scientists can refine the risk estimates. They can make discoveries that may lead to more and better sustainable energy solutions.

    And -- there's a veritable army of engineers, chemists, manufacturers, and other Very Smart People out there in all manner of occupations who can improve the way we do things, or develop those discoveries into things that will reduce the risks and costs associated with solutions to the problem.

    Global warming is more than a problem that must be solved.  It's a problem that can be solved, but not by any one church lady cliquie running its mouth and waiting for listener fatigue to set in.  We're all in this together.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Wed Mar 19, 2014 at 05:35:15 AM PDT

    •  bravo! nicely done. thanks. n/t (2+ / 0-)
      Recommended by:
      dinotrac, freerad
    •  The public, voting or otherwise, don't (1+ / 0-)
      Recommended by:
      kfunk937

      seem inclined to accept what needs to be done to adjust to global warming, even if they accept that it's happening, that it's not good for life of plants, animals and humans, and that people are the cause of its happening.  It's too late to avoid much of the effects of the phenomenon; adjustment is the best we can hope for, but amelioration effects will be costly in lifestyle as well as money.  The public (and not just Americans) are not ready for the changes necessary even to adapt.

      It would be helpful to have a clear path to what needs to be done, or at least a marked route with assessments and directional adjustments along the way.  But even the Very Smart People out there have no clear direction - and even if they did, they would be fought every step of the way.  Change is extremely difficult for people to accept, and the degree of change required to adapt to a future filled with the effects of global climate change is terrifying.  Until people reach an observable emergency, they're not likely to agree on any action that requires them to take collective action for major change or spend money.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Mar 19, 2014 at 12:22:38 PM PDT

      [ Parent ]

      •  I think that's an unfair statement. I see people (0+ / 0-)

        every day trying to do their share, whether it is driving smaller cars, walking, taking the train, recycling, buying CFL or LED lights, etc, etc ,etc.

        It's not enough, but it represents a willingness to do something.

        There are a couple of cases to be made -- and not just "Is it happening?"  I think most people get the "Is it happening" part.  Some convincing, perhaps, on the "Is it really as bad as all that?" front. More convincing on the "Can we really make a difference?" front -- I'm not sure about that one myself.

        TONS of convincing on the "Will I (and my kids) be screwed on this deal because I'm just one of the little people and you guys really don't give a damn what happens to me?"

        Lets face it, we little folks have been getting the short end of the stick for a long time now.  We are fully justified in being skepitcal of a major push that will be gut-wrenchingly expensive and will impact all of our lives in major and potentially unpredictable ways.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Wed Mar 19, 2014 at 01:11:07 PM PDT

        [ Parent ]

  •  Thanks, Jenny! (4+ / 0-)
    ATLANTA — The number of reported cases of measles in the United States this year is nearly three times the annual average, federal health officials said on Thursday, highlighting the continued threat of the disease 50 years after development of a vaccine.

    There have been 175 measles cases so far in 2013, compared with the typical national average of about 60 cases a year, the Centers for Disease Control and Prevention said.

    I live under the bridge to the 21st Century.

    by Crashing Vor on Wed Mar 19, 2014 at 05:39:34 AM PDT

  •  I refuse to say never this early, but Christie (3+ / 0-)
    Recommended by:
    skohayes, Odysseus, SueDe

    might finally be toast WRT Presidential politics.  At the very least, he's shown an arrogance and stupidity that makes it hard for me to believe that he could get very far.

    Let's see -- already the subject of scandal headlines and under investigation. What would most of us do in that situation?  Don't know about you, but I would tread carefully and try to make friends.

    Maybe that's what he thinks he's doing by kowtowing to care dealers.  They do have plenty of money, but money is only loosely related to votes and few "friends" are despised quite as universally as car dealers.

    And -- let's face it: How many times do you get to play red-meat conservative AND cozy up to environmentally concerned citizens?

    "We must protect the free market by letting Tesla sell their green cars."

    Seriously, how often does a politician get handed a bone that tasty?

    Answer: pretty much never.

    It's still early, and there may still be a way, but I think it's time for a little Pink Floyd.  All in all, it's just another brick in the wall.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Wed Mar 19, 2014 at 05:51:49 AM PDT

    •  Can you afford a Tesla? (2+ / 0-)
      Recommended by:
      Geenius at Wrok, kfunk937

      This is a 1%-er issue. Which might actually explain why this complete non-story is in the news and hurting Christie.

      Using the power of his political office to benefit political contributors isn't even a scandal. Screwing over the poor folks who are waiting for Sandy aid isn't fatal. Nor is turning the busiest bridge in the country into a parking lot. He can recover from that!

      But how dare you stop rich people from buying their toys!

      •  Nope. Makes no difference. It's a red-meat (1+ / 0-)
        Recommended by:
        kfunk937

        conservative issue: Protect the free market.

        Better still, it hits a despised group -- auto dealers.

        Finally, it's nice bone for environmentally aware types.  Even those like me, who merely wish they could afford a Tesla.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Wed Mar 19, 2014 at 08:22:48 AM PDT

        [ Parent ]

      •  Not yet but (1+ / 0-)
        Recommended by:
        kfunk937

        Tesla has already cued up a $40k car (not sure if that's before the tax credit).  It should be available in about three years.  In three years, there will be hundreds if not thousands of Tesla supercharger stations and Level 3 charging stations.

        Tesla is very aggressive about maintaining resale value.  Over time, they'll likely make more money from their certified-used program than from new cars.  Other car makers do the same thing but a lot of that goes to their dealers.

        Oh, yes.  The cost of the electricity to drive a Tesla is about half the cost of gasoline for a car that averages 28mpg.

        You start with rich people's toys (this is a 1%er car, but not an 0.1%er car, just based on price and how it's marketed) because that's where you get the margins to build cheaper high volume cars with the same technology.  

        And car retailing is just a problem.  Every car maker in the world wants to sell directly over the web but they are (for a fair number of reasons) chained to their dealer networks.  Tesla seems to have found a way out (it helps that there are fewer moving parts to break on a Tesla and a lot of those are things like brakes and suspension components that any good repair shop can handle).

        Christie isn't just corrupt, he's corrupt in very short term ways.

        •  It'll still be a car for the well-to-do, even if (0+ / 0-)

          more of them will be able to buy it, but...

          So what?

          There is a fundamental issue of market freedom here.

          I suppose there is a counter-argument: The government does subsidize these cars and that's unfair, but...

          It also subsidizes the Volt, as well as cars you can buy at Toyota, Nissan, and Ford dealers, so...
          sell those.

          LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

          by dinotrac on Wed Mar 19, 2014 at 01:14:32 PM PDT

          [ Parent ]

  •  So, Greg: Headaches. Shades of The New Yorker? (1+ / 0-)
    Recommended by:
    Odysseus

    Remember 6 years ago (I think it was six) when the New Yorker came out with that article on Medicare costs that found the acclaimed health mecca of McAllen, TX was near the top of the  Medicare cost list and the home of the Mayo Clinic near the bottom?

    Basic problem was doctors who would do any procedure they could justify, a problem, btw, written into ACA and even specifically so with regard to mammograms.

    It ain't Marcus Welby's world, maybe never was, but...a little reality based medicine would be nice.  Sure makes me understand folks like Nortin Hadler.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Wed Mar 19, 2014 at 06:04:50 AM PDT

    •  There were a lot more problems (2+ / 0-)
      Recommended by:
      Geenius at Wrok, dinotrac

      that weren't really addressed as a part of the health care cost conundrum in that article, namely that McAllen has a huge population of uninsured, less doctors and THE poorest population in the US. They have a high number of people with diabetes and obesity and overall poor health.
      From the New Yorker article:

      To make matters worse, Fisher found that patients in high-cost areas were actually less likely to receive low-cost preventive services, such as flu and pneumonia vaccines, faced longer waits at doctor and emergency-room visits, and were less likely to have a primary-care physician. They got more of the stuff that cost more, but not more of what they needed.

      Your beliefs don't make you a better person. Your behavior does.

      by skohayes on Wed Mar 19, 2014 at 07:54:52 AM PDT

      [ Parent ]

      •  Indeed. Doctors making money remains the biggest (0+ / 0-)

        health care cost escalator we face.

        But patients are co-conspirators in that.  We always want "the best" even though we rarely know what "the best" is.

        Being Americans, our guess of the best tends to lean towards more and newer.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Wed Mar 19, 2014 at 08:19:24 AM PDT

        [ Parent ]

        •  see choosing wisely reccomendations (2+ / 0-)
          Recommended by:
          BelgianBastard, skohayes

          http://www.choosingwisely.org/...
          aka evidence based medicine.

          But you are confusing and conflating procedures that docs do and get paid for with tests that may or may not fall in that category. For example, if I'm a cardiologist and do an echo of your heart in the office I get paid but not for referring for a cxr. And I may not get paid for that office test if it's the original consult but maybe yes if it is a follow-up.

          They are all completely different animals, payment wise. Misunderstanding that makes people wrongly say, "oh it's just so they can get paid", any time any test is ordered.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Wed Mar 19, 2014 at 10:18:20 AM PDT

          [ Parent ]

          •  The distinction is important, but I'm not (0+ / 0-)

            conflating anything for a very simple reason:

            As a patient (or health care consumer, if you prefer), it is nearly impossible to find out what anything will cost beforehand.  You can probably remove the "nearly" for anybody with insurance.  We have no way to know what doctors get paid for and what they don't.  All we know is that, at the end, we get stuck with the bill and have to pay for anything the insurance doesn't pick up.

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Wed Mar 19, 2014 at 11:12:08 AM PDT

            [ Parent ]

            •  that's absolutely true (1+ / 0-)
              Recommended by:
              dinotrac

              and has nothing whatever to do with the original assertion.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Wed Mar 19, 2014 at 12:57:40 PM PDT

              [ Parent ]

              •  Then maybe I should modify with intentionally... (1+ / 0-)
                Recommended by:
                Greg Dworkin

                We can't intentionally confuse and conflate with regard to information nobody shares with us.

                LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                by dinotrac on Wed Mar 19, 2014 at 01:00:46 PM PDT

                [ Parent ]

                •  fair point n/t (1+ / 0-)
                  Recommended by:
                  dinotrac

                  "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

                  by Greg Dworkin on Wed Mar 19, 2014 at 01:13:39 PM PDT

                  [ Parent ]

                  •  It's also why free market health care is a (0+ / 0-)

                    complete myth.

                    Even if you exclude all of the things that interfere with markets from doctors' licences to patent monopolies, to information differentials, to the duress of major illness/trauma, etc, etc, etc,

                    you CANNOT make a free-market decision if you can't get prices.  It just ain't there.

                    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                    by dinotrac on Wed Mar 19, 2014 at 01:16:57 PM PDT

                    [ Parent ]

  •  After the publication of that chart, anyone... (3+ / 0-)

    who claims that the two parties are the same, or even comparable, deserves to be laughed off the internet.

    Art is the handmaid of human good.

    by joe from Lowell on Wed Mar 19, 2014 at 06:14:55 AM PDT

  •  Try explaining to your kids (1+ / 0-)
    Recommended by:
    skohayes

    that they'll never be able to have kids of their own because a bimbo on TV told you that getting measles was safer than getting a shot.

  •  Relating heartaches to headaches --- (0+ / 0-)

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Wed Mar 19, 2014 at 06:51:08 AM PDT

  •  primary colors- talk radio is a great PC cop for (1+ / 0-)
    Recommended by:
    Stude Dude

    keeping the GOP in line and makes it easy for their sycophants to keep to the script, after helping to advance the sycophants.

    This is a list of 76 universities for Rush Limbaugh that endorse global warming denial, racism, sexism, and GOP lies by broadcasting sports on over 170 Limbaugh radio stations.

    by certainot on Wed Mar 19, 2014 at 08:03:06 AM PDT

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