A couple points: (1) the two countries have radically different climates, demographics, lifestyles, etc,
That's not true. As David Himmelstein said, the differences between Boston and Toronto are less than the differences between Boston and Jackson, Mississippi.
(2) many people would disagree that Canada has better healthcare than the USA.
So what? They're wrong. The evidence says that the outcomes in Canada are at least as good. The costs are about half. That makes it better.
And you know what's another thing that's funny? A lot of Canadians come to the USA for treatment.
So what? The numbers are few. The Canadians have done studies to find out why. Most Canadians who go to the U.S. for health care have relatives in the U.S. that they want to stay with. For example, they will have a knee replacement or open heart surgery and stay with their children in Florida or New York while they're recovering.
For that matter, a lot of Americans come to Canada to buy their medicine, and more Americans them would buy medicine by mail from Canada if our lobbyist-funded government allowed it.
If Americans could get Canadian health care, at Canadian price, quality and service, it would be the most popular health care plan in the U.S.
Yes, you are correct, Canadian health care costs half as much as U.S. health care, and the outcomes of the Canadian system are at least as good -- possibly better. This has been demonstrated repeatedly in scientifically rigorous comparisons in peer-reviewed journals.
A systematic review of studies comparing health outcomes in Canada and the United States
Gordon H Guyatt, PJ Devereaux, Joel Lexchin, et al.
Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.
Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.
Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.
Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92-0.98, p= 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.
Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent.....
The United States also spends far more on health care, i.e., approximately 15% of its gross domestic product versus about 10% in Canada. In 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.
Costs of Health Care Administration in the United States and Canada
Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D.
N Engl J Med 2003; 349:768-775 August 21, 2003
Results
In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.
There was an article by Carl Elliot (I think it was in the Atlantic but I can't find it right now) in which he explained that he was a philosophy professor, he had written about medical ethics, and he got calls from drug companies wanting him to work on their ethics panels. They would pay him a lot of money, and all he had to do was review their clinical trials and approve them.
Indeed, the term "ethicist" has become a term of the art in the pharmaceutical industry. It sounds (to the naive) like some guys sitting around a table drinking wine like Socrates and trying to figure out the good and the truth.
They're actually more like mob lawyers who are very clever and whose job is to get their clients off when they're guilty. A drug company does a study, it turns into a disaster, but they can go back in their files and say, "Our ethics committee reviewed this and said it was OK. Here's their letter. We thought we were doing the right thing."
Ethics committees used to be committees in academic medical centers. Now they've been privatized and there are actually independent private companies that do ethics reviews under contract and are paid by the drug companies.
1. Celltex hasn't done any clinical trials of any sort. To prove a treatment works you need a double-blind trial at least - administer placebo to one group, and the cells to another and make sure the physician in charge doesn't know which one is being given to which patient. Then when you 'unblind' the trial and reveal which patient got what - that's when (if it's worked) you start charging. In the trial phase, a company should be providing the treatment free with placebo and working with the FDA. They shouldn't be charging for voodoo treatments/homeopathy.
That's the way it should work but unfortunately it doesn't. In cancer, for example, many studies of new drug treatments or combinations for a particular cancer are done by doctors as part of their regular practice, who are getting paid by the drug company for the study and also getting paid by the patients for their treatment. Sometimes they get the drug free, but if it's a drug that's already approved for another indication, they charge the patient for that too.
I always thought it was unethical. Then I found out how ethicists are paid by the pharmaceutical companies.
There's no evidence for that and some evidence to the contrary. Jessie Gruman, who interviewed 200 patients about the way they make medical decisions, said that most patients can't and don't want to make their own decisions about health care. http://en.wikipedia.org/wiki/Consumer-driven_health_care
Those patients want their doctors to make the decisions. Most patients also want government regulations to protect them against bad decisions. They are surprised to find out when they get a bad result from a "dietary supplement" that dietary supplements are not regulated.
In many countries, doctors are paid by the government and follow government guidelines, and most patients prefer it that way. If you live in the U.K., and your doctor follows NICE guidelines, you'll get pretty close to the best medical decisions in the world.
In health care, the governments of developed countries usually make the best decisions. The U.S. federal government usually makes the best decisions, except for those times when they're under pressure from the health care industry. Best example: If you get a head injury in Iraq or Afghanistan, military medicine will give you the best chance of getting home alive and with the least cognitive damage that you could get anywhere in the world. I've looked up some of the studies of results of major surgery, and the Veterans Affairs hospitals have some of the best outcomes in the country and the world.
For some decisions, there is one clearly superior path, and patient preferences play little or no role — a fractured hip needs repair, acute appendicitis necessitates surgery, and bacterial meningitis requires antibiotics. For most medical decisions, however, more than one reasonable path forward exists (including the option of doing nothing, when appropriate), and different paths entail different combinations of possible therapeutic effects and side effects. Decisions about therapy for early-stage breast cancer or prostate cancer, lipid-lowering medication for the primary prevention of coronary heart disease, and genetic and cancer screening tests are good examples. In such cases, patient involvement in decision making adds substantial value.
I agree with your sentiments, but in my understanding it doesn't always work that way.
First, insurance companies do cover unproven treatments under some circumstances. Legitimately, there are some diseases that have no proven treatments, so doctors have to do the best they can, with treatments they think will work. Some cancer is so rare that no one has ever done a controlled trial before, so they say, "It looks like a colon cancer, so let's treat it as a colon cancer."
What's proven? How much evidence do you need? This is one of the worst areas of medicine. It doesn't help matters when insurance companies have a financial stake in the matter. Sometimes people can browbeat insurance companies into covering a treatment (good or bad).
In New York State, the chiropractors passed a law that requires the insurance companies to cover chiropractic (I'm not sure if it's still in effect).
Second, I was surprised to find that patients do pay for treatments in medical trials. You have metastatic colon cancer, a doctor is a consultant to a drug company trying out a new drug which is approved (but not for metastatic colon cancer), he's got a grant to do a clinical trial, and he doctor says, "we don't really have a good treatment, but I can get you into a clinical trial." You pay. Sometimes the company "donates" the drug, sometimes they don't.
Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments.
It happens occasionally. One way is massive soft tissue infection, to which the arms and legs are particularly sensitive. One woman had that happen to her after childbirth. Another way is blood clots throughout the body, that particularly affect the arms and legs.
One of the body's survival mechanisms in extreme cases is to withdraw blood circulation to the arms and legs, so the limbs are particularly vulnerable.
These are terrible diseases in which most people die, so the doctors thought it was an accomplishment to have them survive at all. You might think that they would be better off dead, but the people who survive are almost always glad to be alive and almost never want to die.
If the FBI showed up on my door and asked for their tracking device back, I'd say, "I don't know who you are, whether you own it, or whether you have a legal right to get it. Send me a letter giving me all the details and establishing that you own it, and I'll take it to a lawyer and do what he says."
Suppose an hour later another bunch of guys showed up and said that they were the FBI and they wanted their tracking device back?
You don't understand economics, and you don't understand the German employment system.
The German auto workers, and the unemployed German auto workers, aren't getting something for nothing. They worked hard for it all their lives. There are no goldbrickers.
(They don't work as many hours as American workers did, but they're more productive in the hours that they do work, because they don't have the hostile unions and union restrictions that Americans do, and they're better trained.)
In return for working hard, and being well-trained and smart, the German workers in effect own part of their own company. They have labor representatives on the company's board of directors. So when they draw a paycheck, it's more like a company's owner taking a draw on the profits. It's their profits.
Their pay is not just hourly pay. In return for working hard, one of the goals of the German auto companies is to give the German workers a lifetime job, and unemployment insurance when they're not needed. They don't treat unemployment insurance as coming out of their profits. It's the cost of doing business, like all employment costs.
The traditional German employers, at their best, were like a family. During an economic slump, they continue to provide for their workers. They don't dump them. When you provide for a long-time loyal worker, who is unemployed now and will be coming back to work again, that worker isn't a freeloader. It's part of the responsibility that the employer and employee have for each other.
The Germans sometimes refer to the "brutal American system" where workers are left on their own when the economy doesn't need them any more. The German system reflects German (and European) values, where they care for each other. It works, because it gives them a productive economy in which everybody shares.
Here we play Russian roulette with unemployment and poverty. Unless they're very wealthy, Americans face a risk of being unemployed and wiped out economically during your lifetime. Most Americans would be better off economically if they moved to Germany. I think we would be better off with a system like the Germans have.
I think the Germans would say that the employers who abandon their workers during the next economic turndown are the freeloaders.
The Scantronic can not only mark the test answers, they can also mark the erased answers. A large number of erasures suggests that the teachers corrected the answers afterwards. That's how they caught Michelle Rhee.
I really don't know how they helped the Romanian dictator, Nicolae Ceausescu. As far as I know he got the FULL execution platoon 22 years ago. So, I'd say that's a pretty bad example.
PR firms always say they can never guarantee results, they can only provide efforts and their professional judgments.
And a monthly bill for services, describing all the wonderful efforts they made in your behalf.
Darnedest thing is though, what hasn't been done is for someone to propose a plausible mechanism as to why GE crops would be dangerous. We know the genes inserted (cry genes, epsps, bar, nptII, PRSV/CMV coat protein genes) are safe, but for all the cries of 'what might happen' no one has explained what in GE crops allegedly hurts you, how it is produced, its mode of action, ect.
Actually there is a mechanism. One of the big companies tried to insert a gene into brazil nuts (either BT or herbicide resistance) and found out that it produced an unexpected immune response because of the way the protein was folded. They abandoned the project, and wrote an article about it in the New England Journal of Medicine, which I read. That's the poster child of the anti-GM movement.
I'm not particularly worried about GM food. I eat GM cornflakes every day (as I found out afterwards). I couldn't avoid GM food if I wanted to. And I do get annoyed when I see the truly stupid arguments against GM food by political science majors who never took a biology course.
But give the critics their due. We in the US turned our entire corn and soybean production into GM crops without notifying consumers about it, and without letting them make their own decisions as consumers who supposedly rule this wonderful free market. There was no labeling and food processors weren't even allowed to sell their food as GM-free for years. Monsanto may believe in a lot of things but they certainly don't believe in a free market.
You can't even get GM-free food in this country any more because the GM strains have contaminated everything else, and when the food companies try to sell grains to Europe, where there are restrictive laws, they're forced to go to the international trade commission and ask (or rather demand) that they be allowed to define food with no more than 1%, or 0.1% (or whatever) GM food as GM-free.
You believe in science? The scientific method says that you have to take your hypotheses and beliefs, and subject them to confirmation in the real world. If you believe that GM food is safe, you have to prove it with data. That's not as easy as you make it out to be. It's not enough to feed a hundred mice for 6 months and see if any of them keels over. It's not even enough to feed 300 million Americans GM corn and soybeans for 20 years and see if any of them keels over, as we did. It is actually impossible to prove generically that GM food is safe. You have to take each specific food.
Let's suppose you're really, really smart and you thought really, really hard, and you couldn't think of a plausible mechanism by which GM food can do harm. That doesn't mean there isn't one. Nobody would have thought that inserting a BT gene into brazil nuts would produce an immune reaction, but it happened.
I don't care how smart you are -- you don't understand the human immune system well enough to predict what can go wrong, because nobody understands the human immune system well enough to predict what can go wrong. That's why that contract lab in England injected a half dozen test subjects with a new drug that caused an unexpected autoimmune reaction and caused one kid to lose his fingers a few years ago. I was taught that proteins were all destroyed in the digestive system, but then I saw in the New Scientist that some of them do survive. What can they do?
I went to a meeting where a scientist from the Natural Resourced Defense Fund made the case that GM foods might cause unexpected immune reactions. I thought it was bullshit. Then I found out about the brazil nuts. What other totally unexpected problems could we have? You don't know. They've got a point.
I will stipulate that Jeremy Rifkin is an idiot, and if we listened to him in 1984 we wouldn't have been able to develop T cell growth factor, we wouldn't have developed a test for AIDS, and we wouldn't have developed treatments for AIDS. We wouldn't have sequenced the human genome, we wouldn't have developed imatinib and CML would st
First, I'd like to know what data (not anecdotes) you have to support the claim that the problem has been getting worse for 50 years.
If you believe in test scores, the NAEP has tests scores in math and reading going back to 1973. They've improved steadily over 35 years. http://nationsreportcard.gov/ltt_2008/alt_index.asp The improvement has been most dramatic for black and hispanic kids. That's a problem?
You need a school board that hires qualified principals and lets them do their job. If the school board is corrupt, and yields to political pressure, you can never be sure of getting qualified teachers, and you can never fire unqualified teachers. (Tenured teachers can be fired in the NYC schools; management just have to make a good, well-documented case.)
Fred Hechinger, who used to cover education for the New York Times, said that there are some school districts where the main concerns are things like somebody's brother-in-law getting the contract for supplying the lunchroom, and other districts where the main concern is giving the students a good education.
School boards and government officials are elected. If voters are willing to elect corrupt officials, they'll never have good schools.
If you read the Wall Street Journal regularly, where this story is from, you'll see that the German auto companies give even more generous benefits to their laid off workers than the UAW does.
When German workers get laid off, they get about the same salary. They can take their choice between learning new job skills or just treating it as a vacation.
According to people like Diane Ravitch, who was assistant commissioner of education under both GHW Bush and Bill Clinton, the data is still too noisy.
They can't correct for socioeconomic makeup because schools have no way of knowing family income unless the kids are in a free lunch program.
Ravitch has a PhD, she spent her life studying the data. She started out believing in high-stakes testing, and now she says she had to change her mind because the data doesn't support it.
If the LA tests found that there was no correlation between the judgement of the administrators and the results of the tests, that doesn't mean the administrators were wrong. The tests could have been wrong. It could have been the tests that were no better than random, which is what seems to have happened in NYC.
I'd like to see anything that shows the LA tests were scientifically valid.
BTW, one teacher in LA killed himself after his low test results were posted.
Immigrant children are even harder to compare, because they don't go to the same school year after year. So you don't have last year's scores.
And there's just as much variation among Mexican immigrants as there are among other students. Some parents are educated in Spanish and English, others are illiterate peasants. Some are legal, some aren't.
You can't say that a teacher's students did badly because he's a bad teacher. It might have been the demographics.
New York City has some of the most diverse school demographics in the country.
You will find kids whose parents are both educated professionals, living on the same block as kids who have a single mother working as a hotel maid. I know families like that.
So you could easily have schools with completely different demographics a block away (or in the same building, since different schools share the same building). You could have classes with completely different demographics in the same school.
It's impossible to match demographics. The most significant predictor of student achievement in these studies is family income, and the schools don't even know family income of students, unless they're in the free lunch program.
Another major predictor is speaking English at home. One teacher may draw a class from non-English speaking families, another teacher may draw a class from professional families, with lawyers and college teachers.
How do you correct for that? You can't.
These are well-known problems. Read Diane Ravitch's articles in the New York Review of Books.
I've read about it in Science magazine, where they had advocates on both sides. When the testing advocates have to write an article in a peer-reviewed journal, they admit these these problems.
One of the many serious problems here is that the politicians are ignoring the science.
Slashdot Mirror
A couple points: (1) the two countries have radically different climates, demographics, lifestyles, etc,
That's not true. As David Himmelstein said, the differences between Boston and Toronto are less than the differences between Boston and Jackson, Mississippi.
(2) many people would disagree that Canada has better healthcare than the USA.
So what? They're wrong. The evidence says that the outcomes in Canada are at least as good. The costs are about half. That makes it better.
And you know what's another thing that's funny? A lot of Canadians come to the USA for treatment.
So what? The numbers are few. The Canadians have done studies to find out why. Most Canadians who go to the U.S. for health care have relatives in the U.S. that they want to stay with. For example, they will have a knee replacement or open heart surgery and stay with their children in Florida or New York while they're recovering.
For that matter, a lot of Americans come to Canada to buy their medicine, and more Americans them would buy medicine by mail from Canada if our lobbyist-funded government allowed it.
If Americans could get Canadian health care, at Canadian price, quality and service, it would be the most popular health care plan in the U.S.
Yes, you are correct, Canadian health care costs half as much as U.S. health care, and the outcomes of the Canadian system are at least as good -- possibly better. This has been demonstrated repeatedly in scientifically rigorous comparisons in peer-reviewed journals.
http://www.openmedicine.ca/article/view/8/1
A systematic review of studies comparing health outcomes in Canada and the United States
Gordon H Guyatt, PJ Devereaux, Joel Lexchin, et al.
Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.
Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.
Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.
Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92-0.98, p= 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.
Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent. ....
The United States also spends far more on health care, i.e., approximately 15% of its gross domestic product versus about 10% in Canada. In 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.
http://www.nejm.org/doi/full/10.1056/NEJMsa022033
Costs of Health Care Administration in the United States and Canada
Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D.
N Engl J Med 2003; 349:768-775 August 21, 2003
Results
In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.
Bullshit indeed.
There was an article by Carl Elliot (I think it was in the Atlantic but I can't find it right now) in which he explained that he was a philosophy professor, he had written about medical ethics, and he got calls from drug companies wanting him to work on their ethics panels. They would pay him a lot of money, and all he had to do was review their clinical trials and approve them.
Indeed, the term "ethicist" has become a term of the art in the pharmaceutical industry. It sounds (to the naive) like some guys sitting around a table drinking wine like Socrates and trying to figure out the good and the truth.
They're actually more like mob lawyers who are very clever and whose job is to get their clients off when they're guilty. A drug company does a study, it turns into a disaster, but they can go back in their files and say, "Our ethics committee reviewed this and said it was OK. Here's their letter. We thought we were doing the right thing."
Ethics committees used to be committees in academic medical centers. Now they've been privatized and there are actually independent private companies that do ethics reviews under contract and are paid by the drug companies.
1. Celltex hasn't done any clinical trials of any sort. To prove a treatment works you need a double-blind trial at least - administer placebo to one group, and the cells to another and make sure the physician in charge doesn't know which one is being given to which patient. Then when you 'unblind' the trial and reveal which patient got what - that's when (if it's worked) you start charging. In the trial phase, a company should be providing the treatment free with placebo and working with the FDA. They shouldn't be charging for voodoo treatments/homeopathy.
That's the way it should work but unfortunately it doesn't. In cancer, for example, many studies of new drug treatments or combinations for a particular cancer are done by doctors as part of their regular practice, who are getting paid by the drug company for the study and also getting paid by the patients for their treatment. Sometimes they get the drug free, but if it's a drug that's already approved for another indication, they charge the patient for that too.
I always thought it was unethical. Then I found out how ethicists are paid by the pharmaceutical companies.
There's no evidence for that and some evidence to the contrary. Jessie Gruman, who interviewed 200 patients about the way they make medical decisions, said that most patients can't and don't want to make their own decisions about health care. http://en.wikipedia.org/wiki/Consumer-driven_health_care
Those patients want their doctors to make the decisions. Most patients also want government regulations to protect them against bad decisions. They are surprised to find out when they get a bad result from a "dietary supplement" that dietary supplements are not regulated.
In many countries, doctors are paid by the government and follow government guidelines, and most patients prefer it that way. If you live in the U.K., and your doctor follows NICE guidelines, you'll get pretty close to the best medical decisions in the world.
In health care, the governments of developed countries usually make the best decisions. The U.S. federal government usually makes the best decisions, except for those times when they're under pressure from the health care industry. Best example: If you get a head injury in Iraq or Afghanistan, military medicine will give you the best chance of getting home alive and with the least cognitive damage that you could get anywhere in the world. I've looked up some of the studies of results of major surgery, and the Veterans Affairs hospitals have some of the best outcomes in the country and the world.
If I were a doctor, I couldn't imagine making a blanket statement that everyone would want the same thing.
This was discussed in the latest New England Journal of Medicine.
http://www.nejm.org/doi/full/10.1056/NEJMp1109283
I agree with your sentiments, but in my understanding it doesn't always work that way.
First, insurance companies do cover unproven treatments under some circumstances. Legitimately, there are some diseases that have no proven treatments, so doctors have to do the best they can, with treatments they think will work. Some cancer is so rare that no one has ever done a controlled trial before, so they say, "It looks like a colon cancer, so let's treat it as a colon cancer."
What's proven? How much evidence do you need? This is one of the worst areas of medicine. It doesn't help matters when insurance companies have a financial stake in the matter. Sometimes people can browbeat insurance companies into covering a treatment (good or bad).
In New York State, the chiropractors passed a law that requires the insurance companies to cover chiropractic (I'm not sure if it's still in effect).
Second, I was surprised to find that patients do pay for treatments in medical trials. You have metastatic colon cancer, a doctor is a consultant to a drug company trying out a new drug which is approved (but not for metastatic colon cancer), he's got a grant to do a clinical trial, and he doctor says, "we don't really have a good treatment, but I can get you into a clinical trial." You pay. Sometimes the company "donates" the drug, sometimes they don't.
Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments.
It happens occasionally. One way is massive soft tissue infection, to which the arms and legs are particularly sensitive. One woman had that happen to her after childbirth. Another way is blood clots throughout the body, that particularly affect the arms and legs.
One of the body's survival mechanisms in extreme cases is to withdraw blood circulation to the arms and legs, so the limbs are particularly vulnerable.
These are terrible diseases in which most people die, so the doctors thought it was an accomplishment to have them survive at all. You might think that they would be better off dead, but the people who survive are almost always glad to be alive and almost never want to die.
Since when does Apple have a trademark on the use of "iPhone" for a gas grill?
Those devious scientists!
And all along I thought they were warning us because they thought global warming would mess up the environment.
That's actually a good response.
If the FBI showed up on my door and asked for their tracking device back, I'd say, "I don't know who you are, whether you own it, or whether you have a legal right to get it. Send me a letter giving me all the details and establishing that you own it, and I'll take it to a lawyer and do what he says."
Suppose an hour later another bunch of guys showed up and said that they were the FBI and they wanted their tracking device back?
You don't understand economics, and you don't understand the German employment system.
The German auto workers, and the unemployed German auto workers, aren't getting something for nothing. They worked hard for it all their lives. There are no goldbrickers.
(They don't work as many hours as American workers did, but they're more productive in the hours that they do work, because they don't have the hostile unions and union restrictions that Americans do, and they're better trained.)
In return for working hard, and being well-trained and smart, the German workers in effect own part of their own company. They have labor representatives on the company's board of directors. So when they draw a paycheck, it's more like a company's owner taking a draw on the profits. It's their profits.
Their pay is not just hourly pay. In return for working hard, one of the goals of the German auto companies is to give the German workers a lifetime job, and unemployment insurance when they're not needed. They don't treat unemployment insurance as coming out of their profits. It's the cost of doing business, like all employment costs.
The traditional German employers, at their best, were like a family. During an economic slump, they continue to provide for their workers. They don't dump them. When you provide for a long-time loyal worker, who is unemployed now and will be coming back to work again, that worker isn't a freeloader. It's part of the responsibility that the employer and employee have for each other.
The Germans sometimes refer to the "brutal American system" where workers are left on their own when the economy doesn't need them any more. The German system reflects German (and European) values, where they care for each other. It works, because it gives them a productive economy in which everybody shares.
Here we play Russian roulette with unemployment and poverty. Unless they're very wealthy, Americans face a risk of being unemployed and wiped out economically during your lifetime. Most Americans would be better off economically if they moved to Germany. I think we would be better off with a system like the Germans have.
I think the Germans would say that the employers who abandon their workers during the next economic turndown are the freeloaders.
The Scantronic can not only mark the test answers, they can also mark the erased answers. A large number of erasures suggests that the teachers corrected the answers afterwards. That's how they caught Michelle Rhee.
... and see if we can find any influence yet.
Ed Bernays, the man who got America's women addicted to cigarettes by subverting feminism in the service of his tobacco industry clients.
I really don't know how they helped the Romanian dictator, Nicolae Ceausescu. As far as I know he got the FULL execution platoon 22 years ago. So, I'd say that's a pretty bad example.
PR firms always say they can never guarantee results, they can only provide efforts and their professional judgments.
And a monthly bill for services, describing all the wonderful efforts they made in your behalf.
Darnedest thing is though, what hasn't been done is for someone to propose a plausible mechanism as to why GE crops would be dangerous. We know the genes inserted (cry genes, epsps, bar, nptII, PRSV/CMV coat protein genes) are safe, but for all the cries of 'what might happen' no one has explained what in GE crops allegedly hurts you, how it is produced, its mode of action, ect.
Actually there is a mechanism. One of the big companies tried to insert a gene into brazil nuts (either BT or herbicide resistance) and found out that it produced an unexpected immune response because of the way the protein was folded. They abandoned the project, and wrote an article about it in the New England Journal of Medicine, which I read. That's the poster child of the anti-GM movement.
I'm not particularly worried about GM food. I eat GM cornflakes every day (as I found out afterwards). I couldn't avoid GM food if I wanted to. And I do get annoyed when I see the truly stupid arguments against GM food by political science majors who never took a biology course.
But give the critics their due. We in the US turned our entire corn and soybean production into GM crops without notifying consumers about it, and without letting them make their own decisions as consumers who supposedly rule this wonderful free market. There was no labeling and food processors weren't even allowed to sell their food as GM-free for years. Monsanto may believe in a lot of things but they certainly don't believe in a free market.
You can't even get GM-free food in this country any more because the GM strains have contaminated everything else, and when the food companies try to sell grains to Europe, where there are restrictive laws, they're forced to go to the international trade commission and ask (or rather demand) that they be allowed to define food with no more than 1%, or 0.1% (or whatever) GM food as GM-free.
You believe in science? The scientific method says that you have to take your hypotheses and beliefs, and subject them to confirmation in the real world. If you believe that GM food is safe, you have to prove it with data. That's not as easy as you make it out to be. It's not enough to feed a hundred mice for 6 months and see if any of them keels over. It's not even enough to feed 300 million Americans GM corn and soybeans for 20 years and see if any of them keels over, as we did. It is actually impossible to prove generically that GM food is safe. You have to take each specific food.
Let's suppose you're really, really smart and you thought really, really hard, and you couldn't think of a plausible mechanism by which GM food can do harm. That doesn't mean there isn't one. Nobody would have thought that inserting a BT gene into brazil nuts would produce an immune reaction, but it happened.
I don't care how smart you are -- you don't understand the human immune system well enough to predict what can go wrong, because nobody understands the human immune system well enough to predict what can go wrong. That's why that contract lab in England injected a half dozen test subjects with a new drug that caused an unexpected autoimmune reaction and caused one kid to lose his fingers a few years ago. I was taught that proteins were all destroyed in the digestive system, but then I saw in the New Scientist that some of them do survive. What can they do?
I went to a meeting where a scientist from the Natural Resourced Defense Fund made the case that GM foods might cause unexpected immune reactions. I thought it was bullshit. Then I found out about the brazil nuts. What other totally unexpected problems could we have? You don't know. They've got a point.
I will stipulate that Jeremy Rifkin is an idiot, and if we listened to him in 1984 we wouldn't have been able to develop T cell growth factor, we wouldn't have developed a test for AIDS, and we wouldn't have developed treatments for AIDS. We wouldn't have sequenced the human genome, we wouldn't have developed imatinib and CML would st
First, I'd like to know what data (not anecdotes) you have to support the claim that the problem has been getting worse for 50 years.
If you believe in test scores, the NAEP has tests scores in math and reading going back to 1973. They've improved steadily over 35 years. http://nationsreportcard.gov/ltt_2008/alt_index.asp The improvement has been most dramatic for black and hispanic kids. That's a problem?
You need a school board that hires qualified principals and lets them do their job. If the school board is corrupt, and yields to political pressure, you can never be sure of getting qualified teachers, and you can never fire unqualified teachers. (Tenured teachers can be fired in the NYC schools; management just have to make a good, well-documented case.)
Fred Hechinger, who used to cover education for the New York Times, said that there are some school districts where the main concerns are things like somebody's brother-in-law getting the contract for supplying the lunchroom, and other districts where the main concern is giving the students a good education.
School boards and government officials are elected. If voters are willing to elect corrupt officials, they'll never have good schools.
If you read the Wall Street Journal regularly, where this story is from, you'll see that the German auto companies give even more generous benefits to their laid off workers than the UAW does.
When German workers get laid off, they get about the same salary. They can take their choice between learning new job skills or just treating it as a vacation.
In Germany they still have lifetime jobs.
They are graded on a curve. If you read those two links I posted, you'll see what the problems are.
According to people like Diane Ravitch, who was assistant commissioner of education under both GHW Bush and Bill Clinton, the data is still too noisy.
They can't correct for socioeconomic makeup because schools have no way of knowing family income unless the kids are in a free lunch program.
Ravitch has a PhD, she spent her life studying the data. She started out believing in high-stakes testing, and now she says she had to change her mind because the data doesn't support it.
See
http://www.nybooks.com/blogs/nyrblog/2012/feb/21/no-student-left-untested/
No Student Left Untested
Diane Ravitch
http://aera.net/uploadedFiles/Gov_Relations/GettingTeacherEvaluationRightBackgroundPaper(1).pdf as her supporting data.
If the LA tests found that there was no correlation between the judgement of the administrators and the results of the tests, that doesn't mean the administrators were wrong. The tests could have been wrong. It could have been the tests that were no better than random, which is what seems to have happened in NYC.
I'd like to see anything that shows the LA tests were scientifically valid.
BTW, one teacher in LA killed himself after his low test results were posted.
If students are grouped by ability, then the students in room 204 would be completely different from the students in room 274.
Immigrant children are even harder to compare, because they don't go to the same school year after year. So you don't have last year's scores.
And there's just as much variation among Mexican immigrants as there are among other students. Some parents are educated in Spanish and English, others are illiterate peasants. Some are legal, some aren't.
You can't say that a teacher's students did badly because he's a bad teacher. It might have been the demographics.
New York City has some of the most diverse school demographics in the country.
You will find kids whose parents are both educated professionals, living on the same block as kids who have a single mother working as a hotel maid. I know families like that.
So you could easily have schools with completely different demographics a block away (or in the same building, since different schools share the same building). You could have classes with completely different demographics in the same school.
It's impossible to match demographics. The most significant predictor of student achievement in these studies is family income, and the schools don't even know family income of students, unless they're in the free lunch program.
Another major predictor is speaking English at home. One teacher may draw a class from non-English speaking families, another teacher may draw a class from professional families, with lawyers and college teachers.
How do you correct for that? You can't.
These are well-known problems. Read Diane Ravitch's articles in the New York Review of Books.
I've read about it in Science magazine, where they had advocates on both sides. When the testing advocates have to write an article in a peer-reviewed journal, they admit these these problems.
One of the many serious problems here is that the politicians are ignoring the science.