Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.
Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.
But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.
The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives…and discussion with bible-thumping populist idjits is useless as ever. Why waste the time?…
States that have legalized medical marijuana tend to experience an unexpected benefit — fewer overdose deaths from narcotic painkillers…
Access to medical marijuana is associated with 25 percent fewer prescription drug overdose deaths each year compared to states where medical pot is illegal, according to findings published Aug. 25 in JAMA Internal Medicine.
What’s more, states that pass medical marijuana laws see their overdose death rates decrease dramatically in the years immediately afterward…
The study authors believe that people suffering from chronic pain tend to rely on medical marijuana when they have that option, which reduces the risk of addiction and overdose that accompanies use of narcotic medications.
The study used data from the U.S. Centers for Disease Control and Prevention to determine the prescription painkiller overdose death rate for each state between 1999 and 2010, and then took into account whether and when each state had passed a medical marijuana law…
Critics are trying hard to come up with rationales that support continued reliance on the profitable trade in prescription painkillers – and don’t confront idjit ideology that says cannabis is the Antichrist.
Overdose deaths from prescription painkillers have skyrocketed over the past two decades, increasing 118 percent between 1999 and 2011, according to the CDC.
The agency estimates that every day 113 people die from drug overdoses in the United States, and another 6,700 land in the emergency room from an overdose…
States’ overdose death rates decline an average 20 percent in the first year following the passage of a medical marijuana law, the researchers found. By the second year, overdose death rates on average decline 25 percent, and as much as 33 percent by five years after legalization of medical pot.
Medical marijuana laws also are associated with a more dramatic decrease in overdose death rates than other means commonly used to tackle prescription drug abuse, the study noted.
There is no reason for Congressional opposition to medical marijuana other than it may cut down contributions from amoral corporations chartered to profit from pain and illness.
Creeps like Mitch McConnell and Erik Paulsen may as well take their contributions directly from the drug cartels instead of the painkiller producers. Cut out the middleman.
A random act of kindness at a Tampa-area Starbucks set into motion a chain of giving that lasted for nearly 400 customers…Around 7 a.m. a woman ordering from the coffee house’s drive-through paid for her own drink and said she’d like to pay for the customer behind her. Moved by the stranger’s generosity, that customer returned the favor for the next, who did the same.
The chain grew so big that employees began keeping a tally of consecutive customers who chose to “pay it forward.” The tally was over 250 by 1:30…
As the afternoon rush hour came and more and more customers kept the streak going, the baristas entertained hopes of it continuing until closing and perhaps using a gift card to extend it to the following day.
But around 6:00 p.m., customer number 379 crushed their hopes of a fairy-tale ending. An unknown woman driving a white Jeep Commander refused to pay for anything but her own drink — even though it had already been paid for. Starbucks employee Vu Nguyen explained the special circumstances but the woman was unmoved and, in Nguyen’s opinion, visibly unable to understand the concept of paying it forward.
Oh, it would be so easy to identify the politics, personal philosophy of someone who doesn’t comprehend good works. Tempting. But, not enough data.
Now, imagine trying to get the same thing started at a corner liquor store or cigarette shop! Phew.
Not-so-incidentally, this really is a Starbucks tradition. The record was set last December’s holiday season with 1468 customers in Newington, Connecticut…and ran from Tuesday morning the 24th through Saturday evening the 28th.
Amazon.com will set up shop in China’s Shanghai free trade zone, the company said on Wednesday, aiming to take advantage of less stringent trade regulations to sell a wider range of products in the country.
The U.S. online retailer’s move shows an intent not only to remain in China but to beef up its presence in an e-commerce market dominated by Alibaba Group Holding and Beijing-based JD.com, the second-biggest player.
Amazon did not say when the company is likely to begin operations in the free trade zone, which enjoys more relaxed import and export regulations than the rest of China.
The company is also pushing its Amazon Web Services (AWS) cloud computing business in China and said in December that the country will have its own AWS region to improve speeds for its mainly corporate customers…
Amazon’s move to the free trade zone comes nearly a year after the zone was launched, attracting attention from overseas businesses and hailed as one of China’s boldest reforms in decades. However, there has been a lack of specific policy details since the initial fanfare.
Foreign banks, such as Citigroup and HSBC Holdings have set up branches in the zone, but many foreign companies have been reluctant to follow suit, citing a lack of clarity on what will and will not be allowed in the zone.
The 2nd half of that last sentence is representative of what investors call the chickenshit index. Since Reuters was purchased by Thomson you’re bound to find some editorializing by omission. It’s the imperial disease.
In truth, this first free trade zone has been so successful that another dozen or more cities around China are lobbying to follow Shanghai’s model.
Three teens in Georgia just made a mobile app they hope will help prevent the next police shooting of an unarmed young person…It’s called Five-O, after the slang term for police, and it’s the brainchild of siblings Ima, 16, Asha, 15, and Caleb Christian, 14, who live in a suburb of Atlanta.
Here’s how it works: After interacting with a cop, users open the app and fill out a Yelp-like form on which they can grade the officer’s courtesy from A to F, check a box if they were verbally or physically abused, and add details about the incident. They can view ratings on other cops and police departments across the country, participate in community forums, and check out a Q&A titled “Know Your Rights.”
Ima Christian says their parents encouraged them to think about how they could respond productively to incidents like Brown’s death. “One of the things they really stress is that we focus on finding solutions,” she told Mother Jones. “We really hope that Five-O will be able to give every citizen a voice when interacting with the police.”
But the Christians say Five-O isn’t just for outing bad cops; they hope it will help also highlight good policing. “We want people to be able to document if the police are very courteous or if they save your cat or something,” Ima says…
The siblings have been honing their coding skills since elementary school by participating in the MIT programs +K12, Scratch, and App Inventor, and they’ve also taken programming classes at Georgia Tech and Emory, all with encouragement from their parents. They’ve started their own app development company, Pine Tart, Inc., and they’re currently working on two other projects…
Solid. Filling a need with modern tech designed by the youngest among us in this online world. I love it.
I’ve been online since 1983, watching the changes, hoping for more real content like this. Yes, there’s lots of other niche products, some serious growing of whole world communications and knowledge out here. But, watching a couple of kid-coders knock out something like this app warms the cockles of this cranky old activist geek.
The fundamental law of capitalism is that if workers have no money, businesses have no customers. That’s why the extreme, and widening, wealth gap in our economy presents not just a moral challenge, but an economic one, too. In a capitalist system, rising inequality creates a death spiral of falling demand that ultimately takes everyone down…
Policy makers debate incremental changes for arresting this vicious cycle. But perhaps the most powerful and elegant antidote is sitting right before us: a spike in the federal minimum wage to $15 an hour.
True, that sounds like a lot. When President Barack Obama called in February for an increase to $9 an hour from $7.25, he was accused of being a dangerous redistributionist. Yet consider this: If the minimum wage had simply tracked U.S. productivity gains since 1968, it would be $21.72 an hour — three times what it is now…
Raising the minimum wage to $15 an hour would inject about $450 billion into the economy each year. That would give more purchasing power to millions of poor and lower-middle-class Americans, and would stimulate buying, production and hiring.
Studies by the Economic Policy Institute show that a $15 minimum wage would directly affect 51 million workers and indirectly benefit an additional 30 million. That’s 81 million people, or about 64 percent of the workforce, and their families who would be more able to buy cars, clothing and food from our nation’s businesses.
This virtuous cycle effect is described in the research of economists David Card and Alan Krueger (the current chairman of the White House Council of Economic Advisers) showing that, contrary to conventional economic orthodoxy, increases in the minimum wage increase employment. In 60 percent of the states that raised the minimum wage during periods of high unemployment, job growth was faster than the national average.
Some business people oppose an increase in the minimum wage as needless government interference in the workings of the market. In fact, a big increase would substantially reduce government intervention and dependency on public assistance programs.
An objection to a significant wage increase is that it would force employers to shed workers. Yet the evidence points the other way: Workers earn more and spend more, increasing demand and helping businesses grow.
Critics of raising the minimum wage also say it will lead to more outsourcing and job loss. Yet virtually all of these low-wage jobs are service jobs that can neither be outsourced nor automated.
Raising the earnings of all American workers would provide all businesses with more customers with more to spend. Seeing the economy as Henry Ford did would redirect our country toward a high-growth future that works for all.
Nick Hanauer really is in the top 1% of America’s 1%. One of the original investors in Amazon.com, he and his partners in Second Avenue Investors own their own bank. He sold his ad agency to Microsoft for $6.4 billion in 2007 – in cash. He is a self-described plutocrat.
He would like to prevent a revolution. Something on the order of French peasants and workers rolling out the guillotine in 1793. He believes economic justice will rescue our economy from the crapper it was dropped into by investment bankers in 2007 – and rebuild a prosperous nation with a healthy middle class.
Or you could pay attention to the scumbag side of class warfare in the Republican Party.
Japan marked the 69th anniversary of the bombing of Hiroshima on Wednesday, with the city’s mayor inviting world leaders to see atomic bomb-scarred cities firsthand to be convinced that nuclear weapons should not exist.
Speaking before a crowd of survivors, their descendants and dignitaries including U.S. Ambassador Caroline Kennedy, the mayor urged U.S. President Barack Obama and others to visit, referring to a proposal made at a ministerial meeting in April of the Non-Proliferation and Disarmament Initiative in Hiroshima.
“President Obama and all leaders of nuclear-armed nations, please respond to that call by visiting the A-bombed cities as soon as possible to see what happened with your own eyes,” Mayor Kazumi Matsui said. “If you do, you will be convinced that nuclear weapons are an absolute evil that must no longer be allowed to exist.”
About 45,000 people stood for a minute of silence at the ceremony in Hiroshima’s peace park near the epicenter of the 1945 bombing that killed up to 140,000 people. The bombing of Nagasaki three days later killed another 70,000, prompting Japan’s surrender in World War II.
I’m enough of a cranky old geek to remember when the cabinet member in charge of killing people in other lands was called the Secretary of War. Was WW2 a war I could support? You betcha. Did we sometimes act like the vicious monsters on the “other side”? You betcha. As an American, therefore, I have a responsibility to fight to keep my nation on a righteous path – opposing the greed and deceit so often prompting war.
Yes, I stood in the street with my family and neighbors and cheered and cried with joy – August 6, 1945 – because the war was over. At that moment we didn’t consider the threat our government had unleashed upon the world.
As for the music up top – Pete Seeger was a freedom fighter for us all. He would never let us forget evils committed in our name. The music was written by James Waters. Pete’s performance.
The lyrics are a poem written by one of my favorites, Nazim Hikmet. Even in exile from his beloved Turkey he, too, was a freedom fighter.
Thanks, Mike – who found something completely different.
Like any politician skewered by Colbert, Pearce has now passed beyond the deer-in-the-headlights stage and has his minions running hither and yon – trying to soften the effect of Colbert and his army of fans who laugh at what passes for a conservative in 21st Century America.
Thanks to Steve Terrell
We’ve known for a few months now that lots of people signed up for health insurance this year in new marketplaces. A new survey shows that the people who did so are also pretty happy with their purchases.
The survey, from the Commonwealth Fund, a research group, came to similar conclusions as other surveys about the expansion of health insurance. It found that about 15 percent of adults younger than 65 now lack health insurance, down from 20 percent before the Affordable Care Act rolled out in January.
What was more surprising is that people who got the new coverage were generally happy with the product. Overall, 73 percent of people who bought health plans and 87 percent of those who signed up for Medicaid said they were somewhat or very satisfied with their new health insurance. Seventy-four percent of newly insured Republicans liked their plans. Even 77 percent of people who had insurance before — including members of the much-publicized group whose plans got canceled last year — were happy with their new coverage.
Larry Levitt, the senior vice president for special initiatives at the Kaiser Family Foundation, another research group that polls on the Affordable Care Act, said he wasn’t sure we’d see such high satisfaction so early…
The Commonwealth poll appears to be the first national survey since the health-law passed to have gone beyond questions about insurance status and asked about satisfaction and usage.
Of course, since the article appears in the newest copout version of the NY TIMES, they meet the editorial requirement of stuffing the end of the article with beaucoup “what-ifs” just in case you might take a positive view – of a positive poll.
Perish the thought that changing times, a wee bit of change in politics as usual, might support even further movement in a population world-reknowned for ennui.
RTFA for more good news about legislation that benefits 99.9% of this nation.