Eideard

Jeffrey Brenner and William Bratton

If Camden, New Jersey, becomes the first American community to lower its medical costs, it will have a murder to thank. At nine-fifty on a February night in 2001, a twenty-two-year-old black man was shot while driving his Ford Taurus station wagon through a neighborhood on the edge of the Rutgers University campus. The victim lay motionless in the street beside the open door on the driver’s side, as if the car had ejected him. A neighborhood couple, a physical therapist and a volunteer firefighter, approached to see if they could help, but police waved them back.

“He’s not going to make it,” an officer reportedly told the physical therapist. “He’s pretty much dead.” She called a physician, Jeffrey Brenner, who lived a few doors up the street, and he ran to the scene with a stethoscope and a pocket ventilation mask. After some discussion, the police let him enter the crime scene and attend to the victim. Witnesses told the local newspaper that he was the first person to lay hands on the man.

“He was slightly overweight, turned on his side,” Brenner recalls. There was glass everywhere. Although the victim had been shot several times and many minutes had passed, his body felt warm. Brenner checked his neck for a carotid pulse. The man was alive. Brenner began the chest compressions and rescue breathing that should have been started long before. But the young man, who turned out to be a Rutgers student, died soon afterward.

The incident became a local scandal. The student’s injuries may not have been survivable, but the police couldn’t have known that. After the ambulance came, Brenner confronted one of the officers to ask why they hadn’t tried to rescue him.

“We didn’t want to dislodge the bullet,” he recalls the policeman saying. It was a ridiculous answer, a brushoff, and Brenner couldn’t let it go…

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Data center dress code will be casual and comfortable

Intel, the world’s largest maker of computer chips, is telling its data-center customers they can turn up the heat.

Most server and storage computers sit in rooms cooled to a brisk 64 to 69 degrees Fahrenheit, an effort to avoid hot spots that might cause equipment to malfunction. All that air conditioning contributes to electricity costs of $26 billion a year. The facilities use 1.5 percent of the planet’s power, and that’s set to double by 2014, Intel says.

By using new software and hardware to get a more detailed picture of what’s hot and what’s not, data centers can spread work around to different computers to keep them cool, says Jay Kyathsandra, an Intel marketing manager. That approach, together with a range of other technologies sold by Intel, could let technicians eventually turn the heat up past 100 degrees. The challenge is convincing customers, which count on servers to keep their businesses running, that the approach is safe.

“For a long time people just kept the data center running at what’s comfortable for humans, because that’s our frame of reference, but servers can handle a lot more than that,” said Katie Broderick, an analyst at Framingham, Massachusetts-based research firm IDC…

Allowing the average temperature in data centers to rise by 9 degrees would cut $2.16 billion in annual power budgets, saving the amount of power Spain or South Africa uses in a month, according to Intel’s research…

The approach would mean data centers don’t need air conditioning — outside air alone would do the trick — in more than 95 percent of the world, according to Intel.

Overdue. That Intel is running one of ts own data centers just down the road from here at 92 degrees F. – at savings of 67% over previous accepted costs – speaks eloquently of what can be achieved.

Creil, the Netherlands — Modest farms, 90 acres or less, dot the region here, most of them raising grains and vegetables, some the occasional sheep or cow.

In the midst of this idyllic scene a few years back there appeared what residents now call “the pink invasion,” three huge hog barns each with 10,000 or more pigs in the fields that skirt the dike that protects the region from the Ijsselmeer, once known as the Zuiderzee.

“Some people don’t like the idea,” said Dick van Leeuwen, 65, who walks his dog Thor along the roads leading to the largest of the barns. Local people feared that the pig farms would stink, while bringing an unwanted increase in truck traffic, he said, delivering feed for the thousands of pigs or hauling away manure or grown hogs for slaughter. But their complaints fell mostly on deaf ears.

The Netherlands, a country of almost 17 million people, is home to a pig population of 14 million. Despite its status as one of the smaller countries in the European Union — about half the size of the state of Maine — the Netherlands has long been Europe’s leading exporter of pork and pork products, though that ranking has been contested in recent years by wurst-loving Germany.

Like pork producers everywhere, Dutch farmers are fighting rising costs by resorting to ever bigger herds and barns, a trend that is reinforced by the petite size of the Netherlands…As the big barns become more common, the government has begun to respond to public complaints about industrial farming and cruelty to animals. Officials are now discussing ways to curb the size of barns like those in tiny Creil, with its 1,600 people in trim brick homes, much to the chagrin of the new generation of farmers who see industrial-scale husbandry as their only means to compete…

Critics of the pork industry argue that enormous pig barns damage the environment because of the immense amounts of manure they produce, threaten people’s heath because of the antibiotics used liberally to avoid sickness among the animals and disregard the welfare of the animals by confining them to barns…

Pig farmers like Mr. Vowinkel insist that they can compete only if they keep costs and the price of their pork down. “Some disappear, others get bigger, to lower production prices,” he said. A fellow farmer, Sietse van der Meer, agreed. “You grow bigger, or you stop,” he said.

Politicians feel the pressure of the environmentalists and animal rights groups. In December, Parliament will begin discussing a possible restriction on the size of farms and a ban on antibiotics, two steps the farming region of Noord-Brabant, in the south, has already taken on its own.

RTFA. The arguments of the Pig Farmers Association seem specious to me. They argue that the diminishing number of pig farmers is proof of their inability to compete because of regulation. They sound like Wall Street Republicans. But, the enormous expansion of the size of farms, number of pigs produced at lower prices is as likely to be the cause for small farmers being forced out of business.

They’ll never be able to compete with pork produced in nations with an excess of arable land – from China to Brazil – and their natural market is the citizens of the Netherlands and Europe. The rest – especially reliance on antibiotics – is the same sort of propaganda we get from members of every greed-driven guild in the world.

Corporate headquarters in Westport, Connecticut

A 1969 documentary by Ken Loach, made for and later banned by Save the Children, has been shown to an audience of critics and colleagues in London. The untitled film will have its public premiere on 1 September and forms part of a major retrospective of the British director’s work at BFI Southbank.

The film took a critical view of the charity’s work in the UK and Kenya that its backers felt subverted its aims.

“There was a showing and not much was said,” the 75-year-old Loach remembers. “People left the room, and then we heard from the lawyers.”

The 53-minute film was co-funded by Save the Children, then celebrating its 50th anniversary, and London Weekend Television. “We assumed LWT would support the independence of a critical eye,” said Loach on Monday. “But they just backed away.”

As a result, the piece was consigned to the British Film Institute’s National Archive “and the key thrown away”.

That’s the version the Brits get to deal with. During my years in performing arts in among other places – Fairfield County in Connecticut – there were several happenings like this in the same time period.

Of course, films can be strange beasts. I saw the first cut of “Carry it On” and Joan Baez liked to have a fit on the spot with so much portrayed of her hubby, David, walking away from pacifism after he spent serious time in prison with folks from mean streets. The version that made it to nicey-nicey film festivals had lots of changes.

Taxpayers have spent more than $4 billion on capital punishment in California since it was reinstated in 1978, or about $308 million for each of the 13 executions carried out since then, according to a comprehensive analysis of the death penalty’s costs.

The examination of state, federal and local expenditures for capital cases, conducted over three years by a senior federal judge and a law professor, estimated that the additional costs of capital trials, enhanced security on death row and legal representation for the condemned adds $184 million to the budget each year.

The study’s authors, U.S. 9th Circuit Judge Arthur L. Alarcon and Loyola Law School professor Paula M. Mitchell, also forecast that the tab for maintaining the death penalty will climb to $9 billion by 2030, when San Quentin’s death row will have swollen to well over 1,000…

Their report traces the legislative and initiative history of the death penalty in California, identifying costs imposed by the expansion of the types of crimes that can lead to a death sentence and the exhaustive appeals guaranteed condemned prisoners…

Alarcon four years ago issued an urgent appeal for overhaul of capital punishment in the state, noting that the average lag between conviction and execution was more than 17 years, twice the national figure. Now it is more than 25 years, with no executions since 2006 and none likely in the near future because of legal challenges to the state’s lethal injection procedures…

Unless profound reforms are made by lawmakers who have failed to adopt previous recommendations for rescuing the system, Alarcon and Mitchell say, capital punishment will continue to exist mostly in theory while exacting an untenable cost…

As with the recommendations in Alarcon’s 2007 report, none of the remedies outlined by the commission chaired by former Atty. Gen. John Van de Kamp has been adopted by lawmakers or put to the public for a vote.

As on so many issues, California leads the way to problems as often as solutions. Personally, I have no problem with economics overruling biblical morality. I may have strong feelings about the justice of execution on a case-by-case basis; but, securely warehousing some demented killer until he dies of old age at a savings of $1.1 million [as the report describes] makes fiscal, social and political sense.

Eight doctors from the U.S.-based Physicians for a National Health Program visited Toronto’s Women’s College Hospital for an inside look at Canada’s single-payer health care system. Hosting the trip was family physician Danielle Martin, chair of Canadian Doctors for Medicare.

New York dermatologist Elizabeth Rosenthal, board member of the New York metro chapter of Physicians for a National Health Program, spoke to The Globe and Mail about what she learned during her visit…

What is the most surprising thing you have learned so far?

I learned that doctors are compensated much better than what we presumed they were here and their work lives are very nice. In the U.S., most doctors are afraid of two things with a single-payer system: they will lose money – of course, they won’t say that – and that they are going to lose autonomy.

What is work life like for an American doctor?

You spend so much time hassling with insurance companies, you just can’t imagine. You have to fight with them to get paid…

The U.S. system spends twice as much as other industrialized nations on health care, yet it still leaves more than 50 million without health coverage. Why has reform been so difficult?

We’re always racking our brains and always bemoaning the fact that it shouldn’t be so hard. Part of it is cultural. With Canadians, it’s a community – we’re all in this to help each other. In the U.S., it’s the frontier – I’m going to take care of myself and you can’t tell me what to do…

There’s lots of ways to improve the health care system. The first thing we have to do is get rid of the private health insurance industry because the administrative costs that they entail, we say it adds costs but no value to the system. We don’t think health care should be an opportunity for profit, we think health care is a human need, like the fire department. But in our country, it’s treated as how you make a buck. And we will be mandated to buy their lousy health insurance.

If I was comparing operating costs as if I have to choose between investing in Medicare or investing in private health insurance the decision ain’t exactly difficult. Operating costs for Medicare run less than 3%. The typical American insurance company walks away from any market that only allows 20% for management costs. Not too difficult choosing which is more efficient.

Thanks, Cinaedh

Will electric car charging networks have the type of roaming commonly found between cell phone providers? If Nokia Siemens Networks — a joint venture between the European networking giants — has anything to say about it, in Europe they will. This week at Mobile World Congress, an annual telecom conference in Barcelona, Spain, Nokia Siemens Networks and a German public utility group called Smartlab announced they are developing an authentication and authorization service to enable electric vehicle drivers to “roam” when charging up via various service providers.

Called e-clearing.net, the service will essentially authenticate your data across charging infrastructure, using information like your EV charging contract ID, an RFID card number, a PIN number or a telephone number. The group notes that the service is built to be secure, and says in the future, electric charging service providers can use e-clearing.net to make customer billing easier…

The group’s new e-roaming project highlights just how nascent the electric vehicle industry is. While there are some early standards in place for charging, the IT layer for the data involved with charging isn’t yet standardized…Nokia Siemens Network’s involvement also shows how the telecom sector is increasingly looking to work on using their networks for the “Internet of things,” including EVs and smart meters….

Katie takes the time to reinforce her belief that Open Source is needed to advance the tech. I’m not at all convinced of that. But, I hadn’t considered this solution to roaming with an electric car.

I can conceive of a salesman out for dinner with a client falling over himself to pick up the tab for charging the client’s car.

Fleets could have 200,000 electric vehicles in service by 2015, generating the volume needed to bring down prices and make EVs broadly practical, according to a new report released by the Electrification Coalition, a Washington, DC, group created in 2009 to promote development of electric-drive vehicles.

FedEx expects to see EV costs “overtake internal combustion light-duty vehicles in the 2015 to 2016 timeframe,” said FedEx chairman Fredrick Smith at a press conference called to release the coalition’s “Fleet Electrification Roadmap.” With advances in battery technology promising to cut initial capital costs for EVs, fleet operating characteristics could offer “per-mile costs that are 70% to 80% less than current [internal combustion vehicle] costs,” Smith said.

Looking at the 250-million personal vehicles in the U.S., Smith pointed out that the infrastructure for recharging EVs “at home or in parking lots” is already largely in place and that “the vast majority of fuel that would be used is already being produced and dissipated at night right now.”

Acknowledging GE’s announcement that it would purchase 25,000 EVs for fleet operations, Smith said the fleet roadmap outlined by the coalition “has real potential to move [conversion to EVs] much faster…”

“It is important to consider all of the applications where electric drive technology makes sense, and what we have found is that the case is very strong for a number of fleet applications over the next five years,” said Smith. “Fleet electrification alone will not solve our pressing energy-security challenges, but by bringing costs down, it will provide a critical boost to the consumer electric vehicle market.”

I saw Smith being interviewed about this, yesterday, on Bloomberg TV. Though FedEx already has halved their operating costs in urban markets by switching to diesel hybrids, they’re now ready to move those vehicles out into suburban markets – and replace them with pure electric-drive trucks.

Medicare patients in regions that spend the most on prescription medications are not necessarily getting better quality care, according to a new study of spending practices from the University of Pittsburgh Graduate School of Public Health (GSPH). The findings, published in the Nov. 3 Online First issue of the New England Journal of Medicine, reveal great variation across the country in both drug spending and the rate of inappropriate prescriptions for the elderly.

Lead investigator Yuting Zhang, Ph.D., assistant professor of health economics at GSPH, said that even after demographic characteristics such as age and sex, individual health status and insurance coverage are taken into account, it’s clear that Medicare drug spending varies broadly among hospital-referral regions (HRRs).

“Higher spending can be justified if it’s for drugs that are necessary and appropriate and improve patients’ health,” she said. “But if certain drugs are being incorrectly prescribed to seniors, then that can lead to complications and expensive interventions, such as hospitalization. As we try to reform health care to get costs under control, we need a better understanding of how spending differs regionally to make a positive impact…”

Regions where beneficiaries were more likely to be given prescriptions for high-risk or potentially harmful drugs did not necessarily spend more on drugs overall than regions where beneficiaries were less likely to use high-risk or harmful drugs.
In addition, the researchers found that regions where non-drug medical spending was higher also were the places where there was a greater likelihood of high-risk or harmful drugs being prescribed for Medicare beneficiaries.

“That contradicts the idea that high spending leads to better prescription practices,” Dr. Zhang noted.

Computational analysis of a half-million Medicare patients used for the study.

Interesting maps. Interesting study.

Try telling that to a Republican/Libertarian/No-responsibility Neocon.

Basic actions taken by everyday people can yield fast savings at low cost, according to MSU Professor Thomas Dietz and colleagues.

Cutting consumer energy waste is a good place to start, said Dietz, a professor of sociology and environmental science and policy at MSU. Household energy consumption accounts for 38 percent of carbon emissions in the United States and 8 percent of world emissions, he said.

Activities such as home weatherization, routine vehicle maintenance and opting for the clothesline instead of the dryer could cut total U.S. carbon emissions by 5 percent over just five years and 7.4 percent in 10 years, Dietz said. That’s the equivalent of France’s total carbon output, or of total emissions by the U.S. petroleum refining, steel and aluminum industries…

“We can make great progress with the technologies we already have if we pay attention to behavior – how people use the technologies they already have.”

Dietz and collaborators…didn’t base their estimates on a best-case consumer behavior scenario. Instead, they used the best available information to calculate how many families could reasonably be expected to take such measures if they were provided information, offered financial assistance and could interact with others doing so…

“I’ve seen many analyses that make wild assumptions about how hard or how easy it is to get people to change their behavior, without any basis in science,” he said. “Our analysis is based on science. We look at what has been feasible in bringing about changes in energy consumption behavior…”

“We know from a lot of research that most people, companies and governments are most likely to change behavior when they see their peers change. So someone will weatherize their houses when they see others do it, and governments are most likely to develop policies when they see other governments doing it.”

Now, the example up top is what Professor Dietz is talking about. What follows on – is that the nutball response to this involved Republicans dragging one or another conservative motorhead who said Obama is wrong – it ain’t 3-4% oil consumption reduction, it’s only 3-4% increase in gas mileage!

Point still remains that conservatives used to be conservationists – not copouts.