Friday, March 30, 2012

3/29-3/30

I'm not the only one out there who has exhausted his lifetime benefit via an inadequate student health care plan:
You see, in the space of almost eight months, Kenya Wheeler will have almost exhausted his entire lifetime cap for treatment under his student health insurance plan. The cap: $400,000. That's close to half a million dollars in only eight months--and that's all he will ever receive. His standard of care is evaluated by a dollar figure, not by whether or not his treatment is completed or successful. As of this writing, he has $40,000 remaining in his account: enough to cover five more days in the hospital. That's an average of $8,000 per day.

For more information on Kenya's journey, click here.

On Friday morning, Kenya will check-in for his last scheduled round of chemotherapy. This intensive treatment will require an 18-25 day hospital stay. But his lifetime health insurance fund caps out on Day Five.

In a morbid way, the impact of the "lifetime" insurance cap provisions of the Affordable Care Act provide a new spin to the word "lifetime" when dealing with patients like Kenya, who without treatment, could very well find the end of treatment means the end of their lives. For the Supreme Court to keep this law alive would quite literally mean that many sick Americans could live, among them, Kenya Wheeler.
The Affordable Care Act will remove lifetime benefit caps from student health plans. But if it's repealed or struck down, stories like this will remain far too common.

Help out Kenya here. And if you're so inclined, check out my website and help me cover the cost of chemo and related health care expenses here.


Some twenty years ago, the UN published a report at the Rio Earth Summit on sustainable development called Agenda 21. It provided a vague roadmap on how to move towards sustainability. Many years later, the radical right is freaking out, believing that sustainability is a codeword for SOCIALISM!:
While a recent New York Times article described anti-Agenda 21 activism as emerging roughly two years ago, the roots of the Agenda 21 conspiracy theory go back at least a decade. As early as 2002 Dr. Stanley Monteith, a Santa Cruz County, Calif., physician, who runs the conservative Christian website Radio Liberty, hosted a series of lectures on the dangers of Agenda 21. An insurance salesperson named Joan Peros gave a nearly hour-long lecture on the perils of Agenda 21, warning, it “doesn’t matter which party is in power or control … some of our leaders totally understand and embrace the ushering in of a one-world order.”

The paranoia behind such fears was expressed by another guest lecturer on Monteith’s program, Jean Soderman, a self-professed former participant in Local Agenda 21 planning in Santa Cruz. When asked whether Agenda 21 would be worse than what Hitler did, she responded, “Yes. We are controlled by computers now and it has been said … that they have been trying this for two times already … first with Hitler, and it is going to be much, much worse.”

Michael Shaw, also from Santa Cruz and founder of the anti-Agenda 21 website Freedom Advocates, gave a lecture in 2006 at the Eagle Forum Conference in Santa Rosa, titled “Speaking of Agenda 21.” Shaw spoke about the loss of property rights through the ruse of “sustainable development,” and described Agenda 21 as “political globalists … moving toward a form of … state capitalism. It is an assault on land and that is where we have to stand up and protect our land.”

The anti-Agenda 21 critique entered the conservative mainstream in an October 2009 article in the American Thinker. Scott Strzelcky and Richard Rothschild charged that, through the implementation of “smart growth” initiatives, Agenda 21 would force people to relocate into highly urbanized areas — what anti-Agenda 21 activists commonly describe as “stack ‘em and pack ‘em” housing, evoking the image of Soviet-era East Berlin apartments. According to Strzelcky and Rothschild, Agenda 21 will ultimately lead to the demise of the suburban way of life.
As I've noted before, the great irony here is that these people choose to ignore the fact that the suburbanization of America was the result of government actions and a variety of incentives that distorted the housing and transportation markets; the free market would have never allowed for sprawl. Yet it is this government-created “suburban way of life” that these folks are valiantly trying to protect.

What's particularly distressing is that these fringe thinkers are now wielding influence over the mainstream of the GOP. To wit:

The RNC has been infected:
In a resolution approved in January, the Republican National Committee characterized the United Nations’ Agenda 21 as “destructive strategies for sustainable development.” Included in this resolution was the RNC’s condemnation of the “insidious nature” of Agenda 21, and the recommendation by the RNC to adopt this resolution at the 2012 RNC Convention.
The Tennessee House has bought in to the nonsense:
Tennessee lawmakers passed a resolution Thursday condemning a United Nations environmental plan as a “destructive and insidious” effort to advance a communist agenda through the guise of community planning.

The state House of Representatives voted 72-23 in favor of House Joint Resolution 587, which denounces the nonbinding Agenda 21 plan adopted by a United Nations environmental conference two decades ago.
Participants at public hearings in Virginia are equating a comprehensive plan with an attack on property rights:
Citizen input will be instrumental in a rewritten comprehensive plan. At a public hearing in January, nearly every speaker was in opposition of the plan.

A tea party-like group called the Chester Patriots led the opposition charge, often equating Chesterfield's plan with a United Nations plan known as Agenda 21, which sets options for sustainable development. The group said the plan would trample their property rights.

Daren Gardner, who has lived in Chesterfield for more than 50 years, was one of the citizens to speak out against the proposed plan.

"The plan that was set forth, was pretty much a cookie-cutter copy of Agenda 21, which the U.N. has tried to impose on all the communities and localities, not only in our nation but the world," he said. "It's imposing on property rights."
And it's not just the comprehensive plan; these folks see government intrusion everywhere:
Donna Holt, director of the Virginia Campaign for Liberty, a tea party group, said she and other Agenders helped defeat Chesterfield's proposed comprehensive growth plan.

Language in the plan about land and energy conservation, among other things, represented "a blueprint of what I had read coming out of Agenda 21," Holt said.

Another of the Agenders' concerns is "smart meters" in homes — computerized devices that can be read from remote locations. Smart meters "are, by definition, surveillance devices," says a posting on the website Virginians Against UN Agenda 21.

At Dominion Virginia Power, which is just beginning to test smart meters, customers' privacy is a "top priority," said spokesman David Botkins. "I haven't even heard of Agenda 21."

Virginia's Middle Peninsula is a hotbed of Agenda 21 activism, said Lewis L. Lawrence, acting executive director of the region's planning district commission.

Some people see references to zoning, comprehensive plans, conservation easements, bike paths, sustainability or smart growth and immediately assert that Agenda 21 is the force behind them, Lawrence said.

"It makes it really hard to have meaningful discussions about what you want to do with your community when 95 percent of the professional language is off-limits because of the supposed nexus to Agenda 21."
A US Senate candidate in Texas is buying into the nonsense, as well:
Called Agenda 21, it's described by U.S. Senate candidate Ted Cruz as a "globalist plan that tries to subvert the U.S. Constitution and the liberties we all cherish as Americans."

"Agenda 21," Cruz says on his campaign website, "is wrong and must be stopped."

[...]

Agenda 21 has no direct bearing on such local and state measures to control sprawl and conserve energy, yet activists and politicians with ties to the tea party see such actions as part of a U.N.-led conspiracy. Allegedly concocted by philanthropist George Soros and implemented by urban planning groups and bureaucrats, the U.N. resolution, in their view, is an effort to deny property rights and force Americans to cluster like cooped chickens in ever-denser cities.
What's especially troubling to me, as one who studies sustainability and believes in inclusive, bottom-up governance, is how to push forward a sustainability agenda in such a politicized environment. Limiting our impact on the Earth shouldn't be a partisan matter, yet it has become one. And this most certainly doesn't bode well for actually making that sustainability transition.


The weather is weirding:
As the planet warms, many scientists say, more energy and water vapor are entering the atmosphere and driving weather systems. “The reason you have a clothes dryer that heats the air is that warm air can evaporate water more easily,” said Thomas C. Peterson, a researcher with the National Oceanic and Atmospheric Administration.

A report released on Wednesday by the Intergovernmental Panel on Climate Change, the United Nations body that issues periodic updates on climate science, confirmed that a strong body of evidence links global warming to an increase in heat waves, a rise in episodes of heavy rainfall and other precipitation, and more frequent coastal flooding.

“A changing climate leads to changes in the frequency, intensity, spatial extent, duration and timing of extreme weather and climate events, and can result in unprecedented extreme weather and climate events,” the report found.

Some of the documented imbalances in the climate have certainly become remarkable.

United States government scientists recently reported, for instance, that February was the 324th consecutive month in which global temperatures exceeded their long-term average for a given month; the last month with below-average temperatures was February 1985. In the United States, many more record highs are being set at weather stations than record lows, a bellwether indicator of a warming climate.

So far this year, the United States has set 17 new daily highs for every new daily low, according to an analysis performed for The New York Times by Climate Central, a research group in New Jersey. Last year, despite a chilly winter, the country set nearly three new highs for every low, the analysis found.

[...]

Because greenhouse gases are causing the Arctic to warm more rapidly than the rest of the planet, the sea ice cap has shrunk about 40 percent since the early 1980s. That means an area of the Arctic Ocean the size of Europe has become dark, open water in the summer instead of reflective ice, absorbing extra heat and then releasing it to the atmosphere in the fall and early winter.

Dr. Francis, of Rutgers, has presented evidence that this is affecting the jet stream, the huge river of air that circles the Northern Hemisphere in a loopy, meandering fashion. Her research suggests that the declining temperature contrast between the Arctic and the middle latitudes is causing kinks in the jet stream to move from west to east more slowly than before, and that those kinks have everything to do with the weather in a particular spot.

“This means that whatever weather you have today — be it wet, hot, dry or snowy — is more likely to last longer than it used to,” said Dr. Francis, who published a major paper on her theory a few weeks ago.

“If conditions hang around long enough, the chances increase for an extreme heat wave, drought or cold spell to occur,” she said, but the weather can change rapidly once the kink in the jet stream moves along.
The piece rightly notes that this is still a contentious topic among scientists and not everyone agrees. Nevertheless, there's certainly cause for concern and there's more than enough evidence for other weather-related impacts of climate change. There's a reason some people are advocating for using the term “global weirding” in place of global warming...


I'm not generally one to read Gawker, but this summary of the right-wing racist response to the Trayvon Martin case is a must read:
Whether or not Martin was a good kid or a bad kid, an angel or a thug, a normal teenager or a dangerous deviant, he had every right to walk in the streets of his soon-to-be-stepmother's neighborhood without fear of being shot. A criminal record, a manner of dress, a height: none of these make the shooting of an unarmed, law-abiding teenager justified. And yet here we are, forced to defend Martin's honor, as though if he had been a gangster there'd be nothing to say. As though the minute a black man is anything but a choir boy it's okay to shoot him in the street.

We should have known this was coming. Maybe not for most of last week, when for once everyone seemed to be on the same page. But we had to have known it would get here on Friday morning, when Fox News symbolically broke its silence with a Geraldo Rivera segment urging young men of color to stop wearing hoodies — so as not to get shot — the hilariously inept logic of which failed to mask its true intent: to shift the blame for Martin's death back on to Martin.

A few hours later, the president stood in front of journalists in the Rose Garden and, taking a question about Trayvon Martin, said "If I had a son, he'd look like Trayvon." That was it. Rivera had given the horseshit its window, and Obama had given it its direction. What jacked-up right blogger could stop himself then? Who could resist calling the president's son a thug?

Balkinization has had some absolutely great coverage of the Affordable Care Act:
Some-time Balkinization blogger Alex Koppelman explains that the Medicaid challenge is a political one, and one that cannot be justified from a legal perspective:
The federal spending issue turns on the expansion of Medicaid. Under the ACA, millions of the working poor – people with incomes up to 133 percent of the federal poverty level – are eligible for Medicaid. From 2014 to 2016, the federal government will pay 100 percent of the costs. Then its share decreases, to 90 percent after 2020. Because the ACA also gives states assistance with their new administrative costs, overall state spending will actually be lowered.

Twenty-six states are claiming that this conditional spending unconstitutionally coerces them, because they cannot realistically forgo the money, and because if they refuse to expand their rolls, they might lose every cent of Medicaid money. But let’s be clear: This is not about the states wanting to conserve their own money. It is about the states refusing to spend federal money, to help people that they do not want to help. (Paul Clement, the attorney for the challenging states, declared that his argument would not change if the federal government permanently paid 100 percent of the costs.)

As a legal matter, this is the craziest argument yet, which is why it was rejected by every lower court that heard it. It implies that, when states get federal money, they have a right to spend it any way they want, with no federal conditions. It means that Medicaid itself has always been unconstitutional, along with federal unemployment benefits, highway funds, education funds and many other programs. Justice Breyer repeatedly pointed out that the provision in the Medicaid statute that is being challenged has been there since 1965.

Yet the conservative justices took it remarkably seriously. Because the federal government “has the authority under this provision to say you lose everything,” Chief Justice John Roberts declared, “it seems to be a significant intrusion on the sovereign interests of the state.” Justice Anthony Kennedy said, “There’s no realistic choice.” Justice Scalia offered the astounding claim that “if you predict … that 100 percent of the States will accept it, that sounds like coercion.” If this is right, then if I offer 10 people triple their salaries to come work for me, and I can confidently predict that they will all accept, I am coercing them. Alito endorsed the same idea, and also thought it relevant that the money “is going to have to come out of the same taxpayers that the States have to tax to get their money.” That would mean that the federal tax code is itself an invasion of states’ rights. How long must we keep a straight face when presented with this stuff?

There was a legitimate basis for the Court to consider many of the issues raised by the healthcare law, since they had divided the lower federal courts and the law needed clarification. But the Medicaid claim created no division: Every lower court agreed that it was without merit. (Just how meritless is explained at length in a characteristically lucid piece by Marty Lederman.) Even the most preposterous arguments are magically elevated to respectability if they are arrayed against the ACA.

The Medicaid issue also calls attention to the political decisions that were made here – the decision of all those Republican officeholders to join this litigation. Why would you work so hard to deny decent medical care to working poor people in your own state? Political warfare evidently produces collateral damage. Obama owns the healthcare bill, so anything that can gum up its works is a Republican victory – and all 26 of the state challengers, attorney generals and governors, are Republicans. But all those working poor people are not Democratic Party operatives. They are ordinary folk trying to get by. The decision to pursue this litigation displays a calculated viciousness and cruelty that we have not seen in American politics in some time. It is like getting back at my enemy by hurting his children or his pets.
And Krugman discusses the horribly disingenuous (and overwhelmingly political) economic arguments being made against the ACA:
Let’s start with the already famous exchange in which Justice Antonin Scalia compared the purchase of health insurance to the purchase of broccoli, with the implication that if the government can compel you to do the former, it can also compel you to do the latter. That comparison horrified health care experts all across America because health insurance is nothing like broccoli.

Why? When people choose not to buy broccoli, they don’t make broccoli unavailable to those who want it. But when people don’t buy health insurance until they get sick — which is what happens in the absence of a mandate — the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain. As a result, unregulated health insurance basically doesn’t work, and never has.

There are at least two ways to address this reality — which is, by the way, very much an issue involving interstate commerce, and hence a valid federal concern. One is to tax everyone — healthy and sick alike — and use the money raised to provide health coverage. That’s what Medicare and Medicaid do. The other is to require that everyone buy insurance, while aiding those for whom this is a financial hardship. Are these fundamentally different approaches? Is requiring that people pay a tax that finances health coverage O.K., while requiring that they purchase insurance is unconstitutional?

[...]

Indeed, conservatives used to like the idea of required purchases as an alternative to taxes, which is why the idea for the mandate originally came not from liberals but from the ultra-conservative Heritage Foundation. (By the way, another pet conservative project — private accounts to replace Social Security — relies on, yes, mandatory contributions from individuals.)

[...]

I was struck, in particular, by the argument over whether requiring that state governments participate in an expansion of Medicaid — an expansion, by the way, for which they would foot only a small fraction of the bill — constituted unacceptable “coercion.” One would have thought that this claim was self-evidently absurd. After all, states are free to opt out of Medicaid if they choose; Medicaid’s “coercive” power comes only from the fact that the federal government provides aid to states that are willing to follow the program’s guidelines. If you offer to give me a lot of money, but only if I perform certain tasks, is that servitude?

Yet several of the conservative justices seemed to defend the proposition that a federally funded expansion of a program in which states choose to participate because they receive federal aid represents an abuse of power, merely because states have become dependent on that aid. Justice Sonia Sotomayor seemed boggled by this claim: “We’re going to say to the federal government, the bigger the problem, the less your powers are. Because once you give that much money, you can’t structure the program the way you want.” And she was right: It’s a claim that makes no sense — not unless your goal is to kill health reform using any argument at hand.
Noah Feldman discusses Kennedy's take on dignity, freedom, and broccoli:
Kennedy was expressing the worry that penalizing someone for failing to do something infringes on liberty in a different way from putting conditions on the things a citizen does. Individual liberty, along with dignity, is one of Kennedy’s constitutional touchstones. If he believes that the health-care law is a new kind of infringement on individual liberty, Kennedy will not uphold it.

In fact, Kennedy asked Verrilli, “When you are changing the relation of the individual to the government … do you not have a heavy burden of justification to show authorization under the Constitution?” This query was especially chilling for proponents of the law. Kennedy was rehearsing a route he could use to strike it down. He might say that a new kind of infringement on liberty must be justified by a compelling government reason -- one that Verrilli clearly did not provide.

What, Kennedy wanted to know, is the limiting principle on the government’s ability to regulate? There is a good, sharp answer to this wholly reasonable question. And although Verrilli did not quite manage to make it, he may be able to do so on Wednesday, when the court discusses whether the mandatory coverage provision can be severed from the rest of the law if, indeed, the court wants to strike the mandate down.

The answer is that health care insurance is different because if the healthy people fail to get themselves coverage, it becomes extremely difficult -- under some conditions, impossible -- for the insurance market to operate. That is, as the healthiest people leave the pool, the market for health insurance starts to unravel, as people who would buy it at a price where the insurance companies would be willing to provide it will be unable to do so.

In other words, when it comes to the strange and unusual case of health insurance, inaction causes the whole market to break down. By not buying health insurance, the healthiest person is depriving everyone of a public good. By sitting on their hands -- and acting rationally -- people who do not purchase insurance are unintentionally causing the market to fail.

The limiting principle that Kennedy was seeking is therefore readily at hand. The government can penalize inaction only when that inaction deprives everyone else of a public good. That happens very rarely in the real world. There must be an asymmetry of information about the relevant facts governing insurance -- like the difference between my knowledge of how healthy I am and the insurance company’s ability to suss it out. And the market must be one in which that information asymmetry leads to adverse selection.

Kennedy was therefore correct when he said, in his last comment, “In the insurance and health-care world … the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries.”

Broccoli, by contrast, presents no problems of adverse selection. Scalia’s intuition is that the federal government may not go around ordering people to buy things that they do not wish to buy. That intuition is plausible. The Constitution gives Congress the power to regulate interstate commerce, which has been held to extend to essentially all economic activity. Inaction is ordinarily not economic activity -- not unless perfectly reasonable inaction throws an entire market into dysfunction.

[...]

[I]naction is different in the health insurance context. If I choose not to buy broccoli, others can still buy it at a market price. If I choose not to buy health insurance, universal coverage becomes impossible. That is a fundamental difference. The solicitor general should say so. If he does, Justice Kennedy should listen. 
More on limiting principles: if Kennedy and Roberts are so concerned, they can write one themselves.

Reagan's Solicitor General, Charles Fried, has no need for a limiting principle; there's no question in his mind of the constitutionality of the ACA:
[T]he power of Congress is to regulate interstate commerce. Is health care commerce among the states? Nobody except maybe Clarence Thomas doubts that. So health care is interstate commerce. Is this a regulation of it? Yes. End of story. Here’s another thing Marshall said. To regulate is “to make the rule for.” Does this make a rule for commerce? Yes!

And David Frum offers the most pithy take-down of the activity/inactivity distinction I've seen so far, as it applies to health care:
[I]t's absurd to describe as "inactivity" the actual experience of most uninsured Americans: desperately seeking an affordable policy and poignantly discovering that they cannot find it.
And, of course, the finest commentary comes from The Onion.



Since we refuse to pay the true cost of fossil fuels, the recent oil and gas boom in the US is killing the chances of success for clean energy.

Agriculture destroys the Everglades, taxpayers on the hook for clean-up.

It looks like part of what's killing bees are pesticides.

Climate activist/hero Tim DeChristopher has been put into isolation. It's no surprise that when corporations engage in the same federal felony as DeChristopher, there's no criminal prosecution.

Andy Revkin, in his love for all things middle ground, praises the notion of moving “away from “solving the climate crisis” toward managing climate risk.” Which is, of course, a recipe for not actually taking the effort to reduce emissions, no matter what Revkin claims. And that is most definitely not a reasonable way to manage climate risks.

Fighting fracking through historical preservation.

Photos of fracking and its impact on water supplies in Pennsylvania.

Trade-offs between fracking and carbon storage?

Government policies can be effective in curbing deforestation.

Food security, climate change, and agricultural intensification.

The Colorectal Cancer Legislation Report Card for 2012 is here.

Development economics is a complete joke if some of the biggest names in the field like Bill Easterly are shocked and dismayed by the nomination of Jim Kim to lead the World Band on the grounds that he's supposedly anti-growth and thinks that prioritizing corporate profits over people may not actually lift the poor out of poverty. Fortunately, there are some sane economists out there who applaud the pick — quite likely the best move Obama has made as president.

The GOP's War On Women goes even deeper into Batshitcrazyville, as a Republican lawmaker encourages women to stay in abusive relationships.

But some women continue to fawn.

Seriously, conservative ladies love Rick Santorum.

Drones will not make war easier, or more humane, or more accurate, or more successful. They will, however, make it last longer.”

Giving money to cops involved in shootings probably isn't a good idea.

Islamophobia and the GOP.

Political polarization and changing accents.

The GOP in Tennessee is going out of its way to prove its xenophobic bona fides.

The Republican Party is nothing more than a collection of corporate interests.

Law schools keep on lying about their employment rates. And ASU is one of the biggest liars.

Václav Havel: an appreciation of his writing.

Understanding the brain through split-brain patients.

If Kentucky wins it all, college basketball will change for the worse. Granted, I don't actually buy this argument; college basketball has already embraced the one-and-done era. Kentucky's victory won't change the rush towards recruiting the top players who will leave after one year. (That said, the one silver lining to Kentucky's nearly-inevitable victory is that we can all take joy in the fact that Calipari will likely see his Final Four appearance stripped from him yet again.)

Bionic limbs? Ain't happening anytime soon.

If Google is resorting to trickey and under-handed tactics, should we trust them?

How to cite a Tweet?

What do our kitchens say about us?

Living life without regrets.

Crazy birds on our streets.

John Darnielle meets the Anonymous 4.

It's Nick Cave Week over at the music blog.

Kayhan Kalhor performs a Tiny Desk Concert at NPR:

Wednesday, March 28, 2012

3/21-3/28

The end of an era? The EPA decides to regulate the carbon emissions of coal-burning power plants.
The proposal does not cover existing plants, although utility companies have announced that they plan to shut down more than 300 boilers, representing more than 42 gigawatts of electricity generation — nearly 13 percent of the nation’s coal-fired electricity — rather than upgrade them with pollution-control technology.

Michael Brune, executive director of the Sierra Club, said the new rule “captures the end of an era” during which coal provided most of the nation’s electricity. It currently generates about 40 percent of U.S. electricity.

The power sector accounts for 40 percent of the nation’s greenhouse gas emissions, and Brune said it is “the only place where we’re making significant progress” in curbing greenhouse gas emissions linked to climate change, adding that “at the same time, it’s not sufficient.”

Cheap natural gas is also contributing to the closure of aging coal-fired plants, as many utilities switch over to gas plants, which produce about half the carbon emissions.

“Gas is contributing to the closure of these plants,” Dominion Resources chief executive Thomas F. Farrell II said in an interview last week. Farrell, who also chairs the Edison Electric Institute, the utility trade association, added: “It’s not all EPA. It’s a combination of low gas prices and EPA working at the same time.”
Then again, this doesn't really change much:
Still, the agency emphasized that the proposed rules would apply only to future construction, not to existing plants or others for which permits have already been granted. The declining price of natural gas has made it the fuel of choice for companies planning new plants, and the latest gas-fired generation on the drawing boards is expected to easily meet the new standards without adding new controls.
Time's Bryan Walsh explains in greater detail why natural gas is really the big winner:
Indeed, while we can all gird ourselves for a political war over these regulations, the reality is that they may not make much of a difference. Existing Clean Air Act rules and the shale gas revolution—yes, fracking—already made new coal plants uneconomical. The greenhouse gas rules only solidify those facts. A braver EPA would have tackled the enormous problem of existing coal plants now, but understandably the Obama Administration has little stomach for that fight—especially in an election year. “Today’s rule only applies to new plants,” said Jackson. “We don’t have plans to address existing plants,” she added, saying that any additional regulations would have to go through open public debate.

It’s true that under the Clean Air Act the EPA eventually has a responsibility to tackle carbon emissions from existing power plant, and the EPA is working with environmentalists, industry and states on just how those rules will work. But don’t expect anything to happen before the November elections—and if a Republican takes the White House, expect the momentum to halt all together. Politically, the EPA has no virtually no other choice. But don’t think that these regulations will make much of a dent in climate change which—as scientists meeting this week in London declared—appears to be moving towards a disastrous tipping point. (And while coal consumption may be down in the U.S., it is up, up, up in rapidly growing China.) Today’s rules are much better news for natural gas than for the climate.
And so while EDF's Fred Krupp may be excited, this move is nothing but a very small first step in tackling climate change. And if we've learned anything about the Obama administration when it comes to environmental regulations, they're generally content with taking nothing more than small steps.


San Francisco attempts to deal with coastal erosion:
“We are in some ways the tip of the spear for this issue,” said Benjamin Grant, a city planner who is leading a study of the problem for the nonprofit San Francisco Planning and Urban Research Association, or SPUR.

Mr. Grant describes the beach’s south end as “an erosion hot spot.” But, he said, all coastal communities will have to grapple with rising seas.

A disruptive rate of sea-level rise is one of the most daunting potential consequences of climate change. Recently, researchers warned in two new studies that severe coastal flooding could occur regularly in the United States by the middle of the century and that California would be among the states most affected. Previous studies have suggested that the rise in sea levels is poised to accelerate globally, although the evidence that this is happening is not yet definitive.

“Communities will be forced to respond in one way or another to the increased erosion and coastal storm damage,” economists at San Francisco State University concluded in a recent study. Communities can either plan for the long term or improvise, storm by storm, until ad hoc solutions are inadequate, they warned. 

Elizabeth Kolbert takes a look at the GOP's lies regarding gas prices; sadly, the collective denial extends to the current administration:
Like almost anything that the Republican candidates can manage to agree on, the Obama Administration gas-price-hike conspiracy theory is nearly a hundred-per-cent hokum. The fakery begins with the theory’s premise: that the President could, if he wanted to, reduce the price of oil. Oil, as it is well known, is a global commodity traded on a global market. Gasoline prices have risen—they are up roughly fifteen per cent since the start of the year—mostly because demand is climbing in countries like China and because instability in the Middle East has prompted worries about supply. (Since sabre rattling on Iran tends to increase those worries, candidates like Santorum, who calls the Administration’s policies toward Iran “appeasement,” are almost certainly aggravating the very situation they decry.)

But an idea doesn’t have to be true, or even especially convincing, to be politically effective, and nowadays it’s the most rational policy options that seem to have the hardest time getting heard. When it comes to gas prices, it’s been clear for, well, let’s just say forever that the cost of gasoline in America is actually too low. Cheap gas generates sprawl and traffic. It discourages the use of mass transit and the development of alternative fuels. It contributes to regional smog and to global climate change. The easiest and most obvious solution has long been to raise the federal gasoline tax, which now stands at only 18.4 cents a gallon. Among economists, there’s widespread support for this idea, including from Greg Mankiw, a Harvard professor who happens to be a top adviser to Romney. Writing in the Times earlier this year, Mankiw observed, “Economists who have added up all the externalities associated with driving conclude that a tax exceeding $2 a gallon makes sense.” He went on, “By taxing bad things more, we could tax good things less.”

[...]

What the country needs—and has always needed—is an energy policy that, instead of pandering to Americans’ sense of entitlement, would compel us finally to change our ways. In addition to a phased-in increase in the gas tax, it would include a comprehensive, economy-wide tax on carbon, or, alternatively, a cap-and-trade system. As it turns out, Mankiw isn’t the only senior person in a Republican campaign to see the importance of a new policy. When Romney was governor of Massachusetts, he presided over the introduction of one of the country’s first cap-and-trade programs, for the six largest power plants in the state. And in his book “No Apology” he wrote that “higher energy prices would encourage energy efficiency.” Perhaps, once he secures the nomination, he can Etch A Sketch his way back to reality, and challenge Obama to do the same.

Trayvon, race and class prejudice, and the war on drugs:
It still surprises people to learn that in the U.S., African Americans and whites take drugs at about the same rate, but black youth are twice as likely to be arrested for it and more than five times more likely to be prosecuted as an adult for drug crimes. In New York City, 87% of residents arrested under the police department’s “stop and frisk” policy are black or Hispanic. As Michelle Alexander writes in her bestselling book, The New Jim Crow: Mass Incarceration in the Age of Colorblindness:
In the era of colorblindness, it is no longer socially permissible to use race, explicitly, as a justification for discrimination, exclusion, and social contempt. So we don’t. Rather than rely on race, we use our criminal justice system to label people of color “criminals” and then engage in all the practices we supposedly left behind.
The drug war and the stigma it imparts on users are key weapons here. America’s cultural images of drug-related danger continue to be racially charged and the resulting stereotypes appear to be becoming increasingly deadly.

[...]

If we want to avoid tragedies like the Martin case, we must confront the racism and class prejudice that infect our ideas about drug users and warp our view of how drugs work. We need to admit that drug use itself doesn’t make people evil. Perhaps if we weren’t so quick to let these biases demonize drug users, Trayvon Martin might still be with us.

If Martin’s school had not suspended the boy under its “zero tolerance” policy for drug use — one that punishes students for possession of an empty plastic baggie with trace amounts of marijuana as severely as for possession of heroin or a gun — he probably would never even have crossed paths with the man who shot him. Martin was serving his suspension on Feb. 26, when he was killed.

Such school policies have not been shown to reduce drug problems, but they, too, have been found to be applied more often to black youth. A recent analysis showed that black children are 3.5 times more likely than whites to be suspended from school for drugs and that 70% of all youth referred by school authorities to police for prosecution are black, even though they make up only 18% of the school population in the U.S.
Trayvon, race, and clothing:
Whether through the Zoot Suit, Afrocentrist hair and clothing styles, or the emergence of b-boy and gangsta aesthetics, the twentieth and twenty-first centuries witnessed the continuation of a tradition that judged the acceptability of black bodies by the way clothing either supported or subverted societal norms. In Riviera Beach, Florida, nearly 70 percent of voters in 2008 passed an ordinance banning “sagging pants” in public, a style commonly associated with African-American male youths. Similar laws have been adopted in such disparate communities as Albany, Georgia and Lynwood, Illinois. African-American hairstyles are just as heavily policed, with bans passed in certain districts on unnatural hair colors for black students and dreadlocks (because the principal considered the style threatening)—and we all remember Don Imus’s comments about the Rutgers women’s basketball team. (Meanwhile, white youths around the country continue to mock African Americans by attending school, sporting events, and parties wearing blackface and dressing in stereotypically black attire.) When looked at through history’s lens, Martin’s hoodie is just the most recent example of America’s long-standing belief that race can be read through attire.

George Zimmerman’s suspicions about Martin were not formed in a vacuum, nor can they be written off as an anomaly in our otherwise post-racial society. Though by itself a hoodie is nothing more than fabric and dye, it stands at the intersection between racial stereotypes and cultural currency. Clothing, like race, gains meaning through the masses’ socio-political and cultural whims. This fluidity helps explains why Zimmerman was able to rely on Trayvon Martin’s sartorial choices to justify his suspicions that night, and why activists are able to organize their protest movement around the same hoodie. While most major networks focused on the apparent legality of shooting an unarmed black teenager, Geraldo Rivera, perhaps unwittingly, stumbled upon an important and heretofore overlooked component of Trayvon Martin’s death: in America, clothing is still one of the ways society fashions race and racism onto the black body.
The impacts of Florida's Stand Your Ground law:
In Florida, prosecutors and police associations opposed Stand Your Ground, to no effect. Since the law was passed, the number of “justifiable homicides” has tripled. Last year, according to the Tampa Bay Times, “twice a week, on average, someone’s killing was considered warranted.” This week, the state attorney in Tallahassee, Willie Meggs, told the Times, “The consequences of the law have been devastating around the state. It’s almost insane what we are having to deal with.” Gang members, drug dealers, and road-rage killers are, according to Meggs, all successfully invoking Stand Your Ground. “The person who is alive always says, ‘I was in fear that he was going to hurt me.’ … And the other person would say, ‘I wasn’t going to hurt anyone.’ But he is dead. That is the problem they are wrestling with in Sanford.”

Cancer, aspirin, and uncertainty.

Let us hope this means that it will be impossible to patent genes.

However, a recent SCOTUS decision on the liability of generic drug makers is hurting consumers.

Will Steffen thinks we're getting close to passing irreversible tipping points in the Earth system.

The cascading impacts of noise pollution on forests.

Climate change, loaded dice, and the increased probability of heat waves.

Could a judge's ruling force factory farms to do what the FDA refuses to tell them to do regarding antibiotics?

They may make billions in profits, but ExxonMobil pays even less in taxes than Mitt Romney.

Emily Bazelon on why we should be skeptical of leaked information from the police in the Trayvon Martin case.

Good thing Krugman isn't at a public university; otherwise, supporters of ALEC would probably be suing the government to release all his email correspondence (like they did with Bill Cronon) just because of this column exposing ALEC's disingenuous lies.

The depressing reality is that Dick Cheney was completely correct when he predicted the Obama administration would embrace unchecked executive power and government secrecy.

In short, drones provide the technological impetus and the military capacity to turn the entire world into one giant, permanent theater of war and a subject of total surveillance.”

An interview with Noam Chomsky.

Looks like the GOP's voter suppression efforts in Florida are working.

Wegman's: the anti-WalMart?

Bittman on the "right" to sell kids junk food.

Cuts to WIC's fresh produce program.

More on fake chicken.

The loss of a pet can rival the hurt of losing a relative.

Ben Zimmer on baseball and jazz.

Listen to the new album from former Books member Nick Zammuto.

And a new song from Sigur Ros.

Lastly, some self-promotion. Four more days to buy Poop Strong shirts on sale. Colorectal Cancer Awareness Month Special: 15% Off All T-shirts; enter code: STRONGPOOP.

Tuesday, March 20, 2012

3/14-3/20

Chemicals needn't be in large doses to affect you:
“Current testing paradigms are missing important, sensitive endpoints” for human health, they said. “The effects of low doses cannot be predicted by the effects observed at high doses. Thus, fundamental changes in chemical testing and safety determination are needed to protect human health.”
Unfortunately, the problem is that our regulatory framework isn't designed to deal with the issue of low-dose exposures:
Thomas Zoeller, a University of Massachusetts biologist and paper co-author, said that regulatory testing of chemicals for endocrine-disrupting impacts lags behind the growing evidence of the compounds’ health effects, particularly at levels to which people are routinely exposed. “There is a very large disconnect between regulatory toxicology and the modern science of endocrinology that is defining these issues,” said Zoeller.

How much will testing chemicals at low, environmentally relevant levels improve human health, the paper authors ask? While it’s not currently possible to quantify in dollars, current evidence “linking low-dose EDC exposures to a myriad of health problems, diseases, and disorders suggests that the costs of current low-dose exposures are likely to be substantial,” they conclude.
And we barely have a clue about the overall exposure landscape. Though household toxins are potentially everywhere. Though they may be everywhere, as Katelyn reminds us: “With so much emphasis on the ubiquity of chemicals today, let's not forget exposure is still uneven and inequitable.”


Climate change is disrupting the relationships between species:
The real trouble lies in the fact that these changes create mismatches in how species interact. For example, the Stanford biologist Carol Boggs tells the story of the wildflower and the butterfly. Dr. Boggs has been tracking wildflowers and their pollinators for 40 years in the Colorado Rockies. The Mormon Fritillary butterfly (Speyeria mormonia) is a montane species that depends on the nectar of the Aspen Fleabane (Erigeron speciosus) — an alpine wildflower. Warmer springs mean that the flower buds of the Aspen Fleabane are emerging earlier, when frost is still a high risk. That risk translates into an increased incidence of frost damage, fewer wildflowers and fewer butterflies.

Examples like this highlight the fact that wildlife species will need help from us to rescue them from climate change. And we will need to accept that human activities like burning fossil fuels disrupt the well-tuned clockwork of nature. As a result, we need to be willing to both increase our overall energy efficiency and switch to renewable energy sources. At this point, nobody knows how well ecosystems will manage to overcome these timing glitches, but scientists do know that there will be big disruptions.

Where should we be worried about sea-level rise and storm surges? Lots of places, especially Florida. (Be sure to check out the map.) There are some solutions, however — like making the cost of flood insurance reflect the true costs of risk:
Perhaps their single strongest recommendation is to start pricing flood insurance, sold mainly by the National Flood Insurance Program and backstopped by federal taxpayers, at levels that reflect the true risk of coastal storms and incorporate the likelihood of future sea-level rise.

That by itself, one imagines, would cut down on oceanfront construction, since it would raise the running costs of owning coastal property. An interesting left-right coalition is pushing just such a package of measures in Congress.

The coalition includes environmentalists who want to limit coastal building and libertarian groups that want the government to stop using taxpayer money to subsidize it. With the National Flood Insurance Program in serious financial trouble after Hurricane Katrina and other recent disasters, the chances that this group might get something through Congress would seem to be greater than zero.
(Meanwhile, another study shows mixed results for California.)


The sound of silence is disappearing:
An undeveloped swath of land nearly the size of Vermont, Denali should be a haven for natural sound. Enormous stretches of wild country abut the park in every direction save east, where Route 3 connects Fairbanks to Anchorage. One dead-end and mostly unpaved road penetrates the park itself. Yet since 2006, when scientists at Denali began a decade-long effort to collect a month’s worth of acoustic data from more than 60 sites across the park — including a 14,000-foot-high spot on Mount McKinley — Betchkal and his colleagues have recorded only 36 complete days in which the sounds of an internal combustion engine of some sort were absent. Planes are the most common source. Once, in the course of 24 hours, a single recording station captured the buzzing of 78 low-altitude props — the kind used for sightseeing tours; other areas have logged daily averages as high as one sky- or street-traffic sound every 17 minutes. The loudest stretch of the year is summer, when hundreds of thousands of tourists flock to Denali, embarking on helicopter or fixed-wing rides. Snowmobiles are popular with locals, and noise from the highway, the park road and daily passenger trains can travel for miles. That sort of human din, studies are beginning to suggest, is imperiling habitat — in Denali as well as wilderness areas around the world — as surely as a bulldozer or oil spill. But scientists have so little information about what landscapes should sound like without human interference that trying to correct the problem would be like a surgeon’s wielding a scalpel without knowing the parts of the body, let alone his patient’s symptoms. To restore ecosystems to acoustic health, researchers must determine, to the last raindrop, what compositions nature would play without us.

For more than 40 years, scientists have used radio telescopes to probe starry regions trillions of miles away for sounds of alien life. But only in the past five years or so have they been able to reliably record monthslong stretches of audio in the wildernesses of Earth. Last March, a group of ecologists and engineers taking advantage of advances in collecting, storing and analyzing vast quantities of digital data declared a new field of science: soundscape ecology. Other disciplines have long observed how various sounds affect people and individual animal species, but no one, they argued in the journal Bioscience, has yet studied the interconnected sounds of whole ecosystems. Soundscapes — composed of biological utterances like birdcalls, geophysical commotions like wind and running water and anthropogenic noises like motors — are “an acoustic reflection of the patterns and processes of the landscape,” the paper’s lead author, Bryan Pijanowski, an ecologist at Purdue University, told me. “And if we can take sound samples and develop appropriate metrics, we might be able to say, ‘Hey, this is a healthy landscape and this is an unhealthy landscape.’ ”

Indeed, though soundscape ecology has hardly begun, natural soundscapes already face a crisis. Humans have irrevocably altered the acoustics of the entire globe — and our racket continues to spread. Missing or altered voices in a soundscape tend to indicate broader environmental problems. For instance, at least one invasive species, the red-billed leiothrix of East Asia, appears to use its clamorous chatter to drown out the native European blackbird in Northern Italy. Noise can mask mating calls, cause stress and prevent animals from hearing alarms, the stirrings of prey and other useful survival cues. And as climate change prompts a shift in creatures’ migration schedules, circadian rhythms and preferred habitats — reshuffling the where and when of their calls — soundscapes are altered, too. Soundscape ecologists hope they can save some ecosystems, but they also realize they will bear witness to many finales. “There may be some very unique soundscapes around the world that — just through normal human activities — would be lost forever,” Pijanowski says — unless he and colleagues can record them before they disappear. An even more critical task, he thinks, is alerting people to the way “soundscapes provide us with a sense of place” and an emotional bond with the natural world that is unraveling. As children, our grandparents could hope to swim in a lake or lie in a meadow for whole afternoons without hearing a motorboat, car or plane; today the engineless hour is all but extinct, and we’ve grown accustomed to constant, mild auditory intrusions. “Humans are becoming an increasingly more urban species, and so we’re surrounding ourselves with concrete and buildings” and “the low hum of the urban landscape,” Pijanowski says. “We’re kind of severing the acoustic link that humans have with nature.”

Higher ed is increasingly unaffordable. Mike Konczal proposes some solutions:
What vision should we advance in response? Rebuilding what used to exist—something we should call the social democratic vision. This is the vision in the California Master Plan for Higher Education: one were college is free and grants and loans cover supplemental expenses for the poor. Higher ed would be broadly accessible, with a variety of options ranging from elite schools to community colleges.

Beyond ensuring equality of opportunity, another advantage of this approach is that it would help stop cost inflation. Free public universities would function like the proposed “public option” of healthcare reform. If increased demand for higher education is causing cost inflation, then spending money to reduce tuition at public universities will reduce tuition at private universities by causing them to hold down tuition to compete. This public option would reduce informational problems by creating a baseline of quality that new institutions have to compete with, allowing for a smoother transition to new competitors. And it allows for democratic control over one of the basic elements of human existence—how we gather information and share it among ourselves.

This isn’t to romanticize the past. As always, this egalitarian vision of education is an incomplete project. The past set-up privileged certain groups over others. Its socioeconomic shape piggybacks off the dysfunctional K-12 education system. It doesn’t address the collapsing wages and bargaining power of labor more broadly. And much of the past justification for college accessibility had less to do with the normative claims of social democracy and more with the practical, militarized needs of Cold War infrastructure.

But this shouldn’t stop us from reclaiming the good from the bad, and calling for a reinvestment in public education in an era of mass privatization. Reclaiming this project of broadly accessible and public higher education is as essential a part of rebuilding education as reducing the harsh legal regime associated with student loans. True public education builds the future, contains costs, and provides access in a way that the new privatized regime is failing to do.
(With aid at pubic universities dwindling and costs increasing, it's now more expensive for a student from an upper middle class family to attend Cal State or a UC school than it would be to attend Harvard. It used to be that public support made up for endowment size at public institutions. No longer. UPDATE: The president of Cal State-Long Beach disagrees, though deceptively uses average tuition paid numbers to make his case.)


What's the conservative response to our “moral crisis”?:
Greed is a human given. But there are institutions that reward greed, or turn the other way, or both, and institutions that discourage it. Among the institutions that reward it are the same institutions who built an entire economic system on fraudulent paper; found ingenious ways of packaging that paper in order to disguise its fraudulence; succeeded in convincing the federal government that it would be good to dampen bank regulations; clamped quantitative values on worthless paper so that, once monetized, it could be “securitized” and exported. Many of these are among the graduates of our presumably finest (in any case most exclusive) universities. Some, no doubt, attended institutions which insist that their students sign honor codes.

I daresay that never in human history have there been so many business school courses on ethics; or so many people who believe that they have been born again into a personal relation with Jesus Christ. At the same time, never have so many citizens been in prison or on parole or probation. We are a punitive nation when it comes to marijuana, especially in the hands of blue-collar people and most especially hands that are not white. We are also, at the same time, a nation of white-collar scofflaws.

Some questions for conservatives: Do you believe there is a moral crisis in a country where such conduct is rewarded (until the bubble bursts)? If so, do you support tight regulations of the banks concerned? Why don’t your political candidates support such regulations? Why don’t they want to punish the criminals? (Are they soft on crime?) If those criminal-harboring enterprises should not be broken up, why not? (Gangs that sell marijuana are broken up.) Why shouldn’t there be national hearings on the management structures that cultivated these violations of law? Will you go to shareholder meetings and vote your shares in favor of punishing responsible bank officials? (Here’s a wild though mild idea: deprive them of bonuses.) Do you think that multiculturalism is at the root of this moral crisis? Sex-role confusion? Abortion?

On the militarization of our society in the post-9/11 world:
All told, the federal government has appropriated about $635 billion, accounting for inflation, for homeland security-related activities and equipment since the 9/11 attacks. To conclude, though, that “the police” have become increasingly militarized casts too narrow a net. The truth is that virtually the entire apparatus of government has been mobilized and militarized right down to the university campus.

Perhaps the pepper spray used on Occupy demonstrators last November at University of California-Davis wasn’t directly paid for by the federal government. But those who used it work closely with Homeland Security and the FBI “in developing prevention strategies that threaten campus life, property, and environments,” as UC Davis’s Comprehensive Emergency and Continuity Management Plan puts it.

Government budgets at every level now include allocations aimed at fighting an ephemeral “War on Terror” in the United States. A vast surveillance and military buildup has taken place nationwide to conduct a pseudo-war against what can be imagined, not what we actually face. The costs of this effort, started by the Bush administration and promoted faithfully by the Obama administration, have been, and continue to be, virtually incalculable. In the process, public service and the public imagination have been weaponized.

Krugman explains why we need Obamacare:
The act is aimed ... at Americans who fall through the cracks, either going without coverage or relying on the miserably malfunctioning individual, “non-group” insurance market.

The fact is that individual health insurance, as currently constituted, just doesn’t work. If insurers are left free to deny coverage at will — as they are in, say, California — they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care. Yet simply requiring that insurers cover people with pre-existing conditions, as in New York, doesn’t work either: premiums are sky-high because only the sick buy insurance.

The solution — originally proposed, believe it or not, by analysts at the ultra-right-wing Heritage Foundation — is a three-legged stool of regulation and subsidies. As in New York, insurers are required to cover everyone; in return, everyone is required to buy insurance, so that healthy as well as sick people are in the risk pool. Finally, subsidies make those mandated insurance purchases affordable for lower-income families.

Can such a system work? It’s already working! Massachusetts enacted a very similar reform six years ago — yes, while Mitt Romney was governor. Jonathan Gruber of the Massachusetts Institute of Technology, who played a key role in developing both the local and the national reforms (and has published an illustrated guide to reform) has surveyed the results — and finds that Romneycare is working pretty much as advertised. The number of people without insurance has dropped sharply, the quality of care hasn’t suffered, and the program’s cost has been very close to initial projections.

Oh, and the budgetary cost per newly insured resident of Massachusetts was actually lower than the projected cost per American insured by the Affordable Care Act.

[...]

As I said, the reform is mainly aimed at Americans who fall through the cracks in our current system — an important goal in its own right. But what makes reform truly urgent is the fact that the cracks are rapidly getting wider, because fewer and fewer jobs come with health benefits; employment-based coverage actually declined even during the “Bush boom” of 2003 to 2007, and has plunged since.

What this means is that the Affordable Care Act is the only thing protecting us from an imminent surge in the number of Americans who can’t afford essential care. So this reform had better survive — because if it doesn’t, many Americans who need health care won’t.

The debate over Komen has receded over the past few weeks, but this piece from the height of the storm should still be required reading on Komen's fetishization of screening and how their view flies in the face of science:
“What’s key to surviving breast cancer? YOU. Get screened now,” the ad says. The unmistakeable takeaway? It’s your fault if you die of cancer. The blurb below the big arrow explains why. “Early detection saves lives. The 5-year survival rate for breast cancer when caught early is 98%. When it’s not? 23%.”

If only it were that simple. As I’ve written previously here, the notion that breast cancer is a uniformly progressive disease that starts small and only grows and spreads if you don’t stop it in time is flat out wrong. I call it breast cancer’s false narrative, and it’s a fairy tale that Komen has relentlessly perpetuated.

It was a mistake that most everyone made in the early days. When mammography was new and breast cancer had not yet become a discussion for the dinner table, it really did seem like all it would take to stop breast cancer was awareness and vigilant screening. The thing about the false narrative is that it makes intuitive sense–a tumor starts as one rogue cell that grows out of control, eventually becoming a palpable tumor that gets bigger and bigger until it escapes its local environment and becomes metastatic, the deadly trait that’s necessary to kill you. And this story has a grain of truth to it—it’s just that it’s far more complicated than that.

Years of research have led scientists to discover that breast tumors are not all alike. Some are fast moving and aggressive, others are never fated to metastasize. The problem is that right now we don’t have a surefire way to predict in advance whether a cancer will spread or how aggressive it might become. (Scientists are working on the problem though.)

Some breast cancers will never become invasive and don’t need treatment. These are the ones most apt to be found on a screening mammogram, and they’re the ones that make people such devoted advocates of mammography. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, calls this the overdiagnosis paradox. Overdiagnosis is what happens when a mammogram finds an indolent cancer. A healthy person whose life was never threatened by breast cancer is suddenly turned into a cancer survivor. She thinks the mammogram saved her life, and so she becomes an advocate of the test.

Some cancers behave just the opposite of these slow-growing, indolent ones. Researchers now know that some cancers are extremely aggressive from the start. There’s simply no such thing as “early” detection for these cancers. By the time they’re detectable by any of our existing methods, they’ve already metastasized. These are the really awful, most deadly cancers, and screening mammograms will not stop them.

Then there are cancers that fall somewhere in between the two extremes. These are the ones most likely to be helped by screening mammography, and they’re the lives that mammography saves. How many? For women age 50 to 70, routine screening mammography decreases mortality by 15 to 20% (numbers are lower for younger women). One thousand women in their 50′s have to be screened for 10 years for a single life to be saved.

So let’s recap. Getting “screened now,” as the Komen ad instructs can lead to three possible outcomes. One, it finds a cancer than never needed finding. You go from being a healthy person to a cancer survivor, and if you got the mammogram because of Komen’s prodding, you probably become a Komen supporter. Perhaps a staunch one, because hey—they saved your life and now you have a happy story to share with other supporters. Another possibility is that the mammogram finds a cancer that’s the really bad kind, but you die anyway. You probably don’t die later than you would have without the mammogram, but it might look that way because of a problem called “lead time bias.” The third possibility is that you find a cancer that’s amenable to treatment and instead of dying like you would without treatment, your life is saved. Here again, you’re grateful to Komen, and in this case, your life truly was saved.

Right now, breast cancer screening sucks. It’s not very effective, and if you measure it solely based on the number of lives saved versus healthy people unnecessarily subjected to cancer treatments, it seems to cause more harm than good. For every life saved, about 10 more lives are unnecessarily turned upside down by a cancer diagnosis that will only harm them. In a study published online in November, Danish researchers concluded that, “Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.”

But it’s not quite that simple. Some people really are helped by mammography screening, and if you’re the one helped, it’s hard to discount that one life. Right now mammography is the best tool we have. Welch, who has spent more time than probably anyone else in America studying this issue, has deemed the decision about whether or not to get breast cancer screening a “close call.”

Reasonable women can decide that for them, the potential benefits outweigh the risks. Other reasonable women will decide that for them, the risks outweigh the potential benefits.

Komen isn’t wrong to encourage women to consider mammography. But they’re dead wrong to imply that “the key to surviving breast cancer” is “you” and the difference between a 98% survival rate and a 23% one is vigilance on the part of the victim. This message flies in the face of basic cancer biology.

Between 2004 to 2009, Komen allocated 47% of it $1.54 billion toward education and screening. Much of its education messaging promotes the same false narrative as its ads, which means they are not only not furthering the search for a cure, they are harming the cause. By implying that the solution to breast cancer is screening, Komen distracts attention from the real problem, which is that way too many women (and men) are still dying of breast cancer, and screening is not saving them. We still can’t prevent breast cancer, because we don’t know what causes it.
And as much as I like them, that makes me a bit skeptical as to whether Fuck Cancer is taking the right approach.


I'm not alone: colon cancer is on the rise among young adults.

In a new survey, colon cancer patients younger than 50 and those with low incomes or unemployed were most likely to experience severe financial hardships as a result of the treatments meant to save their lives.”

Supporters of the ACA shouldn't forget about making the argument for a fundamental right to health care.

Unless they're required to do so, insurers will never cover those of us with pre-existing conditions.

How does your state rate when it comes to covering colorectal screenings?

Sure, we're three months in to 2012, but it's not too late to buy a Colondar.

Big Pharma's R&D costs aren't nearly as high as they claim.

Carl Zimmer takes a look at advances in medical science and false expectations.

Emissions from land change make the mining of oil sands look even worse.
 
Ecosystem services, shade-grown cacao, and a partial win-win.

Americans don't like the idea of regulations, but they don't seem to mind specific regulations.

Perhaps we should rename George Mason University by its more accurate name: Koch Brothers University.

California attempts to go sustainable.

Better global governance to deal with our myriad global environmental challenges, please.

Alex Steffen on intergenerational equity.

Paranoid conspiracy theories about the UN, sustainability, and New World Order reach the Tennessee House and also Texas.

Cities can't take on the challenge of global warming on their own.

Our water infrastructure is falling apart.

Water in China: my friend Britt discusses China's huge South-North Water Diversion Project.

On defending science and its epistemological principles.

Says the GOP: “No, we don't hate women; we just hate immigrants, gays, native Americans, the rest of those undesirables, and sure as hell don't think battered women should have access to legal remedies.”

And, of course, the contrarians over at Slate find a way to blame the Dems for the GOP's misogynistic nonsense. Wonkette has a great, snarky take-down.

Linking women's health, development, and climate change.

On loving abortion.

Maddow on the GOP's laws on ladyparts.

Corey Robin dissects “birth control McCarthyism.”

Margaret Talbot tries to understand the GOP's War On Women.

The financial costs of including birth control in insurance plans?: Zero.

In case you missed the censored Doonesbury comics, here they are.

The landmark settlement re: the harassment and bullying of gay students in the Anoka-Hennepin school district and why it matters.

What to make of the Mike Daisey/This American Life story? Some wise thoughts over at The Edge of the American West and also from David Carr. Mark Engler chimes in with a thoughtful response, as well.

Ethan Zuckerman chimes in with more thoughts on Kony 2012.

Nobel Peace Prize-winner Ellen Johnson Sirleaf doesn't care much for gay people and has no problem with criminalizing them. Despicable.

A primer on Trayvon Martin.

Another primer on Trayvon Martin.

Charles Blow on Trayvon Martin.

Trayvon and white privilege.

Unfortunately, Florida's “Stand Your Ground” law makes prosecution difficult.

Pity the white man who's a police officer because his life is so hard.

Yes, the Justice Department should be investigating the NYPD for shredding the Constitution.

Sadly, a majority of New Yorkers stands for ignorance and unconstitutionality.

The state of Virginia has DNA tests that would exonerate people who have been found guilty of crimes they didn't commit; inexplicably they're not sharing this information.

The NSA is expanding its capacity to spy on you.

Double-standards and the motives of the Afghan shooter.

And now we're providing support to the imprisonment of journalists.

The legacy of the War on Terror: a war on the Constitution.

The Americanization of India: “The American promise of renewal and reinvention is deeply seductive — but, as I have learned since coming back home, it is also profoundly menacing.”

Anti-Putin punk rock. (And more here.)

Bittman: meat'll kill ya.

Fast Food Nation: 10 years later.

Fake chicken worth eating?

Bittman on denying the cruelty of how we treat animals.

An interview with environmental justice activist Majora Carter from a few years ago that's still worth reading:

The benefits of bilingualism.

Jhumpa Lahiri on the craft of writing.

Margaret Atwood and Twitter.

Who called out the banks?

An important CATMMUNICATION.

During March Madness, it's probably worth remembering just how sketchy the entire enterprise is, especially so far as recruiting goes.

Your Quote Of The Day, from Terrell Suggs: “They say we were giving [Tebow] a hard time because he's a Christian. No, that's not it! We were giving him a hard time because he was terrible.”

Yesterday was World Water Day. Pictures! We're still lagging on the sanitation front.

Pictures of spiders! Fleeing floods!

Jack White on SNL:



Eric Harland, Avashai Cohen, and scrap metal: