Friday, March 31, 2017

House of Cards

On the first day of March 2017, the combined market capitalization of U.S. nonfinancial and financial stocks reached $34 trillion. Those trillions of dollars in paper wealth filter down to the investment statements of millions of investors, reflected in quotes on computer screens and blotches of ink on paper. Over the completion of the current market cycle, we estimate that roughly half of U.S. equity market capitalization - $17 trillion in paper wealth - will simply vanish. Nobody will “get” that wealth. It will simply disappear, like a game of musical chairs where players think they've won by finding chairs as the music stops, and suddenly feel them dissolving as if they had never existed in the first place.

As I noted in 2015, because equities are correlated with other assets, the total private net worth of U.S. households and corporations tends to change by about $1.50 for every dollar that U.S. equity market capitalization changes. With total U.S. private net worth currently at about $120 trillion, it would currently take an equity market loss of only about 20% to wipe out $10 trillion in U.S. private net worth (0.2 x 1.5 x 34). By contrast, an expected 50% loss of U.S. equity market capitalization over the completion of this market cycle (a decline that would not even bring historically reliable valuation metrics below their long-term historical norms), would produce an expected loss of over $25 trillion in U.S. total private net worth.

To understand how paper wealth vanishes, recognize that market capitalization is merely the product of two objects: the number of shares outstanding, and the price of those shares. For example, there are currently nearly 9 billion shares of General Electric outstanding. If a dentist in Poughkeepsie sells a single share of GE to some buyer, just 10 cents below the price of the preceding trade in the stock, fully $900 million dollars of market capitalization is instantly erased from the U.S. stock market as a result of that one $30 stock trade. Nobody “got” the $900 million. The lost market capitalization didn't "go into" bonds, or real estate, or gold, or cash on the sidelines, or anything else. It just plain vanished. Conversely, if our dentist buys a single share just 10 cents above the preceding trade in the stock, fully $900 million dollars of market capitalization is instantly “created” as a result of that one $30 stock trade.

Because of those fluctuations, investors across the nation imagine that they are actually gaining or losing “wealth” as market capitalization appears and vanishes. They alternately celebrate and suffer because they can’t distinguish wealth from the illusion of wealth. When one understands how ephemeral market capitalization can be, it may become clear why I’m so adamant about the actual claim that investors actually obtain by owning a share of stock.

See, the actual “wealth” inherent in a share of stock is embodied in the very long-term stream of future cash flows that the company will actually deliver into the hands of investors over time. As long as a share of stock is outstanding, somebody has to hold it at every point in time, and that long-term stream of cash flows is actually what’s being traded. Everyone who owns the stock owns a divided claim to those cash flows. Investors don’t get to claim those future cash flows until they actually buy, and they don’t get to claim the market price until they actually sell. Put another way, the only investor who has a reliable claim to the current market price is an investor who is selling at that price.

Let’s pause to recognize the opportunity, and the risk, that investors face at the obscene levels of valuation that have been created by years of Fed-induced yield-seeking speculation, coupled with Wall Street’s enthusiasm over largely imaginary prospects for a sustained acceleration in economic growth (more on that below). The chart below presents the market capitalization of U.S. equities (left scale, $billions). The thin line shows the ratio of market capitalization to corporate gross value added (right scale) to offer an additional valuation perspective. On this measure, current valuations now rival those of the 2000 market extreme, standing at more than double the historical norm (including the bubble period since the late-1990’s), and about 160% above pre-bubble norms. Put simply, the U.S. equity market could lose $17 trillion in value - over 50% of its market capitalization - even without taking reliable valuation measures below their historical norms. (...)


I have no pointed market expectations over the very near-term here. We presently observe further deterioration in equity market internals, but we've also seen a bit of improvement in interest-sensitive measures. Overall, I view valuations as obscene, measures of overextended prices and sentiment as dangerous, and market internals as negative, but short-term narratives about taxes, health care and so forth are wild cards with regard to day-to-day market behavior. My near-term views will become more pointed if we observe fresh deterioration in either equity-market or credit-sensitive measures. On every other horizon - intermediate-term, full-cycle, and long-term (10-12 years), I am thoroughly convinced that the U.S. equity market is a house of cards.

by John P. Hussman, PhD., Hussman Funds |  Read more:
Image: Hussman Strategic Investors

With Floating Farm, New York Looks to the Future of Public Parks

If you always thought Central Park needed more edible plants, you're in luck.

Come April, a farm full of fruit trees and other crops will float to locations in three New York City boroughs, and visitors will be invited to enjoy nature by literally picking, snipping, and sowing to their hearts' content. Located on a 5,000-square-foot barge, "Swale" will include 4,000 square feet of solar-powered growing space, including a perennial garden, an aquaponics area, and an apple orchard sponsored by Heineken USA's Strongbow Apple Ciders atop a large man-made hill. (The hill allows deeper root space for fruiting trees.)

The project will be open to the public, but it’s more interactive exhibit than floating Central Park; only 75 people can board at once, and docents will usher guests around the grounds. Free educational workshops will include “painting with plants” and “dying natural fabrics,” and volunteers will always be on hand to explain how thoughtful permaculture planning can create a virtually self-sustaining farm.

But founder Mary Mattingly’s goals go far beyond providing city dwellers with a high-design place to forage for mushrooms in their next attempt at Beef Bourgignon.

She wants to make people work harder for public spaces, and public spaces work harder for people. She wants to create a model for sustainable urban farming. She wants to create an educational space. And she wants to eradicate the problem of food deserts in blighted urban neighborhoods.

“We don’t have much access to stewardship in New York City,” Mattingly told Bloomberg, “so we wanted to highlight and cultivate opportunities around that idea. People care for spaces that they can pick food from.”

That's exactly what appealed to the approving committee at the New York City Parks Department. "We are trying to prioritize community engagement," said Bram Gunther, co-director of the Urban Field Station, who cited a growing field of study that believes that community involvement, empowerment, and land management must all go hand in hand. "This project will act like a magnet, in a way, and inspire people to civic action," he added.

That's exactly Mattingly's plan. Eventually, she hopes community investment (and city grants) will take the project from floating farm to philanthropic powerhouse. She’d like to use it as a springboard to raise awareness of such food deserts as Hunts Point in New York's South Bronx, where, Mattingly says, “10,000 trucks pass through each day, and everyone has asthma, and nobody has access to fresh food.” In her perfect world, Swale becomes a conduit to a public park in the Bronx, where “people could pick food 24 hours a day.”

Here’s the only issue with that: Public policy in New York makes that kind of project legally impossible—or close to it—as it currently stands. And on a trial run last summer, Swale barely raised enough funds to keep itself going for a second season. Its manifestation this year in the East River was made possible by the partnership with Strongbow, which has made it a brand pillar to conserve and create orchards around the world. Before Mattingly can sustain entire neighborhoods, she’ll need to sustain Swale itself.

There’s reason to believe in the project, though. First, there’s Mattingly’s own record: In 2009, she spent half a year creating and living aboard a fully self-sustained ecosystem on a barge in New York, which partially inspired the Swale project.

Then there’s the success of other so-called “food farms” around the country.

In Hawaii, the Malama Kauai Food Forest supplies several underserved schools and food banks—to the tune of 37,000 pounds of fruit and 1,000 volunteer hours in the last two and a half years. In North Carolina, the George Washington Carver Edible Park anchored a major urban revitalization project near downtown Asheville, replacing a trash-filled lot with a natural source for plums, figs, chestnuts, and pawpaws, among other things. The list extends to Massachusetts, Colorado, Alaska, Seattle, and beyond.

With the exception of a nascent project in London, no other food forest has cropped up in such an urban setting. Certainly, no other initiative has as striking a design. So Swale should drum up interest. And with an advocate like Mattingly at its helm, converting interest into action should be a real possibility. Even if she fails to create her public farm in the South Bronx, she will likely open up a dialogue that can lead to lasting public policy impacts.

by Nikki Ekstein, Bloomberg |  Read more:
Image: swaleproject
[ed. If this sounds like some kind of New Age wacko deal, imagine massive floating parks along your waterfront providing peaceful contemplation and barriers against storm surges. Might be the future.] 

Eric Kemberlin Bowley // Instagram
via:

High-Tech Hope for the Hard of Hearing

When my mother’s mother was in her early twenties, a century ago, a suitor took her duck hunting in a rowboat on a lake near Austin, Texas, where she grew up. He steadied his shotgun by resting the barrel on her right shoulder—she was sitting in the bow—and when he fired he not only missed the duck but also permanently damaged her hearing, especially on that side. The loss became more severe as she got older, and by the time I was in college she was having serious trouble with telephones. (“I’m glad it’s not raining! ” I’d shout, for the third or fourth time, while my roommates snickered.) Her deafness probably contributed to one of her many eccentricities: ending phone conversations by suddenly hanging up.

I’m a grandparent myself now, and lots of people I know have hearing problems. A guy I played golf with last year came close to making a hole in one, then complained that no one in our foursome had complimented him on his shot—even though, a moment before, all three of us had complimented him on his shot. (We were walking behind him.) The man who cuts my wife’s hair began wearing two hearing aids recently, to compensate for damage that he attributes to years of exposure to professional-quality blow-dryers. My sister has hearing aids, too. She traces her problem to repeatedly listening at maximum volume to Anne’s Angry and Bitter Breakup Song Playlist, which she created while going through a divorce.

My ears ring all the time—a condition called tinnitus. I blame China, because the ringing started, a decade ago, while I was recovering from a monthlong cold that I’d contracted while breathing the filthy air in Beijing, and whose symptoms were made worse by changes in cabin pressure during the long flight home. Tinnitus is almost always accompanied by hearing loss. My internist ordered an MRI, to make sure I didn’t have a brain tumor, and held up a vibrating tuning fork and asked me to tell him when I could no longer hear it. After a while, he leaned forward to make sure the tuning fork was still humming, since he himself could no longer hear it. (We’re about the same age.) There’s no cure for tinnitus. The ringing in my ears is constant, high-pitched, and fairly loud—it reminds me of the cicadas I listened to on sweltering summer nights when I was a kid—but I’m usually able to ignore it, unless I’m lying awake in bed or, as I discovered recently, writing about tinnitus.

Unlike taste buds and olfactory receptors, which the body replenishes continuously, the most delicate elements of the human auditory system don’t regenerate. The National Center for Health Statistics has estimated that thirty-seven million American adults have lost some hearing, and, according to the National Academy of Sciences, hearing loss is, worldwide, the “fifth leading cause of years lived with disability.” Hearing problems can lead to social isolation and cognitive decline, both of which make getting older—itself a cause of hearing loss—seem worse than it does already.

In recent years, scientists searching for ways to restore hearing have made a number of promising discoveries. There are also increasingly effective methods of preventing damage in the first place, and of compensating for it once it’s occurred. The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong. (People who notice they’re having hearing problems typically wait more than ten years before doing anything about them.) I recently heard a joke about a man who was worried his wife was going deaf. He told his doctor, who suggested a simple test. When the man got home, he stood at the door of the kitchen, where his wife was at the stove, and asked, “Honey, what’s for dinner?” She didn’t respond, so he moved closer and asked again. She still didn’t respond, so he stood directly behind her and asked one more time. She turned around and snapped, “For the third time, chicken!” (...)

If I could relive my adolescence, I wouldn’t listen to Steppenwolf with loudspeakers leaning against my head, and I wouldn’t have cherry-bomb fights with my friends unless I was wearing ear protection. On the recommendation of James Henry, at the V.A., I now own several sets of so-called musician’s earplugs, which reduce the over-all level of sound but maintain the full sonic spectrum—unlike regular foam earplugs, which disproportionately mute high frequencies. I wear them even while vacuuming (or will the next time I vacuum anything), and if I were a hunter I would buy a pair of microprocessor-controlled earmuffs, which amplify quiet sounds but turn gunshots into muffled pops.

Luckily for those of us who have been careless with our ears, there are hearing aids. Most of them are made by six major manufacturers, only one of which is based in the United States: Starkey Hearing Technologies, whose headquarters are in Eden Prairie, Minnesota. Starkey’s greatest marketing triumph occurred in 1983, when President Ronald Reagan revealed that he was wearing one of its products. (The main source of Reagan’s hearing problem was a gun that someone fired near his right ear on a movie set in the early thirties.)

I visited Starkey in February, and when I arrived at the company’s testing department the receptionist greeted me in a voice that she seemed to have turned up a couple of notches—an occupational necessity, I assumed. Another employee told me, as I waited to be examined by an audiologist, that I had been preceded recently by two members of a well-known rock band that’s been around since the early seventies. The rockers, she said, looked “very old and very weathered,” and had hearing problems they’d apparently ignored for decades. “Oh, my gosh, they’ve lived hard,” she said. But they have hearing aids at last. (...)

Based on my audiogram, I was fitted for a pair of Starkey’s Muse hearing aids. Each unit sits behind an ear, as my grandmother’s hearing aid did, but is so small that it’s all but invisible. A coated wire leads to a receiver—red for right, blue for left. Each receiver is about half an inch long and the diameter of a kitchen match, and it goes right into the ear canal. A button on the part behind the ear allows me to choose among settings programmed by the audiologist. Two of them add a subtle tone that’s meant to mask my tinnitus, which during my hearing test she pinpointed at about six thousand hertz. My main reaction when I first put the hearing aids on was mild annoyance at the sound of my voice. I also became more aware of turning pages, creaking doors, and the surprisingly varied noises made by my pants. The audiologist said that people with new hearing aids get used to all that within about a month, as the brain adjusts.

With my hearing aids on, I was given a tour of the premises. Hearing aids that fit snugly into the ear canal, as many do, are custom-made from silicone impressions that audiologists create by injecting goop into patients’ ears. The cured impressions look like miniature Henry Moore sculptures. Laser scanners turn them into three-dimensional digital files, and the images are trimmed, shaped, and manipulated by technicians using an in-house computer program that’s essentially Photoshop for ear canals. I saw test hearing aids being subjected to stresses that were meant to replicate the surprisingly hostile microenvironment of an external auditory canal: baking in an oven suffused with “salt fog”; lengthy exposure to blowing clouds of dustlike talc; submersion for days at the bottom of a metre-tall column of water.

The Starkey line with the most features is Halo, the first version of which was introduced in 2014. Halo wearers can stream music, phone calls, recorded books, television shows, and other audio content via Bluetooth directly into their hearing aids from all current Apple devices. The hearing aids adjust automatically to different environments. They eliminate wind noise and reduce background sounds between spoken syllables during conversations in crowded places, and they can be used with a smartphone app that enables them to do things like switch to a customized automobile mode as soon as the phone’s accelerometer detects that the wearer is moving faster than ten miles an hour. Chris McCormick, who is Starkey’s chief marketing officer, told me, “If you regularly visit a Starbucks, you can fine-tune a setting for that particular environment—the barista grinding coffee beans, other customers talking—and then geotag it, so that when you pull into the parking lot your hearing aids will switch to that mode.”

by David Owen, New Yorker |  Read more:
Image: Sarah Illenberger

Ghost in the Shell

Thursday, March 30, 2017

PWR BTTM


[ed. See also: Answer My Text (You Dick).]

The Hour of the Attorneys General

On a Tuesday night in early February, not three weeks after Donald Trump’s inauguration, three federal judges in San Francisco heard arguments about whether to halt his first major policy undertaking. Trump had issued an executive order banning hundreds of thousands of travelers from entering the country, including citizens of seven Muslim-majority countries, and all refugees. As many as 60,000 individuals had their visas revoked. Almost immediately, a pair of Democratic attorneys general, Washington state’s Bob Ferguson and Minnesota’s Lori Swanson, brought suit against Trump’s executive order, arguing it violated the 14th Amendment’s guarantee of equal protection under the law as well as the First Amendment’s Establishment Clause, harmed all Washington and Minnesota businesses and communities, and was “undermining [their] sovereign interest” as welcoming destinations for immigrants and refugees.

More than 100,000 people from across the nation sat glued to a YouTube livestream of the legal hearing. The high-profile courtroom drama unfolded amid massive protests against Trump in streets and airports. Besides Democratic attorneys general, civil rights groups and private lawyers filed dozens of other lawsuits in federal courts across the country. A few days later, the United States Court of Appeals for the Ninth Circuit blocked Trump’s executive order, ruling that it failed to advance U.S. national security. So went the opening round in what will surely be a continuing legal struggle over Trump’s powers.

As millions of Americans steel for years of conflict with a Republican-controlled Congress and an authoritarian president, Democratic state attorneys general—politicians with independent authority to sue on behalf of their states—are expected to take a leading role on the front lines of the mobilized resistance. Though their numbers have fallen in recent years, the 21 Democratic AGs now in office have pledged to work together to use their powers to protect citizens from executive overreach. They will be a crucial source of support in fighting a president who says he will deport millions of undocumented immigrants and deregulate everything from the banking industry to the environment.

The Supreme Court and, ironically enough, Republican state attorneys general have paved the way for the Democratic AGs. Thanks to the Supreme Court, the states have stronger grounds for contesting federal authority than they did in the past, and during the Obama administration Republican state AGs honed the legal playbook for challenging federal laws, regulations, and executive orders. Democratic AGs may now be able to use that same playbook to contain Trump, especially because the Republican Congress shows little evidence of serving as an independent check on the executive branch. Since Democrats at the federal level have no power to conduct investigations, much less bring indictments, state AGs have been propelled into the forefront as a check and balance against one-party national government. (...)

It was in the mid-1990s, though, that state AGs really began to innovate new ways to use the powers of their office. More than 40 states came together to sue the five largest U.S. tobacco companies, charging them with consumer fraud and seeking payment for the Medicaid costs incurred for tobacco-caused illness. The bipartisan effort led to a groundbreaking settlement in 1998 and provided the template for multistate litigation ever since.

“We knew AGs were increasing [their] power back in 1995, when they started to take on the powerful tobacco industry,” says Karen White, the executive director of the Conference of Western Attorneys General, another AG association, which White has worked for since 1991. “This was the first time that AGs had front-page news headlines every day. Their powers were elevated, and people started to understand what they do, and could do. It wasn’t the first multistate case, but it was the most impactful in terms of catching people’s attention and catapulting AGs into a force to be reckoned with.”

Paul Nolette, a Marquette University political scientist who studies AGs, finds that while there were a few multistate cases in the 1980s, their numbers increased during the 1990s and 2000s and reached new heights during the Obama years. Some were bipartisan—particularly around consumer protection issues—but the later years of the last century and early years of the new one saw the birth of party-affiliated AG associations and more multistate, partisan litigation.

Republicans led the way, bolstered by the Republican Attorneys General Association (RAGA), a group dedicated to electing Republican AGs and litigating cases based on conservative legal philosophy. RAGA launched in 1999, moving under the auspices of the Republican State Leadership Committee in 2002. But the group’s formidable legal efforts did not take off until the Obama years.

And take off they did. Launching a concerted effort to beef up its political power, RAGA began fundraising and spending money on AG campaigns at unprecedented levels. In 2014, the group split off to become its own organization, creating its own super PAC to boot. RAGA raised $16 million that year, nearly four times what it raised in 2010. Pharmaceutical companies, the fossil fuel industry, the U.S. Chamber of Commerce, and the Koch brothers were among the group’s largest benefactors. Promises to fight for deregulation in the courts proved to be effective fundraising appeals. In joint actions, Republican AGs challenged President Obama’s policies on immigration, health care, the environment, and the workplace—raking in even more money with each successful court action.

Increased campaign spending paid off. By 2015, Republicans commanded a majority of AG seats, and in the 2016 election, Republican attorneys general increased their numbers from 27 to 29, the most at any time in U.S. history. (...)

Democratic AGs will surely look to the example set by their GOP colleagues as they prepare to oppose Trump’s policies. During the Obama years, Republican AGs took their cases to Texas courts, which are chock-full of conservative judges who are amenable to their arguments. The GOP did not originate “forum shopping”—Democratic AGs won injunctions against George W. Bush’s policies from district court judges in California’s more liberal Ninth Circuit—but the Republicans did increase the practice. Greg Abbott, Republican governor of Texas, says that on a typical day when he was Texas’s AG, he went into the office, sued the federal government, and went home. Abbott sued the Obama administration 31 times, and his successor, Ken Paxton, brought 17 additional legal challenges.

For nearly a century after Massachusetts v. Mellon, a 1923 Supreme Court case, states were treated like any other litigant. They were not allowed to bring lawsuits unless they had “standing” to sue—that is, they could not challenge federal policies they believed were generally bad unless they could show a concrete and specific injury caused by the challenged conduct that could be remedied by a court. A harm affecting everyone was not a sufficient legal basis.

“Otherwise you’d get every state marching into court the second that you do something they don’t like,” says Stephen Vladeck, a University of Texas Law School professor. “You’d turn what are really political disputes into court challenges at the outset. Find me a federal policy that all 50 states endorse.”

Under George W. Bush, however, Massachusetts’s AG, joined by 11 other Democratic AGs, sued the Environmental Protection Agency to regulate greenhouse gases. In a surprising 5–4 decision in 2007, the Supreme Court gave Massachusetts “special solicitude” in the standing analysis, making it easier for states to get into court than it is for individuals and private organizations. The ruling effectively expanded states’ authority to bring lawsuits against the federal government.

Under Obama, Republican AGs pushed open this door even further. In 2014, Obama announced new policies to give undocumented parents and lawful permanent residents permission to live and work for three years without fear of deportation. Twenty-six Republican AGs sued the federal government in response, arguing that the president violated procedural norms and exceeded his constitutional authority.

Abbott argued that Texas had standing to challenge Obama’s immigration program because his state would suffer a financial burden in providing undocumented immigrants with state-subsidized driver’s licenses. A Texas district judge, Andrew Hanen, agreed that this burden constituted sufficient “harm” to bring the case and issued a national injunction to block the order. (Hanen, it should be noted, was no fan of Obama: He had previously been on record saying that the administration worked with drug cartels to smuggle children illegally over the Mexican border.) In a 2–1 decision, an appellate panel on the Fifth Circuit upheld Hanen’s injunction.

Last year saw even more preliminary national injunctions against Obama’s policies, all issued by federal district court judges in Texas. Republican AGs were able to block several Department of Labor regulations, a letter from the Department of Education advising schools about policies regarding transgender students and public-school bathrooms, and a rule interpreting an anti-discrimination clause in the Affordable Care Act.

Some scholars, such as Samuel Bray, a professor at UCLA School of Law, have been speaking out against the trend of issuing national injunctions—a legal innovation that didn’t become commonplace until the latter half of the 20th century. The idea that a single district judge could issue an injunction to block federal policy nationwide, as opposed to just restraining the defendant’s conduct vis-à-vis the plaintiff, was, Bray says, unthinkable for most of U.S. history.

But what goes around comes around, and Democratic AGs intend to use the new legal strategies forged by their Republican colleagues to challenge President Trump.

“Republican AGs engaged in continuous warfare,” says Maryland’s attorney general, Brian Frosh. “Scott Pruitt [the former Oklahoma Republican AG and new EPA head] created a federalism unit in his office and went out and sued the Obama administration repeatedly. Maybe that’s what this evolves into for us. I really hope it doesn’t, but we will engage when necessary.”

Democrats, in short, have no interest in unilaterally disarming.

by Rachel M. Cohen, American Prospect | Read more:
Image:Elaine Thompson

Wednesday, March 29, 2017

Those Indecipherable Medical Bills? They’re One Reason Health Care Costs So Much.

The catastrophe struck Wanda Wickizer on Christmas Day 2013. A generally healthy, energetic 51-year-old, she suddenly found herself vomiting all day, racked with debilitating headaches. When her alarmed teenage son called an ambulance, the paramedics thought that she had food poisoning and didn’t take her to the emergency room. Later, when she became confused and groggy at 3 a.m., her boyfriend raced her to Sentara Norfolk General Hospital in coastal Virginia, where a scan showed she was suffering from a subarachnoid hemorrhage. A vessel had burst, and blood was leaking into the narrow space between the skull and the brain.

During a subarachnoid hemorrhage, if the pressure in the head isn’t relieved, blood accumulates in that narrow space and can push the brain down toward the neck. Vital nerves that control breathing and vision are compressed. Death is imminent. Wickizer was whisked by helicopter ambulance to the University of Virginia Medical Center in Charlottesville, 160 miles away, for an emergency procedure to halt the bleeding.

After spending days in a semi-comatose state, Wickizer slowly recovered and left the hospital three weeks after the hemorrhage, grateful to be alive. But soon after she returned home to her two teenage children, she found herself confronted with a different kind of catastrophe. Wickizer had had health insurance for most of her adult life: Her husband, who died in 2006, worked for the city of Norfolk, which insured their family while he was alive and for three years beyond. After his death, Wickizer worked in a series of low-wage jobs, but none provided health insurance. A minor pre-existing condition — she was taking Lexapro, a common medicine for depression — meant that her only insurance option was to be funneled into the “high-risk pool” (a type of costly insurance option that was essentially rendered obsolete by the Affordable Care Act and now figures in some of the G.O.P. plans to replace it). She would need to pay more than $800 per month for a policy with a $5,000 deductible, and her medical procedures would then be reimbursed at 80 percent. She felt she couldn’t afford that. In 2011, she decided to temporarily stop working to tend to her children, which qualified them for Medicaid; with trepidation, she left herself uninsured.

And so in early 2014, without an insurer or employer or government agency to run interference between her and the hospital, she began receiving bills: $16,000 from Sentara Norfolk (not including the scan or the E.R. doctor), $50,000 for the air ambulance. By the end of January, there was also one for $24,000 from the University of Virginia Physicians’ Group: charges for some of the doctors at the medical center. “I thought, O.K., that’s not so bad,” Wickizer recalls. A month later, a bill for $54,000 arrived from the same physicians’ group, which included further charges and late fees. Then a separate bill came just for the hospital’s charges, containing a demand for $356,884.42 but little in the way of comprehensible explanation.

In other countries, when patients recover from a terrifying brain bleed — or, for that matter, when they battle cancer, or heal from a serious accident, or face down any other life-threatening health condition — they are allowed to spend their days focusing on getting better. Only in America do medical treatment and recovery coexist with a peculiar national dread: the struggle to figure out from the mounting pile of bills what portion of the fantastical charges you actually must pay. It is the sickness that eventually afflicts most every American.

What’s less understood is the extent to which our current medical-billing system itself is responsible for the high prices patients are charged. There are, of course, many factors that have led to the United States’ record-breaking $3 trillion health care bill: runaway drug prices, excessive testing and sky-high charges for even the most basic medical interventions. But all of those individual price increases have been enabled — indeed, aided and abetted — by the complex system of billing and coding that underlies bills like those sent to Wickizer. That system, with its lines of alphanumeric codes and arcane medical abbreviations, has given birth to a gigantic new industry of consultants, armies of back-room experts whom medical providers and insurance companies deploy against each other in an endless war over which medical procedures were undertaken and how much to pay for them. Caught in the crossfire are Americans like Wanda Wickizer, left with huge bills and indecipherable explanations in languages they cannot possibly understand.

Disease-classification systems originated during an outbreak of the bubonic plague in 17th-century London — epidemiologic constructs to classify and track causes of death and prevent the spread of infections among populations that spoke different languages. In the 1890s, the French physician and statistician Jacques Bertillon further systematized death reporting by introducing the Bertillon Classification of Causes of Death, the first medical-coding system, which was adopted and modified in many countries. It became an official global effort, which was periodically revised by an international commission. During the first half of the 20th century, the number of entries naturally increased with improved understanding of science, and many countries began tabulating not just causes of deaths but also the incidence of diseases.

In the 1940s, the World Health Organization took over stewardship of Bertillon’s system and renamed it to reflect a new, broader focus: the International Statistical Classification of Diseases, Injuries and Causes of Death (ICD). The codes became an invaluable tool, a common language for epidemiologists and statisticians to track the world’s afflictions. But over the last several decades in the United States, codes gradually took on a bedrock financial function as the basis for medical billing. In 1979, the government decided to use what by then were called ICD-9 codes — which specify the patient’s diagnosis — in adjudicating Medicare and Medicaid claims, with some modifications added specifically for that purpose; the United States version was called ICD-9-CM. (The country has recently moved to a new iteration, ICD-10-CM.) For its beneficiaries, Medicare pays a fixed fee for inpatient hospitalization based primarily on the ICD-CM code, which is translated into a DRG (diagnosis-related group) code — which is the immediate basis for reimbursement.

Other insurers followed in making codes the basis for billing. Coding systems begot new coding systems, because few hospitals wanted to be paid according to Medicare’s relatively low DRG standards. And because strategic coding meant increased payment, that begot coding specialists and coding courses and coding degrees. There are now different increasingly complex coding languages that define payment for different kinds of services: CPT codes, for office visits delivered by doctors, as well as HCPCS, ICD-PCS-CM and DRG, for charges that are incurred in the hospital. There are tens of thousands of codes in each lexicon that have become increasingly specific. For example, there are different codes for in-office earwax removal depending on the method used (irrigation or instruments), different codes for delivering different vaccinations and a code for each injection delivered in the hospital. Different insurers also use different coding systems. While Medicare would have most likely considered Wickizer’s brain bleed as DRG 021, if billed to a commercial insurer, it could result in more than a dozen ICD codes and hundreds of HCPCS entries.

Seemingly subtle choices about which code to use can have large financial consequences. If after reviewing a hospital chart of, say, a patient who has just had a problem with his heart, a hospital coder indicates the diagnosis code for “heart failure” (ICD-9-CM Code 428) instead of the one for “acute systolic heart failure” (Code 428.21), the difference could mean thousands of dollars. “In order to code for the more lucrative code, you have to know how it is defined and make sure the care described in the chart meets the criterion, the definition, for that higher number,” says one experienced coder in Florida, who helped with Wickizer’s case and declined to be identified because she works for another major hospital. In order to code for “acute systolic heart failure,” the patient’s chart ought to include supporting documentation, for example, that the heart was pumping out less than 25 percent of its blood with each beat and that he was given an echocardiogram and a diuretic to lower blood pressure. Submitting a bill using the higher code without meeting criteria could constitute fraud.

Each billing decision, then, can be seen as a battle of coder versus coder. The coders who work for hospitals and doctors strive to bring in as much revenue as possible from each service, while coders employed by insurers try to deny claims as overreaching. Coders who audit Medicare charts look for abuse to reclaim money or fraud that needs to be punished with fines. Hospital coders teach doctors — and doctors pay to take courses — to learn how they can “upcode” their charts to a more lucrative level with minimal effort. In a doctor’s office, a Level 3 visit (paid, say, at $175) might be legally transformed into a Level 4 (say, $225) by performing one extra maneuver, like weighing the patient or listening to the lungs, whether the patient’s illness required that or not.

While most hospitals and insurers set their own rates for each level of care, adding a step when interacting with a patient can also bring windfalls. E.R. doctors, for example, learned that insurers might accept a higher-reimbursed code for the examination and treatment of a patient with a finger fracture (usually 99282) if — in addition to needed interventions — a narcotic painkiller was also prescribed (a plausible bump up to 99283), indicating a more serious condition.

Toward the end of the 20th century and into the next, as strategic coding increased, a new industry thrived. For-profit colleges offered medical-coding degrees, and internships soon followed. Because alphanumeric coding languages are as distinct from one another as Chinese is from Russian, different degree tracks are necessary, along with distinct professional organizations that offer their own particular professional exams, certifications and licensing. Hospital systems and insurers — which have become huge, Hydra-like enterprises — now all employ roomfuls of coding-program graduates to perform these tasks. Membership in the American Academy of Professional Coders has risen to more than 170,000 today from roughly 70,000 in 2008.

Individual doctors have complained bitterly about the increasing complexity of coding and the expensive necessity of hiring their own professional coders and billers — or paying a billing consultant. But they have received little support from the medical establishment, which has largely ignored the protests. And perhaps for good reason: The American Medical Association owns the copyright to CPT, the code used by doctors. It publishes coding books and dictionaries. It also creates new codes when doctors want to charge for a new procedure. It levies a licensing fee on billing companies for using CPT codes on bills. Royalties for CPT codes, along with revenues from other products, are the association’s biggest single source of income.

Patients with good health insurance are often blissfully unaware and mostly unaffected by the jockeying that goes on over how to code their bills. But uninsured patients like Wickizer, or (increasingly) those with high deductibles, are stuck with no insurer to argue on their behalf. Her experience with the University of Virginia Medical Center is not unique: Studies have shown that hospitals charge patients who are uninsured or self-pay 2.5 times more than they charge those covered by health insurance (who are billed negotiated rates) and three times more than the amount allowed by Medicare. That gap has grown considerably since the 1980s.

by Elisabeth Rosenthal, NY Times |  Read more:
Image: Paul Sahre

BVD / LemonAid Beverages GmbH / LemonAid / Packaging / 2009
via: here and here

Trolling For Hate

One morning near the end of her long-shot congressional campaign, 25-year-old Erin Schrode rolled over in bed, reflexively checked her cellphone - and burst into tears.

With mounting horror, she scanned a barrage of anti-Semitic emails from anonymous trolls. "Get out of my country, kike," read one. "Get to Israel to where you belong. That or the oven. Take your pick."

Included was a photograph of Schrode digitally stamped with a yellow "Jude" star, the badge that Nazis forced Jews to wear during the Holocaust.

Schrode, a Democrat and activist who would come in third in the June primary in her Northern California district, had become the latest target of The Daily Stormer, a popular neo-Nazi website known for orchestrating internet trolling campaigns.

After the site published a post about the "Jewess" and her candidacy, a reader posted Schrode's contact information in the comments section. Over the past 10 months, her email and social media accounts have been polluted with a torrent of slurs and disturbing images.

Her tormentors are faceless. They hide behind screen names, in the shadows.

Andrew Auernheimer says he is not one of them, but he applauds their vitriolic spirit.

A notorious computer hacker and internet troll associated with The Daily Stormer, Auernheimer scoffs at the notion that anyone can be harmed by "mean words on the internet." For him, anonymous trolling is a modern form of a generations-old, "distinctly American" political tactic.

"Being offensive is a political act," he said. "If something pushes up against polite civilization, it's for a purpose."

Auernheimer, whose anti-Semitic rhetoric matches the swastika tattooed on his chest, chuckled at the mention of Schrode's name.

"Why should I have any empathy? What's she ever done for me?" he asked. "I don't feel any empathy for any Jew anywhere."

Trolling is a calling card of the "alt-right" - an amorphous fringe movement that uses internet memes, message boards and social media to spread a hodgepodge of racism, anti-Semitism, misogyny and xenophobia.

Troll tactics edged into the mainstream with the 2014 birth of GamerGate, an online campaign against feminists in the video game industry. GamerGate arguably provided a blueprint for some white nationalists and other extremists who rallied around Donald Trump's presidential campaign, flooding the internet with "Pepe The Frog" cartoons and other hate symbols.

The Daily Stormer's founder, Andrew Anglin, published a primer in August that attempted to define the "alt-right" and explain its origins. At the core of the movement is a "trolling culture" bred on the 4chan.org website, he wrote. (....)

Auernheimer is known online as "weev." He trolls for the "lulz," a slang term he defines as "the joy that you get in your heart from seeing people suffer ironic punishments."

"The reality is internet trolling is entertaining. People love to watch it. It's become a national sport," Auernheimer said. "It's something that anyone can jump into."

by Michael Kunzelman, AP |  Read more:
Image: Eric Risberg

Tuesday, March 28, 2017

US Consumers Lose Privacy Protections for Their Web Browsing History

US politicians voted Tuesday to kill privacy rules meant to prevent internet service providers (ISPs) from selling users’ web browsing histories and app usage histories to advertisers.

The planned protections, proposed by the Federal Communications Commission (FCC) and scheduled to take effect by the end of 2017, would have forced ISPs to get people’s consent before hawking their data.

Republicans in the House of Representatives followed their colleagues in the Senate with a vote – of 215 to 205 – to approve a resolution that uses the Congressional Review Act to prevent the privacy rules from taking effect.

Without these protections, ISPs such as Comcast, Verizon and AT&T are free to track your browsing behavior and sell that data to advertisers without consent. This represents a huge treasure trove of personal data, including your health concerns, shopping habits and visits to porn sites. ISPs can find out where you bank, your political views and sexual orientation simply based on the websites you visit. The fact that you’re looking at a website at all can also reveal when you’re at home and when you’re not.

“Give me one good reason why Comcast should know what my mother’s medical problems are,” said congressman Mike Capuano during the hearing before the vote, explaining how he had researched her condition after a trip to the doctor. “Just last week I bought underwear on the internet. Why should you know what size I take? Or the color?”

“Consumers should be in control of their own information,” added congressman Jared Polis. “They shouldn’t be forced to sell it to who knows who simply for the price of admission to access the internet.” (...)

Those in favor of repealing the privacy rules argued that it levels the playing field for internet service providers who want to get into the advertising business like Google and Facebook. According to ISPs, scrapping the rules will allow them to show the user more relevant advertising and offers, which would give the companies better return on the investment they have made in infrastructure. They argue that web browsing history and app usage should not count as “sensitive” information.

In the run-up to the hearing, privacy campaigners argued that ISPs should be treated differently from Google and Facebook, as in many cases consumers only have one choice of broadband provider. You can choose not to use Facebook or Google’s search engine, and there are lots of tools you can use to block their tracking on other parts of the web, for example, Privacy Badger from the Electronic Frontier Foundation (EFF), a nonprofit civil liberties group.

It’s much harder to prevent ISPs from tracking you. To mask all of your browsing behavior you can use a VPN service (which incurs a subscription cost) or try using Tor, both of which make browsing more complicated.

What’s the next step for privacy campaigners? The EFF’s Jeremy Gillula said: “It’s certainly a bit of a Hail Mary, but I think we’d try to convince President Trump that signing a bill that helps big corporate interests by eliminating Americans’ privacy and weakening their cybersecurity isn’t exactly ‘draining the swamp’.”

by Olivia Solon, The Guardian | Read more:
Image: Tolga Bozoglu/EPA

Selling Water

Bottled water is starting to seem more like soda, and sometimes taste like it, too.

As bottled water surges in popularity, Coke, Pepsi and other companies are using celebrity endorsements, stylish packaging and fancy filtration processes like "reverse osmosis" to sell people on expanding variations of what comes out of the tap. They're also adding flourishes like bubbles, flavors or sweeteners that can blur the lines between what is water and what is soda.

For this year's Super Bowl, PepsiCo even ran an ad for its new Lifewtr, promoting the drink in a spotlight typically reserved for sodas. Also running their first Super Bowl ads were Fiji and Bai Brands, which sell "enhanced waters" made with fruit juice and stevia sweetener.

Michael Simon, Bai's chief marketing officer, says its drinks "give people that healthy profile they're looking for, but now they no longer have to sacrifice on taste with the neutrality of water."

Bottled water has been gaining ground for years, and overtook soda as the No. 1 drink in the U.S. by sales volume last year, industry tracker Beverage Marketing Corp. said. Some of the fizzy, sweetened drinks are considered water by the companies or industry trackers in some cases, as the distinctions between them lose meaning. Companies aren't as interested in the big, economy packs of plain bottled water that have been fueling the growth, says Ali Dibaj, a Bernstein analyst who covers the industry, since those are less profitable than sodas and are a "horrible business to be in."

So Coke and Pepsi are focusing on pricier options that compete with brands like Evian and Perrier. And they're introducing fizzy and fruity varieties to get a better foothold in increasingly crowded marketplace where options like LaCroix and others are gaining popularity. Showing just how blurry the lines are getting, PepsiCo launched a drink last week that it describes as "sorta juice, sorta soda, sorta sparkling water." Such options can capture people looking to cut back on sodas or juices, and may get people who might buy lower-priced waters to upgrade.

by Candice Choi, AP |  Read more:
Image: Matt Rourke/AP

For the Love of Caddieing

Some are household names among golf fans. Mike (Fluff) Cowan—and his walrus mustache—comes to mind. A few struck it rich, such as Steve Williams in his 13 years with Tiger Woods, and Jim (Bones) Mackay, who has worked with Phil Mickelson since 1992. But those are the exceptions, and they work on the PGA Tour. Among caddies, they are the haves.

The have-nots are those who shoulder bags on the LPGA Tour, trying to survive where the prize money—and potential income—is one-fifth of what’s available on the men’s tour, with the same lack of job security, healthcare and pension.

Looping on the LPGA Tour is a labor of love laced with economic hardships requiring perseverance, imagination and a supportive family. It’s a life where veteran caddies say only about 30 percent last more than 10 years. Yet, a hardy handful of lifers have blown past the quarter-century mark.

John Killeen, 58, is among those captivated by the lifestyle that is alien and often absurd. He has been a caddie on the LPGA Tour for nearly 35 years, with Patty Sheehan, Juli Inkster, Ayako Okamoto, Meg Mallon, Cristie Kerr and others, before landing his current gig with Mirim Lee, winner of last week’s Kia Classic.

Last year, when Killeen was still working for Angela Stanford, he said goodbye to his wife, two teenage kids and home near Atlanta for a swing that took him to the Bahamas, Florida, Thailand, Singapore, Arizona, California, Hawaii, Texas and Alabama. From mid-May, when he took a week off for his son’s high school graduation, until the Olympics in August, Killeen had only one other scheduled week off.

How do you make a life like that work financially and emotionally? For starters, you need a lot of help from your friends. Imagine that house you shared with your buddies in college and the fun you had. Now imagine that house moves around the country—one golf tournament after another. That’s what life is like for Killeen and a handful of his fellow caddies who share living quarters when possible to save money and find sanity in each other’s company. They love the life, each other, golf and the competition. It’s not the money that keeps them chasing this nomadic existence.

In recent years, Killeen was one of eight caddies who rented a house at the Bank of Hope Founders Cup in Phoenix. I spent a week with them, and there are few experiences more valuable and fun for a journalist than hanging with caddies. They know everything—or at least think they do. And they know how to have a good time. (...)

Eking Out a Living

... “You have to finish in the top 40 [on the money list] out here to have a significant year,” says Killeen, who in 1984 at age 23 and planning to be a stockbroker, told his mother and girlfriend in Portland, Ore., he’d be back after a two-week stint caddieing, then came home eight months later and said he’d found his calling.

In Phoenix, the eight men in the house paid $430 each for rent. There were two rental cars, plus Castrale’s car he drove from Palm Desert, Calif. Food and drink came to $125 a man, with the rental cars totaling $100 each. Castrale says the seven guys who flew in averaged about $250 for airfare. That put the total expenses per person at $905 for the week, much less than it would have cost to stay in a hotel, not to mention food and drink.

“Some weeks, like Asia events, all we pay for is food and hotel because we have no rental cars and 99 percent of the players pay for international caddie flights,” says Castrale. “But then Hawaii and San Francisco, for example, I spend $1,500 at least. Overall, $1,000 to $1,200 per week is our typical average expense for the 25 to 30 events played.”

The way it works, the caddies say, is they get on average a guarantee of $1,000 to $1,500 for each week the player competes. If your player misses the cut, that’s all you get. On average, a caddie gets 5 percent of a made-cut check, 7 percent of a top-10 check and 10 percent for a win. Some players are more generous than others.

Now what kind of money are we talking here? No. 40 on the LPGA money list last year—Moriya Jutanugarn, older sister to player-of-the-year Ariya—earned $446,948 in 29 starts with two top-10 finishes. Those two top-10s earned $170,895, with the caddie’s 7-percent share coming to $11,962.65. The other 22 cuts made earned $276,053, and 5 percent of that is $13,802.65. Assume the caddie got $1,000 a week, and the total for the year would be $54,765.30 before taxes. And then there is about $35,000 in expenses. That’s a break-even proposition. (...)

Although it’s fun to recite the caddie creed of “Show Up, Keep Up, Shut Up,” the job is way more complicated than that. Pretty much the only time off is the weeks your player is not competing. Monday and Tuesday used to be an opportunity for a caddie to sneak in some golf. Now those days are reserved for working with players on the range or playing a practice round.

The days of the hard-living bag-toter who would close the bars at night and work the next day through bloodshot eyes are mostly gone. These loopers are more than mere porters lugging around a 45-pound staff bag. Caddies have evolved into a mix of mathematician, psychologist, cartographer and bodyguard, all while remaining a Sherpa.

“Oh, my, those early days,” says Killeen, smiling. “At our house in Oakmont in 1992 [for the U.S. Women’s Open] we had empties stacked up this high,” he said, holding his hand over his head. “What do I like the most about this job? The people. The travel. The fact I have half the year off.”

And Killeen clearly relishes his role as house father of the group.

by Ron Sirak, Golf Digest |  Read more:
Image: J.D. Cuban
[ed. See also: Tommy's Honour, coming soon.]

Blue Lies

Donald Trump tells lies.

His deceptions and misleading statements are easy to unmask. In the latest example—after hundreds of well-documented lies—FBI director James Comey told Congress this week that there is “no information that supports” Trump’s claim that President Obama tapped his phone.

But Trump’s political path presents a paradox. Far from slowing his momentum, his deceit seemed only to strengthen his support through the primary and national election. Now, every time a lie is exposed, his support among Republicans doesn’t seem to waver very much. In the wake of the Comey revelations, his average approval rating held at 40 percent.

This has led many people to ask themselves: How does the former reality-TV star get away with it? How can he tell so many lies and still win support from many Americans?

Journalists and researchers have suggested many answers, from hyper-biased, segmented media to simple ignorance on the part of GOP voters. But there is another explanation that no one seems to have entertained. It is that Trump is telling “blue” lies—a psychologist’s term for falsehoods, told on behalf of a group, that can actually strengthen the bonds among the members of that group.

Children start to tell selfish lies at about age three, as they discover adults cannot read their minds: I didn’t steal that toy, Daddy said I could, He hit me first. At around age seven, they begin to tell white lies motivated by feelings of empathy and compassion: That’s a good drawing, I love socks for Christmas, You’re funny.

Blue lies are a different category altogether, simultaneously selfish and beneficial to others—but only to those who belong to your group. As University of Toronto psychologist Kang Lee explains, blue lies fall in between generous white lies and selfish “black” ones. “You can tell a blue lie against another group,” he says, which makes it simultaneously selfless and self-serving. “For example, you can lie about your team's cheating in a game, which is antisocial, but helps your team.” (...)

Around the world, children grow up hearing stories of heroes who engage in deception and violence on behalf of their in-groups. In Star Wars, for example, Princess Leia lies about the location of the “secret rebel base.” In the Harry Potter novels (spoiler alert!), the entire life of double-agent Severus Snape is a lie, albeit a “blue” one, in the service of something bigger than himself.

That explains why most Americans seem to accept that our intelligence agencies lie in the interests of national security, and we laud our spies as heroes. From this perspective, blue lies are weapons in intergroup conflict. As Swedish philosopher Sissela Bok once said, “Deceit and violence—these are the two forms of deliberate assault on human beings.” Lying and bloodshed are often framed as crimes when committed inside a group—but as virtues in a state of war.

This research—and those stories—highlight a difficult truth about our species: We are intensely social creatures, but we’re prone to divide ourselves into competitive groups, largely for the purpose of allocating resources. People can be prosocial—compassionate, empathic, generous, honest—in their groups, and aggressively antisocial toward out-groups. When we divide people into groups, we open the door to competition, dehumanization, violence—and socially sanctioned deceit.

“People condone lying against enemy nations, and since many people now see those on the other side of American politics as enemies, they may feel that lies, when they recognize them, are appropriate means of warfare,” says George Edwards, a Texas A&M political scientist and one of the country’s leading scholars of the presidency.

If we see Trump’s lies not as failures of character but rather as weapons of war, then we can come to see why his supporters might see him as an effective leader. From this perspective, lying is a feature, not a bug, of Trump’s campaign and presidency.

by Jeremy Adam Smith, Scientific Amercian | Read more:
Image: Alberto Ruggieri Getty Images

Monday, March 27, 2017

Spinach Leaf Transforms Into Sheet of Beating Human Heart Cells

To create artificial tissue with functioning vasculature, tissue engineers looked no further than their salad bowls.

By peeling away the cells from a spinach leaf and seeding the cellulose matrix left behind with heart cells, researchers were able to create a beating sheet of human heart tissue—complete with a functional vascular system. The proof-of-concept experiment, appearing in the May issue of Biomaterials, provides an intriguing plant-based approach to generating realistic tissues for grafts and transplants.

Vasculature has been a sticking point for bioengineers. Modern methods for creating artificial tissues and organs, such as 3D printing, haven’t included a good way to recreate the vital conduits. Yet the success (and survival) of any bioengineered tissue or organ hinges on whether it’s equipped with an extensive network of blood-carrying vessels, which drop off oxygen and critical nutrients to cells while flushing away molecular garbage.

Though the vasculature of plants is fundamentally different from that of animals, the structures and cell access are similar. Plus, cellulose—the main organic polysaccharide left standing in de-celled leaves—is known to be biocompatible, that is, it’s safe in humans and already used in other tissue-engineering applications, such as wound healing. This sparked ideas in the study's authors, led by bioengineers at Worcester Polytechnic Institute in Massachusetts.

“When I looked at the spinach leaf, its stem reminded me of an aorta,” Joshua Gershlak, first author on the study and a researcher at WPI, said in a press release. “So I thought, let’s perfuse right through the stem. We weren’t sure it would work, but it turned out to be pretty easy and replicable. It’s working in many other plants."

Basically, the researchers first pumped a detergent solution through the leaves’ veins, which stripped away the plant cells over several days. Then, the researchers pumped in cells that blanket human blood vessels so they could re-line the leaves' pipes. Lastly, the researchers seeded the outside of the leaves with human heart cells, which took to their plant-based skeleton.

Over the course of a 21-day experiment, the heart cells started spontaneously beating, like normal heart tissue. The researchers also found that mock-blood could flow through the system. The researchers did similar experiments with parts of parsley and peanut plants.

by Beth Mole, Ars Technica |  Read more:
Image: Worcester Polytechnical Institute

[ed. Even if this doesn't work out, isn't science great? (for the most part)]
Tom Gauld
via:

Home Inspectors on Their Weirdest Discoveries

When a home is sold, its many secrets can come out of the closet. Brokers, potential buyers and home inspectors step inside properties that may have been completely private for years. They peer into basements, attics and electrical panels and find a home’s shortcomings. Such moments offer a rare glimpse inside the workings of a place, and can uncover shoddy renovations, failed do-it-yourself projects, neglect and, in the case of Mr. Burns, baffling remnants of the lives of the former occupants.

Sometimes, owners hide flaws in the hopes a buyer will miss an expensive problem. Other times, homeowners are caught completely unaware that, say, a family of raccoons has taken up residence in the chimney. The home inspector, whom buyers and some sellers hire to uncover flaws, is often the one who has to explain to a stunned seller that the new insulation in the attic was installed improperly, or not at all. Or perhaps the inspector has to inform an eager buyer that the stylish white shag rug in a luxury Flatiron apartment is hiding serious, and ongoing, water damage. Sometimes it is the broker who discovers that, say, a vagrant has set up residence in a vacant property.

And so begins a delicate dance to inform an anxious buyer that a dream home is not perfect, or let a seller know that it is not O.K. to sever the main support beam of a house to make room for an entertainment center’s electrical cables, an unfortunate modification that Blaise Ingrisano, a home inspector on Long Island, once uncovered.

For the last two years, John C. Quinn, the owner of Homerite, a Long Island home inspection company, has compiled an annual list of quirky home inspection photos collected from other inspectors in the area. Last year’s winners included an in-ground pool that had been filled with soil and sodded with grass to hide its existence. The rectangular walkway and ladder rail gave it away.

In another photograph, a new addition to a house was built atop a working chimney, enclosing it in the attic. “You could have a fire or carbon monoxide poisoning,” Mr. Quinn said. “It was just unbelievable.”

Mr. Quinn blames duct tape for many D.I.Y. fails. “They use duct tape for everything,” he said. “I’ve seen shower enclosures covered with duct tape. It’s like putting a Band-Aid on a large wound.” Other inspectors have seen the tape used to fix plumbing leaks, secure electrical wiring and hold rotted-out windows in place.

An ambitious, but unskilled homeowner can wreak havoc on a house. Watch enough shows on HGTV or spend enough time on YouTube, and it’s hard not to want to take a sledgehammer to the bathroom wall all by yourself. “You look at the ingenuity of some of these guys. It’s like ‘Wow,’” said Frank Lesh, the executive director of the American Society of Home Inspectors, an industry trade group. “They see a YouTube video and say, ‘I can do that!’ But it’s more than just monkey see, monkey do.” (...)

Sometimes, property owners try to hide flaws. Vincent Fundaro, the owner of Square One Professional Home Inspectors in Levittown, N.Y., was inspecting a ground floor condominium on West 22nd Street in Manhattan last April. The apartment, which was listed for $1.8 million, had new kitchen cabinets and new floors. As he walked through the garden level, he tripped over a white shag carpet, revealing the floorboards, which were floating in water. The owner had covered the boards with newspaper and plastic to keep the water from seeping through, but the water problem was unmistakable. “It was definitely saturated,” Mr. Fundaro said. “You would step on it and float.”

The buyer, who was supposed to put down a large deposit that afternoon, was livid. The seller’s broker tried to assure her that the problem could be easily fixed. But Mr. Fundaro spoke up. “I turned around and said it’s not a simple glue and patch fix,” he said. He never found out what effect his findings had on the sale.

by Ronda Kaysen, NY Times |  Read more:
Image: uncredited

When An Animal Dies Mysteriously in Alaska, This Woman Gets the Call

When they captured her off Cohen Island in the summer of 2007, she weighed 58 pounds and was the size of a collie. The growth rings in a tooth they pulled revealed her age — eight years, a mature female sea otter.

They anesthetized her and placed tags on her flippers. They assigned her a number: LCI013, or 13 for short. They installed a transmitter in her belly and gave her a VHF radio frequency: 165.155 megahertz. Then they released her. The otter was now, in effect, her own small-wattage Alaska radio station. If you had the right kind of antenna and a receiver, you could launch a skiff into Kachemak Bay, lift the antenna and hunt the air for the music of her existence: an occasional ping in high C that was both solitary and reassuring amid the static of the wide world.

Otter 13, they soon learned, preferred the sheltered waters on the south side of Kachemak Bay. In Kasitsna Bay and Jakolof Bay, she whelped pups and clutched clams in her strong paws. She chewed off her tags. Some days, if you stood on the sand in Homer, you could glimpse her just beyond Bishop's Beach, her head as slick as a greaser's ducktail, wrapped in the bull kelp with other females and their pups.

"They're so cute, aren't they?" said the woman in the gold-rimmed eyeglasses. She was leaning over 13 as she said this, measuring a right forepaw with a small ruler. The otter's paw was raised to her head as if in greeting, or perhaps surrender.

"They're one of the few animals that are cute even when they're dead."

Two weeks earlier, salmon setnetters had found the otter on the beach on the far side of Barbara Point. The dying creature was too weak to remove a stone lodged in her jaws. Local officials gathered her up, and a quick look inside revealed the transmitter: 13 was a wild animal with a history.

This made her rare. She was placed on a fast ferry and then put in cold storage to await the attention of veterinary pathologist Kathy Burek, who now paused over her with a sympathetic voice and a scalpel of the size usually seen in human morgues.

Burek worked with short, sure draws of the knife. The otter opened.

"Wow, that's pretty interesting," Burek said. "Very marked edema over the right tarsus. But I don't see any fractures."

The room filled with the smell of low tide on a hot day, of past-expiration sirloin.

A visiting observer wobbled in his rubber clamming boots.

"The only shame is if you pass out where we can't find you," said Burek without looking up. She continued her exploration. "This animal has such dense fur. You can really miss something."

She made several confident strokes until the pelt came away in her hands, as if she were a host gently helping a dinner guest out of her coat. The only fur left on 13 was a small pair of mittens and the cap on her head, resembling a Russian trooper's flap-eared ushanka. (...)

Important work in Alaska

Burek often spends her days cutting up the wildest, largest, smallest, most charismatic and most ferocious creatures in Alaska, looking for what killed them. She's been on the job for more than 20 years, self-employed and working with just about every organization that oversees wildlife in Alaska. Until recently, she was the only board-certified anatomic pathologist in a state that's more than twice the size of Texas. (There's now one other, at the University of Alaska.)

She's still the only one who regularly heads into the field with her flensing knives and vials, harvesting samples that she'll later squint at under a microscope.

Nowhere in North America is this work more important than in the wilds of Alaska. Scientists say 2016 was the planet's hottest year on record, beating out 2015.

As human-generated greenhouse gases continue to trap heat in the world's oceans, air and ice, and carbon dioxide reaches its greatest atmospheric concentration in 800,000 years, the highest latitudes are warming twice as fast as the rest of the globe.

Alaska was so warm last winter that organizers of the Iditarod Trail Sled Dog Race hauled in snow from Fairbanks for the traditional start in Anchorage (though the snow was never used). The waters of the high Arctic may be nearly free of summertime ice in little more than two decades, something human eyes have never seen.

If Americans think about the defrosting northern icebox, they picture dog-paddling polar bears. This obscures much bigger changes at work. A great unraveling is underway as nature gropes for a new equilibrium.

Some species are finding that their traditional homes are disappearing, even while the north becomes more hospitable to new arrivals. On both sides of the Brooks Range — the spine of peaks that run 600 miles east to west across northern Alaska — the land is greening but also browning as tundra becomes shrub-land and trees die off. With these shifts in climate and vegetation, birds, rodents and other animals are on the march. Parasites and pathogens are hitching rides with these newcomers.

"The old saying was that our cold kept away the riffraff," one scientist told me. "That's not so true anymore."

During this epic reshuffle, strange events are the new normal. In Alaska's Arctic in summertime, tens of thousands of walruses haul out on shore, their usual ice floes gone. North of Canada, where the fabled Northwest Passage now melts out, satellite-tagged bowhead whales from the Atlantic and Pacific recently met for the first time since the start of the Holocene era.

These changes are openings for contagion. "Anytime you get an introduction of a new species to a new area, we always think of disease," Burek told me. "Is there going to be new disease that comes because there's new species there?"

A lot of research worldwide has focused on how climate change will increase disease transmission in tropical and even temperate climates, as with dengue fever in the American South. Far less attention has been paid to what will happen — indeed, is already happening — in the world's highest latitudes, and to the people who live there.

Put another way: The north isn't just warming. It has a fever.

She'll see epidemics first

This matters to you and me even if we live thousands of miles away, because what happens in the north won't stay there. Birds migrate. Disease spreads. The changes in Alaska are harbingers for what humans and animals may see elsewhere. It's the front line in climate change's transformation of the planet.

This is where Burek comes in. Fundamentally, a veterinary pathologist is a detective. Burek's city streets are the tissues of wild animals, her crime scenes the discolored and distended organs of tide-washed seals and emaciated wood bison.

"She's the one who's going to see changes," says Kathi Lefebvre, a lead research biologist at Seattle's Northwest Fisheries Science Center, a division of the National Oceanic and Atmospheric Administration, or NOAA. "She's the one who's going to see epidemics come along. And she's the one with the skills to diagnose things."

As the planet enters new waters, Burek's work has made her one of the lonely few at the bow, calling out the oddness she sees in the hope that we can dodge some of the melting icebergs in our path.

It's a career that long ago ceased to strike Burek as unusual, and she moves without flinching through a world tinged with blood and irony. The first time we spoke on the phone, Burek offhandedly said of herself and a colleague, "We've probably cut up more sea otters than anybody else on the planet."

"Congratulations," I said.

"We all got to brag about something," she replied. (...)

Surprisingly little is known about the diseases of wildlife. As a result, many veterinary pathologists end up focusing on a few species. Thanks to Burek's curiosity and her gifts, and to a necessary embrace of the Alaska virtue of do-it-yourself, her expertise is broad. "Anyone who gets into this kind of thing, you like a puzzle," she told me. "You have to pull together all kinds of little pieces of information to try to figure it out, and it's very, very challenging."

Over the years, Burek has peered inside just about every mammal that shows up in Alaska field guides. One morning, as we drank coffee at her kitchen table, she rattled off a few dozen examples. Coyotes. Polar bears. Dall sheep. Five species of seals. Many whales, including rare Stejneger's beaked whales.

As we talked, I wandered into the living room. On a wall not far from the wedding photos hung feathery baleen from the mouths of bowhead whales and the white scimitars of walrus tusks. Upstairs in a loft lay an oosik — the baculum, or penis bone, of another walrus. It was as long as a basketball player's tibia. Atop the fireplace mantel, where other families might display pictures of wattled grandparents, grinned a row of skulls: brown bear, lynx, wood bison. Burek tapped one of the skulls in a spot that looked honeycombed. "Abscessed tooth," she said. "Wolf. One of my cases."

Working on wild animals, often in situ, routinely presents her with job hazards that simply aren't found in the Lower 48.

Anchorage sits at the confluence of two long inlets. When Burek performs necropsies on whales on Turnagain Arm, she has to keep a sentry's eye on the horizon for its infamous bore tide, when tidal flow comes in as a standing wave, fast enough that it has outrun a galloping moose. Knik Arm is underlain in places by a fine glacial silt that, when wet, liquefies into a lethal quicksand. Burek's rule of thumb in the field is never to sink below her ankles. Not long ago, while taking samples from a deceased beluga, she kept slipping deeper. Exasperated, she finally climbed inside the whale and resumed cutting.

Then there's the problem of the whales themselves. "Whales are just like Crock-Pots," Burek said. "They're kind of encased in this thick layer of blubber that's designed to keep them warm. They might look OK on the outside, but inside everything is mush."

Decay is the nemesis of the pathologist. Decay erodes evidence. "Fresher is always better," Burek said, sounding like a discerning sushi chef. It isn't possible every time.

Colleagues told me about a trip with Burek to a remote beach outside Yakutat, to do a postmortem on a humpback. There were several in the group, including a government man with a shotgun to keep away the brown bears that sometimes try to dine on Burek's specimens. It was raining and cold, and the whale had been dead for a while. Inside, the organs were soup. The pilot who retrieved them had to wear a respirator.

"My wife," Henry told me, "has a high threshold for discomfort."

by Christopher Solomon, Alaska Dispatch | Read more:
Image: Joshua Corbett

[ed. One of my first jobs as a wildlife technician with the Alaska Dept. of Fish and Game involved retrieving, skinning, dismembering and incinerating a 700lb muskox that had died giving birth and been laying in the sun for a few days. It took me a week. Every day - all day - I was covered in blood, fat, hair and flies (talk about a motivation killer for the daily commute). Working alone in the autopsy lab (a large open air garage), it felt like I'd been transported into a horror movie (and won't even try to describe the smell). Kudos to folks like Kathy who get so little recognition but do the hard work that everyone needs to get done.] 

Sunday, March 26, 2017


Fritz Ruoff - Schwarz über Blau, 1967
via:

Sean Costello

The Great Forgetting

I'm the youngest by far of five children. My mother was 35 when she conceived me in 1951, so chagrined by this chronological indiscretion that she tried to hide the pregnancy from her sister. My mortified oldest brother didn’t want to tell his high-school friends that a new baby was on the way, but it was a small town. Word spread.

My mother’s age and my late arrival in the family felt burdensome to me too, especially when I started school in 1957 and met my classmates’ mothers. They were still having babies! Still piling their children into cars and heading off to picnics at the river or hikes into the lava-capped, wild flower-rampant plateau outside town. They still had to mediate hair-pulling and toy-snatching. But by the time I started first grade, my siblings were gone, the oldest three to college and the youngest to a residential school four hours away, and we went from a very noisy household to a very quiet one.

My family has told me stories about those years before everything changed. How my oldest brother nicknamed me ‘Ubangi’ because my hair grew in tight fat curls close to my head. How my other brother liked to ambush me around corners with a toy crocodile because it never failed to make me shriek in terror. How my oldest sister carried me around like a kangaroo with her joey. But I can offer very few stories of my own from those early years.

My strongest recollection is a constant straining to be with my brothers and sisters. I remember having to go to bed when it was still light out, kicking at the sheets as I listened for their voices coming down the hall or through the windows from the back yard. Sometimes I could smell popcorn. The next morning, I’d search the living room rug for their leftovers and roll the unpopped kernels around in my mouth. I do remember that, probably because it was something that played out night after night – our father loved popcorn.

Several years ago, I thought I might have the chance to recover that lost past when we were all tightly clustered together in one house. My brothers had driven to Bucks Lake up in the Sierras of northeastern California where, until I was around three years old, our family had leased a house every summer to escape the Sacramento Valley heat. They found our old cabin unchanged. Even a table built by a local sawmill was still in the living room. They knocked on the door and, weirdly enough, my younger brother knew the current lessee. He invited them in and then invited the rest of us back for a look.

With our father, we set off a few months later, up highways that narrowed into dusty roads through dark pines and past bright stony summits. When we got to the cabin, my siblings scattered to claim their favourite outdoor spots, but I was rooted near the car, struck by how much this place differed from what I thought I remembered.

I recalled that the water was a long walk across a sandy beach from the house; I had an image of my mother standing on that wide beach, her dress whipped by the wind, her hand cupped near her mouth. But the pebbled shoreline was just a few feet away. I recalled the spine of a dam jutting from the water not far from the house, a perilous and sudden cliff at the edge of the lake that my siblings had once ventured too close to. But even though the lake is a man-made one, the dam wasn’t visible from the house. I followed my father inside, where the tininess of the kitchen fascinated him. He kept opening cabinet doors and laughing as they banged each other in the narrow aisle. ‘Mother just hated this kitchen!’ he said. ‘She always made big breakfasts – eggs and sausage and pancakes – and as soon as she finished cleaning up, you kids would come running back in the house wanting lunch.’

I didn’t remember that. I didn’t remember the table. I didn’t remember anything about the place. My siblings tugged me through the house, pointing out where everyone had slept – they said I had been in a little alcove in the hallway, though I recalled staying in my parents’ room and watching them sleep in the early morning light. They pointed out other features tied to the life that we all lived in the cabin, eager for me to remember, but there was nothing. I even dropped to my knees and circled the living room at toddler level, peering at dusty windowsills and sniffing at the knotholes in the pine walls and running my fingers over the floorboards. Nothing.

I now know that it would have been unusual for me to remember anything from that time. Hardly any adult does. There is even a term for this – childhood amnesia, coined by Sigmund Freud in 1910 – to describe the lack of recall adults have of their first three or four years and our paucity of solid memories until around the age of seven. There has been some back and forth over a century of research about whether memories of these early years are tucked away in some part of our brains and need only a cue to be recovered. That’s what I was hoping when I revisited our old cabin with my siblings. I intended to jostle out a recalcitrant memory with the sights, sounds, smells and touch of the place. But research suggests that the memories we form in these early years simply disappear.

Freud argued that we repress our earliest memories because of sexual trauma but, until the 1980s, most researchers assumed that we retained no memories of early childhood because we created no memories – that events took place and passed without leaving a lasting imprint on our baby brains. Then in 1987, a study by the Emory University psychologist Robyn Fivush and her colleagues dispelled that misconception for good, showing that children who were just 2.5 years old could describe events from as far as six months into their past.

But what happens to those memories? Most of us assume that we can’t recall them as adults because they’re just too far back in our past to tug into the present, but this is not the case. We lose them when we’re still children. (...)

‘So much has to happen biologically to store a memory,’ the psychologist Patricia Bauer of Emory University told me. There’s ‘a race to get it stabilised and consolidated before you forget it. It’s like making Jell-O: you mix the stuff up, you put it in a mould, and you put it in the refrigerator to set, but your mould has a tiny hole in it. You just hope your Jell-O – your memory – gets set before it leaks out through that tiny hole.’

In addition, young children have a tenuous grip on chronology. They are years from mastering clocks and calendars, and thus have a hard time nailing an event to a specific time and place. They also don’t have the vocabulary to describe an event, and without that vocabulary, they can’t create the kind of causal narrative that Peterson found at the root of a solid memory. And they don’t have a greatly elaborated sense of self, which would encourage them to hoard and reconsider chunks of experience as part of a growing life-narrative.

Our first three to four years are the maddeningly, mysteriously blank opening pages to our story of self. As Freud said, childhood amnesia ‘veils our earliest youth from us and makes us strangers to it’. During that time, we transition from what my brother-in-law calls ‘a loaf of bread with a nervous system’ to sentient humans. If we can’t remember much of anything from those years – whether abuse or exuberant cherishing – does it matter what actually happened? If a tree fell in the forest of our early development and we didn’t have the brains and cognitive tools to stash the event in memory, did it still help shape who we are?

Bauer says yes. Even if we don’t remember early events, they leave an imprint on the way we understand and feel about ourselves, other people, and the greater world, for better or worse. We have elaborate concepts about birds, dogs, lakes and mountains, for example, even if we can’t recall the experiences that created those concepts. ‘You can’t remember going ice-skating with Uncle Henry, but you understand that skating and visiting relatives are fun,’ Bauer explained. ‘You have a feeling for how nice people are, how reliable they are. You might never be able to pinpoint how you learnt that, but it’s just something you know.’

And we are not the sum of our memories, or at least, not entirely. We are also the story we construct about ourselves, our personal narrative that interprets and assigns meaning to the things we do remember and the things other people tell us about ourselves.

by Kristen Ohlson, Aeon |  Read more:
Image: Kristin Ohlson