Category Archives: Vintage

Doctors Aren’t Really Very Smart About Buying Generics

Mother Jones

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Sarah Kliff takes a look today at our use of generic drugs. Long story short, it’s surprising how few of us save money by buying generic pain medicine instead of name brands (Advil, Tylenol, Bayer, etc.). Why? In most cases, I suppose it’s just ignorance: people don’t realize that the “store brand” is genuinely identical to the name brand. In other cases it might be something else. I buy generic ibuprofen, and it usually comes in the form of small brown pills. One day, however, I went to to a different drug store to stock up, and it turned out that their generic ibuprofen came in the form of small orange pills. Marian used these for a while, but really hated them. Eventually she cracked, and insisted on buying a new bottle from our usual drug store. Sometimes little things can make all the difference.

Anyway. The main point of Kliff’s post is that generics are good, and as evidence of this she puts up a chart showing what doctors themselves buy. Here’s an excerpt from the chart:

It’s true that doctors mostly favor generics when it comes to basic pain relievers. But frankly, what’s amazing to me is how little they prefer them. For chrissake, they prefer generic aspirin by only ten percentage points. That means they buy the name brand about 45 percent of the time. Why would a doctor do this? Granted, the extra few dollars is probably no big deal to them, but why waste it anyway? Certainly not because of ignorance. Are their spouses doing the buying? Or what?

And why the active preference for name-brand rubbing alcohol, of all things? It’s hard to think of anything more generic than that. What’s the deal here?

As for Alka-Seltzer, the dislike of generics is so huge that there just has to be some real difference here. But what?

In any case, I suspect this might have some real importance beyond the question of doctors spending a few dollars they don’t have to. If physicians aren’t really sold on generics in their own personal lives, does this mean they’re not really sold on them in their professional lives too? Do they tend to prescribe name brands when they shouldn’t? And how much does this cost all of us?

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Doctors Aren’t Really Very Smart About Buying Generics

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You’d Scream, Too, If You Were This Close to a Collapsing Iceberg

Mother Jones

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Climate change is melting ice at both ends of the planet—just ask the researchers who published two papers in May saying that a major expanses of antarctic ice are now undergoing a “continuous and rapid retreat” and may have “passed the point of no return.”

As the poles melt, icebergs are breaking off and drifting with greater ease, creating a world of problems for humans and animals alike. In Antarctica, warmer winters mean icebergs aren’t held in place as they once were, and are now colliding with the ocean floor more frequently, laying waste to a complex ecosystem. In Greenland, summer icebergs— like one twice the size of Manhattan that broke off 2012—can clog up shipping lanes and damage offshore oil platforms.

But whether climate change set it free or not, even a single ‘berg can be dangerous if you get too close, as this couple discovered when they took a look at one floating off the coast of Newfoundland, in eastern Canada.

h/t to Minnesota Public Radio News for finding this one.

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You’d Scream, Too, If You Were This Close to a Collapsing Iceberg

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Republicans Maybe Not as Inept as We Think

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Paul Waldman thinks Republicans have become a bunch of bumblers and idiots:

Think about it this way: Has there been a single instance in the last few years when you said, “Wow, the Republicans really played that one brilliantly”?

In fact, before you’ll find evidence of the ruthless Republican skillfulness so many of us had come to accept as the norm in a previous era, you’ll need to go back an entire decade to the 2004 election. George W. Bush’s second term was a disaster, Republicans lost both houses of Congress in 2006, they lost the White House in 2008, they decided to oppose health-care reform with everything they had and lost, they lost the 2012 election—and around it all they worked as hard as they could to alienate the fastest growing minority group in the country and make themselves seem utterly unfit to govern.

In fact, in the last ten years they’ve only had one major victory, the 2010 midterm election.

Hmmm. It’s true that the GOP has had a rough decade in a lot of ways. The number of self-IDed Republicans has plummeted since 2004; their standing among the fast-growing Hispanic population has cratered; and their intellectual core is now centered in a wing of the party that believes we should return to the gold standard. This isn’t a promising starting point for a conservative renaissance.

Still, let’s not kid ourselves. If Republicans were really as woefully inept as Waldman says, then Democrats should be kicking some serious ass these days. I haven’t especially noticed this. They won in the sixth year of Bush’s presidency, when out parties always win, and then won in 2008, when an economic collapse pretty much guaranteed a victory for anyone with a D after their name. Then they had a single fairly good year—followed by an epic blunder that lost them a sure seat in Massachusetts, and with it control of the Senate. They got crushed in 2010. They won a squeaker in 2012 against an opponent who made a wedding cake figurine look good by comparison. For the last four years, they’ve basically gotten nothing done at all.

And what about those Republicans? Well, they have a hammerlock on the House, and they might very well control the Senate after the 2014 election. They’ve won several notable Supreme Court victories (Heller, Citizens United, Hobby Lobby, etc.). They control a large majority of the states, and have passed a ton of conservative legislation in areas like voter ID and abortion restrictions. Their “Just Say No” strategy toward President Obama has tied Democrats in knots. They won an all but total victory on spending and deficits.

Nor is it really true that today’s GOP is notably more bumbling than it used to be. The myth of “ruthless Republican skillfulness” in the past is just that: a myth. George H.W. Bush screwed up on Supreme Court picks and tax hikes. Newt Gingrich—ahem—sure didn’t turn out to be the world historical strategic genius everyone thought he was in 1994. George W. Bush—with the eager backing of every Republican in the country—figured that a war in Iraq would be just the ticket to party dominance for a decade. Ditto for Social Security reform. Republicans were just sure that would be a winner. By contrast, their simpleminded Obama-era strategy of obstructing Democrats at all times and on all things has actually worked out pretty well for them given the hand they were dealt.

Make no mistake: It’s not as if Republicans have been strategic geniuses. There’s no question that they have some long-term issues that they’re unable to address thanks to their capitulation to tea party madness. But if they’re really so inept, how is it that in the past 15 years Democrats haven’t managed to cobble together anything more than about 18 months of modest success between 2009-10?

I dunno. Republicans keep getting crazier and crazier and more and more conservative, and liberals keep thinking that this time they’ve finally gone too far. I’ve thought this from time to time myself. And yet, moving steadily to the right has paid off pretty well for them over the past three decades, hasn’t it?

Maybe it will all come to tears in the near future as the lunatic wing of the party becomes even more lunatic, but we liberals have been thinking this for a long time. We haven’t been right yet.

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Republicans Maybe Not as Inept as We Think

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Paul Ryan’s Anti-Poverty Plan Would Cost Billions to Implement. Will GOPers Go for That?

Mother Jones

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When Rep. Paul Ryan (R-Wis.) laid out a new set of proposals to revamp the federal safety net during a speech on Thursday at the American Enterprise Institute, central to his vision was the idea of consolidating federal programs to create a “personalized, customized form of aid—one that recognizes both a person’s needs and their strengths—both the problem and the potential.”

The plan, wrapped in caring language about giving the poor individual attention, has earned plaudits from both the right and the left for avoiding partisanship and offering up a concrete idea that policy makers will have to take seriously. Liberals have given Ryan—an Ayn Rand devotee who on the campaign trail reduced American society to one of makers versus takers and whose budgets have proposed slashing millions in spending on the poor—credit for getting out of the office and spending some time with actual poor people during his year-long “listening tour,” whose genuine impact is evident in his proposal.

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Paul Ryan’s Anti-Poverty Plan Would Cost Billions to Implement. Will GOPers Go for That?

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Gruber: "It Was Just a Mistake"

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Why did Jonathan Gruber tell an audience in 2012 that states which failed to set up Obamacare exchanges would be depriving their residents of federal subsidies? Jonathan Cohn caught up with Gruber this morning and got an answer:

I honestly don’t remember why I said that. I was speaking off-the-cuff. It was just a mistake.

….There are few people who worked as closely with Obama administration and Congress as I did, and at no point was it ever even implied that there’d be differential tax credits based on whether the states set up their own exchange. And that was the basis of all the modeling I did, and that was the basis of any sensible analysis of this law that’s been done by any expert, left and right.

I didn’t assume every state would set up its own exchanges but I assumed that subsidies would be available in every state. It was never contemplated by anybody who modeled or worked on this law that availability of subsides would be conditional of who ran the exchanges.

So there you have it: Gruber screwed up. More importantly, as he points out, he’s performed immense amounts of technical modeling of Obamacare, and all of his models assumed that everyone would get subsidies even though not every state would set up its own exchange. As Cohn says, this was pretty much the unanimous belief of everyone involved:

As I’ve written before, I had literally hundreds of conversations with the people writing health care legislation in 2009 and 2010, including quite a few with Gruber. Like other journalists who were following the process closely, I never heard any of them suggest subsidies would not be available in states where officials decided not to operate their own marketplaces—a big deal that, surely, would have come up in conversation.

Kudos to Peter Suderman and his sleuths for uncovering this and getting everyone to talk about it for a day. It’s a news cycle win for conservatives. But restricting subsidies to state exchanges just flatly wasn’t part of Congress’s intent. There’s simply no way to rewrite history to make it seem like it was.

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Gruber: "It Was Just a Mistake"

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57 Percent of Republicans Want to Impeach Obama

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This is completely, barking insane:

I don’t even know how to react to this stuff anymore. A solid majority of Republicans wants to impeach President Obama for….what? An EPA regulation they don’t like? Postponing Obamacare’s employer mandate for a year? Not prosecuting some immigrant kids who have been in the country since they were three?

This goes beyond politics as usual. It’s nuts. Fox News is now officially in charge of one of America’s two major political parties.

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57 Percent of Republicans Want to Impeach Obama

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We’re Still at War: Photo of the Day for July 24, 2014

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US Navy sailors participate in a replenishment-at-sea on a scheduled deployment aboard the USS Oscar Austin guided-missile destroyer. (US Navy photo by Mass Communication Specialist 3rd Class DJ Revell.)

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We’re Still at War: Photo of the Day for July 24, 2014

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The NFL Was Harder on These 6 Players for Smoking Pot Than It Was on Ray Rice for His Assault Arrest

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The National Football League handed Baltimore Ravens running back Ray Rice an unexpectedly lenient punishment Thursday following his offseason arrest for assaulting his fiancée back in February: a two-game suspension for violating the league’s personal conduct policy. Rice allegedly hit Janay Palmer (now his wife) so hard she lost consciousness—and then security cameras caught him dragging her out of an elevator in Atlantic City. Aggravated assault charges eventually were dropped against both of them (Palmer allegedly hit Rice, too), and the two later held a bizarre joint press conference addressing the whole incident.

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The NFL Was Harder on These 6 Players for Smoking Pot Than It Was on Ray Rice for His Assault Arrest

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Another Casualty of the War on Terror: the Fifth Amendment

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This story first appeared on the TomDispatch website.

You can’t get more serious about protecting the people from their government than the Fifth Amendment to the Constitution, specifically in its most critical clause: “No person shall be… deprived of life, liberty, or property, without due process of law.” In 2011, the White House ordered the drone-killing of American citizen Anwar al-Awlaki without trial. It claimed this was a legal act it is prepared to repeat as necessary. Given the Fifth Amendment, how exactly was this justified? Thanks to a much contested, recently released but significantly redacted—about one-third of the text is missing—Justice Department white paper providing the basis for that extrajudicial killing, we finally know: the president in Post-Constitutional America is now officially judge, jury, and executioner.

Read Peter van Buren’s breakdown of the destruction of the Fourth Amendment.

Due Process in Constitutional America

Looking back on the violations of justice that characterized British rule in pre-Constitutional America, it is easy to see the Founders’ intent in creating the Fifth Amendment. A government’s ability to inflict harm on its people, whether by taking their lives, imprisoning them, or confiscating their property, was to be checked by due process.

Due process is the only requirement of government that is stated twice in the Constitution, signaling its importance. The Fifth Amendment imposed the due process requirement on the federal government, while the Fourteenth Amendment did the same for the states. Both offer a crucial promise to the people that fair procedures will remain available to challenge government actions. The broader concept of due process goes all the way back to the thirteenth-century Magna Carta.

Due process, as refined over the years by the Supreme Court, came to take two forms in Constitutional America. The first was procedural due process: people threatened by government actions that might potentially take away life, liberty, or possessions would have the right to defend themselves from a power that sought, whether for good reasons or bad, to deprive them of something important. American citizens were guaranteed their proverbial “day in court.”

The second type, substantive due process, was codified in 1938 to protect those rights so fundamental that they are implicit in liberty itself, even when not spelled out explicitly in the Constitution. Had the concept been in place at the time, a ready example would have been slavery. Though not specifically prohibited by the Constitution, it was on its face an affront to democracy. No court process could possibly have made slavery fair. The same held, for instance, for the “right” to an education, to have children, and so forth. Substantive due process is often invoked by supporters of same-sex unions, who assert that there is a fundamental right to marry. The meaning is crystal clear: there is an inherent, moral sense of “due process” applicable to government actions against any citizen and it cannot be done away with legally. Any law that attempts to interfere with such rights is inherently unconstitutional.

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Another Casualty of the War on Terror: the Fifth Amendment

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Boy, Hipsters Sure Are Defensive About Their Almond Milk

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When I penned my little opus about almond milk last week, I really didn’t intend to insult anyone’s intelligence, provocative headline aside. What I really wanted to do was encourage people to think about what they’re buying when they buy this hot-selling product. My editors chose the title and I went along, because they know more than me about what makes people click. And people clicked! I’m pretty sure that “Lay Off the Almond Milk, You Ignorant Hipsters” is my most-read piece ever at Mother Jones.

It takes a gallon of water to grow a single almond. How does an almond’s water footprint stack up to other foods’?

Reactions mostly hovered in a range between mild annoyance and blind rage. One guy dropped by the Facebook page of the farm I helped found, Maverick Farms, to inform me that he planned to keep drinking almond milk—and spilling it, even. To drive his point home, he even looked up the farm’s phone number and repeated his pledge on the answering machine. Thanks for the update!

The oddest response came from Gawker’s Hamilton Nolan, who took the opportunity to school me in the art of the “food troll”:

This fool is talking about how almond milk is not as good as just eating almonds. False comparison. I eat tons of almonds. Love em. And I drink almond milk too. Love it. I can have both. You love regular almonds so much? Do you eat more almonds than me? Not a chance. I eat more almonds than you. And still drink almond milk. Case closed on that particular argument I guess.

Still not convinced? Nolan adds the coup de grace: “If I puked up almond milk it probably wouldn’t even taste that bad relative to other kinds of puke.”

Right. Meanwhile, several people thundered that since I dare question the value of almond milk, I must be a tool for Big Dairy. “Were you paid off by the Dairy Farmers of America to write that piece?” one wag wondered on Twitter, adding, helpfully ” PS I’m no hipster and I love my Almond Milk!”

Actually, my piece did not purport to judge almond milk against the standards of dairy milk and find it wanting. “I get why people are switching away from dairy milk, I wrote, since “industrial-scale dairy production is a pretty nasty business.” I did cop to drinking a bit of kefir, a fermented milk product. But my intention wasn’t to promote Big Dairy, but just to point out that almond milk is nutritionally pretty vapid compared to other products. An eight-ounce serving of Helios brand organic kefir contains 16 grams of protein, vs. 1 gram per serving in most almond milk brands. That’s a remarkable difference. But of course, people consume things for all sorts of good reasons, not just protein content.

Now, I didn’t get into much of an ecological analysis in my piece, but there is an interesting one to make here. Back in May, my colleagues Julia Lurie and Alex Park looked at the literature and found that it takes 23 gallons of water to produce a glass of almond milk and 35 gallons to produce a serving of yogurt. Let’s assume that it takes a similar amount of water to make Helios kefir, which is essentially fermented skim milk. On the surface, the almond milk looks a lot easier on the water supply. But if you look at it on a protein basis, almond milk looks like a disaster: it takes 23 gallons of water to produce a gram of almond milk protein—and less than two gallons to produce a gram of kefir protein.

Even though kefir costs more than $4 per quart vs. about $2 for almond milk, it starts to look like quite a bargain on a protein basis.

Almond milk’s dilute nature lies at the heart of the critique made by Slate’s Maria Dolan, the most thoughtful one I’ve seen of the piece. My basic complaint against almond milk is that it’s a watered-down product: you take something that’s quite nutrient-dense and deluge it with water, essentially selling people a few almonds and a lot of water.

I’m thinking about it in the wrong way, counters Dolan. “Is drowning them in water to create almond milk really a bad thing from an environmental perspective?” she asks. “Just as making meat a garnish, not the centerpiece of your meal, thins the environmental impact of eating beef, so consuming almonds sparingly—by diluting them into milk, for instance—reduces their ecological impact.”

But I’m not sure that almond milk works to moderate people’s almond consumption. California’s rapid, and ecologically troubling, expansion of almond production is largely driven by booming exports, mainly to Asia. But US consumption is booming too. According to the Almond Board of California, the US market consumed 394 million pounds of almonds from the 2007-’08 harvest and 605 million pounds in 2012-’13. That’s a 50 percent jump in five years. And as I noted in my post, almond milk sales are surging at an even faster clip. It seems to me that the almond milk craze, whatever else it is, reflects a clever food industry strategy to sell yet more almonds, not a way for consumers to reduce their environmental impact.

The Almond Board also reports that California now provides 84 percent of the globe’s almonds. Given the state’s severe water constraints, and that current levels of production already require 60 percent of managed US honeybees for pollination, often to disastrous effect, we may all have to ease up—not just on the almond milk, but also on almonds themselves. Hell, even ignorant hipsters like me love almonds.

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Boy, Hipsters Sure Are Defensive About Their Almond Milk

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