Ebola Spreads To Nurse and Is Affecting Chocolate Supplies (Updated)

It has been a day for bad news related to Ebola. The more serious concern is the apparent transmission of Ebola to a nurse caring for the patient in Texas despite wearing protective gear. It is of concern that these precautions did not prevent the spread to this individual (although it now is reported to have been due to a breach in protocol), but it is at least encouraging that surveillance efforts were successful and the person was quickly identified and precautions taken against further spread.

John McCain, a member of the party which has been protesting the number of czars in the Obama administration, has now called for an Ebola Czar. Perhaps as a first step, the Republicans should reconsider their actions in blocking the appointment of Obama’s nominee as Surgeon General.

On top of this is the news that Ebola could affect supplies of chocolate:

Ebola is threatening much of the world’s chocolate supply.

Ivory Coast, the world’s largest producer of cacao, the raw ingredient in M&M’s, Butterfingers and Snickers Bars, has shut down its borders with Liberia and Guinea, putting a major crimp on the workforce needed to pick the beans that end up in chocolate bars and other treats just as the harvest season begins. The West African nation of about 20 million — also known as Côte D’Ivoire — has yet to experience a single case of Ebola, but the outbreak already could raise prices…

The market is worried, too. Prices on cocoa futures jumped from their normal trading range of $2,000 to $2,700 per ton, to as high as $3,400 in September over concerns about the spread of Ebola to Côte D’Ivoire, noted Jack Scoville, an analyst and vice president at the Chicago-based Price Futures Group. Since then, prices have yo-yoed down to $3,030 and then back to $3,155 in the past couple of weeks.

While not yet time to panic, are we now in danger of seeing riots at the supermarkets and hoarding of chocolate?

(Original post updated with further information on the case in Texas and John McCain’s call for an Ebola Czar.)

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Bill Maher Reconsidering Idea Of Voting For Rand Paul Due To His Denial Of Climate Change

Bill Maher has previously said he might consider voting for Rand Paul if he were to run against Hillary Clinton for president in 2016. It is certainly understandable why someone might give this a thought in light of Clinton’s hawkish foreign policy views but this idea breaks down with a closer look at Rand Paul. Maher found that Paul is not as anti-war as he would prefer, but another issue is a real deal-breaker:

Maher said he was most attracted to Paul because of the senator’s general views on foreign policy, though he’s not a fan of his recent support for bombing ISIS.

“He’s great on ending the empire, not getting into any more foreign entanglements — I’m even to the left of him on the bombing (of ISIS); he wants to keep bombing ISIS, I want us to stop bombing altogether,” he said.

While Maher donated $1 million to a super PAC backing President Barack Obama in 2012, he has been less than enthusiastic about a potential Clinton presidency, especially when it comes to her foreign policy.

But Maher told Salon there’s stark daylight between him and Paul on a different issue.

“I had drinks with him about two weeks ago. He’s a nice guy, he’s a smart guy. My big problem is I asked him about the environment, which is my big issue,” Maher said. “He had made a comment that was very similar to what Dick Cheney said about a month or two ago, which was basically, ‘Why are we talking the environment when ISIS is out there?’ I said, ‘Senator, y’know, you sounded just like Dick Cheney.’ “

Last month, Paul blasted Clinton for saying climate change marked the “most consequential, urgent, sweeping collection of challenges we face.”

“I don’t think we really want a commander in chief who’s battling climate change instead of terrorism,” Paul said on Fox News.

Maher said that Paul’s answer on the environment was “wholly unsatisfactory” and that the senator would lose his vote based entirely on that issue unless Paul comes up with a better answer.

“This is the deal-breaker issue with me. You’ve got to be good on this or, I’m sorry, not going to happen,” Maher said.

In an ideal world, we would be able to exclude someone such as Hillary Clinton who backed the Iraq war with claims of a connection between Sadaam and al Qaeda. However in such an ideal world, we would also not have a major political party which denies science, including the scientific consensus on climate change. In addition to drumming up fear about terrorism, it makes no sense to say we cannot deal with climate change due to the presence of another problem. It is as if Paul and Cheney are unable to walk and chew gum at the same time.

Salon has more on Rand Paul’s anti-scientific views, related to both climate change and Ebola:

In a breathless “exclusive,” Breitbart News revealed that Paul thinks the Obama administration is misleading the public about the nature of the threat and how the disease is spread. “They’re downplaying and underplaying the risk of this,” Paul claimed. “They keep emphasizing that it’s so hard to transmit. Well if it’s so hard to transmit why are doctors getting it with masks, gloves, boots and hats—the whole works?”

You might think an ophthalmologist (though he’s not board certified) would be more responsible about spreading health panic. But you’d be wrong. “Could we have a worldwide pandemic? The Spanish flu in 1918 killed 21 million people, the plague in the 14th century killed 25 million people; I’m not saying that’s going to happen, I don’t know what’s going to happen. But I think we should have travel restrictions at this point in time coming from Africa,” Paul added.

Health experts shot Paul down almost immediately. “I don’t think that there’s data to tell us that that’s a correct statement, with all due respect,” NIH veteran Dr. Anthony Fauci told CBS’s “Face the Nation.” “We have had experience since 1976 with how Ebola is transmitted. And it is clear that it’s transmitted by direct contact with body fluids, blood, diarrhea, vomit, or what have you.

“And there’s no indication that there is another insidious way that it’s transmitted that we’re missing because of the experience that we’ve had. So, we’ve really gotta go with the evidence base. There’s always hypothesis and surmising about that, but there’s no scientific evidence,” Fauci added.

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Response To Republican Support For Making Birth Control Pills Available Over The Counter

While Republicans have generally been trying to restrict access to contraception, recently some Republicans have been promoting making oral contraceptives available over the counter without prescription. Many people quickly saw through this. It gives the Republicans a way to claim they are removing a barrier to receiving contraception and avoid situations like the Lobby Hobby case. It also does something else–make contraception less accessible for many women. While the Affordable Car Act requires that contraception be covered without out-of-pocket expense to the woman, many insurance plans do not cover over the counter medications. This is also an incomplete response to the issue as there are many other types of birth control, including forms which many Republicans are attempting to restrict.

The Guttmacher Institute issues a statement regarding this topic (via Talking Points Memo):

Birth Control Pills Should Be Available Over the Counter, But That’s No Substitute for Contraceptive Coverage

September 11, 2014

By Adam Sonfield and Sneha Barot, Guttmacher Institute

In recent weeks, some opponents of the Affordable Care Act’s (ACA) contraceptive coverage guarantee have promoted the idea that oral contraceptive pills should be available to adult women without a prescription. Sens. Kelly Ayotte (R-NH) and Mitch McConnell (R-KY), for example, recently introduced the so-called Preserving Religious Freedom and a Woman’s Access to Contraception Act, a bill that would urge the Food and Drug Administration (FDA) to study whether to make contraceptives over the counter (OTC)—though for adults only.

Making birth control pills available over the counter, if done right, would meaningfully improve access for some groups of women. However, such a change is no substitute for public and private insurance coverage of contraceptives—let alone justification for rolling back coverage of all contraceptive methods and related services for the millions of women who currently have it.

The Policy Behind Over-The Counter Contraception
Making birth control pills available OTC has merit, and the Guttmacher Institute is part of a coalition that has been working toward this goal for years. Leading medical groups have also endorsed such a move, including the American Medical Association and the American Congress of Obstetricians and Gynecologists. By removing the need to obtain a prescription, OTC status would eliminate this potential barrier to contraceptive use and thereby increase access.

This is especially true for uninsured women and those who don’t have time for a doctor’s visit or otherwise can’t readily reach a health care provider. However, if the goal is to truly expand access to contraceptive care—and not just provide cover for undercutting insurance coverage for contraceptives—the case to move birth control pills to OTC status should proceed alongside several other important policies and goals:

Protect contraceptive coverage and full method choice: The ACA requires most private health plans to cover the full range of women’s contraceptive methods and services, without out-of-pocket costs for the patient. This policy eliminates cost as a barrier to women’s ability to choose the method that is best for them at any given point in their lives, an approach that has been proven to make a substantial difference in facilitating access to and use of contraceptive services.

Contrary to what some policymakers and commenters have claimed, giving the pill OTC status would not be an effective substitute for the ACA policy. First, it would do nothing to help women access any contraceptive method other than the pill. This matters, since most women use four or more different contraceptive methods over their lifetime to meet their changing needs. If only the pill were available OTC and contraceptives were no longer covered by insurance, women would face significant new barriers in choosing the method that best suited their needs. Cost is a particularly steep barrier for highly effective methods like the IUD or implant that not only have high upfront expenses, but also require a trained provider for insertion and therefore are not candidates for OTC status.

Even for the pill itself, there is no convincing evidence to suggest that moving it to OTC status would substantially lower out-of-pocket costs to patients, let alone come close to the $0 out-of-pocket cost guaranteed under the ACA policy. Rather, making the pill available OTC, if done at the expense of insurance coverage, would replace one barrier (ease of access) with another (cost). Likewise, greater reliance on Health Savings Accounts or Flexible Spending Accounts, as some opponents of insurance coverage have proposed, would also merely replace full insurance coverage with patient out-of-pocket costs—leaving most privately insured women, particularly low-income women, worse off. Uninsured women on average pay $370 for a full year’s supply of the pill, the equivalent of 51 hours of work at the federal minimum wage of $7.25.

Millions of women already benefit from the ACA’s contraceptive coverage guarantee and these hard-won gains must be protected. Rather than substituting for contraceptive coverage of all methods and related services, OTC status for birth control pills should complement and enhance such coverage.

Strengthen coverage for over-the-counter methods: While the ACA’s preventive care provision specifically requires private health plans to cover certain products with over-the-counter status (including the emergency contraceptive Plan B, folic acid, aspirin to prevent heart disease and tobacco use cessation products), a prescription is needed for these items to be covered—essentially negating the benefits of OTC status. This prescription requirement should be eliminated for any current and future over-the counter contraceptives. Coverage of over-the-counter products without a prescription is already the norm in some state Medicaid programs and in the U.S. military’s Tricare insurance program. Further, ensuring full coverage for over-the-counter contraceptives would prevent “free-riding” by insurance companies that benefit from not having to cover pregnancies that were averted through patient out-of-pocket expenditures.

Ensure equal access for young women: Adolescents and young women, who face greater risk of unintended pregnancy and more barriers to accessing contraception than older women, have among the most to gain from a switch to OTC status. However, recent calls to give birth control pills OTC status as a substitute for contraceptive coverage have specifically excluded minors. That would require women 17 and younger to obtain a prescription, without providing any medical evidence to justify such restrictions. This approach would be harmful to adolescent women and would be counterproductive to helping them avoid unplanned pregnancies and the negative health, social and economic consequences that often follow.

In addition, excluding minors would likely not result in a true over-the-counter status, but instead could put contraceptive pills behind the counter, much as happened when the emergency contraceptive Plan B was first approved for OTC sales. To comply with an age restriction, stores would have to require proof of age via a valid picture ID from any woman who looks young enough to potentially be barred from purchasing birth control pills without a prescription. This would be an added hurdle for millions of women, and it ignores the reality that many young women do not have government-issued forms of photo ID.

Keep politics out of FDA decision making: To switch any drug to OTC status, the typical process involves the drug’s manufacturer submitting an application to the Food and Drug Administration (FDA), which—based on several criteria, including the safety and efficacy profile of the medication—decides whether to grant the request. The evidence is quite strong that providing birth control pills OTC would be safe and effective, including for minors. The FDA process should be driven by the evidence and free from political interference by the administration, Congress and others.

It is troubling but not at all surprising that Senator Ayotte and others who purport to be interested in contraceptive access would preempt the FDA with unfounded calls to bar minors from benefiting from any future OTC status for birth control pills. This echoes the longtime political and legal wrangling over minors’ access to OTC emergency contraceptive pills, despite clear evidence that minors could safely use these products without a prescription.

It is also noteworthy that there are dozens of brands and formulations of birth control pills, most of which would likely have to undergo the lengthy and expensive FDA process to gain OTC status separately. Because formulations of the pill are not medically interchangeable, with some women tolerating specific pills better than others, making one or several versions of the birth control pill available OTC would not benefit all current pill users.

Not A One-Size-Fits-All Policy Solution
Just as birth control methods are not “one size fits all” at any point in a woman’s life, let alone for all of her reproductive years, neither is there a one-size-fits-all policy solution to enhance access to the full range of methods, information and services for women of all ages and income levels, regardless of where they obtain their care. A wide range of approaches is necessary to meaningfully respond to women’s family planning needs in a comprehensive way.

One such approach includes making birth control pills available over-the-counter, if done so without additional costs or barriers to women. Doing so can complement and enhance current efforts to help more women become effective contraceptive users, including the ACA’s significant gains for comprehensive private and public insurance coverage for contraceptive counseling, services and supplies.

If anything, contraceptive coverage should be broadened to cover more women and strengthened to eliminate the prescription requirement for OTC methods that are covered. Other urgent priorities include expanded access to Medicaid, public support for safety-net family planning centers and the Title X national family planning program, comprehensive sex education and the development of new contraceptive technologies.

Truly increasing access to contraceptive care requires a multifaceted approach to meet the needs of all women throughout their reproductive lives. Political talking points will not do it.

This article was originally published on Health Affairs Blog at this link.

Click here for a recent statement from the American Congress of Obstetricians and Gynecologists (ACOG) supporting over-the-counter access to birth control pills as part of a broader dialogue about improving women’s health care as opposed to a political tool.

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Big Hype For Apple Today

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There was certainly a lot of ridiculous hype today. Apple had their big announcement that their phone and watch can now do what Android devices could do for months, if not years, as long as you don’t want the freedom to configure things the way you want them to work, as opposed to how Apple thinks your devices should work. They were even doing their own live tweeting of the event, showing what control freaks they are.

There might have been a time when Apple was on the leading edge. Now they are just charging more for old tech which has an Apple logo on it. The Apple watch will start at $349–well more than the cost of my Sony Smartwatch II, even with the more expensive metal wrist band. The only real surprise was that the watch will be called the Apple Watch and not iWatch.

When I first responded to the event on Facebook and Twitter as the news came in, I did get a comment questioning the value of a smartwatch. I’ve been using a smartwatch for over two years and do find it to be of value, but I suspect that the majority of people do have little real need for one.

For me, the smartwatch essentially replaces my beeper. I receive many messages a day on my phone, including Facebook notifications, personal text messages, news bulletins, along with messages from the hospital or answering service which previously went over a pager. I need to both make sure I don’t miss any important messages, and know when an incoming message is important enough to respond to immediately versus letting it sit on the phone.

The smartwatch allows me to very quickly see whether an incoming message is urgent, and is far more discreet to check than pulling out a phone every time it vibrates. In some situations this is especially important, such as in a dark movie theater where it would be awkward to turn on the phone every time a message comes in. It also comes in handy if at the pool. I can put my phone safely in a nearby bag, and pick up messages on my waterproof smartwatch. In the event anyone does see me checking messages, people tend to think it is cool to see a message come in over a watch due to the novelty factor, while it often looks tacky to look at a phone when with other people.

Under some situations I just want to use the watch to monitor for important messages. At other times I can read more. This includes text messages, email, RSS feeds, and any notifications which a smartphone app can make.

Plus my smartwatch has an advantage which the Apple Watch does not–it is connected by blue tooth to an Android phone.

Of course there are many other things it can do. Some try to respond to tweets on their smart watch, but personally I think that if you are actually following an ongoing discussion, and especially if you want to type responses, at that point it makes more sense to just use your watch. (I also prefer to use a blue tooth keyboard if doing very much typing). Fitness apps are popular on Android smartwatches and I’m sure that many will use them on the Apple Watch. Some use their watch for fitness apps which track their foot steps every day but I found a limitation to this. I sometimes take the phone out of my pocket to charge during the day, preventing a complete count. While my LG G3 will generally last all day, I hear bigger fears that the iPhones will not do so, and changing the battery during the day is not an option as on many Android phones.

While certainly not essential, my smartwatch will also tell me the weather and remotely control my phone. I haven’t yet used the apps to remotely see the view screen of the camera or take pictures, but I can see situations where this might come in handy. I do use it to remotely control music sent from my phone to a blue tooth speaker. I have impressed friends over for football games when, after a score, I tap my watch and a speaker across the room starts playing Hail to the Victors. Sadly, for the first time since 1984, there was no opportunity to do this last Saturday.

Update: Reading more about the Apple Phone, it does look like some of the fitness/health capabilities are beyond what is currently available for Android. Of course, by the time the Apple Watch makes it to market, there are likely to be even more advanced Android apps. Plus, trusting your private health information with Apple sounds as sensible as sharing your nude selfies with them. Just ask Jennifer Lawrence.

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Study Shows Reduction In Opioid Overdoses By 25% In States Which Have Legalized Medical Marijuana

A major problem with narcotic pain medications is the risk of overdose. This problem has led to the DEA announcing last week that hydrocodone combination pain medications such as Norco and Vicodin are being reclassified as Schedule II narcotics, with additional restrictions being placed upon prescribing them. Any measures to help control chronic pain while reducing the incidence of overdose would certainly be welcome. The August 25, 2014 issue of JAMA Internal Medicine presents a study of states which have legalized medical marijuana, showing a reduction in opioid overdoses by almost 25 percent:

Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time…

The study did not indicate the cause of this association. It is speculated that some people with chronic pain might use less opioid when medical marijuana is available. More study is needed to confirm this, but considering the problems faced with opioid overdoses, marijuana should be considered as an alternative. At very least, when considering any potential adverse consequences to legalization of medical marijuana, it must be kept in mind that the currently used medications for chronic pain do have a serious potential for adverse effects themselves.

Marijuana is now classified as a Schedule I drug which prevents prescribing it. (In states where medical marijuana is legal, the change in the law protects those using it from prosecution but marijuana still cannot be prescribed). Many have already questioned the classification of marijuana as a Schedule I drug as it appears to show less risk of problems from overdose compared to current Schedule II and Schedule III drugs. This study suggests that marijuana might also help protect against some of the adverse effects of narcotics.

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Decriminalization of Prostitution Led To Reduction In Rape And Gonorrhea

An unintended experiment in Rhode Island found that when prostitution conducted indoors  was decriminalized due to a loophole in the law, there was a decrease in rape and cases of gonorrhea. The Wall Street Journal reports:

A loophole in Rhode Island law that effectively decriminalized indoor prostitution in 2003 also led to significant decreases in rape and gonorrhea in the state, according to a new analysis published by the National Bureau of Economic Research.

“The results suggest that decriminalization could have potentially large social benefits for the population at large – not just sex market participants,” wrote economists Scott Cunningham of Baylor University and Manisha Shah of the University of California, Los Angeles, in a working paper issued this month.

Mr. Cunningham and Ms. Shah got an opportunity to study the effects of decriminalized prostitution on crime and public health because Rhode Island lawmakers made a mistake. A 1980 change to state law dealing with street solicitation also deleted the ban on prostitution itself, in effect making the act legal if it took place indoors. The loophole apparently went unnoticed until a 2003 court decision, and remained open until indoor prostitution was banned again in 2009.

As you might expect, the economists found that decriminalizing indoor prostitution was a boon to the sex business. “Decriminalization decreased prostitute arrests, increased indoor prostitution advertising and expanded the size of the indoor prostitution market itself,” they wrote.

Rhode Island also saw “a large decrease in rapes” after 2003, while other crimes saw no such trend in the state, they wrote. There also was “a large reduction in gonorrhea incidence post-2003 for women and men,” they wrote.

The economists then used several economic models to track the decriminalization’s effects versus other possible causes. They found “robust evidence across all models that decriminalization caused rape offenses and gonorrhea incidence to decrease.” One model estimated a 31% decrease in per-capita rape offenses and a 39% decrease in per-capita female gonorrhea cases due to the decriminalization of indoor prostitution.

This sounds like a strong argument for decriminalizing prostitution.

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Doctors No Longer Strong Republicans

JAMA Internal Medicine has some data which I would have predicted–doctors are less likely to support Republicans now than in the past. The data is based upon campaign contributions and therefore has no data regarding reasons for the change. This data would not include contributions under $200 and it is not known if those making smaller donations differ from the larger, reportable contributions.

The study found that since 1996 contributions to Republicans by physicians have decreased, dropping to under 50 percent leading up to the 2008 election. Many of the results suggest that doctors are contributing based upon factors comparable to the general population. This includes a significant gender gap with 57 percent of men and 31 percent of women contributing to Republicans over the entire study period. Leading up to the 2012 election, 52.3 percent of male physicians contributed to Republicans and 23.6 percent of female physicians contributed to Republicans.

I am apparently an exception to the trend that male physicians and physicians in solo or small practices are more likely to contribute to Republicans. Another trend mirrors the general population with those earning more being more likely to contribute to Republicans.

Overall the trend against support for Republicans is similar to the overall trend for more highly educated people to be less likely to support Republicans. The education in science might make many physicians more likely to reject Republicans in recent years as scientists have tended to oppose Republicans. Many people trained in science would have a difficult time supporting a party in which many believe in creationism, and most reject the view of 97 percent of climate scientists on global warming.

The study is unable to determine whether medically related issues have any bearing on the results. Democrats have been far more supportive of health care in recent years, but I also find that many of my colleagues get their news from Fox and have the same misconceptions about the Affordable Care Act and other issues as Republicans in general have. On the other hand, many physicians, along with many physician organizations, have been highly supportive of Obamacare after having seen the serious problems in health care delivery in this country. Republican policies would also be terrible for the future of Medicare, but I’m not sure how widespread this realization is among physicians.

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Increased Health Care Spending Just Might Be Buying Higher Quality Care

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Jonathan Cohn has looked at what appears to be a recent increase in health care spending (national health expenditures in the above graph) after a period of decline. Most likely this is due to a variety of reasons, and I don’t find it surprising that a period of decreased spending would be followed by increased spending. This is partially a sign of an improving economy as people are less likely to put off spending on medical problems when they have more money available. The increase in people covered by insurance this year due to the Affordable Care Act should lead to a further increase in spending, but this spending is desirable

Cohn looked at a variety of possible causes but didn’t hit on the key point that increases in medical spending might not necessarily be a bad thing until late in the article:

It’s not always the case that spending more on health care is a bad thing. New or more treatments might alleviate suffering, reduce disability, or extend life—all of which have value. Providing insurance to more people, so that they are more secure financially, also has value. The reason to worry about high health care spending is that the extra money America spends doesn’t actually seem to buy America better health care. But, over the long run, the real goal of health care reforms should be a combination of restraining costs and improving quality.

Traditionally it has been true that we could not see benefits from increased spending compared to other countries, but there are factors in health care which could currently be causing increased spending compared to previous spending in the United States as well as increased quality. There has been a push for Medical Homes, increased payment for primary care services, and for increased attempts at payment of doctors based upon performance as opposed to fee for service alone. If doctors are given incentives to screen more for elevated cholesterol and do more to treat diabetic patients this would lead to increased spending, with this spending being beneficial.

Contrary to the argument that we were not seeing quality for our past spending, The New England Journal of Medicine reports this week that complications among diabetic patients have decreased between 1990 and 2010. The Annals of Internal Medicine also reports that between 1999 and 2010 the number diabetics has increased, with a decrease in the number who have the disease but are undiagnosed, and that treatment has improved. Both having more diabetic patients and providing treatment which results in better control is going to cost more money. It is too soon to have any data to see if there is a correlation between increased spending over the past year and quality of care, but I do wonder to what degree the trends I noted in the above paragraph are contributing to higher costs and how this might correspond with further improvements in the quality of care.

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Another Study Showing No Medical Benefits From Prayer

Periodically there have been reports in which someone actually bothered to compare medical outcomes with and without prayer. As expected, no benefit was found from situations in which someone was praying for someone else without their knowledge (to remove any psychological benefits). Irregular Times has reported on another study:

Does prayer really work wonders? Not according to epidemiologst Maria Inês da Rosa.

Da Rosa and her research team published results of a double-blind randomized trial in the Brazilian Journal of Science and Public Health last year. Half of the more than five hundred pregnant women in the trial had their health prayed for from a distance by a prayer team. The other half received no such prayers. When Da Rosa’s team measured the apgar scores, type of delivery and birth weight of the two groups, there was no difference in pregnancy outcomes.

A few years ago, intercessory prayer researchers were promising a golden age in which they would supposedly prove the effectiveness of their religion. That’s not happening. Careful science is establishing the opposite.

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The Success Of The Stimulus

Barack Obama’s economic stimulus was launched five years ago. Regardless of how successful it turned out to be, conservatives would attack it in order to try to avoid giving Obama credit for reversing the economic problems created by George Bush and Republican economic ideas. Michael Grunwald looked at the report from the Council of Economic Advisers on the success of the stimulus, finding that its report is consistent with other reports on economic improvement:

The main conclusion of the 70-page report — the White House gave me an advance draft — is that the Recovery Act increased U.S. GDP by roughly 2 to 2.5 percentage points from late 2009 through mid-2011, keeping us out of a double-dip recession. It added about 6 million “job years” (a full-time job for a full year) through the end of 2012. If you combine the Recovery Act with a series of follow-up measures, including unemployment-insurance extensions, small-business tax cuts and payroll tax cuts, the Administration’s fiscal stimulus produced a 2% to 3% increase in GDP in every quarter from late 2009 through 2012, and 9 million extra job years, according to the report.

The White House, of course, is not an objective source — Council of Economic Advisers chair Jason Furman, who oversaw the report, helped assemble the Recovery Act — but its estimates are in line with work by the nonpartisan Congressional Budget Office and a variety of private-sector analysts. Before Obama took office, it would have been a truism to assert that stimulus packages stimulate the economy: every 2008 presidential candidate proposed a stimulus, and Mitt Romney’s proposal was the most aggressive. In January 2009, House Republicans (including Paul Ryan) voted for a $715 billion stimulus bill that was almost as expansive as Obama’s. But even though the stimulus has been a partisan political football for the past five years, that truism still holds.

The report also estimates that the Recovery Act’s aid to victims of the Great Recession — in the form of expanded food stamps, earned-income tax credits, unemployment benefits and much more — directly prevented 5.3 million people from slipping below the poverty line. It also improved nearly 42,000 miles of roads, repaired over 2,700 bridges, funded 12,220 transit vehicles, improved more than 3,000 water projects and provided tax cuts to 160 million American workers.

My obsession with the stimulus has focused less on its short-term economic jolt than its long-term policy revolution: I wrote an article about it for TIME titled “How the Stimulus Is Changing America” and a book about it called The New New Deal. The Recovery Act jump-started clean energy in America, financing unprecedented investments in wind, solar, geothermal and other renewable sources of electricity. It advanced biofuels, electric vehicles and energy efficiency in every imaginable form. It helped fund the factories to build all that green stuff in the U.S., and research into the green technologies of tomorrow. It’s the reason U.S. wind production has increased 145% since 2008 and solar installations have increased more than 1,200%. The stimulus is also the reason the use of electronic medical records has more than doubled in doctors’ offices and almost quintupled in hospitals. It improved more than 110,000 miles of broadband infrastructure. It launched Race to the Top, the most ambitious national education reform in decades.

At a ceremony Thursday in the Mojave Desert, Energy Secretary Ernest Moniz dedicated the world’s largest solar plant, a billion-dollar stimulus project funded by the same loan program that financed the notorious Solyndra factory. It will be providing clean energy to 94,000 homes long after Solyndra has been forgotten. Unfortunately, the only long-term effect of the Recovery Act that’s gotten much attention has been its long-term effect on national deficits and debts. As the White House report makes clear, that effect is negligible. The overwhelming majority of the Recovery Act’s dollars have gone out the door; it’s no longer adding to the deficit. It did add about 0.1% to our 75-year debt projections, but allowing the economy to slip into a depression would have added a lot more debt.

Grunwald did warn of the political ramifications. As conservatives have convinced themselves that economic stimulus doesn’t work as a knee jerk reaction to anything proposed by Obama, politicians are likely to shy away from stimulus when needed in the future, following the European mistakes in promoting austerity. Such views in this country already led to the stimulus being significantly smaller than it should have been, especially in light of continuing problems with unemployment.

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Steve Benen has more facts and tables on the benefits of the stimulus, such as the table above on the effect of the stimulus on GDP.

Think Progress cited several Republicans who attacked Obama on the stimulus and then took credit for its benefits.

Cross posted at The Moderate Voice

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