This study changed how a Harvard professor thinks about health care

Stephan:  Why is the American illness profit system so much more expensive than any other healthcare system in the world? Over use of services as many Republicans assert? Nope, nothing to do with it. Grotesque profiteering as reflected by the prices charged for services and medications is the reason. In the U.S. patients are just cows to be milked; it has nothing to do with actual healthcare. Here is a very interesting fact based analysis of the illness profit system.

Ashish Jha is a health care professor at Harvard. And there’s this thing he used to say when he gave talks, a thing he thought was definitely true about the American health care system.

”I have probably said in more than a dozen talks that our health care system is much more specialty care-driven, whereas in Western Europe there are more primary care physicians, and that mix is just really different,” he’s said. “That mix is really different, and that drives the use of high-cost services. I’ve repeated those words.”

Jha isn’t quite sure where he learned this — it was just a truism of American health care that he took for granted (and, to be fair, a truism that I’ve also taken for granted as a health care reporter).

But Jha doesn’t believe this anymore. Earlier this month, he and two co-authors published a paper in the Journal of the American Medical Association that is one of the most comprehensive studies of what actually drives high health care spending in the United States.

He looked at […]

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Leaked Memo: EPA Shows Workers How To Downplay Climate Change

Stephan:  Scott Pruitt's corruption is so off the charts it is hard to actually conceptualize it. The latest news break on it is that he has been living in a townhouse owned by a carbon energy lobbyist. But his mandating the deliberate distribution of misinformation is the part I find really alarming. Here's the story.

Scott Pruitt
Illustration by Sean McCabe

The Environmental Protection Agency on Tuesday evening sent employees a list of eight approved talking points on climate change from its Office of Public Affairs ― guidelines that promote a message of uncertainty about climate science and gloss over proposed cuts to key adaptation programs.

An internal email obtained by HuffPost ― forwarded to employees by Joel Scheraga, a career staffer who served under President Barack Obama ― directs communications directors and regional office public affairs directors to note that the EPA “promotes science that helps inform states, municipalities and tribes on how to plan for and respond to extreme events and environmental emergencies” and “works with state, local, and tribal government to improve infrastructure to protect against the consequences of climate change and natural disasters.”

But beyond those benign statements acknowledging the threats climate change poses are talking points boiled down from the sort […]

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Two million Dutch homes to be gas free by 2030, as energy transition takes shape

Stephan:  While the Trump administration is doing everything it possibly can to continue our dependency on carbon energy, including officially lying to people about climate change, or trying to avoid talking about it at all, other nations have better sense and are actually interested in the wellbeing of people, the ecosystem, and the planet itself. The Dutch for instance, who want all carbon vehicles off their roads by 2040, and all homes to be gas free by 2050. It must be wonderful to have a government that actually cares of about your wellbeing.
The Dutch government has set a target of ensuring one in four Dutch homes no longer relies on gas for heating or cooking by 2030, according to Diederik Samsom, the former Labour party leader who is part of the team charged with negotiating the energy transition. Instead, homes will be heated via geo-thermal pumps or sustainable city heating networks which either generate heat directly or use excess heat from industry, Samsom says. Samson has been asked by the government to reach agreement on the necessary measures with business and interest groups. I
In an interview with Trouw he describes the target as ‘realistic and ambitious’. In the first year of the project, 50,000 homes should be cut off from gas and the rate of transition ramped up in the following years. In addition, no more new homes should be connected to the gas network, Samsom says. In Amsterdam, for example, two new residential districts are being built without gas and some 70,000 homes in the city are already on district heating networks. Relatively new, well insulated homes can start running on heat pumps and electricity – preferably green energy from wind turbines and solar panels. For older districts that will often […]

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This famous French economist has a counterintuitive idea for how Democrats can retake America

Stephan:  French Economist Thomas Piketty, who captured international attention with Capital in the Twenty-First Century, has come out with a new work arguing basically for the Theorem of Wellbeing. This article and most of the rest I have seen couch his argument in liberal vs conservative politic terms which, I think, almost completely misses the point Piketty is making. He is arguing that Bernie Sanders idea, with which I am in complete agreement, that the function of state is to foster wellbeing is the way forward for the Democratic Party.  Like myself, Piketty cares only about facts, so his arguments are based on social outcome data. I hope the Democrats are listening.

French economist Thomas Piketty
Credit: Screenshot

Would Bernie Sanders have won? French economist Thomas Piketty seems to think so.

The author of Capital in the Twenty-First Century, a New York Times best-seller and the most-bought book in the history of Harvard University Press, has published a paper that uses exit polling data to argue that embracing economic populism would power the left toward huge electoral wins.

The paper is called “Brahmin Left vs. Merchant Right: Rising Inequality & the Changing Structure of Political Conflict” and it’s a book-length 174 pages with references and charts.

Piketty says that both parties now appeal to elites in America, with high-education elites liking the left, while wealthy elites support the right—though he points out that this is changing in the era of Trump, with polling showing that wealthy suburbs are now a danger zone for Republicans.

It’s dense stuff—not the sort of thing the “low education, low income voters” he writes about are likely to read:

“I argue that this structural evolution can contribute to explain rising inequality and the lack of democratic response […]

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Why eating healthy is so expensive in America

Stephan:  The other day I went to Costco, and sat at a table eating a turkey sandwich with a very stout middle age man  who was eating several slices of pizza, an order of fries, and a brownie, all washed down with a coke. We had one of those superficial weather-centric conversations one has with strangers when silence would be rude. It made me think about the American diet. This story makes the point that came to me as I thought about that meeting.

Credit: VOX

The American plate has increasingly lacked nutritious food. This eating trend has serious consequences: There is a strong link between diets low in fruits and vegetables and obesity and diabetes.

One reason why Americans tend to choose less healthy options is simple: cost. Processed foods tend to have a lot more calories at a lower price; that’s more bang for your buck than fresh food if you’re on a budget.

Fresh fruits and veggies are more expensive to farm than crops that will be processed. Produce relies on human labor rather than machines, and machines are more efficient and cheaper in the long run. But the US government also doesn’t subsidize leafy vegetable crops in the same way it supports wheat, soy, and corn, vital ingredients in a lot of junk food.

Some programs in the United States are trying to steer consumers toward healthier options. Researchers are suggesting a junk food tax on “nonessential” foods like candy, soda, and potato chips as the next frontier in public health policy. Experts cite similar […]

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