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Health

American Epidemic: Rise In Diabetes Rate Is The ‘Main Driver’ Of Increased U.S. Medical Costs

The reality of America’s obesity and diabetes epidemics and their resulting effects on national health care costs have been well-established — and on Thursday, a new report revealed that the public health crisis has gotten even worse in the last decade.

According to the report by the American Diabetes Association (ADA), direct and indirect health care costs associated with diabetes rose from $174 billion in 2007 to $245 billion in 2012 — an increase of 41 percent over 5 years. Only a little bit of that can be attributable to general medical inflation, which has actually been slowing down in the last couple of years. The sheer scope of the increase indicates that more and more Americans are falling prey to the disease — and it’s taking a clear toll on U.S. health care spending:

“As the number of people with diabetes grows, so does the economic burden it places on this country,” [said ADA's Chief Scientific & Medical Officer, Robert Ratner, in a statement.]

The study finds that medical expenditure for people with diabetes is about 2.3 times higher than for people who don’t have the disease and that the main driver of the increased overall financial burden on the country is the rise in proportion of the population that has the disease.

“The cost of diabetes is rising at a rate higher than overall medical costs with more than one in 10 health care dollars in the country being spent directly on diabetes and its complications, and more than one in five health care dollars in the US going to the care of people with diagnosed diabetes,” says Ratner.

Diabetes and obesity-related illnesses tend to disproportionately affect populations that are also on government-subsidized health programs — especially low-income Americans — and made up anywhere between 10 and 12 percent of all health insurance spending back in 2006. Considering the new report’s findings, that number has probably ballooned further. The study found that 64 percent of diabetes-related care, specifically, was funded by Medicare, Medicaid, and military health care programs.

Alyssa

Joss Whedon’s ‘Much Ado About Nothing,’ Slut-Shaming, And Hero And Claudio’s Story

I’m hoping to catch Joss Whedon’s Much Ado About Nothing at South By Southwest, though it looks like scheduling may not allow for it. But looking at the trailer, I’ve got two thoughts:

First, I love me some Alexis Denisof and Amy Acker, but I think it’s going to be hard for me to see them not in the context of Kenneth Branagh and Emma Thompson’s performances in those roles in from twenty years ago. Acker’s so good at retiring roles that it’s hard for me to really imagine her with a delightfully poisonous tongue.

And second, I’m curious as to how the adaptation is going to handle Hero and Claudio, played respectively by Jillian Morgese and Fran Kranz. Their story, in which Hero’s chastity is called into question, the wedding between the young lovers is called off, and Claudio is made to feel guilty by being told that Hero’s literally died of grief is a much harder thing to bring into the moder era than a clash of wits between a much more contemporary couple like Beatrice and Benedick. There’s very interesting stuff to be done with Hero and Claudio about anxiety about relative sexual experience, slut-shaming, and the anxiety of marriage. But getting there and doing it right in this setting probably means jettisoning the set-up in which Claudio believes that Hero is dead. I’m curious to see how Whedon will work it all out. Giving us modern screwball with Beatrice and Benedick is awfully fun, but it’s the easy lift here. Transforming Hero and Claudio and doing it well will be the much more impressive feat.

Justice

How Just One Senator Vetoed A Judge And Gave A Big Gift To The NRA

Senate Republicans Explain The Rules Governing Judicial Nominees

Judge Elissa Cadish, a state court judge in Nevada who President Obama nominated to a federal district court, asked the President to withdraw her nomination, according to a letter that became public today. Cadish was the victim of an arcane senate tradition that allowed just one senator, Sen. Dean Heller (R-NV), to unilaterally block her nomination. Heller objected to her nomination because she once correctly described the state of gun rights law prior to the Supreme Court’s decision in District of Columbia v. Heller.

In 2008, before Heller established for the first time in American history that the Second Amendment protects an individual right to bear arms, Cadish was asked whether the Constitution does indeed protect such an individual right, and she gave the only correct answer a judge could have given at that point in history — “I do not believe that there is this constitutional right,” adding “of course, I will enforce the laws as they exist as a judge.” This statement accurately described the state of the law pre-Heller.

Nevertheless, Cadish’s nomination languished without a hearing due to a Senate tradition that allows a single senator to veto a nominee from their home state. In Senate parlance, Heller refused to return his “blue slip” on Cadish, and Senate Judiciary Chair Pat Leahy (D-VT) honored a tradition establishing that a nomination will not receive a hearing unless both home-state senators sign these slips.

It should be noted that not every Senate Judiciary Chair has honored this tradition in the past. In 2003, for example, when Sen. Orrin Hatch (R-UT) took over as Judiciary chair and George W. Bush was president, Hatch largely abandoned the blue slip rule. According to the Congressional Research Service, “[a] return of a negative blue slip by one or both home-state Senators d[id] not prevent the committee from moving forward with the nomination — provided that the Administration [] engaged in pre-nomination consultation with both of the home-state Senators,” during during Hatch’s tenure.

There is no good reason why President Obama’s nominees should not enjoy the same deference that President Bush’s nominees enjoyed under Hatch.

Justice

How A Man Charged But Not Convicted Of A DWI Spent Two Years In Solitary Confinement

Stephen Slevin before and after he spent almost two years in soliltary confinement.

A $15.5 million settlement to a man who was confined in isolation for almost two years after he was charged but not convicted of driving while intoxicated is shedding light on the horror that can befall someone incarcerated even on mere allegations of criminal activity.

Stephen Slevin, arrested for a DWI and accused of driving a stolen car that he said he borrowed from a friend, was placed in solitary confinement shortly after he arrived at Dona Ana County Detention Center in New Mexico because he declined to post a $40,000 bond. After one medical examination, Slevin, who was severely depressed even before his arrest, was deemed suicidal and placed in a padded isolated cell with no natural light for 23 hours a day.

Once in that cell, Slevin faced an insurmountable battle in changing his circumstance, in spite of neglect so severe that his toenails grew to curl around his foot, he pulled out his own decaying tooth and fungus grew on his face. He sent letters saying “I’m afraid to close my eyes” and “I don’t know much longer I can go on.” But the only response he received was greater sedation, his lawyer told NBC News. After two years in this circumstance, the charges against Slevin were dropped and he was released, having never been found guilty of any crime. Slevin later sued and won a $22 million jury award, an amount that was upheld by a federal judge in a decision that sums up the horror of the conditions he withstood:

[The] evidence included letters written by Plaintiff seeking help, and sick call requests documenting Plaintiff’s suffering from bed sores on his thighs, fungus growing on his face, rotting teeth, pain, inability to sleep and nightmares where he could not sleep. … Medical records kept by the Detention Center similarly documented Plaintiff’s experience of pain and suffering, and the lack of treatment for his many medical and dental conditions. … Plaintiff … spent six months along in his cell with virtually no human contact before his release.

Although first attempting to explain away his lack of recreation time by testifying that Plaintiff refused to come out of his cell, [Detention Center Director Christopher] Barela testified that he would not have put his dog in a cell like Plaintiff’s cell and left him there for a month at a time, even if his dog refused to come out. He admitted that, if his dog refused to come out, he would wonder what was wrong with her and take her to the veterinarian. Barela also acknowledged that he knew it was not acceptable to leave his dog or Plaintiff in the conditions in which Plaintiff was left [...]

With regard to the injurious effects of administrative confinement on Plaintiff, his expert, Dr. Grasisan,  … testified that Plaintiff was “more massively impaired by the PTSD, post-traumatic stress disorder, than [he] ha[d] ever seen in [his] entire professional life.” According to Dr. Grassian’s testimony, Plaintiff’s life “is kind of torture.”

To compound matters, Slevin is now suffering from lung cancer, and he accepted the county’s settlement offer of $15.5 million even though the higher $22 million judgment was upheld by a judge. Even that lower sum is one of the largest prisoner civil rights payouts in history – an unsurprising fact considering the extremity of the mistreatment of an individual who, it is worth repeating, was never found guilty of any wrongdoing whatsoever. But the solitary confinement of individuals with identified mental health concerns is alarmingly common, in spite of evidence that the mentally ill are particularly vulnerable to long-term psychological harm from isolation. As in many detention facilities around the country, it was the policy of Dona Ana County jail to put people with mental health issues into solitary confinement — one of several issues that also prompted a class lawsuit by the ACLU of New Mexico that yielded reforms in 2010.

The rampant use of solitary confinement in U.S. prisons for not just the mentally ill (who are increasingly jailed in place of mental health treatment) but also children as young as 13 has become so severe that the federal agency tasked with overseeing prisons agreed last month to undertake a closer examination of the practice, which has been deemed torture, cruel and inhumane, and worse than being held hostage in Iran.

Alyssa

FIFA Investigates Claims That Nigera Banned Lesbians From Playing Soccer

Members of Nigeria's women's national soccer team

The Nigerian Football Federation has officially banned lesbians from participating in competition in the country, the chair of the Nigeria Women’s Football League announced Thursday. The move has drawn an inquiry from FIFA, soccer’s international governing body, since such a ban would violate its anti-discrimination policy.

Nigeria is one of several African countries that have moved to legally ban homosexuality, and Nigerian club officials have boasted of driving lesbians from the game before, but under the new policy, lesbian players will be disqualified from competition and won’t be allowed to join the national team, NWFL chair Dilichukwu Onyedinma said, according to Inside World Football:

“Any player that we find is associated with it will be disqualified.

“We will call the club chairmen to control their players, and such players will not be able to play for the national team,” said Onyedinma. She said the governing body will work with clubs to stop the practice.”

While outright bans on lesbians are obviously (and thankfully) rare, discrimination aimed at gay female athletes is hardly limited to soccer or to Nigeria. The push for LGBT equality in sports has largely focused on men while gay women athletes get ignored, since the stereotypical female athlete is often already presumed to be gay. As Deadspin’s Barry Petchesky wrote when American soccer star Megan Rapinoe came out ahead of the 2012 Olympics, “An openly gay female athlete almost isn’t news. A lesbian in the locker room conforms to a stereotype, just as a straight male athlete is a stereotype.”

But in both American and international sports, there is “an amazing division between lesbians and straight women in sports” that persists because straight women don’t want to be stereotyped as gay, Dr. Pat Griffin, a professor and advocate for LGBT rights in sports, has said before. That has led to discrimination against female athletes who actually are gay and a culture, particularly in American college sports, where both coaches and players are expected to “be straight, or at the very least, act straight.” It’s no wonder then, that many lesbian athletes wait until their careers are over to come out of the closet.

So while Nigeria’s ban is uniquely horrific, and while FIFA will hopefully help put an end to it, it is emblematic of a larger sports culture that remains tilted against LGBT equality not just for men but for women too.

Climate Progress

Fox And Friends: Polar Bears Prove Climate Change Is ‘Not Really Real’

(Photo credit: AP)

Polar bears can’t catch a break anywhere, least of all Fox News.

On Fox and Friends this morning, Fox Legal Analyst Peter Johnson Jr. was asked about last week’s ruling by the D.C. Circuit to uphold the decision to protect polar bears as a “threatened” species. He made the case that environmentalists use polar bears as a fundraising tool, and that the threat to polar bears may be imaginary:

JOHNSON: It really depends upon whether you believe the global warming is real, whether polar bears are actually threatened or not. This has become a big fundraising tool and it’s become a problem, too, for oil interests throughout the world because they have to act in a way that is very expensive in terms of making modifications.… So is global warming real or not real? I’ve heard a lot of people say it’s not really real.

Watch it:

Global warming is undoubtedly real. In fact, the real climate debate has shifted to how much climate scientists have actually underestimated global warming impacts.

With regard to polar bears, the court said that the Fish and Wildlife Service listed the polar bear correctly as “threatened”:

“The Listing Rule rests on a three-part thesis: the polar bear is dependent upon sea ice for its survival; sea ice is declining; and climatic changes have and will continue to dramatically reduce the extent and quality of Arctic sea ice to a degree sufficiently grave to jeopardize polar bear populations…. No part of this thesis is disputed and we find that FWS’s conclusion – that the polar bear is threatened within the meaning of the ESA – is reasonable and adequately supported by the record.” [Page 14]

It went on to say that 13 out of 14 peer reviewers found the rule generally “represented a thorough, clear, and balanced review of the best scientific information available from both published and unpublished sources of the current status of polar bears.”

Polar bears depend on sea ice for feeding. Arctic sea ice volume has collapsed. The question on threats to polar bears is not over whether general population estimates are stable. (Where there is sufficient data, many more subpopulations are decreasing than are increasing.) If Fox and Friends wants to get to the root of the issue, they should host a discussion about whether polar bears should be classified as “threatened” or “endangered.”

Polar bear ranges will only get more crowded by other animals. Under an incorrect-yet-ironic headline (“Study: Global Warming Helps Polar Bears,”) Fox News reported in January that many mammal species will expand their ranges northward as the Arctic warms. As the sea ice melts, the polar bears will surely welcome their new grizzly bear overlords from the south.

Economy

How Everybody Pays The Price Of Wall Street’s Unregulated High-Frequency Trading

During an appearance on CNBC yesterday, Charlie Munger, deputy to billionaire investor Warren Buffett, had some harsh words for high-frequency trading, the practice used by huge financial firms to trade stocks in milliseconds. “Take the rapid trading by the computer geniuses with the computer algorithms,” said Munger. “Those people have all the social utility of a bunch of rats admitted to a granary.”

As a new report from Demos makes clear, high-frequency trading definitely is the equivalent of admitting rats to a granary, as it extracts value for traders but without bolstering investment. The price of that is ultimately paid by consumers:

The increasing inefficiency of the Capital Intermediation process is in part attributable to the trading practices of [high-frequency traders] HFTs, which generate high trading volume and no investment. The cost to the system is generated by several factors. First, the illusion of market liquidity provided by HFT volume leads to the inherent instability of market pricing mechanisms. In addition, aggressive HFT tactics mislead market participants in terms fundamental price. Finally, Dark Pools, trading venues that exist because of HFTs, impair price discovery.

All of these distortions extract value for the HFTs. Investors pay the cost initially because their investments are less valuable in conditions of chronic price distortion. However, investors must compensate for the additional cost that results from the extracted value by adjustment of price. This price adjustment is paid for by the consumers of capital.

High-speed trading now makes up more than half of the stock market’s volume. As this chart from the research firm Nanex shows, high-frequency trading has exploded since 2007, spiking in the aftermath of the Great Recession:

The Securities and Exchange Commission voted yesterday to draft new rules to rein in high-frequency trading. Doing so would both drive investment to productive sectors of the economy while removing dangerous volatility from the market like that which caused 2010′s “flash crash.”

Health

Why The European Plan To Ban Porn Is A Bad Idea

Early next week, the European Union Parliament is planning to vote on a resolution calling for a sweeping ban on pornography in the name of gender equality. If it passed, the resolution could be the first step towards a continent-wide ban on pornography on a wide swath of media. But, good intentions aside, that would actually be a bad move for both Europe’s women and the EU’s commitment to free speech.

The Parliament vote scheduled for next week would recommend this resolution on gender equality (which includes the porn ban) to the EU Commission, which would then turn it into legislation which would then, finally, be enacted into binding law by the Parliament. As Wired UK notes, the Commission would have the discretion to simply leave out the provision calling for “a ban on all forms of pornography in the media” — which could well cover all online pornography — in the final law.

But if the ban were to make it into the final law, it would likely do more harm than good. Though a few studies have found that, under laboratory conditions, porn makes men more sexually aggressive, there’s no real-world evidence bearing out the claim that this translates into sexist attitudes or sexual violence. According to Professor Milton Diamond, director of the Pacific Center for Sex and Society at the University of Hawaii at Manoa, “[t]here’s absolutely no evidence that pornography does anything negative.”

There is, however, empirical evidence that it reduces the incidence of sexual violence. One 2007 study by Todd Kendall compared the rates of crime between U.S. states with greater and lesser access to the internet. After controlling for other crime-inducing variables (like rates of urbanization and alcoholism), Kendall found that more internet access led to lower rates of two crimes only — rape and prostitution:

I find that internet access appears to be a substitute for rape; in particular, the results suggest that a 10 percentage point increase in internet access is associated with a decline in reported rape victimization of around 7.3%…internet has no apparent substitution effect on any of 25 other measured crimes, with the exception of the only other well-defined sex crime, prostitution. Moreover, I show that the effect on rape is concentrated among states with the highest male-to-female ratios, and that by age, the effect on rape is concentrated among teenage men, who are the prime consumers of pornography, and for whom the internet induced the largest change in availability.

Two other studies support Kendall’s finding — one correlating the international spread of the internet with a concomitantly international decline in sexual violence, the other presenting survey evidence that, as Scientific American puts it, “patients requesting treatment in clinics for sex offenders commonly say that pornography helps them keep their abnormal sexuality within the confines of their imagination.”

Read more

LGBT

NOM Highlights Gay Man Opposed To Marriage Equality (Who Married A Woman)

Doug Mainwaring

The National Organization for Marriage believes its arguments against marriage equality if they come from people who are actually gay, which is why it is more often highlight “gays against gay marriage.” Today, NOM highlights just such a story from Doug Mainwaring, who believes it’s “possible to oppose same-sex marriage based on reason and experience.” Of course, NOM doesn’t bother to mention any of the details that distinguish Mainwaring’s experience from people who actually identify with the LGBT community, nor the fact that he’s sung this tune plenty of times before.

Mainwaring’s narrative echoes many ex-gay testimonials, particularly in his abstention from gay sex, choosing instead to have non-sexual philia love friendships with men. In fact, he married a woman with whom, despite a temporary divorce, he still lives and raises a family. He has repeatedly written and testified against marriage equality for same-sex couples, but not just because of his trite “kids need a mother and a father” argument — Mainwaring believes the “liberal intelligentsia” is trying to dismantle marriage altogether. Such paranoid perceptions of liberal views are perhaps unsurprising; Mainwaring is co-founder of the National Capital Tea Party Patriots in Maryland.

His own words demonstrate just how far removed he is from the reality of LGBT  families. Here’s how he describes his despair at the thought of raising his kids with another man:

Over the last couple of years, I’ve found our decision to rebuild our family ratified time after time. One day as I turned to climb the stairs I saw my sixteen-year-old son walk past his mom as she sat reading in the living room. As he did, he paused and stooped down to kiss her and give her a hug, and then continued on. With two dads in the house, this little moment of warmth and tenderness would never have occurred. My varsity-track-and-football-playing son and I can give each other a bear hug or a pat on the back, but the kiss thing is never going to happen. To be fully formed, children need to be free to generously receive from and express affection to parents of both genders. Genderless marriages deny this fullness.

Mainwaring’s shallow perception of what constitutes intimacy, including what he is even capable of showing, demonstrates how unqualified he is to discuss same-sex marriage and families. He has clearly carried an anti-gay stigma with him throughout his entire life and has just as narrow an understanding of the lives of gays and lesbians as his fellow opponents of equality. NOM’s attempt to somehow drive a wedge within the gay community is pitiful, if only because Mainwaring in no way represents it.

Justice

As Recall Looms, Arizona Republicans Pass Bill To Make It Harder To Remove Anti-Immigrant Sheriff


Maricopa County, Arizona Sheriff Joe Arpaio may be the most despicable law enforcement officer in the country. A Justice Department legal complaint against his office alleges widespread constitutional violations and mistreatment of Latinos, including an alleged assault against a pregnant Latina woman, widespread racial profiling and use of racial slurs, and incidents where “female Latina [limited English proficiency] prisoners have been forced to remain with sheets or pants soiled from menstruation because of [the Maricopa County Sheriff's Office's] failure to ensure that detention officers provide language assistance in such circumstances.”

He also may not be sheriff much longer, as an effort to recall Arpaio already collected 120,000 of the 335,000 signatures needed to force a recall election.

A bill that passed the GOP-controlled Arizona House of Representatives could make Arpaio very difficult to defeat, however. Currently, a recalled official in Arizona faces a single election that could include challengers from their own party. The GOP bill would change this process so that the parties would choose their candidates in a primary election, and then Arpaio would likely face the winner of the Democratic primary in the general election.

The reason why this change matters is because Maricopa County is very Republican — Romney won the county by nearly 12 points — so it would be difficult for a Democrat to defeat Arpaio in a one-on-one race. At the same time, Maricopa’s Democratic voters could potentially join with a minority of the county’s Republicans in order to elect a Republican challenger to Arpaio. Indeed, this is exactly what happened when Democrats joined with some Republicans to remove anti-immigrant Senate President Russell Pearce (R) and replace him with Republican challenger Jerry Lewis in a 2011 recall election.

In other words, it may be the case that a majority of Maricopa’s voters want to remove Arpaio, and thus he could lose a recall election under the current rules. Under the GOP House’s bill, however, Arpaio would likely have a clear shot to survive the recall election so long as a majority of the county’s Republicans vote for him in the primary election.

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