Monthly Archives: November 2010

What we used to eat

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FishingThe subtitle of Paul Greenberg’s wonderful book, Four Fish, is “The Future of the Last Wild Food.” In discussing the history and future of salmon, tuna, bass, and cod, the author also remarks on other wild foods our ancestors used to eat.

How did early humans choose the animals they were going to tame and eat? An examination of middens [a collection of waste products – like a garbage dump — that provides archaeologists with clues to everyday life] at Neolithic European dwellings reveals that humans used to eat from a fairly wide buffet of wild game. In varying amounts, the meats they consumed consisted of red deer, boar, cow, roe deer, horse, goat, antelope, elk, chamois, bison, reindeer, fox, badger, cat, marten, bear, wolf, dog, otter, lynx, weasel, mouse, rat, rabbit, beaver, and marmot.

That’s quite a variety.

This diet didn’t last, however. “By the time of Christ, we were down to four basic kinds of mammals in our fire pits: sheep, goats, pigs, and cattle.”

Greenberg goes on to list the variety of birds humans once consumed.

When it came to birds, there was a similarly broad choice available. Pigeon, snipe, woodcock, pheasant, grouse, dozens of different ducks, grebe, various wading birds, and many more.

What birds do we eat today? Chickens, turkeys, ducks, and geese. Read more

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Professionalism of UK doctors questioned over health inequalities

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Failing NHS cartoonThe policies of Margaret Thatcher have been characterized as dog-eat-dog social Darwinism. On matters of health she refused to use the word “inequalities,” preferring instead to speak of “variations” in health. One of those well-documented “variations”: people who lived in the poorest neighborhoods didn’t live as long as people who lived elsewhere.

Thatcher was prime minister of the UK until 1990 and was succeeded by John Major, another Conservative Party member. But in 1997 political power shifted to the Labour Party, when Tony Blair became prime minister. In its political campaign, Labour had promised to address the problem of health inequalities.

“New Labour came in 1997 and announced it would put reducing health inequalities at the heart of tackling the root causes of ill-health,” reports The Guardian. Sure enough, once in office, the Labour government created a commission: The Independent Inquiry into Inequalities in Health. Hopes were high that inequities would be addressed.

Where was the medical profession?

A recent report from Labour’s public accounts committee details what’s happened since 1997, and it’s not a pretty picture. The difference in life expectancy between the poorest areas and the national average increased 7% for men and 14% for women. The national average for the number of doctors per 1000 residents is 0.6. For poor areas of the country, that number is 0.25. (The number for the US is 1.6.)

The medical journal The Lancet describes the report as “a tale of decrepitude at every level of the health system.” The report’s author, Margaret Hodge, commenting on information she received from the Department of Health’s Permanent Secretary, described his “claptrap” as “despairing.” Virtually nothing has been done since 1997. “[T]hat is just gobsmacking,” said Hodge. According to another source, “it’s a mess, it’s a tragedy really.” Read more

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Candid comments from the medical profession

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Doctors are sometimes held to impossibly high standards. They’re only human, yet they’re not allowed to make mistakes.

Reader’s Digest ran an article earlier this year in which doctors revealed their human side – something patients rarely get to see. Here’s a sample of what they shared.

On intimidating the patient:

I was told in school to put a patient in a gown when he isn’t listening or cooperating. It casts him in a position of subservience. –Chiropractor, Atlanta

Ageism:

In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time. –Family physician, Washington, D.C.

On listening to patients:

I used to have my secretary page me after I had spent five minutes in the room with a difficult or overly chatty patient. Then I’d run out, saying, “Oh, I have an emergency.” –Oncologist, Santa Cruz, California

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Life expectancy of the rich and the poor

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Income inequalityPaul Krugman doesn’t find much to like in the recent report from the bipartisan National Commission on Fiscal Responsibility and Reform – the group charged with proposing solutions to the country’s long-term fiscal problems. He makes an interesting point about Social Security. (emphasis added)

There were rumors beforehand that the commission would recommend a rise in the retirement age, and sure enough, that’s what Mr. Bowles and Mr. Simpson do. They want the age at which Social Security becomes available to rise along with average life expectancy. Is that reasonable?

The answer is no, for a number of reasons — including the point that working until you’re 69, which may sound doable for people with desk jobs, is a lot harder for the many Americans who still do physical labor.

But beyond that, the proposal seemingly ignores a crucial point: while average life expectancy is indeed rising, it’s doing so mainly for high earners, precisely the people who need Social Security least. Life expectancy in the bottom half of the income distribution has barely inched up over the past three decades. So the Bowles-Simpson proposal is basically saying that janitors should be forced to work longer because these days corporate lawyers live to a ripe old age.

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The post-midterm world

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Sarah Palin with baby at Tea Party ExpressIn a time when extremists at both ends of the political spectrum are hard to reason with, it’s a relief to hear a sane voice in the wilderness. David Frum is one of my favorite conservative commentators (along with David Brooks). He offers some sage advice to Republicans in a post-Tea-Party world.

On understanding that the economy is more important than the budget: “If fiscal stimulus leads to socialism, and quantitative easing [fighting inflation] leads to Nazism, what on earth are we supposed to do?”

On the welfare state: (emphasis added)

Even from a conservative point of view, the welfare state is not all bad. … [P]ost-Depression … social-welfare programs … were not motivated only — or even primarily — by “compassion.” They were motivated as well by the desire for stability. … “[A]utomatic stabilizers” [of the economy]. …

This shift to a more welfare-oriented economy helps explain why business cycles in the second half of the 20th century were so much less volatile than they were in the 19th century. And fortunately enough, this shift put a floor under the economic collapse of 2008-09. …

Those who denounce unemployment insurance as an invitation to idleness in an economy where there are at least five job seekers for every available job are not just hardening their hearts against distress. They are rejecting the teachings of Milton Friedman, who emphasized the value of automatic stabilizers fully as much as John Maynard Keynes ever did. Conservatives should want a smaller welfare state than liberals in order to uphold maximum feasible individual liberty and responsibility. But the conservative ideal is not the abolition of the modern welfare state, and we should be careful of speaking in ways that communicate a more radical social ideal than that which we actually uphold and intend.

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Do gruesome graphics deter or promote smoking?

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New US cigarette package labelingIn 2009 the FDA finally acquired the authority to regulate the production and marketing of tobacco. On the marketing front, the tobacco industry fought back with a legal challenge. It claimed the new Congressional law violated the industry’s right to free speech. If cigarette packaging had to feature strong graphic images – one of the provisions of the bill — the industry would required to “stigmatize their own products through their own packaging.”

The lawsuit is still pending, but the results of new marketing requirements have begun to appear. The question remains: Will they be effective?

Scary labels may be counter-production

Martin Lindstrom, a former ad agency executive and expert on the science of marketing, has used neuroimaging to study what makes people buy. In his bestseller Buyology: Truth and Lies About Why We Buy, he describes a study he conducted on cigarette advertising. He found that especially vivid anti-smoking warnings actually increase a smoker’s craving for cigarettes.

There’s a possible explanation for this in a concept called Terror Management Theory, which includes the idea that a threat to one’s life increases the need for self-esteem. Read more

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Taking natural foods too far

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Pet ratsThe description of Rentokil’s Rodine Rat & Mouse poison includes the following assurance: “Contains natural whole wheat.” Doesn’t this take the sales appeal of healthy ingredients just a bit too far?

Not being in the market for rat poison myself, I came across this information in the Feedback section of New Scientist. The editors raise a few interesting points:

[W]hat [are] the mice and rats … expected to make of this. Will the mummy and daddy rodents take the poison home and say to their children, “Eat up, it’s good for you. It’s made from whole wheat”?

Or are the humans who use the poison supposed to feel good about killing small animals using healthy organic ingredients?

Perhaps what’s happened is that the word “natural” – so thoroughly overused and misused for products on supermarket shelves — is now so completely devoid of meaning that we don’t even notice it anymore. Read more

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Tony Judt lives on

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Tony Judt The Memory ChaletI miss Tony Judt. As I read the news every day, I speculate on what he would have to say. I was thinking of him during the mid-term elections as I listened to blatant misinformation about the Affordable Care Act coming from conservative politicians. Judt was interested in broader themes than mid-terms and health care, but his life was about intellectual honesty. He was never afraid to speak the truth, even if his position was controversial. Timothy Garton Ash makes this point quite nicely in his obituary of Judt.

So I was momentarily shocked today to see – in The New York Times – an op-ed by Judt. Turns out it’s from a collection of essays, The Memory Chalet, which goes on sale this Thursday. I was pleased to see that this particular essay – on New York City — was not one that I’d already read in The New York Review, so there are more new essays to read. The New York piece is a good example of how superbly Judt could write.

According to Timothy Synder, there is also a forthcoming book that he and Judt worked on together. Read more

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An Edgar Allan Poe moment

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Cute kitten on keyboardI’ve been doing some home repairs lately that involve knocking out part of a wall. This has been going on for days, and it’s quite noisy. I don’t really mind the noise, but my two cats dislike the whole process mightily. When the repairman arrives, they try to make themselves invisible by hiding in new and obscure places. The littler cat, FuFu, is noticeably less brave than her brother. (She’s named after Fu Manchu’s mustache: She’s completely black, but had a prominent white whisker as a kitten.)

The other day, I couldn’t find FuFu after the repairman left. I went out and did errands. Came back. Still no FuFu. I walked around the house calling and whistling. The cats dislike whistling, and they usually come running to investigate the sound.

Finally I heard a faint meow. I tracked it down to the area where the repairman had been working. It was coming from behind the wall. Read more

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Healthy lifestyles serve political interests

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Runner healthy lifestylesThe practice of western medicine remained virtually unchanged from the time of the ancient Greeks to the mid-19th century. This is a testament to medicine’s basically conservative nature: Let’s not risk human life with something brand new.

Dramatic changes occurred, however, once medicine became a science. By the mid-20th century, medicine was experiencing a Golden Age: Life-saving drugs, miraculous medical breakthroughs, new diagnostic technologies, and a profession held in high public regard.

By the 1970s the Golden Age had ended. Medicine, along with other professions and institutions, fell victim to the anti-establishment sentiments of the 1960s. It was criticized harshly by consumers, journalists, and scholars. Medicine — it was alleged — was no longer concerned with the needs of patients, but with the ambitions of doctors.

The advent of Medicare and Medicaid in the 1960s not only brought government into the health care equation. The American Medical Association’s strenuous opposition to this legislation led the public to associate doctors with small businessmen — avaricious and probably dishonest. The practice of medicine changed from a healing relationship between doctor and patient to a profit-driven business enterprise. Read more

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The politics behind personal responsibility for health

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Reagan and Thatcher danceConsumers of cell phones – actually, consumers of any product or service that isn’t essential for health or survival — clearly benefit from the competitive, market-driven economies of today’s modern world.

There are certain goods and services, however, that are essential for the public’s welfare: Drinking water, city sewage systems, financial support in old age, and the administration of things like prisons, schools, and health care. These “public goods” benefit from government influence. That’s because the profit motive needs some restraint in matters essential for basic survival. (Schools are not technically essential, but they’re important for a successful, prosperous society.)

This is only my opinion, of course. Conservatives, libertarians, free market fundamentalists, and members of the Tea Party would disagree vigorously.

Privatization

Privatization is the transfer of responsibility for public interests to the private sector. The PR argument for privatization is that the private sector is more efficient than government. The more basic, underlying motive, however, is that privatization has great potential for private profits. (See my recent post on the privatization of water as the investment opportunity of a lifetime.)

The downside of privatizing public services is that corporations are answerable only to their shareholders, not to the public they serve. We saw this quite clearly during the health care debate, as the dirty linen of the health insurance industry was aired in Congress. Read more

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Water privatization in South Africa: Victory and reversal

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Children collect water South AfricaFollowing the 2005 fire in Soweto (South Africa) when prepaid meters shut off the water and two children died, the residents of the Phiri neighborhood challenged the use of prepaid meters in a lawsuit. They claimed the practice violated South Africa’s basic water policy of a constitutionally guaranteed right to water.

The High Court ruled in favor of the residents in April 2008 — a jubilant legal victory. The daily water allotment was increased from 25 to 50 liters per person per day. The forced installation of prepaid meters was declared unlawful and unconstitutional.

The case was appealed, however, to the Constitutional Court of South Africa. Here’s a video from Friction Films that describes the struggle up to this point. Read more

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Water privatization in South Africa: Prepaid meters

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Water for profit South AfricaThe struggle to provide safe, adequate water and sanitation in South Africa is a more complicated story than the events in Cochabamba, Bolivia. South Africa — a democracy since the end of apartheid in 1994 — is one of the few nations that guarantees a constitutional right to “sufficient” water: “Everyone has the right to have access to … sufficient food and water.” The country has not been able to deliver enough water to many of its poorer citizens, however.

The system for providing water in South Africa is complex. It includes government policy makers, Water Boards, and local municipalities. With the end of apartheid, some cities turned to giant water corporations in France and Britain to manage their water utilities. In other cities, water utilitites remained public, but began to operate like a private business. For the poor, the experience was the same – water sold for a profit.

The World Bank has encouraged a policy of water privatization ever since the neoliberal policies of Reagan and Thatcher came into favor in the 1970s. The Bank acknowledged that the poor would stop paying for water once the cost was more than five percent of income. In South Africa, privatized water can cost up to 20 per cent of income. The poor were forced to choose between water and food. Read more

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The Cochabamba water wars

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Bolivian woman confronts policeWater is not free. Even if there’s an abundant supply, there are costs associated with making it safe to drink, delivering it to homes, and removing wastes (sanitation).

I live in a US city where water is a public utility. Home owners get a bill for their water and sanitation fees. Renters pay the cost in their monthly rent checks. The homeless depend on the faucets and restrooms of public buildings, such as libraries.

The situation is different in the developing world, where over a billion people lack access to safe drinking water. Many women spend over six hours a day collecting enough water for their families (and wait until after dark to relieve themselves). When it comes to sanitation, 2.6 billion people do not even have access to “improved” pit latrines – open pits with simple modifications to reduce flies and odors.

The health consequences of unsafe drinking water and poor sanitation include diarrheal diseases (such as cholera), infection with the parasite schistosomiasis (a cause of blindness), and various parasitic intestinal worms. Five million people die every year from waterborne diseases. Read more

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Water privatization: An investment bonanza

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Water faucetIn May 2000, Fortune magazine published an article on the financial benefits — benefits for corporations and investors, that is — of privatized water. (emphasis added)

From Buenos Aires to Atlanta to Jakarta, the liquid everybody needs–and will need a lot more of in the future — is going private, creating one of the world’s great business opportunities. The dollars at stake are huge. Supplying water to people and companies is a $400-billion-a-year industry. That’s 40% of the size of the oil sector and one-third larger than global pharmaceuticals. And this is just the beginning. The World Bank estimates that one billion people, one-sixth of humanity, have poor access to clean drinking water, and three billion lack sanitary sewage facilities. Unless governments begin spending much more, the number of people without clean water will rise to 2.5 billion, about one person in three, by the year 2025. …

Water promises to be to the 21st century what oil was to the 20th century: the precious commodity that determines the wealth of nations. … Elizabeth Mackay, chief investment strategist at New York investment house Bear Stearns, calls water “the best sector for the next century.” …

So far [the French company] Suez has had a leg up on its rivals because it understands what’s really needed to turn plain water into big money. … “Where else can you find a business that’s totally international, where the prices and volumes, unlike steel, rarely go down?” he [CEO of Suez, Gerard Mestrallet] argues. …

Here’s how deals work in the developing world. … To turn a profit, it [Suez] must collect far more in water charges than it pays out in salaries, equipment, and interest.

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