Wednesday, August 19, 2009
Tuesday, August 18, 2009
In recent weeks, opponents of Barack Obama's health-care-reform plans have criticized Britain's National Health Service (NHS) in an effort to counter the President's proposals for greater government involvement in health care. Republican Senator Chuck Grassley of Iowa suggested that his Democratic colleague Edward Kennedy would have been left to die in Britain because doctors would have refused the 77-year-old treatment for his brain tumor, and former House of Representatives Speaker Newt Gingrich wrote in an article that British health care is run by "Orwellian" bureaucrats who put a price tag on life. Meanwhile, the lobby group Conservatives for Patients' Rights (CPR) has been running scare ads with horror stories from British patients on its website. TIME takes a look at what the NHS is really all about.What is the NHS?
The NHS is a rare example of truly socialized medicine. Health care is provided by a single payer — the British government — and is funded by the taxpayer. All appointments and treatments are free to the patient (though paid for through taxes), as are almost all prescription drugs. The maximum cost of receiving any drug prescribed by the NHS is $12.
How was it formed?
The NHS officially came into being in July 1948, in the wake of World War II, to replace an inadequate system of volunteer hospitals that had, during the war, come to rely on government funding. Doctors and conservative politicians vehemently opposed the NHS in the run-up to its formation, using many of the arguments that opponents of greater government involvement in the U.S. cite today. According to Geoffrey Rivett, author of From Cradle to Grave — The First 60 Years of the NHS, the then head of doctor's body the British Medical Association (BMA), Charles Hill, gave a radio address in 1948 in which he asked, "Do you really want the state to be your doctor?" Today, the BMA is a champion of the NHS and resists any privatization initiatives. In a statement on Aug. 14, BMA chairman Dr. Hamish Meldrum said, "The NHS is not perfect. But the market-style philosophy of the U.S. is a lesson we could do well without."
How does NHS health care compare with U.S. health care?
Like most developed countries, Britain ranks above the U.S. in most health measurements. Its citizens have a longer life expectancy and lower infant mortality, and the country has more acute-care hospital beds per capita and fewer deaths related to surgical or medical mishaps. Britain achieves these results while spending proportionally less on health care than the U.S. — about $2,500 per person in Britain, compared with $6,000 in the U.S. For these reasons, the World Health Organization (WHO) ranked Britain 18th in a global league table of health-care systems (the U.S. was ranked 37th). However, there are measures by which the U.S. outperforms Britain: for instance, the U.S. has lower cancer mortality rates.
Does private health insurance exist in Britain?
Yes, and it works in a similar way to health insurance in the U.S. Many employers offer private health-insurance plans as a perk to workers — a minority of patients opt out of the NHS system to receive their medical treatments privately. Private patients can choose their specialists and avoid waiting lists for non-emergency procedures; NHS patients wait an average of about eight weeks for treatments that require admission to a hospital, four weeks for out-patient treatments and two weeks for diagnostic tests. While NHS patients have a choice of hospitals, they cannot always choose their specialist.
Is it true that NHS bureaucrats put a price tag on life?
The short answer is yes. The NHS has a body called the National Institute for Health and Clinical Excellence (NICE) that decides which new treatments and drugs the NHS should pay for. One of the factors NICE considers when deciding whether to approve funding for a new treatment or drug is cost-effectiveness. To determine the dividing line between what is cost-effective and what isn't, it must set a threshold. Taking its lead from Britain's Department of Transport — which has a cost-per-life-saved threshold for new road schemes of about $2.2 million per life, or about $45,000 per life year gained — NICE rarely approves a drug or treatment that costs more than $45,000 per life year gained. In short, NICE does not want the NHS to spend more than $45,000 to extend a citizen's life by one year.
While NICE's decisions have angered some doctors and patient groups — particularly some oncologists who say they are unable to prescribe expensive, life-extending cancer drugs — mainstream politicians, the media and most Britons accept NICE's rare rejections as a necessary compromise to keep universal coverage affordable in the face of rising health-care costs. As NICE chairman Sir Michael Rawlins recently told TIME, "All health-care systems have implicitly, if not explicitly, adopted some form of cost control. In the U.S., you do it by not providing health care to some people. That's a rather brutal way of doing it."
Is it true that old people receive inferior care on the basis of their age?
NICE uses what it calls "citizens councils" to help it sort through difficult ethical issues, and one of the decisions the councils have made is that age should not be a factor in the institute's approval process — that is to say, a year of life should be considered as valuable to a 77-year-old as to a 12-year-old. In every part of the system, a 77-year-old has the same access to treatment as anyone else in Britain.
What about the ad by lobby group CPR that interviews a British woman who developed cervical cancer after being refused a Pap test because she was too young, and another for a woman whose mother died while waiting for treatment for kidney cancer? Are these experiences typical?
As mentioned above, cancer treatment is one area in which British patients probably receive inferior treatment to Americans who have comprehensive health insurance. However, Britain's policy of beginning cervical-cancer screening at age 25 is in accordance with WHO guidelines, which are based on evidence that screening below that age produces false-positive results that can lead to unnecessary and dangerous surgical interventions. Overall, the WHO has found that the risks posed by false positives outweigh the benefits of earlier screening.
It's also true that Americans who have comprehensive health-insurance plans do, in some cases, have access to a greater range of cancer treatments, without waiting lists. The two British women used in the CPR ads have since told various newspapers that their views were inaccurately portrayed. While both have complaints about how cancer is treated within the NHS, they support the service as an institution. The woman who developed cervical cancer (it is now in remission) told the Times of London, "My point was not that the NHS shouldn't exist or that it was a bad thing."
That view seems typical. It's a British pastime to complain bitterly about the NHS but remain fiercely protective of its existence. A recent "We Love the NHS" Twitter campaign has received thousands of messages of support, including from British Prime Minister Gordon Brown, whose eyesight was saved by British doctors after he was involved in a rugby collision as a young man and whose son suffers from cystic fibrosis. The leader of Britain's right-wing Conservative Party, David Cameron, expressed his support for the health service on Aug. 14: "One of the wonderful things about living in this country is that the moment you're injured or fall ill — no matter who you are, where you are from or how much money you've got — you know that the NHS will look after you."
Friday, August 14, 2009
First things first: I like Green Day. I think they are a tremendously talented band, and are an influence in music that will be felt for years and years to come. Their songs have spoken to me, motivated me, and moved me. That, in part, makes this review hard to write.
Nine years ago, Green Day released Warning:, and after some setbacks and a side project, released American Idiot four years later. It was loud, political, and in-your-face. Green Day rode their new wave of popularity high for another several years, releasing another side-project album in between, and are readying the release of 21st Century Breakdown, an album which "chronicl[es] the life of a young couple as they deal with the mess our 43rd president left behind."
Herein lies the first problem: the album is still rooted in the politics of old. When Idiot hit, everything that Green Day had to say was relevant to the times. Since the election of Barack Obama to the Presidency, it seems to me that most people just want to move forward. The theme of this album comes nearly seven months too late.
However, the real problem lies in the songs themselves. They don't sound bad, but the problem is that it sounds like I've heard each of them before. Some new things are nice, such as a piano intro and Billie Joe singing falsetto, but quickly things change, and it's the old familiar sound. Before the Lobotomy and 21 Guns each sound like a hybrid of Give Me Novocaine and Letterbomb, while Restless Heart Syndrome has an ending that reminded me of Boulevard of Broken Dreams. Last of the American Girls, thematically, is like a carbon copy of the songs regarding Whatsername on the Idiot opera. The title track sounds like Green Day's version of Working Class Hero, the John Lennon song they covered a couple of years ago; they even use that title in this song. Musically, the song is alright, until the Queen-like breakdown, which just doesn't fit the song. It's almost like an afterthought tacked on to the end of it.
Similarly, the piano intro and band entrances are used more than once, and sound too similar to one another to stand out. A little piano intro, and boom!, it's into the swing of things, but each time, it's done too similarly to the other to stand out. A piano filled bridge may have done better.
Like American Idiot had two "suites," a song composed of five shorter songs, complete with transitions, Breakdown features one--American Eulogy--composed of two shorter songs. It's about half the length of either of Idiot's suites, but the transition is reminiscent. It even starts like Idiot's latter suite, Homecoming, just Billie Joe and a guitar, though his voice is slightly distorted this time, then we get the whole band coming in. Mike Dirnt even sings lead vocals on one part...just like he did in the Homecoming suite. Each member of Green Day has a good singing voice; why not alternate whole songs? Why not trade off lead vocals with Mike singing verses, Billie Joe singing choruses, and Tre singing the bridge?
American Eulogy is divided into two parts: Mass Hysteria and Modern World. Almost immediately into Hysteria, the vocal melody reminded me of an older song. I had to check it out, and while not identical, the melody to Hysteria and Warning:'s Deadbeat Holiday are quite similar. Likewise, while remaining its own song, 21st Century Breakdown has transitional pieces into a guitar solo that sound like something heard on Idiot.
The lyrics are available online, and I've read them all. I know like Idiot, Breakdown is a rock opera, nonetheless, the conventions of repeating themes and phrases don't seem to work here, they just seem like Idiot revisited. There's not much new here, which is what kills the album.
Warning:, while not commercially viable, was strikingly different from what Green Day had done in the past and was critically acclaimed. Idiot was relevant to our times, and set a new standard for Green Day. I would have like to see that standard met, but unfortunately, thus far, it hasn't been. I would have liked to see something different. The lone song that stood out was the closer, See the Light. I enjoyed it, but it came seventeen songs (literally) too late. After four years--and a LOT has happened in that time--it would have been nice to hear something new. Green Day has proven they can do it; their side project Foxboro Hot Tubs was unlike anything they've done before. I realize it takes a lot of talent and skill to write an album, and maybe it's not my place to call this like I see it and be so critical, however, it just feels like they've rehashed their last album and released it under a different name. It feels like I've wasted my anticipation on nothing.
After hearing the album, I've changed my rating: 1/4 stars. And that one star is pushing it. Sorry to anyone who disagrees, but this is one of the most disappointing albums I've heard in recent memory.
Wednesday, August 12, 2009
Moderator and AARP radio host Mike Cuthbert then told Obama: “As I read the bill, it’s saying that Medicare will, for the first time, cover consultation about end-of-life care, and that they will not pay for such a consultation more than once every five years. This is being read as saying every five years you’ll be told how you can die.” The president responded: “Well, that would be kind of morbid.”
He went on to explain: “The intent here is to simply make sure that you’ve got more information, and that Medicare will pay for it.” Exactly so.
So an option for people to have their information updated every five years and provide a way for them to have a living will has been distorted into "the government will tell you how you can die," and "death panels will decide who gets health care and who doesn't"; both radically far from what the actual clause is.
The President recently held a town hall-style meeting where he addressed some of these issues personally. He said:
"[Opponents] will try to scare the heck out of folks, and they'll create bogeymen out there that just aren't real."
Directly confronting the death panel issue, he said:
"[D]eath panels that will basically pull the plug on grandma because we've decided that it's too expensive to let her live anymore. … I'm not in favor of that."
"For all the chatter and the yelling and the shouting and the noise, what you need to know is this ... if you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need."
I am of the belief that we need a health care plan that covers all Americans. I lived in Canada and have seen the system work--although I agree with the President that the Canadian system wouldn't work for the United States; there are definitely kinks that could and should be ironed out in an American system. I also don't believe that any legislation should be rushed through, and that it should definitely be refined before being passed into law.
No universal health care bill will get passed that pleases everyone and that doesn't have some sort of problem, but I believe it will be beneficial for everyone to either have coverage in some way, or have the cost of their existing care lowered. If the government and private care coverage can compete, then everyone can benefit from lower costs and quality care. But everyone needs to know the truth about the bill that is currently being considered, and know what is downright false.
For further information on the death panel falsehood, please click here.
Tuesday, August 4, 2009
With product placement already ubiquitous in television and movies, the next logical place for brand integration is the CD — and Mariah Carey is taking the first step.
Brandweek magazine has reported that Carey's upcoming CD, Memoirs of an Imperfect Angel, will feature a 34-page insert in the CD booklet that is a collaboration with Elle magazine and which will include ads from upscale brands like Elizabeth Arden, Angel Champagne, Carmen Steffens, Le Métier de Beauté and the Bahamas Board of Tourism.
In addition to the ads, the mini-magazine will feature stories about the singer with titles such as "VIP Access to Her Sexy Love Life," "Amazing Closet" and "Recording Rituals" written and designed by the Elle team and mixed in with lyrics and other traditional liner-note materials. A spokesperson for Carey's label, Island/Def Jam, confirmed the report.
The ad-supported booklets — which will also be available in a digital format for downloaders — will appear in the first 1 million U.S. copies of the CD and the first 500,000 overseas, and if the experiment is well-received, even bigger branding deals could be in the works for upcoming CDs from Rihanna, Bon Jovi, Kanye West and other IDJ acts, according to the magazine.
A condensed version of the booklet, without the music-specific material, will be inserted into 500,000 subscription copies of Elle's October issue.
"The idea was really simple thinking: 'We sell millions of records, so you should advertise with us,' " said Antonio "L.A." Reid, IDJ's chairman. "My artists have substantial circulation — when you sell 2 million, 5 million, 8 million, that's a lot of eyeballs. Most magazines aren't as successful as those records." Reid said Carey was "very open" to the idea when he showed her a mock-up of the magazine with brands that fit her jet-setter lifestyle. "I wouldn't want to do Mariah Carey and Comet abrasive cleaner," Reid said. "I wanted things that really reflected her taste." Advertising revenues will subsidize the label's entire costs for producing the booklet.
The deal comes amid the continuing bad news for the music industry, which has seen sales down 13.9 percent so far this year compared with last year. It also follows on the heels of last year's deal by Chris Brown's label, Jive Records, with the William Wrigley Jr. company, which found him writing and recording a single, "Forever," that doubled as a commercial for Doublemint gum, a campaign that was suspended after Brown was arrested for assaulting then-girlfriend Rihanna; Brown pleaded guilty to a felony count of assault and was recently sentenced to 180 days of community service.
The Mariah initiative also gives IDJ a chance to promote the CD outside of traditional music stores and the constantly shrinking music aisles in large retailers like Wal-Mart and Target. At Wal-Mart, the CD will be featured outside the music section in a special display coordinated with Carey's new Arden fragrance, Forever, which will be advertised on the booklet's back cover. The CD and perfume will also be displayed together in the stores' beauty departments.