Many in US get too much medical care: survey

http://www.breitbart.com/article.php?id=CNG.a1a0fa7851ea5002e0eaf3cb1af82a01.6d1&show_article=1
Forty-two percent of US doctors believe that their patients are getting too much medical care, according to a survey published Monday which suggests fears of malpractice suits may be to blame.
A total of 28 percent said they felt they were treating their patients too aggressively, while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse.
Fifty-two percent said they felt their patients were receiving just the right amount of care and six percent said their patients were receiving too little, said the study in the Journal of the American Medical Association.
"Our findings show that many primary care physicians believe there is substantial unnecessary care that could be reduced, particularly by increasing time with patients, reforming the malpractice system, and reducing financial incentives to do more," it said.
The United States has the world's highest health spending per capita among developed nations, at $5,475 compared to the next-highest country,Switzerland at $3,581, according to a separate US study published in 2007 in the journal Health Affairs.
Health care in the United States is a hot political issue, and President Barack Obama's moves to reform the system and extend insurance coverage to an extra 32 million people has faced opposition from Republicans and sparked court challenges.
Seventy-six percent of survey respondents said that concerns about possible malpractice suits were the main reason why they gave patients more aggressive treatment.
"Physicians believe they are paid to do more and exposed to legal punishment if they do less," said the article.
"The extent to which fear of malpractice leads to more aggressive practice (so-called defensive medicine) has been hotly debated; based on our findings, we believe it is not a small effect."
Forty percent said they did not have enough time to spend with patients.
While only three percent said their own style of practice was influenced by financial considerations, 39 percent "believed that other primary care physicians would order fewer diagnostic tests if such tests did not generate extra revenue," said the study.
"Almost two-thirds (62 percent) said that medical subspecialists would cut back on testing in the absence of a financial incentive."
The results are based on a mail survey that was filled out by 627 doctors in theUnited States.
Seventy percent of the doctors included in the initial mailing replied, which the authors called "exceptional for a survey of American physicians."
The study was led by Brenda Sirovich and colleagues from the VA Outcomes Group in Vermont and the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.

Climate skeptics don’t ‘deny science’

http://articles.boston.com/2011-09-25/lifestyle/30201605_1_climate-skeptics-climate-depot-global-warming/2

BILL CLINTON declared last week that Americans “look like a joke’’ because leading Republican presidential contenders decline to embrace the agenda of the global-warming alarmists. Presumably he had in mind Texas Governor Rick Perry, who says that “global warming has been politicized’’ and calls claims of a decisive human role in climate change an unproven theory. “You can’t win the nomination of a major political party in the US,’’ fumed the former president, “unless you deny science?’’

To which Marc Morano, publisher of the irreverently skeptical website Climate Depot, promptly replied: “Bill is correct! No Democratic presidential candidate could get the nomination unless they deny the large role that natural variability plays in climate.’’

n truth, global-warming alarmism is not science at all - not in the way that electromagnetic radiation or the laws of planetary motion or molecular biology is science. Catastrophic climate change is an interpretation

of certain scientific data, an interpretation based on theories about the causes and effects of growing concentrations of carbon dioxide in the atmosphere. It is not “denying science’’ to have doubts about the correctness of that interpretation any more than it is “denying economics’’ to have doubts about the efficacy of Kenyesian pump-priming.

You don’t have to look far to see that impeccable scientific standards can go hand-in-hand with skepticism about global warming. Ivar Giaever, a 1973 Nobel laureate in physics, resigned this month as a fellow of the American Physical Society (APS) to protest the organization’s official position that evidence of manmade climate change is “incontrovertible’’ and cause for alarm. In an e-mail explaining his resignation, Giaever challenged the view that any scientific assertion is so sacred that it cannot be contested.

“In the APS it is OK to discuss whether the mass of the proton changes over time and how a multi-universe behaves,’’ Giaever wrote, incredulous, “but the evidence of global warming is incontrovertible?’’

Nor does Giaever share the society’s view that carbon emissions threaten “significant disruptions in the Earth’s physical and ecological systems, social systems, security, and human health.’’ In fact, the very concept of a “global’’ temperature is one he questions:

“The claim (how can you measure the average temperature of the whole earth for a whole year?) is that the temperature has changed from ~288.0 to ~288.8 degrees Kelvin in about 150 years, which (if true) means to me … that the temperature has been amazingly stable, and both human health and happiness have definitely improved in this “warming’ period.’’

By now, only ideologues and political propagandists insist that all reputable scientists agree on the human responsibility for climate change. Even within the American Physical Society, the editor of “Physics and Society’’ (an APS publication) has acknowledged that “there is a considerable presence within the scientific community of people who do not agree … that anthropogenic CO2 emissions are … primarily responsible for the global warming that has occurred since the Industrial Revolution.’’

Giaever is only one of many distinguished scientists who dissent from the alarmist view on climate change. Among the others are Richard Lindzen of MIT and John Christy of the University of Alabama at Huntsville, both noted climatologists; the eminent physicist Freeman Dyson of Princeton’s Institute for Advanced Study; and S. Fred Singer, professor emeritus of environmental science at the University of Virginia. As for the population of weather experts best known to the public - broadcast meteorologists - The New York Times reported last year that skepticism of the prevailing anthropogenic global-warming theory “appears to be widespread.’’

Such skepticism is not “anti-science.’’ Everything in science is subject to challenge; innumerable facts about the natural world have been discovered only by poking holes in once-dominant theories. And if that is true generally, how much more so is it true when it comes to something as vast as climate change? Researchers still have no way “to reliably discriminate between manmade warming and natural warming processes,’’ climate scientist Roy Spencer has written. “We cannot put the Earth in a laboratory and carry out experiments on it. There is only one global warming experiment, and we are all participating in it right now.’’

Someday the workings of climate change may be as well understood as plate tectonics or photosynthesis. Until then, different theories will compete, assumptions will be fought over, and scientific findings will be overstated by people with political or social agendas. We’ll know that the science really is settled when the battles have come to an end.

Jeff Jacoby can be reached at jacoby@globe.com. Follow him on Twitter @Jeff_Jacoby.

'Buffett Rule' is just playing to the crowd

http://www.cnn.com/2011/09/22/opinion/navarrette-buffett-rule/index.html?hpt=op_t1

Editor's note: Ruben Navarrette Jr. writes a weekly column for CNN.com and is a nationally syndicated columnist.

San Diego, California (CNN) -- Billionaire Warren Buffett has been thinking about the inequities in the U.S. tax system at least since June 2007. I know this because, during PBS' Democratic presidential debate in which I served on a panel of journalists, I asked the eight Democrats, including Barack Obama, what they thought of comments Buffett had made about the unfairness of a tax system where his secretary paid a higher percentage of her income in taxes than he did.

I asked Obama if he agreed with Buffett that the rich weren't paying their fair share, and what he would do about it.

"There's no doubt that the tax system has been skewed, " Obama answered. "But I think this goes to a broader question, and that is, are we willing to make the investments in genuine equal opportunity in this country?

"People aren't looking for charity, and one of the distressing things sometimes when we have a conversation about race in America is that we talk about welfare and we talk about poverty, but what people really want is fairness," he said. "They want people paying their fair share of taxes."

I'll co-sign the last part. People should pay their fair share, and that clearly isn't happening. It's true that, at the macro level, the wealthiest people collectively pay most of the taxes in this country. But it's also true that, at the micro level, individual taxpayers in the upper income brackets often take advantage of tax laws that allow them to pay a lower percentage of their income in taxes than everyday Americans.

This doesn't make the wealthy bad people. But it does make for a bad system. It's no wonder that public opinion polls consistently show that Americans want the rich to pay more.

This week, a Gallup Poll found that 70% of respondents favor raising taxes on some corporations by eliminating certain tax deductions and 66% favor increasing income taxes on individuals earning at least $200,000 a year and families earning at least $250,000.

Now, under what it is being called the Buffett Rule, the White House wants to give people what they want. Framing it as an attempt at deficit reduction, the administration is proposing a new minimum rate for people earning more than $1 million a year, all to help make sure they pay at least the same percentage of their income as middle-class Americans.

Predictably, conservatives reacted with howls of protest and accused Obama of engaging in class warfare. Obama responded, "This is not class warfare. It's math."

Actually, it's neither. It's election year gimmickry that stands no chance of going anywhere with a Republican-controlled House of Representatives. Obama knows that, and that's why he considers it safe to propose such a plan now rather than in the first half of his administration when the House was in the hands of Democrats.

Why didn't he propose it then? I think it's because it might actually have become law, and then the Democrats would have owned this new tax policy and have had to answer to voters in future elections. This way, Obama gets to excite the base in time for his re-election campaign with a proposal that won't go anywhere, without having to pay a political price.

As for the Buffett Rule itself, it isn't a bad idea. But it isn't a particularly good one either. The current system, the one Buffett complains about, is inequitable. But the Obama plan would just flip the inequity so the wealthy pay more. We would go from overburdening the middle class to putting the burden on the rich. That would preserve the progressive tax rates, but it wouldn't be progress.

The answer lies in a third way: a fairer, flatter tax that lets all Americans pay the same percentage of their income in taxes. Maybe it would be 15%. Or 17%. Or 20%. The specifics aren't as important as the concept.

About 15 or 20 years ago, you could hear support for that idea from conservative Republicans like the late Jack Kemp, the former congressman and 1996 GOP vice presidential nominee, and billionaire Steve Forbes, who ran for president in 1996 and 2000. Fiscal conservatives liked a flat tax because they thought it was wrong to punish overachievers who earn a lot of money with confiscatory tax rates, and they saw it as a way of making the tax system more equitable.

Conservatives were right back then. Yet, they're wrong now to defend the current system. The White House doesn't have the right solution. But there is no point in denying the problem.

Stimulus and the Depression: The Untold Story The U.S. doesn't need another war to revive the economy. We need a policy turnaround like the one in the late 1930s.

http://online.wsj.com/article/SB10001424053111904787404576532141884735626.html?mod=WSJ_Opinion_LEADTop

By HAROLD L. COLE AND LEE E. OHANIAN

About one-half of President Obama's proposed $447 billion American Jobs Act consists of payroll tax holidays designed to boost spending and increase hiring. But these temporary policies will do little to jump-start the economy, much as earlier temporary economic Band-Aids, such as the 2009 stimulus, did little to improve the economy.

Proponents justify stimulus spending in part based on the widely held view that government-fueled increases in "aggregate demand" during FDR's New Deal ended the Great Depression and brought recovery. Christina Romer, former chairwoman of Obama's Council of Economic Advisers, has argued in op-eds that government should continue to spend for this reason. And in a 2002 speech as a Federal Reserve governor, current Fed Chairman Ben Bernanke claimed that monetary expansion and the turnaround from the deflation of 1932 to inflation in 1934 was a key reason that output expanded.

But boosting aggregate demand did not end the Great Depression. After the initial stock market crash of 1929 and subsequent economic plunge, a recovery began in the summer of 1932, well before the New Deal. The Federal Reserve Board's Index of Industrial production rose nearly 50% between the Depression's trough of July 1932 and June 1933. This was a period of significant deflation. Inflation began after June 1933, following the demise of the gold standard. Despite higher aggregate demand, industrial production was roughly flat over the following year.

The growth that followed the low point of the Depression was primarily due to productivity. Productivity is considered a supply-side factor by many economists: It is determined by the technology and regulatory structure of the economy and therefore is largely independent of spending policies.

The growth rate of real per capita output is the sum of the growth rate of per capita labor input and productivity growth. Increasing aggregate demand is supposed to increase output growth by increasing labor input. But between 1932 and 1934, the period that Mr. Bernanke cited in his speech, per capita real gross domestic product (GDP) growth was entirely due to productivity growth, as per capita total hours worked—a standard measure of labor input—was actually, according to our research, lower in 1934 than it was in 1932.

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Corbis

A bread line forms at 42nd Street and Sixth Avenue in New York City on Feb. 1, 1932.

One reason that many believe higher aggregate demand brought about by government spending programs and monetary expansion created recovery is because unemployment did decline between 1933 and 1937. But declining unemployment reflected significant work-sharing in New Deal policies that began in 1933 with the President's Reemployment Agreement and continued with the National Industrial Recovery Act of 1933 and the Fair Labor Standards Act of 1938.

Work-sharing increased employment by spreading jobs across more people. Spreading scarce jobs was probably desirable. But the key point is that higher aggregate demand didn't significantly expand the amount of work that was done.

Productivity growth continued to be the major factor for the rest of the 1930s, accounting for about three-quarters of the growth in real per capita output that occurred between 1932 and 1939. But despite rapid productivity growth, the economy remained well below trend because labor input failed to recover. In 1939, labor input as measured by total hours worked per adult was more than 20% below the 1929 level.

Per capita real GDP was about 27% below trend in 1939, with more than three-quarters of this shortfall due to the continuing depression in labor. Our research indicates that New Deal industrial and labor policies, such as the National Industrial Recovery Act and the Wagner Act (the National Labor Relations Act), were the main reasons. The NIRA, for example, fostered monopoly and raised wages well above underlying worker productivity by a quid pro quo arrangement of relaxing antitrust enforcement in exchange for industry paying substantially higher wages.

The Wagner Act substantially increased unionization and union power. This, in conjunction with government's toleration of sit-down strikes, in which union workers forcibly seized factories to stop production, increased wages further.

In the absence of these policies, we estimate that labor input would have been about 20% higher than it was at the end of the 1930s and would have returned the economy to trend by that time.

Productivity growth is overlooked today. But as in the case of the Great Depression, economic growth since the trough of the Great Recession in June 2009 has been largely accounted for by productivity growth rather than the restoration of jobs. Following the recession's June 2009 trough, about 80% of real per capita GDP growth is due to growth in output per hour worked. And GDP growth is slowing now because productivity is no longer growing.

The economy began to recover following the New Deal because policy changed for the better. In a 1938 speech President Roosevelt acknowledged that some administration policies were retarding recovery. Economic policy shifted considerably around this time, and the economy boomed. Antitrust enforcement resumed. The fiercely controversial undistributed profits tax, which was retarding investment, was drastically reduced and then eliminated in 1939. The sit-down strike was declared illegal, and employers could fire sit-down strikers.

The policy changes in the late 1930s benefited the economy by increasing competition, by bringing wages more in line with productivity, and by improving the incentives for investing. Many assume that World War II spending singlehandedly brought the economy out of the Depression, but nearly half of the increase in nonmilitary hours worked between 1939 and the peak of the war already had occurred by 1941, well before the major wartime spending took place.

Policy can also improve today. The bipartisan Joint Select Committee on Deficit Reduction will make a recommendation by Nov. 23 to deal with future deficits. It has an outstanding opportunity to initiate broad-based tax reform that adopts the recommendations of most bipartisan tax reform commissions of the last 20 years: a simpler tax code that improves the incentives to hire and invest, broadens the tax base, lowers the corporate income tax, and also eliminates loopholes to equalize tax treatment of capital income. Sensibly addressing our long-run challenges will do more for the economy than continuing the stop-gap measures that have dominated policy-making for the last three years.

Mr. Cole is professor of economics at the University of Pennsylvania. Mr. Ohanian is professor of Economics at UCLA and a senior fellow at the Hoover Institution. They are authors of "New Deal Policies and the Persistence of the Great Depression: A General Equilibrium Analysis" (Journal of Political Economy, 2004).