Using barbershops to encourage better health

In centuries past there was considerable overlap between the professions of barber and surgeon, and recently there have been efforts to use barber shops, particularly in African-American communities, for medical outreach. Pediatrician and medical school professor Dr Aaron Carroll talks about that in this video:


Link: https://youtu.be/VvtmC-PdqJY

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Where's the money going?

The middle decades of the 20th century were boom times for Americans. Partly this is because much of the rest of the industrialized world had been devastated by World War II, but actually recovering from that devastation meant that economic growth rates were pretty good even in Europe and Japan after the war. Even better, for once a rising tide really did lift all boats. Low-, middle-, and high-income people all saw major gains from economic growth, and low-income people working people actually saw their income grow a little faster in percentage terms than their higher-income counterparts.

Since roughly 1980, however, the spread between rich and poor has been getting worse. Consider just the 2000s: Below is a graph showing the change in real per capita gross domestic product for the United States. That is, it's the total amount of economic activity in the United States adjusted for inflation and divided by the size of the population:

Real GDP 2000-2018

This is an increase of over 25 percent on top of inflation, which is pretty good considering we went through a very bad recession starting in 1998 that was on its way to becoming a deep depression had the government not adopted a massive economic stimulus early in the Obama administration. (The last months of the Bush administration did some serious bailing as well.)

If the distribution of income had stayed the same, everyone would be about 25 percent better off in terms of gross income. The rich would be the same proportion better off than the poor and middle class, etc., but every group would be doing the same percentage better relative to a couple of decades earlier.

But of course we're not all equally better off. Quite the contrary, as the graph below illustrates. It was created by blogger Kevin Drum based on census data you can find here.

U.S. household income 1999-2018

The rich are getting richer, the poor are getting poorer, the people in the middle are doing a little better, and the top fifth of the population saw their income rise by about 11 percent.

But this looks like nobody is enjoying a 25 percent income increase. How is that possible? The answer, of course, is that the great bulk of that additional income is flowing to the narrow sliver of the population at the very top. These are of course the people enjoying the main benefits of last year's massive tax cuts for wealthy individuals and corporations.

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Jon Stewart offers to negotiate with Donald Trump

Jon Stewart interrupts The Late Show with Stephen Colbert to offer to negotiate with Donald Trump to end mistreatment of children at the border. This is actually from June 28 so it's a bit out of date, though less so than it should be.


Link: https://youtu.be/PYCPZrOkZx

This is a reference to the Trump administration's botched policy of separating immigrant children from their parents other caregivers at the U.S. border with Mexico, in many cases even when they presented themselves legally at a border crossing to request asylum in accordance with U.S. law. (If you think the policy applied only to illegal immigrants, you've been misinformed.)

The immediate reaction was so negative that even President Trump declared himself opposed to the cruel policy that traumatized children, but, he said, it was out of his hands, because the policy was required by laws that had been passed by Democrats and that only Democrats could change, which doesn't even make sense. Of course, the policy not only wasn't required, it was prohibited, and courts ordered the administration to comply with the actual law. Trump then retreated and reversed the policy he had just said he could not reverse.

Despite that, not all children have been reunited with their families in part because the policy change had been introduced in such a rushed and incompetent manner that there was no time to implement it properly, and the authorities royally screwed up the record-keeping.

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Bernie Sanders summarizes his views

I'm not a full-on Bernie Sanders partisan, but I like him well enough and appreciate his willingness to speak frankly. I do wish he wouldn't insist on calling himself a "democratic socialist" since he's not a socialist in the normal sense of the word but rather what in Europe would be called a social democrat, a species of moderate. True socialists believe in state control of major industries, whereas social democrats favor such things as public education, healthcare as a right, reasonable business regulations, and so on.

Below, in an appearance on CBS's The Late Show with Stephen Colbert in mid-August, Senator Sanders concisely summarizes his views, which I found pretty interesting. The two segments below are from before and after a commercial. The main discussion is in the first video.


Link: https://youtu.be/NaNkgtEnrW0


Link: https://youtu.be/dUIA_Ga6q4E

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What's wrong with short-term health insurance?

Back before the Affordable Care Act took effect, a lot of the health insurance horror stories I heard had to do with short-term health insurance policies. They were typically purchased by people who thought they were getting a really good deal since the policies tended to be cheap.

Unfortunately those policies are generally not renewable unless you stay healthy, so a serious illness or injury near the end of the policy's term could leave the patient suddenly uninsured and back then uninsurable. On top of that, such policies typically provide limited coverage and cap how much the insurance company will pay out. There had to be some reason the policies were so cheap, and that's it.

Under a full Affordable Care Act (Obamacare) policy it's the patient's spending that's limited, not the insurance company's.

The Affordable Care Act did allow temporary short-term policies to be issued, but only for three months, as a way of helping people get at least some inexpensive insurance between jobs. But now the Trump Administration has authorized "short term" policies for as long as a year. This can again lead naïve consumers to buy such bargain-basement insurance under the mistaken impression that health insurance is health insurance. (Others might buy them even knowing the coverage is skimpy because they're convinced that since they've never yet been seriously injured or ill, they never will be.)

Here's Dr Aaron Carroll on the subject:


Link: https://youtu.be/nz4Cb9oJuvc

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Self-driving vehicles from 45-60 years ago

Filmmaker Brady Haran visits the archive of The Associated Press in London and finds old newsreels of driverless tractors from 1958 and driverless cars from 1972-73. Then there's the creepy Billy the Beacon, a rather creepy robot for teaching British children how to cross the street in 1953:


Link: https://youtu.be/j5RYRwHKqRs

The AP archivist is Jenny Hammerton and the non-archival video was shot by Brady's associate James Hennessy.

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High death rate for mothers giving birth in the U.S.

As noted by, for example, a report last year from ProPublica and National Public Radio, the United States has by far the highest death rate in the developed world for women around the time of giving birth. It's not even close: As of 2015, there were 26.4 maternal deaths per 100,000 live births in the U.S. while in other advanced countries the rate ranged from 3.8 to 9.4. (These figures are from the NPR/ProPublica report; other estimates differ somewhat because of varying definitions and methods of measurement, but they're similar.)

Even worse, that rate has been rising in the U.S. even as it declines elsewhere. Here's a graph from the article on the NPR website:

Maternal death rates in the United States versus other developed countries

For possible reasons why, see this article by Dr Felicia Lester, MD, medical director of gynecologic services at the University of California, San Francisco.

Bad as the overall rate is, maternal mortality among African American mothers is about three times worse. Here's a summary of the situation and its likely causes from Dr Aaron Carroll, whose YouTube videos I often share here:


Link: https://youtu.be/VYc-Eq-vDuA

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Distracted driving: Even talking on a hands-free phone is pretty bad

My cell phone connects with my car via Bluetooth so I can make and receive phone calls in my car without taking my hands off the steering wheel. I rarely do it, though, because of what I've read about credible research.

You might think that because you're careful, you can talk on the phone or even text and send emails without impairing your driving. Unfortunately, you're almost certainly wrong. I know, I know, it seems that talking on the phone wouldn't be any more distracting that talking with a passenger, but again the research says otherwise. And on average, people who think they're better at dealing with distractions actually turn out to be worse.

People tend to be remarkably stubborn about their driving, so I doubt a lot of people will be persuaded by this, but if you do have an open mind the following might interest you:


Link: https://youtu.be/vpva5vr9tGE

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The cost of single-payer health insurance

In this video published August 31, pediatrician and medical school professor Dr Aaron Carroll points out that according to independent estimates, the Medicare for All program proposed by Senator Bernie Sanders would reduce total U.S. healthcare spending, in part because doctors and hospitals would be paid at Medicare rates.


Link: https://youtu.be/rZIF3LAIQWE

Of course, healthcare providers have a fair amount of political clout and might lobby for higher compensation, which could end up wiping out the savings.

On the other hand, the current complicated system means that nearly a third of healthcare spending actually goes to administrative overhead that would almost certainly be lower in a single-payer system, so healthcare providers might well wind up better off even with lower gross billings.


Link: https://youtu.be/wnZKKvG5rQQ

It's of course worth recalling that all other advanced countries spend less per citizen, often a lot less, than the United States does, and our healthcare outcomes aren't on the whole better than average. Single-payer systems, as used in the United Kingdom, Italy, Canada, and Taiwan, but the better-regulated multi-payer systems found in Switzerland, Germany, Israel, Japan, and elsewhere still cost less than ours.

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