AlterNet.org: Personal Health

Bill Moyers: Our Media Is Polluted by Toxic Lies About the Risks Posed by Lead

Bill Moyers, David Rosner, Gerald Markowitz, BillMoyers.com — Fri, 17 May 2013 14:43:00 -0700

There’s no safe level of exposure to this dangerous toxin still lurking in millions of homes, but that truth is consistently under attack from industry-funded public relations excecutives.

From BillMoyers.com:

INTRO:Science can be a battleground — witness the politics of climate change, the teaching of evolution, the uncharted terrain of genetic modification and stem cell research, among other contentious issues. But when industries release untested chemicals into our environment — putting profits before public health — our children are the first to suffer. Nowhere is this more troubling than in the ongoing story of lead poisoning.

Bill talks with David Rosner and Gerald Markowitz, public health historians who’ve been taking on the chemical industry for years — writing about the hazards of industrial pollution and the neglect of worker safety — despite industry efforts to undermine them. Their latest book, Lead Wars: The Politics of Science and the Fate of America’s Children, is the culmination of 20 years of research. Markowitz and Rosner warn that, for young children, there’s no safe level of exposure to this dangerous toxin still lurking in millions of homes.

The authors discuss thwarted efforts to hold the lead industry accountable, failed attempts to find cheap solutions, and the cost to the future of our children. As long as the chemical industry and its powerful lobbies prevail in blocking efforts to reform outdated laws, Markowitz and Rosner say, we will continue to float in a soup of toxins — inhaling, drinking, and absorbing chemicals that we may learn, years later, have put us all in harm’s way.

***

BILL MOYERS: At the end of a week that reminded us to be ever vigilant about the dangers of government overreaching its authority, whether by the long arm of the IRS or the Justice Department, let’s pause to think about another threat, from too much private power over public policy.

All too often, instead of acting as a brake, government becomes the enabler of corporate power and greed, undermining the very rules and regulations intended to keep us safe.

Think of inadequate inspections of food and those infections which kill 3,000 Americans each year and make many millions sick. Think of the 85,000 industrial chemicals available today. Only a handful have been tested for safety. Think of the explosion of perhaps as much as half a million pounds of ammonium nitrate in that Texas fertilizer plant. People can die when government winks at bad corporate practices.

As long as there are insufficient checks and balances on big business and its powerful lobbies, you and I are at their mercy. Which is why their ability to buy off public officials is an assault on democracy and a threat to our lives and health. Keep that in mind as I introduce you to David Rosner and Gerald Markowitz.

Some years ago, their book, Deceit and Denial, told how the chemical industry tried to conceal the truth about untested and unregulated chemicals in our food, water, and air. Twenty companies responded with a vicious campaign to smear their reputations. That proved hard to do, actually, impossible.

Gerald Markowitz is a distinguished professor of history at both John Jay College of Criminal Justice and the City University of New York’s Graduate Center. David Rosner is co-director of the Center for the History and Ethics of Public Health at Columbia University where he also teaches science and history.

This is their new book, which revisits a chemical menace you might have thought was behind us, but isn’t: Lead Wars: The Politics of Science and the Fate of America’s Children.

BILL MOYERS: Gerald Markowitz, David Rosner, welcome.

DAVID ROSNER: Thank you.

GERALD MARKOWITZ: Thank you.

BILL MOYERS: Your book concludes that after all these years, lead is still a problem.

GERALD MARKOWITZ: Absolutely. You know, in some ways the story of lead is a great success. We’ve reduced the amount of lead in children's blood and we've gotten lead out of gasoline and we've gotten lead out of paint. But there are still children who have too much lead in their blood. And it is endangering their life chances, endangering their futures.

BILL MOYERS: Does it kill?

DAVID ROSNER: It doesn't kill anymore. It used to send kids into convulsions, into comas and into paroxysms and ultimately killed them up until the 1980s. But we've gotten lead levels down to the point where we're now discovering new, even in some sense, more troubling problems.

BILL MOYERS: What's the most important thing you've discovered about lead since we last talked?

DAVID ROSNER: Well, that in what we would once have considered miniscule amounts lead in children can cause neurological damage, causes behavioral problems, attention deficit disorders, dyslexia. Studies show that children who are exposed in utero can have permanent neurological changes that put them at risk later in life for learning disabilities that lead to failure in school and IQ loss. There are a whole series of problems that we never even thought about in the old days, so to speak.

GERALD MARKOWITZ: It's shocking that we know that children can be prevented from any kind of lead poisoning if they are, live in a home that is lead free. And this is no longer, you know, a priority of the country. We still have many homes millions of homes that contain lead that are endangering our children.

BILL MOYERS: Is it the cost of getting rid of the lead from homes that are already established and we're living in, is that the main barrier?

DAVID ROSNER: For some it is. But the history of public health, and that's what we are, historians, is rife with examples of decisions that are very costly that we decided are necessary for the population as a whole.

But somehow because we have in some sense accepted a definition of what the problem is and who the victims are and we've devalued their lives, we decided not to address this issue because it's quote, “too costly.”

GERALD MARKOWITZ: We really made a morally bankrupt calculation that it is less costly to endanger the health and futures of our children rather than to protect them by paying to remove lead from their homes.

DAVID ROSNER: The message really should be is we need to really think of lead as one symbol, one symptom of this much larger problem of the pollution of our children, pollution of their lives, the pollution of all of us from a whole host of toxic materials that we are, we've grown accustomed to using and tend to put out of our consciousness.

BILL MOYERS: When I first met you, people were saying, scientists were saying, that the smaller the dose of lead, the exposure to lead, the safer it would be.

GERALD MARKOWITZ: Scientists now say that it is very likely there is no safe level of lead, that any amount of lead in a child's body, in a child's blood, you know, causes a variety of neurological and intellectual problems. So this is really a sea-change in our understanding of what, the amount of a toxin that causes a problem for children.

DAVID ROSNER: We no longer have children convulsing and going into comas. In other parts of the world they still are from lead exposures. In Africa, in Nigeria, children still are exposed to huge amounts of lead from a variety of sources. And a recent article indicates that we're still selling lead paint, for example, to other countries despite the fact that we in this country no longer use it on our walls. But if you look at where lead poisoning is most prevalent, when you look at the communities that are most affected by lead they're usually communities, poor communities, working class communities, parts of the cities that are more run down because the lead that is dangerous is the lead that comes off of walls of old buildings. And walls of old buildings that are not maintained give off more lead than walls of old buildings that have been recently renovated. It's hard to believe how much lead there is in an old home. I mean, we often think of paint as just a lot of liquid with a little bit of color. But in fact, when you looked at lead paint and you lifted it in your grandfather's garage or, you know, my grandfather's garage, it was very, very heavy. And that's because about, in that can of paint there was 15 pounds of lead. And that was being painted on walls, three coats on each wall, every five to ten years, whatever the renovation took. We were putting literally hundreds and hundreds of pounds of lead, a deadly toxin at that point, that a small fingernail's worth could actually cause convulsions, into the children's environment.

BILL MOYERS: Well, there were ads actually promoting lead paint as the right paint for your home.

DAVID ROSNER: They said that lead paint was a friend of the child and that it could be spread on any surface and it could be fun to do. And they showed these ads in which children are painting their toys, painting their cabinets, painting their walls, painting their furniture with a poison. At the same time when all these cases are appearing in the medical press about lead poisoned children, at the same time when in their own internal documents they're saying, we have these examples, we have, we're being attacked because children and babies are getting poisoned by lead on their cribs.

And so you see this kind of progression of this problem from the 1930s when it once killed children and sent them into comas straight through the early 2000s and now when the CDC says there are a half million children, I mean half million children at risk, a half million children with elevated blood lead levels. This would be a national epidemic, I mean, if this were meningitis, if this were polio. I mean, could you imagine the reaction of the society?

GERALD MARKOWITZ: And the industry said over 50 years ago that this was an insoluble problem, it was a problem of, caused by slums, it was a problem caused by who they called uneducable parents. And so that they washed their hands of the problem and they have still washed their hands of the problem. Parents have played, excuse me, paid the cost of lead poisoning. Landlords have even paid the cost of lead poisoning. The government has paid the cost of lead poisoning. The industry has not paid to get that lead off the walls so future generations of children can be protected.

BILL MOYERS: What your critics say is, look, it's like gasoline in cars. We didn't intend harmful effects to come from a product that was fueling America's economy. We found out later and we're trying to cut back on emissions.

This applies as well to lead and other toxins in our environment. Nobody intended it, it proved to be a consequence of, as even you say in here, the enormous amount of material we've taken out of the earth and turned into the engine of our prosperity.

GERALD MARKOWITZ: Well, unfortunately they didn't give them the information about the dangers of lead that they had. They knew that lead was killing children in the 1930s. They knew that researchers were uncovering lead and they were fighting those, the diagnoses of lead poisoning in children. They, even into the 1970s and '80s, they went after researchers like Herbert Needleman who were uncovering the low levels of lead that were damaging children. They were not innocent purveyors of a product. They were actively involved in the political dialog attempting to increase their profits at the expense of public health.

BILL MOYERS: I interviewed Herbert Needleman some years ago for a documentary on Kids and Chemicals. Let's take a look.

BILL MOYERS in Kids and Chemicals: In the late 1970s Dr. Needleman studied the baby teeth of healthy schoolchildren in two Boston suburbs […]

DR. HERBERT NEEDLEMAN in Kids and Chemicals: When we looked at the data, we found that children who had high lead in their teeth, but who had never been identified as having any problems with lead, had lower IQ scores, poorer language function, and poorer attention.

BILL MOYERS in Kids and Chemicals: It was a stunning discovery, and no one knew it better than the lead industry. Leaded gasoline was the single greatest source of lead exposure, and as a result of Needleman’s work the Environmental Protection Agency sped up efforts to ban it. The lead industry fought back, denying Needleman’s science.

JEROME COLE in Kids and Chemicals: Lead has been used in gasoline for over 60 years. There’s simply no evidence that anyone in the general public has ever been harmed by this usage […]

DR. PHILIP LANDRIGAN in Kids and Chemicals: The lead industry attacked it viciously and they attacked Dr. Needleman himself. They accused him of scientific misconduct and they actually filed charges against him at his university and at the National Institutes of Health.

DR. HERBERT NEEDLEMAN in Kids and Chemicals: It’s like a death sentence. If you’re found guilty of scientific misconduct you’re out of business; your reputation is ruined; you’re through.[…]

BILL MOYERS in Kids and Chemicals: The assault went on for three years. For three years, Dr. Needleman stood his ground.

DR. PHILIP LANDRIGAN in Kids and Chemicals: Those were tough years in Dr. Needleman’s life. Eventually those charges were shown to be baseless and the people that brought them forward who had portrayed themselves as neutral scientists were, in fact, revealed as consultants to the lead industry. It took several years for the truth to out. But he triumphed.

DR. HERBERT NEEDLEMAN in Kids and Chemicals: I knew I was right. I mean, I knew that the work was good. I knew that my colleagues who worked with me on it were honest people. But I realized that science is not always the polite intellectual activity that it appears to be; that environmental science sometimes becomes something closer to warfare.

BILL MOYERS: So that's why you called this Lead Wars, I assume?

DAVID ROSNER: That's right.

GERALD MARKOWITZ: Yes.

DAVID ROSNER: That's where the title comes from. This is one of the, you know, tactics of this industry, of these industries to essentially control the regulators, to find ways of both undermining, in Herb Needleman's case, the integrity or the scientific integrity of the researcher by trying to attack his personality or his research, his data, but also trying to find ways of getting the regulatory agencies in government to see anyone who in any way cast doubt on their product as biased as opposed to a neutral observer. But it wasn't only lead. The more industries we look at, the more like other industries the lead story is.

BILL MOYERS: How so?

DAVID ROSNER: Well, you look at the asbestos story. Our homes are still, you know, covered with asbestos. It's on, in old homes, it's on the shingles that, you know, we use, it's in the floor coverings that, the vinyl that we use, it’s on the roofs. It's on our boil, older boilers still, but when you look at the history of asbestos the knowledge about that product goes back literally decades and decades and decades.

Then you look at the silica industry, the, when you look at the vinyl chloride industry, when you look at the PCB story. And the same unfortunate, the same unfolding of, what can you say but corporate greed.

GERALD MARKOWITZ: And in addition to the corporate greed there is their war on science. The attacks on global warming. There is a war on bisphenol A, which is in a wide variety of products, it is virtually in every human being in the United States--

BILL MOYERS: What is it?

GERALD MARKOWITZ: It is basically an ingredient in plastic that is in the linings of cans, it's even in receipts that we get every day from a clerk at a store, the credit card receipt. And we take that and that has bisphenol A on it. And we end up absorbing that.

There's been a tremendous amount of research that shows that it is an endocrine disruptor, that it causes a disruption of the endocrine system that can affect reproduction, that can affect development of the fetus. But it's also a carcinogen. And so this is a real problem that the industry has been fighting to cast doubt on really amazing science that has been done by a wide variety of people.

BILL MOYERS: Just this April California's Environmental Protection Agency put it on its toxins list. The American Chemistry Council is suing California to keep this off of that list of dangerous substances.

GERALD MARKOWITZ: And they are supporting research that, as David said creates doubt about the independent scientists who are finding these variety of subtle and not so subtle effects. And they are determined, as they did, as we talked about in tobacco, in global warming, in lead, in asbestos, to make people not be convinced. And if they're not convinced, if they have a question in their mind, then they can continue to sell their chemical.

BILL MOYERS: You two have been yourselves the subject of harassment, legal suits, attacks, efforts to discredit you, right?

GERALD MARKOWITZ: Absolutely.

DAVID ROSNER: There was an article in a legal journal that kind of warned us about what was going to happen. It talked about the title of our book--

GERALD MARKOWITZ: Which was Deadly Dust.

DAVID ROSNER: --which was called Deadly Dust. And it said, you know, we could let Rosner and Markowitz play by themselves in their own little play yard of historians, but they, their book has appeared in lawsuits against the industry. And it has become the dominant narrative or it's becoming the dominant narrative of how silicosis is understood. Therefore we have to do something about them. They didn't quite say it in those words, but that was the implication.

GERALD MARKOWITZ: Well, they said, you know, be an academic and talk only to academics. But when you talk to the public that's dangerous.

DAVID ROSNER: And then very shortly afterwards we found Deceit and Denial, the next book we did came under enormous attack. They actually subpoenaed the press, they subpoenaed the foundation that supported us, the Milbank Foundation.

GERALD MARKOWITZ: They subpoenaed the peer reviewers of the book for a university press.

DAVID ROSNER: And then they hired a historian to call us unethical, lousy historians, to attack minor footnotes in the book that weren't wrong, but he claimed were wrong. It was quite an attack. And I think the biggest thing they do, though, is try to introduce doubt. One of the issues that they constantly are raising is you don't have definitive, you don't have definitive proof that in 60 years, for example, children might develop cancer from exposure to bisphenol A, right. You don't have the long term studies that we think are really essential.

But you introduce doubt about the data and then you find other people to introduce studies that raise questions about it. So you introduce, it's really the production of uncertainty. Produce uncertainty about the issue and we as an industry have no obligation to prevent disease. And it's completely antithetical to everything that public health could, public health's supposed to be about preventing disease and you always work on imperfect data. You never have the long term 60-year study that tells you you're going to have damage 60 years from now. So that's one of the tactics, it's just to keep saying there's a question, there's a question.

GERALD MARKOWITZ: And to attack people like Herbert Needleman, and to create the kind of uncertainty that gives parents pause. Should I act or should I not act? And that is probably the, as David says, the most dangerous thing they do.

BILL MOYERS: But it's consistent with what you have learned as historians this industry and others have done over the years to whistleblowers, to truth tellers, to neutral scientists and journalists who are just simply trying to report what the public should know.

GERALD MARKOWITZ: But if you can't contest the message then you go after the messenger. But think about all the younger academics who are deciding what they're going to study, what they're going to work on. And for those people it is a real decision. Are they going to go up against powerful industries or are they going to do something safe? And our fear is that more and more younger scholars and younger scientists will end up doing something safe rather than something that could really make a difference in the public arena.

BILL MOYERS: Both of you were witnesses in that big case in Rhode Island. Can you summarize that and what happened?

GERALD MARKOWITZ: Well, this was the longest civil trial in Rhode Island history, or at least up to that point. And it was a remarkable effort by the attorney general of the state of Rhode Island to prevent future damages for lead’s harm to the children of Rhode Island. It was really a public health lawsuit, an amazing public health lawsuit.

BILL MOYERS: As I understand it Senator Whitehouse whom I have met had this problem before he was a senator. He had inadvertently exposed his own children to lead when he renovated his house. And then he became attorney general and brought this suit to try to hold the industry accountable.

GERALD MARKOWITZ: It took, unfortunately, his personal tragedy to get him to take this extraordinarily important action. And we were asked to testify in that case to provide the historical evidence of what the lead industry knew about the dangers and what did they do with that knowledge, which basically was to deny that there was a problem, to say that this was a public relations problem for them rather than a public health problem.

Our documents showed that they had been, they'd known about what they were creating, they'd known that children would be poisoned, they were discussing children dying as early as the 1920s and '30s, and yet they had created this huge environmental mess of millions and millions of pounds on the walls of Rhode Island, all of which was waiting to poison future generations.

DAVID ROSNER: And that they had done nothing about it, they continued to market. And that really, I think, enraged the jury.

GERALD MARKOWITZ And we were thrilled, just thrilled when at the end of this trial the jury came back and for the first time in lead industry lawsuits they held three lead companies responsible for cleaning up the mess, in the form of lead paint on the walls of houses throughout Rhode Island.

BILL MOYERS: So the jury said the industry has to clean up and pay for it?

GERALD MARKOWITZ: Absolutely.

BILL MOYERS: For the first time?

GERALD MARKOWITZ: First time.

DAVID ROSNER: This was the high point of our professional careers, the idea that we could use history and we could use the legal system really prevent disease for the future, not just pay back for the damages already done that were irreversible to children, but to actually prevent future generations. This was a suit that actually was going to demand somewhere between $1 billion and $4 billion from the companies to clean up the mess they had created. The low point of our lives, our professional lives, came two years later when the Supreme Court in Rhode Island overturned the decision.

BILL MOYERS: And what was the basis for them taking it back?

GERALD MARKOWITZ: Basically, they said that the lawsuit was filed under the wrong law, that it was filed under public nuisance law rather than under liability law.

DAVID ROSNER: What's interesting now is that there's another suit coming up in California. And there was fear that the California suit would not go forward because they thought the precedent of the Rhode Island Supreme Court denying the legitimacy of the suit would undermine that case. The Court in California rejected the arguments of the Supreme Court in Rhode Island. The Supreme Court of Rhode Island had said this can't go under, there is no standing in future generations to get damages from these companies because they haven't been damaged yet. Until the kids are damaged you can't actually sue. And California has said that absolutely, public health law is all based upon preventing disease. All regulations are in order to prevent future damage, therefore it can go forward in California. So we're quite excited because in June this court is, this case is going to be heard by a California jury.

BILL MOYERS: Tell me about the Baltimore case that you write about.

DAVID ROSNER: In the 1980s, researchers at Hopkins wanted to find a way of remedying the conditions of Baltimore's housing, which lead was all over the place. And they were trying to find a way of doing it cheaply. So what they did is they set up three kinds of housing, one of which has been renovated to $1,650 worth of renovation, another to $3,500 and the last to $7,000 worth of renovation.

And then they recruited mothers, young mothers with children between the ages of six months to five years to live in these different houses, knowing that each house had lead exposures, but that if they could find which was the cheapest and which was the most effective way of lowering the blood lead level, not actually eliminating lead but lowering it a little bit.

GERALD MARKOWITZ: And perhaps the most troubling part of the experiment was that we've seen the consent forms and the consent forms do not tell parents that living in these homes may cause their children to be lead poisoned.

And as a result they ended up exposing 100 kids to less than fully abated homes expecting that most of those blood lead levels of those children would go down. And in fact, for most of the children their blood lead levels did go down. But some of the children, their blood lead levels went up.

DAVID ROSNER: What the court says is they were using children as human guinea pigs, as canaries in the mine so to speak, they were using them to measure the effectiveness of each one of their methods of abating lead. You know, this is young women, single mothers by and large with children, young children. And--

GERALD MARKOWITZ: Overwhelmingly African American.

DAVID ROSNER: And this is the, one of the most prestigious medical institutions in the country, Johns Hopkins.

BILL MOYERS: Weren't they trying to figure out how little could be spent to protect children in the short term? And wasn't that the wrong question altogether, don’t we need to solve these problem for the long run?

GERALD MARKOWITZ: Absolutely. And the lead researchers understood that the only way to solve the problem of lead poisoning in children was to get rid of all the lead from the walls. But they didn't think that there would be the political will to do that.

BILL MOYERS: Why don't we have that political will?

GERALD MARKOWITZ: Basically the industry has bought that political system.

DAVID ROSNER: For the past 40 years really we've been living under this set of assumptions about the scarcity in our society, how we can't afford anything and how government can't do anything. Government is the problem, not the answer. That's diametrically opposed to virtually all principles of course of public health which sees government as something that really could do something good. And but we've been taught over and over again that it's too expensive and government is the problem. And therefore we're incapacitated.

BILL MOYERS: With millions, billions of dollars at stake in profits aren't they following a kind of logic of capitalism?

GERALD MARKOWITZ: They absolutely are following the logic of capitalism. But we are all research subjects in a grand experiment where we are being exposed to literally thousands of chemicals that we have no data about. And do we want to know in ten, 20, 30 years that these are going to be either making us gravely ill or killing us?

Do we want our grandchildren to be exposed to this toxic soup of chemicals and only to find out when they're in their 30s and 40s that this is endangering their lives? And there really is a way that we can handle that problem. There is legislation in Congress now, the “Safe Chemicals Act,” which would require the EPA to test all existing and, existing chemicals and the 700 chemicals that are introduced every year and to not allow those that are dangerous to continue.

BILL MOYERS: But Jerry, you know that, as you write in here about the politics of science, that the industry went to Congress in 2005 and got fracking, even before it had come to full blossom, got fracking exempted from the Safe Drinking Water Act. And you think, and you have hope for any kind of legislation such as you just described?

GERALD MARKOWITZ: Well, I have hope that there were actually 29 senators who were willing to cosponsor this piece of legislation, but no, I don't have hope that it's going to pass. I think only if environmental groups all around the country, and there are hundreds of environmental groups around the country, really mobilize a mass movement to demand that Congress protect our health, we really care about our health, but we are not doing the political mobilizing that is necessary in order to put that caring about health into legislative action.

BILL MOYERS: So how is the politics of science affecting the fate of America's children?

GERALD MARKOWITZ: You know, in our lifetime we have seen the abandonment of the commitment to try to help those who are most vulnerable in our society. And instead of that commitment today we ask how much does it cost. And by that we mean how many dollars does it cost. We don't ask what does it cost in terms of the health of our children, what does it cost in terms of the futures of our children and of our society.

Hospitals Should be Care Providers not Loan Sharks

Deborah Burger, AlterNet — Fri, 17 May 2013 10:38:00 -0700

Predatory pricing practices can be found nearly everywhere in healthcare.

If there is one problem that symbolizes the ongoing national healthcare emergency, it is the rampant price gouging in the healthcare industry that continues to price too many Americans out of access to care and into financial ruin. Not only is the problem not solved by the Affordable Care Act, but it is a likely reason many will continue to demand more effective reform, as in expanding and extending Medicare to cover everyone.

Predatory pricing practices can be found nearly everywhere in healthcare, by the drug companies, insurance companies, medical suppliers, outpatient clinics, boutique medical services, and many others as chronicled this spring in Time magazine.

U.S. hospitals are among the biggest abusers, as illuminated in recent datareleased by Medicare on hospital charges for a variety of common procedures as well as brand new findings by the Institute for Health and Socio-Economic Policy, the research arm of the National Nurses United, based on Medicare cost reports.

The nurses’ data augments the Medicare findings, and goes the next step, illustrating a trend of rising high hospital charges while providing context to a very ugly picture and the deplorable impact on anyone who needs healthcare.

Here’s the sobering numbers:

· U.S. hospitals charge on average $331 dollars for every $100 of their total costs, in statistical terms a 331 percent charge to cost ratio.
· While hospital charges over costs have been climbing steadily over the past 15 years – the charges took their biggest leap ever in 2011– a 22 point vault.
· From 2009 to 2011 (the most recent year for which the data is available), hospital charges lunged upward by 16 percent, while hospital costs only increased by 2 percent.
· U.S. hospital profits, pushed upward by the high charges, hit a record $53.2 billion, while nurses see more and more hospitals cutting patient services and limiting access to care.
· One case study is California where hospitals soared past the national average with a charge to cost ratio of 451 percent, or $451 for every $100 of costs.

That similar pricing practices occur elsewhere in the healthcare industry is hardly an excuse for the private hospitals to act more like Wall Street corporations than responsible, community based institutions. It should be no shock that the lowest charges are by government-run hospitals that operate in public, not in secret, and have far more accountability and transparency.

Hospitals ought to act as responsible providers of needed medical care, not loan sharks. Piling up profits in large part by jacking up prices is at sharp odds with the glossy feel good ads from hospitals we see so often on our TV screens, newspaper pullouts, sponsorship of sports teams, and on mass transit placards.

Hospital lobbyists have tried for years to convince us all that predatory pricing policies don’t matter. These are just “list” prices that few people actually pay, they claim, and it is a random phenomenon that two hospitals in the same city, or even on the same block, might have widely varying prices for similar patient services.

But the grotesque reality tells a different story.

We’re not the only ones who think so. As Glenn Melnick, a USC health economist, told a reporter, "If (hospital prices are) meaningless how come hospitals spend all this money on consultants to raise them? Why haven't they stayed flat for the past 15 years? Why do hospitals keep raising them if they have no impact?"

While it is true that major payers seldom pay the list price, hospitals typically bargain with insurance companies over reimbursements. Anyone who has ever bought a car knows that the higher the list price, the more you end up paying. That’s true with hospital charges as well.

The inevitable result is insurance companies respond by ratcheting up their charges to employers and individuals. In California, for example, since 2002, premiums have risen 170% -- more than five times the inflation rate, as noted in a California Healthcare Foundation survey last month.

An alarming, if predictable ripple effect follows. As the CHF survey noted, in the past decade, the percentage of California employers providing health coverage dropped from 71 to 60 percent; 21 percent said they’d increased workers’ co-insurance premiums while 17 percent said they had reduced benefits or increased other out of pocket costs. More than one-fourth of workers in small firms have deductibles of $1,000 or more on their health plan.

Then there’s the uninsured who do not have the collective clout to bargain down the list price. Hospitals say they write off a lot of those bills, but clearly not all of them. How many distressing stories have we all heard about patients staggered by $50,000 or $100,000 un-payable medical bills while being hounded by the hospitals or bill collection agencies to pay up?

Patients and families, even those paying for insurance, have a stark choice. Use your health coverage and get socked with huge out of pocket costs that may mean choosing between medical bills, housing costs, food, or other necessities, or facing financial calamity, or forgo needed care.

As the Washington Post recently noted, the Affordable Care Act has not ended the deplorable story of medical bills accounting for more than half of all personal bankruptcies in the U.S.

Even many of those now paying for health insurance either through their employer or as individuals, or who will be required to buy insurance under the ACA, choose not to use it because of the high co-insurance, deductibles, co-pays, and all the add ins that get thrown in by the hospitals, such as professional fees, facility fees, pathology fees, anesthesia fees, and so on.

A 2011 Commonwealth Fund study found that the U.S. stands out among high income countries with as many 42 percent of Americans skipping doctors’ visits, recommended care, or not filling prescriptions due to cost.

Consequently, people end up in emergency rooms for medical problems that should have been resolved earlier at far less cost and pain. It is also why two recent reports disclosed that the U.S. has the lowest life expectancies and the highest first day infant death rate among major industrial countries.

It’s long past time to fix this nightmare, and sadly the ACA won’t meet that test. At a minimum we need to crack down on price gouging by all the corporations that control our health, with real penalties for lack of compliance.

But a longer vision is needed. Replace our profit focused health care system with one based on patient need and quality care as all those other countries with national or single payer systems that surpass us in access, quality, and cost, have long figured out.

One Company Has Enormous Power in the Breast Cancer 'Market' -- and Their Pricey Test Could Be Costing Lives

Irin Carmon, Salon — Tue, 14 May 2013 14:55:00 -0700

Angelina Jolie's op-ed about her approach to mitigating breast cancer risk helped a company's stock value rise 4%. Is that what medicine is really about?

So far, much of the heated discussion about Angelina Jolie’s brave Op-Ed in the New York Times today has focused on her decision to undergo a double mastectomy after learning she carried the BRCA1 gene. As Salon noted here, that’s not the only option. But for those who do want to consider following Jolie’s path, there are structural barriers to even gaining the information to make those choices, something she mentions but doesn’t explain. It’s because one company, Myriad Genetics, owns the patent to the two genes that indicate an increased risk of breast or ovarian cancer. You read that right: The genes themselves, not the procedure to test for them. And the Supreme Court will decide in a matter of weeks whether that should continue.

Jolie wrote, “It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.” According to the ACLU, which brought the lawsuit heard recently by the Supreme Court, Myriad actually recently raised the price to over $4,000, despite the fact that “genetic testing technologies have advanced to the point where all 23,000 human genes can be sequenced for $1000.” The test is often covered by insurance, but policies vary, and of course, not everyone is insured.

Myriad’s monopoly over BRCA1 and BRCA2 not only means showing that it can charge whatever it wants for the test; it also means that further research on the genes is restricted, and that women who take the test and get an ambiguous result can’t get a second opinion, only take the test again. An ambiguous result can mean the difference between removing breasts or ovaries or leaving them intact.

The economic and racial implications of all this are major, both for how the research has been done and who gets access to it. In a video on the case, the ACLU points out, “Initial gene studies focused on white women. And now the patents make it more difficult to learn what some mutations mean in women of color, because Myriad has total control over researchers’ access to those mutations.” And information that allows some women to choose prophylactic surgery likely contributes to the massive disparities in who dies of breast cancer. Black women are the likeliest to die of breast cancer, even as they are less likely than white women to be diagnosed with it. A 2005 study in the Journal of American Medicine found that “African American women with a family history of breast or ovarian cancer were significantly less likely to undergo genetic counseling for BRCA1/2 testing than were white women with a family history of breast or ovarian cancer.” That was true even when controlling for socioeconomic factors, suggesting cost was not the only barrier.)

Myriad has argued that its patent was valid because it had innovated in the process of extracting the gene, and that patent protection was needed to incentivize more such research. It lost at the district court level, which threw out its patents, but prevailed at the circuit court. The Supreme Court heard oral arguments in the case a month ago. According to Lyle Denniston at SCOTUSBlog, the ACLU’s “Hansen wanted a flat declaration that human genes are not patentable – period. The Justices who pressed him closely left the impression that the suggestion was both too simple, and possibly too inhibiting for inventors and their financial backers.” Meanwhile, the Obama administration took a middle route, with Solicitor General Donald B. Verrilli saying that only synthetic DNA molecules should be patented.

Myriad’s patent on the genes expires in two years, but the Supreme Court’s ruling will set the broader principle going forward. For now, Jolie’s Op-Ed has apparently made Myriad’s stock price rise 4 percent, its best level in years.

Metal Shards and Much Worse In Your Food? What Happens When the Food Industry Regulates Itself

Martha Rosenberg, AlterNet — Mon, 13 May 2013 17:13:00 -0700

In a move that may prove deadly for workers and consumers, the federal government is washing its hands of slaughterhouse inspection and encouraging industry self-regulation.

Was Jose Navarro, a federal poultry inspector who died two years ago at the age of 37, a victim of increasingly noxious chemicals used in poultry and meat production? Chemicals like ammonia, chlorine and peracetic acid that are frequently employed to kill aggressive bacteria in meat and poultry?

Navarro coughed up blood several months before his death, the Washington Post reported last week, and he died in November 2011 of lung and kidney failure, according to the autopsy report. An OSHA inspector during a subsequent investigation said “the combination of disinfectants and other chemicals” in addition to pathogens such as salmonella “could be causing significant health problems for processing-plant occupants,” reports the Post. The plant where Navarro worked and the chicken industry defend the chemicals as safe.

It is no secret that new methods are being used in the war against bacteria because of the antibiotic resistance the meat industry's widespread reliance on antibiotics has helped cause. Antibiotics save money for livestock operations in two ways: they keep the animals alive in filthy, packed conditions in which they might otherwise die; and they make animals gain weight with less food because of their metabolic effects.

Despite the routine use of antibiotics in livestock operations, bacteria and resistant bacteria are rampant in the food supply. Almost half of US beef, chicken, pork and turkey contained staph bacteria when they were tested, reported the Los Angeles Times in 2011--including the resistant MRSA bacterium (methicillin-resistant S. aureus). Two serious strains of antibiotic-resistant salmonella, Salmonella Heidelberg and Salmonella Hadar, forced recalls in recent years of turkey products from Jennie-O Turkey and Cargill. The resistant salmonella strains were so deadly, officials warned that disposed meat should be placed in sealed garbage cans to protect wildlife.

But there is another reason that stronger and more volatile chemicals are being used. The federal government is increasingly washing its hands, pun intended, of slaughterhouse inspection and encouraging industry "self-regulation," which is cheaper for both sides. Thanks to the new era of food industry laissez-faire, assembly lines are moving even more quickly--if that's possible--and more aggressive chemicals are being employed. "Pink Slime" treated with puffs of ammonia to kill E. coli, was only one example of extreme chemicals routinely used to kill germs, often under the public's radar.

There is also an ongoing battle between US trade officials and the European Union and Russia over US poultry because it is dipped in chlorine bleach to kill germs. Who knew? And conventional US poultry is often grown on feed that contains arsenic, which the FDA says is used to control parasites, promote weight gain and feed efficiency and improve “pigmentation.” In 2011, Pﬁzer announced it would stop selling arsenic-treated chicken feed after the FDA found residues in chicken livers and most people assumed the substance had been retired from poultry farms. Guess again. Histostat, or nitarsone, another arsenic-based feed additive, is still on the market, reports the New York Times.

Inspectors Add Their Voices To Agribusiness Critics

Over the years, reports about the deleterious effects of self-regulating agribusinesses on animals, workers, the environment and consumers who eat the products have made headlines. But increasingly, federal meat inspectors are speaking out about the broken system.

“My plant in Pennsylvania processed 1,800 cows a day, 220 per hour,” and veterinarians were pressured “to look the other way” when violations happened," Lester Friedlander, a federal meat inspector told the Winnipeg Free Press. The reason? Stopping "the line" cost the plant about $5,000 a minute. Friedlander was a USDA veterinarian for 10 years and trained other federal veterinarians.

When mad cow disease was first a US threat in 1991, Friedlander says a USDA ofﬁcial told him not to say anything if he ever discovered a case and said he knew of cows who had tested positive at private laboratories but were ruled negative by the USDA. Friedlander told United Press International that the USDA attempted to force him out after he alleged, on national TV, that meat from downer cows supplied the national school lunch program. His charge proved true, and led to the biggest meat recall in US history.

National Joint Council of Food Inspection Locals, the union that represents meat and poultry inspectors in federally regulated slaughterhouses, also spoke out about mad cow disease risks. In a letter to the USDA in 2004, the union said that cattle parts that could give humans the disease were “being allowed into the production chain.” Heads and carcasses of cattle over 30 months old sailed through slaughter and processing lines, said the whistle-blowing inspectors. “We couldn’t determine that every part out of there was from a cow under 30 months,” said Stan Painter, the union’s chairman, to MSNBC. “There was no way to determine which one was which.” Inspectors were “told not to intervene” when kidneys from older animals were sent down the line to be packed for the Mexican market, which prohibited cows over 30 months, the union charged. Cows younger than 30 months were considered to pose less mad cow disease risk to humans.

Food Safety and Inspection Service (FSIS) inspectors in the Department of Agriculture have traditionally been responsible for a plant’s compliance with the Federal Meat Inspection Act (or Poultry Products Inspection Act or the Egg Products Inspection Acts) and the Humane Methods of Slaughter Act but the balance of power is switching to self-regulation. A turning point was the implementation of the Hazard Analysis and Critical Control Points (HACCP) inspection system in 2000 which replaced inspectors' visual examination of carcasses with inspectors simply ratifying that companies are following their own self-created systems--as in "trust me."

The HACCP system was developed by former Monsanto lobbyist Michael Taylor, which is no surprise in light of his pro-industry initiatives while working at the government. Taylor facilitated the approval of unlabeled GMO crops and recombinant bovine growth hormone (rBGH), both spearheaded by Monsanto, and has even lobbied against the Delaney Clause, which prohibits cancer-causing chemicals in food.

Food activists, animal activists, consumers and even industry insiders called HACCP "Have a Cup of Coffee and Pray" and an unvarnished a gift to industry. It's a “politically based policy masquerading as a science-based measure” that privatizes the meat inspection process for large plants while regulating smaller plants out of business. It allows contaminated meat to leave the plant with “smaller downstream processors . . .left accountable for problems caused by the original slaughterhouses,” writes Nicole Johnson.

Soon after HACCP was implemented, a study by the Government Accountability Project and Public Citizen found that 62 percent of inspectors surveyed allowed contamination like feces, vomit and metal shards in food under HACCP on a daily or weekly basis, which had never happened before. Almost 20 percent of inspectors said they’d been instructed not to document violations. In fact, a full 80 percent of 451 inspectors surveyed said that HACCP attenuated their ability to enforce the law and the public’s right to know about food safety.

Another federal meat inspector who spoke out about the broken system was veterinarian Dean Wyatt. The Food Safety and Inspection Service supervisory public health veterinarian from Williston, VT testified at congressional hearings in 2010 about federal inspectors' shocking lack of authority in slaughter plants. Plant managers openly defied the federal inspectors he said, and workers followed suit, actually ridiculing them.

Both Wyatt and public health veterinarian Deena Gregory reported that they witnessed a Seaboard employee hit an, "animal hard in the face and nose 8-12 times," but David Ganzel, the District Veterinary Medical Specialist, deemed the acts was not "egregious," hence not a violation, said Wyatt in his congressional testimony. Seaboard employees began to snicker when Wyatt walked past.

Food Safety and Inspection Service officials overtly served plant managers not the government, food consumers, employees or the animals. Wyatt was instructed not to file violation reports--not to do his job--and official reports were sanitized and deleted. In one report of an employee abusively throwing an animal, the word “threw” was changed to “dropped” he testified.

Shortly after testifying to Congress in 2010, Dean Wyatt died of brain cancer at the age of 59. He was a second-generation federal meat inspector and told Congress that, “Public service is in my blood.” His father died in the “line of duty,” he said, contracting a lethal pathogen at a turkey slaughter plant he inspected.

Welcome to the Brave New World of Corporatized Medicine: Just Hope You Don't Get Sick!

Yves Smith, Naked Capitalism — Mon, 13 May 2013 14:02:00 -0700

"Business freedom" in America increasingly means the God-given right to exploit the vulnerability of the public.

One of the most effective scare techniques employed to preserve our grotesquely inefficient, overpriced health care system has been to invoke the red peril of “socialized medicine”. Never mind that foreigners in advanced economies fail to recognize the caricatures scaremongers supply, or that Americans who need emergency care while overseas are almost without exception impressed with the caliber of care and astonished by the low (sometimes no) cost to them. After all, Americans live in the best of all possible worlds, and consumer and business freedom are always better.

In fact, business freedom here increasingly means the God-given right to exploit the vulnerability of the public. The example slouching into view is more corporate control over the practice of medicine. And based on the previews, it will make the horrors falsely attributed to socialized medicine look pale.

Two accounts last week bring the issue home. The first came in the Health Care Renewal blog (hat tip Lysa). It’s a reminder of how the current institutional efforts to regiment doctors undermine the caliber of medical care. It has become distressingly common for HMOs and other medical enterprises to have business-school trained managers putting factory-style production parameters on doctor visits. Outside of foreclosure mills, it’s hard to find similar approaches in other professions.

The post describes how a pediatrician, Pauline, who has developed a reputation for treating chronic conditions is at loggerheads with her for-profit practice. The suits don’t like her patient mix. She gets too many tough cases, when they’d rather have basically healthy kids who are there for a cold or ear infection. Mind you, this is only partly a money issue. These visits can be “up coded” so as to get larger insurance/patient payments, but she gets a higher level of patients in less-generous state insurance programs. But some of the pushback is that her practice is perceived as disruptive, since she uses what is perceived as too much of her and staff time, separate and apart from the economics. She’s constantly breaking management’s precious guidelines. One of her turf struggles:

She had set up a visit to see a new medically complex patient and had blocked off 40 minutes, the amount of time she felt she needed to do a good job. The child had a complex genetic disorder, cerebral palsy, and heart, lung, and kidney problems. Both the cardiologist and the nephrologist had called asking her to take this patient. She agreed. After she had scheduled the visit, a manager called her and told her that she was being allowed only 15 minutes to see that patient. After some fruitless discussion with him, Pauline finally said, “Okay, I guess that means that you’ll be seeing the patient instead of me, right?” The shocked voice at the other end of the phone line replied, “What do you mean? I don’t know how to take care of patients.” “That’s exactly my point,” Pauline put in.
Pauline explained that this manager assigned to her office is not even a college graduate. Physicians cannot access the schedule electronically and have no control over scheduling. These functions are controlled by the office manager and (amazingly) by some of the medical assistants who have received some “leadership” training. These medical assistants are even allowed to evaluate the clinical competency and skills of the physicians.

And to add insult to injury, how long did this discussion take? All those minutes the doctor spent fighting with a petty bureaucrat come at the expense of patient care.

As an aside, it’s hard to stress enough that this sort of demoralizing micromanagement and unwillingness to listen to and learn from workers, is a widespread shortcoming of management American-style. And it has weirdly been airbrushed out of the media. When I was a kid in business school, US manufacturers were having their clocks cleaned by Germans and the Japanese. There was a good deal of critical self examination back then. One source of foreign ascendancy was that they had newer factories, so you couldn’t really blame American management for that one. But the second was that it was widely acknowledged that US managers were generally poor at dealing with labor. And this wasn’t “labor” in the union sense, but at having productive relationships with factory workers (note that there has been massive revisionist history since then. When I was in Bschool, none of my classmates, nearly half of whom had worked in major manufacturing companies, had bad things to say about unions.) Now you’ll often see the decline of American manufacturing attributed to unions in an “everybody knows that” tone.

Now before you come running to the defense of management against the doctor, think twice:

So let me add a further nugget about Pauline’s background. In one of her previous jobs, she was made the manager of a pediatric outpatient center within a county hospital caring for a largely indigent population. This center had been running in the red for a good while. Pauline took over and within 28 months she’d streamlined the place and had them running well in the black, while still administering a quality of care that Pauline and her colleagues could be proud of. In short, Pauline could probably tell the managers of her current practice a thing or two about how to optimize patient scheduling without compromising care or cost —if they’d listen.

As bad as that is, most patients are unware of how much their care has been fitted to a Procrustean bed. The deliberate degradation in the name of profits is going to become more obvious, at least if the health care industry has its way.

I strongly encourage you to read this post from Whole Health Chicago (hat tip Lambert) in full. It shows how the future of American medicine is to fire the ones who are unhealthy. No, I am not making that up. The writer, Dr. David Edelberg, describes a recent presentation by a large insurance company. They’ve apparently been hosting similar sessions with physicians in the Chicago area in large medical practices. Here are the key bits (emphasis original):

The speaker at these evenings is always a physician employed by the insurance company. His/her title is medical director (I begin to think there must be dozens and dozens on their payroll) and he always begins by reassuring the audience that he was in clinical practice himself so he understands something of what physicians–especially primary care physicians–are facing. I view this physician more as a “Judas steer,” the animal that leads an innocent but doomed herd of cattle through the slaughterhouse corridors to the killing floor.
• The health industry hopes that individual medical practices and small medical groups will ultimately disappear from the landscape by being financially absorbed into larger groups owned by hospital systems.

And why do the powers that be regard this as desirable? Although the article does not stress this point, doctors have an established revenue stream. So the acquirers buy them out and impose discipline on those artistic, freewheeling doctors. The “practice style,” which used to mean the independence that doctors once enjoyed, is now an Orwellianism and includes hewing to corporate guidelines as to how to operate.

And here’s what to expect:

Physicians are expected to spend a limited amount of time with each patient, and are encouraged to see as many patients as possible during a workday. The insurance companies, sometimes with the token cooperation of a few physician-employees, create vast books of patient-care guidelines to which they believe their physicians must be “accountable” (remember this word, it will crop up again). These guidelines might mean documented Pap smear and mammogram frequency, weight management and exercise, colonoscopies for patients over 50, and getting that evil LDL (bad cholesterol) below 99 by any means possible…
If the chart audit system discovers that a physician, for whatever reason, is an “outlier”–that she’s either not following the guidelines exactly or not getting the results anticipated for her patient population—she’ll be financially penalized. A quick example of what might occur: if your LDL is 115, you may be on the receiving end of a statin sales pitch from your doctor, not because bringing it down to 99 will improve your longevity, but because your refusal to do so will impact her financial bottom line.

Now of course, you might say, “Well, in fairness, medicine is too much of a cottage industry. Look at how many doctors give unnecessary annual EKGs to patients in low risk groups. How else are we going to get to evidence-based medicine?” The problem is that what we as patients will get isn’t driven by best outcomes, it’s driven by profits. Edelberg explains:

…the subtext of “standardized” always includes the unspoken “spend less money on the patient.” Thus, a doctor might be financially penalized for recommending nutritional counseling to lower cholesterol (“counseling is expensive”) instead of writing a generic statin drug (cheap). Or recommending psychotherapy (“therapy is very expensive”) instead of generic Prozac (cheaper than M&M’s). Or referring patients for massage, acupuncture, or even chiropractic (“expensive, expensive, expensive!”) instead of pushing an over-the-counter antiinflammatory (free to the insurance company, as it’s OTC).

And I shudder to think what becomes of patients who don’t hew to standard templates: the person who had a high body mass but not due to dangerous abdominal fat (which is what creates the health risk) who is pushed to take the latest, greatest diet drug. What about people who don’t buy into the religion of getting your LDL down to below 100 (one reader argued that while it may lower your risk of heart disease, it increases your all-factor death risk by reducing your ability to fight MRSA)? Will they face penalties if they fail to comply?

No, you just will find it nearly impossible to get a doctor to take you:

• Let me close with a best-as-I-recall quote from an insurance company medical director. “We can no longer afford to pay for health care under the PPO model. Our plan is to phase out all fee-for-service care during the next few years. We’ll pay you doctors a finite amount of money to take care of a defined population. We tell doctors, ‘Don’t spend much money and you can keep the difference. Period. Don’t follow guidelines, and you’ll be leaving behind some serious money on the table and we’ll just take it back.’”

In case you think I overstated the implications, Edelberg recapped the discussion that ensued:

One physician piped up…. “But what about the non-compliant patients who won’t take the meds, don’t eat well, don’t have mammograms, continue to smoke? And what about super-health-conscious patients who want their vitamin levels measured and want referrals to acupuncturists?”
Another physician answered wearily for the medical director (who didn’t disagree): “You’ve got to fire patients like that. Get the non-compliant and the super-demanding out of your system. They’ll drag your numbers down. Hit your personal bottom line.”
Hey you, patient. Yes, I mean YOU. Pink slip time! Canned! Take your medical records and don’t let the frosted glass door hit you in the…on the way out.

In other words, if you are high maintenance because you don’t do what your doctor says (and remember, “non-compliant” includes people who don’t follow orders because they think the cookie-cutter approach isn’t right for them) or want higher service or per the example of the pediatrician Patricia’s 40 minute case, have a complicated set of ailments, you’ll be shunted. The brave new world of corporate medicine will eject you.

The rich are unlikely even to know that this change is occurring. There will be a tier of doctors on the high end to cater to patients who want more personalized, cutting edge treatment and might need some prodding. And they can always go abroad if they can’t find what they need here. But for ordinary schlubs, expect to find the doctor’s office become more hostile as the brave new world of corporatized medicine becomes entrenched.

Merchant of Death Steps Down: A Look at the Deadly Work of Philip Morris International's Outgoing CEO Louis Camilleri

Michele Simon, John Stewart, AlterNet — Mon, 13 May 2013 11:13:00 -0700

During his tenure, nearly 30 million people died from tobacco-related causes globally.

This week, when tobacco giant Philip Morris International hosts its annual shareholders’ meeting in New York, the company will honor outgoing CEO Louis Camilleri for his years of service. But a look back at Camilleri’s tenure shows a trail of death and destruction unworthy of celebration.

In 2008, parent company Altria Group spun off the international division of Philip Morris to focus more on “emerging markets,” the euphemism corporations use to describe the exploitation of Global South nations. For decades, as the regulatory environment and public sentiment has turned against smoking in the U.S., tobacco corporations have set their sights overseas. As a result, Philip Morris International now derives more revenue from Asia than from the European Union, and nearly 80 percent of tobacco-related deaths occur in the Global South.

While the Marlboro man has been retired in the United States, he is alive and well as a marketing icon in several countries around the world. Sales of Philip Morris International’s brands grew in other nations last year, with shipments of 927 billion cigarettes and revenue of more than $31 billion -- an accomplishment for which the CEO is well compensated. Also in 2012, Camilleri received an astonishing $24.7 million, up 23 percent from the previous year.

Second in size only to state-controlled China National Tobacco Corp., Philip Morris International is the biggest bully of the tobacco industry globally. On Camilleri’s watch, the corporation has engaged in numerous aggressive marketing tactics and legal maneuvers to ensure increased sales in nations that are trying to stem the rising tide of smoking deaths. Here are just a few recent examples:

In 2010, Philip Morris International filed a lawsuit against Norway challenging that country’s ban on point-of-sale tobacco advertising displays. Last year, the Oslo District Court ruled in favor of Norway’s landmark law. How many lives were lost during the policy’s delay?
In 2012 in the Philippines, Philip Morris International circumvented that nation’s ban on advertising by paying for an article in a popular magazine that praised the corporation’s efforts on disaster aid and relief. The NGO HealthJustice Philippines filed a legal complaint against the company.
Also in the Philippines, Philip Morris International sued to stop that country from banning deceptive words such as “light” and “low tar” on tobacco packaging. In 2010, the courts rejected the company’s challenge.
In 2009, Uruguay issued an executive order demanding graphic health warnings cover 80 percent of cigarette packaging. It also required a single design, preventing corporations from using colors to indicate allegedly less-harmful varieties. In response, Philip Morris International sued the country for $2 billion through an obscure World Bank Court. Although tobacco control philanthropist Michael Bloomberg stepped up to help the small country fend off this legal bullying, the case will be tied up in international courts for years.
In 2010, the company filed a lawsuit against Brazil, arguing that images the government requires on cigarette packages do not accurately depict the health effects of smoking and “vilify” tobacco companies.

On this page on the Philip Morris International website, the company makes clear that it has little patience for such inconveniences as the World Health Organization’s global tobacco treaty, adopted in 2003. Formally known as the Framework Convention on Tobacco Control, the treaty specifically prevents industry interference in public health policy, thanks to the active work of civil society, such as organizations like Corporate Accountability International. All of the above challenged policies are included in the treaty, which has been ratified by 175 countries and prohibits advertising, promotion and sponsorship. As a result, more than 60 percent of countries have some form of ad ban already in place. But that’s just a nuisance to Philip Morris International.

Calling such policies as point-of-sale display bans and plain packaging “extreme,” the company invokes familiar rhetoric about “communication with adult smokers” and whines about bans on charitable contributions, “use of journalistic expression or political commentary” and “restrictions on the rights of the tobacco industry to participate in the democratic process.” This is rich coming from a company whose modus operandi is to upend the democratic process in every nation it does business with.

But it’s also no surprise given Philip Morris International’s leadership. Hardly a class act, CEO Louis Camilleri remarked at the 2011 shareholder’s meeting that it wasn’t really “that hard to quit” smoking. Also, in this Michael Moore style 20/20 segment on ABC, Camilleri attempted to dodge hard questions about why his company was targeting children in Indonesia. (Included is the infamous and startling video of the “smoking baby.”)

Will Philip Morris International change its destructive ways with Camilleri stepping down as CEO? (He remains as board chair.) During his tenure, nearly 30 million people died from tobacco-related causes globally. When will the tobacco industry’s largest player stop obstructing public policy in nations that are trying to save lives and reduce suffering among their citizens? With this change in leadership, Philip Morris International has the opportunity to stop being the world’s bully.

Michele Simon is a public health lawyer specializing in industry marketing and lobbying tactics. She is the author of Appetite for Profit: How the Food Industry Undermines Our Health and How to Fight Back and on Corporate Accountability International's advisory board. You can follow her on Twitter.

John Stewart is the director of Corporate Accountability International's Challenge Big Tobacco campaign. You can follow him on Twitter @JMS255.

How the Economic Slowdown Has Drastically Affected How Much America Spends on Health Care

Laura Tyson, Al Jazeera English — Sun, 12 May 2013 16:14:00 -0700

The weak economy has caused people to postpone consumption of health care services and has encouraged states and employers to restrain their spending on health.

Over the last five years, the growth of health care spending in the US has slowed dramatically - to the lowest rate in the past 50 years. The slowdown is not a surprise. It is a predictable result of the recession and slow recovery that have left millions of Americans without health insurance and dampened household spending.

But the size of the slowdown is surprising, as is the fact that it started several years before the 2008 recession - and not only in the private insurance system, but also in Medicare and Medicaid, the two major government health programmes. (Medicare provides health coverage for retirees, and Medicaid provides coverage for low-income Americans and their children and those with disabilities.)

What explains this slowdown in health care spending? How much of it is attributable to the weak economy, and how much is the result of changes in provider and consumer behaviour?

Slowdown

Two recent studies offer different answers, but both predict that at least some of the slowdown will persist even after the economy recovers. That would be good news for the US economy, which currently devotes nearly 18 percent of GDP to health care, by far the largest share among developed countries. It would also be good news for America's fiscal position, because Medicare and Medicaid are the two largest contributors to the long-term federal budget deficit.

The growth of health care spending declined or remained unchanged in real (inflation-adjusted) terms each year between 2002 and 2011, falling to 3-3.1 percent in 2009-2011, the lowest rates on record since reporting began in 1960. Recent data indicate that after a slight acceleration in 2012, the growth of real health-care spending in 2013 has fallen back to its 2009-2011 average.

As a result of the recession and lagging recovery, health care spending has also slowed significantly since 2009 throughout the OECD. Indeed, for the first time on record, real health-care spending stalled on average in the OECD in 2010, as developed countries, reeling from budgetary constraints, clamped down on health programmes. Growth in health care spending was slower in every OECD country in that year, with the exception of Germany.

A new study by Drew Altman, a respected health care expert and President of the Henry J Kaiser Family Foundation, concludes that slower growth in real GDP, along with a lower inflation rate, accounts for more than three-quarters of the slowdown in health care spending in the US after 2001. The weak economy has caused people to postpone consumption of health care services and has encouraged states and employers to restrain their spending on health.

But important cost-containing changes in the private health care system, including more cost-sharing in private insurance plans and tighter controls in managed care, have also contributed to the slowdown. Altman conjectures that, overall, the growth in health care spending between 2008 and 2012 was about one percentage point lower than predicted by deteriorating macroeconomic conditions alone.

If this reduction continues after the economy recovers - as seems likely, given the cost-containment incentives in the Affordable Care Act (commonly known as Obamacare) - the US stands to spend $2 trillion less on health care over the coming decade.

Based on the relationship between changes in real per capita health care spending and changes in unemployment rates at the state level, the recent Economic Report of the President concludes that the recession and lacklustre recovery account for less than 20 percent of the slowdown in health care spending since 2007 - and for an even smaller share of the slowdown that began in 2002. And difficult macroeconomic conditions explain little (if any) of the slowdown in Medicare spending per enrollee since 2001.

Who are vulnerable?

That is not unexpected, because the largely retired Medicare population is less vulnerable to macroeconomic fluctuations than is the working-age population. The Council of Economic Advisers, whose members write the president's report, surmise that structural changes - including stronger incentives for efficiency by hospitals and providers, more cost-sharing in insurance policies, and the substitution of generic drugs for branded drugs - explain most of the deceleration in per capita spending growth.

They also suggest that payment reforms contributed to the slowdown in Medicare's spending growth after 2001, and that early responses to new Medicare regulations in the Affordable Care Act may have caused a further decline after 2010.

The long-term effect on the federal budget implied by a sustained reduction in the growth of Medicare and Medicaid spending to the rates of the last several years would be profound. These programmes currently claim 21 percent of the budget, with Medicare accounting for two-thirds of that amount.

Even a small reduction in the growth of these programmes would save billions of dollars. Based on the unexpected slowdown in spending growth during the last few years, the Congressional Budget Office recently cut its 10-year projections for these programmes by 3.5 percent, reducing the 10-year deficit by $382bn.

In 2011, Medicare spending accounted for 3.7 percent of GDP. Based on current policies, the government forecasts that Medicare spending per beneficiary will grow at an average annual rate of 4.3 percent and will rise to 6.7 percent of GDP over the next 75 years. If, instead, Medicare spending per beneficiary grew by only 3.6 percent a year, the average rate of the last five years, Medicare's share of GDP would remain unchanged. This would narrow the fiscal gap, a widely used measure of long-term budgetary imbalance, by almost one-third.

Trends in the US budget reflect an inconvenient truth: If the growth of spending on health care programmes cannot be slowed, stabilising the federal debt at a sustainable level will require deep cuts in spending on other priorities and increases in taxes on the middle class. The recent slowdown in the growth of health care spending is a promising sign that America's budgetary tradeoffs may turn out to be less difficult than expected.

Laura Tyson, a former chair of the US President's Council of Economic Advisers, is a professor at the Haas School of Business at the University of California, Berkeley.

My First Baby Was Born with a Rare Syndrome -- I'm Pregnant Again, and Worried About What Could Happen

Heather Kirn Lanier, Salon — Fri, 10 May 2013 16:20:00 -0700

My first baby was born with a rare syndrome. Now pregnant with my second, I wonder: What could happen this time?

The technician pushed the plastic wand onto my belly, and there on the TV screen were white blobs and filaments in a black cone.

“There’s the cervix,” she said, as though I’d driven two hours to get the inside scoop on my cervix. “And there’s the placenta.” She ran a computer curser over a fuzzy white mass.

But I wanted a profile or a full-body shot, some image that would tell my brain, Yes, there’s a person in there, which would tell my heart, Yes, you can risk loving this person.

Right now it was still an it, and I still called it “Baby X.” Right now I still imagined a giant mathematical variable in my pelvis, offering a host of faceless unknowns.

But the tech held off on the print-worthy images and dwelled instead on organs. A flapping, four-chambered heart. A black marble of a spleen. Look, there’s the brain: two hemispheres inside a globe.

Finally, the face. “There,” she said.

Except it was not the usual ultrasound profile of sloping forehead, dainty nose, and chin. It was a square shot, and I saw deep and ghostly eyeball cavities. The angular bone structure of the cheeks. A black opening for a mouth, gaping wide. It was a skull in my uterus. A Halloween icon floating in my womb.

The tech almost sounded apologetic. “They look pretty skeletal at this stage,” she said.

I would have to remain patient, and it was hard. My first child already required regular trips to a children’s hospital. She will probably never live on her own. Could I love yet another child whose life is not necessarily the typical promise of a sunshiny future but a gray, worrying question mark?

* * *

A life, by definition, possesses the end of itself. This was what I’d thought 18 weeks back, when my husband and I started trying for our second kid. And this was what I’d thought two years before, when we’d tried for our first. But with my first, I was only thinking about the coexistence of life and death in some abstract way. O Life. O Death. The nouns could be capitalized and personified as in some shoddy poem.

Then, two and a half months into my first child’s life, a doctor suggested we get her chromosomes studied.

And three months into her life, the nurse explained what she was missing.

And four months into her life — into my life as her parent — I had the courage to Google her diagnosis, Wolf-Hirschhorn syndrome. I learned what that missing bit of her fourth chromosome could mean. Developmental delays and cognitive disabilities, yes. But also life-threatening seizures. Potential kidney failure. And a 1-in-3 chance of dying before age 2.

So with my second child, when I say I thought about how a life also possessed its end, I was not just waxing philosophical. I was holding everything I knew to be true about parenting — that it seemed as crazy as standing at the edge of a precipice and jumping off — and I was baffled by my urge to do it again.

Now here was my second baby. Not a plump, cooing thing, but a skull staring back at me, sending a message I’d hoped the ultrasound would erase: You are right to fear. Beneath life — beneath flesh and dew and blood — is always bone, is always death.

Shortly after the ultrasound, I bought Emily Rapp’s book, “The Still Point of the Turning World,” which had just come out. It was an odd choice for an anxious parent. Rapp’s memoir tells the story of mothering a child with Tay-Sachs disease. When I carted the book to my midwife’s office, with its cover image of a sweet baby’s face, I hoped nobody would ask what it was about. But I was spending nights sleepless and fretting about all the terrors and unknowns that faced my second child. I needed camaraderie, and I chose that of a mother who walked an even tougher road than mine.

* * *

My first daughter’s chromosomal deletion was not hereditary, so some think I shouldn’t worry, but the randomness of her syndrome has made the world all the wackier, all the less trustworthy. There are 22 other chromosomes that could have deletions, or additions, or extra copies. There are single genes that could wreak havoc on a body. There are too many ways to get sick, to die.

Since having Fiona, I’ve learned about not only genetic syndromes but also babies born with cords around their necks, babies born too early, babies with intestines on the outsides of their bodies. Babies and babies and babies who live nothing like most of the babies I see posted on friends’ Facebook walls, who are fat and smiley and cooing and/or babbling and/or doing what I’m told statistically most babies do.

I could have gotten an amnio, which at the very least would have told me if my unborn child has any chromosomal deletions or additions. But that would have put me in a 1-in-300 risk for miscarriage, and my daughter already has a syndrome that only 1-in-50,000 babies has. I see myself in the big, fat “1” on top of any fraction, no matter how large the denominator.

Besides, science can’t offer certainty. An amnio only reveals so much. As a geneticist once told my friend whose results came back normal, “Some things we can test for. Some things we can’t. But that’s what you sign up for when you sign up to be a parent.”

“I didn’t sign up for this,” I cried into a cellphone just a few weeks after learning about Fiona’s diagnosis. I was pumping gas, and the world, including the gas station, was filled with able-bodied people, and my child was not one of them, was now slated for a swallow-study to see if she could even handle her own spit without slowly killing herself.

But I was wrong — I had signed up for it. Or at least the possibility of it. I just didn’t know.

You, Aspiring Parent, thought you were signing up for burping and night feedings and fingerprints on your windows, for Little League and pubescent door slams and an eventual first day of college. You weren’t. You signed up for uncertainty. You signed up to stand at the edge of a cliff and jump off. You signed up for love, too, but whenever you sign up for love, you’re also signing up for the risk of loss, for the possibility of heartbreak.

And maybe that’s the reason why I carted Emily Rapp’s memoir to my midwife’s appointments. I needed to hear from a woman who intimately knew this risk, this heartbreak, a woman who understood the real contract a person signs when she or he looks at another and says, “Yes, let’s become parents.”

In one essay, Rapp talks about one of the most isolating sentences she hears as a mother to a Tay-Sachs kid: I cannot imagine. Within three years of life, a child with Tay-Sachs will die. She challenges people to imagine this kind of parenting. “In the end there are no limits to what one can imagine. It’s how humans are built; it’s how we survive. You could care for a dying child if you had to, because that’s what love would require.”

I cannot imagine having one of those babies I see posted on Facebook. A baby who does not raise alarms with her very first breath. Maybe because my first baby has a neurologist and a cardiologist and an orthopedist and a nephrologist and an early interventionist, a geneticist and a homeopath and a naturopath and a speech pathologist and an occupational therapist and a physical therapist. Maybe because my baby, while delightful and happy, will never reside in any realm of typical. Will always put those of us who love her in a precarious spot of worry, hovering over her bed at night to see if that strange breathing is a seizure, monitoring her kidneys with ultrasounds to see if there’s a warning of failure, scanning the workings of her heart to see if the hole closes or widens or just holds still.

I cannot imagine mothering a child who looks and feels and behaves as most babies do, who is dewy and fat with the promise of the future. A child who I can expect will outlive me, will drive cars away from me, will write her own bills for a house without me. Instead, as my belly button pops out and as my tent-shaped maternity T-shirts become too short, it seems more important to imagine a child whose days are not just unknown but clearly numbered, a child who challenges his mother to reinterpret much of what she knows about being human.

* * *

This year, at least three children with my daughter’s syndrome have died. One died just last week. A friend wrote that her thoughts went to all the families who parent kids with this syndrome because we “appreciate these fragile lives and know the importance of embracing every moment.”

To which I thought of all the times I did not embrace the moment. The times I checked my email while Fiona whined for me to play with her. The times I prayed she’d just go down for a nap so I could get this or that done.

Because my daughter’s syndrome doesn’t come with an absolute life end — because while some die at birth, others live on to middle age — I can forget how fragile she is. I can sometimes pretend I don’t live with zero ground beneath me.

Can you really hold the preciousness of a life every day, every minute? Is it possible to carry the true weight of our lives — which is the fragility of them — if we aren’t intimately reminded?

For my second child, the first ultrasound came back “normal.” No red flags. All systems go.

Still, I’ve worried.

“You’re afraid to let yourself love this baby,” an intuitive friend said after I described my sleepless nights.

“Yes,” I said, and teared up. The thought hadn’t occurred to me.

I love my daughter with a hugeness I’ve never known before, but it is a hard love. She is a clapping, music-loving joy, and at almost 2 years old, she is also a floppy, willowy creature who cannot make most vowels or consonants and is nowhere near crawling, much less walking. And loving her breaks my heart open. It can hurt almost as often as it heals. That I’m afraid to love again seems cold and cruel to the little one in my middle, whose nails are growing and whose organs are all present and whose eyes are just starting to open.

I crave the illusion of certainty, the pat on the shoulder and the words, “Everything will be OK,” and the courage, no, the naiveté to believe them.

About two months after the first ultrasound, I told the midwife that I couldn’t shake my worry. She thought she was being kind when she ordered a second ultrasound, which she called “therapeutic.” It would put my mind at ease.

The universe is a tricky bastard. It bit my quest for certainty and spit it back at me. The results indicated, not just a “too-big” baby, but a baby with a larger-than-expected abdomen. There were now health concerns. It took several versions of the question to get the midwife to answer, but eventually she told me the worst-case scenarios. A gastrointestinal issue, maybe. Microcephaly, maybe. The latter diagnosis, I knew, could be a marker for a host of other problems.

“Well, now I’m terrified,” I said.

To which the midwife said, “Yeah, it’s terrifying.”

* * *

Rapp makes clear that any lesson she learns as a result of mothering her son is not the reason he exists. “The meaning of Ronan’s life was not to teach me; we often say this about people who defy our notions of normal and I find it pathetic, patronizing … Ronan would have his own path that had nothing to do with me, and I would try to understand it in my limited way.”

Yes, yes, yes, I thought, and furiously underlined. Though my heart has repeatedly broken open as a result of mothering my daughter, she does not exist to transform me. She has her own purpose. Still, the experience of loving Ronan teaches Rapp lessons, many of which I’m slowly learning myself. For example: “It took this experience to help me see clearly, to understand that the bulk of the popular parenting advice champions an approach to living that completely complies with achieving bogus standards of success.” More furious underlining.

Rapp mentions the mothers who make “products” of their kids, the moms for whom parenting becomes yet another venture at which to succeed. In such a case, the child is not a person but a measurement of one’s success. But the limits of Ronan’s body refuse to offer Rapp the back-patting moments of typical modern parenting. Walked before age 1! Started signing at 9 months! Breast-fed immediately after delivery, that’s how smart he is! Instead, Rapp’s son played with his toys in reverse.

At 0 days old, my daughter already came out delayed. She was born at 41 weeks gestation, and some exam of her body’s natural movements had her pegged at 37. She was so small she didn’t even land on the growth curve — she fell somewhere off the bottom margin of the page.

Before Fiona’s diagnosis, I was susceptible to this achievement style of parenting. I’d read birth stories, for instance, from women who forewent the epidural and bragged that their children were consequently “so aware” and scored “perfect 10′s” on the Apgar. A perfect 10? That was like an A-plus. I was hell-bent on a natural birth from then on.

But my daughter never measured up to doctors’ expectations.

“Did you smoke?” a nurse asked within an hour of Fiona’s life? “Were you on any drugs?”

“It’s either bad seed or bad soil,” one of the hospital pediatricians said, meaning either I was the bad soil or my daughter was the bad seed.

Just as parents were asking me, “So is she sitting up yet? Eating solid food yet?” and on and on, I was learning that my child might never do these things, that to do even one of these things would be, not a given of development, not an aspiration to do “early” so that I could brag and say, “Look how smart,” but a major achievement that, if she’d do them at all, she’d do them far later than expected.

And the only way to survive this, at least with any joy, was to see what Rapp also had to see: that the desire to approach parenting as a race, as a series of achievements measured by the output of one’s kid, is a cultural sickness. That there is a deeper, more transformative way to parent.

I’ve found no greater teacher of this transformative way of parenting than Rapp. And maybe I’m reading her book while pregnant to highlight the real power of parenting. It is not to raise children who outlive us (Rapp: “My son was being destroyed, every minute of every day, by the lack of one stupid enzyme”), not to raise children who will eventually become the future as long as we teach them well à la Whitney Houston.

I think it’s to be brought to our knees with a love we have no choice over. To surrender to that love. To say, Yes, yes, yes, I will love whomever we find ourselves holding. Nothing seems to underscore this love more than the possibility of its loss.

Rapp: “What makes the situation with my son so horrible is that one can imagine such a loss; if you allow yourself to feel great love (which is not an option when you are rocketed by love for a child, a connection that allows for no option but to be all-in), then you must imagine gutting loss. You cannot have one without the other. To fully live is to tremble, always, on the lip of losing everything, which is why true love — of a child, of a parent, of a partner, of a friend, of a pet — is so terrifying, and why many people never allow themselves to feel it fully.”

Yeah, it’s terrifying, the midwife had said after my second ultrasound, and that was about all she could say, other than, Come back in three weeks for another measurement.

* * *

Today, at my third and hopefully final ultrasound, the first image I see surprises me. It’s not a scary skull, not a sweet profile, not even an indifferent blob of organ. As I crane my neck toward the computer screen, I immediately catch the intricate, long ripple of vertebrae up my child’s back. Her spine. It’s a tightly knit totem. A series of stepping stones. It seems holy. Evidence of my child’s life force. Each intricate bump is crucial, guarding the nerves as they weave through the spaces in the vertebrae to find the organs, to communicate to the brain.

I often feel crazy for doing this. I often shake my head at myself, amazed and baffled that I’ve asked to do this a second time: to stand at the precipice and jump.

But here I am. Seven-plus months pregnant. Having no DNA test to tell me who lurks behind the stretched skin of my abdomen. Having only one “normal” ultrasound and one “big-belly” ultrasound and no other clue, really, as to what this life holds, the life that will now become my responsibility.

My new daughter has shown me a skull beneath her face, and she has shown me a dazzling spine. She’s shown me that she possesses the inevitability of death, yes. But she is also living. And she is mine.

And as I stare at that third ultrasound while the technician clicks and measures her femur bone, her head circumference, her supposedly giant abdomen, I think this without even consciously meaning to: “Are you OK, my love? Are you OK in there?”

The white blobs and filaments in the black cone do not answer me. And yes, that is terrifying. But I notice she is no longer Baby X. She is “my love.” Whatever loving her entails.

Heather Kirn Lanier is the author of the memoir, "Teaching in the Terrordome: Two Years in West Baltimore with Teach For America." She blogs about her daughter, Fiona, at starinhereye.wordpress.com.

Is Cutthroat Capitalism Pushing a Growing Number of Baby Boomers to Suicide?

Les Leopold, AlterNet — Fri, 10 May 2013 10:51:00 -0700

American baby boomers are taking their own lives like never before.

There's no question about it--American baby boomers are taking their own lives like never before. Suicide rates in the United States jumped dramatically for 35- to 64-year-olds between 1999 and 2010, according to a new report from the Centers for Disease Control and Prevention (CDC). These self-inflicted deaths increased from 13.7 per 100,000 to 17.6. As a result, in 2010 more people died from suicide (38,364) than from car accidents (33,687).

The increase in suicide is particularly acute for older folks: Those aged 50-54 years saw their rates increase from 20.6 per 100,000 to 30.7, a jump of 49.4%. For those aged 55-59 years the rates increased by 47.8%. The rates for women, although much lower than for men, also climbed: "Among women," the report states, "suicide rates increased with age, and the largest percentage increase in suicide rate was observed among women aged 60–64 years (59.7%, from 4.4 to 7.0)."

Is Wall Street's version of capitalism driving up our suicide rates?

We really don't know why humans take their own lives. But we can get a sense of what events correlate with increasing and decreasing suicide rates. Ileana Arias, CDC deputy director, provides some suggestions:

“It is the baby boomer group where we see the highest rates of suicide. There may be something about that group, and how they think about life issues and their life choices that may make a difference....The increase does coincide with a decrease in financial standing for a lot of families over the same time period."

Dr. Arias is referring to research that shows a correlation between the rise of suicide rates and economic hard times. For example a 2001 study by sociologist Augustine J. Kposowa found:

"After three years of followup, unemployed men were a little over twice as likely to commit suicide as their employed counterparts. Among men, the lower the socio-economic status, the higher the suicide risk. Among women, in each year of followup, the unemployed had a much higher suicide risk than the employed. After nine years of followup, unemployed women were over three times more likely to kill themselves than their employed counterparts."

More Older Workers Join the Ranks of the Long-Term Unemployed

In winner-take-all capitalism, if your job disappears during a massive sustained job crunch, you will have a hard time finding another one. In fact, the older you are, the more likely you are to enter the ranks of the long-term unemployed (out of work a year or longer).

The 2008 Wall Street financial meltdown killed more than 8 million jobs in matter of months. Reckless bankers, not the unemployed workers, caused the destruction of jobs:

By the end of 2011 more than 31 percent of the total unemployed had been jobless for a year or longer, according to a Pew Trust study.
It also found that "unemployed older workers were the most likely to have been jobless for a year or more."
At that time, "more than 42 percent of unemployed workers older than 55 had been out of work for at least a year, a higher percentage than any other age category."

But wait, doesn't egalitarian Scandinavia have even higher suicide rates?

For decades, Scandinavia was known for its egalitarian economies and its high suicide rates. In fact, for much of the post-WWII era, countries with more egalitarian societies seemed to have suffered higher rates of suicide. This led to a widely accepted narrative that described countries like Denmark, Norway and Sweden as having fundamentally flawed socialistic economies that kill the desire to take risks and live fully. Allegedly, their high taxes and cradle-to-grave social benefits harm the most fundamental instincts to compete, to create and to thrive. While some claimed the higher suicide rates came from the lack of sunshine during the long northern winters, the dominant explanation always centered on the evils of Scandinavian egalitarianism.

But blaming egalitarianism no longer works since we now have a new leader in suicides -- ruthless, American-style capitalism. The most recent comparative suicide rate statistics for all age groups and genders show that we have higher suicides rates than Scandinavia: (per 100,000 people) :

Denmark 11.3
Norway 11.9
Sweden 11.9
U.S. 12.0

If we singly out the male suicide rates, normally three times higher than the female rates, the U.S. clearly leads the pack:

Denmark 15.3
Norway 15.7
Sweden 16.1
U.S. 20.0

Of course, die-hard anti-socialists still could argue that Scandinavia has become more capitalistic and unequal, while the U.S. is growing more socialistic thereby lowering the Scandinavian suicide rates while increasing ours. However, it's painfully obvious that American inequality is growing more extreme by the day. If the anti-egalitarian mythology were true, the U.S. should have the lowest suicide rates in the world. So maybe, it's time to consider alternative explanations.

A counter-narrative to the egalitarian myth of suicide:

Wall Street bankers and hedge fund managers gambled the economy into the ground. Through mergers, acquisitions and leveraged buyouts they're still creating and recreating a form of capitalism that throws millions of older workers out on the street. To enrich themselves, financial elites helped to destroy defined pension plans as well as unions, which provide enormous protections for older workers. Wall Street also helps companies load up on debt that can bankrupt the pension funds that still exist. And now our financial barons are leading the charge for cuts in Social Security and Medicare to pay for the damage Wall Street has done to the economy. In short, the Wall Street version of capitalism makes life enormously insecure for the many, while enriching the few.

If you're a baby boomer who has spent a lifetime working hard, you could be hurting if Wall Street destroys your job and wipes out your savings. Because you are old, you could wind up lost among the long-term unemployed without much of a chance of ever finding a job again. At the very least, you are under a great deal of economic stress, the likes of which very few Scandinavians would ever experience.

Do suicide rates go down when Americans fight back?

Perhaps some scholars should test the following hypothesis: Do suicide rates in America go down when empowering movements arise? Did the rate of suicide among African Americans decline during the civil rights movement? Did suicide rates among women and the LBGT communities also decline as these movements emerged? Was there even a dip when Occupy Wall Street took center stage?

In short, what would happen to our overall feeling of self-worth if a major movement emerged to take on the Wall Street plutocrats and their Washington enablers? What if unemployed workers were part of a mass movement for jobs and justice as they were in the 1930s? Wouldn't that make us feel more hopeful?

Well, a national movement to take back our country from Wall Street sure would bring a smile to this boomer.

How a Legal Loophole Allows Untested Pesticides in Everything From Cosmetics to Clothing

Laura Fraser, OnEarth Magazine — Fri, 10 May 2013 08:53:00 -0700

The EPA is abusing a legal loophole to let products like nanosilver be used in your clothing and baby blankets without ensuring their safety.

This story first appeared at OnEarth.org.

You probably wouldn’t expect to find pesticides in your toothpaste or your gym socks, but they might be in there all the same. And the vast majority of those pesticides have made it into everyday products without adequate oversight by the Environmental Protection Agency. That’s because they’ve been approved through a bureaucratic loophole known as "conditional registration," which means they haven’t been fully tested to ensure that they pose no threat to human health or the environment, as required by U.S. law.

Most of us think of pesticides as the chemicals that get sprayed on weeds or used to kill rodents and bugs, but they’re actually found in everything from cosmetics to food containers, as well as antimicrobial textiles (such as the exercise shirt you might have worn to the gym this morning). By killing bacteria and other microorganisms, pesticides can help clothes resist stains or help containers keep food fresh longer. But some have also proven to cause health concerns in humans, kill trees, birds, bees, and fish, or do other unintended harm to the environment.

The EPA has been responsible for registering pesticides since 1972, and during that time, 90,000 have been allowed on the market. A significant number of those -- just over 25,000, according to the EPA -- were initially approved through the conditional registration process. An internal report by the EPA’s Office of Pesticide Programs shows that of the more than 16,000 pesticides allowed on the market as of 2010, about 11,000 of them were conditionally registered. Because of the agency’s poor record-keeping and flawed procedures, it remains unclear how many of these conditionally registered pesticides have ever gone through the full gamut of safety testing required by law.

“The dirty little secret of the EPA is that almost every pesticide gets put on the market while the agency is looking the other way,” says Michael Hansen, a senior staff scientist at Consumers Union. “That’s not good for consumers, and it’s not the intent of the regulations.”

By law, in order to register and sell a pesticide, companies are supposed to go through a process than can last several years; it includes public comment, reviews of scientific studies, and evaluations by the agency’s in-house science experts. The fast-track conditional registration process was intended to be used only under rare circumstances -- when a product is nearly identical to one already on the market, for instance, or when the EPA needs to approve a new pesticide immediately to prevent a disease outbreak or other public health emergency (a new treatment for bedbugs, for example).

No one knew the extent to which the EPA had been abusing the conditional registration rules until 2008, when the Natural Resources Defense Council (which publishes OnEarth) began asking questions about why nanosilver, an antimicrobial made of extremely tiny bits of silver and used to kill bacteria in products such as athletic gear and baby blankets, had been granted conditional registration.

That year, Swiss manufacturer HeiQ had applied to the EPA for permission to use nanosilver in textiles, including clothing and bedsheets. NRDC scientists were concerned that nanosilver might be more toxic than regular silver -- which is not very harmful to humans, but toxic and persistent in aquatic environments -- because its tiny size allows it to travel into cells, organs, and blood, with potentially dangerous, but poorly understood, health effects. A 2010 internal EPA report on nanosilver notes: “the same property that makes it lethal to bacteria may render it toxic to human cells.”

“Until we understand the risks of nanosilver, we really shouldn’t be wearing it in our clothing and bedding,” says NRDC senior scientist Jennifer Sass. Chemist Martin Mulvihill, the executive director of the Berkeley Center for Brain Chemistry, agrees that more studies are needed, especially because nanosilver is widely used in consumer products. The effects of nanosilver on human health are not well understood, “which is not to say there are no concerns,” says Mulvihill, who adds, “It’s very clear silver is bad for the environment.” Silver bioaccumulates and is toxic to single-celled organisms and aquatic invertebrates; a 2010 study found that runoff containing silver particles dramatically reduced the reproductive capabilities of mollusks in San Francisco Bay. Products like nanosilver washing machines, which kill bacteria with nanosilver ions embedded in the machinery, could also damage water organisms with their runoff.

“Do I really need nanosilver in my jeans or Tupperware?” Mulvihill asks. “I don’t think so. I can just wash them.”

In response to HeiQ’s 2008 request to use nanosilver, the EPA Scientific Advisory Panel recognized that the effects of nanosilver are different from regular silver. The panel said its regulations would require the company to produce numerous studies on the specific health effects of nanosilver before it could be registered for use as a pesticide.

Then the agency went ahead and allowed the company to use nanosilver in its products anyway.

During the course of reviewing the conditional registration of nanosilver, NRDC filed a Freedom of Information Act request seeking the EPA’s database of conditionally registered pesticides. “Their recordkeeping is a mess,” says NRDC’s Sass. After the group’s questions compelled EPA to take a closer look, the agency found that of approximately 16,000 pesticides currently on the market, more than two-thirds were conditionally registered. Even worse, the EPA has no system to track whether the data and studies it asked a company to provide for full registration have ever appeared. And if the data were provided, there’s no way to evaluate how many of those studies were reliably conducted. Nor is there any way for the public to access any of the records on these pesticides.

“Pesticides are harmful chemicals that Congress intended go through a rigorous scientific review process,” Sass says. “Instead, they’re going through a loophole, forcing us to trust the data provided by the pesticide industry.”

The EPA press office says that the agency looked at some of the pesticides approved between 2000 and 2010 and found that, of 544 products conditionally registered during that decade, 533 of them had submitted additional data, and all but 10 of those had been reviewed by the agency. (Recall that there were 16,000 pesticides allowed on the market as of 2010, and 11,000 of those were conditionally registered, according to the EPA’s own report). “For 96 percent of the subset of registrations, all actions intended by the conditional registration have been completed in a timely fashion,” an EPA spokesperson said in response to queries from OnEarth, adding that most of the conditionally registered pesticides were what the EPA calls “me-too” products, which are substantially similar to ones already on the market. EPA also says that it is in the process of improving its procedures for tracking pesticides that have been approved through conditional registration.

Environmental and health advocates believe that such a process is not adequate and insist that the agency immediately cancel all the pesticide registrations that have overdue studies. (How many that would be isn’t clear.) NRDC has specifically asked the EPA to establish a public database on conditional registrations that would make gaps in information and unanswered questions transparent -- and to stop using the conditional registration process as a loophole. “It should only be used in very rare circumstances, as Congress intended,” says NRDC staff attorney Mae Wu.

Paul Towers of the Pesticide Action Network, a nonprofit group that advocates to replace harmful pesticides with safer alternatives, says that at the very least, the EPA should put a hold on any new conditional registrations until a better system is put in place. “Then the agency can begin to evaluate each conditional registration as soon as information comes to light about potential harms.”

People connected with the pesticide industry deny that the conditional registration process is being abused. Lynn Bergeson, a Washington, D.C.-based attorney who specializes in helping clients with product regulation and approval, says she doesn’t believe that conditional registrations are “somehow on automatic pilot.” She says the EPA takes the conditions “very seriously … Any initiative to review all 11,000-plus conditional registrations would have a severe adverse effect on EPA given its already strained resources.” And it would harm the industry, she adds, because it would give the impression that the EPA was casting doubts on existing products with conditional registrations.

Environmentalists seem unsympathetic to that particular concern. NRDC, for instance, has sued the EPA to undo the conditional registration of nanosilver; its attorneys argued that the EPA didn’t properly assess the risks of the product, basing its assessments on studies that analyze risks to humans 3 years old and above. But what about infants? “They're particularly at risk for a pesticide like this because it’s applied to clothing and other fabrics they’re likely to chew on,” says Cassie Rahm, the NRDC attorney who argued the case before the U.S. Court of Appeals for the Ninth Circuit.

As of March 2011, according to the Project on Emerging Technologies, 1,317 consumer products contained nanosilver, including 182 clothing products.

The Government Accountability Office, an investigative arm of Congress, is also getting in the act and preparing a report on the EPA’s conditional registration. Its last such report recommended that the EPA review those registrations, determine what progress was being made in submitting the required data, and take appropriate action, such as suspending or cancelling the pesticide registration in cases where the companies had not made reasonable progress fulfilling their obligations.

That was in 1986. Two years later, the EPA promised to develop a new system to track the data requirements of conditional registrations. An update on the report listed the recommendation as “Closed-Implemented.” Yeah, right.

Is Climate Change Fueling a Deadly Disease in California and Other Parched States?

Tara Lohan, AlterNet — Wed, 08 May 2013 16:28:00 -0700

Environmental changes may be to blame for spiking rates of an often misdiagnosed and potentially fatal disease.

If you haven’t heard of valley fever, you’re not alone. Although cases in states like California are rising, public awareness is low and misdiagnoses from doctors are sadly high. The AP reported an 850 percent spike in cases across the country from 1998 to 2011, with California and Arizona being the worst states.

“The fever has hit California’s agricultural heartland particularly hard in recent years, with incidence dramatically increasing in 2010 and 2011,” wrote the AP’s Gosia Wozniacka. “The disease — which is prevalent in arid regions of the United States, Mexico, Central and South America — can be contracted by simply breathing in fungus-laced spores from dust disturbed by wind as well as human or animal activity.”

Why have things gotten so bad? “The fungus is sensitive to environmental changes, experts say, and a hotter, drier climate has increased dust carrying the spores,” wrote Wozniacka.

Valley fever can have a host of symptoms and is painful, debilitating and sometimes deadly. It sometimes starts with flu-like symptoms but “the infection can spread from the lungs to the brain, bones, skin, even eyes, leading to blindness, skin abscesses, lung failure, even death,” reported Wozniacka.

The Reporting on Health Collaborative has been collecting stories from Californians who have been affected.

Bernadette Madrid, 29, says she “was tested for practically everything except valley fever.” After months of misdiagnoses doctors finally realized she had valley fever, but by then it was so severe she was hospitalized and her parents were told she likely wouldn’t live. Her weight dropped to 80 pounds, and despite seven surgeries the disease has left her blind, and the drugs prescribed to fight it have destroyed her kidneys.

Karen Werts said, “I have lost two years of my life to valley fever and now live with these constant fears in the back of my mind. I would not wish this for anyone, even my worst enemy.” It took doctors two months after her symptoms started to test Werts, 53, for valley fever. She said:

The valley fever symptoms were bad, and I also had two bouts of pneumonia and the night chills and sweats continued. But I was placed on the highest dosage allowed of Diflucan, and I would compare the side effects of this anti-fungal medication to chemotherapy. I lost my eyelashes, eyebrows and most of my hair, and had sores in my nose and mouth. I had severely cracked and bleeding lips, and joint pain that made moving unpleasant. I was so fatigued that even getting up to use the bathroom was a huge effort. I also had to undergo constant blood tests to check my liver function, due to the Diflucan.

“On January 9, 2001, my big, strong healthy husband of 30 years died at age 49, a 144-pound shell of his former self,” said Cheryl Youngblood, who lost her husband Michael to valley fever. “He left behind four children and two grandchildren. It was just three months shy of our 30th wedding anniversary.”

In California in recent years, hundreds have died from valley fever. Humans are not the only ones at risk: dogs are just as susceptible to valley fever as people are, and the disease is often fatal, when owners -- and even veterinarians -- cannot figure out their pets' puzzling and painful symptoms.

One of the groups most at risk are prison inmates. “Prisoners are vulnerable both because they are more likely to have chronic diseases like HIV and diabetes, and because they are often coming from outside the geographic area and have not developed immunity to the fungus,”wrote Tracy Wood from the Voice of OC for the Reporting on Health Collaborative.

Rebecca Plevinreported that 200 inmates in California, mostly from the San Joaquin Valley, are hospitalized a year because of valley fever. “A study by the state prison health system found that the rate of valley fever in Pleasant Valley State Prison in Coalinga was 600 times the rate found outside the prison walls in Fresno County,” she wrote. “On top of that, research studies have shown that blacks are far more likely to develop the most serious form of the disease. The prison population has a higher proportion of blacks than whites, and prisoner advocates criticize state and federal agencies for putting black inmates in harm’s way.”

A new federal health order is seeking the relocation of 3,000 highly at-risk inmates from two San Joaquin Valley prisons.

Did Make-Up Give My Wife Breast Cancer? The Ugly Truth Hidden by the Cosmetics Industry

John Wasik, The Washington Monthly — Wed, 08 May 2013 10:38:00 -0700

The virtually unregulated beauty industry puts potential carcinogens in their products. Then they shower us with pink ribbons.

When Kathleen felt a lump in her right breast she began a journey that millions have experienced—or, sadly, will experience. After a painful biopsy and other tests confirmed it was cancer, my wife was thrown into a cauldron of tears, doubt, and fear for herself and her loved ones. Our two daughters were then just eight and twelve.

Like many cancer patients, Kathleen also experienced a stranglehold of guilt. Was it something she did or didn’t do that fed the tumor? Was it the meat in our diet? Our water? The air? Her genes? I assured her that we couldn’t be at fault. We had banned soda pop and anything with high-fructose corn syrup from our house more than a decade before. We tried to eat organic food, we were transitioning to more vegetarian fare, and she did yoga and took regular walks. We didn’t even have cable.

After a test showed that Kathleen didn’t have the BRCA breast cancer gene, her surgeon, Dr. Sonya Sharpless, suggested that environmental factors might be implicated. But what could they be? Kathleen had already thrown out a bevy of household cleaning products and plastic containers.

Then she discovered the work of the Breast Cancer Fund, a San Francisco-based advocacy group that for the last ten years has been focusing on cancer-causing agents in personal care products. Through a coalition of health and environmental groups called the Campaign for Safe Cosmetics (of which the Breast Cancer Fund is the principal sponsor), the organization has been drawing attention to the fact that known carcinogens—substances like formaldehyde—are used as preservatives in everything from suntan oil to makeup. Kathleen frantically threw out her all her expensive Clinique and Shiseido cosmetics.

Did a lifetime of using cosmetics cause or contribute to Kathleen’s breast cancer? We don’t know. But here are some facts that every American woman and her loved ones should absorb. The European Union bans nearly 1,400 chemicals from personal care products because they are carcinogenic, mutagenic, or toxic to reproduction. But in the United States, the Food and Drug Administration entrusts safety regulation of cosmetics to a private entity that is housed and funded by the industry’s trade association. To date, this entity has found only eleven chemicals to be “unsafe for use in cosmetics.” The FDA has no oversight of cosmetics products before they come on the market and, unlike the EU, leaves it to the cosmetics industry to determine which ingredients should be banned.

Because the American cosmetics industry is largely self-regulated, American women have to worry that they may be exposed to all sorts of cosmetics ingredients that may be dangerous to their health. Without greater powers for the FDA to regulate cosmetics, there is just no way that people like Kathleen who have cancer, or those who fear getting it, can know for sure. Indeed, even while in the hospital cancer patients are exposed to cosmetic products that the FDA has never evaluated and that activist groups like the Campaign for Safe Cosmetics say contain known or suspected carcinogens.

This happened to Kathleen. During her first round of chemo in 2009, some volunteers at the hospital came calling with a little red bag that contained products from Clinique, Estée Lauder, and Del Laboratories. Everything from eyeliner pencils to blush was in the bag, accompanied by a brochure that provided helpful advice on skin care and wig purchases.

Her well-meaning visitors were part of the Look Good Feel Better program (LGFB), which involves 16,000 volunteers who hand out $10 million worth of personal care products every year to women being treated for cancer. Behind this effort is a Who’s Who of the personal care industry: Alberto Culver, Avon, Chanel, Coty, Aveda, Johnson & Johnson, Neutrogena, L’Oreal, LVMH, Mary Kay, Procter & Gamble, and Unilever, among others. The sponsors, as Kathleen learned from the brochure, are the American Cancer Society and the Personal Care Products Council (PCPC), the leading national trade association representing the global cosmetic and personal care products industry, which, through its tax-exempt foundation, kicked in $8.6 million to LGFB in 2011.

No doubt many women who are feeling awful about the loss of their hair, breasts, and dignity are grateful for these gifts from the cosmetics industry. But Kathleen, even though the chemotherapy by this point had caused her hair to fall out and turned her skin ghostly white, was not one of them. Upon reviewing the contents of her LGFB bag, she realized that several of the products in it contained parabens—chemicals that mimic estrogen and that according to the Campaign for Safe Cosmetics are linked to cancer. You can image how that made her feel.

For a while, fighting the cancer was all we could do. After her mastectomy, Kathleen’s chemo treatments proved so debilitating that she ended up in the emergency room and in isolation wards twice in December of 2009. The drugs in her body were robbing her of hemoglobin and she became dangerously anemic, a common side effects of blasting the entire bloodstream with
toxic chemicals.

Kathleen could barely walk. Her immune system was also in shambles and needed frontline antibiotics. We had to get rid of our houseplants for fear of infection. Meanwhile, I was trying to hold body and soul together even as I lost my main source of income as a contract columnist for Bloomberg News.

Once Kathleen began to recover from the trauma of the chemo I decided, however, to throw myself into answering a basic question: How is it, I wanted to know, that the FDA, which was created by the Federal Food, Drug, and Cosmetic Act of 1938, leaves the regulation of cosmetics largely up to the cosmetics industry?

Start with a fact that is hardly a secret yet still little known by the public:the FDA does not have the authority to test cosmetics ingredients before they go on the market. This is explained right on its Web site: “FDA’s legal authority over cosmetics is different from other products regulated by the agency, such as drugs, biologics, and medical devices. Cosmetic products and ingredients are not subject to FDA premarket approval authority, with the exception of color additives.”

Instead, as the FDA’s site goes on to explain, “Cosmetic firms are responsible for substantiating the safety of their products and ingredients before marketing.” In other words, the industry is largely responsible for regulating itself. How good a job do they do?

There exists an obscure entity called the Cosmetic Ingredient Review. According to the industry, the CIR is responsible for ensuring the safety of cosmetic products. On its board sit nine voting members. The voting members are all academics, and, according to the CIR, they must meet the same conflict-of-interest requirements as individuals serving on FDA advisory committees. However, there is no independent way to verify what conflicts of interest might actually exist. As a private organization, the CIR is not subject to the Freedom of Information Act, as I found out when I tried to make a FOIA request. Nor will the CIR publicly disclose its budget.

“Since we are not a part of FDA, there is no obligation to provide information under FOIA,” Dr. F. Alan Andersen, the CIR’s director, explained in an email, adding, “The annual budget is not a matter of public record, so that information is not available.” According to a search of the Internal Revenue System’s database of tax-exempt organizations, the CIR has not filed a Form 990, which would contain at least its budget. It is accordingly not known whether the cosmetics industry pays the “experts” on the CIR, much less how much.

The CIR does admit that its overall funding comes from the industry’s main trade association, the Personal Care Products Council. The PCPC has filed Form 990, and it shows that in 2011, the organization paid Dr. Andersen, the CIR executive director, a total of $372,151 in wages and other compensation, including a performance bonus of $55,675. And the form shows that PCPC paid a total of $292,257 in employee compensation and contracting fees to a Mr. John Bailey, “a key employee who retired from the Council during 2011 because of his former employment with the FDA.” (John Bailey’s wife also received $49,930 for her part-time work with the council.) There is no breakdown, however, of what the PCPC may have paid the CIR’s expert panel.

The two organizations both list their mailing address as 1101 17th Street in Northwest Washington, D.C., though one is in Suite 300 and the other in Suite 412. In Suite 412, the CIR goes about its business, which does not include conducting any clinical studies or trials. “The panel does not conduct its own research,” spokesperson Lisa Powers explained in an email, “but carefully examines all of the currently available scientific data.”

The CIR discusses its findings at four meetings a year that are open to the public, and publishes the proceedings on its Web site. It also publishes reports in the peer-reviewed International Journal of Toxicology.

Does that mean you should rest assured that your blush won’t give you cancer or damage your unborn children? At least on one occasion, the CIR has pronounced cosmetics ingredients to be safe despite protests that there was no scientific basis for doing so. For example, in 2002, the CIR pronounced that it was safe for the industry to continue adding possible endocrine and reproductive disruptors known as phthalates to cosmetics marketed to women of childbearing age. This decision was based on what the Environmental Working Group characterized as the “ad hoc calculations” by one of the trade association’s scientists during the course of its proceedings.

But the more salient reality is that, regardless of the quality of its research, the CIR has no power over the industry that finances it. How often has the industry taken action to reformulate products that contain harmful chemicals? According to the PCPC, the trade organization does not “keep a record of products that have been reformulated or removed from the market as a result of a CIR review.” Of the 12,500 ingredients used in personal care products, only a handful are not used in the U.S.

By law, cosmetics companies are supposed to do some kind of research into the safety of their products before putting them on the market. “If the safety of an ingredient as used in a cosmetic product has not been established by CIR,” a PCPC spokesman stated, “a company must possess other information to substantiate the safety of the ingredient for its intended use and make that information available for inspection by FDA upon request.” But the FDA’s review of industry-sponsored research, if it happens at all, won’t occur until the product is already on the market.

For example, in recent years, a substantial controversy has arisen over the use of lead in lipstick. Lead can be a pretty serious substance. The Consumer Product Safety Commission banned the use of lead in house paint in 1977, due to the brain damage it has been proven to cause in children. Because of its neurotoxicity, leaded gasoline has been entirely banned in the U.S. since 1995. The FDA also bans the presence of lead in candy bars in concentrations greater than 0.1 part per million.

Yet the FDA never got around to even testing lead in lipstick until 2010. When it did, it found concentrations as high as 3.06 parts per million—or more than thirty times the maximum allowed in candy bars. Whether this is an unsafe level for lipstick users I’ll leave to others to dispute, but the point is, under the current regulatory regime, lipstick users were exposed to these concentrations of lead for decades without their knowing it and without the FDA ever conducting so much as one test. For now, at least, the FDA says the lead in lipstick is safe, though if I were a woman, I wouldn’t be licking my lips.

And what if the FDA does determine that a cosmetic product being sold on the market is unsafe? “FDA does not have the legal authority to order a recall of a cosmetic,” a spokesman explained. “However, FDA works with firms to ensure that voluntary recalls are effective.” One exception provided by the FDA’s statutory authority is for cosmetics products with ingredients that are “adulterated and misbranded.”

The FDA’s lack of regulatory authority over perfumes and other fragrances is also troubling. In 2010, the Campaign for Safe Cosmetics and the Environmental Working Group tested popular colognes and body sprays and found fourteen “secret chemicals not listed on the label.” These substances are linked to hormone disruption, skin irritation, and allergic reactions, according to several studies. The FDA did not test, much less ban, the products, which included American Eagle Seventy Seven, Chanel Coco Mademoiselle, and Britney Spears Curious.

It’s the same story with hair products. In August 2011, under pressure from consumer groups such as the Campaign for Safe Cosmetics, the FDA tested hair straighteners produced by a California company called Brazilian Blowout. The agency found high levels of formaldehyde, a known carcinogen, but did not request the manufacturer to pull the product off the market. The state of California is suing the company while the product remains on the market. The company has agreed to disclose the presence of formaldehyde in Brazilian Blowout, which was previously labeled “formaldehyde free.” In the case of hair products used in beauty salons across the country, which often contain formaldehyde and other toxins, the FDA has even more limited authority to regulate.

The only exception to this pattern of lax regulation is telling: the FDA does vigorously regulate imported cosmetics. Just between January 2000 and December 2011, the FDA stopped more than 14,000 shipments from various countries abroad. That information led me back to the FDA. I wanted to know if they at least had any evidence of personal care products harming people in the U.S.

As it turns out, the FDA does collect reports of adverse reactions to personal care products through its Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS). (Should you care to drop them an email, the address is CAERS@cfsan.fda.gov.)

The FDA was kind enough to let me read through 543 pages of complaints from users of different cosmetics products. People reported about products that burned their skin or caused their eyes to water, and that in some cases sent them to the emergency room. The names of the people involved were all redacted. I wondered how or if the agency was following up on these reports. Despite my queries, the FDA didn’t respond directly, instead referring me to their Web site, which doesn’t have the answers either.

Kathleen’s greatest fear when she was diagnosed with cancer was that our daughters, who were just then getting to the age where they would start to use cosmetics, would be at risk. Again, we can’t know for sure. But there is no doubt that the lax regulation of cosmetics exposes American girls and women—and men and boys as well—to an unknown health risk they do not need to be taking, even if definitive, unbiased science is not always available to evaluate each particular ingredient.

We know, for example, that the skin, our largest organ, easily absorbs cosmetic ingredients, safe or toxic. Repeated low-level exposures may accumulate through a person’s lifetime (such as lead in hair dyes and mercury in skin whiteners). Girls often start using cosmetics at a very young age, thereby increasing lifetime exposure. Puberty is a critical development time for both girls and boys, and exposure to reproductive and/or hormonal toxins often starts before.

So why doesn’t the American public demand that we at least take a precautionary approach, and not use ingredients in cosmetics until they are proven safe, instead of waiting to see how many people they harm?

One explanation is the pervasive corporate influence over how most Americans even think about cancer. Have you noticed all the feel-good advertising that hundreds of companies have adopted to make it appear that they are “working for the cure”? Often they do this by releasing merchandise in pink, the color that has been chosen to show support for breast cancer victims and research. Companies have jumped on the bandwagon to promote everything from pink guns to pink vodka to pink fried chicken. Even NFL players wear pink shoes during the breast cancer awareness period. Some critics call this phenomenon “pinkwashing.”

The first such campaign originated with the cosmetics giant Estée Lauder, which gave $1.5 million worth of pink ribbons away in 1992 to show support for breast cancer patients and research. Cosmetics manufacturers have been in the forefront of pinkwashing ever since. Avon, for example, sponsors the Avon Walk for Breast Cancer. And, of course, with those Look Good Feel Better bags, the whole industry associates itself with being behind a cure or palliative for a devastating disease—albeit one it may be exacerbating. Don’t worry about what’s in your rouge; the money you spend on it goes to “cancer research,” and meanwhile, using more cosmetics will make you “Feel Better.”

When I challenged the industry’s trade group to disclose what chemicals might be in those bags, the PCPC responded, “In an abundance of caution, certain types of products and ingredients, which may be used safely in products for the general public, may not accepted for use in the LGFB kits … each product accepted into the LGFB program is subject to FDA oversight and has undergone multiple levels of review including safety, quality and regulatory reviews by the manufacturer, and is re-evaluated by Council staff before being accepted for use in the kits.”

Yet as we’ve seen, FDA “oversight” is, to put it mildly, weak. To make sure it stays that way, the PCPC alone spent $809,000 in direct lobbying in 2011, according to its disclosures to the IRS, plus $933,955 in conferences, conventions, and meetings, and $785,000 in travel. Meanwhile the staff of its putative research arm, the CIR, serves at the pleasure of the industry.

As public awareness has grown of the links between environmental chemicals and cancer, at least some politicians have responded. One is Illinois Democratic Representative Jan Schakowsky, who in 2012 cosponsored the Safe Cosmetics Act. It would have banned the use of ingredients linked to cancer and reproductive disorders while also requiring companies to include complete ingredient labels on fragrances and salon products. Sponsored as well by Wisconsin Democratic Representative Tammy Baldwin, who was recently elected U.S. senator of Wisconsin, the bill received strong support from the Breast Cancer Fund, along with other consumer groups. Nonetheless, it received just one hearing in the Republican-controlled House, and never left committee. Schakowsky has reintroduced her bill again this year.

Meanwhile, the PCPC and other industry groups, after a $3.5 million lobbying campaign, seeded the introduction of a weak, pro-industry bill called the Cosmetic Safety Amendments Act of 2012. Introduced by New Jersey Republican Senator Leonard Lance last year, the legislation called for registering product manufacturing facilities, disclosing product ingredients, and reporting adverse events from product use (which, as noted above, is already done through the FDA’s adverse report-
ing system).

The bill favored the industry, because it didn’t give the FDA any meaningful power to take harmful products off the market, and rubber-stamped research from the industry-funded CIR. The Lance bill (which has since died) would also have preempted tough state laws such as those found in California, while the Schakowsky bill would not.

In voicing the industry’s support for the Lance bill, the PCPC issued a statement in April 2012. It asserted, without apparent irony, that “FDA regulation of cosmetics has protected the public for decades, and this landmark legislation will enhance protections for millions of American consumers.”

When I requested further comment from the PCPC, spokesperson Lisa Powers replied, “We support increased regulation and authority by FDA over cosmetics. This increased regulation should allow and require FDA to set safety levels on ingredients found in cosmetic and personal care products. We look forward this year to working with Members of Congress on both sides of the aisle on discussion of these issues.”

Schakowsky is optimistic she can reach a compromise with Republicans. “We’re hearing that there’s some possibility that something on cosmetics might move,” she told me in a telephone interview in mid-January. As of this writing, the legislation has not been allowed to come to a vote.

Research for this piece was generously supported with grants from the Nation Institute Investigative Fund, the Chicago Headline Club, and the National Press Foundation.

Zoloft Put the Pleasure in My Sobriety

Maia Szalavitz, The Fix — Tue, 07 May 2013 14:06:00 -0700

I've been on antidepressants for 20 years, and can still remember exactly when the first one started to work—allowing my recovery to begin for real.

Drug addicts and alcoholics are surprisingly conservative when it comes to psychiatric medications. We’re willing to try virtually anything to get high—but when it comes to taking drugs to get better, we tend to get all “Just say no.” For me, this tendency led to years of suffering before I finally had no choice other than to try antidepressants.

Part of the problem can be attributed to widespread skepticism about these medications, which is prevalent in some 12-step programs. This fear has two facets: the first, a justified anxiety based on historical claims about certain medications not being addictive, which later proved false; the second, a more problematic moralizing that use of medication to “fix” an emotional or mental problem is somehow “cheating.”

The issue of AA members telling people to stop taking—or advising them never to try—psych meds became so acute by the early ’80s that a 1984 conference-approved document, “The AA Member and Other Medications,” explicitly warns against “playing doctor” and states starkly:

AA members and many of their physicians have described situations in which depressed patients have been told by AAs to throw away the pills, only to have depression return, with all its difficulties, sometimes resulting in suicide.

Although I attended 12-step groups daily for the first five years of my recovery from cocaine and heroin addiction, I never thought that I bought into the extreme anti-drug line. Indeed, I handed out that pamphlet to many people who had been reprimanded for sharing, or felt otherwise beleaguered, about taking medication—and yet I resisted it for myself.

And so I continued going to meetings and trying to get on with my life, even as I wrestled with feelings of self-hatred and anchorless fear. I’d spend hours on the phone, analyzing tiny incidents of social rejection, thereby ruining the friendships I actually had but felt I didn’t. I tried talk therapy, but several years of ruminating about my childhood didn’t change much.

Throughout this time, my mid-20s, my career was taking off and I’d managed to sell my first book. At the lowest points of my life, work was the one area of life where I’d always felt good about myself. But when the publisher killed the book, I found myself paralyzed by apprehension.

I thought the problem might be the structurelessness of my freelance life, so I got a job. When even working on an AIDS documentary—something that normally would have energized me—didn’t change the state of deadness and dread, I knew I had to try something else, especially when I found myself unable to stop crying at the office.

The next day, I managed to get myself to a psychiatrist, who rapidly prescribed Zoloft. It turned out to be lucky that I took the oblong blue pill for the first time on a weekend. Several hours later, I experienced an oddly familiar sensation.

It was a feeling in the pit of my stomach that things were about to get weird—the vaguely nauseous lurch I’d often experienced after taking acid, right before the drug kicked in. Soon, as with LSD although less intensely, I was seeing multidimensional red and green geometric shapes if I looked at anything bright for too long.

Concerned, I called my psychiatrist, and she said it would pass and that I should take my next dose on time, but halve it. And indeed, the hallucinations soon diminished to the point where I felt normal enough to go back to work on Monday. Ironically, I missed my colorful visions: although the hallucinations hadn’t lifted my depression, they had at least distracted me from it.

I had never before been consciously aware of the minute bursts of pleasure until they’d leached away—and now suddenly returned.

For about 10 days after first taking Zoloft not much changed. I didn’t relapse; I went to meetings. I did the bare minimum necessary to get through the day. This was not helped by the fact that after my office-crying incident, one of my bosses responded cruelly. I tried to explain what was wrong with me, saying I was seeking help. She barked, “Don’t bring it to the office.”

Then one morning, something changed. I noticed it when I was writing an op-ed and found myself pleased by a line that I had written. It was no great ecstasy, but it was striking all the same. I actually felt…good. That’s when it hit me: This drug is working and I am going to get better.

What I hadn’t realized until that moment was that pleasure had disappeared from my life. I knew something was wrong, of course, but I had never before been consciously aware of the minute bursts of joy that I had typically gotten from my work and my interactions with people until this pleasure had leached away—and now suddenly returned.

That moment and those that followed helped me recognize a fundamental truth about my addiction: It had largely been driven by an inability to take pleasure in emotional support. The reason I seemed insatiably needy was that I didn’t see or feel the love around me. I always needed more support because I couldn’t truly take in what I had.

Twelve-step programs had taught me that my perceptions of social rejection might be misguided and that when I walked into a room and thought everyone wanted me to leave, that was my interpretation, not necessarily what the data suggested. But they couldn’t teach me to experience emotional connection that I wasn’t physically—chemically—capable of feeling. When even work no longer provided satisfaction—when whatever brain chemicals that had allowed that last pleasure broke—everything had collapsed. And by boosting dopamine, serotonin or some type of nerve growth factor—as current theories of antidepressant action suggest—the Zoloft solved the problem.

One study of the effects of these antidepressants shows that almost immediately after you first take them, you start to perceive emotional expressions in faces more accurately—and the better you get at recognizing happy faces, the greater the improvement in your symptoms. It may be that the time it takes for the drugs to kick in is the time it takes you to really take in these smiles and warmth that you have missed. It may also be that when you can feel pleasure again, you are better able to see it in other people.

Regardless, this experience taught me that simply changing your thinking often cannot solve serious problems; a change in brain chemistry is needed. And that’s not an ignoble shortcut. We cheer new medications that make recovery from cancer or heart disease possible, why should someone already cursed with depression or addiction have to do more and more “hard work” to overcome it if an easier, softer way does work? While opposition to medication has certainly mellowed in the 12-step world—to the point where Hazelden itself now offers maintenance medication for opioid addiction, when once it wouldn’t even permit Prozac—there is still lingering discomfort, if not stigma.

I’ve taken antidepressants for around 20 years. The drugs have dramatically improved my relationships, ending the days when I needed so much reassurance that no one could stand it. Now I get to support other people. By turning down the volume on negative emotions, they have also allowed me to be sad when it is appropriate—not when I watch AT&T commercials. Incidentally, the fact that the drugs have worked for me in this way also shows that I am not simply having a placebo effect: In their ability to lower emotional over-responsiveness, studies have shown that serotonin antidepressants like Prozac and Zoloft have dramatically better effects than placebo.

While they don’t work for everyone, the widespread notion that these antidepressants have no pharmacological effects—or only negative ones ("they "turn you into a zombie," etc.)—has been debunked by more than two decades of research. For many people, including a surprising number of 12-step members, these drugs improve or regulate mood to a very significant degree—and that can be exactly what a person needs to do the work of recovery. But because these medications alter brain chemistry, they can also have undesirable side effects. These can be truly terrible: The wrong drug for the wrong person can absolutely be worse than doing nothing.

For me, however, the only thing I regret about taking medications for depression is not having done so sooner—in fact, I wonder if I might have skipped addiction entirely had these drugs been available during my teens. Of course, your mileage may vary, but I encourage everyone who is struggling in recovery to consider the possibility that drugs can help as well as harm. And whatever you do, make sure it truly works for you. Don’t settle for any treatment—whether medication, talk or support group—that doesn’t allow for the full return of joy.

Over 5,000 Children's Products Contain Toxic Chemicals Linked to Cancer and Hormone Disruption

Kathleen Schuler, Think Forward Blog — Sun, 05 May 2013 11:20:00 -0700

Dolls, car seats, party hats and others pose dangers to public health

Over 5000 children’s products contain toxic chemicals linked to cancer, hormone disruption and reproductive problems, including the toxic metals, cadmium, mercury and antimony, as well as phthalates and solvents. A new report by the Washington Toxics Coalition and Safer States reveals the results of manufacturer reporting to the Washington State Department of Ecology.

Makers of kids’ products reported using 41 of the 66 chemicals identified by WA Ecology as a concern for children’s health. Major manufacturers who reported using the chemicals in their products include Walmart, Gap, Gymboree, Hallmark, H & M and others. They use these chemicals in an array of kids’ products, including clothing, footwear, toys, games, jewelry, accessories, baby products, furniture, bedding, arts and crafts supplies and personal care products. Besides exposing kids in the products themselves, some of these chemicals, for example toxic flame retardants, build up in the environment and in the food we eat.

Examples of product categories reported to contain toxic chemicals include:

Hallmark party hats containing cancer-causing arsenic
Graco car seats containing the toxic flame retardant TBBPA (tetrabromobisphenol A)
Claire’s cosmetics containing cancer-causing formaldehyde
Walmart dolls containing hormone-disrupting bisphenol A

The chemical reports are required under Washington State’s Children’s Safe Products Act of 2008. A searchable database of chemical use reports filed with the Washington State Department of Ecology is available athttp://www.ecy.wa.gov/programs/swfa/cspa/search.html.

Like Washington, the Minnesota Department of Health has published a list or priority chemicals in children’s products. Eight of the nine chemicals on this list are also on the Washington list. The nine priority chemicals are lead, cadmium, bisphenol A, formaldehyde, two brominated flame retardants and three phthalates. However, in Minnesota, manufacturers are not required to report if they use a priority chemical in a children’s product—so both states agencies and consumers are in the dark when it comes to these chemicals. Last month Minnesota’s Senate Commerce Committee voted down the Toxic Free Kids Act of 2013, a bill that would have required such reporting.

Minnesota can take a lesson from the Washington experience. Manufacturers were able to produce this information without undue burden and yes these chemicals are in products our kids are chewing on, touching and inhaling every day! It’s time for Minnesota to follow Washington’s lead and require manufacturers to submit the same type of data. I urge the Minnesota Legislature to come back in 2014 and pass the Toxic Free Kids Act.

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