Monthly Archives: October 2012

Shortage of Doctors

The Family Doctor, Minus the M.D.


Adapted from:

The Family Health Clinic of Carroll County, in Delphi, Ind., and itssmaller sibling about 40 minutes away in Monon provide full-service health care for about 10,000 people a year, most of them farmers or employees of the local pork production plant. About half the patients are Hispanic but there are also many German Baptist Brethren. Most of the patients are uninsured, and pay according to their income — the vast majority paying the $20 minimum charge for an appointment. About 30 percent are on Medicaid. The clinics, which are part of Purdue University’s School of Nursing, offer family care, pediatrics, mental health and pregnancy care. Many patients come in for chronic problems: obesity, diabetes, hypertension, depression, alcoholism.


“Doctors are trained to focus on a disease. Nurses are trained to think more holistically.” 

What these clinics don’t offer are doctors. They are two of around 250 health clinics across America run completely by nurse practitioners: nurses with a master’s degree that includes two or three years of advanced training in diagnosing and treating disease. A proposal endorsed by the American Association of Colleges of Nursing for 2015 would require nurse practitioners to have a doctorate of nursing practice, which would mean two or three more years of study. Nurse practitioners do everything primary care doctors do, including prescribing, although some states require that a physician provide review. Like doctors, of course, nurse practitioners refer patients to specialists or a hospital when needed.

America has a serious shortage of primary care physicians, and the deficit is growing. The population is aging — and getting sicker, with chronic disease ever more prevalent. Obamacare will bring 32 million uninsured people into the health system — and these newbies will need a lot of medical care. According to the American Association of Medical Colleges, the United States will be short some 45,000 primary care physicians by 2020.

The primary care physicians who do exist are badly distributed — 90 percent of internal medicine physicians, for example, work in urban areas. Some doctors go to work in rural areas or the poor parts of major cities, treating people who have Medicaid or no insurance. But they are few.

In part it’s the money. Primary care doctors make less than specialists anywhere, but they take an even larger financial hit to treat the poor. Particularly in the countryside — even with programs that offer partial loan forgiveness, it’s very hard to pay off medical school debt treating Medicaid patients, much less those with no insurance at all.

And the job of a primary care doctor today is largely managing chronic disease — coordinating the patient’s care with specialists, convincing him to exercise or eat better. Poor patients can be a frustrating struggle. Compared with wealthier patients, they tend to have more serious diseases and fewer resources for getting better. They are less educated, take worse care of themselves and have lower levels of compliance with doctors’ orders. Very few people start medical school hoping to do this kind of work. Those who do it may burn out quickly.

It might seem that offering the rural poor a clinic staffed only by nurses is to give them second-class primary care. It is not. The alternative for residents of Carroll County was not first-class primary care, but none. Before the clinic opened in 1996, the area had some family physicians, but very few accepted Medicaid or uninsured patients. When people got sick, they went to the emergency room. Or they waited it out — and then often landed in the emergency room anyway, now much sicker.

Just as important, while nurses take a different approach to patient care than doctors, it has proven just as effective. It might be particularly useful for treating chronic diseases, where so much depends on the patients’ behavioral choices.

Doctors are trained to focus on a disease — what is it? How do we make it go away?

Nurses are trained to think more holistically. The medical profession is trying to get doctors to ask about their patients’ lives, listen more, coach more and lecture less — being “patient-centered” is the term — in order to better understand what ails them.

“I’ve been out of nursing school since 1972 and I still remember that when faculty members finished talking about the scientific parts of the disease they would talk about the psycho-social part,” said Donna Torrisi, the executive director of the Family Practice and Counseling Network, which has three clinics in Philadelphia. “It’s not about the disease, it’s about the person who has the disease. While in the hospital you’ll often hear doctors refer to a patient as ‘the cardiac down the hall.’”

Younger doctors are no doubt better at this than their older peers. But the system conspires against them. The 15-minute appointment standard in fee-for-service medicine — which pays doctors according to how many patients they see and treatments they provide — makes it unlikely that doctors will spend time discussing a patient’s life in any detail. Physician reimbursement places a zero value on talking to the patient. But nurse practitioners are salaried, giving them the luxury of time. At the Family Health clinics, appointments last half an hour — an hour for a new diabetic or pregnant patient.

Jennifer Coddington, a pediatric nurse practitioner who is a co-clinical director of Family Health Clinics, said that she spends a lot of time teaching patients and their families about their diseases and how to manage it. “We want to know socially and economically what’s going on in their life — their educational level, how are they making it financially,” she said. “You can’t teach patients if you’re not at their educational level. And if a patient can’t afford something, what’s the point of trying to prescribe it? He’s going to be non-compliant.”

A physician might suggest that a patient lose weight and hand him a diet plan — or refer him to a nutritionist. At the Family Health clinics, nutrition counselors — graduate students at Purdue — will sit down with patients to talk about the specific consequence of their diet, and suggest good foods and how to cook them, Coddington said. “When you don’t have enough money to buy fruits and vegetables, so you go to the dollar menu at McDonald’s — we help those people put planners together for the week.”

Data has shown that nurse practitioners provide good health care. Areview of 118 published studies over 18 years comparing health outcomes and patient satisfaction at doctor-led and nurse practioner-led clinics found the two groups to be equivalent on most outcomes. The nurses did better at controlling blood glucose and lipid levels, and on many aspects of birthing. There were no measures on which the nurses did worse.

Nurse-led clinics can save money — but not always in the obvious way. Many are cheaper than comparable physician-led clinics. Suzan Overholser, the business manager of the Family Health clinics, said that their cost per patient was $453 per year — lower than the Indiana average for similarly federally qualified clinics (all the others physician-led) of $549. But nurse-led clinics aren’t always cheaper. Coddington examined published studies of clinic costs and found that in some cases, nurse-managed clinics had slightly higher per-patient costs than traditional clinics.

Although nurses are paid less than doctors (Medicare reimburses them at 85 percent of what it pays doctors,) nurse-led clinics are often very small, and so don’t have the variety of practitioners necessary to keep a clinic running at full capacity. They also serve the most difficult and expensive patients.

The biggest financial benefit, however, likely comes from offering patients an alternative to the emergency room. Coddington’s review cites studies showing large savings in paramedic, police, emergency room and hospital use. A traditional clinic in an underserved area would do that, too, of course — it’s just that nurses tend to go where doctors won’t.

There are about 150,000 nurse practitioners in America today. The vast majority practice in traditional settings — only about a thousand are in nurse-managed clinics. One reason these clinics are rare is that they may equal traditional clinics in health care, but not in business success.

Nurse-managed clinics have to overcome regulatory and financial obstacles that traditional clinics don’t face. Powerful physicians’ groups such as the American Academy of Family Physicians oppose allowing nurses to practice independently. “Granting independent practice to nurse practitioners would be creating two classes of care: one run by a physician-led team and one run by less-qualified health professionals,” says a paper from the A.A.F.P., citing the fact that doctors get more years of education and training. “Americans should not be forced into this two-tier scenario. Everyone deserves to be under the care of a doctor.”

Only 16 states and Washington, D.C., allow nurses complete independence. In other states, some of the restrictions are bizarre — in Indiana, for example, nurse practitioners may do everything doctors do, with two exceptions: they can’t prescribe physical therapy or do physicals for high school sports.

Jim Layman, the executive director of the Family Health clinics, said he thought that nurse practitioners cared for the majority of Medicaid patients in Indiana. But if you look through Medicaid records, you’ll find only doctors — nurses are not allowed to be the primary caregiver of record. So the Family Health clinics, like others, employ a physician off-site from 4 to 6 hours a week who uses electronic health records to examine a sample of cases and consult when necessary. Medicaid is billed in his name.

It is not easy for nurse-run clinics to win status as a Federally Qualified Community Health clinic, which would allow them to get federal grants. This is largely because most come out of universities, and most universities don’t want to cede control to the community — a requirement for this status. Purdue decided it would, and the Family Health clinics qualified in 2009. Before that, they received some money from the state, and raised the rest from local March of Dimes, United Way and Chamber of Commerce donations, plus fund-raising dinners and auctions. This was enough to support just one full-time provider at each clinic. Getting F.Q.C.H. status allowed them to hire more staff and move the Carroll County clinic into a modern new building — and probably saved them from collapse. “It would have been very difficult for us had we not gotten F.Q.C.H. status,” said Coddington. The Affordable Care Act — Obamacare — did authorize $50 million for five years for nurse-managed clinics. So far 10 clinics have gotten a total of $15 million.

In some ways, the nurse practitioner-managed clinic is a throwback to the small-town family practice, when your doctor asked about the schoolyard bully and your dad’s unemployment. Among the many changes needed in how America values and reimburses health care, it’s important to encourage and support these clinics. They may be old-fashioned, but that doesn’t mean they should be financed with bake sales.

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Adverse impact of urbanization

Casualties of Toronto’s Urban Skies

By Ian Austen

Published: October 27, 2012

Adapted from:

TORONTO — In the shadow of the massive black towers of a bank’s downtown headquarters here was an almost indistinguishable puff of dark gray fluff on the sidewalk.

It was the body of a golden-crowned kinglet, an unlucky one, that had crashed into the iconic Toronto-Dominion Center building somewhere above.

There is no precise ranking of the world’s most deadly cities for migratory birds, but Toronto is considered a top contender for the title. When a British nature documentary crew wanted to film birds killed by crashes into glass, Daniel Klem Jr., an ornithologist at Muhlenberg College in Allentown, Pa., who has been studying the issue for about 40 years, directed them here, where huge numbers of birds streaking through the skies one moment can be plummeting toward the concrete the next.

“They’re getting killed everywhere and anywhere where there’s even the smallest garage window,” Professor Klem said. “In the case of Toronto, perhaps because of the number of buildings and the number of birds, it’s more dramatic.”

So many birds hit the glass towers of Canada’s most populous city that volunteers scour the ground of the financial district for them in the predawn darkness each morning. They carry paper bags and butterfly nets to rescue injured birds from the impending stampede of pedestrian feet or, all too often, to pick up the bodies of dead ones.

The group behind the bird patrol, the Fatal Light Awareness Program, known as FLAP, estimates that one million to nine million birds die every year from impact with buildings in the Toronto area. The group’s founder once single-handedly recovered about 500 dead birds in one morning.

Toronto’s modern skyline began to rise in the 1960s, giving it a high proportion of modern, glass-clad structures, forming a long wall along the northwestern shore of Lake Ontario. That barrier crosses several major migratory flight paths, the first large structures birds would encounter coming south from the northern wilderness.

Though those factors make Toronto’s buildings particularly lethal, Professor Klem was quick to say that the city also leads North America when it comes to addressing the problem.

After years of conducting rescue and recovery missions and prodding the city to include bird safety in its design code for new buildings, FLAP has recently begun using the courts to help keep birds alive. It is participating in two legal cases using laws normally meant to protect migratory birds from hunting and industrial hazards to prosecute the owners of two particularly problematic buildings.

Briskly walking on a recent morning with a volunteer bird patrol, Michael Mesure, who founded FLAP 19 years ago, pointed out many examples of killer buildings. As he neared one particularly troublesome spot, on the eastern edge of the financial district, he pointed to a gaggle of sea gulls sitting in trees across the street from an office building. They were waiting, he said, to dine on the smaller birds maimed or killed by the building.

The building has a glass facade that disorients birds by reflecting the surrounding trees. Perceiving the reflection as habitat, birds zoom at it full throttle without regard for the danger.

The victims are largely songbirds. Perhaps because of familiarity, the urbanites of the bird world, like house sparrows, pigeons and gulls, are much less prone to crashing into glass, Professor Klem said.

All the birds collected by FLAP, dead or alive, go into paper bags. Though there were no survivors that recent morning, the merely stunned or frightened would have been released in a park near the shore of Lake Ontario. The injured would have been taken to one of two animal rehabilitation centers outside the city.

The dead birds, with the location of their deaths marked on their bags, first end up in a freezer at FLAP’s headquarters, which is part of a sympathetic city councilor’s offices. Although the autumn migration was barely under way, the freezer was already close to full. Its contents ranged from owls to hummingbirds, and the vividness of their plumage was generally offset by the gruesomeness of their smashed heads.

“If the people were colliding with buildings at the same rate birds are, this issue would have been dealt with a long time ago,” Mr. Mesure said. “There’s a detachment in society about this.”

One especially effective, if unpopular, method of reducing the threat to birds, Mr. Mesure said, is simply to cover the outside of windows up to the height of adjacent trees with the finely perforated plastic film often used to turn transit buses into rolling billboards. The film can be printed with advertising or decorative patterns, although the group has found that a repetitive pattern of small circles made from the same adhesive plastic is both effective and less likely to prompt aesthetic objections.

For new buildings, the solution can be as simple as etching patterns into its glass. A German glass company is also developing windows that it hopes can take advantage of the ability of birds to see ultraviolet light, by including warning patterns that are invisible to humans.

But even after nearly two decades of drawing attention to the problem, Mr. Mesure acknowledged that the threat to birds was still rarely considered by architects and developers. Along the morning search route was a hotel that was one of the last buildings approved before Toronto’s new rules took effect. Its extensive use of irregularly shaped reflective glass will most likely make it “quite lethal to birds,” Mr. Mesure said.

Wryly, he also noted a statue at its base depicting a dragon covered in small birds.

The first decision in the court cases, which both involve office complexes outside downtown, is expected on Nov. 15. Though the charges were brought under federal and provincial laws, the cases are being prosecuted byEcojustice, a nonprofit environmental law group, rather than the government, which Canadian law permits.

The effect of the cases is already obvious at Consilium Place, a suburban complex of three office towers involved in the first prosecution. Consilium sits between a river valley that is a major migratory bird resting spot and Lake Ontario. The location and the reflective glass exterior on two of the buildings, which is helpful in reducing heating and air-conditioning costs, but deceiving to birds, make it consistently among the city’s most dangerous structures for birds, Mr. Mesure said.

The former owner, Menkes, consistently rejected proposed solutions on the basis of cost and aesthetics, he said. “We tried to get them engaged in this issue and really didn’t get anywhere.”

Menkes declined to comment for this article. But since the complex was sold this year, the new owner, Kevric Real Estate, has begun to apply a pattern of small white dots on the windows. While far from complete, the measure was already having an effect. A freezer for storing dead birds, which the new landlord had placed in an underground parking garage, contained only a dozen remains, far fewer than usual during a migratory period.

In the case of the Toronto-Dominion Center, however, the birds are also running up against aesthetic concerns. The soaring 1967 towers are the last major work of the modernist master Mies van der Rohe. The property’s owner, Cadillac Fairview, said that it recently applied a dot-pattern film on the windows to protect birds, but used a black pattern apparently to avoid detracting from the architect’s minimalist design. Because they blend in, Mr. Mesure said, the black dots are ineffective as a warning for birds.

The company declined an interview request, but in a statement said, “Bird protection is a matter we take seriously.” The activists’ final stop that morning made it clear that buildings do not have to be skyscrapers to be lethal. A dead chickadee and red-breasted nuthatch lay at the base of a small industrial building that featured mirrored blue glass that reflected an adjacent woodlot. As Paloma Plant, a FLAP employee, picked up the two dead birds, waves of chickadees swept overhead, narrowly avoiding collision.

“When you go through the freezer and it’s constant dead birds, it gets to you after awhile,” Ms. Plant said, holding the two casualties in her palms.

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Essay Questions 13

Year 5 Common Test

1. “Religion has only resulted in divided societies.” What is your view?

2. “People who are in poverty have only themselves to blame.” Comment.

3. Should scientific research be largely driven by commercial interests?

4. “The pursuit of gender equality will do more harm than good.” Discuss.

5. “New media is a new evil.” Discuss.

Year 6 Common Test

6. “Literature, drama and art  all amount to making something out of nothing.” Is this a fair assessment of the arts?

7. “Image is everything.” How far do you agree with this statement?

8. Do you think your society will benefit from having more freedom?

9. “Fine in principle but a failure in practice.” How far do you agree with this assessment of democracy?

10. How far do you agree that war is a necessary tool for peace?

11. “Moral considerations hinder scientific progress.” Comment.

12. Would you agree that we can do little to help the poor in our world today?

13. “Science makes believe in God obsolete.” Comment.

14. Discuss the extent to which it has become harder to lead healthy lives today.

15. “The rise of the East and fall of the West are inevitable.” Do you agree?

16. Do you agree that the tools of social media have reinvented social activism?

17. To what extent should schools use examinations to evaluate students?

18. Consider the view that efficient government is more important than democracy.

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Would you believe this?

Paul Ceglia charged with trying to defraud Facebook

A New York businessman has been charged with trying to defraud Facebook by claiming he was owed a 50% share of the social media company, prosecutors say.

Paul Ceglia is accused of fabricating and destroying evidence in a lawsuit asking for half-ownership of the firm.

Arrested at his home in Wellsville, New York, Mr Ceglia was due in court on Friday afternoon.

US Attorney Preet Bharara said the entrepreneur had been chasing a “quick payday based on a blatant forgery”.

In 2003, Facebook founder Mark Zuckerberg, then a Harvard University student, agreed to do programming work for Mr Ceglia and his fax business, say prosecutors.

Mr Ceglia later filed his lawsuit claiming that he and Mr Zuckerberg had signed a two-page contract awarding him a 50% stake in Facebook.

But Mr Zuckerberg said he had not yet conceived the idea for the social network at the time.

Facebook’s lawyers said the contract that Mr Ceglia and Mr Zuckerberg signed in 2003 was to develop street-mapping software.

Mr Ceglia subsequently doctored the document to insert Facebook references, it is alleged.

Facebook page and logo displayed on computers

Facebook is a multi-billion dollar company

This article is adapted from:

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Hyenas and humans coexist – A Heartwarming story

Large numbers of hyenas and humans coexist, study


By Jeremy Coles

Reporter, BBC Nature

Large hyena populations are living alongside human communities in Africa without coming into conflict, a recent study has found.

An international team of scientists surveyed the population size and diet of spotted hyenas in northern Ethiopia.

The study found a large hyena population with a diet that consisted almost exclusively of domestic animals.

Humans and hyenas are able to coexist because the cost of livestock predation to the local people is relatively low.

The results are published in the journal of Mammalian Biology.

Spotted hyenas (Crocuta crocuta) are common large carnivores of sub-Saharan Africa, and are the most important large scavengers and hunters in many areas of Ethiopia.

According to lead author Gidey Yirga of Mekelle University, Ethiopia, these findings demonstrate a “remarkable case of co-existence between spotted hyena and local communities”.

The study, conducted in the Wukro district of northern Ethiopia, determined that this area has very little natural prey because agriculture has degraded and fragmented the habitat.

The consequence is that “spotted hyenas are almost entirely dependent on anthropogenic food,” Mr Yirga told BBC Nature.

“Based on regular sightings of hyenas we hypothesised that our study area will have moderately high densities, in spite of the absence of native prey,” he said.

To estimate the hyena population the team played continuous gnu-hyena distress sounds, as well as spotted hyena sounds, through a megaphone at randomly selected calling stations.

“Spotted hyenas benefit from waste disposal and human communities benefit from the waste-clearing service”   ~~~~~   Gidey YirgaMekelle University, Ethiopia

They found 52 hyenas per 100 square kilometres living alongside 98 people per square kilometre.

By analysing hairs in the hyenas’ droppings they found that 99% of their diet was made up of domestic animals – chiefly cattle, donkeys, goats and sheep.

Mr Yirga explained that it is likely that waste scavenging is one of the most important food sources for spotted hyenas and that the associated cost to people is both marginal and tolerable.

This peaceful coexistence is mutually beneficial – “spotted hyenas benefit from waste disposal and human communities benefit from the waste-clearing service,” Mr Yirga explained.

He also commented on the wider significance of these findings: “This also indicated that large carnivores could coexist with people at remarkably low costs.”

This article really shows how humans can coexist with animals. If we do not do any harm to them, such as over-logging (hence destroying their habitat at a rapid rate), or illegal poaching (which threatens animals’ survival and turn them towards extinction), we can live in harmony. Animals, on the other hand, would do their best to help us if we do not provoke them and want to maintain peace between the two parties. “Do not do unto others what you do not want others to do unto you”, this quote encapsulates the essence of what this article is trying to bring across, and we as a huge community can live together harmoniously. 🙂

This article is adapted from:

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Social Media 101 – Follow-up on Amy Cheong’s case

Adapted from:–finance.html

By Shi Tianyun

If there’s anything the Amy Cheong saga has taught us, it is to watch what you say on the World Wide Web. Social media platforms can be a double-edged sword. Facebook and Twitter can help you re-connect with long-lost friends and stay updated with what’s happening in the world but it can also stab you in the back if you don’t follow the rules – as Amy Cheong has learnt the hard way.

Just like in real life, social media has its own set of etiquette, especially for the working individual. Even if your company does not have an official social media policy, here are some tips every employee with an online presence – be it a Facebook account or blog – can follow.

1. Separate personal and business

It may seem like a no-brainer but not everyone has separate private and work social media accounts. While your friends and even your colleagues might love to see your baby parading in her new dress but a status update filled with cutesy baby talk might undermine your professionalism in the eyes of bosses and clients. The general practice is to include all work contacts to one’s LinkedIn account and family and friends to the more general Facebook account.

2. Think twice before you post

Use the same common sense and courtesy that you would in real life. Before you click on the “post” button, see whether what you have typed adhere to these golden rules:

a. Don’t treat social media like your own personal soap box

In the same way that you won’t proclaim how much you hate your superior out and loud in public, you should not be ranting and raving online. Never say anything virtually that you wouldn’t in person, especially about touchy issues like politics, race, and gender. Your co-workers and boss may not be your friends on Facebook but as the Amy Cheong lesson has shown, sensational comments have the tendency to go viral and the online community is merciless.

b. Don’t check-in everywhere

It’s definitely not wise to check in on Foursquare when visiting locations for work, especially when important private-and-confidential deals are taking place. On the flipside, don’t get complacent and declare that you are having after-work drinks at 4pm – there is a chance your boss will find out that you didn’t return to the office after your meeting ended early today.

c. Don’t post every single picture you take

While uploading pictures of you hanging out with your pals may seem harmless, you never know how this information may be used against you when you advance in your career – remember a certain Tin Pei Ling Kate Spade incident? And that photo of you hugging your female colleague could lead to a potential sexual harassment suit. So whenever you are in doubt, do not post.

3. Don’t take advantage of your workplace access to social media

While this has little to do with how you behave on cyber-space, this still is part of online etiquette. If you are lucky to work in an office that does not ban social media sites, lucky you! However, this does not give you the license to go overboard. While there’s no harm in taking a Facebook break once in a while, you can imagine what will go through your boss’ mind if she sees you playing Farmville every time she passes your desk.

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Scientists say billions required to meet conservation targets

By Matt McGrath

Science reporter, BBC World Service

Ethiopian bush crow

The most threatened species tend to be relatively cheap to save because of small range sizes

Reducing the risk of extinction for threatened species and establishing protected areas for nature will cost the world over $76bn dollars annually.

Researchers say it is needed to meet globally agreed conservation targets by 2020.

The scientists say the daunting number is just a fifth of what the world spends on soft drinks annually.

And it amounts to just 1% of the value of ecosystems being lost every year, they report in the journal Science.

“Start Quote

Nature just doesn’t do recessions, we’re talking about the irreversible loss of unique species and millions of years of evolutionary history”

Donal McCarthyRSPB

Back in 2002, governments around the world agreed that they would achieve a significant reduction in biodiversity loss by 2010. But the deadline came and went and the rate of loss increased.

Significant cost

At a meeting of the Convention on Biological Diversity in Nagoya that year governments re-committed to a series of targets to be achieved by 2020.

But there is a marked lack of data on how much it would cost to protect species and landed areas. And some experts believe that uncertainty about financial information helps governments who are reluctant to commit to funding the targets.

Now researchers from a number of conservation organisations and universities have set out in detail the likely costs of preserving all threatened species. They’ve also worked out the cost of establishing and expanding protected areas to cover seventeen percent of land and inland water areas.

Phillippine eagle
The Philippine Eagle needs relatively large tracts of pristine forest to survive

Environmental economist Donal McCarthy from the RSPB lead the study. He told BBC News that the amounts involved are significant.

“Reducing the extinction threat for all species would cost $5bn a year, but establishing and maintaining a comprehensive global network of protected areas would cost substantially more,” said Mr McCarthy.

“It could be up to $76bn annually to meet both targets.”

The researchers used the threat to birds as a model for working out the costs of extinction to all species. They asked experts around the world to estimate the costs of conservation actions required to move them down the IUCNlist of those at greatest threat.

“A key finding of our analysis was that the most highly threatened species tend to relatively cheap to save on account of their small range sizes, such as the Razo lark, which lives on the island of Razo in the Cape Verde islands,” said Mr McCarthy.

“Experts say conserving the species would cost less than one hundred thousand a year over the next ten years.”

The costs for protecting land areas were worked out by including estimates of what would be needed to protect sites from threats including deforestation, poaching and over harvesting as well as improving existing conservation zones.

Donal McCarthy says that when compared to some global expenditures the $76bn price tag is a small price to pay.

“These are just a fraction of what we as consumers spend on soft drinks each year which is almost half a trillion dollars – the total required for species and sites is less than half of what is paid out in bonuses to bankers on Wall street’s biggest investment banks,” he explained.

Tough choices needed

Some scientists though are uncertain as to whether the world can afford such large sums in a time of economic crisis.

Prof Tim Benton from the University of Leeds says that tough choices may have to be made.

White shouldered Ibis
Cambodia’s white shouldered ibis receives just 10% of the annual investment needed to save it.

“Some species in some places are absolutely crucial to the way the ecosystem works, but that may not the case in other places.” he told BBC News.

“So rather than trying to save everything everywhere, I think we need to be more strategic, in a very money-limited world, to optimise conservation targets rather than to maximise all biodiversity everywhere.”

Dr Andy Jarvis is with the International Centre for Tropical Agriculture in Colombia. He feels the targets and the finance will be hard to realise. He says that the growing global population and shifting consumption patterns are putting additional pressures on the food system, and so the pressure on land is only going to increase from that side.

“Whilst it would be fantastic if this money were to become available, and ensure that we do maintain critical ecosystem services, this is unlikely to happen,” he said.

But Donal McCarthy argues that at the very least knowing the cost of the targets that governments have agreed to will bring some realism to the discussions.

“Nature just doesn’t do recessions, we’re talking about the irreversible loss of unique species and millions of years of evolutionary history that does need to be borne in mind.”

“These total sums are essentially investments in natural capital. They are not bills.”

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Sponging boomers

The economic legacy left by the baby-boomers is leading to a battle between the generations


ANOTHER economic mess looms on the horizon—one with a great wrinkled visage. The struggle to digest the swollen generation of ageing baby-boomers threatens to strangle economic growth. As the nature and scale of the problem become clear, a showdown between the generations may be inevitable.

After the end of the second world war births surged across the rich world. Britain, Germany and Japan all enjoyed a baby boom, although it peaked in different years. America’s was most pronounced. By 1964 individuals born after the war accounted for 41% of the total population, forming a generation large enough to exert its own political and economic gravity.

These boomers have lived a charmed life, easily topping previous generations in income earned at every age. The sheer heft of the generation created a demographic dividend: a rise in labour supply, reinforced by a surge in the number of working women. Social change favoured it too. Households became smaller, populated with more earners and fewer children. And boomers enjoyed the distinction of being among the best-educated of American generations at a time when the return on education was soaring.

Yet these gains were one-offs. Retirements will reverse the earlier labour-force surge, and younger generations cannot benefit from more women working. There is room to raise educational levels, but it is harder and less lucrative to improve the lot of disadvantaged students than to establish a university degree as the norm for good ones, as was the case after the war. In short, boomer income growth relied on a number of one-off gains.

Young workers also cannot expect decades of rising asset prices like those that enriched the boomers. Zheng Liu and Mark Spiegel, economists at the Federal Reserve Bank of San Francisco, found in 2011 that movements in the price-earnings ratio of equities closely track changes in the ratio of middle-aged to old workers, meaning that the p/e ratio is likely to fall. Having lived through a spectacular bull market, boomers now sell off assets to finance retirement, putting pressure on equity prices and denying young workers an easy route to wealth. Boomers have weathered the economic crisis reasonably well. Thanks largely to the rapid recovery in stockmarkets, those aged between 53 and 58 saw a net decline in wealth of just 2.8% between 2006 and 2010.

More worrying is that this generation seems to be able to leverage its size into favourable policy. Governments slashed tax rates in the 1980s to revitalise lagging economies, just as boomers approached their prime earning years. The average federal tax rate for a median American household, including income and payroll taxes, dropped from more than 18% in 1981 to just over 11% in 2011. Yet sensible tax reforms left less revenue for the generous benefits boomers have continued to vote themselves, such as a prescription-drug benefit paired with inadequate premiums. Deficits exploded. Erick Eschker, an economist at Humboldt State University, reckons that each American born in 1945 can expect nearly $2.2m in lifetime net transfers from the state—more than any previous cohort.



Boomers’ sponging may well outstrip that of younger generations as well. A study by the International Monetary Fund in 2011 compared the tax bills of a cohort’s members over their lifetime with the value of the benefits that they are forecast to receive. The boomers are leaving a huge bill. Those aged 65 in 2010 may receive $333 billion more in benefits than they pay in taxes (see chart), an obligation 17 times larger than that likely to be left by those aged 25.

Sadly, arithmetic leaves but a few ways out of the mess. Faster growth would help. But the debt left by the boomers adds to the drag of slower labour-force growth. Carmen Reinhart and Kenneth Rogoff, two Harvard economists, estimate that public debt above 90% of GDP can reduce average growth rates by more than 1%. Meanwhile, the boomer era has seen falling levels of public investment in America. Annual spending on infrastructure as a share of GDP dropped from more than 3% in the early 1960s to roughly 1% in 2007.

Austerity is another option, but the consolidation needed would be large. The IMF estimates that fixing America’s fiscal imbalance would require a 35% cut in all transfer payments and a 35% rise in all taxes—too big a pill for a creaky political system to swallow. Fiscal imbalances rise with the share of population over 65 and with partisan gridlock, according to other research by Mr Eschker. This is troubling news for America, where the over-65 share of the voting-age population will rise from 17% now to 26% in 2030.

That leaves a third possibility: inflation. Post-war inflation helped shrink America’s debt as a share of GDP by 35 percentage points (see article). More inflation might prove salutary for other reasons as well. Mr Rogoff has suggested that a few years of 5% price rises could have helped households reduce their debts faster. Other economists, including two members of the Federal Reserve’s policymaking committee, now argue that with interest rates near zero, the Fed should tolerate a higher rate of inflation to speed up recovery.

The generational divide makes this plan a hard sell. Younger workers are typically debtors, who benefit from inflation reducing real interest rates. Older cohorts with large savings dislike it for the same reason. A recent paper by the Federal Reserve Bank of St Louis suggests that as a country ages, its tolerance for inflation falls. Its authors theorise that a central bank could use inflation to achieve some generational redistribution. Yet pressure on the Fed to cease its expansionary actions has been intense, and led by a Republican Party increasingly driven by boomer preferences.

The political power of the boomers is formidable. But sooner or later, it cannot escape the maths.

Categories: Economics, News Article, Social Changes | Leave a comment

How Chavez Does Business

After almost 14 years in office, and with an impressive record of electoral victories behind him, Venezuelan President Hugo Chávez now faces the most challenging campaign of his political career. Venezuela’s economy is weak, and, for the first time since 1998, Chávez, who has cancer, could suffer defeat when the country goes to the polls, on October 7.

The conventional wisdom is that Chávez’s prospects will depend, as they have in the past, on his strong support from the country’s poor. He has spent years developing social programs to dole out state funds to those in need, and the tactic has made him wildly popular. But that strategy alone might not work this time around. Chávez’s electoral fortune today depends not so much on his connections to the poor but on his approach to Venezuela’s private sector.

Chávez has long undercut private enterprise, which has resulted in a weak economy that is hurting his appeal to voters. (Click the image to the right to see how.) But he can also use economic troubles to demonize the private sector and rally ideological voters. This complicated relationship to the private sector explains why, this this time around, Chávez’s candidacy is damaged but still afloat.


This round of voting is especially significant, because more than at any point in recent memory, stability is an issue: the ruling party is heavily armed, and the opposition is highly charged. (Last weekend, three followers of the opposition were killed; click here to see a timeline of Chávez’s rise to power.) Neither side trusts the other, nor the rules by which the other plays. The outcome could be close — the numbers vary, but two reputable pollsters have shown the opposition candidate, Henrique Capriles Radonski, to be closing the gap — and there is a risk that neither party will recognize unfavorable results. In other words, the threat of violence is very real in a country that is the fourth most important source of oil for the United States.

At least in theory, Chávez shouldn’t be having so many problems. In Latin America, incumbents have a huge advantage because the office of the president is often the most powerful branch of government; the fact is all the more true in Caracas. More, Chávez has presided over one of the most extraordinary oil booms in history, generating nearly $1 trillion since the early 2000s. Yet the president’s political prospects look very much like his physical health: he is not quite dying, but he is not thriving either.

Chávez’s main problem is that social spending may have reached a saturation point. Since the 2010 parliamentary elections, the urban poor have largely split politically. Some poor continue to trust Chávez as their patron saint, awed by his “missions,” as his varied social assistance programs are known. His latest project — handing out some 244,000 free houses to low-income Venezuelans — has captured headlines for its imaginativeness and grandiosity.

But the other half of the urban poor seems to have had enough. These people feel besieged by the worst crime wave in the world — this year, experts expect the homicide rate to reach 70 murders per 100,000 inhabitants (in the United States, the rate is about 4 per 100,000). They are frustrated by declining real wages and scarce job prospects. They are tired of empty promises; many of the new giveaway houses, for instance, are proving to be uninhabitable. And they are frustrated by infrastructure that is collapsing around them. In the last several months alone, a bridge on a major interstate highway collapsed, and an oil refinery exploded, killing 41 people. The electricity grid is in such disrepair that Caracas now schedules daily power outages.


Chávez’s real hope, then, is his relationship with the business class. Contrary to what conservative analysts claim, Chávez is no Bolshevik. He says that he wants to “pulverize” capitalism, but the truth is that he is not intent on obliterating the country’s private sector. He wants to keep it alive — but small, uncompetitive, and dependent on the state.

On that score, he has succeeded. Since the mid-2000s, Chávez has nationalized approximately 100 major firms and almost 900 minor ones, while expanding public-sector employment from 15 to 19 percent of the labor force. He has saddled the private sector with onerous regulations and price controls, overburdening firms with heavy costs. He deliberately overvalues the country’s currency, which discourages exports and overstimulates imports. To survive, private firms have had to become import retailers rather than local producers. Thus, imports have increased and private-sector exports have virtually collapsed, down in 2010 by 55 percent since 1998. And finally, firms can’t access dollars on their own because they are not exporting; the only way for them to get cash is to go knocking on the government’s door. But Caracas sells dollars only at very high prices and under strict controls. Businesses are forced to maintain very good connections with the state.

The result is a reduced, highly unproductive, increasingly state-dependent yet very profitable private sector. The Venezuelan stock market says it all — the bourse has skyrocketed during Chávez’s tenure, appreciating by 870 percent between 2000 and 2010, far outstripping stock markets in the more avowedly capitalist countries of Chile (275 percent), Brazil (299 percent), and Mexico (554 percent). Firms make profits by acquiring import licenses or a privileged exchange rate, or by bribing the state for contracts and exemptions to regulations. Few firms seek profits by investing in their own businesses.

The Venezuelan stock market outshines not just stock markets in other countries but, ironically for a socialist state, workers’ earnings at home. Real wages in Venezuela have collapsed by almost 40 percent since 2000 (see the interactive graphic). Elsewhere in the region, real wages have either improved or remained stable.

This odd relationship with the private sector explains both Chávez’s not-so-high electoral ceiling and his not-so-low electoral floor. Whereas in most countries governments experiment with different forms of partnerships with the private sector to advance development, in Venezuela the state tries to go it alone. Consequently, Chávez cannot tout achievements in job growth, salary growth, infrastructure improvement, expansion of the middle classes, and jumps in education seen elsewhere in emerging markets. This is a burden on his campaign.

But the underperformance of the private sector works wonders ideologically, as it allows Chávez to bluster on with his anti-capitalist rhetoric. On the campaign trail, he regularly accuses the private sector of predatory hoarding. He complains that businesses are not producing enough or creating jobs fast enough. He blames them for relying on imports and expatriating profits (and thus being in cahoots with international capitalism). His rhetoric about a faltering private sector allows the state to portray itself as the only hope for the poor. To move the masses into the ranks of the middle class, the state cannot act alone — the private sector must also generate well-paying jobs. But that is not happening in Venezuela, despite the fact that it has everywhere else in Latin America. In many ways, of course, Chávez is correct. The private sector is atrophied. What he fails to mention is the problems are government-induced.

So Chávez’s strategy has been to keep the election discussion at the ideological level, emphasizing the problems of capitalism. Since these problems are so visible in Venezuela, his ideological attack resonates. And because there has been some poverty alleviation but not enough growth of the middle class, there is still a constituency for Chávez’s self-description as the country’s greatest-ever welfare provider.

But in this campaign, Chávez is pushing new boundaries. On the stump, he has portrayed his regime as the country’s guarantor of order, and thus, the best choice for business and business-friendly voters. On several occasions this year, Chávez has actually said that to vote for him is to vote for stability and, in turn, more profits. In Latin America, the argument that the state exists to protect the country, and especially businesses, from political unrest dates back to the military juntas of the 1970s. It is the essence of reactionary ideology.

Chávez is campaigning not just on ideological grounds but also, schizophrenically, on both extremes of the ideological spectrum: he is portraying himself as Venezuela’s savior from capitalism and as Venezuela’s savior of capitalism.


This puts the opposition in a corner. The 40-year-old center-left Capriles Radonski, known as el Flaco (the Skinny One), has run a successful campaign. He has united a fragmented opposition, avoiding getting personal when responding to the government’s ad hominem attacks. (When Chávez accused him of being a Nazi sympathizer and thus betraying his grandmother, a Holocaust survivor, Capriles Radonski simply responded, in so many words, I’ve never messed with your family; don’t mess with mine. Last Sunday, he led one of the largest marches ever to take place in Caracas. Capriles Radonski has widened the appeal of the opposition with a conciliatory, rather than vengeful, discourse. He has forced the government to recognize some of its own failings, including an admission by Chávez in June that crime is a “serious problem” that social spending alone cannot cure — an admission that not long ago would have been unimaginable.

But when it comes to the business class, Capriles Radonski is stuck. He understands that the foremost curse on Venezuela today is not so much the tyranny of oil but the noncompetitiveness of the private sector. To say as much openly, however, would only play into Chávez’s accusation that this newcomer is out to serve the elites.

So Capriles Radonski has focused on the next best tactic. Rather than promising better management of the business sector, he is promising better management of the state’s businesses: improving garbage collection, ending power outages, easing traffic jams, ensuring water provision, making social spending more transparent, and, of course, fighting crime. Anyone who has visited Venezuela recently knows the dismal state of its public services, and a campaign built around making things better resonates widely.

The election will come down to a showdown between a relentlessly ideological incumbent and a man running as the handyman-in-chief. Chávez wants to be all things ideological while his adversary wants to be all things competent. Chávez’s strategy is risky and desperate, and it will not win over the millions of Venezuelans who long for a better-functioning state. Such voters might go with Capriles Radonski. But he faces his own risks — of overstating his powers as a repairman and of disappointing those who want to know which tasks he’ll address first, and how. Thus, Chávez’s ideological approach won’t convince everyone, but he could end up convincing at least half of Venezuelan voters. And that’s all he needs to eke out one more victory.

Categories: Economics, News Article, Politics, Social Changes | 1 Comment

Summer ice in the Arctic Ocean is vanishing rapidly


IN 2007 climate scientists were shocked when the regular summer retreat of the Arctic’s sea ice went far farther than they had ever seen before. In the spring of that year ice covered just under 15m km2 (5.8m square miles) of ocean—an area 90% as big as Russia. By mid-September, when it reached its minimum, there were just 4.17m km2 left. That is about the area of the European Union minus Greece. Since 1979, when satellites made such measurements possible, there had been no melt like it.

Until now. Though the extent of the September sea ice did bounce back a little from 2007’s nadir, in every year since then the minimum has been lower than it was in every year before 2007. And this year 2007’s record has not been merely broken, it has been smashed. Coverage fell below 4.17m km2 as early as August 26th. By September 16th, which America’s National Snow and Ice Data Centre (NSIDC) thinks marked the low point, it was down to 3.41m km2 (see map). That is the European Union minus Greece, Portugal, Ireland, Britain and Germany.

This is all the more surprising because 2012 has in other ways been a pretty ordinary year in the Arctic. In 2007 the summer weather was particularly inimical to the persistence of ice, with lots of warm southerly winds and clear skies that allowed the sunshine to do its worst. This year has seen far less in the way of special circumstances. It is true that a powerful cyclone chewed up a lot of ice in the East Siberian and Chukchi seas in early August—but the rate of ice loss outstripped that seen in 2007 both before the storm and after it.

The summer sea ice is shrinking so much mostly because greenhouse warming is raising Arctic temperatures. This has direct effects: when the air is warmer, more ice melts. It also has indirect effects. Warm, salty water from the North Atlantic sliding below the cold, fresh upper layers of the Barents Sea may be one of them. Another could be that warmer air is often moister. Moist air traps more heat in summer. In winter it tends to create more clouds, which keeps the surface below warm.

Disappearing trick

In theory, climate models should help tease out which of these indirect effects is playing the biggest role, and also say how much of the decline in ice cover can be assigned to natural variability and how much to feedback loops in which a little warming leads to a lot more. The most famous of these feedbacks is the ice-albedo effect: the darker (“lower-albedo”) surfaces revealed when bright, reflective ice melts go on to absorb more sun than the ice did, accelerating the process that originally provoked the melting.

Unfortunately, climate models do not seem to be good at coping with the Arctic. The melt is happening much faster in reality than it does in computer programs. It seems these are not capturing the subtleties of the ways in which more heat is getting to the far north, and that these subtleties matter.

This makes it hard to say how fast the summer ice cover will continue to shrink. But the betting has to be that it will indeed continue to do so. The warming trend means that, every year, there is less old ice and more new ice that has formed in the winter just past. That new ice will often be fragile and thin, easily disrupted by summer weather. And in a warmer world the sort of cold conditions that used to allow the ice to thicken and reinforce itself are that bit less common, so opportunities to reverse the trend are rare.

It is still possible that changes in wind patterns and longer-term natural climate shifts may slow the currently tumultuous process of decline. But according to Mark Serreze of NSIDC the system has entered a “new regime” in which, eventually, most of the ice will come and go every year, with little lasting the whole summer. September ice cover of less than 1m km2 could be normal within decades. That’s just France and Germany.

Our animation of previous September sea-ice extents reveals the shipping routes that could be unlocked

A world in which sunshine and ocean currents push a lot more energy into the Arctic in the summer will be one where much of that energy comes back out in the winter, as the surface waters cool and the ice freezes back. This release of heat will probably change the atmosphere’s circulation patterns, perhaps through the jet stream, a wind which circles the world in the lower stratosphere, perhaps through other means. Such changes will, in turn, affect the weather at lower latitudes.

Various groups of researchers have sought to link the expanses of open water north of Siberia in years with strong summer melting to cold subsequent winters in western Europe. More generally it has been suggested that the effect on the jet stream might increase the frequency of “blocking” patterns, in which weather conditions that would normally be expected to stay over a given region for only a few days get stuck for weeks or months, provoking droughts and heatwaves.

Over and out?

As yet none of these ideas has been confirmed, and for now there is no definitely discernible pattern in terms of severe weather. James Overland of America’s National Oceanic and Atmospheric Administration, who works on the matter, points out that normally temperate places saw unusually cold winters in 2009-10 and 2010-11, which some people have linked to strong previous melting; but after similar melting the winters of 2011-12 and 2008-09 turned out quite differently.

The effects in the Arctic, on fisheries and trade, may be easier to measure. But low levels of ice do not mean open water everywhere. Shell’s attempts to drill for oil in the Chukchi Sea this August were forestalled by ice floes which, though small by the scale of continents, were pretty large by the standards of human engineering. On the other side of the ocean the Parry Channel, a part of the Northwest Passage which has been ice-free in previous years, this year stayed resolutely impassable.

Such quirks will make the Arctic an unpredictable place to work. But if the details are tricky, the big picture is clear. Clear as an open ocean.

Categories: Environment, News Article | Leave a comment

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