ECHIDNE of the snakes

But that obscures the fact that the Gang of Six tax plan doesn’t really pencil out. They have promised:
• Lower marginal tax rates so that they fall in 3 brackets: one at 8-12%, one at 14-22%, and one at 23-29%;
• The elimination of the alternative minimum tax, which would cost $1.7 trillion;
• Reform but not elimination of the really big tax expenditures, like charitable deductions, the employer health care deduction and the mortgage interest deduction;
• Revenue-neutral corporate income tax reform;
• And yet a grand total of $1 trillion in net revenues, on top of the $800 billion built in from the assumption of the end of the high-end Bush tax cuts.
How in the would do you lower rates, cancel the AMT, get nothing from the corporate side, promise not to nix the biggest tax expenditures, and raise at least $3.5 trillion? That’s the cost of the AMT, $1.7 trillion, plus the revenue raising targets, $1.8 trillion. I’m NOT EVEN COUNTING the money you would have to make up for lowering the individual rates. You’d have to tax Wall Street trades or add a carbon tax to get to that number.

A spate of exceptionally brutal rapes in the northern state of Uttar Pradesh has shocked India. Many of the victims were young girls.

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"With the help of his friends, he dragged me to a secluded area and began to assault me with knives and axes. I was conscious for some time, but once they cut me on my head and neck, I fainted. When I became conscious, I was in hospital."
Sarika shows me her injuries - a fist-size wound on her scalp, her jaw which has been sewn together, her right hand which had to be re-attached, her right earlobe from where big chunks are missing, and long scars on her arms.
Shivam has been arrested, but the others are still free. One told the BBC he had been wrongly accused.
A terrified Sarika and her family have abandoned their home and land in Fatehpur district's Udrauli village to stay with relatives in another village nearly 45km (30 miles) away.

Virtually all health insurance plans could soon be required to offer female patients free coverage of prescription birth control, breast-pump rentals, counseling for domestic violence, and annual wellness exams and HIV tests as a result of recommendations released Tuesday by an independent advisory panel of health experts.

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Women’s health advocates pronounced themselves delighted that the Institute of Medicine committee had chosen to recommend not only the widest possible range of contraceptive services but also an expansive spectrum of other preventive services.
These include screening for gestational diabetes in pregnant women; more sophisticated testing for a virus, known as HPV, that is associated with cervical cancer; annual counseling for sexually active women on sexually transmitted infections; and multiple visits to obtain preventive services if they cannot be provided in one annual exam.

Jeanne Monahan, director of the Center for Human Dignity at the socially conservative Family Research Council, said that many Americans may object to birth control on religious grounds. “They should not be forced to have to pay into insurance plans that violate their consciences. Their conscience rights should be protected,” she said.

People always ask me what happened to sex since “Fear of Flying.” While editing an anthology of women’s sexual writing called “Sugar in My Bowl” last year, I was fascinated to see, among younger women, a nostalgia for ’50s-era attitudes toward sexuality. The older writers in my anthology are raunchier than the younger writers. The younger writers are obsessed with motherhood and monogamy.

It makes sense. Daughters always want to be different from their mothers. If their mothers discovered free sex, then they want to rediscover monogamy. My daughter, Molly Jong-Fast, who is in her mid-30s, wrote an essay called “They Had Sex So I Didn’t Have To.” Her friend Julie Klam wrote “Let’s Not Talk About Sex.” The novelist Elisa Albert said: “Sex is overexposed. It needs to take a vacation, turn off its phone, get off the grid.” Meg Wolitzer, author of “The Uncoupling,” a fictional retelling of “Lysistrata,” described “a kind of background chatter about women losing interest in sex.” Min Jin Lee, a contributor to the anthology, suggested that “for cosmopolitan singles, sex with intimacy appears to be neither the norm nor the objective.”

A clinical psychologist, Farley studies prostitution, trafficking, and sexual violence, but even she wasn’t sure how representative her results were. “The question has always remained: are all our findings true of just sex buyers, or are they true of men in general?” she says.
In a new study released exclusively to NEWSWEEK, “Comparing Sex Buyers With Men Who Don’t Buy Sex,” Farley provides some startling answers. Although the two groups share many attitudes about women and sex, they differ in significant ways illustrated by two quotes that serve as the report’s subtitle.
One man in the study explained why he likes to buy prostitutes: “You can have a good time with the servitude,” he said. A contrasting view was expressed by another man as the reason he doesn’t buy sex: “You’re supporting a system of degradation,” he said.
And yet buying sex is so pervasive that Farley’s team had a shockingly difficult time locating men who really don’t do it. The use of pornography, phone sex, lap dances, and other services has become so widespread that the researchers were forced to loosen their definition in order to assemble a 100-person control group.

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Overall, the attitudes and habits of sex buyers reveal them as men who dehumanize and commodify women, view them with anger and contempt, lack empathy for their suffering, and relish their own ability to inflict pain and degradation.
Farley found that sex buyers were more likely to view sex as divorced from personal relationships than nonbuyers, and they enjoyed the absence of emotional involvement with prostitutes, whom they saw as commodities. “Prostitution treats women as objects and not ... humans,” said one john interviewed for the study.
In their interviews, the sex buyers often voiced aggression toward women, and were nearly eight times as likely as nonbuyers to say they would rape a woman if they could get away with it. Asked why he bought sex, one man said he liked “to beat women up.” Sex buyers in the study committed more crimes of every kind than nonbuyers, and all the crimes associated with violence against women were committed by the johns.
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Prostitution has always been risky for women; the average age of death is 34, and the American Journal of Epidemiology reported that prostitutes suffer a “workplace homicide rate” 51 times higher than that of the next most dangerous occupation, working in a liquor store.

Farley’s findings suggest that the use of prostitution and pornography may cause men to become more aggressive. Sex buyers in the study used significantly more pornography than nonbuyers, and three quarters of them said they received their sex education from pornography, compared with slightly more than half of the nonbuyers. “Over time, as a result of their prostitution and pornography use, sex buyers reported that their sexual preferences changed and they sought more sadomasochistic and anal sex,” the study reported.

From the AFL-CIO to the Consumer Union, few liberal groups have expressed anything but the mildest of disappointment that their heroine did not get the job.
Warren herself, who very much wanted to head the agency she conceived and has been building, put out a statement on Sunday supporting Cordray. She followed it up on Monday with an article backing the decision on Huffington Post, a liberal outlet that had crusaded for her nomination.

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“She is playing extremely well with others right now,” said one close observer of the process who declined to be identified by name because he continues to work with the administration and CFPB. The White House did not immediately response to a request for comment.
One school of thought holds that Warren’s warm support came in return for White House assurances of assistance in a possible campaign against Republican Scott Brown (R-Mass.) next year. Senior Democrats have indeed suggested that Warren could count on such support.
But it is not at all clear that such a campaign will ever materialize.
For one thing, it is not clear that Warren, now on leave from Harvard Law School to serve on the White House staff, is inclined to run. And while the financial industry is not happy with Brown for what they see as his failure to fight against new limits on debit card swipe fees, bankers would certainly prefer him to Warren, meaning he would raise massive amount of money off her candidacy.
“If [Warren] runs, Brown will be opening bank accounts in the Caymans to hold all the financial industry cash that will flow his way,” said one industry executive.
Said another: “Banks are furious at Brown over [debit card] interchange. But they would never support Warren.”

The New York Times this week reports on a phenomenon that you’ve likely experienced if you take more than a couple of prescription drugs, or especially if you care for an elderly parent who juggles a rainbow of blood pressure meds, statins, prostate shrinkers, memory enhancers, and other sundry pills and potions: all that confusion that happens when one generic pharmaceutical is substituted for another, and suddenly a little oval pink pill they’ve been taking for years is substituted with an oblong white pill and the patient no longer has any idea what they are taking for what purpose anymore.

The article suggests that the problem lies in the transition that occurs when expensive branded drugs go generic: you knew that your Viagra was a little blue diamond because Pfizer masterminded a decade-long PR program to ensure that you knew this. But when the little blue pill or the big purple pill turns into a bland little yellow thing, the patient loses the differentiation between those and the six other bland little tablets they are taking. Lipitor is next on the block to go generic this year – and about time: as one of the highest-potency anti-cholesterol drugs, a generic Lipitor could stop the hair-splitting between those who can take the old low-potency statins and those who need the expensive blockbuster cholesterol medications like Crestor and Lipitor. But still: those generics will be variable, produced by dozens of generics makers, likely in a rainbow of neutral colors - instead of the old oval white that Lipitor users have been taking since the drug came onto the market 14 years ago.

Marketing people argue that the look of a pill is part of a company’s right to set their product aside from all other products – including generic equivalents; generics should not carry the same look of branded Viagra or Prilosec (the famed first Purple Pill) because that was part of the propriety marketing of the patented drug. Proponents of drug safety argue the opposite: that changing the drug’s look when it goes off-patent to a variety of appearances that change every time a pharmacy stocks a different supplier contributes to confusion, non-compliance, and even harmful drug errors. (This would also save me at least half a dozen conversations a week in which a patient tries to explain which medication they are taking by saying, “You know, it’s a that little yellow one with the oval shape, you must know what it is…” I try to cut these conversations short as fast as possible: I do not know what pill that is, and there is no utility to my committing these thousands of variations to memory. I prescribe between 20-50 medications on a daily basis, and some hundreds more as a matter of course, most of which have dozens of generic variations. You want your doctor to spend their free brain space reading up on the latest data, engaging in lively discussions with colleagues about the evidence on controversial cases, maybe reviewing ways to make their office practice more efficient. You do not want them wasting space limited brain space brain memorizing the size and shape of infinite varieties of generic pills.)

To a certain extent, I agree with the latter: confusion would drop precipitously if one drug always came in the same form, no variation between size, shape, or color. But there is a fundamental flaw in that thinking, a deeper problem with pharmaceutical labeling, and a systematic fix parallel to the color and size issue that strikes deeper at the heart of medical error:

Currently, all medications on the market are required to carry a unique identifier code; to figure out what a drug is from the code on any pill, you essentially have to run it through a program that is designed to suss out this information. This code identifies the drug and maker, but often with letter and number combinations that have nothing to do with what is in the pill – they just have to use a unique code (AN 627, for example is – inexplicably – one formulation of tramadol). What would work better? Regulators could require that the unique identifier be almost microscopically small, but that every pill actually have the generic name and dose imprinted or inscribed on it. Like this.

This may not solve the issue of the elderly patient whose sight is beginning to fail but who is still juggling their own medications – certainly the big-pink-pill versus small-yellow-pill is going to be a lot easier to distinguish than the tiny writing it will take to fit words like “atorvastatin 20mg” on a standard Lipitor tablet. But it will help caretakers keep the jumble of meds apart – and it can help give hospital and care facility nurses a layer of final checks on medications that are completely lacking now: when you know you are supposed to be handing out the combination blood pressure drug Zestoretic but the only marker on the pill is an “A” on one side and a “26” on the other, you have no final verification that you chose the right medication from the supply, that the Pyxis machine spat out the right drug, that you did not mix up the drugs between the first patient’s room, the emergency call back to the desk, the stop by a third patient’s room who has been frantically delirious all night, and finally back to the room of the second patient who is receiving the medication: all part of the normal chaos that nurses cope with on a shift-wide basis.

Forcing the use of generic names from the day a drug is marketed would also encourage an early familiarity and reliance on generic names, which separates providers and patients from the attachment to well-branded and well-marketed drugs later on. In training I had faculty who refused to let trainees use brand names of drugs – even those which had no off-patent equivalent – because they were so passionate about the effect of branded drug pricing on health care costs; it was atorvastatin or no name at all.

In medicine – as in most disciplines – some errors are fundamentally due to individual incompetence and cannot be fixed by systemic solutions; these are few and far between. Most errors have systemic solutions that could drastically reduce harm, and this is a core example of them. Maintaining the same shape, size, and color to medications across the generics would be ideal, but labeling clear identifiers on pills at all is such a fundamentally much more important issue that has largely not even hit the radar: a issue of convenience, an issue of efficiency, and moreover, an issue of safety for you and your family as the patients who rely on these products to maintain their health.

Cross-posted from my recently relocated and re-launched blog at America, Love it or Heal It.

The U.S. Federal Reserve approved a rule that would require credit-card issuers to consider consumers’ individual incomes before extending credit.
Credit-card applications generally can’t request “household income” because that term is too vague for issuers to evaluate whether customers will be able to make the required payments on the accounts, according to a statement from the Fed today. The rule is needed to prevent making credit available to consumers who lack the ability to pay, the Fed said.
The change is supposed to limit issuers from giving cards to college students, yet some lawmakers have been concerned that stay-at-home spouses will suffer.
“The proposed regulations ignore their demonstrated credit-worthiness because of their lack of current market income,” Representative Carolyn Maloney, a New York Democrat who sponsored the credit-card bill and Representative Louise Slaughter, a New York Democrat, said in a letter to the Fed in January.
Card issuers can allow spouses to apply jointly for credit, the Fed said.

Earlier this year, the Fed ruled that credit card applications should ask about a consumer’s individual income or salary rather than his or her “household income.” This isn’t just for students under 21, but for everyone. That means that a stay-at-home parent is considered as unworthy of credit as an unemployed college kid–and seven out of eight stay-at-home parents are mothers. No one without a pay stub, no matter the value of her contribution to her household, can get a line of credit unless her spouse cosigns the account.
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In response to criticism from women’s rights advocates who believe that access to credit is a key tenet of financial independence, the Federal Reserve noted that the individual-income provision may be “inconvenient or impractical,” but that such restrictions are necessary to prevent reckless lending and borrowing.

Today's deep, patient sigh goes out to the California Milk Processor Board and Goodby, Silverstein & Partners for their new "Got milk?" campaign positioning milk as a cure-all for the grab bag of unpleasantness known as PMS. They tried this once before, in 2005. The new campaign is called "Everything I Do Is Wrong," and with headlines like "We can BOTH blame myself" and "I apologize for letting you misinterpret what I was saying," it presents women as more uncontrollably irrational than ever before! The print ads send you to a Flash-heavy microsite (how quaint!) that tracks the global PMS level and helps men create apology videos with big-eyed flying kittens.

The California Milk Processor Board’s latest campaign is meant to raise awareness of milk’s health benefits in reducing the symptoms of PMS. The campaign is not targeted at women, though, but at dudes.

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Connie Bohon, an ob-gyn in Washington, D.C., calls the link between milk and PMS “soft,” telling the Washington Post, “There are some beliefs that calcium can improve PMS symptoms [but] I don’t know that it’s universally accepted.” The belief is based on a 1998 study in the American Journal of Obstetrics and Gynecology–a study sponsored by SmithKline Beecham Consumer Healthcare, makers of calcium-supplying TUMS–which found that women who took 1,500 milligrams of calcium via supplements experienced nearly a 50-percent reduction in PMS symptoms. Still, there’s no clear evidence that this would work the same with calcium-rich foods like milk.

Because the campaign is being positioned partly as a public service announcement, it straddles the line between commercial marketing (the profit motive) and social marketing (the do-good motive). In this case, the Milk Board appears to want to improve women’s health, but ultimately, commercial profit is their bottom line. It’s frustrating enough when advertisements capitalize on anti-feminist messages, but it’s absolutely maddening to see commercial marketing masked as social marketing and using the same anti-women tactics.

Shree Bose, age 17, from Fort Worth, Tex., won the grand prize for developing a way to improve ovarian cancer treatment for patients who have developed a resistance to chemotherapy. Naomi Shah, 16, from Portland, Ore., found ways to improve indoor air quality and decrease people’s reliance on asthma medications. And Lauren Hodge, 14, from Dallastown, Pa., researched the effects of different marinades on potential carcinogens in grilled chicken.

“As a girl, to see that my gender actually is going to come into this field that’s been so dominated by men is exciting to me, and to be a part of that is even more exciting,” Ms. Bose said in an interview.