Yes, it’s driven by greed — but the mania for cryptocurrency could wind up building something much more important than wealth.
Yes, it’s driven by greed — but the mania for cryptocurrency could wind up building something much more important than wealth.
Just because we can extend life, should we? The U.S. is expected to spend $2.8 trillion on health care in 2012. Medicare alone will cost taxpayers $590 billion, with over 25% going toward patients in their last year of life. If health care is a scarce resource, limited by its availability and our ability to pay for it, should government step in to ration care, deciding whose life is worth saving? In other words, how much is an extra month of life worth?
For The Motion
The U.S. spends more on health care than any other industrial nation—in 2012 we are expected to spend $2.8 trillion. We cannot afford our health care system and expensive end-of-life care costs are a major contributor to this problem.
Rationing means getting better value for the trillions we spend every year.
Rationing already happens. Medicare decides what it will reimburse, private insurance decides what they will cover, and individuals go without care and medicine every day when they can’t afford it.
We must ration based on cost-effectiveness, not on an individual’s ability to pay.
If we spent less on those who, with or without treatment, have only a few months left to live, we would be better able to help those who may have decades.
Against The Motion
The government should not have the power to determine who lives, who dies, and who gets treatment based on calculations of quality and quantity of life.
Health care costs can be reined in without rationing care.
Targeting “end-of-life” care specifically would result in very little cost savings.
Rationing care will lead us down a moral slippery slope. How many years of life is enough? Who is productive and worthy, and who is not?
In 1994, Oregon voters passed the Death with Dignity Act, which legalized physician-assisted suicide for the terminally ill. Since then, it has become legal in 4 more states, including New Mexico, where the state court ruling that it is constitutional is under appeal. Is it, in the words of the American Medical Association’s code of ethics, “fundamentally incompatible with the physician’s role as healer”? Will these laws lead to a slippery slope, where the vulnerable are pressured to choose death and human life is devalued? Or do we need to recognize everyone’s basic right to autonomy, the right to end pain and suffering, and the right to choose to die with dignity?
For The Motion
The right to die as one chooses—and to decide when life is no longer worth living—is integral to human freedom, liberty, and personal autonomy. Neither the government, nor religious institutions, should impose their own conceptions of morality upon individuals who are not harming others.
As an option in end-of-life care, aid in dying would allow terminally ill, mentally competent individuals to retain dignity and bodily integrity in the face of insurmountable pain and suffering.
In places where assisted suicide is legal—namely, Oregon and the Netherlands—there is no evidence that the law is being abused, that vulnerable populations are being targeted, or that patients are being coerced by doctors and/or their families to choose death.
If physician-assisted suicide remains illegal, lesser and more dangerous alternatives—shooting oneself, enlisting doctors or family to break the law, DIY suicide—will spread in its place.
Against The Motion
If assisted suicide is legalized, we will be led down a slippery slope towards pervasive medical killing, endangering vulnerable populations—disabled, elderly, minority, or poor—whose lives are seen as a burden on society.
If pain is treated effectively, there is no need to treat the patient as if the patient were the “problem to be eliminated.”
Starting with the Hippocratic Oath, medical professional codes prohibit killing, holding the intrinsic value of human life and dignity above all other ethical principles. Assisted suicide erodes the doctor-patient relationship and has grave potential for misuse and abuse.
Many physicians do not want to have God-like power over others, and they should not be pressured, against their own convictions, to assist in a patient’s suicide.
Discussion leader: David Mace
Here is a good overview piece from the Pew Research Center on refugees
Since the Syrian Civil War began in 2011, more than 4 million Syrians have fled the country, creating the greatest refugee crisis since World War II. Most have fled to Turkey, Lebanon, and Jordan, but many have risked death to reach Europe and the possibility of a better life. Unlike Europe and Syria’s neighbors, the United States has had the advantage of picking and choosing from afar, taking in just over 2,000 Syrian refugees since the war’s start. The Obama administration has pledged to take another 10,000 in 2016, but there are some who suggest that we are falling well below the number that we can and should accept. What are our moral obligations, and what are the cultural, economic, and security issues that must be taken into account? Should the U.S. let in 100,000 Syrian refugees?
Fact sheet supporting the debate:
And a rebuttal to the fact sheet:
Discussion leader: Bryan Hooper
The American Dream is still alive, but it has been fading into the distance with the growth of inequality of income and wealth distribution over the past few decades. There are some good research guides to help us understand the current situation and provide a basis for discussion of how changes in automation might affect the situation in future. In particular, the economists Thomas Piketty of the Paris School of Economics and Raj Chetty of Stanford University specialize in the study of inequality and its causes and possible cures, and the reading items suggested in these notes draw on their work.
For those of you with really limited time go to the review of key findings from the report in a New York Times article from 12/14/2017:
• The second major recommendation is to pull up The Equality of Opportunity Project website, and look at the second chart on the home page that provides the support for the first sentence of these notes. To quote, “Our work shows that children’s prospects of earning more than their parents have fallen from 90% to 50% over the past half century.” One of the Project Directors is Raj Chetty and a podcast on Freakonomics Radio expands on his research on the American Dream: there is a link to the podcast in the second paragraph of the item on Project Motivation next to the chart. You can either listen to the 40 minutes of the broadcast, or for the time-challenged, try reading the on-screen transcript instead. To save even more time read a summary of his key points below:
Young kids who move out of a high-poverty neighborhood do much better later on in life because of several factors:
– Residential integration.
– Income inequality.
– Family influence.
– Social capital.
– School quality.
The investment in moving these children is repaid to society by the income taxes they pay back on the higher earnings they eventually make as adults.
The website is:
Chetty is also working on a project using Facebook data to help understand better the causes of inequality:
The Brookings Institution has Chetty in 14 Charts on this site:
• A third suggestion is to read the key points from the IPPR report titled Managing Automation which is mainly about the UK economic outlook in this area, but contains on page 17 chart 1.6 using data from the McKinsey study cited below indicating that 60% of occupations in the USA consist of activities that are 30% automatable. (Does that mean that 18% of those jobs will disappear?) It also states that occupations with zero chance of being automated include psychiatrists and legislators! The executive summary on pages 2 to 5 is a quick read, but section 2 on pages 24 to 30 covers their forecast for the growth of inequality due to automation. The potential loss of wages associated with automating activities is estimated as $1.1 trillion in the USA.
• The fourth recommendation is to review the key findings of a McKinsey Global Institute study titled A Future that Works: Automation, Employment and Productivity. Pages ii to iii provide a quick summary. The subsequent executive summary is on pages 1 to 3, and for those with perseverance the full report covers an additional 16 pages of analysis and opinion.
https://www.mckinsey.com/~/media/McKinsey/Global Themes/Digital Disruption/Harnessing automation for a future that works/MGI-A-future-that-works-Executive-summary.ashx
• For the fifth reference point, if you still have the time and energy, have a look at the debate on Intelligence Squared from October, 2014, Income Inequality impairs the American Dream of Upward Mobility. Again, you can download a transcript to read in a shorter time than listening takes – 1:44 hours – and it will also save you having to listen to the self-centered moderator. Note that the motion was judged to have failed by their scoring system, but a majority of the audience ended up supporting it.
• And for those with even more stamina here is a selection of newspaper articles to browse on this subject:
From the New York Times 2/28/18: The Unmet Promise of Equality:
As the World Economic Forum convenes in Davos, the powerful are feeling optimistic because of waning worries about populism and global economic growth.
From The New York Times: Open Societies Under Siege. Trump is a symptom, not a cause. That is why he will be hard to dislodge.
Discussion Leader: Gary Banks
The IQ2 Debate is an excellent introduction to the subject. (One debater is Rob Fraley from Monsanto – I used to work with him) Spoiler alert – the Pro GMO side won by 28%.
Genetically modified (GM) foods have been around for decades. Created by modifying the DNA of one organism through the introduction of genes from another, they are developed for a number of different reasons—to fight disease, enhance flavor, resist pests, improve nutrition, survive drought—and are mainly found in our food supply in processed foods using corn, soybeans, and sugar beets, and as feed for farm animals. Across the country and around the world, communities are fighting the cultivation of genetically engineered crops. Are they safe? How do they impact the environment? Can they improve food security? Is the world better off with or without GM food?
Set of Short Articles from Harvard University These are terrific.
Introduction:Words from the editors:
We all have strong opinions about what we eat and how it affects our health, and with such a large portion of land dedicated to growing our food, many are also concerned about the environmental impacts of feeding billions of people. For this reason, the discussion about genetically modified organisms (GMOs) in our food is a highly politicized topic. When we started this project, we had heard a lot about GMO foods, but much of it seemed to come from people with a mission: the agrotech companies and food safety advocates. As scientists, we believe that the best way to really understand an issue is to go back to the primary sources. So we started with a list of questions we had about GMOs, and we asked members of our scientific community to do just that. This Special Edition is a presentation of what we found.
The articles here start from the basics: what foods are genetically modified, and how long have we been doing this? We next look at the GMO foods available now: how does eating GMOs affect organ toxicity and allergies? And what’s the health impact of the pesticides that we use on GMO crops? We also asked about the environmental effects of growing Roundup Ready and Bt crops, and the potential for GMOs to have an unintentional effect on genetic diversity. We looked at legal and policy issues—how does the patenting process affect companies and farmers? How are GMOs regulated in the US and in Europe? How have GMOs changed farming culture? And finally, we took a look at the future of GMOs: How can GMOs help us to fight world hunger and nutritional deficits in the developing world? And what technologies will we see in the next wave of genetically engineered crops?
So, did we find that GMOs are good or bad? The answer is complicated. The overwhelming majority of scientific evidence suggests that eating food with genetically modified DNA has no effect on human health, but there is also ample evidence that some GMOs have negative environmental impacts, such as the creation of superweeds. And while GMOs have not yet been wildly successful in providing solutions to an ever-growing global population and changing climate, there are certainly promising technologies in the works. It seems to us that GMOs have the potential to do great good, but in order for this to happen, research must proceed conscientiously, with consideration of the environmental risks of introducing engineered plants into our farms. But that’s just our opinion—we encourage you to put aside what you think you know about GMOs and read on to develop your own.
August 10, 2015.
aka Roundup, Wikipedia article about its history and chemistry. Key point – It has low toxicity because glyphosate inhibits the EPSPS enzymes of different species of plants and microbes at different rates. EPSPS is produced only by plants and microbes; the gene coding for it is not in the mammalian genome.
Bacillus thuringiensis, aka Bt. A naturally occurring soil bacterium used in organic farming. Some GMO’s, specifically corn, have been engineered to contain specific Bt proteins. Hence, they have built-in insect resistance. It was news to me that only certain strains of Bt have insecticidal properties. Further, that specific proteins can target specific insects. The article describes how they contain a crystalline protein that destroys the digestive tract of the insect.
We aren’t as genetically pure human as we’d like to think. Genes move between species both naturally (e.g. virus’s and bacteria to animals) and by targeted genetic engineering. The reason genes can be moved is, at the genetic level, all life has a lot in common.
No-Till Farming and Herbicide Resistant Crops
Widely practiced by farmers and highly recommended by the USDA, no till farming is enabled by GMO’s.
In the spring, weeds will begin to grow on any field. The farmer plows to turn the weeds under –
not to loosen the soil for seeds. There is an undeserved romance about plowing. In fact, it is really bad thing to do to land. Plowing:
The farmer then plants the crop. But
Once the crop is established it will choke out the weeds.
But as with a plowed field, weeds will regrow and eventually choke out the crop. The framer can’t use glyphosate again as it will kill both the weeds and the crop. However, if the crop is genetically engineered to tolerate glyphosate the field can be sprayed with glyphosate and only the weeds will be killed. Like with inter-row plowing, once the crop is established, it will choke out the weeds.
It is important that government regulators thoughtfully oversee GMO’s. They must be scientifically capable as the technology is complex and ever changing. One hopes they are data driven and not pro or con GMO zealots. That isn’t always the case as the European laws were written without the input of their scientists.
National Academy of Sciences
New technologies in genetic engineering and conventional breeding
are blurring the once clear distinctions between these two cropimprovement
approaches. While recognizing the inherent difficulty
of detecting subtle or long-term effects in health or the environment, the
study committee found no substantiated evidence of a difference in risks
to human health between currently commercialized genetically engineered
(GE) crops and conventionally bred crops, nor did it find conclusive
cause-and-effect evidence of environmental problems from the GE crops.
GE crops have generally had favorable economic outcomes for producers
in early years of adoption, but enduring and widespread gains will depend
on institutional support and access to profitable local and global markets,
especially for resource-poor farmers.
Cornell Alliance for Science – the GMO debate is over
Also see article in the Harvard series above: Same Science, Different Policies: Regulating Genetically Modified Foods in the U.S. and Europe
Some African countries have barred GMO food aid based, I think, on the notion that if it’s too dangerous for Europeans it must be too dangerous for Africans and African lives are just as valuable as European ones. Set against that is malnutrition in many of these countries and the availability not only of US-raised food aid but also better harvests in Africa. It’s a lively debate:
GMO’s in Africa
Here’s a report from the buyer at Whole Foods, which is committed to labeling but discusses how difficult it is to ensure transparency. Clearly their Millennial customer base wants to avoid GMO products as noted below.
Why I don’t buy organic – Forbes
Why organic food costs more:
Organic does not mean healthy:
So Ben & Jerry’s ice cream is good but not necessarily good for you. It non-GMO and uses eggs from cage free chickens. But a half cup contains 160 calories, 45 from fat, and not much else.
Retained Identity (RI) is a system where an agricultural product is tracked from field to the consumer at a detailed level. It supersedes labelling. Already, food must state the country of origin may say “Organic”, “Non-GMO” and “Free Range” though those terms can be fuzzy. Food must state its ingredients but not where those ingredients came from. (Think of the scandals in China.) Food must also state nutritional information. Better than nothing but still superficial.
Already, organic farming requires detailed record keeping of all inputs (fertilizers, pesticides), land maps, and supply chain records.
Food does not have to specify the seed variety or the pesticides that were used to grow it.
Many restaurants, markets and groceries promote “know your local farmer” with pictures of kindly farmers you want to grow your food. At the Stone Barn you can meet the pig or lamb you are about to eat (no thanks). All good.
But some food processing is better done at industrial sites where sanitation, testing and handling is controlled. Even organic farms cannot slaughter their own animals and I worry about local food trucks. And of course not all food can be sourced locally.
Block Chain (Jim – note I finally worked block chain into Current Affairs) is a promising technology to implement Retained Identity – essentially a rigorous lot control system.
Organic vs. GMO
From the USDA:
NPR Story – Organic Pesticides: Not An Oxymoron
From Genetic Literacy:
Using GMO’s to produce drugs and other products
From the FDA:
What is a biological product?
Biological products include a wide range of products such as vaccines, blood and blood components, allergenics, somatic cells, gene therapy, tissues, and recombinant therapeutic proteins. Biologics can be composed of sugars, proteins, or nucleic acids or complex combinations of these substances, or may be living entities such as cells and tissues. Biologics are isolated from a variety of natural sources – human, animal, or microorganism – and may be produced by biotechnology methods and other cutting-edge technologies. Gene-based and cellular biologics, for example, often are at the forefront of biomedical research, and may be used to treat a variety of medical conditions for which no other treatments are available.
How do biological products differ from conventional drugs?
In contrast to most drugs that are chemically synthesized and their structure is known, most biologics are complex mixtures that are not easily identified or characterized. Biological products, including those manufactured by biotechnology, tend to be heat sensitive and susceptible to microbial contamination. Therefore, it is necessary to use aseptic principles from initial manufacturing steps, which is also in contrast to most conventional drugs.
Biological products often represent the cutting-edge of biomedical research and, in time, may offer the most effective means to treat a variety of medical illnesses and conditions that presently have no other treatments available.
Below is an article from the NYT’s 1/2/18. A Danish company Novozymes, has discovered enzymes that clean clothes in cold water, in less water, using less chemicals and removes stains better. All good.
To make commercial quantities of the enzyme economically researchers started with an enzyme from soil bacteria in Turkey, and modified it through genetic engineering to make it more closely resemble a substance found in cool seawater.
Next, they found a way to mass produce the enzyme. Novozymes implanted the newly developed product’s DNA into a batch of microbial hosts used to cultivate large volumes of enzymes quickly and at low cost. The enzymes were then “brewed” in large, closely monitored tanks before being sold.
Politics, Fake News, Fear, Uncertainty and Doubt
A question from the audience in the IQ2 debate referenced above was wicked. She asked the Con team ” If the the scientific consensus and the regulators say GMO’s are safe, what would it take to change your mind?” Implied answer is they will nver change their mind. The irony is, many of the anti GMO people are exasperated by people who deny human caused climate change in the face of equally strong scientific consensus.
Why People Oppose GMOs Even Though Science Says They Are Safe
With G.M.O. Policies, Europe Turns Against Science
With G.M.O. Policies, Europe Turns Against Science
General article on agriculture:
Precision Agriculture – It might be the best way forward
Precision Ag is farming every square meter optimally.
Organic farming requires this already though records are not available to consumers.
The genetic genie isn’t going back in the bottle.
Knowing precise genetic vulnerabilities of disease, weeds and insects enable highly targeted solution with less collateral damage.
Meanwhile natural mutations and selection continues. Bacterial and viruses are evolving rapidly. They aren’t malevolent but the results can be an existential threat to human survival. Consider the Spanish flu, small pox, HIV, bubonic plague, … Since antibiotics were discovered in the 1930’s many bacteria have become resistant. We don’t have good drugs for viruses. It’s an arms race and genetic engineering is a powerful weapon.
Specific to agriculture, there are threats to our food supply. Population growth is straining the agricultural system to produce more and better food. Arable land is limited – and possibly declining due to erosion, climate change and mismanagement. Creating more farm land by clearing forests creates major problems. Disease and pests are an evolving threat.
We would hope that the universities and companies doing genetic engineering will be responsible. In case they aren’t we need even smarter regulators to help them be responsible. The public has an obligation to understand genetic engineering to make informed choices and set thoughtful policy. This is a global issue.
Agriculture – An Integrated Solution
Agriculture is an industry that is ripe for big data. In fact, some companies and organizations are already big data repositories. With onboard GPS and sensors, satellites and sampling data from every square meter of farm land, every day can be captured.
Collect this data over time to show the effects of crop rotation.
Applying analytics this data will optimize the output of the farm with the least amount of treatment. The data would show certain seed varieties are recommended for this year for this land. The may or may not be genetic engineered.
We recently heard from a speaker that it makes no sense to take drugs for a problem until diet and lifestyle solutions have been fully implemented. Farmers can first attempt to farm using minimally intrusive pest control.
These data sharing programs have all been voluntary to date. However, a case can be made to treat pesticides as pharmaceuticals. That is, even though it is your body you can’t go the drug store and buy an antibiotic. Most wouldn’t know what to buy or the dose. Do-it-yourself medicine is unthinkable. Why is it any different for farm land – even if you own it?
For agriculture a farmer who had a problem would call a crop consultant (doctor) and they would prescribe a certain treatment (drug) and application (dosage). The farmer would take the prescription to the ag supplier (drug store) for fulfillment. There might be a followup to make sure the problem has been solved.
The crop consultant would also police abuse. Pest resistance is caused by overuse. Wrong treatment, wrong rate, wrong timing is wasteful economically and damaging to the environment.
As a homeowner most of us are a county mile from scientific management of our yards. We wouldn’t dream of polluting the Sound but yard run off is a problem. Have you had your soil tested? Exactly what type of fertilizer does your yard need? When you put down crab grass preventer or broadleaf weedkiller do you really need it? Was it done at the right time? Is setting the dial on your spreader at “4” for the whole yard correct? Or was it because Scott’s Turf Builder Plus 2 was on sale at Home Depot and it is “recommended” to apply in early spring? So you have brown spots. Might be grubs so you buy Grub Ex. Despite the label it only works at a certain time and there are many reasons for brow spots.
An article by Robert Fraley whom you saw in the IQ2 debate.
I read this last year. Great book. You’ll need that college biology course to fully understand it. But to truly be informed about GMO’s you need to understand genetics. Gary
From the Pulitzer Prize-winning, bestselling author of The Emperor of All Maladies–a magnificent history of the gene and a response to the defining question of the future: What becomes of being human when we learn to “read” and “write” our own genetic information?The extraordinary Siddhartha Mukherjee has a written a biography of the gene as deft, brilliant, and illuminating as his extraordinarily successful biography of cancer. Weaving science, social history, and personal narrative to tell us the story of one of the most important conceptual breakthroughs of modern times, Mukherjee animates the quest to understand human heredity and its surprising influence on our lives, personalities, identities, fates, and choices. Throughout the narrative, the story of Mukherjee’s own family–with its tragic and bewildering history of mental illness–cuts like a bright, red line, reminding us of the many questions that hang over our ability to translate the science of genetics from the laboratory to the real world. In superb prose and with an instinct for the dramatic scene, he describes the centuries of research and experimentation–from Aristotle and Pythagoras to Mendel and Darwin, from Boveri and Thomas Morgan to Crick, Watson and Rosa Franklin, all the way through the revolutionary twenty-first century innovators who mapped the human genome. As The New Yorker said of The Emperor of All Maladies, “It’s hard to think of many books for a general audience that have rendered any area of modern science and technology with such intelligence, accessibility, and compassion…An extraordinary achievement.” Riveting, revelatory, and magisterial history of a scientific idea coming to life, and an essential preparation for the moral complexity introduced by our ability to create or “write” the human genome, The Gene is a must-read for everyone concerned about the definition and future of humanity. This is the most crucial science of our time, intimately explained by a master.
Discussion Leader: Bob Baker
Factors in developing initiatives for affordable housing- DMA discussion Thursday are:
5. Legal Issues
Application to the Heights in Darien:
HUD Rental Assistance:
Typical Percentages for Household Budgets – Budgeting Money
Our own Evonne Klein is CT Commissioner of Housing:
Section 8-30g has been used in town to override local zoning rules to add affordable housing.
Section 8 Housing In Connecticut And HUD Low Income House Rentals
NY Times Magazine, Jan 27, page 53
“New York is facing an affordable-housing crisis.”
“Of the roughly 2300 apartments in…the project, about 700 will be reserved for lower-income tenants. The first 105 affordable units were recently made available at monthly rents ranging from$590 to $964: 87,000 people entered the lottery for them.
NY Times Jan. 8. Business section. “Homeowners want a Say Past Their Lot Lines” [ zoning regulations raise home prices]
Denver Has a Plan for Its Many Luxury Apartments: Housing Subsidies – WSJ
Affordable Housing Resources | Texas Health and Human Services
This posting on “food stamps” in CT. is in contrast to how assistance for housing is administered.
National Affordable Housing – Section 8 Help and Resources
How to Apply for Section 8 Housing in Connecticut
Connecticut Section 8 Housing | Section-8-Housing.org
Learn about Homeownership Vouchers (Section 8 Homeownership Vouchers)
Web Notes – HUD.gov / U.S. Department of Housing and Urban Development (HUD)
Gary here. I just read this in preparation for our discussion. Gates and Obama have it on their suggested reading list. It is about people at the very bottom. Depressing – extremely difficult to find solutions.
From Harvard sociologist and MacArthur “genius” Matthew Desmond, a landmark work of scholarship and reportage that will forever change the way we look at poverty in America In this brilliant, heartbreaking book, Matthew Desmond takes us into the poorest neighborhoods of Milwaukee to tell the story of eight families on the edge. Arleen is a single mother trying to raise her two sons on the $20 a month she has left after paying for their rundown apartment. Scott is a gentle nurse consumed by a heroin addiction. Lamar, a man with no legs and a neighborhood full of boys to look after, tries to work his way out of debt. Vanetta participates in a botched stickup after her hours are cut. All are spending almost everything they have on rent, and all have fallen behind. The fates of these families are in the hands of two landlords: Sherrena Tarver, a former schoolteacher turned inner-city entrepreneur, and Tobin Charney, who runs one of the worst trailer parks in Milwaukee. They loathe some of their tenants and are fond of others, but as Sherrena puts it, “Love don’t pay the bills.” She moves to evict Arleen and her boys a few days before Christmas. Even in the most desolate areas of American cities, evictions used to be rare. But today, most poor renting families are spending more than half of their income on housing, and eviction has become ordinary, especially for single mothers. In vivid, intimate prose, Desmond provides a ground-level view of one of the most urgent issues facing America today. As we see families forced into shelters, squalid apartments, or more dangerous neighborhoods, we bear witness to the human cost of America’s vast inequality–and to people’s determination and intelligence in the face of hardship. Based on years of embedded fieldwork and painstakingly gathered data, this masterful book transforms our understanding of extreme poverty and economic exploitation while providing fresh ideas for solving a devastating, uniquely American problem. Its unforgettable scenes of hope and loss remind us of the centrality of home, without which nothing else is possible.
Leader: Sunil Saksena
Drug Pricing–Tentative Discussion Outline for Dec 14, 2017
The Problem Document that drug prices are higher in the US than anywhere else
Why are they higher and how are prices set ? Compare US with foreign countries
Pharmaceutical Cos justify high prices needed to support high R&D expenditure- the case for and against
What can be done to lower them? What do other countries do? In the US it seems a combination of modifying patent law, FDA approval process,some regulatory changes, allowing certain imports, and allowing Govt negotiated Medicare drug prices, could hel lower prices.
What is an “appropriate “ price for a drug? A value based approach. Who decides?
The High Cost of Prescription Drugs in the United States
Origins and Prospects for Reform
IQ2US: Health care costs in the U.S. are some 18 percent of GNP, nearly double what other rich countries spend. We read of drug therapies that cost $100,000 a year or more, and of drug price increases that are 6 times the rate of inflation, on average, and often much more when mergers reduce competition in the industry. Is this a major driver of excessive health care costs? Or is it a by-product of the huge costs of getting new drugs approved? Has big pharma delivered drugs that reduce the need for costly surgeries, which extend life and improve its quality? Or do they deserve the blame that has been leveled against them?
An article about how and why some drugs are less expensive paying cash vs through insurance:
Leader: Harvey Mogenson
Part I – Brief example/ discussion of the current corporate tax system as a basis to compare the Tax Reform Proposals. This would include the concepts of a) tax rules applicable to a US corporation vs a foreign corporation/subsidiary; b) what does “effective tax rate” mean; c) the historical trend away from corporations to pass-throughs. (We only need this last item if we want to touch upon why there are proposals for special business rates for individuals.)Part II – Discuss the proposals for a lower corporate tax rate and the major “offsets”. (We could even compare the “offsets” with the current list of tax expenditures to see where the offsets came from.)Part III – Discuss the proposals for a “territorial system” applicable to dividends from foreign subsidiaries. This would focus on “deferral” vs “exemption” and probably some discussion of global competition.
ESTIMATES OF FEDERAL TAX EXPENDITURES FOR FISCAL YEARS 2016-2020
Tax Cuts and Jobs Act H.R. 1 Section-by-Section Summary
Corporate Income Tax Rates around the World, 2017
Labor Bears Much of the Cost of the Corporate Tax
An Overview of Pass-through Businesses in the United States
International Comparision of Effective Corporate Tax Rates
Ernst & Young LLP’s rapid response to the House Ways and Means Committee’s tax reform
draft bill, “The Tax Cuts and Jobs Act”
A Turnabout on Corporate Taxes
Republican Plan: Tax People, Not Companies
Historical background and European VAT taxes.
Senate Tax Reform Bill
In our first article Tony Seba makes the case that multiple technologies are converging that will massively disrupt the auto industry, use of space, transportation, energy, climate, … – all a big part of how we now live and work. He calls it “Clean Disruption”.
Our discussion will review his model. Are the assumptions valid? Is the logic consistent and complete? What other scenarios are possible? Timing? US vs ROW? Politics and regulation? Business threats and opportunities?
UK and France will ban ICE (internal combustion engine) autos by 2040:
Forbes: Volvo will stop designing ICE only cars by 2019. (They are not going all electric as some reported.)
Forbes: What if everyone installed solar?
When you reduce the number of moving parts in an engine from 2000 to 20, increase the efficiency and useful life of each auto, and eliminate truck drivers, then that is going to result in unemployment on a massive scale in the socio-economic classes that have already suffered from the widening income gap experienced over the past 30 years, and contributed to the election of Trump. Are our politicians capable of recognizing the consequences and bold enough to take action to offset the disappearing jobs? Given our current ineptitude in gaining consensus in Congress and the absence of forward vision from the White House I do not feel confident of the corrective means being devised and applied. Add to that the possible turmoil created by falling demand for oil from the Middle East, and we begin to approach the conditions for a perfect storm. Bryan Hooper.
What should the price be to sell electrons back price to the utility? It can’t be the retail cost of electricity because all the fixed costs remain. Fixed costs include the power station and transmission lines. The variable cost is just the cost of fuel. But for nuclear that variable fuel cost is zero.
So with residential roof top solar, a battery and a maybe back up generator – do you need to be on the power grid at all? If you are off the grid you can’t sell excess power, but do you owe the utility anything? (Note that you pay for sewers whether you are hooked up to them or not.) Do people dropping off lead to a death spiral as fixed costs of a universal power grid are spread over a shrinking customer base?
Will electric cars break the grid?
From Bloomberg Businessweek:
Dyson plans to build an electric car (or at least a street legal riding vacuum):
From Paul Williams: http://brook.gs/2fAZBmc
On the rapidly emerging technologies to improve electric storage: https://www.brookings.edu/blog/techtank/2015/09/15/five-emerging-battery-technologies-for-electric-vehicles/
Comprehensive Immigration Reform: challenges and problems in accomplishing it.
Discussion leader: Charlie Goodyear
Discussion Outline: http://sma.darien.org/wp-content/uploads/Immigration-2.pdf
Background information: http://sma.darien.org/wp-content/uploads/Immigration-I-.pdf
A general history immigration: https://en.wikipedia.org/wiki/Immigration_to_the_United_States
On the 1986 Immigration Act: https://en.wikipedia.org/wiki/Immigration_Reform_and_Control_Act_of_1986
Immigration Reform Act of 2007
On illegal immigration: https://en.wikipedia.org/wiki/Illegal_immigration_to_the_United_States
E-Verify is a government system to verify a workers legal right to work in the US. It seem logical that if illegal immigrants cannot work “above the table” it would discourage immigration. But it is not mandatory: http://www.marketwatch.com/story/make-e-verify-mandatory-when-hiring-and-that-will-help-stop-illegal-immigration-2016-11-02
Also (may want to read the comments following the article): http://www.pbs.org/newshour/rundown/5-things-you-should-know-about-e-verify/
An article from the Economist on the education levels of new immigrants. Also the +/- of a point system. http://www.economist.com/news/united-states/21723108-far-being-low-skilled-half-all-legal-migrants-have-college-degrees-immigration?frsc=dg%7Cc
An article in the current issue of Weekly Standard hits the spot on immigration enforcement.
Without Visas, Carnival Workers Are Trapped at Home in Mexico https://www.nytimes.com/2017/07/22/world/americas/mexico-h2b-visas-tlapacoyan-carnivals.html
Discussion leader: Gary Banks
President Trump and Mexican leaders have been disagreeing since the first moments of Trump’s presidential campaign, when Trump accused Mexico of using the United States as a dumping ground for criminals; he went on to campaign on building a wall, imposing a tariff, and revising NAFTA.
But beneath the heated rhetoric is a complex and largely beneficial relationship. Mexico is the United States’ third-largest trading partner, with $531 billion in two-way trade in 2015. More than 35 million Americans have Mexican roots. While U.S. companies’ investments in Mexico get more attention, Mexican companies employ more than 123,000 people in the U.S.
Our discussion will examine this issue from several vantages. What makes this interesting, and challenging, is the fact that every action will have a reaction and, in turn, a counter reaction. As in any complex adaptive system, you can’t do just one thing. There is plenty of news from a US perspective. Here, we’ll also explore how Mexico and its people see the relationship and what actions and reactions they may take.
Summit in Mexico from the Yale School of Management.
By antagonizing the U.S.’s neighbor to the south, Donald Trump has made the classic bully’s error: He has underestimated his victim. https://www.theatlantic.com/magazine/archive/2017/05/mexicos-revenge/521451/
Nafta has made Mexico a better place, writes @MaryAnastasiaOG from Harris
Here is an example of how difficult trade negotiation are. One industry, in this case sugar growers in Florida want to restrict imports from Mexico. (The Florida sugar industry in known for sleazy politics and environmental damage.) But the sugar refining industry wants inexpensive raw sugar. But wait! The Iowa corn farmers want to sell high fructose corn syrup to Mexico and that market might be jeopardized. Now the sugar buyers, such as candy makers threaten to move their manufacturing off shore to get access to raw materials. Not simple – everything is connected. Like ecology, you can’t do just one thing. https://www.nytimes.com/2017/06/04/world/americas/mexico-nafta-north-american-free-trade-agreement-sugar-subsidies.html?ref=business&_r=0
Not mentioned is both corn and sugar cane can make ethanol. Sugar cane as biomass makes more sense as the stalks are waste, corn is a crop. Brazil is a leader in cane ethanol but there is an import duty to the US to protect domestic growers. But there is no import duty on oil –
even from unsavory countries. The impoverished Caribbean could grow sugar cane and the have refineries but they are blocked.
George Friedman, Stratfor, has some provocative perspectives. Namely, the US-Mexico relationship goes back to their defeat in the Mexican-American war. That the US Southwest is occupied Mexican territory. And with the rapid growth of the Latino population in those states soon to determine their politics,the area could become some sort of semi-autonomous zone between the two countries. This is outlined in his book “The Next 100 years”.
How Mexico’s President Laid the Foundation for a Wall
Enrique Peña Nieto helped put Trump in the White House. https://www.theatlantic.com/international/archive/2017/01/trumps-accomplice-in-mexico/514430/
Nearly 5 Million U.S. Jobs Depend on Trade With Mexico
Arguments that policies such as NAFTA have killed American manufacturing jobs often ignore the many other American jobs that such deals create and support. https://www.theatlantic.com/business/archive/2016/12/mexico-nafta-trade/510008/
America Is Already Paying for the Wall With Mexico
How Trump made an enemy. https://www.theatlantic.com/international/archive/2017/01/america-is-already-paying-for-the-wall-with-mexico/514658/
Now that you have done your reading, there is a test of how much you know about Mexico courtesy of the Christian Science Monitor. http://www.csmonitor.com/World/Americas/2012/0701/How-much-do-you-know-about-Mexico-Take-our-quiz/What-does-the-5th-of-May-commemorate-in-Mexico How did you do?