National News

Inside the economics of the delivery room

Marketplace - American Public Media - Mon, 2014-05-26 09:22

Sarah Beth Mathews just can't seem to get comfortable these days. She gets up in the middle of the night to go the bathroom. She's lugging extra weight around. Normal stuff when you're 38 weeks pregnant.

She's come in for a checkup with Sarah Aultman, an obstetrician at Brookwood Medical Center in Birmingham, Ala. When it comes time to deliver this baby, Aultman has no plans to rush to do a C-section.

"Now we recognize that it's safe to let a woman continue to try and labor," she says. "And the conversation I have with my patients is as long as mom is safe and baby is safe, I'm happy to continue trying for a vaginal delivery."

That falls right in line with guidelines issued last month by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. They essentially say wait, give moms a chance to deliver vaginally.

"This document is about being patient," says Aaron Caughey, an obstetrician who helped draft the new guidelines.

But experts say that's easier said than done. And for those in the business of delivering babies, the change is going to affect the bottom line.  

Caughey says that recently, hospitals have pushed to cut C-section rates. Hospitals charge more for C-sections, but they also cost more.

"Women stay longer after C-sections. They require more intensive nursing care. They require more intensive O.R. care," he says, referring to the operating room.

So what about obstetricians, who feel pressure to deliver as many babies as they can?

"It does lead to us being patient and waiting for longer periods of time," Caughey says. "So if it's Friday at 8 p.m. and, you know, I could be at home, instead I'm going to hang out and see if someone's cervix will change."

So they might lose a little more sleep, but they're not likely to make much more money, says Neel Shah, a Harvard Medical School obstetrician based at Beth Israel Deaconess Medical Center, who has studied the cost of labor.

"The hospital might make more money on a C-section, but the person who decides to do the C-section doesn't necessarily make more money," Shah says.

In fact, one report says out of the private insurance payout on a vaginal birth, doctors get a 25 percent slice of the pie. That's slightly more than the 21 percent they get for a C-section birth.

Still, Shah says, C-sections are faster than vaginal deliveries. So if an obstetrician is paid per delivery, more is better for the bottom line.

"The longer that labor lasts, the more attractive it might be or the stronger the incentive might be to offset your workload by just getting her delivered," he says.

Doctors to test suspended animation

Marketplace - American Public Media - Mon, 2014-05-26 08:59

CNET reports that doctors and scientists are beginning to test out suspended animation as a way to keep critically-wounded patients alive. According to the report:

The technique will initially be used on 10 patients whose wounds would otherwise be lethal in an attempt to buy the surgeons some time. It works, as suggested by science fiction, by cooling the body -- but not by applying an external temperature change.

The procedure has been performed on pigs, but this would be the first time the technique is used on humans. 

Dr. Samuel Tisherman told New Scientist, "We are suspending life, but we don't like to call it suspended animation because it sounds like science fiction."

Why the legend of the cupcake is mostly myth

Marketplace - American Public Media - Mon, 2014-05-26 08:55

Ah yes, the food trend story.

In today's age of Upworthy, Buzzfeed and attention-grabbing viral headlines, we see a lot of them... consider this story from the Huffington Post titled, "We're Just Going To Declare That 2014 Is The Year Of The Sheet Cake."

Here at Marketplace, we're not immune: We've covered the Cronut and the Waffle Taco and Sriracha

And when talking about food trends, it is impossible to ignore the cupcake. The most frequently-told tale about the ascendance of the treat is rooted in a scene in Sex and the City that supposedly launched it into our collective cultural conciousness. Early on in his book, Sax asks a question: "Thousands of years in the future, when archaeologists are cobing through the artificants of our age... will the archaeologists recognize cupcakes?"

"In the first decade of the the twenty-first century there were cakes baked in cups, cakes of every imaginable flavor and combination; that these cakes were covered in sweet frosting, in everything from simple vanilla creams to elaborate artistic 3-D creations, that for more than ten years these little cakes were a subject of great power and fasination all over the world; and that all of that, from the global tribes of devoted bakers to the chroniclers of the phenomenon to the multibillion-dollar cupcake economy, all began here, on this sacred corner of Manhattan, at this small bakery."

But Sax says it's not as simple as Carrie and Miranda eating cupcakes on screen. 

"Sex and the City was distilled down into all these different consumer items that were attached to it. Sex and the City!: Manolo Blahnik heels, Rabbit vibrators, cupcakes and Cosmos, come on ladies!" Sax says. "And when I went on the Sex and City [tourist bus] tour, that was sort of the essence of it... but anytime you read an article about Sex and the City... they all referenced it, 'Go to Magnolia Bakery, because that's where Carrie and Miranda's favorite cupcake place is,' and it just perpetuated itself."

"It was a 20-second scene in one episode of the show. There was never another cupcake in Sex and the City that ever appeared again. And yet it has this incredibly strong association with the show that transformed the cucpake."

PODCAST: Comcast's massive lobbying push

Marketplace - American Public Media - Mon, 2014-05-26 08:05

Comcast is going to war in its pursuit to merge with Time Warner Cable. The telecom giant has reportedly bought up lobbyists at 40 different firms around Washington.

It turns out anxiety-- that nagging feeling that something, everything might go wrong -- actually has benefits in the business world.

White House Mistakenly Blows Cover Of CIA Officer In Afghanistan

NPR News - Mon, 2014-05-26 07:55

A list of U.S. officials who briefed President Obama on his surprise trip to Bagram air base in Afghanistan this weekend inadvertently included the name of the agency's station chief in Kabul.

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Wash And Deliver: Startups Aim To Solve First World Problems

NPR News - Mon, 2014-05-26 07:49

With services that pick up your laundry, deliver you gourmet food, take you on a cheap ride — all with the tap of an app — many of the hassles of life are disappearing. But can these companies last?

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Dad Catches Son's Home Run Ball At Minor League Game

NPR News - Mon, 2014-05-26 06:33

Conrad Gregor thanked his parents for making a five-hour drive to watch him play by driving a home run over the wall to where his father was standing.

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The value of negative thinking

Marketplace - American Public Media - Mon, 2014-05-26 06:25

It turns out anxiety-- that nagging feeling that something, everything might go wrong -- actually has benefits in the business world. Wharton Business School professor Adam Grant joins Marketplace Morning Report host David Brancaccio to discuss the value of negative thinking. Click on the audio player above to hear more. 

Why Some Pet Owners Ditch Chow To Cook For Fido From Scratch

NPR News - Mon, 2014-05-26 05:45

Whether for philosophical or health reasons, pet owners are whipping up batches of pet food for their beloved animals. But veterinarians warn that these meals need to be nutritionally balanced.

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Ukraine's Poroshenko Says He'll Restore Peace In East

NPR News - Mon, 2014-05-26 05:37

Ukraine's projected new president Petro Poroshenko welcomed his victory Monday by pledging to speed up operations to quell pro-Russian separatists in eastern Ukraine.

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A stroll across the Golden Gate Bridge

Marketplace - American Public Media - Mon, 2014-05-26 05:09

From the Marketplace Datebook, here’s a look at what’s coming up Tuesday, May 27:

In Washington, President Obama will host the 2014 White House Science Fair and celebrate the student winners of a broad range of science, technology, engineering and math (STEM) competitions from across the country.

U.S. Secretary of Labor Thomas E. Perez, will participate in his first live Facebook Q&A to discuss the "importance of increasing the federal minimum wage, ensuring our workforce has the skills to succeed in today’s economy, and equal pay."

On this day in 1930, Richard Gurley Drew received a patent for his adhesive tape, later manufactured by 3M as Scotch tape.

And in 1937, 200,000 pedestrians crossed San Francisco’s Golden Gate Bridge on its opening day. Cars weren’t allowed on the span until the next day.

Killed The Mockingbird? American Classics Cut From British Reading List

NPR News - Mon, 2014-05-26 04:47

U.K. Education Secretary Michael Gove has decided that the English literature list for a national exam needs to be more English, so he is swapping American texts in the curriculum for British ones.

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In prison and getting an education

Marketplace - American Public Media - Mon, 2014-05-26 04:46

In a ground floor classroom, dark but for the glare of fluorescent lights, about a dozen men are discussing "The Odyssey." They’re talking about the part where Odysseus comes home after being away for so long. 

It’s hard not to imagine that the story has an added poignancy for them, students in the Bard College program at the Woodbourne Correctional Facility, a medium-security prison inupstate New York. 

Earlier this spring, New York Governor Andrew Cuomo presented a new plan for higher education. Citing the cost savings of preventing recidivism and helping newly released inmates find jobs, he said that New York planned to set up—and fund—college programs at 10 prisons around the state. Soon after, though, some New Yorkers began complaining that it was unfair for the state to fund education for prisoners, when many middle class families are struggling to pay for college. The plan was dropped. 

But the Bard Prison Initiative has been offering college courses -- and degrees -- to prisoners around New York State since 1999.

It may sound abstract, said BPI’s founder and director, Max Kenner. But he thinks a liberal arts education is a better investment than many vocational training programs.

“Nothing prepares people for the challenges of the workforce like a liberal education,” he said.  “Liberal education is the best vocational education we can provide, because it trains people to respond to the dynamics of their circumstances.”’

The sample size is small -- Bard only has about 278 graduates. But Kenner says that of the alumni the college is still in touch with, around two-thirds of them have gotten jobs and/or continued their educations after leaving prison.

And he says the actual cost of running college programs in prison is cheap.

“The round number that we’ve come up with is roughly $5,000 a year,” he said. “And that is books, teachers, and the administrative cost of staff or the people who oversee the programs.” (Part of the reason it’s so much cheaper than regular campus-based programs is that it a lot of the fixed costs, say for the physical plant, are a already covered.)

The Rand Corporation did a study recently, looking at all the studies that have been done about the benefits of prison education. Lois Davis, one of the report’s authors, says she found the real economic benefit of educating inmates is that education makes people less likely to recidivate.

“For every dollar spent on correctional education programs, you save about four to five dollars on reincarceration costs,” she said. “That’s a huge difference in terms of cost-effectiveness.”

Having a job is another thing that helps keep people from coming back to prison, but having a criminal record can make it hard to get a job. 

Francisco Feria, who’s been incarcerated since he was 16, for robbery and assault, got his GED when he was in the county jail. Now 24, he hopes his Bard degree will help him get a job when he gets out of prison.

“College or not,” he said. “I’m still considered a felon. I’ve committed a crime. And that’s always going to follow me throughout my whole life, but I just think that college just boosts that chance that much more.”

Feria got his associate’s degree this spring, and plans to spend the last two years of his sentence getting his bachelor’s.

Merger push means big lobbying effort

Marketplace - American Public Media - Mon, 2014-05-26 02:43

Comcast is going to war in its pursuit to merge with Time Warner Cable. The telecom giant has reportedly bought up lobbyists at 40 different firms around Washington.

There's a simple way you could describe Comcast's strategy: have an unlimited budget and then exceed it. The Sunlight Foundation’s Bill Allison says the nation’s capital eats it up.

“You know Washington is the kind of girl that always falls for the dozen of flowers sent three or four times a day,” he says.

By the looks of it, Comcast’s got all the florists on speed-dial. According to the Center for Responsive Politics, the company spent nearly $20 million dollars lobbying the federal government last year, putting it in the top 10, and it is on track to be there again this year.

Former FCC chief of staff Blair Levin says this is less about influencing Congress than convincing regulators and Comcast competitors this is a done deal.

“Because if you have the impression this deal is going to go through and everybody is going to rearrange their lives, it’s much harder for a government to act in a way that upsets those expectations,” he says.

Levin says there is something of a firewall. He says regulators at the Department of Justice – key decision-makers in telecom mergers – are historically immune to lobbying campaigns, regardless of size.

World War II Vets Honor Their Own In Cactus Division

NPR News - Mon, 2014-05-26 02:37

In Gainesville, Texas, on Monday, World War II vets from a unit known as the Cactus Division will remember their fallen comrades. These veterans helped liberate Germany's Dachau concentration camp.

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The right to be forgotten... or, at least, edit

Marketplace - American Public Media - Mon, 2014-05-26 01:00

The Venn Diagram of "people who use the internet" and "people who have googled themselves" is pretty much just a circle. And if you've participated in such an activity, you know the fear of turning up an item of your past that you'd rather not have available to the public at large. 

Mario Costeja Gonzalez of Spain certainly knows how that goes. His case against Google argued that he should have the right to remove links to an article detailing his debt to the government (which he has since settled). The European Union ruled in his favor, thus creating "The Right to be Forgotten."

While there are still questions of exactly how this ruling will play out, Jonathan Zittrain, professor of law at Harvard and co-founder of the Berkman Center for Internet and Society, certainly understands the desire to control one's online identity, or as he puts it: "that first magic page result on Google, in particular, does more to define you than pretty much anything else."

Zittrain also points out that Google has experimented in the past with features that let users influence their internet presence. In 2007, for example, Google News allowed people who were quoted or mentioned in an article to add a comment contextualizing the content pertaining to their name and reputation.

It's this kind of curation that gets the regulation of the internet into a gray zone, according to Zittrain.

With Google being merely a search engine -- a machine, if you will -- no one is to blame for a curated selection of materials that appear when someone is Googled. According to Zittrain, when you add a hand-picked element, however, and regulating becomes more problematic:

"The more curated that [Google results] is -- whether by machine or by human -- the more it deserves some kind of scrutiny and possibly an ability to contextualize for people who are mentioned or implicated by those results."

Killer's Family Tried To Intervene Before Rampage

NPR News - Mon, 2014-05-26 00:31

By the time Elliot Rodger's mother and father arrived, it was too late: their son had killed six people and then, authorities say, himself.

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Early Returns Show Candy Tycoon Poroshenko Winning Ukraine Vote

NPR News - Mon, 2014-05-26 00:23

Billionaire Petro Poroshenko was elected president of Ukraine in the first round of balloting, according to early returns. He claimed victory after exit polls showed him with a commanding lead.

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One Of Many: Remembering A Fallen Son On Memorial Day

NPR News - Mon, 2014-05-26 00:04

Lance Cpl. James Boelk was a Marine killed in Afghanistan in the fall of 2010. Like many families of fallen soldiers, on this Memorial Day his parents say they will gather to honor and remember.

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Mexico City's Campaign To Encourage Breast-Feeding Backfires

NPR News - Sun, 2014-05-25 23:53

Breast-feeding rates in Mexico are among the lowest in Latin America. But a campaign to encourage the practice featured topless actresses, drawing sharp criticism from some women's groups.

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