Back in the day, doctors made house calls and actually got to know their patients. But as times and technology changed, a home visit from your doctor became a luxury for the 1 percent. Dissatisfied doctors and frustrated patients have forced the industry to adjust, and house call doctors are making a comeback. But are they for everyone?
Patients want that personal relationship as well. People who grew up with house call doctor visits remember them fondly.
Dr. Michael Farzam is CEO of House Call Doctor Los Angeles. He's been seeing patients in their homes for 13 years, and almost never has to make a referral. Part of the reason is he speaks with patients on the phone before making the trek in LA traffic to their home, but also, he says, "I can do everything in the home, essentially, a doctor's office or a typical urgent care can do. So, we do x-rays and ultrasounds, we administer IV fluids."
And there are advantages to seeing patients in their homes. Some cases can only be solved by a home visit, like the time he diagnosed a whole family with carbon monoxide poisoning from an old furnace.
"It's just something you had to see visually in the home to be able to make that diagnosis. You know, if they had been in the house one more night, they probably all would have died. And that was a nice day. That makes the job very worthwhile."
During our interview, Dr. Farzam took several calls from patients on his cell phone. It's this personal care and the access his patients have that make them so satisfied. But this kind of service must be for the super-wealthy. Right? At around $400 a visit, Dr. Farzam says he does see the 1 percent here in LA – corporate executives and celebrities who want the privacy and convenience.
However: "But I'd say 95 percent of my patients are middle income people, who hold average jobs, and any way you look at it, our fee is less expensive than an emergency room visit, even if you have good insurance."
"It's really as simple as just clicking a button when you're not feeling well,” CEO Sam Zebarjadi says, “and we find a nearby on-call doctor who will come to your home, your office or hotel in under two hours."
Patients can also summon a doctor from their website or by calling in to the call center. Medicast has been up and running in Miami and South Florida for almost a year and it launches in Los Angeles and Orange Counties in the beginning of June.
Of course, there was a reason house calls all but disappeared in the middle of last century. Medicine became more expensive, having medical insurance became necessary, and dealing with that ate into doctors' profits.
"About 60 to 70 percent of the costs of healthcare are really in the overhead that come with traditional practices," Zebarjadi says -- and to make up for all that overhead, doctors might have to see 30 patients a day. "They spend about 6-8 minutes per patient…so it's a very stressful experience."
The Medicast model is a twist on a relatively new trend. It's called private medicine and it's growing by 25 percent a year. The idea is to eliminate some of the costs associated with billing insurance. That way, doctors can afford to spend more time with patients. These house call practices are a cash business – they don't take insurance. They also don't need nurses, receptionists… they don't even need the office.
But still, these are doctors driving to your homes. How do the non-millionaire patients afford that? Zebarjadi says people are saving money on insurance by choosing policies with high deductibles.
"A lot of people are using healthcare for catastrophic events and actually looking elsewhere to services like ours for basic wellness and urgent care needs."
So when you go to sleep with a high deductible insurance plan and wake up in the middle of the night with an alarming fever, you're faced with a choice: a potential $3,000 in the Emergency Room, or $400 or so for a home visit. That house call might just be the frugal choice, as well as a lot more restful.
This week is Hurricane Awareness Week, which precedes the official start of the hurricane season. While storms like Hurricane Sandy are still unusual, protecting populated coastal areas like New York City is a technological challenge.
Innovation requires brains, but also requires money -- and the early money often comes from venture capitalists. But all too often minority and women innovators miss out on venture capital funding.
Innovation requires brains, but also requires money -- and the early money often comes from venture capitalists. But all too often minority and women innovators miss out on venture capital funding.
Jules Pieri, found and CEO of the product launch platform, The Grommet, sees a bias in the system, but she also sees a simple, practical solution. Pieri calls her idea “Title IX for business.” In short, remove the lucrative carried interest tax loophole from any venture firms that do not fund women’s businesses proportionate to men's.
Pieri joins Marketplace Morning Report host David Brancaccio to discuss. Click on the audio player above to hear more.
Sheryl Santiago's son, Erik, was addicted to pills he'd been prescribed for anxiety and depression.
But when he finally decided to quit, he learned that asking for help and getting it can be two very different things.
"As soon as he contacted [a treatment facility], he thought he could go that night,” Santiago recalled. “He was ready to go and then he just got more and more discouraged."
Erik didn't have health insurance, and neither he nor his parents could afford the private facilities, where a month of treatment can cost as much as $30,000. So the first step for the family was to purchase insurance for Erik.
"When we got the insurance, they only covered a couple places, and they had waiting lists," she said.
A few weeks later, Erik was moved off the waitlist at a local treatment facility in Ocean County, N.J. However, he had been trying to stop using drugs on his own while he waited for help, and the program he was accepted into was the kind of place that helps patients detox with the assistance of medication. Like many facilities of this type, it required potential patients to be active drug users to get treatment -- to actually fail a drug test.
"He told me, he goes, 'Don't be mad at me if I use something because I have to test dirty in order to go into their program,'” said Santiago. “And he did, he must have used whatever he was using prior — the dosage — and it was too much."
Santiago said Erik had been clean for four weeks before he overdosed and died. In that time, his body may have lost some of its tolerance for the drug.
He had just turned 31 when he died, so it's hard not to play a game of “what-ifs?” but Santiago believes her son would still be here today if he'd gotten into a program right away.
"There's not enough beds, there's not enough providers,” confirmed Bruno Silie, a health educator who helps place addicts in treatment facilities at a drop-in center run by the South Jersey AIDS Alliance in Atlantic City, N.J.
"There's options, but the waiting period is ridiculous,” he added. “I've had clients wait for 60-plus days, and by that time they've given up."
"You really have to strike when the iron's hot," said Kimberly Reilly, the alcohol and drug coordinator in Ocean County, N.J. "So if someone comes to us and says I'm motivated for treatment, you really want to get them in, really, within that hour, because the next hour they could be off looking for their next hit of heroin."
There are simply not enough beds to meet New Jersey’s growing demand for substance abuse treatment. Statewide, admissions are up nearly 40 percent since 2006. As the state diverts more nonviolent drug users to treatment over prison, the waiting lists are even more of an issue.
Increasingly, people are seeking treatment for heroin and opiate additions. In Ocean County, half the admissions last year were for heroin. It's cheap and easily accessible, so many users turn to the drug after getting addicted to prescription pills, such as OxyContin.
The situation in New Jersey is mirrored across the country, according to Roseanne Scotti, director of the Drug Policy Alliance in New Jersey.
Scotti noted the Affordable Care Act will eventually add coverage for many people with mental health and substance abuse issues. The Substance Abuse and Mental Health Services Administration estimates that the ACA will eventually extend coverage to approximately 11 million people with behavioral health conditions, which include mental health and substance use issues.
Without significant expansion of treatment options, that expansion may create additional backlogs.
“In some states, like New Jersey, there just isn’t the infrastructure, at this point,” said Scotti. “There’s going to have to be new facilities, new providers, new licensed addiction counselors, and that’s going to take a while to ramp up.”
In addition to expanded access to insurance, other factors – like the aging population, the high turnover of substance abuse counselors, and better medical screening for addition – affect the availability of treatment options, according to Andrea Kopstein, a division director in SAMHSA’s Center for Substance Abuse Treatment.
Kopstein says the Obama administration is making a “significant investment” in both the number of treatments slots and to expand the number of professionals working in the field, SAMHSA was unable to specify how much. The most recent figure available on U.S. spending for substance abuse was $24 billion in 2009.
A new report from the American Enterprise Institute suggests that home-buyers are more likely to default on new mortgages.
The mortgages were subjected to a stress test. Under the worst case scenario, an increasing percentage of the loans would fall into foreclosure.
But when considered historically, housing consultant Thomas Lawler says new mortgages are, “Substantially lower in terms of overall risk than any time in 20 plus years.”
Lawler says the risk of another all-out housing crisis is much lower because fewer mortgages are backed with borrowed money.
This week is Hurricane Awareness Week, which precedes the official start of the hurricane season.
While storms like Hurricane Sandy are still unusual, protecting populated coastal areas like New York City is a technological challenge.
"In the last 150 years, the sea level has risen 45 centimeters in New York," said Portland State University's Stefan Talke.
Talke said that may not sound like much, but the result is any storm that hits today is nearly a foot and half higher than it was during the mid 1800s.
One short term solution is to move sensitive tech equipment and electrical boxes out of basements, or build houses several feet off the ground.
Another technology that might help is a deployable flood barrier.
Philip Orton, a professor at the Stevens Institute of Technology, said it's a temporary structure built to help protect the city.
"It just gets deployed when there's a storm coming. It's unpopular to some people because there can be human error if it's not deployed correctly."
Anyone can invest in exchange-traded funds. That's the beauty of them: they're dead simple in concept and dead easy to use.
But they're also like matches: they're so simple that a toddler can use them, and there's a real risk of getting burned.
I'm not saying that retail investors who buy ETFs are toddlers – although, let's be honest, most of us could use some supervision or advice when we make investment decisions – but I do think many investors are lulled into a false sense of security by the apparent simplicity of the ETF model.
Part of the problem is that ETFs look a lot like one of the most easily understood investments out there: the company share.
Just like a company share, an ETF is listed on an exchange; just like a company share, the ETF rises and falls depending on investors view of the fund; and just like a company share, you can trade in and out of an ETF any time.
But just because they look easy to understand, doesn't mean they are. ETFs are often a lot more complicated than company shares. For one thing, as Forbes columnist Rick Ferri points out, there are several kinds of ETFs. Depending on how your ETF is structured, you may be taking on a lot more risk than you think you are, and you may be treated differently by the taxman.
And ETFs can go into some dangerous territory.
One of the great lures of ETF investing to retail investors is our ability to gain exposure to a market that would otherwise be closed to us, or at least difficult to access. ETFs allow us to make bets on commodities like gold and palladium without having to buy the actual product or leave the comfort of our den.
They also allow us to wager on the health of corporations via the credit derivatives market. That's right, the kind of wildly complicated investment that helped drag the financial system to its knees is now open to you and I via the magic of ETFs.
Most normal people have no idea how a credit default swap works. So, for most of us, investing in an ETF of CDS is highly risky. It's true that most people won't invest in this kind of fund – the letters CDS will probably have the same effect on retail investors as a sign that says "Warning! Land mines!" – but the same rules apply for all ETFs: if you don't understand the stuff that's in the fund, you'd be wise not to buy the shares.
After all, if you have no idea what you're investing in, you're a whole lot more likely to get burned.
It can be discouraging for a first time home-buyer out there right now. High prices and a lot of cash buyers can make the process of finding and buying a new home for the first time fairly frustrating. Here are some tips from RealtyTrac’s Daren Blomquist.
1. Have your financing in place: be pre-qualified and pre-approved for a loan so you are ready to move quickly.
2. Don’t make your offer contingent on financing or inspection (even though you are getting financing). This is happening a lot in competitive markets like Seattle. It’s a bit risky though, because if for some reason the deal fell through, you could lose your earnest money.
3. Write a love letter! Seriously, write a letter to the seller of the house. Try to explain why you really need this house, connect with the seller on an emotional level.
4. Brace yourself. You’re not gonna get the first house you put an offer on. You’re going to be making many offers, and you should be prepared to for this. Fight buyer fatigue.
5. Go where the cash buyers aren’t. Co-ops in NYC, for example, or homes that need more rehab than usual.
6. Find sellers before the cash buyers do. Look at unlisted bank-owned homes, pre-foreclosures, or just knock on doors to find out who’s going to sell soon.
7. If you can’t beat them join them. Some people have found crowd-funding works, where they pool money with friends and family to purchase a home with cash. You can also use a self-directed IRA, a type of retirement account you can use to buy with cash.
For about six months, Kevin Erspamer has been looking to buy his first home, in Brooklyn. “We’ve looked at 30 places at least,” he says.
His verdict? “We’re holding off for now.”
Him and would-be first-time homeowners across the country.
At one point, first-time home buyers accounted for 50 percent of all home sales. Right now, they’re 29 percent. And that number is pretty much where we were four years ago. Even counting the fact we are in a post-bubble, post-recession recovery, “first-time home buyers are down 20-25 percent from where they would normally be in the market,” says Chris Mayer, Paul Milstein Professor of Real Estate at the Columbia School of Business.
In Erspamer’s case, prices have been high, for starters – sometimes rising 30 percent in just the time he’s been looking. Another problem he’s run into is the all-cash offer.
“You go, the open houses are completely full, and then the guy is like, we’ve had a number of offers over asking price, including all cash offers,” he recalls. “It makes you feel a little discouraged, like why would they ever accept my offer with financing if they have an all-cash offer.”
In the first quarter of 2014, 43 percent of U.S. residential property sales were all cash.
“That’s the highest number we’ve ever seen and it’s really an astounding number,” says Daren Blomquist, vice president of RealtyTrac.
So who are these people who can lay down cash?
“Investors – just regular investors, as well as a new breed of investors entering this market, what we call institutional investors backed by hedge funds,” Blomquist says.
In some markets, foreign buyers looking for a place to park cash are an issue. Florida, California, Arizona, Texas, and New York account for 61 percent of international home purchases, according to the National Association of Realtors. But there’s also a significant domestic competitor, says Blomquist.
“You also have retirees who in some cases are selling their homes in other parts of the country, and because they have built up equity they have cash to go buy a place in Florida,” where they can downsize.
While it might seem easy to blame Wall Street, the foreigners, and Grandma, there’s more going on.
“In a sense its crowding out, but it’s really just a reflection of the challenges that younger households are having coming into the market to buy a first home,” Mayer says.
There’s less inventory and more demand, which has pushed prices higher than many first-time buyers are comfortable with. Replenishing that inventory will “take some time because that’s going to require home builders building more homes and current homeowners who own a price deciding they have sufficient equity to sell their home and move up,” says Mayer. “That’s another missing piece – the move-up buyers,” he adds.
Mortgage lenders are still extremely fearful of lending to anyone without the most pristine credit. “Until very recently, the last couple weeks, if you were a lender for Fannie or Freddie, and the borrower missed any payment in the first 36 months, you’re facing the potential of having to buy that loan back from Fannie or Freddie.”
Student loans are crowding out first time homebuyers’ ability to buy as well. “People with student loan debt, historically, have also been more likely to have a mortgage,” says Mayer. “Which meant they were able to buy a home. That has switched to the point that people with student loans today are less likely to have a mortgage. So it looks like student loan debt is pushing back the age of first time home purchase for many people.”
And don’t forget that the Federal Housing Authority now charges much higher default insurance premiums, meaning consumers can’t turn to the government for the same kind of support as in the past. “In typical years, the FHA’s share of the first-time home buyer market has been as high as 60 to 70 percent, it’s dropped to the 30 percent range,” says Malcolm Hollensteiner, director of retail lending sales and production at TD Bank.
In the short term, these factors don’t appear to be changing much.
“Until that first-time homebuyer regains confidence and becomes more active in the marketplace, we’re going to continue to have a very soft housing recovery,” Hollensteiner says.
The first time Sonia Kendrick got out in her fields of tomatoes, cucumbers and corn, something magical happened. “It was as if the earth had grounded me,” she says.
Kendrick served in the Army and National Guard for nine years, including eight months in Afghanistan. She has PTSD. Around 2009, she started farming in her hometown near Cedar Rapids, Iowa. Kendrick says veterans like her don’t want office jobs. She says, when you’ve almost lost your life repeatedly, it’s hard to care about office rules. So farming’s perfect.
“You're not in a cubicle playing bureaucratic rules, I don’t think we enjoy,” she explains.
So many veterans have turned to farming, the Agriculture Department has created special programs to help them. The department says 45 percent of service members are from rural areas. Non-profits are springing up to teach them how to farm -- groups like Growing Warriors, based on a 286-acre spread in eastern Kentucky.
Kevin Lanzi is the farm manager. He’s been farming for about five years. He’s a former Marine who spent almost 10 months in Iraq. He’s also got PTSD. He says he spent years trying to find himself after leaving the military.
“I finally found farming and, ever since I’ve never looked back," Lanzi says. "Just seeing what you’re making. The responsibility is all you. It’s awesome.”
Why does farming seem to help veterans with PTSD?
“They’re distracted. They’re engaged in something that’s fun and they don’t necessarily have to think about or it’s easier to avoid those memories and thoughts of the traumatic event,” says Craig Bryan, head of the National Center for Veterans Studies at the University of Utah.
But Bryan says farming offers only temporary relief from PTSD symptoms. Veterans suffering from it still need therapy. Those I talked to all have done therapy. They say it helps. But only if they can farm, too.
Fritz Maytag, an heir to the Maytag family fortune, saved the Anchor Brewing Company from bankruptcy back in 1965. And he did it by making beers that were, shall we say, more complex than what was widely available back then.
Steve Hindy credits Maytag with starting, "The Craft Beer Revolution." That's the title of his new book.
And Steve isn't just an author; he's the co-founder of the Brooklyn Brewery.
Click play on the audio player above to hear the whole interview.
There’s only so much excitement you can squeeze out of an ad for a mop, says Jen Drexler, Senior Vice President of Insight Strategy Group, a market research firm.
“You can only show how many after-pictures of a clean floor and a dirty mop,” she says.
But Swiffer, the company that promises it’s “built smarter”, is taking a swipe at reinvigorating its advertising with a new campaign featuring real married couples, one of which is biracial with a husband who lost part of his arm to cancer.
“When you only have one hand,” he says in an online spot, “you’re not doing anything as fast as you used to. Which is funny cause I still do it better than her.”
Swiffer says the Rukavinas, the couple in the ad, represent the evolution of the American family.
The ads, says, Drexler, show something a different side than a typical commercial does.
“A real like, advertising catching up with demographics, of these interesting families,” she says. “There’s something so great about the emotional connection that goes way beyond what the product benefit is of a mop.”
Ads, says Drexler, used to be testimonials, but that’s old. Now they have to move beyond the functional – like Swiffer’s do - to emotionally connect with consumers.
“This is so different,” she says. “It’s not testimonials, it is real life situations, that have humor and a level of gravity to it that reflect what’s happening for all of us.”
Cheerios also has an ad with a bi-racial family. And fashion brands are aiming for more reality too. New ads for “Diesel” feature a model with Muscular Dystrophy in a wheelchair. And Barney’s NY uses transgender models. The company even shot a half hour film telling its model’s stories. In the beginning of the trailer for the film we meet a models, Arin Andrews who explains how he came to be he is today.
“I am a guy,” says Andrews. “I just happen to be born a girl.”
The campaign was shot by renowned fashion photographer Bruce Weber. And if you didn’t know the models are transgender you’d think it was just another high fashion photo shoot, but because of all buzz around the campaign, you know it’s not.
Candace Corlett, president of WSL Strategic Retail, says that’s part of the strength of the ads.
“What the Barneys ads are doing is making you pause and look. And that is a real challenge for any brand,” she says.
But against the backdrop of a typical fashion magazine where, as Corlett describes the models they might as well be clones, “just about all the of the models are Caucasian and most of them blond,” she says, Barney’s models will stand out.
The store says it wants to help break stereotypes. But when you use a model in a wheelchair, or with only one arm, who really benefits?
Ryley Pogensky, an event promoter, blogger and one of Barney’s new models says, the situation is win-win.
“I think before people are quick to judge what this might mean for Barneys sales, he says, what they should really recognize is that 17 people stepped forward and said, you’re going to accept us for the people we are. Your consumers are going to accept us for the people we are.
Swiffer says we should expect to see more ads with real families. By using everyday people Drexler says brands hope to create a new kind of aspiration -- to live a happy life on our own terms.
If public radio sometimes feels a little like a classroom—and we all know it does – there’s a reason.
Or, at least, a convenient excuse.
Public radio got its start in schools. “Broadcasting began in the U.S., largely on university campuses in engineering departments,’’ said Michele Hilmes, a professor of media and cultural studies at the University of Wisconsin- Madison. “People were experimenting with radio and building radio sets.”
By the mid-1920s, those engineering experiments were becoming stations, and broadcasting educational programs.
The earliest programs were aimed mainly at homemakers and farmers. Later, said Hilmes, the stations “got into schoolroom broadcasts, where kids in schools could actually listen to things that related to their lessons.”
Dozens of state universities, departments of education and school boards created shows for kids.
In Cleveland, for instance, WBOE was licensed to the local board of education in 1938 (hence the BOE). The station broadcast instructional programming for nearly 40 years, beginning in the morning—like the school day— and ending in mid-afternoon.
John Basalla, an archivist with the Cleveland Metropolitan School District, says schools had radios made specially to pick up only WBOE’s frequency.
The idea was simple. Broadcasting would transform education by making it possible for students to learn from great teachers wherever they were—so long as there was a radio in the classroom.
There was hype. Hope.
And a lot of money.
Check out these photos and captions from the 1952 book Teaching Through Radio and Television.
Levenson and Stasheff, Teaching through Radio and Television, 1952
But, the revolution never came. Lots of schools didn’t have radios. Those that did, often had trouble coordinating regular lessons with those on the radio. And many of the shows just weren’t that good. “If you talk to old practitioners in public broadcasting, they actually use ‘educational radio’ as a pejorative,” said Josh Shepperd, a media studies professor at Catholic University, in Washington, DC.
Commercial broadcasters also took a crack at the classroom. CBS had the American School of the Air; NBC broadcast the Music Appreciation Hour. “The best and most effective educational broadcasts did come out of the networks,” Sheppard said. But there wasn’t enough money in it, to keep them interested. Broadcasting education shows to school kids just wasn’t sustainable for commercial radio.
Gradually, public stations that stayed on the air started making better shows. They started making radio less -geared to students sitting, listening, in circles.
And more for learners like us.
We’ve got more on the history of radio in the classroom here.Marketplace Morning Report for Thursday May 29, 2014Seven more fun facts about the history of public radioPutting public radio on the mapby Adriene HillStory Type FeatureSyndication PMPApp Respond NoBranded story type News
We’ve got the audio piece and the 1951 map of instructional radio stations across the country. But there’s only so much ground they can cover. Here are more cool things to know about the history of radio as an education technology.
The hype was huge. In his 1932 book, Radio: The Assistant Teacher, Benjamin Darrow (who founded the Ohio School of the Air) wrote: "The central and dominant aim of education by radio is to bring the world to the classroom, to make universally available the services of the finest teachers, the inspiration of the greatest leaders... and unfolding events which through the radio may come as a vibrant and challenging textbook of the air."
Stations named themselves after their educational missions. At WABE in Atlanta, the ABE stands for Atlanta Board of Education. The BE in WBEZ (Chicago) stands for Board of Education. Bonus points to anyone who knows what the Z stands for. Do we need to tell you what Cleveland’s WBOE stood for? And you might think that the “ED” in KQED stands for “education”? Turns out KQED comes from the Latin quod erat demonstrandum, “which was to be demonstrated.”
Some classroom-broadcasts were… live. Check out this archival broadcast from WBOE. Around 0:40, there’s an example of why there’s nothing like live radio. The clip comes courtesy of John Basalla, archivist at the Cleveland Metropolitan School District.
It wasn’t all about listening. Worksheets came with many of the lessons. Here’s one that went with the radio show “Good Health to You”, from WBOE in Cleveland. We found it in Teaching through Radio and Television, published in 1952, by William Levenson and Edward Stasheff. Teaching Through Radio and Television, Levenson, 1952
Educational broadcasting was college material. Ohio State University offered a college class in “Education by Radio” in 1930. Bonus points for anyone that can dig up a syllabus for us.
Public radio almost got left behind. The Public Broadcasting Act of 196, which created the Corporation for Public Broadcasting, was originally the Public Television Act of 1967. Jack Mitchell wrote a great history of how radio finagled it’s way into the legislation over on Current.org. The story includes Scotch-taping the word “radio” into the law at the last minute.
We want to know what else we should add to this list. We know you’ll write. From 1930 to 1940 radio listeners sent approximately 225,000,000 fan letters to radio stations.MAP: Where did your public-radio station come from?Public radio's teachable momentby Adriene HillStory Type BlogSyndication PMPApp Respond NoBranded story type News
Consumers who pay extra for coffee or other products with Fairtrade labels may not be helping the lives of the world’s poor, a new study suggests. Researchers from SOAS, University of Londonm spent four years looking at coffee, tea and flower workers in Ethiopia and Uganda. The study finds some at Fairtrade sites earning less than those at workplaces that are not Fairtrade certified.
Fairtrade International, which sets standards, is pushing back, saying the study makes unfair comparisons, though CEO Harriet Lamb does says the study makes valid points about the challenge of making sure Fairtrade money flows all the way through farmers to farm hands.
Christopher Cramer, one of the study’s authors, says Fairtrade does do good. He and his colleagues would like to see consumers get “clearer information about exactly who benefits and how and on the basis of what evidence.”
The conversation the study is provoking about Fairtrade is a reminder for anyone who shops with an eye toward a certain goal, be that supporting local, organic or Fairtrade producers. It’s wise to do a bit of homework to make sure that extra money is doing what is hoped.
Mark Garrison: The study finds some workers at Fairtrade sites earning less than those that aren’t Fairtrade. Economist Christopher Cramer, one of the study’s authors, spoke to our partners at the BBC.
Christopher Cramer: If people think that Fairtrade is in the very best interest of the poorest people, then there are serious problems.
Fairtrade International, which sets standards, is pushing back. CEO Harriet Lamb says the study makes unfair comparisons involving workers on very small plots of land.
Harriet Lamb: It compared the conditions they’re in with those of a plantation run by a multinational in the same area. Now that’s not fair.
Bigger companies can pay better because of their larger scale, though the British researchers say they account for that. They want shoppers to have more information. Cornell economist Arnab Basu studies Fairtrade, but isn’t involved in this research. He says Fairtrade buyers are informed overall, but often don’t know the details.
Arnab Basu: There is a bit of a misperception as to what they’re actually doing and who they’re really helping.
And Lamb at Fairtrade International points out there’s only so much most shoppers can take in.
Lamb: As a busy mother or father going around the supermarket, your kids are screaming and you want to play your part in tackling poverty, there’s really a limit to the amount of information that you can seek out or look for on one small chocolate bar, one small pack of coffee.
Cramer says Fairtrade does do good. And Lamb says his study makes valid points about the challenge of making sure Fairtrade money flows all the way through from farmers to farm hands. I'm Mark Garrison, for Marketplace.
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.
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."
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."
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."
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.
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.