Marketplace - American Public Media

Syndicate content
Updated: 52 min 35 sec ago

Using data to treat the sickest and most expensive patients

Thu, 2014-04-24 13:22

Driving to a big data conference a few weeks back, Dr. Jeffrey Brenner brought his compact SUV to a full stop – in the middle of a short highway entrance ramp in downtown Philadelphia.

He shrugged, a grin playing at the corner of his mouth.

"Wait for the car in front of you to go, and then gun it," he told me.

As we picked up speed, I could only watch as we headed straight for traffic down below. Brenner laughed. And we end up merging pretty seamlessly.

"Sitting at the other end of the ramp as 50-mile-an-hour traffic goes flying by you," he said. "You can’t get on the highway. You have to try something different, right?"

Here’s what you need to know about Dr. Jeffrey Brenner: He really likes to figure out how things work. And he’s willing to go to extremes to do it – so far that he’s risking his health policy celebrity status.

Jessica Kourkounis

Perhaps it’s not the smartest move from a guy who just last fall was named a MacArthur Genius, but this month, Brenner began to test his theory for treating some of the sickest and most expensive patients.

"We can actually take the sickest and most complicated patients, go to their bedside, go to their home, go with them to their appointments and help them for about 90 days and dramatically improve outcomes and reduce cost," he says.

That’s the theory anyway. Like many ideas when it comes to treating the sickest patients, there’s little data to back up that it works.

Brenner’s willing to risk his reputation precisely because he’s not positive his approach for treating folks who cycle in and out of the healthcare system -- “super-utilizers” -- actually works.

“It’s really easy for me at this point having gotten a MacArthur award to simply declare what we do works and to drive this work forward without rigorously testing it,” Brenner said. “We are not going to do that,” he said. “We don’t think that’s the right thing to do. So we are going to do a randomized controlled trial on our work and prove whether it works and how well it works.”

Helping lower costs and improve care for the super-utilizers is one of the most pressing policy questions in healthcare today. And given its importance, there is a striking lack of data in the field.

People like to call randomized controlled trials (RCTs) the gold standard of scientific testing because two groups are randomly assigned – one gets the treatment, while the other doesn’t – and researchers closely monitor differences.

But a 2012 British Medical Journal article found over the last 25 years, a total of six RCTs have focused on care delivery for super-utilizers.

“All we have are tiny pieces, when what’s needed is a full arsenal of evidence given the enormity of the challenge,” says Jon Baron, president of the Coalition for Evidence-Based Policy.

Now, to be fair, researchers admit RCTs can be tricky to set up, time-consuming and expensive. And certain situations call for different study designs.

But the bottom line, said WellPoint Chief Medical Officer Dr. Sam Nussbaum, is that most health folks agree the nation needs more rigorous studies that will lead to more reliable data.

“If we look back over the past decades, many of the results we saw were overstating the capability of the program to deliver the results that the programs believed they were achieving,” he said.

Every major health insurance company – Medicare and Medicaid, too – has spent billions on programs for super-utilizers. The absence of rigorous evidence raises the question: Is all this effort built on health policy quicksand?

Jessica Kourkounis

Health worker Margarita Santiago recruits patients for RCTs. Here she is in Camden, New Jersey, talking with patient Hector Rivera.

Not being 100 percent sure can be dangerous, says Duke behavioral scientist Peter Ubel, particularly in healthcare.

Ubel said back in the 1980s and 90s doctors prescribed certain drugs for irregular heartbeats. The medication, he said, made those weird rhythms go away, leaving beautiful-looking EKGs.

“But no one had tested whether people receiving these drugs actually lived longer, and many people thought, ‘Why would you do that? We can look at their cardiogram and see that they're getting better,’" Ubel said. “Finally when somebody put that evidence to the test of a randomized trial, it turned out that these drugs killed people.”

WellPoint’s Nussbaum said he hoped Brenner’s project would inspire others to follow his lead and insert data into the discussion.

“I believe more people should be bold in challenging the status quo of our delivery system,” Nussbaum said. “The Jeff Brenners of the world should be embraced. We should be advocating for them to take on these studies.”

So why aren’t more healthcare luminaries putting their brilliance to the test? There are a couple of reasons.

Harvard economist Kate Baicker said until now there have been few personal incentives pushing people.

“If you’re focused on branding and spreading your brand, you have no incentive to say, ‘How good is my brand after all?’” she said.

And Venrock healthcare venture capitalist Bob Kocher said no one would fault Brenner if he put his brand before science, an age-old practice in this business.

“Healthcare has benefitted from the fact that you don’t understand it. It’s a bit of an art, and it hasn’t been a science,” he said. “You made money in healthcare by putting a banner outside your building saying you are a top something without having to justify whether you really are top at whatever you do.”

Duke’s Ubel said it’s too easy – and frankly, wrong – to say the main reason doctors avoid these rigorous studies is because they’re afraid to lose money and status. He said doctors aren’t immune from the very human trap of being sure their own ideas are right.

He says psychologists call it confirmation bias.

“Everything you see is filtered through your hopes, your expectations and your pre-existing beliefs,” Ubel said. “And that’s why I might look at a grilled cheese sandwich and see a grilled cheese sandwich and you might see an image of Jesus,” he says.

Even with all these hurdles, MIT economist Amy Finkelstein – who is running the RCT with Brenner – sees change coming.

“Providers have a lot more incentive now than they use to,” she said. “They have much more skin in the game.”

Finkelstein said hospital readmission penalties and new ways to pay doctors are bringing market incentives that have long been missing.

Brenner said he accepts that the truth of what he’s doing in Camden may be messier than the myth.

Jessica Kourkounis

But he said he can live with that.

“I think a lot of people are afraid to be wrong,” he said. “It's kind of fun to be wrong. Because being wrong frees you up from things that are not true and lets you move on to figuring out what's true.”

If his brand does take a hit, it means more time at work and more time to figure out what works. And Brenner said he’s willing to go wherever that takes him.

This ongoing series on healthcare and data is produced in partnership with Healthy States.

Bureaucracy, from e-cigs to internet neutrality

Thu, 2014-04-24 13:09

Washington, DC is full of buildings stuffed with bureaucrats. Inside, the paper they push affects our lives in ways big and small. Two of these paper-pushing-processes are in the news this week for striking new moves that could have major impact in very different ways. They involve smoking and how we get online.

First, a look at the Food and Drug Administration’s bid to regulate e-cigarettes for the first time:

“With FDA having no authority to regulate these products, it is a bit of the wild, wild West,” says FDA commissioner Dr. Margaret Hamburg.

The agency’s new proposal would bar sales to minors and require product approval, among other measures. But it does not crack down on advertising or flavored products thought to appeal to kids.

It’s not as tough as the tobacco industry feared. That has tobacco insiders optimistic, and anti-smoking advocates furious.

Up next is a long fight between industry, anti-smoking advocates and regulators:

It could be years before anything currently proposed becomes reality. While that going may be slow, over at the FCC, they’re talking about content we want to go fast, working on rules that could determine the fate of our internet. The FCC's proposal would allow companies to pay broadband providers to allow their content to "sprint" to computers faster. 

"It might behoove a company with deep pockets like Amazon or Facebook to pay extra and make sure they are promptly loaded on to your mobile device. But what about an independent media outlet?" asked Astra Taylor, an activist and author of The People's Platform: Taking Back Power and Culture in the Digital Age. 

But Paul Gallant, a managing director at Guggenheim Securities, wonders if the FCC's proposals could benefit consumers by giving them more - and better - options. He suggests a scenario where ESPN pays Verizon Wireless so that customers can watch ESPN videos on their Verizon phones for free. For a lot of ESPN fans, that might look like good news. 

"I think the FCC is starting to realize that having a blanket rule against any kind of traffic prioritization may wall off innovative new business models," Gallant said. 

None of this is a done deal. The FCC will issue its proposal next month, and then open it up to public comment. There may not be enforceable rules until the end of this year, or later. 

30 years ago, the Air Jordan brought celebrity to sneakers

Thu, 2014-04-24 11:42

The fashion world has always been notoriously fickle. What's hot this season may be considered passé in a few months. But one fashion accessory has had a spectacular run: the Nike Air Jordan. This is the 30th anniversary of the iconic sneaker, which has had a huge impact on the sneaker business. It spawned the era of the signature athletic shoe, and a whole generation of underground sneaker collectors known as sneakerheads, that today are not so underground.

In the early days, sneakerheads logged on to online message boards to buy and trade rare shoes. "Most of these people, they were located in the Midwest and down South and the West Coast," says Brooklyn native Joe Guerrero. Everyone calls him Sneaker Joe. He was one of the first sneakerheads who figured out how to make money buying and selling rare shoes that weren't available in big retail stores.

"I saw a demand," says Sneaker Joe. He set out to meet that demand by "hitting up all these stores in downtown Brooklyn and the Bronx, Harlem, all these mom and pop shops that had urban accounts. I just started selling on eBay."

Sneaker Joe's business grew. Soon, he had international customers. He was cutting deals with stores and buying in bulk. He sold online until 5 p.m., took a break for a couple of hours, then started his second business, hand-delivering rare sneakers to celebrities like Jay-Z and LeBron James.

"That was up until 2007," Joe says. "Then the market became oversaturated. It became harder to acquire shoes once all these blogs started reporting and hyping up stuff."

By 2007, sneaker collecting had reached new heights. Camping outside a store for a new shoe release was common. "What changed the way sneakers are looked at is information, the internet," says DJ Clark Kent. "If you didn't know that a new Jordan was coming out, you wouldn't be hyped up to get it."

He was one of the people Sneaker Joe used to deliver to. Kent is a record producer and a sneaker aficionado who has designed several shoes for Nike, and hosts an online talk show about shoes. He says sneaker companies have mastered the art of hype. The limited edition special release is now a standard marketing strategy. "Everybody is hyped for what's coming out on Saturday," he says. "Saturday comes. Whoever gets it, gets it, and then next Saturday there's something else, and then they are hyped all over again."

For Sneaker Joe, camping out overnight for a shoe was never something he was willing to do. Today there are sneaker conferences and brick and mortar stores that have taken the place of entrepreneurs like him. So he has evolved with the times and altered his business model. He invented the Sneaker Pimp tournament, where sneakerheads compete for who has the coolest kicks.

Pie on the brain

Thu, 2014-04-24 10:40

From the Marketplace Datebook, here's a look at what's coming up April 25:

The University of Michigan releases its final April consumer sentiment survey to show you how others have been affected by current economic conditions.

Ford is scheduled to release quarterly earnings.

And you hear him on The Simpsons as Moe, Apu and others. Actor Hank Azaria turns 50.

Pie lovers from around the country convene in Orlando for the National Pie Championships. Imagine having to think about pie for days.

If after eating all that pie you need some exercise, climb a tree. It's National Arbor Day.

Don't buy beer or cigarettes for strangers

Thu, 2014-04-24 10:25

Over 100 teenagers spent a recent Saturday outside liquor stores across the state of California, asking adults to buy them alcohol. An outbreak of teen drinking? Just the opposite. These kids were part of a statewide effort to keep alcohol away from the under-21 set. 

Volunteer Youth Decoys are recruited from high schools, sold on the idea that they can help "clean up the streets." The teens just need to complete a brief training, and get their parents to sign off on it. 

In a recent coordinated day-long effort with over 100 police and sheriffs departments across California, young decoys netted 544 arrests... and got a unique window into a possible career.  

I rode along in an unmarked car to watch the action. At one point, we were driving towards a startled man in a black Chevy. The sergeant jumped out of the driver’s seat and ran towards the suspect on foot, while out of sight officers in bulletproof vests swarmed in, cutting off the man’s escape routes.

His crime: buying a six pack of Coors Light for an undercover teen.

“I’m the decoy-- I’m the guy that messes up people’s days I guess," says 18-year-old Daniel Gardener. 

Gardener, who is plainclothes and not wearing a bulletproof vest, is undercover with the Alameda County Sheriffs. The officers just arrested a middle-aged man in a sweat suit. The violator, a guy named Fred, is the fourth person busted for buying alcohol for a minor at this location in the past hour and a half.

Fred has his reasons, as he explains to Gardener, “I’m gonna tell you why I did it. You’re the same height as my son… and you look kinda like him-- you're white, though. But you look kinda like him-- same build, you feel me?”

Even though Fred is facing a possible $1,000 fine and 24 hours of community service, he praises the Youth Decoy who set him up saying, “Hey thank you young man. You’re a good actor, dude.”

Let’s meet another cast member of this youth production. Lisset Araugio is 16, but is no stranger to the game. They call me, ‘the veteran’,” she says.

This is Araugio’s third year as a youth decoy, where she works on tobacco stings -- going into corner-stores and buying flavored cigars, called Swishers.

“I usually walk in the stores, I give them a smile and I say, ‘Oh, can I get a Swisher Sweet?’ And then I say, ‘Please.’ And if they give them to me, I say, ‘Thank you, and have a nice day.’ And I smile.”

That’s cold blooded. Evidently, being a youth decoy means putting duty before empathy.  

“This lady, she didn’t speak any English -- I was talking to her in Spanish,” recalls Araugio. “And then when she got the citation, she was like, ‘Can you please tell them that they’re going to kick me out of my job because I did this?’ And I was like, ‘I’m sorry, but next time you should be more careful.’  And she’s like, ‘Please help me!’ And she got so mad she started crying."

All that drama, plus a $200 to $1000 fine may seem like a severe penalty for selling tobacco to a minor. Back at the alcohol decoy operation, Sergeant Scheuller says these stings sometimes catch people engaged in worse crimes.

“A lot of times, what we find is the people that are willing to buy alcohol for a minor -- a lot of times they’ve been involved in other criminal activity,” says Scheuller.

According to the statewide agency that sponsored these operations, about 10 percent of people cuffed today actually went to jail on crimes ranging from drunk driving, illegal drug possession, to resisting arrest. Apart from sending people to jail, Sergeant Scheuller says the Youth Decoy program also brings some kids into the force. 

“So maybe you might wanna think of pursuing a career in law enforcement?" Sergeant Scheuller asks me with a nudge. "You could do this as your job. And get paid. It’s the best job in the world if you ask me.” 

Decoys like Daniel Gardener don’t need persuading. He intends to be a sheriff. He knows some kids who have gone from the decoy program straight into the police academy.  

For me, trapping somebody who thinks they’re doing me a favor is too much. It makes me feel callous and dishonest.

But Fred, the guy who bought the six pack, says a citation does get the message across: “Everybody makes mistakes in life, this was mine, you don’t have to worry about me ever doing this again."

Me neither. 

This story was produced by Youth Radio.

What has changed one year after Rana Plaza

Thu, 2014-04-24 10:01

On April 24, 2013 an eight-story factory building collapsed in Bangladesh, in a complex called "Rana Plaza."

1,129 workers died. More than 2,500 were injured, many seriously so.

The factory made clothing for companies all over the world, from Walmart to Benetton.

The BBC's Akbar Hossain covered the collapse and the aftermath. In the year since, he's spoken with workers and factory owners. He told Marketplace's David Gura about the past year in Bangladesh's garment industry:

Q: What sort of tangible changes have you seen to these factories in Bangladesh? Do they look different?

To be very honest, the situation and the physical infrastructure [of most factories] has not changed yet. Workers [still] are alleging that they're working in very dangerous conditions. 

There are factories in Bangladesh that are very compliant...they meet all the standards of international buyers. But there are many factories which don't even comply with the minimum standards in Bangladesh. And thousands of workers are working there -- there's a problem.

Q: This is an issue that attracted so much attention globally. There was a compensation fund that was intended to raise at least $40 million for victims. This hasn't happened yet. Why?

Bangladeshi garment owners are saying they couldn't insure the factories safety and standards because internatioanl buyers always want cheaper garments from Bangladesh. So they have to maintain the factories in cheaper ways. 

Bangladesh's garment industry is a huge industry for Bangladesh. It earns $20 billion every year. More than 5 million people are directly employed in the garment industry, and there are [many] other people who have links. 

Q: Rana Plaza did contract work for some big western companies, like Mango and Benetton. Have you seen these businesses travelling more to Bangladesh? Taking a closer look since this happened?

The Rana Plaza disaster was a wake up call for the Bangladeshi garment indsustry, and it was a wake up call for international garments and brands also. They are coming to Bangladesh. I've talked to Trade Union Leaders, and they are telling me, yes, international buyers are now more serious. They're trying to maximize they're profit, but now they're focusing on the safety issues. They're actually pressing garment factory owners to insure a safer workplace.

So things are changing, things have worked, but things are going very slow.

PODCAST: The secrets behind college wait lists

Thu, 2014-04-24 07:45

This morning brought a bit of a reversal fortune for tech companies that have been getting pummeled in recent weeks.

The Federal Communication Commission is expected to introduce new rules today that will allow broadband providers to charge companies for faster internet service.

College admissions rates across the country hit some all-time lows this year. Stanford University, for instance, took only around five percent of applicants. In response to the crazy numbers game of college admissions, schools are growing their wait lists and using them in some surprising ways.

Is the FCC neutering Net Neutrality?

Thu, 2014-04-24 07:24

The Federal Communication Commission is expected to introduce new rules today that will allow broadband providers to charge companies for faster internet service.

Net neutrality proponents see this as a blow to the principle that broadband providers can’t give preferential treatment to websites or Internet companies. Broadband providers welcome the proposed rules saying it’ll allow them to deliver better services to consumers, said John Butler, an analyst at Bloomberg Industries. He says, think of your Internet connection as a big highway.  

“And to the extent that you get certain clients that are using too much of the highway if you will and really affecting the quality of service for others on the network, in their view that’s not fair game,” Butler said.

Providers say streaming video companies like Netflix, which use a lot of lanes on the road, should pay more. They say the proposed rules will simply allow them open faster Internet lanes and charge companies for them.

Todd O’Boyle with Common Cause, which advocates for Net Neutrality, says, the new rules allow for paid discrimination. He adds, it will also handicap smaller tech companies.

“By slowing down its rivals its harmful to innovation it’s harmful to end consumers,” O’Boyle said. He says that’s because consumers will end up paying for it in the end.

 

More work study, less financial aid?

Thu, 2014-04-24 05:09

What would happen if the government moved away from financial aid for college students and more towards work study? Marketplace economics contributor Chris Farrell joins Morning Report host David Brancaccio to make his case for growing work study. Click on the audio player above to hear more. 

The post-recall GM: What's it look like?

Thu, 2014-04-24 04:56

[UPDATED: 8:13AM EDT] General Motors  said this morning that its profit fell 86 percent, its worst quarter since came out of bankruptcy in 2009.  A series of recalls hurt the auto giant, but excluding these one-time items, profits radically beat expectations.

GM is suffering not just from bad weather during the winter months -- but also from bad PR over its handling of faulty ignition switches going back ten years.

The problem has caused at least 13 deaths, and the belated recall -- in February 2014 -- could cost the company $1.3 billion. GM faces ongoing inquiries into its knowledge and handling of the defect, as well as lawsuits from consumers.

Since emerging from bankruptcy at the end of the recession in June 2009, GM has gone from a message of redemption to an acknowledgment of mistakes.

"We will not shirk from our responsibilities now and in the future," new CEO Mary Barra told a Congressional hearing earlier this month about the ignition-switch recall. "Today's GM will do the right thing."

That appears to include heads moving and rolling. Several top executives, in HR, communications and engineering, are out, says Paul Eisenstein of the Detroit Bureau, an auto-industry news service.

"Since the recall we have been seeing more and more changes in mid- to upper-management," says Eisenstein, and he adds that company executives have signaled to expect more of the same.

Meanwhile, GM plans to staff up two new engineering divisions -- one specifically to deal with safety and quality problems.

"The image of the company as a huge lumbering company where management holds back on innovation and change is an image that the company’s going to have to rid itself of very quickly," says Gary Chaison, a professor of industrial relations at Clark University who studies the auto industry. And he says HR shuffles alone aren’t likely to accomplish that goal.

Climate change: how to talk about bad news

Thu, 2014-04-24 04:16

It’s been almost eight years since "An Inconvenient Truth," Al Gore’s call-to-action on climate change. Now the televison channel Showtime is taking up the challenge with its nine-part docu-series "Years of Living Dangerously." In between these two films, advocates have learned a lot about communicating climate change. No. 1, it’s harder than anybody thought.

After years of dire warnings, a little over half of Americans worry about climate change “only a little,” if at all, according to a Gallup poll. 

“At first the attitude was, the truth speaks for itself,” says Dan Kahan, a professor of law and psychology at Yale Law School and a member of the Cultural Cognition Project. “Show them the valid science and the people will understand. That’s clearly wrong.”

Ed Maibach, director of George Mason University’s Center for Climate Change Communication, says there are at least three things “we know that you shouldn’t do,” when communicating the science: don't use language people don’t understand, don't use too many numbers, and don't talk about “plants, penguins and polar bears” instead of people. Maibach says another error is talking about the threat of climate change without giving people solutions.

Elke Webber, a business and psychology professor Columbia University’s Earth Institute, takes that one step further. She believes that instead of “scare campaigns” and “visions of apocalyptic futures,” climate advocates need to present visions of what a world less dependent on fossil fuels would look like.

“Focus on the benefits,” Webber says. “Scare campaigns work extremely well when there’s a simple thing you can do to remove the danger. But if it takes protracted action, over time, nobody wants to feel bad for that length of time. People just tune out.”

The real challenge, however, may be to talk about climate change in ways that don’t push people’s cultural and political buttons. Dan Kahan’s research shows that the way people view climate change is closely tied to their values.

People “aggressively filter” information that doesn’t conform to their worldview.

“And remarkably the more proficient somebody is at making sense of empirical data," he says, "the more pronounced this tendency is going to.”

Robert Lalasz, director of science communications at the Nature Conservancy, is convinced that real progress will come at the local level, where people are already confronting drought and rising seas and looking to community leaders for solutions. 

“We need to show people that the people they respect and trust are paying attention to climate science and using it to make decisions about issues they’re dealing with right now and issues in the future,” Lalasz says. Those conversations, however, tend to be about adaptiing to the effects of climate change. The question is whether they can help move the needle on mitigating it, before it's too late.

The business of tourist traps

Thu, 2014-04-24 03:52

The iconic New York restaurant Tavern on the Green is reopening Thursday under new ownership after being shut down for years. It has a storied history, but suffered in recent years from a reputation as a tourist trap with dreadful food. The new owners vow to restore it to its old glory and have invested millions in revitalizing the space and the menu.

By Shea Huffman

In light of Tavern on the Green's return, we decided to look at some of the most well-known, or infamous "tourist trap" restaurants around the country. These restaurants may have originally gained noteriety for good food or intriguing historical origins, but have since become better known for their tourist draw.

Top of the World Restaurant - Stratosphere Hotel, Las Vegas

One could argue Las Vegas itself is one big tourist trap, but to pick one restaurant out of all of them, you have to go with the rotating restaurant atop the Stratosphere Hotel, the Top of the World. Like most touristy places to eat, this one banks mostly on the view it offers customers, but doesn't offer the high quality food to match its high price range (it costs $18 just for admission).

Zehnder's of Frankenmuth - Frankenmuth, Michigan

This all-you-can-eat chicken restaurant is somewhat of a landmark in Michigan, known for its massive 1,500 person seating area, making it one of the largest restaurants in the U.S. Zehnder's staff all wear traditional German-style uniforms to match the general style of the restaurant, though the food is decidedly American.

Fisherman's Warf - San Francisco

This is probably one of the most well known tourist traps in the world, and it would be unfair to single out just one of the restaurants that inhabit it for being unremarkable beyond the fact that they are in Fisherman's Warf.

The Billy Goat Taven - Chicago

"Cheezborger! Cheezborger!" The famous line from the Olympia Restaurant skit in Saturday Night Live was inspired by the Greek immigrant owners of the Billy Goat Taven in Chicago. To this day the restaurant is graced with long lines of patrons waiting to hear the staff recite the words, but the general consensus is that it's just typical diner food.

Times Square - New York

Another famous tourist trap whose restaurants we just couldn't single out. If we had to pick one though, it would probably be Guy's American Kitchen & Bar, the restaurant belonging to celebrity chef Guy Fieri, if only for its brilliantly scathing review in the New York Times.

P.O.V. Rooftop Bar at the W Hotel - Washington, D.C.

This lounge, sitting atop the W Hotel in Washington, D.C., offers patrons a great view of the White House and a number of the city's historic monuments, as well as a chance to rub elbows with a few classy politicos. But that might be all it has to offer, as reviewers contend the drinks are overpriced and the food isn't that good.

The Ivy - Los Angeles

Adorned with flowery cottage-style decor, this nouvelle American restaurant sits not far from the talent agency International Creative Management, which has prompted a number of visits from celebrities and pursuing paparazzi. The chance to spot their favorite movie stars drives many tourists to The Ivy, and they pay for it.

The Varsity - Atlanta

The main branch of this burger chain in Atlanta is the largest fast food drive-in in the world, and has become an iconic fixture in the city's culture. The unofficial catchphrase, "What'll ya have?" has become ingrained in Atlanta's folklore, and the restaurant has even been graced with visits from presidents Jimmy Carter, George H. W. Bush, Bill Clinton and Barack Obama. But pretty much everyone who goes there agrees, the food is just "meh."

Marketplace with Kai Ryssdal: The Road Show

Thu, 2014-04-24 03:47

To celebrate its 25th year of bringing economics to life, Marketplace® is hitting the road.

On stages across the U.S., "How I Learned to Stop Worrying and Love the Numbers" will provide an irreverent, insightful look at the numbers in our lives. Numbers in headlines, numbers without context. From the Dow to the NASDAQ to weekly unemployment, we're bombarded with newsworthy numbers every day, how do we make sense of what they all really mean?

Join Marketplace host Kai Ryssdal — plus reporters Adriene Hill, Stacey Vanek Smith, Lizzie O'Leary, Rob Schmitz and Paddy Hirsch — as they humanize the numbers. It's an evening of radio, with sound elements, interviews and engaging storytelling.

What Marketplace does best, but in person, on stage, at the Strathmore.

April 24, 2014
7:00pm

To purchase tickets visit: http://www.strathmore.org/eventstickets/calendar/view.asp?id=10819

Limited number of half-price tickets available from Goldstar.

Sharing is caring: a collaborative commons economy

Thu, 2014-04-24 03:39

Airbnb has had an up-and-down couple of days. On Friday, investors put an additional $500 million into the company, valuing it at roughly $10 billion. This week, they're in a New York courtroom, defending their model against a subpoena for their list of New York hosts. Hotel regulators argue that the company violates New York law that an apartment cannot be rented for less than 30 days.

Jeremy Rifkin, author of "The Zero Marginal Cost Society," thinks the way Airbnb operates is a sign of a shift in how business will be done in the future. The conflict comes down to the elimination of marginal costs. That's the term for how much it costs for a business to add an additional good or service. According to Rifkin, Airbnb's marginal costs are almost nothing, and that's problematic for brick-and-mortar businesses.

"Businesses have always wanted to reduce marginal costs. They simply never anticipated a tech revolution so extreme in its productivity that it could reduce marginal costs to near zero, making goods and services nearly free, abundant, and sometimes not prone to market exchange forces."

Rifkin also points out that this struggle between Airbnb and hotel regulators is different than, say, what the music industry went through when users tried to share content for free. In that case, the market had to adjust and learn to coexist with new technologies. Sharing economies, however, may have larger implications with how bussinesses operate. According to Rifkin:

"The capitalist market will stay. It will have a role to play. I don't think it'll be the primary arbiter of economic life in 30 years from now. I think the collaborative commons is here to stay."

Waitlisted for college? Here's why

Thu, 2014-04-24 02:29

College admissions rates across the country hit some all-time lows this year. Stanford University, for instance, took only around five percent of applicants. In response to the crazy numbers game of college admissions, schools are growing their wait lists and using them in some surprising ways.

You may think a wait list is for applicants who aren't quite as good as those admitted outright. But it's not that simple. Chris Munoz, the vice president for enrollment at Rice University, says the differences between candidates accepted and those on the wait list "are so subtle and so nuanced." It is less about who is "better" or "worse," and more about the college making sure it can get the exact student body it wants.

Schools stock wait lists with all kinds of applicants -- A-plus students, athletes, candidates who can pay full tuition. Munoz says wait-listing students is like choosing back-ups for a sports team. You want one for every position."Sometimes you need quarterbacks," he says, "and sometimes you need tight ends. So it's luck."

In the end, the wait list comes down to "yield." This is the percentage of students who will accept the college's acceptance. Schools use wait lists to manage the uncertainty of who will actually say yes when admitted. The yield percentage isn't just important for hitting enrollment targets, it has big financial implications.

Over the years, yield numbers have come to affect a school's ranking and bond rating. Low yields will pull down the rank and make it harder to secure financing. To keep yield high, colleges want as many of the students they initially admit to come.

For the most elite colleges, this is less of a problem. Few applicants are going to turn down an Ivy League college or top liberal arts school. But for other institutions it's not so easy. Some schools try to predict which applicants will actually say yes by factoring in a student's "demonstrated interest." This includes things like campus visits and alumni interviews. Other schools, however, are suspected of playing the numbers game a bit more aggressively.

There are rumors that some colleges actually wait-list applicants who seem too good to be true. Admissions offices realize certain top-notch candidates have a high chance of getting in somewhere higher up the rankings food chain. By putting them on the wait list, the admissions office can see if the applicant gets rejected by other schools and comes back begging to be accepted. This way, colleges can catch some prized applicants without risking their yield numbers. Basically, a school doesn't want to be used as safety and then ditched for a first choice.

Admissions consultant Annie Roskin thinks some of her clients may have been wait-listed in this way.

"The thing is you don't know what a wait list means," she says, "kids don't know." Maybe too many quarterbacks applied that year. Did they show enough demonstrated interest? Perhaps their applications just weren't strong enough. Or, the school wanted to soften the blow of rejection and gave them "courtesy wait lists"—a tactic sometimes used for students related to wealthy donors or who have alumni relatives. Who knows?

Katy Murphy is the president of the National Association for College Admission Counseling. She says the wait list "is purgatory for a kid, basically."

Increased use of the wait lists are part of the vicious admissions cycle. Acceptance rates are falling. That panics kids into applying to more and more schools, which drives acceptance rates further down. All of this lowers yield numbers and encourages colleges to use the wait list. "It's our own admissions march madness vortex," Murphy says.

School rankings fuel all this madness. Murphy says it's part of the increasing commodification of higher education—this idea that college is a product that will predictably deliver things like great jobs and happiness. The rankings establish a brand. They suggest some kind of quantification—the better the number, the higher the return on investment.

Murphy says the reduction of schools to numbers drives ambitious applicants to pursue a small group of elite colleges, not because they are the best fits, but because they are the most effectively branded. She says, "I think everybody would be better off if they didn't believe that there were only thirty colleges that were good colleges."

If that doesn't change, expect more kids to be stuck in admissions limbo on the wait list.

Goodbye, productivity. Hello, HBO.

Wed, 2014-04-23 14:00

It's an impressive list of high quality television: The Sopranos, Six Feet Under, The Wire, Big Love, Deadwood, Eastbound & Down, Family Tree, Enlightened, Treme, early seasons of Boardwalk Empire and True Blood, plus mini-series like Band of BrothersJohn Adams. 

These are all of the HBO shows that will be made available next month to Amazon Prime customers.

To some, it will feel like a necessary perk, what with Amazon Prime membership costing more than it used to. To others, it's a farewell to productivity, because let's face it, this is a lot of television to watch. Just how long will it take you to get through all of this content?

Assuming you take no potty breaks, don't sleep, and eat in front of your laptop or television, it will take this long:

Thanks to the website tiii.me, which allows you to calculate how much of your life you've spent watching tv based on what shows you've seen, it will take a grand total of 21 days, 23 hours, and 30 minutes to blaze your way through all of the HBO content.

If you're an Amazon Prime member, maybe don't plan on doing much for the month of May.

Want Botox? A wrinkle filler?

Wed, 2014-04-23 13:23

Valeant, a pharmaceutical company, is trying to look good. It’s made an offer for Allergan, the company that produces Botox. Over the past couple of years, Valeant has bought up other pharma companies including Solta, Obaji and Medicis, makers of skin-smothing-lasers, creams and fillers. Valeant isn't looking to make more by increasing R&D, but you don’t have to wrinkle up your forehead to figure out why it wants to buy the company that produces Botox.

“They are clearly going to have a monopoly in the marketplace," says Dr. Jack Berdy,  CEO of SmoothMed, a service that provides botox treatments in Manhattan. Berdy notes Valeant already bought the company that makes Dysport – a Botox competitor.

“I can’t imagine the company Valeant, who would look for economics in a takeover, maintaining both products in the marketplace," he said. "One of them would probably disappear.”

Along with a lot of jobs -- for some people, Valeant's offer is going to create stress (and wrinkles). Seamus Fernandez, an analyst with Leerink Partners, agrees.  “That’s a fair conclusion,” he says.

Fernandez says the international market for cosmetic dermatology is worth billions every year. And with the potential for consolidating workforces, Valeant is trying to be efficient.

“Most doctors are pretty busy, they would much prefer to just talk to one person who could go through and update them on what’s new on all the products they use, rather than having to have a bunch of different sales people come in from each company,” says David Krempa, an equity analyst with Morningstar.

Fernandez says, unlike the wrinkles it fixes, the market for cosmetic dermatology is growing – at about 12 percent a year.

The Times takes James Franco down (at least) a notch

Wed, 2014-04-23 13:16

About one James Edward Franco:

An actor, yes. But also: A poet! A novelist! A filmmaker! And an artist.

Not so fast, says Roberta Smith, co-chief art critic for The New York Times. Some of Franco's photographs are on display at a gallery in New York, and Smith isn't impressed.

Franco "remains embarrassingly clueless when it comes to art," she writes in her review. "The deep content here, beneath the entitled narcissism, is a confused desperation that seems to drive Mr. Franco's pursuit of visual art."

She continues: "It's hard not to feel some sympathy for him, while also wishing that someone or something would make him stop."

Ouch.

IRS employees who don't pay their own taxes

Wed, 2014-04-23 13:12

More than 1,000 IRS workers who failed to pay their taxes still received performance bonuses.

In all, 28,000 tax workers with substantiated conduct issues collected $2.8 million in bonuses for 2011 and 2012.

Andrew Biggs with the American Enterprise Institute generally favors performance bonuses for federal employees. But, Biggs says, “it is difficult to have employees working for the IRS who didn’t in fact pay their own taxes. That undermines the credibility of the agency as a whole.”

The IRS is considering a policy change.

But in order to make conduct issues affect performance bonuses, the IRS must negotiate a new agreement with the National Treasury Employees Union.

The NYPD learns about #backlash

Wed, 2014-04-23 13:06

The New York Police Department got a big lesson in social media this week. It created a Twitter hashtag – #myNYPD – to get people to tweet pictures of happy New Yorkers standing with smiling officers. But this being both New York, and social media, the NYPD didn’t get quite what it expected.

Not only did it backfire – now the hashtag has spread on Twitter to other police departments like Los Angeles and Chicago.

Twitter users sent in scores of pictures of New Yorkers who appear to be abused, beaten, even run over by officers. Some of the photos may be old or misleading, but the NYPD fell into a trap that has sunk many a social media campaign before it. 

“Part of me is kind of incredulous. Didn’t they expect they would get this kind of backlash?” says Ann Handley, head of content at MarketingProfs, and co-author of Content Rules. “You can’t get people to talk about how great you are on Twitter.”  

The NYPD could have learned something from McDonald’s' experience two years ago. It wanted people to send in nice comments with the hashtag “#McDstories.” They got something else entirely, says Howard Fencl, Vice President at the crisis communications firm Hennes Paynter Communications. “Trolls came out of the woodwork with ‘my brother found fake fingernail in his french fries, #McDstories,” he says. "People are sick of spin.” 

Some companies have more success jumping into what everyone is already talking about on Twitter. After Colorado legalized marijuana, Ben & Jerry’s tweeted a picture of empty ice cream shelves, which went down well with Twitter users. 

But if you’re big and important, the public might just be itching to knock you down a peg.

“The Police Department. McDonald's. You talk about taking it to the man, not every organization is ‘The Man’,” says Jay Baer, founder of the social media consultancy, Convince & Convert.

Baer says social media doesn’t create hate; it just uncovers it. 

ON THE AIR

KBBI is Powered by Active Listeners like You

As we celebrate 35 years of broadcasting, we look ahead to technology improvements and the changing landscape of public radio.

Support the voices, music, information, and ideas that add so much to your life.Thank you for supporting your local public radio station.

FOLLOW US

Drupal theme by pixeljets.com ver.1.4