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Republicans have turned against government funding of evidence-based medicine research for five reasons.
Federal investment in this research (although it predated the 2008 election) became closely tied to the Obama administration’s health-care reform agenda, because big funding increases were tucked into the 2009 stimulus legislation and the Affordable Care Act — two measures the GOP strongly opposed. An increased federal role in comparative effectiveness research, together with payments to physicians for voluntary counseling to Medicare patients about end-of-life options and the creation of the Independent Payment Advisory Board (another agency the GOP wishes to kill) contributed to the “death panels” myth, which Republicans have used to frame health-care reform as “rationing.” As University of Maryland political scientist Frances E. Lee argues, partisan conflict over technocratic issues such as medical research is often “opportunistic and focused on electoral advantage.” As she writes, “The politics of good government, ironically, is hardball.” Although evidence-based medicine might seem likely to have bipartisan support, it has become a partisan issue among voters. In 2010, Alan Gerber, David Doherty, Conor Dowling and I conducted a national survey to gauge public support for government funding of research on the effectiveness of treatments. Among those who reported not voting in 2008, there was not a large difference in support across Democrats and Republicans, but there were significant partisan differences among voters. Republican voters were much less supportive than Democrats. During the debates over the stimulus bill and health-care reform, the two parties took opposing stands on the federal government’s role in this effort, which led to the significant partisan split among politically engaged citizens. Research on the effectiveness of different treatments is a threat to the incomes of some health industry stakeholders. In 1994, the Agency for Health Care Policy and Research (the precursor to AHRQ) issued a report concluding that there was little evidence to support back surgery over nonsurgical alternatives for many cases of lower-back pain. Back surgeons went ballistic, and successfully lobbied Republicans in Congress (who associated the agency with the Clinton health-care reform plan) to slash the agency’s budget and curb its authority. Although some health IT companies see the value of AHRQ and PCORI, there are powerful interest groups that wouldn’t mind if the agencies were weakened. The public is not engaged. Although patients, caregivers, and family members would benefit from better information about the effectiveness of treatments, the benefits of a stronger base of medical evidence are too diffuse to mobilize ordinary citizens. AHRQ and PCORI are public-interest agencies that lack a natural constituency. Republicans have attacked government funding of evidence-based medicine research because there is little political penalty to doing so. The penalty would be higher if Republicans feared getting on the wrong side of doctors. In our survey research, we found that when it comes to the role of evidence in patient decisions as well as in the allocation of health-care money, the public believes that “doctors know best.” The public views doctors as trusted agents of their interests; when respondents are told that doctors support government funding of evidence-based medicine research, the argument of opponents that study findings will be used as a pretext for rationing loses its sting.
Clearly most doctors do believe in the need for research on evidence-based medicine (although medical societies frequently protest when studies question the efficacy of treatments used by their members). “Cutting funding to AHRQ would be a huge mistake in our mission to improve the quality & efficiency of healthcare,” tweeted one surgeon. But the physician community has not organized around the issue.
There is a good chance the proposed cuts to evidence-based medicine research won’t be enacted in this appropriations cycle. Nonetheless, the episode is a reminder that information is a powerful resource in government — one that can be destroyed when people aren’t looking.
Eric M. Patashnik is professor of public policy and politics and director of the Center for Health Policy at the University of Virginia. He is also nonresident senior fellow at the Brookings Institution and a fellow of the National Academy of Public Administration.0999204-f29845aebea6925b530b9072ef34cbb2.txt0000644000000000000000000000271300000000000015205 0ustar 00000000000000After each mass shooting, gun control activists, bereaved parents and lawmakers reissue a call for more restrictive gun control laws. However, eight years after the shooting at Virginia Tech University that killed 32 and two years after the massacre at Sandy Hook Elementary that left 27 dead, Congress has not enacted substantial legislative changes.
The latest mass shooting in Oregon on Thursday again raises the issue of gun control and why efforts to pass gun law reforms have failed.
A simple reason is, perhaps, money. In 2015, the gun rights lobby outspent the gun control lobby about 6 to 1.
Data shows that the gun rights lobby, which includes groups like the National Rife Association and Gun Owners of America, consistently spends significantly more money in lobbying and campaign contributions than gun control groups like Everytown for Gun Safety.
The Center for Responsive Politics said that in the 2008 election cycle, gun rights organizations spent 34 times more on lobbying in 2008 than gun control groups. In raw numbers, that's $3.9 million versus $115,000.
While that money doesn't directly go to politicians, the money does go to lobbyists with access and who lawmakers often depend on for expert opinions and information.
Thursday's shooting at the Oregon community college is the 45th mass shooting this year, if defined as an event at which four or more people were killed. If defined as an event at which four or more people were shot, it's the 294th.0999160-d5a89feeb1eb1a7536c9d018e2fb9f52.txt0000644000000000000000000000335500000000000015364 0ustar 00000000000000NES has signed a new contract with Remontowa Shipbuilding, Gdansk for the delivery of two hybrid electric systems for two new ferries. The contract has a value of 25-30 mill NOK. The owner of the new ferries is Transport for London (TfL) and the LMG Marin 60-DEH design includes a propulsion system, which is the newest within green energy.
The ferries shall be operating the link between Woolwich and North Woolwich across the River Thames. The Woolwich Ferry has been operating since 1889 and carries around 20 000 vehicles and 2.6 million passengers a year across the River Thames.
Norwegian Electric Systems package consists of ultralight converters forming a DC-grid system with totally four battery packages, two on each side of the DC-bus breaker for redundancy. In addition, for the main propulsion there are used water-cooled, high efficiency permanent magnet motors and four direct driven propellers.
"We have had a good and close contact with Remontowa and LMG Design during this sales process", says Fridtjof Erichsen, regional sales manager in NES.
NES will, as usual, deliver a complete integrated DC-Grid system consisting of:
Generators
4 complete battery packs
permanent magnet motors for main propulsion
DC switchboards
Low loss Quadro Drive® DC/AC and AC/DC
EMS and IAS
Project Management
Calculations/Engineering
Commissioning and sea trial
"We are proud to have won this contract," says Fridtjof. "It proves once again that NES is in the forefront when it comes to technology".
NES has already installed one of Europe`s largest test facilities for electric propulsion systems including energy storage. The new Energy Management System will also be a great advantage for future projects.
Source and top image: Norwegian Electric Systems0999192-ef79b2bae77af17c61fba238417f06ad.txt0000644000000000000000000000561700000000000015363 0ustar 00000000000000Five Labour grandees, who previously campaigned for Britain to Leave the EU in the 1975 referendum, have penned an open letter explaining why they’ve changed their position.
Former Labour leader Neil Kinnock, Margaret Beckett, Hilary Benn, David Blunkett and Jack Straw have published a letter in support of the EU in the Sunday Mirror. The four who join Kinnock in signing this letter were ministers under previous Labour governments. Benn is currently shadow Foreign Secretary and is expected to play a big role in Labour’s EU strategy.
Although all five were once Eurosceptics, now they say “It’s clear Britain is stronger, safer and better off than we would or could be if pulled out of the EU.”
The five explain that their previous Euroscepticism was rooted in concerns that “membership would mean a one-way loss of sovereignty and investment.” “This has proved unfounded”, they write. They praise the EU for giving Britain economic partnership with 27 other countries, three million jobs and employment rights.
In a move that’s been interpreted as support for David Cameron’s attempt to renegotiate Britain’s relationship with the EU, they write: “The conclusion of the current renegotiation will hopefully strengthen this relationship as we make the progressive case for Britain in Europe.”
The Prime Minister is hoping to strike a deal at next week’s summit of EU leaders in Brussels. If this successful it would clear the way for Cameron to put the renegotiated terms of British membership to the public in a referendum in June.
The letter in full:
In the 1975 referendum we all campaigned against remaining in what is now the European Union.
Now, and for a long time past, it has been clear Britain is stronger, safer and better off than we would or could be if we pulled out.
Our concern then was that membership would mean a one-way loss of sovereignty and investment. This has proved unfounded.
We are part of an economic partnership with 27 other democracies, exercising full rights to determine agreed rules in the world’s largest single market.
That has brought three million jobs, it attracts large investment, promotes growth and provides for employment rights that protect British workers.
We also have control of our currency, borders, security, defence, foreign affairs and justice.
Britain’s voice on global matters, whether debt relief, peace-keeping or climate change, is amplified by being part of Europe. Intelligence sharing helps us fight terrorism and other crime.
The conclusion of the renegotiation will hopefully strengthen this relationship as we make the progressive case for Britain in Europe.
Leaving would be a huge risk to prosperity, security and the opportunities of future generations.
The EU is not perfect and improvement is always worth making, but the benefits far outweigh the costs.
– Neil Kinnock, Margaret Beckett, David Blunkett, Jack Straw and Hilary Benn0999223-d94a7e2afca5cab1306118e96f940a1e.txt0000644000000000000000000000342200000000000015255 0ustar 00000000000000With no let-up in protests over sacrilege of Guru Granth Sahib in Punjab, 10 companies of the Border Security Force (BSF) have been deployed in four districts of Punjab.
Three companies each of the BSF have been deployed in districts of Amritsar, Ludhiana and Jalandhar, while one has been deployed in Tarn Taran.
Tension has been prevailing in the state since incidents of holy book sacrilege have come to light sparking protests across the state.
Meanwhile, in a fresh incident, pages of the holy book were found torn at Gurusar village in Bathinda district on Tuesday morning leading to tension in the area. As the incident came to light, villagers gathered to protest against the incident.
Heavy police force has been deployed to ensure that the situation doesn’t go out of control.
In Jalandhar, 10 people were rounded up by the police in connection with the clash between the shopkeepers and the Sikh protesters on Monday. The police also conducted flag march. Policemen also kept a close watch at various markets, including Mai Hera Gate and Rainik Bazar.
Traffic also remained suspended on the National Highway 1, only to be cleared by noon on Tuesday.