SCIENTIFIC AMERICAN ONLINE
Comment on this article at ScientificAmerican.com/jan2013

This article was originally published with the title A To-Do List for Washington.

7 Comments

1. 1. Erika963 05:59 PM 12/20/12

   I was surprised to read the following suggestion from the SA Editors: "... rewarding primary care physicians and nurse practitioners with financial bonuses if they keep their patients healthy and out of the hospital". It's not the PC Physicians and NP who keep the patients healthy, it's the patients! It's exactly this school of thought that doctors and nurses have a magic wand and can fix everything that has gotten us into the healthcare mess that we are in. People need to be educated on healthy habits and healthy ways of living so that they don't become patients in the first place. This type of education doesn't have to come from doctors or NPs. If anyone should get incentives, it's people who try to stay healthy and out of doctor's office and hospitals.

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2. 2. alessaandraaa in reply to Erika963 10:06 AM 1/10/13

   I completely agree. Besides some obvious issues--such as constructing metrics to compare doctors with different specialties and patients--this idea completely neglects personal responsibility on the part of the patient. I was also surprised to see US outcomes as part of the “alarmingly dysfunctional health care system.” The US has PHENOMENAL outcomes compared to other countries when you look at studies that do comparisons across nations accounting for lifestyle (e.g. smoking, excessive drinking, etc.). In fact, the worst outcomes in the US occur in our Medicare/Medicaid patients when compared to those patients with private insurance or *no* insurance (see work done by Scott Atlas or John Cochrane). I would like to see more objective information on this research and less echoing of the same ideas that get thrown around on every other “news” site (WSJ, Reuters, CNN, Fox, etc.).
   
   I’m always slightly disappointed when I read political articles on Scientific American and very disappointed when those articles advocate specific policies rather than discussing the objective and scientific circumstances surrounding certain issues. I know this is very rant-ish for a simple article (and I mean no offense against the author), but I always cringe when I see personal opinion or bias mix with objective science.
   

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3. 3. alan6302 10:28 AM 1/10/13

   With the latest advances in "heath care", there should be no problem achieving a cleaner environment. In a world population of less than 500 million and no internal combustion engine.

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4. 4. sjn 11:18 AM 1/10/13

   SA joins the rest of the political establishment in ignoring the real priorities reflected in the Federal budget both overall and specifically as regards science policy as reflected in the federal R&D budget.
   SA can identify whatever "priorities" they think are important. I have no issue with health care & clean energy being clear priorities, though I think there are other issues of greater importance than internet control.
   However the Federal budget for R&D clearly reflects other priorities which SA helps to continue to keep invisible to scientists and the general public.
   Once you take account of health care R&D (the NIH budget) at least 70% of the remaining Federal R&D funds are allocated to the Dept of Defense, Homeland Security, DoE's nuclear weapons programs and other military R&D. So everything SA advocates basically competes with NASA, NIST, NSF & all the non-military national labs for 20-30% of the Federal R&D budgets
   Until SA and the scientific establishment is willing to raise this issue for public discussion, articles such as this are largely irrelevant.

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5. 5. Erika963 in reply to alessaandraaa 11:26 AM 1/10/13

   I agree with you. I would also prefer to see SA publish hard facts and statistics that are verified scientifically to backup their "opinions" or better yet to let the readers draw their own conclusions. That would be the 'scientific' way.

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6. 6. sethdayal 07:11 PM 1/10/13

   Another Big Oil infomercial courtesy of the stenographers copying down Big Oil's boilerplate at Sciam.
   
   Big Oil loves the carbon and have said so. They know there is no real alternative to their carbon so won't affect them much at all. In fact the methane emissions from gas enough to make gas a worse warming forcer than coal, doesn't get counted in a carbon tax, giving Big Oil a significant advantage over nuclear when it comes to shutting down coal.
   
   Carbon tax/credits like the wind/solar/gas scam are simply measures Big Oil uses to make sure nothing effective is done to reduce/eliminate fossil fuels, while at the same time making the rubes believe that the solution is just around the corner. You can do that when you own all politicians ,Big Media and even have managed to purchase organizations like Greenpeace and Sierra. So effective is the propaganda that the very folks that believe in global warming are the ones that are most responsible for ensuring that nothing gets done about it.
   
   In fact in British Columbia, gas consumption stayed the same, despite a 50 cents a liter Big Oil imposed gas tax ($200 a ton carbon tax) while the governments own $30 per ton carbon tax did nothing to reduce CO2.
   
   Nuke power is the only technology that can be built up in time to head off the past approaching civilization ending global warming, ocean acidification, peak oil precipice. The only thing Big Oil and its horde of sycophants - some of them unwitting - fear is nuke power because they know that is the only technology that it is industrially, and economically able to replace Big Oil/Coal's filthy product.
   
   If the money wasted on building wind/solar over the last decade which still produces almost none of the world's energy , had been spent on nukes, we could have eliminated coal power plants saving more than a million lives annually and moving that warming precipice farther into future. Truly the wind/solar scam is not only paid by taxpayer subsidy, but in the blood of millions of innocents.
   
   The US needs 2500 new AP-1000 nukes to end fossil fuel use. The mass produced nukes are so much cheaper than the fossils they replace, that the payback period on the replacement is less than three years - a 40% rate of return of investment.
   
   This national nuke conversion would overnight end unemployment, eliminate tens of thousands of annual air pollution deaths and create the greatest construction boom in history.
   
   Will the evil of Big Oil corruption be enough to stop it?

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7. 7. dubina 05:59 PM 1/14/13

   It is said that a third of our healthcare costs are due to unnecessary and / or ineffective tests, drugs and procedures. Physicians, Hospital Administrators and health insurance executives know that (in spades, I'd bet).
   
   Are we ready to deal with that?

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