by Kevin Schofield
Each year nearly $4 trillion is spent on health care in the United States; of that, about one-quarter, or $950 million, is spent on administrative expenses. This week’s “long read” is a report by the business consultant McKinsey & Company on how money could be saved through administrative simplification and other business process improvements.
American health care is a multi-payer (over 900 of them), largely for-profit system. The benefit of such a system is that it can drive innovation in technology and treatments, as we have seen during the COVID-19 pandemic with vaccines to reduce infections and new drugs to treat the disease. But as we all know only too well, it is a broken system in many aspects: It’s expensive, often inefficient, and far less than comprehensive. Many of the policy decisions that brought us to this point are beyond the scope of McKinsey’s study, but it doesn’t take much work to identify the inefficiency and expense derived from the overhead of having multiple payers, providers, and patients. The health care industry is also heavily regulated, which protects patients but creates additional overhead for compliance.
Continue reading Weekend Long Reads: How to Save a Quarter-Trillion Dollars in Our Healthcare System
by Kevin Schofield
This week’s “long read” is light on words and heavy on charts and graphs. It’s a comparison of the cost to generate electricity from a number of different sources, both clean and dirty.
The business and finance consultant company Lazard has compiled an analysis of the “levelized cost of energy” every year since 2007. By “levelized,” they mean that they factor in all of the costs: capital costs to build out electricity generation facilities, including the materials, manufacturing, construction, installation, permitting, and property; ongoing operational and maintenance costs; fuel costs for the types of generation that require fuel; and regulatory costs. They calculate the expected operational lifetime of a power generation facility and then divide the sum of the costs by the total expected power generation over a facility’s lifetime to arrive at a cost per megawatt-hour.
Continue reading Weekend Long Reads: What’s the Cheapest Form of Energy?
by Kevin Schofield
Over the past 18 months, I’ve read well over a hundred research papers on COVID-19, treatments, and vaccines. This week’s “long read” is hands down the most informative of all of them.
One of the essential tenets of science is that it must be repeatable: Every time an event happens, we should expect the same result. In practice we often don’t see precisely the same result, even in laboratory conditions, because of experimental error, contamination, sampling error, unknown confounding factors, and bias (intentional or otherwise). That’s why in the world of science a single research study alone isn’t enough to establish new knowledge; the scientific community waits until other researchers have replicated the study and independently confirmed the results.
In our mad rush to save lives by developing treatments and vaccines for COVID-19, we have often substituted a single carefully crafted and skeptically reviewed clinical trial for the greater assurance that we would get with multiple complete studies — at least for the purposes of “emergency use authorization” by the U.S. Food and Drug Administration (FDA). But with the passage of time, and the need to recertify the vaccines in multiple countries, there is now a substantial number of vaccine studies that have been published. Together they give us much higher confidence in our estimates of the effectiveness of the vaccines.
Continue reading Weekend Long Reads: The Vaccine Efficacy Studies
by Megan Burbank
At midnight on the first day of September, after the Supreme Court failed to respond to an appeal from abortion providers, a law banning abortions after six weeks of pregnancy went into effect in Texas. SB 8 has ended access to an estimated 85% of procedures, empowered ordinary people to sue fellow citizens for seeking out or facilitating abortion care, and pushed patients to seek care across state lines, some as far as the Pacific Northwest. Less than a month after SB 8’s implementation, Planned Parenthood disclosed to the Emerald that its Central District Health Center had seen its first patient from Texas.
This disruption in care, and rise in anti-abortion vigilanteism, has already been challenged by the Justice Department and drawn widespread criticism. Reproductive health care providers question its use of the term “fetal heartbeat,” a descriptor that’s more emotional than clinical (the sound heard on ultrasounds is caused by electrical activity; heart valves aren’t actually present). Supreme Court Justice Sonia Sotomayor offered a blistering, Ruth Bader Ginsburg-esque dissent calling the law “clearly unconstitutional.” The law has even been condemned by private companies like Lyft, which established a defense fund to cover legal fees for drivers sued under the law. In the words of one Slate headline: “The Supreme Court Overturned Roe v. Wade in the Most Cowardly Manner Imaginable.”
But none of these objections lessen the impact the law has already had. SB 8 has had “a chilling effect” on abortion providers in Texas, said Lisa Humes-Schulz, vice president of policy and regulatory affairs at Planned Parenthood Alliance Advocates. “No one wants to get sued,” she added, and the fallout has been swift.
Continue reading Patients Are Traveling From Texas for Abortion Care. This May Be the New Normal.
by Kevin Schofield
This weekend’s “long read” is an article published by Noah Smith, looking at the productivity of construction workers and how it’s measured.
The conventional wisdom is that for decades construction productivity has been in a slow decline, in sharp contrast to other intensive industries such as agriculture and manufacturing. This graph from the Economist sums up the picture well:
Continue reading Weekend Long Reads: Deconstructing Productivity
by Erica C. Barnett
With just over a month to go before the 2021 Seattle mayoral election, both Lorena González and Bruce Harrell have amassed financial support worth well over a million dollars, including both direct contributions (which are capped at $550) and independent expenditures (which are unlimited). But a closer look at campaign contributions and expenditures reveals key differences between the candidates’ supporters and how they’re spending their campaign funds.
Continue reading The 2021 Seattle Mayor’s Race by the Numbers
by Kevin Schofield
This week’s long read is a survey — but mercifully one that doesn’t ask a single question about candidates on the November ballot. The local organization sea.citi, which bills itself as “a tech industry nonprofit strengthening our region by promoting civic engagement and building relationships between community, government, and innovation workers,” recently polled Puget Sound-area tech workers to test their views on a range of civic issues, their employers’ actions, and where they want to live and work post-pandemic.
The report buries the demographic data in the back, but it’s worth addressing it first to provide some context because tech workers are not representative of the general population in the Seattle area. Not surprisingly, the survey group skewed male, white, and middle-aged. They also are predominantly transplants to the area: 72% of them moved here as an adult.
Continue reading Weekend Long Reads: Puget Sound’s Tech Workers
by Sally James
The past few days have seen a confusing swirl of decisions by health experts at the federal level, but here’s how the COVID-19 vaccine dust is settling. Anyone over 65 who received the Pfizer vaccine can now get a third “booster” shot. Medical experts say the booster can improve protection against COVID-19, which gradually wanes about six months after people get the first two shots.
Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky announced on Thursday, Sept. 24, that the booster is available to everyone over 65 and also to health care workers, teachers, and others in high-risk jobs. She overruled the recommendation of her own advisory committee, which had excluded high-risk occupations.
Within days, vaccine providers at drive-in, pharmacy, and other outlets will likely begin taking appointments for those who qualify for the Pfizer booster. Those who received Moderna or Johnson & Johnson (J&J) vaccines will need to wait until those boosters are approved later in the year.
For children ages 5–11, there was also good news this week. Pfizer officials announced they will seek approval from the CDC to offer those shots later this fall, maybe by Halloween. But other experts warned that approval for the child-safe doses will require further review, and approval is not guaranteed.
Continue reading COVID-19 Plays Halloween Trick — Again
by Jasmine M. Pulido
Black trans women and nonbinary femmes are the most underserved population within the LGBTQIA+ community.
This is the reality that the Lavender Rights Project (LRP) knew but did not yet know how to effectively address after serving as a grassroots nonprofit law firm for the last five years. This September, on their five-year anniversary, after bringing Black trans women and femmes into new leadership to inform LRP’s strategy, they’re changing their mission to better hone in on this problem. While they still intend to be inclusive and serve the larger LGBTQIA+ community, they will center their work around Black trans women and nonbinary femmes moving forward.
“We are hoping to be inclusive of all LGBTQ in our services, but we see focusing in on Black trans women as a method to address all needs of the entire community. When we get it right for Black trans women, we get it right for everyone who reaches out to us for help,” Jaelynn Scott (she/her) said. As LRP’s executive director, Scott exuded a mix of fierce compassion that also somehow felt like a calming balm as she spoke about LRP’s future.
Continue reading The ‘Lavender Rights Project’ Clarifies Their Community Calling
by Mark Van Streefkerk
Even before the pandemic, small BIPOC-owned businesses and restaurants in the South End faced systemic barriers to success, including lack of access or resources as well as the ever-looming threat of gentrification and displacement. The pandemic only magnified these barriers. The processes of applying for vital loans and grants and pivoting to a greater online presence, all while somehow trying to maintain business as usual, were overwhelming without help. That’s where the Essential Southeast Seattle collective (ESES) comes in.
Continue reading Essential Southeast Seattle Collective Fights for Small Businesses in the South End