No news isn’t good news


Signs of promise and peril for American news organisations
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Mar 30th 2013 |From the print edition

“I BELIEVE in equality for everyone, except reporters and photographers,” Mahatma Gandhi once said. Journalist-haters in his mould might not care about the travails of America’s news firms, but many Americans do. Nearly a third of them say they have abandoned a news source because they thought the quality of its information was declining.

According to “The State of the News Media 2013”, a report by the Project for Excellence in Journalism at the Pew Research Centre, the deteriorating financial state of news organisations has hurt their output. Newspaper staffs have shrunk by around 30% since their peak in 1989, and newspapers collectively now employ fewer than 40,000 full-time professionals, the lowest number since the mid-1970s.

Americans who think media firms are putting out fewer original, thoughtful stories are probably right. Weather, traffic and sport now account for around 40% of local television newscasts. The average length of a story keeps falling. Only 20% of local TV stories exceed a minute, and half take less than 30 seconds.

On cable-news channels, live reports, which require camera crews and journalists actually to show up somewhere, have fallen by a third in daytime programmes in the past five years. Interview segments, which are cheap, have risen. Americans may also prefer talking heads because they increasingly prefer to hear opinion rather than fact. This trend is highlighted by the popularity of Fox, a conservative news network, and of MSNBC, its left-leaning counterpart. CNN, which tends to toe the middle line, continues to struggle with its ratings unless there is a big news event.

Newspapers and magazines are also relying on outsiders to fill up space as their staffs shrink. They are featuring more content provided by think-tanks, for instance. A more pernicious trend is the growing number of public-relations workers. In 1980 PR flaks and journalists prowled in around equal numbers; in 2008 the ratio of PR folk to journalists was nearly four to one. Pew says the news industry is “undermanned and underprepared to uncover stories, dig deep into emerging ones or to question information put into its hands.”

Where is the good news? Last year local TV stations, especially those in swing states like Florida and Ohio, got a welcome boost from the $3 billion spent on TV advertising during the election. And newspapers are now starting in large numbers to demand payment for their digital content. Pew reckons that around a third of America’s 1,380 dailies have started (or will soon launch) paywalls, inspired by the success of the New York Times, where 640,000 subscribers get the digital edition and circulation now accounts for a larger portion of revenues than advertising.

Boosting circulation revenue will help stem losses from print advertising, since it has become clear that digital advertising will not be enough. For every $16 lost in print advertising last year, newspapers made only around $1 from digital ads. The bulk of the $37.3 billion spent on digital advertising in 2012 went to five firms: Google, Yahoo, Facebook, Microsoft and AOL. Not much Gandhian equality there.

From the print edition: United States

http://www.economist.com/news/united-states/21574515-signs-promise-and-peril-american-news-organisations-no-news-isnt-good-news

Where have I seen this before?


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U.S. Flies Stealth Bomber Over Korean Peninsula Amid Escalating Tension

By Paul D. Shinkman

A U.S. Air Force B-2 stealth bomber flies over near Osan U.S. Air Base in Pyeongtaek, south of Seoul, South Korea, Thursday, March 28, 2013.

Tensions continue to escalate on the Korean peninsula after the U.S. flew two nuclear-capable stealth bombers over South Korea, while North Korea insists it is cutting off all lines of communications across its southern border after what it calls “reckless acts of the enemies.”

Two B-2 stealth bombers flew more than 6,500 miles from Whitman Air Force Base in Missouri to South Korea on Thursday as a part of a training mission, designed to demonstrate “extended deterrence” for American allies in the western Pacific, the BBC reports. These missions allow the B-2s to conduct “long range, precision strikes quickly and at will,” according to a Defense release.

[READ: North Korea: 1953 Armistice ‘Scrapped Completely’]

Defense Secretary Chuck Hagel spoke with Republic of Korea Minister of National Defense Kim Kwan-jin Thursday night to talk about the “unwavering United States’ commitment” to South Korea “during this time of heightened tension.”

“The secretary highlighted the steadfast U.S. commitment to the defense of South Korea,” said Pentagon spokesman George Little, “including extended deterrence capabilities, and pointed to the recently signed ROK-U.S. counter-provocation plan as a mechanism to enhance consultation and coordination of alliance responses to North Korean aggression.”

Roughly 28,500 U.S. troops are stationed in South Korea. The Pentagon announced earlier in March it also plans to deploy 14 new ground-based missile interceptors in Alaska as a deterrent to North Korean threats.

[READ: Inside North Korea: Defector Predicts Insurgent Violence]

The North Korean state news agency reported Wednesday that its border delegation sent a telephone message to its South Korean counterparts assuring them there would be “no need to keep north-south communications.”

“War and confrontation can never go together with dialogue and reconciliation under any circumstances,” the delegation said, according to the Korean Central News Agency. “This step will be thoroughly implemented as long as the south side’s anachronistic hostile acts against the DPRK go on.”

“Due to the reckless acts of the enemies, the north-south military communications which were set up for dialogue and cooperation between the north and the south has already lost its significance,” it added.

One of the main purposes of this phone connection includes coordination South Korean workers who commute to the Kaesong Industrial Region in North Korea—one of the last symbols of cooperation between the two countries.

More than 160 people crossed the border Thursday morning for work, the BBC reports.

Earlier this month, North Korean officials told the operators of Chinese tour groups that there would be no war on the Korean peninsula and encouraged China to “send as many tourists as possible,” reports South Korea’s Chosun Ilbo newspaper.

More News:

Avoiding ‘Korean War II’
Obama to Award Medal of Honor To Korean War POW
U.N. to Vote on New North Korea Sanctions

About damn time…


Obama and G.O.P. Inching a Little Closer on Medicare

WASHINGTON — As they explore possible fiscal deals, President Obama and Congressional Republicans have quietly raised the idea of broad systemic changes to Medicare that could produce significant savings and end the politically polarizing debate over Republican plans to privatize the insurance program for older Americans.

While the two remain far apart on the central issue of new tax revenue, recent statements from both sides show possible common ground on curbing costs of Medicare, suggesting some lingering chance, however small, for a budget bargain.

Mr. Obama assured House and Senate Republicans during recent separate visits that he could support specific cost-saving changes to Medicare and deliver Democratic votes.

Several changes are likely to once again be in his annual budget, which will be released on April 10, after Congress returns from its break. Mr. Obama also plans a dinner with Senate Republicans that night.

In particular, participants say, the president told House Republicans that he was open to combining Medicare’s coverage for hospitals and doctor services. That would create a single deductible that could increase out-of-pocket costs for many future beneficiaries, but also could pay for a cap on their total expenses and reduce the need to buy Medigap supplementary insurance.

Representative Eric Cantor of Virginia, the No. 2 House Republican, proposed much the same in a speech in February. “We should begin by ending the arbitrary division between Part A, the hospital program, and Part B, the doctor services,” he said. “We can create reasonable and predictable levels of out-of-pocket expenses without forcing seniors to rely on Medigap plans.”

While Mr. Cantor’s proposal got little attention at the time, its echo by Mr. Obama hints at a new route toward compromise — in contrast with the budget that House Republicans passed this month that has no chance of Senate approval.

At a time when retiring baby boomers and mounting medical prices have made federal health care spending the biggest single driver of the nation’s rising debt, the House budget from Representative Paul D. Ryan Jr., Republican of Wisconsin, would transform Medicare into a voucherlike system known as premium support, which Mr. Obama and Democrats adamantly oppose. But Mr. Cantor, like Mr. Obama, is suggesting cost-saving changes within the existing Medicare program.

To Senator Mark R. Warner of Virginia, a Democrat who has long led a bipartisan group of senators seeking a fiscal deal, such a proposal is the sort of newer idea needed for the parties to stop the “stale arguments” that after three years have turned their budget battling into “World War I trench warfare.”

“You’ve got a whole lot of folks on the Republican side saying, ‘Well, we don’t really like what Ryan has done — premium support — but we want systemic reform,’ ” Mr. Warner said at a round table hosted by Bloomberg News.

Mr. Obama’s openness to systemic Medicare changes came as news to many Republicans, even though he first proposed detailed ideas in 2011. That would help explain Republicans’ frequent, inaccurate charge that Mr. Obama opposes any changes in entitlement spending and that he only wants to raise taxes. But it also reflected how little Mr. Obama has talked about his Medicare proposals.

Still, the same hurdle to compromise stands: The president and his party will not support even his Medicare proposals unless Republicans agree to raise taxes on the wealthy and some corporations. Without that trade-off, common ground on Medicare will remain unplowed.

“The president has said this to the Republicans: ‘You want to do entitlement reform? I do, too. I can produce entitlement reform and bring Democrats to the table, because I am a Democratic president. And so I’m ready to sit down with you and work out an approach,’ ” Senator Richard J. Durbin of Illinois, a Democratic leader, said at a recent forum hosted by The Wall Street Journal.

Many Republicans remain distrustful of Mr. Obama. Yet when they speak of altering Medicare, not replacing it, it is clear that they share some concerns about the existing program.

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http://www.nytimes.com/2013/03/29/us/politics/common-ground-in-washington-for-medicare-changes.html?partner=rss&emc=rss&_r=1&

Another Race Case for a Hostile Supreme Court


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Students demonstrate outside the federal courthouse in Cincinnati in March 2012, when the Sixth Circuit Court of Appeals was hearing oral arguments in their review of their ruling that the ban on affirmative action in Michigan is unconstitutional. The Supreme Court announced Monday that it would hear the case. (Al Behrman/AP Photo)

Little doubt exists that the Supreme Court’s most conservative justices want to do away with affirmative action and other race-conscious programs. And for months, the public has waited to see if they would do it with one broad decision: The case of a Texas woman who said she was denied admission to the university of her choice because she is white.

But on Monday, with a ruling in the Texas case expected at any time, the nation’s highest court announced it would hear another affirmative action case out of Michigan. That case challenges a federal appellate court decision that overturned a voter-approved constitutional ban on racial affirmative action in public education, hiring and contracting.

The court’s move surprised activists on both sides of the affirmative action issue, who then quickly did the analysis: Instead of a sweeping ruling on affirmative action, the Texas case may be decided more narrowly. In taking another case right on its heels, the activists believe, the court might well have opted to undo the fabric of race-conscious laws and policies thread by thread.

“If the court is poised to deliver a lethal blow to the use of race across the board in college admissions, why would they hear this case in the fall? That confused me a bit,” said Ward Connerly, head of the American Civil Rights Institute, which led the successful campaign to eliminate affirmative action in Michigan as well several other states. But either way, he said, “It portends good news from my perspective.”

Legal experts agreed.

“The court seems eager to weigh in on race,” said Ian Haney-Lopez, a constitutional scholar at the University of California, Berkeley School of Law. “I think we are about to see an even more aggressive stance, not just against affirmative action but limiting anti-discrimination measures themselves.”

The Texas and Michigan cases, while both centering on the government’s use of race, address substantially different issues.

The Texas case, Fisher v. University of Texas at Austin, challenges whether the Constitution permits the university to consider race in order to achieve diversity when admitting students.

But Schuette v. Michigan Coalition to Defend Affirmative Action deals with whether a ban on affirmative action in the state constitution — adopted in a statewide vote in 2006 — violates the 14th Amendment because it discriminates against racial minorities. The U.S. Court of Appeals for the Sixth Circuit ruled that subjecting the use of race to a popular vote that can only be overturned if racial minorities can convince a majority of the population to change their vote deprives racial minorities of equal protection under the Constitution.

William Eskridge Jr., a Yale University constitutional law scholar, said the timing might be unexpected but that this type of case is tailor-made for this Supreme Court.

“This is the classic case where the Roberts court would grant cert,” he said. “It’s a liberal ruling by one of the courts of appeals overturning a populate initiative or statute that is objected to by racial minorities. That is the sort of case four members of the Supreme Court are strongly opposed to.”

But Eskridge said taking this case likely means that whatever the Supreme Court rules in the Texas case will not affect Michigan’s.

Several legal scholars agree that the exact nature and reach of the coming rulings likely hinge on one man: Justice Anthony Kennedy.

Chief Justice John Roberts, along with Justices Clarence Thomas, Antonin Scalia and Samuel Alito, make up what is widely regarded as the most conservative bench in seven decades, and they have made it clear they would like to strike down any use of race by the government — whether that involves voting laws, education or employment. The liberal judges are expected to vote to uphold such cases to address both the legacy of discrimination and current inequalities.

In recent years, the conservative-leaning Kennedy has planted himself in the court’s middle ground, consistently narrowing the use of race to address racial inequalities while still allowing for it in some limited instances.

“Kennedy is the crucial decider,” said John O. McGinnis, a constitutional law scholar at Northwestern University.

The court’s decision to take the Michigan case so close to an expected decision in the Texas case could signal that Kennedy once again has declined to side fully with his conservative brethren on the court.

“The most plausible explanation really is that the court is not going to end this all the way primarily because of Kennedy,” Connerly said.

In the Michigan case, voters passed a ballot measure that amended the state constitution to prohibit the use of race in college admissions and government contracting and hiring. Opponents filed suit, arguing that singling out race for a constitutional ban and not other factors discriminated against racial minorities.

“It put up a specific roadblock for minorities,” McGinnis said. “It’s an issue that goes to state power. It is a different issue from Fisher. That question was whether a state could give some preferences to minorities. This is can they ban it.”

Haney-Lopez said the issue is broader than that. “This is not about whether a state can end affirmative action or not; they clearly can,” said Haney-Lopez. “It’s about whether they can prohibit supporters of affirmative action from going to the legislature like other groups, whether the voters of Michigan can close the doors of government to supporters of affirmative action.”

Kennedy, it turns out, wrote the decision striking down a constitutional amendment passed by ballot measure in Colorado that would have banned state and local government from passing laws protecting gays from discrimination. Kennedy wrote that the amendment imposed a “special disability” on gay Americans because they could only gain civil rights protections by convincing enough citizens to vote to amend the state constitution in their favor.

This is the same reasoning that the Sixth Circuit used in a split decision overturning Michigan’s constitutional ban on affirmative action.

But Eskridge, the Yale professor, said Kennedy may not necessarily be the only conservative justice standing in the way of a sweeping, precedent-obliterating decision that outlaws any use of race by government to help racial minorities. Robert’s unexpected yet critical vote upholding President Obama’s Affordable Care Act shows that he has softened some of his earlier hardline views because he has grown increasingly concerned about exposing the court to charges of political activism, he said.

“He is more sensitive to the charge that the court is interfering to trump the political process,” Eskridge said.

With that said, the two affirmative action cases should be viewed along with another — the Voting Rights Act challenge the court also took up this term — as evidence of the court aggressively moving to confront the issue of whether race remains a category that should trigger government intervention, experts say.

For Connerly, it’s a long-hoped-for moment. “The country has reached a place where we believe it is morally wrong to discriminate against anyone based on race,” he said, referring, in this instance, to whites.

But Haney-Lopez sees the court’s actions as signaling a new nadir when set against the long history of the Supreme Court’s role in ensuring opportunities for racial minorities.

“They are crafting new jurisprudence around race and equal protection,” he said. “We’re in a period where the more hostile contours of this new equal protection will soon crystalize.”

Correction: This post originally said that both the Texas and Michigan cases center on a university’s use of race in admissions decisions. In fact, they both center on the government’s use of race.
http://www.propublica.org/article/another-race-case-for-a-hostile-court

New Prostate Cancer Tests Could Reduce False Alarms


Cancer Diagnosis: Less Can Be More: Dr. Peter Scardino of Memorial Sloan-Kettering Cancer Center says current prostate cancer screening is painful and imprecise but vastly improving.

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By 
Published: March 26, 2013

Sophisticated new prostate cancer tests are coming to market that might supplement the unreliable P.S.A. test, potentially saving tens of thousands of men each year from unnecessary biopsies, operations and radiation treatments.

Some of the tests are aimed at reducing the false alarms, and accompanying anxiety, caused by elevated P.S.A. readings. Others, intended for use after a definitive diagnosis, examine the genetic workings of the cancer to distinguish dangerous tumors that need treatment from slow-growing ones that might be left alone.

The tests could provide a way out of the bitter debate over whether healthy men should be screened for prostate cancer.

The problem with the P.S.A. blood test is that many of the cancers it detects are unlikely to cause harm. But there is no reliable way to identify them. So a large majority of men with positive tests undergo surgery or radiation treatment, and many suffer for years, needlessly, from complications like incontinence and erectile dysfunction.

In late 2011, the United States Preventive Services Task Force, a government advisory body, provoked a furor by recommending against screening, saying that far more men were harmed by unnecessary biopsies and treatments than were saved from dying of cancer.

But if new tests can better determine risk, screening could become more useful.

“It’s not that screening doesn’t work; it’s that we haven’t done a great job of targeting treatments for the tumors that need it,” said Dr. Matthew R. Cooperberg, an assistant professor of urology at the University of California, San Francisco who has been a consultant to some of the testing companies.

Reducing unnecessary treatments could also reduce the $12 billion in estimated annual spending related to prostate cancer. Test developers hope that such savings will make their tests cost-effective, even at prices that will exceed $3,000 in some cases.

More than a dozen companies have introduced tests recently or are planning to do so in the near future. Rather than looking at a single protein like P.S.A., which stands for prostate-specific antigen, many of these tests use advanced techniques to measure multiple genes or other so-called molecular markers.

“It’s the cancer for the next 18 to 24 months that will be transformed by molecular markers,” said Dr. Doug Dolginow, chief executive of GenomeDx Biosciences, a start-up planning to introduce a test later this year.

Experts caution that it is too early to tell how well most of the tests will perform and whether they will make a difference. Although the tests are intended to help men make treatment decisions, the onslaught of so many could cause more confusion.

“It’s a little tricky to find out which one applies to you and whether it will be paid for by insurance,” said Jan Manarite, who runs the telephone help line for the Prostate Cancer Research Institute, a patient education organization.

Prostate cancer specialists say screening has declined since the task force recommended against it, but millions of men in the United States still get regular blood tests to measure P.S.A. As many as a million have biopsies each year, with about 240,000 prostate cancer cases diagnosed and 28,000 deaths from the disease.

The biggest battle among test developers could be between Genomic Health andMyriad Genetics, which are moving into the prostate cancer field after successes in breast cancer testing.

Myriad is known for its test for genetic mutations that raise a woman’s risk of getting breast cancer. Genomic Health’s Oncotype DX test helps determine if a woman should receive chemotherapy.

Both companies have developed prostate tests analogous to Oncotype DX. They analyze gene activity levels in the tumor sample obtained by biopsy to gauge how aggressive the cancer is, helping doctors and patients decide whether to treat it. The companies say their tests provide better information than the Gleason score, the main tool now used to assess tumor aggressiveness, which is based on how cells look under a microscope.

One study of Myriad’s test looked at stored biopsy samples from 349 British men who were found to have prostate cancer from 1990 to 1996 and did not receive immediate treatment.

About 19 percent of the men with the lowest risk scores on Myriad’s test died from prostate cancer within 10 years, compared with 75 percent of the men with the highest risk scores, according to results published last year in the British Journal of Cancer.

Still, some prostate cancer specialists say the test, which is called Prolaris and went on sale last year, has not been adequately validated, and sales have been very low. Noridian, the Medicare contractor for Utah, where Myriad is based, said it would not pay for the $3,400 test.

Genomic Health says it plans to start selling its test, the Genomic Prostate Score, after releasing supporting data at the American Urological Association’s annual meeting in May.

Insurers might be reluctant to pay for the new tests without evidence that men will trust the results enough to forgo treatment if so indicated. The tests still leave some uncertainty, and many men do not want to live with cancer, no matter how slight some test says the risk is.

“We already know from conventional information that there are a group of men who are very unlikely to have progression, but they still get treated,” said Dr. Lee N. Newcomer, senior vice president for oncology at UnitedHealthcare.

Angel Vasquez, for example, resisted when his urologist told him that he could forgo treatment based on his low Gleason score and P.S.A. levels.

“I said, ‘No, my philosophy is if there is something in my body that is not supposed to be there, I want it to come out,’ ” said Mr. Vasquez, 67, of Matthews, N.C.

The doctor ordered Myriad’s Prolaris test. Rather than justifying a decision to watch and wait, the test showed the tumor to be more aggressive than thought, a finding later confirmed after Mr. Vasquez had surgery.

“Had I left it alone, it would have really progressed,” he said.

Some experts say that even if the new tests are not perfect, they are better than what is available now.

“Even if we can only convince 15 to 20 percent of men that we have enough confidence that they don’t need to be treated, that will be a big step forward,” said Dr. Eric A. Klein of the Cleveland Clinic, who has worked with Genomic Health.

Another company, Bostwick Laboratories, already sells a tumor aggressiveness test called ProstaVysion, and Metamark Genetics is developing its own.

GenomeDx is focusing on a test that would be used after surgery to help determine whether additional treatment with radiation or drugs would be useful. Danaher already sells such a test.

HologicMDxHealth and Mitomics sell tests that they say can reduce the number of unnecessary second biopsies, which are often done when a first biopsy is negative but P.S.A. levels remain high.

Opko HealthBeckman Coulter and Metabolon are developing tests that would be used in conjunction with P.S.A. screening. Because P.S.A. levels can be elevated for reasons other than cancer, as many as three-quarters of biopsies do not find cancer — and the biopsies can cause pain and infections.

One published study showed that Opko’s test could have reduced unnecessary biopsies by about 50 percent, though it would have missed 12 percent of high-grade cancers.

Yet another test could come from the discovery by researchers at the University of Michigan that a particular fusion of two genes is found in half of prostate cancers, and only in prostate cancer.

“You’d still miss 50 percent of the disease, but at least you know if you have it you have prostate cancer,” said Dr. Arul M. Chinnaiyan, a professor of urology and pathology. He said a urine test was being developed that combines the gene fusion with PCA3, another marker.

Some experts say unnecessary procedures can be reduced simply by using the P.S.A. test less frequently, and also by improving imaging. The new tests are “singles and doubles at best,” said Dr. William J. Catalona, director of the prostate program at Northwestern University, who helped bring the P.S.A. test to market in the 1990s. But, Dr. Catalona said, this is only the start. “This field is moving kind of like cellphones,” he said.

`http://www.nytimes.com/2013/03/27/business/new-prostate-cancer-tests-may-supplement-psa-testing.html?ref=health&_r=0