Stay Free! Daily

McDonald's Sends Condolences

I live in Prospect Lefferts Gardens, the Brooklyn neighborhood where Officer Timoshenko was killed.

Timoshenko's death is a tragedy and people respond to tragedy in different ways. For instance, a number of people on a neighborhood listserv collected cards and brought them to the 71st Precinct.

The local McDonald's flew it's its flag at half-mast. It's Its McDonald's flag.

At the risk of seeming insensitive, it looks like Mayor McCheese died.

Pharma Fond of Fraud-Committing Physicians

Sunday's New York Times had a mindbending article about the way drugs are tested in this country. Apparently, doctors who have been disciplined for fraud are finding second careers running clinical trials for drug companies. One such doctor, before being hired directly by drug companies, was cited by the FDA for violating protocol in every study he managed! When a suicidal patient refused to be enrolled in one of his trials, he discharged the patient from his hospital—and the patient committed suicide shortly thereafter. It's as if facility with fraud is a bona fide occupational qualification for running a pharma trial.

Meanwhile, take a wild guess what many of the other doctors hired to run drug trials were disciplined for... if you said "overprescribing," you win!

Gene Carbona, who left Merck on good terms in 2001 as a regional sales manager after 12 years in drug sales, said the only thing the company considered when hiring doctors to give marketing lectures was “the volume or potential volume of prescribing that doctor could do.” ... Mr. Carbona, now executive director of sales for The Medical Letter, which reviews drugs, said that had he known that a doctor had a disciplinary record for excessive prescribing, “I would have been more inclined to use them as a speaker.”

One Love, One Bank

Oh, I'm crying here...

At first, you might think this is just another hilariously awful corporate anthem (in this case, for Bank of America). But listen close and you'll hear a satirical skewering of the entire body of music called alternative rock. This guy sounds just like an alt.rock star. And with all of his bogus emotion and studied posturing, he could be singing about ANYTHING: world love, Jesus, corporate mergers ... sure, he can do that.

(Thanks, Jay Boucher)

To Catch a Terrorist. Or not.

The Wall Street Journal (what else?) reports that a new Israeli-developed "biometric device" may help airlines identify terrorists by their emotions.

At the heart of the system is proprietary software that draws on Israel's extensive field experience with suicide bombers and security-related interrogations. The system aims to test the responses to words, in many languages, that trigger psycho-physiological responses among people with terrorist intent.

The article continues:

The biggest challenge in commercializing Cogito is reducing false results that either implicate innocent travelers or let bad guys slip through.

In other words, in getting Cogito to work.

U.S. behavior-recognition expert Dr. Ekman... expects technology to advance even further, to devices like lasers that measure people's vital signs from a distance. Within a year, he predicts, such technology will be able to tell whether someone's "blood pressure or heart rate is significantly higher than the last 10 people" who entered an airport.

...so they'll be able to catch my mother. Now if only the robot could figure out a way to differentiate the terrorists afraid of getting caught from the people afraid of terrorists.

Anyway, this reminds me of that awesome documentary The Atomic Cafe, which, if you haven't seen it, is worth renting. By showing us the preposterous advice that the U.S. government promoted about how to stay "safe" during a nuclear attack, the film reveals a lot of similarities between the Cold War era and the current chaos.

Which Travelers Have 'Hostile Intent'?
Biometric Device May Have the Answer
By JONATHAN KARP and LAURA MECKLER
The Wall Street Journal
August 14, 2006; Page B1

At airport security checkpoints in Knoxville, Tenn. this summer, scores of departing passengers were chosen to step behind a curtain, sit in a metallic oval booth and don headphones.

With one hand inserted into a sensor that monitors physical responses, the travelers used the other hand to answer questions on a touch screen about their plans. A machine measured biometric responses -- blood pressure, pulse and sweat levels -- that then were analyzed by software. The idea was to ferret out U.S. officials who were carrying out carefully constructed but make-believe terrorist missions.

The trial of the Israeli-developed system represents an effort by the U.S. Transportation Security Administration to determine whether technology can spot passengers who have "hostile intent." In effect, the screening system attempts to mechanize Israel's vaunted airport-security process by using algorithms, artificial-intelligence software and polygraph principles.

Neither the TSA nor Suspect Detection Systems Ltd., the Israeli company, will discuss the Knoxville trial, whose primary goal was to uncover the designated bad guys, not to identify threats among real travelers. They won't even say what questions were asked of travelers, though the system is generally designed to measure physical responses to hot-button questions like "Are you planning to immigrate illegally?" or "Are you smuggling drugs."

The test alone signals a push for new ways to combat terrorists using technology. Authorities are convinced that beyond hunting for weapons and dangerous liquids brought on board airliners, the battle for security lies in identifying dangerous passengers.

The method isn't intended to catch specific lies, says Shabtai Shoval, chief executive of Suspect Detection Systems, the start-up business behind the technology dubbed Cogito. "What we are looking for are patterns of behavior that indicate something all terrorists have: the fear of being caught," he says.
[The Israeli-developed system combines questions and biometric measurements to determine if a passenger should undergo screening by security officials.]
The Israeli-developed system combines questions and biometric measurements to determine if a passenger should undergo screening by security officials.

Security specialists say such technology can enhance, but not replace, existing detection machines and procedures. Some independent experts who are familiar with Mr. Shoval's product say that while his technology isn't yet mature, it has potential. "You can't replicate the Israeli system exactly, but if you can incorporate its philosophy, this technology can be one element of a better solution," says Doron Bergerbest-Eilon, chief executive of Asero Worldwide consulting firm and a former senior official in Israel's security service.

To date, the TSA has more confidence in people than machines to detect suspicious behavior. A small program now is using screening officers to watch travelers for suspicious behavior. "It may be the only thing I know of that favors the human solution instead of technology," says TSA chief Kip Hawley.

The people-based program -- called Screening Passengers by Observation Technique, or SPOT -- began undergoing tests at Boston's Logan Airport after 9/11 and has expanded to about a dozen airports. Trained teams watch travelers in security lines and elsewhere. They look for obvious things like someone wearing a heavy coat on a hot day, but also for subtle signs like vocal timbre, gestures and tiny facial movements that indicate someone is trying to disguise an emotion.

TSA officers observe passengers while consulting a list of more than 30 questionable behaviors, each of which has a numerical score. If someone scores high enough, an officer approaches the person and asks a few questions.

"All you know is there's an emotion being concealed. You have to find out why the emotion is occurring," says Paul Ekman, a San Francisco psychologist who pioneered work on facial expressions and is informally advising the TSA. "You can find out very quickly."

More than 80% of those approached are quickly dismissed, he says. The explanations for hiding emotions often are innocent: A traveler might be stressed out from work, worried about missing a flight or sad because a relative just died. If suspicions remain, the traveler is interviewed at greater length by a screener with more specialized training. SPOT teams have identified about 100 people who were trying to smuggle drugs, use fake IDs and commit other crimes, but not terrorist acts.

The TSA says that, because the program is based on human behavior, not attributes, it isn't vulnerable to racial profiling. Critics worry it still could run afoul of civil rights. "Our concern is that giving TSA screeners this kind of responsibility and discretion can result in their making decisions not based on solid criteria but on impermissible characteristics such as race," says Gregory T. Nojeim, associate director of the American Civil Liberties Union's Washington legislative office.

Mr. Shoval, the Israeli entrepreneur, believes technology-based screening is the key to rolling out behavior-recognition techniques in the U.S. With experience in counter-terrorism service and the high-technology industry, Mr. Shoval developed his Cogito device with leading former Israeli intelligence officials, polygraph experts and computer-science academics.

Here is the Cogito concept: A passenger enters the booth, swipes his passport and responds in his choice of language to 15 to 20 questions generated by factors such as the location, and personal attributes like nationality, gender and age. The process takes as much as five minutes, after which the passenger is either cleared or interviewed further by a security officer.

At the heart of the system is proprietary software that draws on Israel's extensive field experience with suicide bombers and security-related interrogations. The system aims to test the responses to words, in many languages, that trigger psycho-physiological responses among people with terrorist intent.

The technology isn't geared toward detecting general nervousness: Mr. Shoval says terrorists often are trained to be cool and to conceal stress. Unlike a standard lie detector, the technology analyzes a person's answers not only in relation to his other responses but also those of a broader peer group determined by a range of security considerations. "We can recognize patterns for people with hostile agendas based on research with Palestinians, Israelis, Americans and other nationalities in Israel," Mr. Shoval says. "We haven't tried it with Chinese or Iraqis yet." In theory, the Cogito machine could be customized for specific cultures, and questions could be tailored to intelligence about a specific threat.

The biggest challenge in commercializing Cogito is reducing false results that either implicate innocent travelers or let bad guys slip through. Mr. Shoval's company has conducted about 10 trials in Israel, including tests in which control groups were given terrorist missions and tried to beat the system. In the latest Israeli trial, the system caught 85% of the role-acting terrorists, meaning that 15% got through, and incorrectly identified 8% of innocent travelers as potential threats, according to corporate marketing materials.

The company's goal is to prove it can catch at least 90% of potential saboteurs -- a 10% false-negative rate -- while inconveniencing just 4% of innocent travelers.

Mr. Shoval won a contract for the Knoxville trial in a competitive process. Next year, Israeli authorities plan to test Cogito at the country's main international airport and at checkpoints between Israel and the West Bank, where the goal will be to catch genuine security threats while testing the logistics of using the system more broadly. The latest prototype costs about $200,000 a machine.

Even though his expertise is in human observation, U.S. behavior-recognition expert Dr. Ekman says projects like Cogito deserve a shot. He expects technology to advance even further, to devices like lasers that measure people's vital signs from a distance. Within a year, he predicts, such technology will be able to tell whether someone's "blood pressure or heart rate is significantly higher than the last 10 people" who entered an airport.

Coffee Monster

Fun corporate trivia! That mythical creature depicted in the Starbucks logo is NOT a mermaid. It's a melusine !

After you play with this handy coffee cost calculator by Hugh Chou, you may conclude that the creature is a siren, luring you onto the rocks of financial ruin.

Coffee (TM)

The latest target of Starbucks hyperactive trademark attorneys is Tulsa, Oklahoma's DoubleShot Coffee, a small independent shop and retailer. Starbuck's is claiming the rights to the word "DoubleShot," a term that, if I am doing the math correctly, refers to two shots of espresso. I'm having a hard time believing that Starbucks came up with that recipe.

This isn't the first time Starbucks has tried to trademark a common phrase and bully smaller members of the industry out of using it. For example, Starbucks didn't invent Christmas but they attempted to stop the monks of the All-Merciful Savior Monastery from selling a Christmas blend of their Monastery Blend Coffee. I'm glad to see that the DoubleShot folks intend to fight back; I hope it doesn't cost them too much money.

Starbucks has me cowed. I had planned to launch an eponymous business selling gift cards to independent coffee shops called "Star Bucks," but you are just going to have to make do with cash at a not-Starbucks location near you.

Via Consumerist

Take Two and Pass, Japan!

I hate to break it to you, Ford Motor Company, but the Japanese bogarting all the good hybrid parts is not at the root of your failure to provide fuel-efficient vehicles. I'm going to guess that failure is instead based in a long tradition of not offering fuel-efficient vehicles:

Maximum number of miles that Ford's most fuel-efficient 2003 car can drive on a gallon of gas: 36
Maximum number its 1912 Model T could: 35

(Source)

You MUST pay the rent!

In the wake of the Supreme Court's "anything goes" eminent domain decision in Kelo v. New London, states across the country began reconsidering whether state law should permit such lax, abuse-encouraging standards. Even the Governor of Connecticut has called for a moratorium on the exercise of eminent domain, freezing the development that was at issue in the case.

Meanwhile, what are the developers who won Kelo doing? They're planning to sue the litigants for back rent for the time spent fighting to keep their property. One owner allegedly owes over $300,000. They intend to press this claim even though, according to the residents' lawyer, "the [developer] had agreed to forgo rents as part of a pretrial agreement in which the residents in turn agreed to a hastened trial schedule."

Un-fucking-believable.

(Via Protein Wisdom)

What do pharmaceutical giants and anti-abortion nuts have in common?

The Wall Street Journal reports that drug companies have started putting language in their contracts with medical institutions to shape what doctors can and cannot tell patients about specific drugs.

Case in point: Eli Lilly offers a discount to major purchasers of antidepressant Cymbalta as long as those purchasers refrain from "negative D.U.R. [drug utilization review] correspondence to physicians" or "negative educational counter-detailing" -- in other words, as long as they shut the fuck up about side effects and the drug's high costs.

Kind of ironic considering how PhARMA has been pushing the line that regulating direct-to-consumer advertising is unconstitutional because it inhibits corporations' "free speech." 

pdf of Eli Lilly's contract
Full text of article below the fold:

How Lilly Influences What Prescribers Learn About Cymbalta

By SARAH RUBENSTEIN
THE WALL STREET JOURNAL ONLINE
August 5, 2005; Page B1

From TV commercials to pitches in doctors' offices, drug companies try to cast their products in the best possible light. Some use a far less visible approach: contractual restrictions on what insurers, hospitals and other health facilities can tell doctors about certain drugs.

Drug makers commonly offer price breaks to insurers, hospitals and other medical facilities. In exchange, they often get favorable placement on drug formularies, the lists these entities use to encourage prescriptions of certain products. Some of the contracts go further, restricting insurers and medical organizations from making unflattering statements about the costs and risks of drugs when they communicate with health practitioners.

A case in point is the discount contract Eli Lilly & Co. has offered health facilities in connection with Cymbalta, an antidepressant that the Food and Drug Administration approved last year and that faces competition in some cases from cheaper generics. The contract illustrates tactics that some insurers and prescribers say they find troubling.

The Cymbalta discount contract offers large purchasers of antidepressants a 5% discount, but specifies that they could lose most of that discount if they engage in, among other things, "negative D.U.R. correspondence to physicians."

While not defined in the contract, D.U.R. is industry shorthand for "drug utilization review," a kind of analysis of prescription patterns that insurers often use to identify inappropriate or risky practices and often also to cut costs. Prime Therapeutics LLC, an Eagan, Minn., pharmacy-benefits manager owned by nine Blue Cross Blue Shield plans, used drug utilization reviews to try to reduce what it determined was overprescribing of Vioxx and Bextra, painkillers that were later pulled from the market because of safety concerns.

Some insurers worry that contracts such as Cymbalta's could have a chilling effect, discouraging insurers and other groups from disseminating medically relevant information about the drugs on their formularies -- or discouraging them from pursuing D.U.R.s altogether.

Dale Kramer, director of pharmacy contracting at Kaiser Permanente, the big health-maintenance organization based in Oakland, Calif., says his organization doesn't agree to such restrictive terms.

"If I signed something like that, I think our clinicians ... would be very upset," he says. "Someone on the business side should not have the authority to make clinical commitments for the company they represent."

Nancy Stalker, vice president of pharmacy services at Blue Shield of California, based in San Francisco, says she doesn't think her company would sign a contract with broad language that could permit such interference by a drug maker. "We just don't want the manufacturer to drive what we do," she says. "We want to be able to make the best clinical decision."

Eli Lilly, based in Indianapolis, says it has a legitimate interest in controlling negative D.U.R. communications. Drug-industry executives say many of these types of communications, while ostensibly clinical, often are really designed to cut costs. Insurers or other groups may use these communications to steer doctors toward cheaper drugs that may be inferior to more-expensive competitors.

Tarra Ryker, a Lilly spokeswoman, says the Cymbalta contract isn't meant to stop communications that are "backed up by clinical data" and "presented in a fair and balanced manner."

The company also has contracts with the same language for the antipsychotics Symbyax and Zyprexa. "There are a lot of things that are said to physicians and prescribers that in a lot of cases cannot be backed up with scientific evidence," Ms. Ryker says.

One type of communication that might be disallowed under the contract would be a description of side effects for Cymbalta that didn't also describe its benefits, she says. Another possibility: a side-by-side price comparison between Cymbalta and a generic. A comprehensive list of prices for all antidepressants, however, would be OK, Eli Lilly says.

Others in the insurance industry say the contractual restrictions don't compromise their communications with doctors. Mohit Ghose, a spokesman for America's Health Insurance Plans, an insurance-industry trade group based in Washington, says, "The signing of contracts does not in any way interfere with the ability of clinicians [at insurance companies] to discuss or disseminate information on the appropriateness, efficacy and safety of any given drug."

Eli Lilly says more than 100 medical facilities belonging to the Minnesota Multi-State Contracting Alliance for Pharmacy, a St. Paul-based group purchasing organization including student health services, regional psychiatric treatment facilities and hospitals in many states, are signed on to agreements for Cymbalta this year. Representatives reached at several of the member facilities said they weren't aware of these restrictive terms in their discount contracts. Lilly says it hasn't revoked any discounts among this group for noncompliance with those terms.

The power of the contractual restrictions depends, in large part, on how much credence doctors give to the information they get from an insurer or other medical facility. Larry Fields, president-elect of the American Academy of Family Physicians, of Leawood, Kan., says while doctors generally pay attention to such information, they rely primarily on doctors associations and other sources that "don't have a dog in the fight." Insurers, hospitals and other health facilities are "trying to save money," Dr. Fields says.

Still, some people in the industry see the contract terms as a troubling lever for drug companies to use. Stephen W. Schondelmeyer, a pharmaceutical-economics professor at the University of Minnesota, Minneapolis, worries drug makers could invoke the clause if they suspect a drop in sales is the result of medical questions raised by an insurer or health facility. "I would never say that having a clause in a contract, even if it's not implemented, has no effect," he says. "It has the potential to be acted upon."

Also restricted under the Cymbalta contract is "negative educational counterdetailing." Counterdetailing is the industry name for efforts, often made by insurers, to counterbalance drug makers' sales pitches (which are often referred to as "detailing"). Counterdetailing efforts commonly push patients toward generics or poke holes in drug makers' claims about their products.

People in the drug industry say counterdetailing often serves to steer patients toward cheaper drugs. Counterdetailing "language is probably in everyone's contracts," says Jack Cox, a spokesman for Pfizer Inc., New York. He declines to comment on Eli Lilly's or Pfizer's practices specifically, but adds that insurers and others who make drugs available to patients "will come in with clinical data, but their goal is financial."

Counterdetailing and the D.U.R.s restricted under the Lilly contract are generally communications aimed at doctors and others who prescribe drugs -- not at patients.

The contract says that it isn't meant to preclude an individual physician "from making an independent prescribing decision based on such physician's medical judgment in the best interest of patient care."

Cheers for Costco, Jeers for Honda

Here are two quotes of interest from today's New York Times. There were others, but you're going to have to learn to read the paper for yourself.

First up is a statement by Bill Dreher, an analyst at Deutsche Bank, quoted in "How Costco Became the Anti-Wal-Mart." The article draws a distinction between Wal-Mart's notoriously stingy attitude toward employees and Costco's comparatively generous compensation/benefits package.

"Costco's average pay, for example, is $17 an hour, 42 percent higher than its fiercest rival, Sam's Club. And Costco's health plan makes those at many other retailers look Scroogish. One analyst, Bill Dreher of Deutsche Bank, complained last year that at Costco 'it's better to be an employee or a customer than a shareholder.'"

Now, Mr. Dreher is a Deutsche Bank analyst. His only concern is what Costco's stock is going to do, not how society benefits from companies providing a living wage and health insurance. And we have no reason to believe that Mr. Dreher is opposed to either a living wage or health benefits on principle. But, all that being true, the article says Mr. Dreher "complained." Complained? Kinda makes Bill sound like an asshole, doesn't it?

Second, we have a quote from Honda Accord Hybrid owner Mark Buford in "Hybrid Cars Burning Gas in the Drive for Power." Not following the car world as closely as I should, I learned from this article that Honda's Accord Hybrid doesn't use significantly less fuel than its conventional Accord. Instead, the hybrid components increase the car's performance. So rather than being a more environmentally-friendly car, the Accord Hybrid is just a... very nice car. And Mr. Buford says:

"I wasn't prepared to give up anything to 'go green' -- not performance, amenities, or space."

Given that the typical hybrid car -- Honda Accord included -- costs such a premium that you'll probably never make up the extra cost in gas savings, a buyer has every right to expect reasonable performance, amenities and space. But Mark wasn't "prepared to give up anything"? Anything? Kind of makes Mark sound like an asshole, doesn't it?