The numbers about the superstorm's effects keep getting worse. Officials say that nearly 13 million people were affected by Typhoon Haiyan, with at least 4 million left homeless, and that some haven't been reached yet on remote islands.
Far too many doctors in the U.S. prescribe brand-name drugs when generics can be dramatically cheaper. When it comes to lower-income Medicare patients, it can be the taxpayer who covers the difference in price -- up to hundreds of millions of dollars a year. ProPublica senior reporter Tracy Weber has been gathering data about the cost of prescription drugs to the taxpayer, and tells Marketplace Morning Report host David Brancaccio what she found."Medicare has a massive prescription drug program called Part D. It issues one in four prescriptions written in the country every year, and we took a look at the money involved. And we noticed that some doctors were outliers. They were prescribing way more expensively than their peers -- just a small group of these doctors, 900 doctors, were prescribing $1 billion worth of drugs a year. And when we looked closer at these doctors, they had huge percentages of brand name drugs. So while their peers were prescribing 75 percent generics, they were prescribing mostly brand name drugs. We figured out that if those doctors prescribed like their peers, Medicare, every year, could save $300 million just on those doctors."
But why would doctors purposefully prescribe a name-brand over a less expensive, but just as effective, generic?"What we found when we mapped out over the country is there's pockets of doctors who are all prescribing high levels of brand-name drugs, so we went out and talked with these doctors. And, many of them feel, first of all, that the brand-name work better. And many of them, their practices are almost entirely made up of people who are receiving the low-income subsidy. So not only do they not have an incentive, but they believe that the drugs they're prescribing are better."
Weber asked the doctors how they could "feel" a drug is better. She said it boils down to where the doctors are getting their information."We asked the doctors how they received information about the drugs. And many of the doctors said they relied on the representatives from the pharmeseutical companies. And, I must say, when we were visiting them in their offices, often times, there were one, two, three drug representatives lined up at their counters, delivering samples and trying to talk to the doctor. When those drug sales reps come around, they provide studies, but often studies that present their product in the most favorable view. Their job is to get the doctor to prescribe which is often a brand name."
Weber says patients need to be more proactive, and feel free to question their doctors' decisions."Doctors for a long time, this has been sort of the third rail. You're not allowed to ask a doctor what they prescribe. You're not allowed to question that. And, as with all kinds of medical procedures, now hospitals -- as you see -- they have to tell you what their success rates are for certain procedures and such. And you should be able to ask your doctor questions about this. 'Am I getting the drug that has the least amount of side effects? Am I getting the drug that's most cost effective? Am I getting a drug because you got money to speak on behalf of that company?'"
Versions of this story are being co-published by ProPublica, with public radio station WNYC in New York and with Digital First Media web sites and newspapers. ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest.
ProPublica has built a Prescriber Checkup widget – search the prescriber data directly:
Or search online for your doctor’s Medicare prescriptions at projects.propublica.org/checkup/
Last week, the Tennessee Valley Authority announced that it plans to retire eight coal-fired generators. The TVA says more closures could come, and this announcement follows the closures of older coal-fired plants by other electric utilities. So, to what extent is coal actually fading away as an energy source?
Vlad Dorjets is an economist at the United States Energy Information Administration. When utilities retire power plants -- or make plans to -- they file a report with the agency, and he crunches the numbers. He says that of the 1,400 coal-fired generators that existed in 2008, almost 400 will be gone by 2017.
But his models that look past 2017 don’t show the trend continuing very far. Most of the generators going away now are old -- built before 1960. "Basically everything that's going to retire, will retire in the next couple years," he says. "And then you've got a pretty steady fleet."
Even so, by 2020 he estimates that generating capacity from coal will be about 15 percent lower than it was in 2008. That's about half the reduction the Sierra Club would like to see, but it's still a big chunk.
So, what’s taking the place of that coal? "Shale gas, and renewables to a lesser extent," says Marty Rosenberg editor-in-chief of Energy Biz Magazine.
He thinks shale gas looks like a reliable source for some time to come. But, he says, there's no such thing as a sure thing. "You say it’s a hundred-year supply for sure -- then, sure enough in two, three years, something will happen."
After China issued its 20,000-word reform document Friday night, the media’s focus was on proposed changes to the one-child policy. But there were a slew of other ambitious economic reforms announced.
It’s easy to get lost among the sixty points of reform in a document laced with exaggerated Communist lingo, but there were a handful of proposals that encouraged economists. For example, proposals for private investors to start their own banks, farmers to sell their land, and local governments to collect property taxes so that they don’t have to confiscate residents’ land for revenue.
“There seems to be this consensus among the leadership that they need to move in the direction of a more open and a more competitive and more accountable economic and financial system, which is a good thing," says Patrick Chovanec, chief strategist at Silvercrest Assett Management. On the other hand, "There is a big difference in announcing reforms and implementing them.”
For example, China’s already attempted allowing private investors to start their own banks in the city of Wenzhou and has also started to collect property taxes in pilot programs in select cities around the country. None of these efforts have produced results.
The other concern: If China’s government actually follows through on these reforms, it’s likely slow economic growth, threatening one of the few bright spots in the global economy.
Holiday shoppers beware. That "great deal on the internet" may just be counterfeit. The amount of fake merchandise is proliferating.
For an added twist, it's not just the fake products you need to watch out for. Fake websites also try to trick consumers. As Americans have shifted to shopping online, the bad guys have adapted. Some have cut out the middlemen and are now selling counterfeit products directly to unsuspecting consumers online.
“Criminals have begun to set-up counterfeit websites that look and are designed to appear as they are the legitimate retailers’ websites, but are not," says Lev Kubiak, who directs Homeland Security’s National Intellectual Property Rights Center.
For example, a fake website for Tiffany looks just like the luxury jeweler's real website. And if you're shopping for headphones, the fake site for Beats by Dre is almost identical to the original.
And this new tactic comes as officials also see growth in the number and variety of counterfeit products.
“It’s a very serious problem," says Kubiak. "The extent of the issue has been growing significantly.”
Criminal organizations are defrauding American consumers on a more regular basis, says Kubiak.
“And we’re seeing them in larger and larger numbers throughout the United States.”
A visit to the Port of Long Beach shows just how hard counterfeits are to stop. At a customs warehouse, the contents of 44-foot cargo containers are spread across the concrete floor. In the past, criminals sent their fake goods in bulk.
“We used to see five, six, seven containers of the same merchandise," says Jaime Ruiz, a spokesman for Customs and Border Protection. "Now what we see is that they mix some of their products, some of their counterfeits, with legit products as well.”
Customs officers confiscate the knock-off brands you might expect. Like Prada, Chanel, Gucci, Hermes and Louis Vuitton.
Nationwide, in 2012, customs saw 142 percent increase in the number of fake wallets, purses and handbags.
“I’ve learned more about handbags than I ever wanted to know,” says Peter Green, section chief of trade operations with U.S. Customs and Border Protection.
But the most troubling fakes are the unexpected ones. Counterfeit electrical cord can cause a shock or start a fire under the Christmas tree.
Even brands of batteries get impersonated. Fake Duracells even incorporated the Energizer Bunny in the packaging.
“It’s possible for them to explode," says Green, "which they have in the past.”
Counterfeit toothpaste and shampoo can carry harmful bacteria.
“Criminal organizations involved in the sale of counterfeit merchandise have really expanded into literally every name-brand product out there,” says Lev Kubiak.
Surprising counterfeit items include software from the company Rosetta Stone, which teaches people to learn foreign languages.
“They estimate that they lose up to 25 percent of their total annual revenue to counterfeit versions of their product,” Kubiak says. “That, in turn, equates to fewer jobs. Fewer people they can employ.”
Auto parts are a popular target for counterfeiters, who crank out fake brake pads, fake master cylinders, fake seat-belt-actuators and fake air bags.
Officials believe about 15,000 fake air bags have been sold in the U.S.
Tests of counterfeit air bags found that many didn’t deploy. And about 20 percent of cases, Kubiak says, they “explode like a small bomb, shooting a three-and-a-half foot flame.”
Officials have found fake bearings that operate a mine-shaft assembly. Counterfeit parts have even found their way into the military supply chain.
Fakes could be on your medicine shelf.
Kubiak says some Americans are being sold counterfeit pharmaceuticals, “thinking that it’s the real drug, but there’s actually no active ingredient inside there, so absolutely no way for people to get better. Even in such cases like cancer medication.”
To avoid buying a fake, try to avoid visiting an imposter website. Type in the web address directly instead of clicking on a link.
And Kubiak warns to watch out for websites that redirect you to another site when it's time to pay. That’s a sign of a counterfeiter.
Also, when trying to avoid fakes, watch out for prices that are significantly lower than average. And check with the product’s maker to confirm that a particular merchant is a trusted distributor.
It was a deadly combination: Winter jet streams collided with warm and moist air. Twisters flattened subdivisions in Washington, Ill., and tore through farming communities. The destruction spread to other states across the upper Midwest. Six deaths have been reported in Illinois, two in Michigan.
The Federal Communications Commission was started in 1934, long before the internet. But more and more, it's a government organization expected to play referee in the online world.
As a former high powered lobbyist, new chairman Tom Wheeler has a reputation as a Beltway insider, and critics have derided him for the perception that he is too cozy with the industry. Wheeler says his detractors should think of him now lobbying on behalf of all Americans in the way he once lobbied for the cable and wireless industries.
"I'm proud of my previous time working with two dynamic and growing industries, and I hope that I was a good advocate for them," he says. "Today, the American people are my client, and I want to be the best possible advocate for the American people."
Wheeler used to lobby for broadcasters and telecom companies. One big challenge he's facing is net neutrality -- whether internet service providers can restrict or degrade access to online services from competitors.
One of the immediate things on his list, though, is the country's shrinking spectrum for our multiplying mobile devices.
To address the issue, the FCC voted this fall to re-purpose the spectrum from TV broadcasters for wireless networks. Broadcasters will voluntarily sell their part of the spectrum back to the federal government, which in turn will auction it off to wireless broadband providers.
"That, hopefully, will be a marketplace means of determining what the highest and best use of the spectrum is, and then we will take that spectrum -- which we have bought back -- and resell it to the wireless carriers to be able to meet the climbing demand for wireless services," Wheeler says.
During his first day on the job, Wheeler got notice for a blog post about the covenant between networks and the people they connect. Writing that we are in the middle of "the fourth great network revolution" in history, Wheeler says the FCC must adapt to networks since they’re evolving more rapidly than ever before.
"I think that one of the things we have to make sure is that technology doesn't change the basic relationship between networks and those that use them," Wheeler says. "Concepts like the right of access to a network, the need for networks to interconnect, that the values that consumers always come to rely on from their networks are preserved."
How the regulatory agency will weigh in on the ongoing debate over net neutrality could be one of Wheeler’s defining legacies in the role. But if you want to know what his thoughts are, he'll give you a rather neutral answer.
"Access, indeed, is one component of the network compact, and it takes all kinds of forms. There's access to a network itself through a broadband network -- if you're out in a remote area, how do you get access to the network? It is making sure that the rights of consumers are not denied, because if theirs are denied, then their access is de facto denied."
Have trouble understanding Bitcoin? So does Congress. A Senate committee opens an exploration today of how virtual currencies work and how they could contribute to the economy and society -- or do quite the opposite.
Why use a virtual currency? George Peabody, a senior director at Glenbrook Partners, a consulting firm, gives an example: Two suppliers who know each other well could benefit from a payment system like Bitcoin, where they interact with one another directly.
“They could start could sending payments to eachother over what we call Bitcoin rails, that’s a payment rail," he says, "which could be a great deal less expensive than going to their bank and wiring funds.”
Bitcoin cuts out the middle man. That’s one of the things Congress is concerned about -- if there’s no bank, there’s a potentially greater chance of money laundering or other unsavory activity. There could be more mundane headaches for consumers, too.
“You and I can dispute a transaction and charge it back to a merchant and get it taken off of our credit card bill," Peabody says. "That won’t exist in Bitcoin.”
Still, Peabody says, Bitcoin is a worthy experiment, one that needs time to evolve before regulators clamp down.