How curbing health care spending will affect the deficit

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Rapidly growing health care costs have been a major driver of federal budget deficits. Could a decline help solve the nation's long-term fiscal problem?

Rapidly growing health care costs have been a major driver of actual and projected federal budget deficits and the national debt. In recent years, the rate of growth in medical spending has slowed, leading many to ask whether a permanent decline could solve the nations long-term fiscal problem.

The Tax Policy Center is a joint venture of the Urban Institute and Brookings Institution. The Center is made up of nationally recognized experts in tax, budget, and social policy who have served at the highest levels of government. TaxVox is the Tax Policy Center's tax and budget policy blog.

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Along with University of California at Berkeley economist Alan Auerbach,we recentlyexaminedthe role of health spending in budget projections. Our conclusions: Yes, a long-term slowdown in medical cost growth could have a dramatic positive impact on future deficits. But no decline within the realm of our historical experience could fix the nations fiscal imbalance.

We take no position on whether the current slowdown will continueand, in fact,recent evidencesuggests costs may again be bumping up. Rather, we incorporated different health cost scenarios into a budget calculator to see how they change fiscal outcomes.

We did this by modeling a range of possible changes in health spending using a concept known as excess cost growth or ECG. The Center on Medicare and Medicaid Services defines this measure as the growth rate of health spending after adjusting for population aging, sex composition, and overall economic growth. Thus, excess cost growth captures the rate of growth in both per-person utilization and prices, controlling for demographics and the economy. Absent demographic changes, excess cost growth of zero means that health care spending would grow at the same rate as GDP.

Annual excess cost growth has averaged1.9 percent between 1975 and 2011, but has varied a lot; the five-year averages range from -0.3 percent in 19952000 to 2.7 percent in 20002005. The overall rise in excess cost has been driven by a diverse set of factors, including improved medical technology, expanded health insurance coverage, and growth in personal incomewhich increased utilization.

ECG has been lower recently, averaging 1.3 percent in 2005-11, and many believe this could be the beginning of a new long-term trend. For example, the Congressional Budget Office recentlyrevised downwardsits tenyear estimates of Medicare and Medicaid spending.

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How curbing health care spending will affect the deficit

'Alien' DNA used to create life

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A scientific breakthrough has expanded the way genetic information can be stored.

STORY HIGHLIGHTS

(CNN) -- All of life as we know it on Earth -- pigs, pandas, fish, bacteria and everything else -- has genetic information encoded in the same way, with the same biological alphabet.

Now, for the first time, scientists have shown it is possible to alter that alphabet and still have a living organism that passes on the genetic information. They reported their findings in the journal Nature.

"This is the first experimental demonstration that life can exist with information that's not coded the way nature does (it)," said Floyd Romesberg, associate professor of chemistry at the Scripps Research Institute in La Jolla, California.

Medicine can greatly benefit from this discovery, Romesberg said. There's potential for better antibiotics and treatments for a slew of diseases for which drug development has been challenging, including cancers.

The findings also suggest that DNA as we know it on Earth may not be the only solution to coding for life, Romesberg said. There may be other organisms elsewhere in space that use genetic letters we have never seen -- or that don't use DNA at all.

"Is this alien life? No," he said. "Does it suggest that there could be other ways of storing information? Yes."

How they did it

For their genetic experiments, Romesberg and colleagues used molecules, called X and Y, that are completely different from the four building blocks of DNA.

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'Alien' DNA used to create life

New DNA cleavage technique could lead to more versatile genetic engineering

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9 hours ago Figure 1: Quantitative base-induced DNA cleavage (QBIC) is a technique that allows DNA to be cleaved at any thymine site. Credit: lvcandy/iStock/Thinkstock

Genetic engineering of plants, animals and microorganisms such as bacteria typically involves the use of restriction enzymes to 'cut and paste' DNA fragments into certain genetic sequence locations. This process allows scientists to introduce new genes into an organism, but is constrained to specific recognition sequences, limiting the design of recombinant DNA molecules.

A research team led by Hiroki Ueda and colleagues from the Laboratory for Synthetic Biology at the RIKEN Quantitative Biology Center has now developed a chemical-based, non-enzymatic recombination technique that instead uses a DNA base analogue called 5-ethynyluracil to cleave DNA at any site containing the nucleotide thymine.

The technique developed by Ueda and his co-workers, which is called quantitative base-induced DNA cleavage (QBIC), starts with the generation of DNA fragments containing 5-ethynyluracil in place of thyminetwo molecules with similar structures. These products are then immersed in an aqueous solution containing methylamine, a derivative of ammonia. In this chemical bath, all the nucleotides containing 5-ethynyluracil become cleaved, introducing gaps near the cleaved ends. The gaps in the resulting DNA fragments create protruding ends that can be inserted into circular DNA molecules known as plasmids. The plasmids can then be inserted into the target organism, such as a bacterial cell, to complete the genetic engineering process.

"Compared with restriction enzymes, the QBIC reaction has the advantage that we can freely design the sequences at the protruding termini generated by the DNA cleavage," says Katsuhiko Matsumoto from the research team. "The experimental procedure for DNA concatenation using the QBIC reaction is also simple," he adds. "DNA can be concatenated by the addition and removal of methylamine, hybridized by heating and cooling, and incorporated into an organismin this case the bacterium Escherichia coli."

Another potential boon of the QBIC method is that it is less sensitive to laboratory conditions than enzyme-based techniques and can be run at room temperature. Being a chemical method, it is also generally cheaper to perform than enzyme-based methods. One limitation of the QBIC method in its present form is that long stretches of DNA can lose their structure after treatment with the methylamine solution, which prevents the two-stranded, helical shape from being restored. Ueda's team is now refining the protocol to extend its ability to handle longer DNA fragments. "If we find a solution to this problem," Matsumoto notes, "the QBIC method would become very attractive for the concatenation of long DNA fragments."

Explore further: New method for mass-producing high-quality DNA molecules

More information: Ikeda, S., Tainaka, K., Matsumoto, K., Shinohara, Y., Ode, K. L., Susaki, E. A. & Ueda, H. R. "Non-enzymatic DNA cleavage reaction induced by 5-ethynyluracil in methylamine aqueous solution and application to DNA concatenation." PLoS ONE 9, e92369 (2014). DOI: 10.1371/journal.pone.0092369

Journal reference: PLoS ONE

Provided by RIKEN

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New DNA cleavage technique could lead to more versatile genetic engineering

Narendra Modi Touched Feet of 114years old freedom fighter Colonel Nizamuddin in Subash Bose Army – Video

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Narendra Modi Touched Feet of 114years old freedom fighter Colonel Nizamuddin in Subash Bose Army
Narendra Modi seeked blessing from 114years old freedom fighter Colonel Nizamuddin from Subash Chandra Bose Army by touching his feet in 2014 Varanasi Rohaniya Rally.

By: Ashok Reddy

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Narendra Modi Touched Feet of 114years old freedom fighter Colonel Nizamuddin in Subash Bose Army - Video

Abebe Gellaw interrupted Obama and Obama agrees with Ethiopia’s call for freedom – Video

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Abebe Gellaw interrupted Obama and Obama agrees with Ethiopia #39;s call for freedom
Breaking News: Abebe Gellaw interrupted Obama and Obama agrees with Ethiopia #39;s call for freedom...San Jose, California--U.S. President Barack Obama has agreed with journalist Abebe Gellaw #39;s...

By: Save Ethiopia

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Abebe Gellaw interrupted Obama and Obama agrees with Ethiopia's call for freedom - Video

Freedom of voice

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The Cushion in the Road ALICE WALKER, THE NEW PRESS, $22.99 | The World Will Follow Joy, ALICE WALKER, THE NEW PRESS, $18.99

Powerful polemicist: Alice Walker challenges readers to end literary segregation. Photo: Jade Wittmann

The one thing I hope to avoid when writing about Pulitzer Prize-winning author Alice Walker and her two new books is categorising her as a ''black writer'' or even as a ''black feminist writer''. Being black, and a radicalised and radicalising peace-making woman, is central to Walker's consciousness and subject matter. She has for more than 40 years articulated through her fiction, poetry and essays the many experiences she understands from that illuminating perspective. But in a culture as lazily stereotyping as our own, especially when it comes to race, it would be a grave disservice to put Walker on a specialist shelf as though being a ''black writer'' was in some essential way different from being a ''white writer''.

In an essay written in 2010 and reprinted in her new collection, The Cushion in the Road, Walker reports that while searching for audiobooks she discovered, that on Kindle and Amazon websites, ''books by black authors [but not by authors from Iran, Japan, Ireland, England, India, China, Israel, Korea, Tibet, etc] are segregated by race''. She continues: ''Recalling the child I was, who was not allowed into the public library of Eatonton, Georgia, I think of children, especially, who will receive a subliminal message that somehow literature by African Americans isn't really Literature. That it is a separate and smaller, i.e. lesser, creation.''

In the same essay, Loving Audiobooks But Not Segregation, just one of many soul-stirrers in this richly provocative book, Walker challenges us: ''The responsibility for changing literary segregation rests with readers. Would you drink from a segregated water source? Eat in a segregated restaurant? Buy a dress where I could not try one on? Buy a book where black writers are discriminated against?''

The Cushion in the Road, by Alice Walker.

Race, she repeatedly shows, trumps gender as an issue in politics, also. ''It's hard,'' Walker writes in the earliest of her essays on the complex ''making'' of President Obama, ''to relate what it feels like to see Mrs Clinton (I wish she felt self-assured enough to use her own name) referred to as a woman while Barack Obama [then a candidate and Clinton's rival] is always referred to as a black man.''

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Walker is a powerful polemicist. This is not least because she uses here, as elsewhere, a poet's privileges of insight and originality. In Coming to See You Since I Was Five Years Old, first given as what must have been a sensational Steve Biko Memorial Lecture in Cape Town in 2010, she tells us, ''I am re-embracing poetry as a priority Poetry is the lifeblood of rebellion, revolution, and the raising of consciousness. And it is the raising of consciousness that is the most effective way to ensure lasting change Once our consciousness changes, so does our existence.''

Walker's fame, though, and her immense freedom of voice, come from her fiction, especially from her 1982 mega-selling novel, The Color Purple, later made into a film by Steven Spielberg. At the time Walker wrote the book, the literary segregation of which she writes was thriving. Taken as self-evident, it was almost impossible to challenge.

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Freedom of voice

Tier 4 Excavators offer fuel efficiency, advanced instrumentation.

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The new Tier 4-compliant E32i and E35i have been designed as additional offerings from Bobcat Company in the 3-ton class of compact excavators. The E32i and E35i are appealing options for rental customers and first-time equipment buyers. These two 24.8-horsepower excavators feature a direct-inject, 1.7-liter, naturally aspirated diesel engine that provides exceptional fuel economy while maintaining performance expectations for buyers in this excavator class.

Increased fuel efficiency

The E32i conventional tail swing model and the E35i Zero Tail Swing excavator are ideal for operating in confined areas. Additionally, these M-Series machines will provide exceptional fuel efficiency to reduce operating costs up to an 8 percent decrease in fuel consumption when operating in the machines Eco Mode.

Extendable arm advantage

Both Tier 4 excavator models can be equipped with the optional extendable arm, which is a telescoping arm that provides the best of both worlds power and reach. The extendable arm option provides additional reach beyond the standard arm, and allows for the use of a hydraulic clamp, something not possible with any other compact excavator extendable arm on the market. The clamp capability is an ideal solution for contractors wanting to pick up and place material such as rocks, landscaping materials and debris in site preparation applications.

Forward-mount instrumentation improvements

A new forward-mount instrumentation system designed for enhanced functionality and improved ergonomics is being introduced with the E32i and E35i. The new forward location allows the operator to maintain awareness of machine vitals without losing focus on the task at hand and also improves ergonomics when the operator is interacting with the panel. This instrumentation system presents operators of Bobcat excavators with many of the functions, aesthetics and visibility theyve come to enjoy with Bobcat loaders. From the operators viewpoint, the location of the panel also aligns with the existing cab components and work group structures to maintain visibility to the attachment.

An available deluxe instrumentation panel includes an integrated keyless start system that provides for one assignable owner code, and up to eight operator codes. The deluxe panel also provides an Eco-Mode setting, access to fuel consumption data, attachment operating tips and detailed engine and hydraulic systems information. The M-Series excavators optional deluxe instrumentation panel features multi-lingual functionality, similar to other Bobcat products.

M-Series machines

Like all M-Series excavators, these new Tier 4-compliant models feature convenient fingertip activated control of the boom swing function and auxiliary hydraulic circuits. Features such as auto-idle throttle and auto-shift travel are standard equipment for the new excavators. Auto-idle throttle contributes to reduced fuel consumption and easier communication between the operator and workers. The excavator will automatically idle the engine when the machine functions are not used for approximately four seconds, saving valuable fuel. Auto-shift travel automatically shifts the machine out of high range without having to manually downshift.

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Tier 4 Excavators offer fuel efficiency, advanced instrumentation.