The Legacy of the New Deal
Bill Novelli is CEO of AARP, a membership organization of 40 million people age 50 and older, half of whom remain actively employed. AARP’s mission is to enhance the quality of life for all as we age. Prior to joining AARP, Mr. Novelli was President of the Campaign for Tobacco-Free Kids, whose mandate is to change public policies and the social environment, limit tobacco companies’ marketing and sales practices to children and serve as a counterforce to the tobacco industry and its special interests. He now serves as chairman of the board. He was also Executive Vice President of CARE, the world’s largest private relief and development organization.
Mr. Novelli is a recognized leader in social marketing and social change, and has managed programs in cancer control, diet and nutrition, cardiovascular health, reproductive health, infant survival, pay increases for educators, charitable giving and other programs in the U.S. and the developing world. His book, 50+: Give Meaning and Purpose to the Best Time of Your Life, was updated in 2008. Mr. Novelli serves on a number of boards and advisory committees. He holds a B.A. from the University of Pennsylvania and an M.A. from Penn’s Annenberg School for Communication, and pursued doctoral studies at New York University.
Question: Are we headed for Social Security and Medicare crises?
Bill Novelli: Social Security and Medicare are problems. They’re problems waiting to happen. If you look at Social Security first of all, we’re gonna have a problem in about 10 years. Right now we’re sort of in surplus, but the Congress is spending the surplus money. And what we need to do is we need to look at both sides of the Social Security equation. We need to figure out a way to get more revenues into the system, and a way to adjust the benefits. We’ve got to take into account longevity. Social Security was set up when, you know, people lived to be 65. Now they live to be 85. And so we need to do something about that. But this is . . . this is not rocket science. This is something that we could do if we sat down and the two parties reasoned together. And so that’s what . . . that’s what makes it so frustrating. From a Medicare standpoint, Medicare is not sustainable in its current form; but that’s because healthcare is not sustainable in its current form. Medicare is kind of a subset of healthcare. And it’s the healthcare system that we have to fix.
Question: How can we fix Social Security and Medicare?
Bill Novelli: Social Security is . . . as big as it is, it’s the easy one. What we could do is get the two parties together. And what I’ve been saying in Congress is, “Look. It’s going to take two miracles to fix Social Security. One miracle is that you Republicans and Democrats are gonna have to sit down at the same table, and reason together, and come up with a fair, equitable plan for long term solvency. And the second miracle is that the public is gonna have to buy it.” And I think that AARP can help deliver on that second miracle. When we go out and talk to our members and other, you know, elements of the public, we lay out social security. We tell them what the problems are, and they are willing to engage. It’s not the third rail that politicians like to talk about. So we can get that one done. Political will is what we need. The other one, Medicare, as I say . . . the conversation we had on . . . on healthcare is where we have to go. We’ve gotta squeeze down costs, which we can do. We’ve gotta cover the uninsured, which we can do. And we’ve gotta improve quality of care through things like health information technology and electronic prescribing so that we cut down the errors in healthcare and improve the quality of care. We can do all these things, but it’s very hard because of the complexity of the system, and because of the political stalemate in which we find ourselves.
Question: Should we raise the retirement age?
Bill Novelli: It’s a tough question. People do not like that idea. Now you know if you’re 41 or under right now, you’re gonna have to work ‘til you’re 67. But at the same time, many people want to work into their older years. There’s another way to think about it which has been called “longevity indexing”. And some countries do this. And what they basically say is, “Okay. Let’s actuarially figure out how long you’re expected to live. And we’ll give you your Social Security money stretched over that period of time.” So you will get less money per year over a longer period of years. That’s one way to think about it. There are a lot of ways to consider fixing the system.
Recorded on: 9/27/07
New Deal reforms have become obsolete, our surplus is running out and our Medicare system is no longer sustainable, Bill Novelli reports.
A new method promises to capture an elusive dark world particle.
- Scientists working on the Large Hadron Collider (LHC) devised a method for trapping dark matter particles.
- Dark matter is estimated to take up 26.8% of all matter in the Universe.
- The researchers will be able to try their approach in 2021, when the LHC goes back online.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
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