Gary Claxton, Cynthia Cox, Anthony Damico, Larry Levitt, and Karen Pollitz
Kaiser Family Foundation
Originally posted December 16, 2016
Here is an excerpt:
Estimates of the Share of Adults with Pre-Existing Conditions
We estimate that 27% of adult Americans under the age of 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under pre-ACA underwriting practices that existed in nearly all states. While a large share of this group has coverage through an employer or public coverage where they do not face medical underwriting, these estimates quantify how many people could be ineligible for individual market insurance under pre-ACA practices if they were to ever lose this coverage. This is a conservative estimate as these surveys do not include sufficient detail on several conditions that would have been declinable before the ACA (such as HIV/AIDS, or hepatitis C). Additionally, millions more have other conditions that could be either declinable by some insurers based on their pre-ACA underwriting guidelines or grounds for higher premiums, exclusions, or limitations under pre-ACA underwriting practices. In a separate Kaiser Family Foundation poll, most people (53%) report that they or someone in their household has a pre-existing condition.
The article is here.
Tuesday, February 21, 2017
Let's not be friends: A risk of Facebook
By Amy Novotney
The Monitor on Psychology
2017, Vol 48, No. 2
Print version: page 18
Here is an excerpt:
Talking to clients about their privacy concerns.
Kolmes advises all clinicians to discuss privacy risks involved in using social media with their clients and to work through how to handle a situation in which a therapist's name pops up under their "People You May Know" tab.
"It's about having clear and open conversations with your clients about what you're going to do to protect their privacy and confidentiality and avoid inviting a multiple relationship, and letting them know they can also discuss this with the therapist if it comes up on their end," Kolmes says. When she does receive a friend request from a client on Facebook, she waits until she sees him or her next in session and checks to see if the request was accidental or not. Regardless of whether they searched for her or just had her recommended as a friend, she reminds them about the importance of patient confidentiality and privacy, and notes that following one another on social media can add a "social" element to their work and can complicate matters when it comes to what the therapist is supposed to know or not know about them.
The article is here.
The Monitor on Psychology
2017, Vol 48, No. 2
Print version: page 18
Here is an excerpt:
Talking to clients about their privacy concerns.
Kolmes advises all clinicians to discuss privacy risks involved in using social media with their clients and to work through how to handle a situation in which a therapist's name pops up under their "People You May Know" tab.
"It's about having clear and open conversations with your clients about what you're going to do to protect their privacy and confidentiality and avoid inviting a multiple relationship, and letting them know they can also discuss this with the therapist if it comes up on their end," Kolmes says. When she does receive a friend request from a client on Facebook, she waits until she sees him or her next in session and checks to see if the request was accidental or not. Regardless of whether they searched for her or just had her recommended as a friend, she reminds them about the importance of patient confidentiality and privacy, and notes that following one another on social media can add a "social" element to their work and can complicate matters when it comes to what the therapist is supposed to know or not know about them.
The article is here.
Monday, February 20, 2017
Getting Emotions Right in Moral Psychology
Piercarlo Valdesolo
Abstract:
The past two decades of research has repeatedly identified the importance of emotion to moral
judgment, but moral psychology continues to be in need of more nuanced and developed theories
of emotion to inform its process models. Closer attention to how modern affective science has
divided the landscape of emotions can not only help more accurately map the moral domain, but
also help solve current theoretical debates.
(cut)
Basic Emotions and Moral Foundations
MFT argues for the existence of moral foundations comprised of innate cognitive
mechanisms that are responsive to a set of particular adaptive concerns relevant to social living
(e.g. protecting children, forming coalitions). These mechanisms are triggered by particular social
cues (e.g. distress, cheating, uncleanliness), and in turn trigger psychological responses, including
characteristic emotional states, geared towards motivating adaptive behavioral responses. In
keeping with BET, these characteristic emotions represent distinct biological mechanisms thought
to “prompt us in a direction that, in the course of our evolution, has done better than other
solutions in recurring circumstances” (Ekman & Cordaro, 2011, p.364).
Critics of whole number approaches to morality, however, have argued that it is precisely
this conceptual reliance on BET that is problematic (Cameron et al 2013; Schein & Gray; Gray &
Keeney 2015a; Gray, Young and Waytz 2012; Cheng?). These researchers argue that in adopting
this theory of emotions, any theory of distinct moral domains rests on an empirically untenable
basis. Specifically, given that there is no good evidence showing that discrete emotions reflect
“affect programs”, or any other kind of consistent and coordinated affective response specific to
particular kinds of adaptive challenges, then there will likely be no solid empirical basis to accept
the existence of consistent and coordinated psychological responses to discrete moral concerns.
The paper is here.
Abstract:
The past two decades of research has repeatedly identified the importance of emotion to moral
judgment, but moral psychology continues to be in need of more nuanced and developed theories
of emotion to inform its process models. Closer attention to how modern affective science has
divided the landscape of emotions can not only help more accurately map the moral domain, but
also help solve current theoretical debates.
(cut)
Basic Emotions and Moral Foundations
MFT argues for the existence of moral foundations comprised of innate cognitive
mechanisms that are responsive to a set of particular adaptive concerns relevant to social living
(e.g. protecting children, forming coalitions). These mechanisms are triggered by particular social
cues (e.g. distress, cheating, uncleanliness), and in turn trigger psychological responses, including
characteristic emotional states, geared towards motivating adaptive behavioral responses. In
keeping with BET, these characteristic emotions represent distinct biological mechanisms thought
to “prompt us in a direction that, in the course of our evolution, has done better than other
solutions in recurring circumstances” (Ekman & Cordaro, 2011, p.364).
Critics of whole number approaches to morality, however, have argued that it is precisely
this conceptual reliance on BET that is problematic (Cameron et al 2013; Schein & Gray; Gray &
Keeney 2015a; Gray, Young and Waytz 2012; Cheng?). These researchers argue that in adopting
this theory of emotions, any theory of distinct moral domains rests on an empirically untenable
basis. Specifically, given that there is no good evidence showing that discrete emotions reflect
“affect programs”, or any other kind of consistent and coordinated affective response specific to
particular kinds of adaptive challenges, then there will likely be no solid empirical basis to accept
the existence of consistent and coordinated psychological responses to discrete moral concerns.
The paper is here.
Sunday, February 19, 2017
Most People Consider Themselves to Be Morally Superior
By Cindi May
Scientific American
Originally published on January 31, 2017
Here are two excerpts:
This self-enhancement effect is most profound for moral characteristics. While we generally cast ourselves in a positive light relative to our peers, above all else we believe that we are more just, more trustworthy, more moral than others. This self-righteousness can be destructive because it reduces our willingness to cooperate or compromise, creates distance between ourselves and others, and can lead to intolerance or even violence. Feelings of moral superiority may play a role in political discord, social conflict, and even terrorism.
(cut)
So we believe ourselves to be more moral than others, and we make these judgments irrationally. What are the consequences? On the plus side, feelings of moral superiority could, in theory, protect our well-being. For example, there is danger in mistakenly believing that people are more trustworthy or loyal than they really are, and approaching others with moral skepticism may reduce the likelihood that we fall prey to a liar or a cheat. On the other hand, self-enhanced moral superiority could erode our own ethical behavior. Evidence from related studies suggests that self-perceptions of morality may “license” future immoral actions.
The article is here.
Scientific American
Originally published on January 31, 2017
Here are two excerpts:
This self-enhancement effect is most profound for moral characteristics. While we generally cast ourselves in a positive light relative to our peers, above all else we believe that we are more just, more trustworthy, more moral than others. This self-righteousness can be destructive because it reduces our willingness to cooperate or compromise, creates distance between ourselves and others, and can lead to intolerance or even violence. Feelings of moral superiority may play a role in political discord, social conflict, and even terrorism.
(cut)
So we believe ourselves to be more moral than others, and we make these judgments irrationally. What are the consequences? On the plus side, feelings of moral superiority could, in theory, protect our well-being. For example, there is danger in mistakenly believing that people are more trustworthy or loyal than they really are, and approaching others with moral skepticism may reduce the likelihood that we fall prey to a liar or a cheat. On the other hand, self-enhanced moral superiority could erode our own ethical behavior. Evidence from related studies suggests that self-perceptions of morality may “license” future immoral actions.
The article is here.
Saturday, February 18, 2017
Is It Time to Call Trump Mentally Ill?
Richard A. Friedman
The New York Times
Originally published February 17, 2017
Here are two excerpts:
A recent letter to the editor in this newspaper, signed by 35 psychiatrists, psychologists and social workers, put it this way: "We fear that too much is at stake to be silent." It continued, "We believe that the grave emotional instability indicated by Mr. Trump's speech and actions makes him incapable of serving safely as president."
But the attempt to diagnose a condition in President Trump and declare him mentally unfit to serve is misguided for several reasons.
First, all experts have political beliefs that probably distort their psychiatric judgment. Consider what my mostly liberal profession said of Senator Barry Goldwater, the Republican nominee for president in 1964, right before the election. Members of the American Psychiatric Association were surveyed about their assessment of Goldwater by the now-defunct Fact magazine. Many savaged him, calling him "paranoid," "grossly psychotic" and a "megalomaniac." Some provided diagnoses, like schizophrenia and narcissistic personality disorder.
They used their professional knowledge as a political weapon against a man they had never examined and who certainly would never have consented to their discussing his mental health in public.
Goldwater sued (successfully) and, as a result, in 1973 the A.P.A. developed the Goldwater Rule. It says that psychiatrists can discuss mental health issues with the news media, but that it is unethical for them to diagnose mental illnesses in people they have not examined and whose consent they have not received.
(cut)
There is one last reason we should avoid psychiatrically labeling our leaders: It lets them off the moral hook. Not all misbehavior reflects psychopathology; the fact is that ordinary human meanness and incompetence are far more common than mental illness. We should not be in the business of medicalizing bad actors.
The article is here.
The New York Times
Originally published February 17, 2017
Here are two excerpts:
A recent letter to the editor in this newspaper, signed by 35 psychiatrists, psychologists and social workers, put it this way: "We fear that too much is at stake to be silent." It continued, "We believe that the grave emotional instability indicated by Mr. Trump's speech and actions makes him incapable of serving safely as president."
But the attempt to diagnose a condition in President Trump and declare him mentally unfit to serve is misguided for several reasons.
First, all experts have political beliefs that probably distort their psychiatric judgment. Consider what my mostly liberal profession said of Senator Barry Goldwater, the Republican nominee for president in 1964, right before the election. Members of the American Psychiatric Association were surveyed about their assessment of Goldwater by the now-defunct Fact magazine. Many savaged him, calling him "paranoid," "grossly psychotic" and a "megalomaniac." Some provided diagnoses, like schizophrenia and narcissistic personality disorder.
They used their professional knowledge as a political weapon against a man they had never examined and who certainly would never have consented to their discussing his mental health in public.
Goldwater sued (successfully) and, as a result, in 1973 the A.P.A. developed the Goldwater Rule. It says that psychiatrists can discuss mental health issues with the news media, but that it is unethical for them to diagnose mental illnesses in people they have not examined and whose consent they have not received.
(cut)
There is one last reason we should avoid psychiatrically labeling our leaders: It lets them off the moral hook. Not all misbehavior reflects psychopathology; the fact is that ordinary human meanness and incompetence are far more common than mental illness. We should not be in the business of medicalizing bad actors.
The article is here.
A Crime in the Cancer Lab
Theodora Ross
The New York Times
Originally published January 28, 2017
Here is an excerpt:
We have all read about incidents of scientific misconduct; in recent years, a number of manuscripts based on fake research have been retracted. But they usually involved scientists who cut corners or fabricated data, not deliberate sabotage. The poisoned flasks were a first for me. Falsified data is a crime against scientific truth. This was personal.
I turned to my colleagues to ask how to respond, and to my surprise, they all said the same thing: my student, Heather Ames, was probably sabotaging herself.
Their reasoning? She wanted an excuse for why things weren't working in her experiments. Competition and the pressure to get results quickly is ever-present in the world of biomedical research, so it's not out of the question that a young scientist might succumb to the stress.
The article is here.
The New York Times
Originally published January 28, 2017
Here is an excerpt:
We have all read about incidents of scientific misconduct; in recent years, a number of manuscripts based on fake research have been retracted. But they usually involved scientists who cut corners or fabricated data, not deliberate sabotage. The poisoned flasks were a first for me. Falsified data is a crime against scientific truth. This was personal.
I turned to my colleagues to ask how to respond, and to my surprise, they all said the same thing: my student, Heather Ames, was probably sabotaging herself.
Their reasoning? She wanted an excuse for why things weren't working in her experiments. Competition and the pressure to get results quickly is ever-present in the world of biomedical research, so it's not out of the question that a young scientist might succumb to the stress.
The article is here.
Friday, February 17, 2017
There is something rotten inside the medical profession
Anonymous
kevinmd.com
Originally published January 26, 2017
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for the patients — which is often sadly a given, but for the doctors training inside it. Every generation always looks down on the generation training after it — no one ever had it as hard as them, and thus deserve to suffer just as much, if not more. This dubious school of thought has long been acknowledged as standard practice. To be a good doctor, you must work harder, stay later, know more, and never falter. Weakness in medicine is a failing, and if you admit to struggling, the unspoken opinion (or often spoken) is that you simply couldn’t hack it.
In the cutthroat, often brutalizing culture of medical or surgical training many doctors stay stoically mute in the face of daily, soul destroying adversity; at the worst case, their loudest gesture is deafeningly silent — death by their own hand.
The blog post is here.
kevinmd.com
Originally published January 26, 2017
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for the patients — which is often sadly a given, but for the doctors training inside it. Every generation always looks down on the generation training after it — no one ever had it as hard as them, and thus deserve to suffer just as much, if not more. This dubious school of thought has long been acknowledged as standard practice. To be a good doctor, you must work harder, stay later, know more, and never falter. Weakness in medicine is a failing, and if you admit to struggling, the unspoken opinion (or often spoken) is that you simply couldn’t hack it.
In the cutthroat, often brutalizing culture of medical or surgical training many doctors stay stoically mute in the face of daily, soul destroying adversity; at the worst case, their loudest gesture is deafeningly silent — death by their own hand.
The blog post is here.
Uncertainty Increases the Reliance on Affect in Decisions
Ali Faraji Rad and Michel Tuan Pham
J Consum Res (2017) ucw073.
Published: 23 January 2017
Abstract
How do psychological states of uncertainty influence the way people make decisions? We propose that such states increase the reliance on affective inputs in judgments and decisions. In accord with this proposition, results from six studies show that the priming of uncertainty (vs. certainty) consistently increases the effects of a variety of affective inputs on consumers’ judgments and decisions. Primed uncertainty is shown to amplify the effects of the pleasantness of a musical soundtrack (study 1), the attractiveness of a picture (study 2), the appeal of affective attributes (studies 3 and 4), incidental mood states (study 6), and even incidental states of disgust (study 5). Moreover, both negative and positive uncertainty increase the influence of affect in decisions (study 4). The results additionally show that the increased reliance on affective inputs under uncertainty does not necessarily come at the expense of a reliance on descriptive attribute information (studies 2 and 5), and that the increased reliance on affect under uncertainty is distinct from a general reliance on heuristic or peripheral cues (study 6). The phenomenon may be due to uncertainty threatening the self, thereby encouraging a reliance on inputs that are closer to the self and have high subjective validity.
The article is here.
J Consum Res (2017) ucw073.
Published: 23 January 2017
Abstract
How do psychological states of uncertainty influence the way people make decisions? We propose that such states increase the reliance on affective inputs in judgments and decisions. In accord with this proposition, results from six studies show that the priming of uncertainty (vs. certainty) consistently increases the effects of a variety of affective inputs on consumers’ judgments and decisions. Primed uncertainty is shown to amplify the effects of the pleasantness of a musical soundtrack (study 1), the attractiveness of a picture (study 2), the appeal of affective attributes (studies 3 and 4), incidental mood states (study 6), and even incidental states of disgust (study 5). Moreover, both negative and positive uncertainty increase the influence of affect in decisions (study 4). The results additionally show that the increased reliance on affective inputs under uncertainty does not necessarily come at the expense of a reliance on descriptive attribute information (studies 2 and 5), and that the increased reliance on affect under uncertainty is distinct from a general reliance on heuristic or peripheral cues (study 6). The phenomenon may be due to uncertainty threatening the self, thereby encouraging a reliance on inputs that are closer to the self and have high subjective validity.
The article is here.
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