PAU, France, July 25 — Alexander Vinokourov, the Kazakh cyclist who was considered the favorite to win the Tour de France this year and who has won two stages of the race so far, tested positive for an autologous blood transfusion and his Astana team will abandon the tour, a team official said Tuesday.
We wanted an urban tire that was flat resistant AND also gave an excellent ride. A splendid tire for the AIDS Ride. Messengers and hardcore commuters should try them, too.
One of the most controversial subjects in global health is the topic of user fees for health services and commodities. Ever since Nancy Birdsall, David de Ferranti and John Akin declined to rule out user fees as a useful source of health financing way back in 1987, the World Bank has been pilloried for "advocating user fees" in the health sector, which the Bank has never done. By setting out explicit criteria for setting user fees in the 2004 World Development Report, the Bank resisted continuing political pressure to ban them outright and further fueled the debate. Among the donors, DFID (see also this white paper) has most adamantly rejected user fees as either effective or legitimate for improving access to health care by the poor. On the other hand, the social marketing of health care commodities, from condoms to antibiotics, is increasingly popular among actors such as PSI and KfW and presumes that the optimal price of these commodities, while heavily subsidized, is not free.
The obvious argument against user fees is based on the fundamental economic proposition that demand curves slope downward* - e.g. that the number of people willing to purchase a product or service declines as its price increases. It follows that lower prices should result in more health care utilization than higher prices, and that zero prices would be even better. However, a fascinating new study by Nava Ashraf, James Berry, and Jesse Shapiro of the market for home water purification solution in Zambia finds that in fact demand curves seem to flatten out as the price approaches zero, and may even slope upward - or, in plain English, that the act of paying a small amount (up to 18 cents, in this case) actually increases use over distributing Clorin free of charge.
The authors posit two reasons why people might behave contrary to the simple law of demand. First, the price effectively targets the distribution of the health commodity to those least likely to waste it. Second, people who have paid more for a product may have a greater psychological commitment to using it. They find strong statistical support for the first of these effects and weak support for the second.
If these results could be generalized to other health commodities, like bednets to prevent malaria, or to health services such as curative health clinic visits, the suggestion would be that sufficiently small user fees do little to discourage utilization; they might even increase it by stimulating the supply of health care quantity and quality. Although 18 cents - the highest price that can be charged for Clorin in Zambia without reducing utilization - seems like a tiny sum to people in rich countries, this would be enough to substantially motivate a distributor of a health commodity such as bednets or condoms, and a similarly small sum might help fill a financing gap in health clinics.
Obviously, this has huge implications for policymakers in developing countries, where cutting subsidies could actually improve overall health outcomes while motivating both public and private providers at the periphery of health care systems. Let's hope that the debate on user fees for health care is enriched by more such randomized controlled studies and that they look in more detail at supply and financing effects as well as demand-side effects.
*As an aside, the existence of upward-sloping demand curves has actually been in the news a lot this week due to recent evidence proving the heretofore purely theoretical case of Giffen goods.
Shallow Grave
Final Draft Screenplay
by
John Hodge
[Introduction]
Typed and HTMLed by "Greg Adkins"
INT. DAY
A blurred image forms on a white screen. A horizontal strip of
face, eyes motionless and unblinking.
DAVID
(voice-over)
Take trust, for instance, or friendship: these are the important
things in life, the things that matter, that help you on your
way. If you can't trust your friends, well, what then?
EXT. DAWN
A series of fast-cut static scenes of empty streets.
DAVID
(voice-over)
This could have been any city: they're all the same.
A rapid, swerving track along deserted streets and down narrow
lanes and passageways. Accompanied by soundtrack and credits.
The track ends outside a solid, fashionable Edinburgh tenement.
INT. STAIRWELL. DAY
At the door of a flat on the third floor of the tenement. The
door is dark, heavy wood and on it is a plastic card embossed
with the names of three tenants. They are Alex Law, David
Stevens, and Juliet Miller.
A man climbs the stairs and reaches the door. He is Cameron
Clarke, thin and in his late twenties with a blue anorak and
lank, greasy hair. He is carrying an awkwardly bulky plastic bag.
Cameron gives the doorbell an ineffectual ring and then stands
back, shifting nervously from foot to foot until the door is
answered.
CAMERON
Hello, I've come about the room.
Cameron enters and the door closes.
INT. LIVING ROOM. DAY
David, Alex, and Juliet sit in a line on the sofa directly
opposite Cameron, who shifts uneasily in his armchair. Alex
checks some items on a clipboard before speaking.
ALEX
What's his name?
DAVID
I don't know -- Campbell or something?
JULIET
Cameron.
ALEX
Cameron?
JULIET
Yes.
ALEX
(to Juliet)
Really?
CAMERON
That's right.
ALEX
(to Cameron)
What?
Cameron is not sure what to say.
ALEX
(continued)
Well, Cameron, are you comfortable?
CAMERON
Yes, thanks.
ALEX
Good. Well, you've seen the flat?
CAMERON
Yes.
ALEX
And you like it?
CAMERON
Oh, yes, it's great.
ALEX
Yes. It is, isn't it? We alllike it. And the room's nice too,
don't you think?
CAMERON
Yes.
ALEX
Spacious, quiet, bright, well appointed, all that sort of stuff,
all that crap.
CAMERON
Well, yes.
ALEX
So tell me, Cameron, what on earth -- just tell me, because I
want to know -- what on earth could make you think that we would
want to share a flat like this with someone like you?
INT. STAIRWELL. DAY
As Cameron plods slowly down the stairs, his shoes striking out
against the stone steps, Alex's criticisms continue.
ALEX
(voice-over)
I mean, my first impression, and they're rarely wrong, is that
you have none of the qualities that we would normally seek in a
prospective flatmate. I'm talking here about things like
presence, charisma, style and charm, and I don't think we're
being unreasonable. Take David here, for instance: a chartered
accountant he may be, but at least he tries hard. The point is, I
don't think you're even trying.
Cameron has reached the bottom of the stairs. He opens the main
door.
ALEX
(continued)
And, Cameron -- I mean this -- good luck!
Cameron leaves and the main door closes behind him.
ALEX
(continued)
Do you think he was upset?
INT. STAIRWELL. DAY
Inside the hall of the flat, David approaches the door toopen it.
Freeze-frame.
ALEX
(voice-over)
David likes to keep spareshoelaces in sorted pairs in a box
marked, not just shoelaces', but spare shoelaces'.
David opens the door to the Woman.
WOMAN
I've come to see about the room.
INT. STAIRWELL. DAY
Outside the door of the flat a young Goth girl, aged about
twenty, rings the doorbell.
INT. HALL. DAY
Inside the hall of the flat Alex approaches the door to open it.
Freeze-frame.
JULIET
(voice-over)
Alex is a vegetarian. Do you know why? Because he feels it
provides an interesting counterpoint to his otherwise callous
personality. It doesn't. He thinks he's the man for me. He isn't,
though there was a time when, well, there was a time when...
Alex opens the door to the Goth.
GOTH
I've come about the room.
INT. STAIRWELL. DAY
At the door of the flat a Man aged about thrity-five rings the
bell.
INT. HALL. DAY
Inside the hall of the flat Juliet approaches the door to open
it. Freeze-frame.
DAVID
(voice-over)
Like one of those stupid posters -- you know, a gorilla cuddling
a hedgehog, caption love hurts --- that's what I think when I
think of Juliet.
Juliet opens the door to the Man.
MAN
I've come about the room.
INT. LIVING ROOM. DAY
In the living room each of the candidates is interviewed
individually with the same seating arrangements as before (i.e.
the trio on the sofa and the applicant on the chair). What we see
are briskly intercut excerpts from each of these interviews. We
do not get the responses to the questions, although we may see
some facial reaction.
All of David's questions are to the Woman.
All of Alex's questions are to the Goth.
All of Juliet's questions are to the Man.
DAVID
All right, just a few questions.
ALEX
I'd like to ask you about your hobbies.
JULIET
Why do you want a room here?
DAVID
Do you smoke?
ALEX
When you slaughter a goat and wrench its heart out with your bare
hands, do you then summon hellfire?
JULIET
I mean, what are you actually doing here? What is the hidden
agenda?
DAVID
Do a little freebasemaybe, from time to time?
ALEX
Or maybe just phone out for a pizza?
JULIET
Look, it's a fairly straightforward question. You're either
divorced or you're not.
DAVID
OK, I'm going to play you just a few seconds of this tape -- I'd
like you to name the song, the lead singer and the three hit
singles subsequently recorded by him with another band.
ALEX
When you get up in the morning, how do you decide what shade of
black to wear?
JULIET
Now, let me get this straight. This affair that you're not
having, is it not with a man or not with a woman?
DAVID
Turning very briefly to the subject of corporate finance -- no,
this is important. Leveraged buy-outs -- a good thing or a bad
thing?
ALEX
With which of the following figures do you most closely identify:
Joan of Arc, Eva Braun or Marilyn Monroe?
JULIET
It's just that you strike me as a man trapped in a crisis of
emotional direction, afflicted by a realization that the partner
of your dreams is, quite simply, just that.
DAVID
Did you ever kill a man?
ALEX
And when did anyone last say to you these exact words: You are
the sunshine of my life'?
JULIET
OK, so A has left you, B is ambivalent, you're still seeing C but
D is the one you yearn for. What are we to make of this? If I
were you, I'd ditch the lot. There's a lot more letters in the
alphabet of love.
DAVID
And what if I told you that I was the antichrist?
Mr Mwesigye said if NMS predicts the expired drugs, they supply the relevant information to the third party programmes but most of them fail to respond to save them.
From the folks who brought you the Zidane "Coup de Boule' music video...I laugh heartily.
Police officials have said that the neighborhood has seen a surge in violence connected to gang activity. Arrests had been made in at least two of the slayings before yesterday's incident.
