MIAMI -- Four minutes into the
Heat preseason, he was joined on
the floor by Mike Miller, Joel
Anthony, Carlos Arroyo and Chris
Bosh, and at that point, surely you
wondered: Didn't LeBron James
leave a better team in Cleveland?
Dwyane Wade by then was
already in the locker room, icing a
strained right hamstring, which
completely changed the tenor of
the special, much-anticipated night.
This was no longer qualified as a
sneak peak. This was a sneak
tweak.
"LeBron told me he didn't come
here to see me sit on the side,"
Wade said.
American Airlines Arena was still
foggy with resin tossed by LeBron
from his pregame ritual when
Wade pulled up and limped off
against the Pistons. And just like
that, instead of getting a first feel
for how powerful the Heat might
be this season, we discovered how
vulnerable they can be.
They can't afford an injury to
LeBron or Wade or Bosh. This team
is top heavy. There is no "picking
up the slack" or having someone
"step up" should any of the Big
Three be confined to a tailored suit
and a seat at the end of the bench.
You suppose the Celtics or Magic or
Lakers would shiver in their hi-tops
at the sight of a Big-Two-And-A-
Third? No.
"We don't want to be in a situation
a lot where one of our guys go
down," conceded LeBron.
There's relief in Miami today
because Wade's injury isn't serious,
and besides, he has three weeks to
heal. Plus, even though tender
hamstrings can be tricky and tend
to linger, Wade sent a reassuring
message to Miami fans and a
warning to the league.
"They'll have a lot of time to see
the Big Three," he said.
Until then, they'll see plenty of
LeBron taking control and making
the Heat his team; essentially,
doing what he did in Cleveland for
the last seven years. Any notion of
LeBron, flanked by a pair of All-
Stars, suddenly turning into a
facilitator was erased from the
opening tip, when he drove hard to
the basket the first time he
touched the ball. That was a
constant sight against the Pistons,
and LeBron said get used to it,
even when Wade returns.
"I'm never in a defer mentality,"
he said. "I'm in attack mode. No
matter how many weapons we
have on the court, I'm still going to
play my game."
LeBron and Bosh have so far
avoided any kind of sustained
injury in their careers but the same
can't be said about Wade. Three
times in his seven seasons he's
dealt with some serious injury; a
shoulder, a knee, a calf and a wrist
among the brittle body parts. That
doesn't mean Wade is injury-prone.
It does mean he's hardly invincible,
no matter how much more swollen
his biceps are this season.
"I'm not stranger to minor
setbacks," joked Wade. "I'm a
professional in that regard."
Stuck in the trainer's room for all
but three minutes of the game,
Wade had a flat-screen view of
what took place without him. And
although he wasn't too thrilled with
how he felt, he was encouraged by
what he saw.
"You saw what LeBron can do with
his playmaking ability and his
ability to attack the basket," Wade
said. "And Chris' ability to make
one-on-one plays, and he can be a
force on the glass as well."
Given the summer he just went
through, marked by a big decision
and a swarm of criticism for the
way he did it, LeBron wanted the
emotional release that only a
basketball game can provide. He
tore through the Pistons for layups,
hit jumpers, and at times was a blur
during an 18-point, 26-minute
effort. In the words of Heat
assistant coach Bob McAdoo, "he'll
be a one-man fast break if you
don't run with him."
Just the same, Bosh weaved his
way inside for 20 points, a good
bit of them on feeds from
LeBron.
"It feels good to have guys who
have the capabilities they have,"
Wade said.
Until Wade felt a twinge, the night
was a coming-out of sorts. Minutes
before tipoff, the Heat were shown
on the overhead scoreboard
gathering in the hallway leading to
the entrance to the floor, and that
drew a big crowd response. The Big
Three heard, felt and saw a
standing O in the introductions.
LeBron tossed his powder in the air.
Wade raised both arms and
pointed, his traditional pregame
greeting. The announced crowd was
a sellout at 19,600, although the
actual crowd was smaller than that.
Then the game began. Bosh stole a
pass. Wade hit a jumper. LeBron hit
a jumper. And then, Wade to the
locker room.
Is this minor injury destined to
precede something else, something
bigger down the road? Meaning: Is
this an omen? If Year One becomes
known more for surgery than
champagne, then we'll all revisit
the bitter words of Dan Gilbert, the
Cavaliers' owner who predicted as
much last July.
"The good news is that this
heartless and callous action can
only serve as the antidote to the
so-called Curse on Cleveland, Ohio,"
wrote Gilbert, moments after the
Cavs drew the short straw in The
Decision. "The self-declared former
King will be taking the `curse' with
him down south. And until he does
right by Cleveland and Ohio, James
[and the town where he plays] will
unfortunately own this dreaded
spell and bad karma. Just watch."
Oh, we'll watch. Count on that,
considering how much interest
followed a meaningless preseason
game, which fizzled faster than
expected.
"When I told fans at the Dolphins
game to get here early," said
Wade, "I didn't think they had to
be here this early, to see me three
minutes.
Wednesday, October 6, 2010
Miami is basketball central
MIAMI — Put aside, for a
second, the whole idea
of LeBron James,
Dwyane Wade and
Chris Bosh suiting up
tonight for the first time,
the tipoff for what will
be an adventure, one
way or another.
The real surprise is that
this is happening in
Miami, a place nobody
ever confused with
hoops heaven.
The Heat’s preseason
opener with the Pistons
will be a sellout, and in
normal times, maybe
half of American Airlines
Arena would be filled.
But everyone wants to
witness the start of
history, and so 18,000-
plus will shoehorn inside
the building, not for pure
basketball reasons, but
because tonight is an
event. And Miami is an
event town. Not a sports
town. Definitely not a
basketball town. It ’s a
see-and-be-seen town.
Nobody’s hating on
Miami here. This is just
reality. In a perfect
basketball world, these
three players would ’ve
gathered in Indiana,
birthplace of John
Wooden. Or New York,
home of Rucker Park
and the 4th Street cages.
Or Boston or Chicago or a
number of other places
that historically have
embraced basketball on
all levels.
Miami loves the
Dolphins. Always has,
always will.
I speak from some
authority. I was the beat
writer for the Miami
Herald when the Heat
was born in 1988. And
after a curiosity stage,
fans drifted away to
their first love, football.
Even the Marlins rarely
draw well, and while the
blame for that is largely
heaped on playing in a
football stadium, we’ll
see what happens when
the team moves to the
new stadium on the
former site of the
Orange Bowl in two
years and asks people in
Broward County to drive
south during rush hour.
I ’m not optimistic.
Miami is about big
events: Super Bowl,
Orange Bowl, All-Star
Games, those types.
That ’s why you’ve got to
give it up to Pat Riley.
Ever since he arrived,
he ’s tried to turn the
Heat into an 82-game
event. His player haul is
impressive: Alonzo
Mourning, Tim
Hardaway, Dwyane
Wade, Shaquille O’Neal
and now, James and
Bosh. Without big names,
there is no event, and
there ’s no interest in
Miami.
In that sense, Riley is the
basketball equal of
legendary Dolphins
coach Don Shula. All he
needs is a steakhouse
and a highway named
after him. The event
begins tonight. And it
may last a while.
second, the whole idea
of LeBron James,
Dwyane Wade and
Chris Bosh suiting up
tonight for the first time,
the tipoff for what will
be an adventure, one
way or another.
The real surprise is that
this is happening in
Miami, a place nobody
ever confused with
hoops heaven.
The Heat’s preseason
opener with the Pistons
will be a sellout, and in
normal times, maybe
half of American Airlines
Arena would be filled.
But everyone wants to
witness the start of
history, and so 18,000-
plus will shoehorn inside
the building, not for pure
basketball reasons, but
because tonight is an
event. And Miami is an
event town. Not a sports
town. Definitely not a
basketball town. It ’s a
see-and-be-seen town.
Nobody’s hating on
Miami here. This is just
reality. In a perfect
basketball world, these
three players would ’ve
gathered in Indiana,
birthplace of John
Wooden. Or New York,
home of Rucker Park
and the 4th Street cages.
Or Boston or Chicago or a
number of other places
that historically have
embraced basketball on
all levels.
Miami loves the
Dolphins. Always has,
always will.
I speak from some
authority. I was the beat
writer for the Miami
Herald when the Heat
was born in 1988. And
after a curiosity stage,
fans drifted away to
their first love, football.
Even the Marlins rarely
draw well, and while the
blame for that is largely
heaped on playing in a
football stadium, we’ll
see what happens when
the team moves to the
new stadium on the
former site of the
Orange Bowl in two
years and asks people in
Broward County to drive
south during rush hour.
I ’m not optimistic.
Miami is about big
events: Super Bowl,
Orange Bowl, All-Star
Games, those types.
That ’s why you’ve got to
give it up to Pat Riley.
Ever since he arrived,
he ’s tried to turn the
Heat into an 82-game
event. His player haul is
impressive: Alonzo
Mourning, Tim
Hardaway, Dwyane
Wade, Shaquille O’Neal
and now, James and
Bosh. Without big names,
there is no event, and
there ’s no interest in
Miami.
In that sense, Riley is the
basketball equal of
legendary Dolphins
coach Don Shula. All he
needs is a steakhouse
and a highway named
after him. The event
begins tonight. And it
may last a while.
In Rare Move, China Court to Hear H.I.V. Case
BEIJING — In what appears to be a
first for China’s legal system, a
court in Anhui Province has agreed
to hear a complaint by a
prospective schoolteacher that he
was illegally denied a job because
he is H.I.V. positive, the man ’s
lawyer said Tuesday.
The unidentified man, said to be in
his early 20s, brought the case
under a 2006 national regulation
that prohibits job discrimination
against people with H.I.V., his
lawyer, Zheng Jineng, said in a
telephone interview from Hefei, the
provincial capital.
Mr. Zheng said the case would be
heard by a district court in Anqing.
The plaintiff contends that he
passed a written test and
interviews for a teaching job there,
but that the city education bureau
rejected him after a physical
examination showed he was
infected with H.I.V., the virus that
causes AIDS.
“In the past on sensitive cases like
this, the court would be very
reluctant to accept the case, ” Mr.
Zheng said. “But this time they
accepted it smoothly and quickly.
That means the legal system in
China is making progress. ”
H.I.V.-positive Chinese suffered
official and public discrimination for
years after the disease first
surfaced in the country in 1986.
Infected students were often
forced to leave school and workers
were shunted from their jobs.
More recently, the national
government has taken a tolerant
approach, offering free
antiretroviral drugs and prenatal
care to many people who are H.I.V.
positive, as well as screening for
those who suspect that they might
be. Many migrants remain unable
to receive the services, however,
because they lack the appropriate
residence papers.
The National People’s Congress,
China’s legislature, has approved a
law that bans employers from
discriminating against job applicants
with certain kinds of communicable
diseases, as chosen by state
regulators. But the basis for the
Anhui lawsuit is a regulation issued
in March 2006 by the State Council,
the government ’s senior
management body, which states
that “no institution or individual
shall discriminate against people
living with H.I.V., AIDS patients and
their relatives. ”
More than four years later, no court
had placed an H.I.V. discrimination
case on its docket until Monday ’s
decision, said Yu Fangqiang, the
chief coordinator for Yirenping, a
Beijing-based civil-rights advocacy
group involved in the Anhui case.
The group paid the court fee to file
the lawsuit, and Mr. Zheng waived
his legal fees for the case.
Mr. Yu said he agreed with Mr.
Zheng that the court ’s acceptance
of the discrimination lawsuit was a
sign of changing legal standards.
But he added that news media
coverage had probably played a
crucial role in the court ’s decision,
which had been delayed until the
Chinese journal Legal Daily ran an
article about the case.
The newspaper, he said, “is a must-
read for a lot of people in the legal
system. I think the media played a
role in the court accepting this
case. ”
Yirenping, the rights group, had
filed as many as 15 other lawsuits
similar to the Anhui complaint in
the past, Mr. Yu said, but courts
uniformly rejected them. Many
other H.I.V.-positive citizens
approached the organization for
advice on suing, but later dropped
the idea for fear that their
confidentiality would be
compromised, he said.
But the Anhui plaintiff, he said, was
determined to pursue a lawsuit.
“He was born to a poor family in
the countryside,” Mr. Yu said, “and
a job as a teacher means a lot to
him — stable pay and a decent
job.
first for China’s legal system, a
court in Anhui Province has agreed
to hear a complaint by a
prospective schoolteacher that he
was illegally denied a job because
he is H.I.V. positive, the man ’s
lawyer said Tuesday.
The unidentified man, said to be in
his early 20s, brought the case
under a 2006 national regulation
that prohibits job discrimination
against people with H.I.V., his
lawyer, Zheng Jineng, said in a
telephone interview from Hefei, the
provincial capital.
Mr. Zheng said the case would be
heard by a district court in Anqing.
The plaintiff contends that he
passed a written test and
interviews for a teaching job there,
but that the city education bureau
rejected him after a physical
examination showed he was
infected with H.I.V., the virus that
causes AIDS.
“In the past on sensitive cases like
this, the court would be very
reluctant to accept the case, ” Mr.
Zheng said. “But this time they
accepted it smoothly and quickly.
That means the legal system in
China is making progress. ”
H.I.V.-positive Chinese suffered
official and public discrimination for
years after the disease first
surfaced in the country in 1986.
Infected students were often
forced to leave school and workers
were shunted from their jobs.
More recently, the national
government has taken a tolerant
approach, offering free
antiretroviral drugs and prenatal
care to many people who are H.I.V.
positive, as well as screening for
those who suspect that they might
be. Many migrants remain unable
to receive the services, however,
because they lack the appropriate
residence papers.
The National People’s Congress,
China’s legislature, has approved a
law that bans employers from
discriminating against job applicants
with certain kinds of communicable
diseases, as chosen by state
regulators. But the basis for the
Anhui lawsuit is a regulation issued
in March 2006 by the State Council,
the government ’s senior
management body, which states
that “no institution or individual
shall discriminate against people
living with H.I.V., AIDS patients and
their relatives. ”
More than four years later, no court
had placed an H.I.V. discrimination
case on its docket until Monday ’s
decision, said Yu Fangqiang, the
chief coordinator for Yirenping, a
Beijing-based civil-rights advocacy
group involved in the Anhui case.
The group paid the court fee to file
the lawsuit, and Mr. Zheng waived
his legal fees for the case.
Mr. Yu said he agreed with Mr.
Zheng that the court ’s acceptance
of the discrimination lawsuit was a
sign of changing legal standards.
But he added that news media
coverage had probably played a
crucial role in the court ’s decision,
which had been delayed until the
Chinese journal Legal Daily ran an
article about the case.
The newspaper, he said, “is a must-
read for a lot of people in the legal
system. I think the media played a
role in the court accepting this
case. ”
Yirenping, the rights group, had
filed as many as 15 other lawsuits
similar to the Anhui complaint in
the past, Mr. Yu said, but courts
uniformly rejected them. Many
other H.I.V.-positive citizens
approached the organization for
advice on suing, but later dropped
the idea for fear that their
confidentiality would be
compromised, he said.
But the Anhui plaintiff, he said, was
determined to pursue a lawsuit.
“He was born to a poor family in
the countryside,” Mr. Yu said, “and
a job as a teacher means a lot to
him — stable pay and a decent
job.
H.I.V.: National Institutes of Health Licenses Its Patent on a New Drug for AIDS
The rights to the N.I.H. patent on
the drug, darunavir, do not mean
that generic-drug makers will
instantly be able to make it
cheaply for poor countries, since
other darunavir patents are held
by private companies, including
Tibotec, a Johnson & Johnson
subsidiary.
But it increases pressure on drug
makers to follow suit. They have
been reluctant because they fear
losing the profits they could make
as once-poor countries become
richer, as India and Brazil have.
Also, they fear losing control over
quality, since a bad batch of a
generic could hurt the reputations
of their patented drugs. Instead,
they have tended to cut private
deals with generic makers.
The pool is run by Unitaid, an
independent agency founded at
the United Nations in 2006. Its
original mission was to accept the
receipts from several taxes
dedicated to global health —
mostly from a fee on European
airline tickets. The money has been
spent on AIDS drugs for children
and second-line drugs.
“We ask that companies step up
and collaborate so we can quickly
see more affordable, easy-to-use
pills getting into people ’s mouths,”
said Nelson Otwoma, head of
Kenya ’s Network of People Living
with H.I.V./AIDS and a Unitaid
board member.
the drug, darunavir, do not mean
that generic-drug makers will
instantly be able to make it
cheaply for poor countries, since
other darunavir patents are held
by private companies, including
Tibotec, a Johnson & Johnson
subsidiary.
But it increases pressure on drug
makers to follow suit. They have
been reluctant because they fear
losing the profits they could make
as once-poor countries become
richer, as India and Brazil have.
Also, they fear losing control over
quality, since a bad batch of a
generic could hurt the reputations
of their patented drugs. Instead,
they have tended to cut private
deals with generic makers.
The pool is run by Unitaid, an
independent agency founded at
the United Nations in 2006. Its
original mission was to accept the
receipts from several taxes
dedicated to global health —
mostly from a fee on European
airline tickets. The money has been
spent on AIDS drugs for children
and second-line drugs.
“We ask that companies step up
and collaborate so we can quickly
see more affordable, easy-to-use
pills getting into people ’s mouths,”
said Nelson Otwoma, head of
Kenya ’s Network of People Living
with H.I.V./AIDS and a Unitaid
board member.
RECIPES FOR HEALTH Berry-Rose Crumble
The perfume of rose water, which
you can find in Middle Eastern
markets, is irresistible here. Served
with yogurt, this is one of my
favorite breakfasts.
The berries are quite juicy. If you
want a thicker syrup, use corn
starch or arrowroot.
2 quarts mixed strawberries,
blackberries and blueberries (about
2 pounds fruit)
2 tablespoons sugar, preferably
organic
1 tablespoon rose water
2 teaspoons cornstarch or
arrowroot (optional)
1 batch quinoa-oat crumble topping
1. Hull the strawberries. If they’re
large, cut them in half. In a large
bowl, toss the fruit with the sugar,
rose water and (optional)
cornstarch or arrowroot. Cover and
let stand for 15 to 30 minutes.
Meanwhile, preheat the oven to
350 degrees, and butter a two-
quart baking dish.
2. Transfer the fruit to the baking
dish, making sure to scrape all of
the liquid into the bowl. Set the
baking dish on a baking sheet for
easier handling, and place in the
oven for 15 minutes. Remove from
the oven, and spread the crumble
topping over the fruit in an even
layer. Return to the oven for 15 to
20 minutes until the crumble is
bubbling and nicely browned. Allow
to stand for at least 15 minutes
before serving.
Yield: Serves eight generously.
Advance preparation: The
crumble topping keeps for several
months in the freezer. Bake the
fruit without the crumble topping as
instructed in Step 2, then allow it to
sit for a few hours before you finish
it with the crumble topping. This
makes a great leftover; I did not
tire of it for the five days that it
lasted in my refrigerator.
Nutritional information per
serving: 268 calories; 11 grams
fat; 6 grams saturated fat; 23
milligrams cholesterol; 42 grams
carbohydrates; 6 grams dietary
fiber; 103 milligrams sodium; 4
grams protein
Martha Rose Shulman can be
reached at martha-rose-
shulman.com. Her latest book, "The
Very Best of Recipes for Health,
you can find in Middle Eastern
markets, is irresistible here. Served
with yogurt, this is one of my
favorite breakfasts.
The berries are quite juicy. If you
want a thicker syrup, use corn
starch or arrowroot.
2 quarts mixed strawberries,
blackberries and blueberries (about
2 pounds fruit)
2 tablespoons sugar, preferably
organic
1 tablespoon rose water
2 teaspoons cornstarch or
arrowroot (optional)
1 batch quinoa-oat crumble topping
1. Hull the strawberries. If they’re
large, cut them in half. In a large
bowl, toss the fruit with the sugar,
rose water and (optional)
cornstarch or arrowroot. Cover and
let stand for 15 to 30 minutes.
Meanwhile, preheat the oven to
350 degrees, and butter a two-
quart baking dish.
2. Transfer the fruit to the baking
dish, making sure to scrape all of
the liquid into the bowl. Set the
baking dish on a baking sheet for
easier handling, and place in the
oven for 15 minutes. Remove from
the oven, and spread the crumble
topping over the fruit in an even
layer. Return to the oven for 15 to
20 minutes until the crumble is
bubbling and nicely browned. Allow
to stand for at least 15 minutes
before serving.
Yield: Serves eight generously.
Advance preparation: The
crumble topping keeps for several
months in the freezer. Bake the
fruit without the crumble topping as
instructed in Step 2, then allow it to
sit for a few hours before you finish
it with the crumble topping. This
makes a great leftover; I did not
tire of it for the five days that it
lasted in my refrigerator.
Nutritional information per
serving: 268 calories; 11 grams
fat; 6 grams saturated fat; 23
milligrams cholesterol; 42 grams
carbohydrates; 6 grams dietary
fiber; 103 milligrams sodium; 4
grams protein
Martha Rose Shulman can be
reached at martha-rose-
shulman.com. Her latest book, "The
Very Best of Recipes for Health,
Neurofeedback Gains Popularity and Lab Attention
You sit in a chair, facing a computer
screen, while a clinician sticks
electrodes to your scalp with a
viscous goop that takes days to
wash out of your hair. Wires from
the sensors connect to a computer
programmed to respond to your
brain ’s activity.
Try to relax and focus. If your brain
behaves as desired, you ’ll be
encouraged with soothing sounds
and visual treats, like images of
exploding stars or a flowering field.
If not, you ’ll get silence, a
darkening screen and wilting flora.
This is neurofeedback, a kind of
biofeedback for the brain, which
practitioners say can address a host
of neurological ills — among them
attention deficit hyperactivity
disorder , autism, depression and
anxiety — by allowing patients to
alter their own brain waves
through practice and repetition.
The procedure is controversial,
expensive and time-consuming. An
average course of treatment, with
at least 30 sessions, can cost $3,000
or more, and few health insurers
will pay for it. Still, it appears to be
growing in popularity.
Cynthia Kerson, executive director
of the International Society for
Neurofeedback and Research, an
advocacy group for practitioners,
estimates that 7,500 mental health
professionals in the United States
now offer neurofeedback and that
more than 100,000 Americans
have tried it over the past decade.
The treatment is also gaining
attention from mainstream
researchers, including some former
skeptics. The National Institute of
Mental Health recently sponsored
its first study of neurofeedback for
A.D.H.D.: a randomized, controlled
trial of 36 subjects.
The results are to be announced
Oct. 26 at the annual meeting of
the American Academy of Child and
Adolescent Psychiatry. In an
interview in the summer, the
study ’s director, Dr. L. Eugene
Arnold, an emeritus professor of
psychiatry at Ohio State, noted that
there had been “quite a bit of
improvement” in many of the
children’s behavior, as reported by
parents and teachers.
Dr. Arnold said that if the results
bore out that neurofeedback was
making the difference, he would
seek financing for a broader study,
with as many as 100 subjects.
John Kounios, a professor of
psychology at Drexel University,
published a small study in 2007
suggesting that the treatment
speeded cognitive processing in
elderly people. “There’s no question
that neurofeedback works, that
people can change brain activity,”
he said. “The big questions we still
haven’t answered are precisely
how it works and how it can be
harnessed to treat disorders. ”
Russell A. Barkley, a professor of
psychiatry at the Medical
University of South Carolina and a
leading authority on attention
problems, has long dismissed claims
that neurofeedback can help. But
Dr. Barkley says he was persuaded
to take another look after Dutch
scientists published an analysis of
recent international studies finding
significant reductions in
impulsiveness and inattention.
Still, Dr. Barkley cautioned that he
had yet to see credible evidence
confirming claims that such benefits
can be long lasting, much less
permanent.
And another mainstream expert is
much more disapproving. William E.
Pelham Jr., director of the Center
for Children and Families at Florida
International University, called
neurofeedback “crackpot
charlatanism.” He warned that
exaggerated claims for it might
lead parents to favor it over
proven options like behavioral
therapy and medication.
Neurofeedback was developed in
the 1960s and ’70s, with American
researchers leading the way. In
1968, M. Barry Sterman, a
neuroscientist at the University of
California, Los Angeles, reported
that the training helped cats resist
epileptic seizures. Dr. Sterman and
others later claimed to have
achieved similar benefits with
humans .
The findings prompted a boomlet
of interest in which clinicians of
varying degrees of respectability
jumped into the field, making
many unsupported claims about
seeming miracle cures and tainting
the treatment’s reputation among
academic experts. Meanwhile,
researchers in Germany and the
Netherlands continued to explore
neurofeedback ’s potential benefits.
A major attraction of the technique
is the hope that it can help patients
avoid drugs, which often have side
effects. Instead, patients practice
routines that seem more like
exercising a muscle.
Brain cells communicate with one
another, in part, through a constant
storm of electrical impulses. Their
patterns show up on an
electroencephalogram, or EEG, as
brain waves with different
frequencies.
Neurofeedback practitioners say
people have problems when their
brain wave frequencies aren ’t
suited for the task at hand, or when
parts of the brain aren ’t
communicating adequately with
other parts. These issues, they say,
can be represented on a “brain
map,” the initial EEG readings that
serve as a guide for treatment.
Subsequently, a clinician will help a
patient learn to slow down or speed
up those brain waves, through a
process known as operant
conditioning. The brain begins by
generating fairly random patterns,
while the computer software
responds with encouragement
whenever the activity meets the
target.
screen, while a clinician sticks
electrodes to your scalp with a
viscous goop that takes days to
wash out of your hair. Wires from
the sensors connect to a computer
programmed to respond to your
brain ’s activity.
Try to relax and focus. If your brain
behaves as desired, you ’ll be
encouraged with soothing sounds
and visual treats, like images of
exploding stars or a flowering field.
If not, you ’ll get silence, a
darkening screen and wilting flora.
This is neurofeedback, a kind of
biofeedback for the brain, which
practitioners say can address a host
of neurological ills — among them
attention deficit hyperactivity
disorder , autism, depression and
anxiety — by allowing patients to
alter their own brain waves
through practice and repetition.
The procedure is controversial,
expensive and time-consuming. An
average course of treatment, with
at least 30 sessions, can cost $3,000
or more, and few health insurers
will pay for it. Still, it appears to be
growing in popularity.
Cynthia Kerson, executive director
of the International Society for
Neurofeedback and Research, an
advocacy group for practitioners,
estimates that 7,500 mental health
professionals in the United States
now offer neurofeedback and that
more than 100,000 Americans
have tried it over the past decade.
The treatment is also gaining
attention from mainstream
researchers, including some former
skeptics. The National Institute of
Mental Health recently sponsored
its first study of neurofeedback for
A.D.H.D.: a randomized, controlled
trial of 36 subjects.
The results are to be announced
Oct. 26 at the annual meeting of
the American Academy of Child and
Adolescent Psychiatry. In an
interview in the summer, the
study ’s director, Dr. L. Eugene
Arnold, an emeritus professor of
psychiatry at Ohio State, noted that
there had been “quite a bit of
improvement” in many of the
children’s behavior, as reported by
parents and teachers.
Dr. Arnold said that if the results
bore out that neurofeedback was
making the difference, he would
seek financing for a broader study,
with as many as 100 subjects.
John Kounios, a professor of
psychology at Drexel University,
published a small study in 2007
suggesting that the treatment
speeded cognitive processing in
elderly people. “There’s no question
that neurofeedback works, that
people can change brain activity,”
he said. “The big questions we still
haven’t answered are precisely
how it works and how it can be
harnessed to treat disorders. ”
Russell A. Barkley, a professor of
psychiatry at the Medical
University of South Carolina and a
leading authority on attention
problems, has long dismissed claims
that neurofeedback can help. But
Dr. Barkley says he was persuaded
to take another look after Dutch
scientists published an analysis of
recent international studies finding
significant reductions in
impulsiveness and inattention.
Still, Dr. Barkley cautioned that he
had yet to see credible evidence
confirming claims that such benefits
can be long lasting, much less
permanent.
And another mainstream expert is
much more disapproving. William E.
Pelham Jr., director of the Center
for Children and Families at Florida
International University, called
neurofeedback “crackpot
charlatanism.” He warned that
exaggerated claims for it might
lead parents to favor it over
proven options like behavioral
therapy and medication.
Neurofeedback was developed in
the 1960s and ’70s, with American
researchers leading the way. In
1968, M. Barry Sterman, a
neuroscientist at the University of
California, Los Angeles, reported
that the training helped cats resist
epileptic seizures. Dr. Sterman and
others later claimed to have
achieved similar benefits with
humans .
The findings prompted a boomlet
of interest in which clinicians of
varying degrees of respectability
jumped into the field, making
many unsupported claims about
seeming miracle cures and tainting
the treatment’s reputation among
academic experts. Meanwhile,
researchers in Germany and the
Netherlands continued to explore
neurofeedback ’s potential benefits.
A major attraction of the technique
is the hope that it can help patients
avoid drugs, which often have side
effects. Instead, patients practice
routines that seem more like
exercising a muscle.
Brain cells communicate with one
another, in part, through a constant
storm of electrical impulses. Their
patterns show up on an
electroencephalogram, or EEG, as
brain waves with different
frequencies.
Neurofeedback practitioners say
people have problems when their
brain wave frequencies aren ’t
suited for the task at hand, or when
parts of the brain aren ’t
communicating adequately with
other parts. These issues, they say,
can be represented on a “brain
map,” the initial EEG readings that
serve as a guide for treatment.
Subsequently, a clinician will help a
patient learn to slow down or speed
up those brain waves, through a
process known as operant
conditioning. The brain begins by
generating fairly random patterns,
while the computer software
responds with encouragement
whenever the activity meets the
target.
Health Care’s Uneven Road to a New Era
Consider what it would be like to
have a health insurance plan that
capped annual benefits at $2,000.
For any medical care costing more
than that, you would have to pay
out of pocket.
Examples of care that costs more
than $2,000 — and often a lot
more — include virtually any
cancer treatment, any heart
surgery, a year’s worth of diabetes
treatment and care for many
broken bones. Even a single M.R.I.
exam can cost more than $2,000. A
typical hospital stay runs thousands
of dollars more.
So does this insurance plan sound
like part of the solution for the
country ’s health care system — or
part of the problem?
A $2,000 plan happens to be one of
the main plans that McDonald’s
offers its employees. It became big
news last week, when The Wall
Street Journal reported that the
company was worried the plan
would run afoul of a provision in
the new health care law. In
response to the provision,
McDonald ’s threatened to drop the
coverage altogether, until the
Obama administration signaled it
would grant some exemptions.
This episode was only the latest
disruption that the health law
seems to be causing. Also last
week, the Principal Financial Group
said it was getting out of the health
insurance business, while other
insurers have said they might stop
offering certain types of coverage.
With each new disruption come
loud claims — some from insurance
executives — that the health
overhaul is damaging American
health care.
On the surface, these claims can
sound credible. But when you dig a
little deeper, you often discover the
same lesson that the McDonald ’s
case provides: the real problem
was the status quo.
American families spend almost
twice as much on health care —
through premiums, paycheck
deductions and out-of-pocket
expenses — as families in any
other country. In exchange, we
receive top-notch specialty care in
many areas. Yet on the whole, we
do not get much better care than
countries that spend far less.
We don’t live as long as people in
Canada, Japan, most of Western
Europe or even relatively poor
Jordan. Misdiagnosis is common.
Medical errors occur more often
than in some other countries.
Unique to the developed world,
millions of people have no health
insurance, and millions more, like
many fast-food workers, are
underinsured.
In choosing their health reform
plan, President Obama and the
Democrats eschewed radical
changes, for better or worse, and
instead tried to minimize the
disruptions to the current system.
Sometimes, Mr. Obama went so far
as to suggest there would be no
disruptions, saying that people
could keep their current plan if they
liked it. But that’s not quite right. It
is not possible to change a system
as huge, and as hugely flawed, as
ours without some disruptions.
•
McDonald’s offers its hourly
workers two different health care
plans, which are known as “mini-
med” plans. In one, workers can
pay about $730 a year for benefits
of up to $2,000. In the other, they
can pay about $1,660 a year for
benefits of up to $10,000, The
Journal reported.
In a memo to federal regulators,
McDonald ’s executives argued that
their version of health insurance
“ positively impacts” the almost
30,000 workers who are covered.
And that ’s true. A plan with a
$2,000 or $10,000 cap can cover
some modest health problems and
is better than being uninsured.
But should the litmus test for
American health care really be
better than nothing?
Mini-med plans force people to
drain their savings accounts for
dozens of common medical
problems. They also force hospitals
to let some bills go unpaid, which
drives up costs for everyone else.
Senator Charles Grassley,
Republican of Iowa, has previously
criticized AARP for marketing
similarly limited plans to its
members. “It’s not better than
nothing,” Mr. Grassley argued, “to
encourage people to buy
something described as ‘health
security’ when there’s no basic
protection against high medical
costs. ”
Dr. Aaron Carroll, an Indiana
University pediatrics professor who
studies health policy, says of mini-
med plans: “They’re great if you’re
healthy, because you feel like
you ’re covered. But if you ever
need them, they’re so skimpy,
they provide very little.” Gary
Claxton of the Kaiser Family
Foundation adds, “They really just
shouldn’t be considered health
insurance.”
The plans’ skimpiness is the main
reason they ran into legal jeopardy.
Under the new law, most plans
must spend at least 85 percent of
their revenue on medical care,
rather than administrative
overhead. The McDonald ’s plans
aren’t generous enough to clear the
hurdle.
At the same time, it’s probably
unrealistic to expect McDonald’s to
give workers decent health
insurance. Many of those workers
make less than $20,000 a year. A
typical family insurance plan would
raise their total compensation by
more than half, destroying the
McDonald ’s business model.
The workers, for their part, cannot
afford to buy insurance in the so-
called individual market. Plans are
even more expensive in that
market, because it is dominated by
people who desperately need
insurance — which is to say, sick
people.
This is where health reform comes
in. It tried to solve the problem by
creating what policy experts call a
three-legged stool.
First, people will be required to buy
insurance, to spread costs among
the sick and the healthy. Second,
insurers will be prohibited from
cherry-picking only the healthiest
customers, again to spread costs.
Finally, the government will give
subsidies to people, like McDonald’s
workers, who can’t afford insurance
on their own.
Germany, the Netherlands and
Switzerland all use a system along
these lines to cover everyone,
largely through the private sector,
for less money per person than this
country spends.
The recent disruptions in our health
insurance market are partly a
result of the fact that the stool ’s
three legs were not built on the
same timetable. Some of the
insurance regulations, like the one
on overhead costs, are starting to
take effect. But the new markets
for health insurance, known as
exchanges, won’t be up and
running until 2014. This timetable
has its problems, and the Obama
administration will probably need
to grant some more temporary
exemptions.
In 2014, however, the choice for
McDonald ’s workers will no longer
be between a bad policy and no
policy. Through the exchanges,
they will be able to buy a real
health insurance plan — one that
covers cancer, heart attacks,
surgeries, M.R.I. ’s and hospital stays.
Dr. Carroll notes that many families
will end up paying less than they
are now paying out of pocket and
will get more access to care, too.
For insurance companies, these
changes won ’t be quite so positive.
They will no longer be able to sell
plans that devote 30 percent of
revenue to salaries for their
workers. They will not be allowed
to compete over which company
can come up with the most
ingenious ways to say no to the
sick. Their benefits and prices will
become more public, thanks to the
exchanges.
The health care overhaul that
passed Congress is far from ideal,
as I have written many times in
this space. But it does represent
progress.
The fact that it is beginning to
disrupt the status quo — that some
insurance policies will eventually be
eliminated and some inefficient
insurers will have to leave the
market altogether — is all the
proof we need.
have a health insurance plan that
capped annual benefits at $2,000.
For any medical care costing more
than that, you would have to pay
out of pocket.
Examples of care that costs more
than $2,000 — and often a lot
more — include virtually any
cancer treatment, any heart
surgery, a year’s worth of diabetes
treatment and care for many
broken bones. Even a single M.R.I.
exam can cost more than $2,000. A
typical hospital stay runs thousands
of dollars more.
So does this insurance plan sound
like part of the solution for the
country ’s health care system — or
part of the problem?
A $2,000 plan happens to be one of
the main plans that McDonald’s
offers its employees. It became big
news last week, when The Wall
Street Journal reported that the
company was worried the plan
would run afoul of a provision in
the new health care law. In
response to the provision,
McDonald ’s threatened to drop the
coverage altogether, until the
Obama administration signaled it
would grant some exemptions.
This episode was only the latest
disruption that the health law
seems to be causing. Also last
week, the Principal Financial Group
said it was getting out of the health
insurance business, while other
insurers have said they might stop
offering certain types of coverage.
With each new disruption come
loud claims — some from insurance
executives — that the health
overhaul is damaging American
health care.
On the surface, these claims can
sound credible. But when you dig a
little deeper, you often discover the
same lesson that the McDonald ’s
case provides: the real problem
was the status quo.
American families spend almost
twice as much on health care —
through premiums, paycheck
deductions and out-of-pocket
expenses — as families in any
other country. In exchange, we
receive top-notch specialty care in
many areas. Yet on the whole, we
do not get much better care than
countries that spend far less.
We don’t live as long as people in
Canada, Japan, most of Western
Europe or even relatively poor
Jordan. Misdiagnosis is common.
Medical errors occur more often
than in some other countries.
Unique to the developed world,
millions of people have no health
insurance, and millions more, like
many fast-food workers, are
underinsured.
In choosing their health reform
plan, President Obama and the
Democrats eschewed radical
changes, for better or worse, and
instead tried to minimize the
disruptions to the current system.
Sometimes, Mr. Obama went so far
as to suggest there would be no
disruptions, saying that people
could keep their current plan if they
liked it. But that’s not quite right. It
is not possible to change a system
as huge, and as hugely flawed, as
ours without some disruptions.
•
McDonald’s offers its hourly
workers two different health care
plans, which are known as “mini-
med” plans. In one, workers can
pay about $730 a year for benefits
of up to $2,000. In the other, they
can pay about $1,660 a year for
benefits of up to $10,000, The
Journal reported.
In a memo to federal regulators,
McDonald ’s executives argued that
their version of health insurance
“ positively impacts” the almost
30,000 workers who are covered.
And that ’s true. A plan with a
$2,000 or $10,000 cap can cover
some modest health problems and
is better than being uninsured.
But should the litmus test for
American health care really be
better than nothing?
Mini-med plans force people to
drain their savings accounts for
dozens of common medical
problems. They also force hospitals
to let some bills go unpaid, which
drives up costs for everyone else.
Senator Charles Grassley,
Republican of Iowa, has previously
criticized AARP for marketing
similarly limited plans to its
members. “It’s not better than
nothing,” Mr. Grassley argued, “to
encourage people to buy
something described as ‘health
security’ when there’s no basic
protection against high medical
costs. ”
Dr. Aaron Carroll, an Indiana
University pediatrics professor who
studies health policy, says of mini-
med plans: “They’re great if you’re
healthy, because you feel like
you ’re covered. But if you ever
need them, they’re so skimpy,
they provide very little.” Gary
Claxton of the Kaiser Family
Foundation adds, “They really just
shouldn’t be considered health
insurance.”
The plans’ skimpiness is the main
reason they ran into legal jeopardy.
Under the new law, most plans
must spend at least 85 percent of
their revenue on medical care,
rather than administrative
overhead. The McDonald ’s plans
aren’t generous enough to clear the
hurdle.
At the same time, it’s probably
unrealistic to expect McDonald’s to
give workers decent health
insurance. Many of those workers
make less than $20,000 a year. A
typical family insurance plan would
raise their total compensation by
more than half, destroying the
McDonald ’s business model.
The workers, for their part, cannot
afford to buy insurance in the so-
called individual market. Plans are
even more expensive in that
market, because it is dominated by
people who desperately need
insurance — which is to say, sick
people.
This is where health reform comes
in. It tried to solve the problem by
creating what policy experts call a
three-legged stool.
First, people will be required to buy
insurance, to spread costs among
the sick and the healthy. Second,
insurers will be prohibited from
cherry-picking only the healthiest
customers, again to spread costs.
Finally, the government will give
subsidies to people, like McDonald’s
workers, who can’t afford insurance
on their own.
Germany, the Netherlands and
Switzerland all use a system along
these lines to cover everyone,
largely through the private sector,
for less money per person than this
country spends.
The recent disruptions in our health
insurance market are partly a
result of the fact that the stool ’s
three legs were not built on the
same timetable. Some of the
insurance regulations, like the one
on overhead costs, are starting to
take effect. But the new markets
for health insurance, known as
exchanges, won’t be up and
running until 2014. This timetable
has its problems, and the Obama
administration will probably need
to grant some more temporary
exemptions.
In 2014, however, the choice for
McDonald ’s workers will no longer
be between a bad policy and no
policy. Through the exchanges,
they will be able to buy a real
health insurance plan — one that
covers cancer, heart attacks,
surgeries, M.R.I. ’s and hospital stays.
Dr. Carroll notes that many families
will end up paying less than they
are now paying out of pocket and
will get more access to care, too.
For insurance companies, these
changes won ’t be quite so positive.
They will no longer be able to sell
plans that devote 30 percent of
revenue to salaries for their
workers. They will not be allowed
to compete over which company
can come up with the most
ingenious ways to say no to the
sick. Their benefits and prices will
become more public, thanks to the
exchanges.
The health care overhaul that
passed Congress is far from ideal,
as I have written many times in
this space. But it does represent
progress.
The fact that it is beginning to
disrupt the status quo — that some
insurance policies will eventually be
eliminated and some inefficient
insurers will have to leave the
market altogether — is all the
proof we need.
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