How Bitcoin and Other Magic Internet Money Loans Endanger Your Financial Health

It’s The Big Bank Failure Story No One is Talking About

By DAVID CAY JOHNSTON

Investopedia / NoNo Flores

The collapse of Silicon Valley Bank (SVB) last week raises serious issues far more significant than the obvious ones cited by the financial press and a broad range of Washington politicians.

Chief among these are bank loans against dubious assets. That’s not getting much if any attention in the news or from Washington and is likely to soon be swept under the rug, allowing needlessly risky banking practices to continue.

Before its collapse last week, SVB made loans against Bitcoin and other cryptocurrencies.

The question: why is any bank anywhere allowed to accept crypto as collateral for loans?

Bitcoin and its imitators are not money. They are not currency. They’re hardly used to buy and sell, an unsurprising fact given that by design the Bitcoin system can process only seven transactions per second compared to many thousands of transactions per second for credit cards.

Indeed, except for laundering proceeds from drug trafficking as well as hiding assets from creditors, estranged spouses, and the tax police, cryptocurrencies have no use.

Death Cult

It's Clear the GOP Is a Party of Death, Not Life

THOM HARTMANN in Common Dreams

By Marc Murphy

Because they oppose a woman having the right to terminate a pregnancy, Republicans claim to be the Party of Life. In fact, they’re the Party of Death.

Seriously. Unless you’re white, straight, male, Christian, and morbidly rich, Republicans appear to want you and your children dead. In every instance, they will put a corporation or a rich white man’s making a buck over the life of anybody else.

Here's a very long list that proves it.

— Toxic waste kills people, but Republicans have worked for decades to cripple the EPA and other agencies’ ability to regulate it. Trump alone rolled back over 100 environmental regulations that protected families and children.

— Being homeless kills people, but Republicans fight any sort of housing support, rent control, or laws that might inhibit foreign or Wall Street investors from buying up housing stock and jacking up housing costs.

— Guns kill more children in America than any other single cause, and Republicans want more of them, including weapons designed exclusively for use on the battlefield.

— Hunger kills children through weakening their immune systems and diminishing their ability to learn, but Republicans are so opposed to feeding children at school that one rightwing talk host recently argued that hungry kids should be sent to orphanages.

— Pregnancy kills women far more often than abortion (20.1 deaths per 100,000 pregnancies versus .4 deaths per 100,000 abortions), but Republicans are passing laws to force women and girls to endure childbirth whether they want to or not.

— Suicide kills more gay men than AIDS, and queer youth are four times more likely to kill themselves than their cis counterparts, but Republicans continue to stigmatize and attempt to criminalize homosexuality, being transgender, and even dressing in drag.

— Cancer kills people, but Republicans defend carcinogenic pesticides and other chemicals in our food supply.

— Civil wars kill people, but Republicans are openly advocating one today.

Yep, that's fox

 

Trumpism explained

 

Breaking down the new clean water guidelines

A water quality scientist explains technology and investment needed to get forever chemicals out of US drinking water

Joe Charbonnet, Iowa State University

PFAS can be found in hundreds of water systems in
the U.S. d3sign/Moment via Getty Images

Harmful chemicals known as PFAS can be found in everything from children’s clothes to soil to drinking water, and regulating these chemicals has been a goal of public and environmental health researchers for years. On March 14, 2023, the U.S. Environmental Protection Agency proposed what would be the first set of federal guidelines regulating levels of PFAS in drinking water. The guidelines will be open to public comment for 60 days before being finalized.

Joe Charbonnet is an environmental engineer at Iowa State University who develops techniques to remove contaminants like PFAS from water. He explains what the proposed guidelines would require, how water utilities could meet these requirements and how much it might cost to get these so-called forever chemicals out of U.S. drinking water.

1. What do the new guidelines say?

PFAS are associated with a variety of health issues and have been a focus of environmental and public health researchers. There are thousands of members of this class of chemicals, and this proposed regulation would set the allowable limits in drinking water for six of them.

Two of the six chemicals – PFOA and PFOS – are no longer produced in large quantities, but they remain common in the environment because they were so widely used and break down extremely slowly. The new guidelines would allow for no more than four parts per trillion of PFOA or PFOS in drinking water.

Four other PFAS – GenX, PFBS, PFNA and PFHxS – would be regulated as well, although with higher limits. These chemicals are common replacements for PFOA and PFOS and are their close chemical cousins. Because of their similarity, they cause harm to human and environmental health in much the same way as legacy PFAS.

A few states have already established their own limits on levels of PFAS in drinking water, but these new guidelines, if enacted, would be the first legally enforceable federal limits and would affect the entire U.S.

How Parents Decide if They Should Vaccinate Their Kids Against COVID-19

If only they listened to doctors and scientists, not quacks on the internet

By CANADIAN MEDICAL ASSOCIATION JOURNAL 

For parents, the decision to vaccinate their children against SARS-CoV-2 is influenced by multiple factors, including scientific evidence, political and social pressures, and beliefs about individual versus collective benefits. 

A recent study aimed to understand parents’ views about vaccination to aid future initiatives.

New study explores complexity of decision-making.

A recent study published in the Canadian Medical Association Journal (CMAJ) on February 21 has found that the decision for parents to vaccinate their children against SARS-CoV-2, the virus that causes COVID-19, is complex and multifaceted. 

The decision is influenced by a combination of factors, including scientific evidence, political and social pressures, and personal beliefs about the individual versus collective benefits of vaccination.

Researchers conducted a qualitative study with in-depth interviews of 20 parents to understand their views about SARS-CoV-2 vaccination, with a goal to support future vaccination initiatives.

Offensive and outrageous but that seems to be the point

Rep. Quattrocchi asks LGBTQ legislator if she’s a pedophile at committee hearing

By Steve Ahlquist, Uprise RI

After State Representative Rebecca Kislak (Democrat, District 4, Providence) introduced the Equity Impact Statement Act on Friday in the House Committee on State Government and Elections, the committee welcomed questions.

Representative Robert Quattrocchi (Republican, District 41, Scituate) asked first if under her bill he had to take into account those whose sexual orientation was “pedophile”. 

After Rep. Kislak pointed out that “pedophile” is not a type of sexual orientation and that the question was offensive, Rep. Quattrocchi asked Rep. Kislak if she was a pedophile. The entire room reacted with shock and outrage.

Shortly after this exchange Representative Quattrocchi packed up his stuff and left the hearing.

You can watch the entire exchange below, or skip to the offending comments here.

21st century crime-fighting

For more cartoons by Ted Rall, CLICK HERE

 

Of course he did

 

Bird flu is killing New England seals

Bird flu associated with hundreds of seal deaths in New England in 2022

Tufts University

Researchers at Cummings School of Veterinary Medicine at Tufts University found that an outbreak of highly pathogenic avian influenza (HPAI) was associated with the deaths of more than 330 New England harbor and gray seals along the North Atlantic coast in June and July 2022, and the outbreak was connected to a wave of avian influenza in birds in the region.

The study was published on March 15 in the journal Emerging Infectious Disease.

HPAI is more commonly known as bird flu, and the H5N1 strain has been responsible for about 60 million poultry deaths in the U.S. since October 2020, with similar numbers in Europe. The virus was known to have spilled over from birds into mammals, such as mink, foxes, skunk, and bears, but those were mostly small, localized events. This study is among the first to directly connect HPAI to a larger scale mortality event in wild mammals.

Wood River has a short-term gig starting soon. Apply now.

 

The Wild and Scenic Stewardship Council Presents..... Contract Position: Short-Term Project Administration  Application review beginning on April 3, 2023   The Wood-Pawcatuck Wild and Scenic Rivers Program (W&S) seeks applicants for a short-term (~4 months with the possibility of an extension) contract to assist in the administration of the program. The contractor will work remotely and be required to attend regular meetings at the Wood-Pawcatuck Watershed Association’s campus in Hope Valley. Basic information is listed below, however for full description and application directions, follow link here and below.   Tasks Will Include: • Budget management, invoicing, bill payment, and account reporting to the officers and Stewardship Council each month. • Manage W&S communications (web site, constant contact emails, Zoom meetings, written documents). • Act as a liaison with W&S standing committees. • Coordinate and facilitate monthly meetings of the Stewardship Council, including setting agendas and preparing meeting materials. • Act as a liaison between the Stewardship Council and other organizations and agencies (e.g., National Park Service and Wood-Pawcatuck Watershed Association). • Administer the W&S small grants program as needed. • Other duties as assigned.   Term: This is a four-month contract with a possibility of extension. Billing rate is negotiable depending on qualifications and experience. To Apply: Please send via email and PDF attachments: (1) a cover letter stating your qualifications for the position, (2) a current resume, (3) a quote for the outlined tasks for a 4-month period (or a proposed hourly billing rate), and (4) contact information for three references. We will begin reviewing proposals on April 3, 2023. The selected contractor must be able to provide a Completed W9, Certificate of Insurance for General Liability, Certificate of Workers Comp insurance or a waiver. Please email your application materials or any questions to: antoniabryson@gmail.com   Feel free to forward this message and spread the interest.    CLICK HERE for the full job description and application.     Our Contact Information Wood-Pawcatuck Watershed Association 203 Arcadia Road Hope Valley, RI 02832 401-539-9017 http://www.wpwa.org Unsubscribe | Manage email preferences

Cutting Medicare Benefits Will Further Strain Overworked Caregivers

More reasons to stop GOP plans to cut Medicare

MARTA HILL GRAY for Common Dreams

There’s an ongoing debate in Washington about the need to trim government spending. As our representatives in Congress wrangle over words like “cuts” and “reforms,” the salient issue remains that long-standing entitlement programs like Social Security and Medicare are on the chopping block. 

It’s time that we acknowledge just how essential these programs are to supporting home and medical care for older Americans and the caregivers who provide that care.

Care benefits are mistakenly deemed unnecessary but any cuts to this lifeline would be devastating to both older adults and their caregivers. Cuts to Medicare, in particular, would do grave harm to caregivers – direct care providers and unpaid family members alike – who spend countless hours making sure those in their charge live dignified and rewarding lives despite their challenges.

These cuts will only make a hard job infinitely harder by limiting resources and expanding the health burden caregivers bear in their work. We know this because we work with caregivers on a daily basis at Culpepper Garden to serve low-income older adults in our independent- and assisted-living residences. 

That’s why we urge our Congress to immediately take Medicare off the chopping block during these debt ceiling deliberations. Instead, they must preserve, and even strengthen, it.

There are about 65 million Americans on Medicare, and, according to the AARP, one in five Americans in 2020 had been a caregiver — that’s about 53 million adults. Of those, most are female Baby Boomers and the vast majority are women of color taking care of a family member. Given how many people are affected, questions about Medicare’s future are far from insignificant.

America’s worsening child labor problem

‘We know how to fix the problem, but it is politically unpopular to do so’

Dawn Bergantino 

This photo, from a U.S. Department of Labor court filing,
shows a Packers Sanitation Services Inc. child employee
at the JBS Beef Plant in Grand Island, Nebraska.
(U.S. Department of Labor photo/WHI Lopez)

In recent weeks, the issue of child labor in the United States – particularly among migrant children – has come under new scrutiny. In mid-February, the U.S. Department of Labor issued a release detailing a $1.5 million penalty paid by Packers Sanitation Services Inc., one of the largest food sanitation companies in the country. 

An investigation found the company had illegally employed more than 100 children ages 13 to 17 in hazardous jobs, including having them work overnight shifts, at 13 meat processing facilities in eight states. The case was one of the largest in the department’s history.

The next week, The New York Times published an investigative report on the exploitation of migrant child workers arriving as unaccompanied minors in the United States. The report found a shadow workforce, touching virtually every industry in every state in the nation, benefitting not only under-the-table operations, but also global corporations.

According to The Times, “in Los Angeles, children stitch ‘Made in America’ tags into J. Crew shirts. They bake dinner rolls sold at Walmart and Target, process milk used in Ben & Jerry’s ice cream and help debone chicken sold at Whole Foods. As recently as the fall, middle-schoolers made Fruit of the Loom socks in Alabama. In Michigan, children make auto parts used by Ford and General Motors.” 

The report was followed just two days later by the Biden Administration’s announcement of a crackdown on labor exploitation of migrant children.

The Fair Labor Standards Act of 1938 limited many forms of child labor in an attempt to keep children under 16 from leaving school and keep them from jobs that may be dangerous or harmful to their health. While the law is intended to apply to all children, regardless of their citizenship status, it also largely excluded agricultural work. 

Child-labor violations are primarily enforced through civil monetary penalties that are not severe enough to act as a deterrent. Additionally, state laws governing child labor vary – and since COVID-19 some states have weakened protections in response to heightened demand for workers.

URI Professor of Political Science Brendan Skip Mark says more resources and stiffer penalties are needed to combat child labor and to make the cost of employing children too risky for businesses to undertake. 

Mark is co-director of the CIRIGHTS data project – the world’s largest quantitative dataset on global human rights. CIRIGHTS draws on human rights reports from the U.S. Department of State, Amnesty International, the United Nations State of the World’s Indigenous Peoples Report, and other sources. 

Among those rights recorded are workers’ rights— including fair working conditions and the right to unionize. In total, the new dataset measures 72 internationally recognized rights.

Below, Prof. Mark lends his expertise to provide context around the issue of child labor in the United States – why the issue seems to be gaining more traction, some of its causes, as well as what can be done to help stop it.

Is Tucker Carlson an asshole? Just asking.

For more cartoons by Tom Tomorrow, CLICK HERE

 

Wake up

 

Good news or bad news?

Air pollution impairs successful mating of flies

Max Planck Institute for Chemical Ecology

Copulation attempt of two Drosophila males. © Benjamin
Fabian, Max Planck Institute for Chemical Ecology

Insect sexual communication relies to a significant extent on pheromones, chemical attractants that specifically allow males and females of a species to mate. Sex pheromones are distinctive to males and females of a species. 

Even the smallest differences, such as those observed in the formation of new species, ensure that mating no longer takes place, because males and females only find each other through the unmistakable odor of their conspecifics.  

Most insect pheromones are odor molecules containing carbon-carbon double bonds. Such double bonds are known to be easily destroyed by ozone. 

Top 5 Health Benefits of Cinnamon

Heart, diabetes, inflammation, weight loss, brain

By SCITECHDAILY.COM 

Cinnamon is a spice obtained from the inner bark of several tree species. It is commonly used in cooking and baking for its sweet and warm flavor, as well as for its health benefits.

Cinnamon is a spice that has been used for centuries in traditional medicine and cooking. It is derived from the bark of several trees in the Cinnamomum family and is known for its warm, sweet flavor. 

In addition to its culinary uses, cinnamon is also known for its numerous health benefits. You can even find cinnamon in supplement form as capsules, often with the active molecule cinnamaldehyde in a concentrated form. In this article, you’ll learn the major ways in which cinnamon can improve your health.

54% of firearm deaths in the US are from suicide

Easy access to a gun is a key risk factor

Heidi Zinzow, Clemson University

More than half – 54% – of all firearm deaths in the United States in 2021 were attributable to suicide, according to February 2023 data from the Centers for Disease Control and Prevention.

Suicide deaths involving firearms – the most common means of suicide in the U.S. – have increased 28% since 2012. 

Groups particularly at risk include men and veterans, who are more likely to have access to and experience with firearms. Research also suggests that alcohol use is a significant risk factor for gun-related suicides, as opposed to suicides involving less lethal means. This is particularly true for young adults and middle-aged people.

Access to firearms is a key risk factor for suicide due to their high lethality. Suicide attempts that involve firearms end in death 90% of the time. Suicide is often an impulsive act, and when a person has access to swift and lethal means such as a firearm, there is limited opportunity to intervene or allow for a suicidal impulse to pass.

It is a common myth that once a person has made up their mind to die by suicide it is not possible to prevent them from doing so. In fact, most individuals who survive an attempt do not attempt suicide again, and those who survive an initial attempt using one method are unlikely to switch to a different method.

These findings underscore the importance of restriction of access to firearms as a critical suicide prevention strategy.

Research indicates that storing a firearm safely reduces the risk of the owner – as well as others, including any children living in the home – dying by suicide.

Firearm safety measures include gun safes, lockboxes, storing firearms separate from ammunition, and either voluntarily or involuntarily removing firearms from the home when a person has a mental health condition or other warning signs for suicide risk.

New CCA temper tantrum

Failed March 13 attempt to “flood the zone” sparks slander from CCA leadership

By Will Collette

The Charlestown Citizens Alliance (CCA) was soundly rejected by voters in the 2022 election. But, not surprisingly, they still have some tricks up their sleeves to take back power.

One such attempt was made – and failed – at the March 13 Town Council meeting where the CCA attempted to “flood the zone” with a large number of their stalwarts trying to get onto key town commissions and committees.

Such long-time CCA hardcore players as Bonnita Van Slyke, Mikey Chambers, Ron Areglado, Pete Mahoney and Dick Sartor made bids for seats on the Charter Revision Committee, Ordinance Revision Ad Hoc Committee, Town Administrator Search Ad Hoc Committee and Parks & Recreation Commission.

None were approved although several applicants with CCA ties, such as veterinarian Dr. Lew Johnson did win appointment.

Fortunately, there was a large field of experienced and thoughtful non-CCA candidates to fill the ranks of these important town bodies. You can see the full list of people who applied, who was chosen and who was not by CLICKING HERE.

I also encourage you to read their applications and career highlights by CLICKING HERE.

You really should take a close look because the CCA has decided to use their failed blitz as “evidence” that the “Town Council Puts Developers In Charge,” according to the headline in their blog.

Only one appointee, Tim Stasiunas, is an active developer. Evelyn Smith, who was appointed to the Charter Revision Committee, was a developer decades ago. However, Evelyn has put in more than 20 years on the town’s Affordable Housing Commission. Evelyn does own an inactive sand pit.

According to the CCA, any person who owns a business is suspect, as are all attorneys (except the CCA’s last remaining Council member Susan Cooper of course). By the way, contrary to CCA's claim, Cooper voted to approve Evelyn Smith's appointment.

For some inscrutable reason, about half of the CCA’s screed rehashes their own tragic handling of the COPAR Quarry crisis, re-writing history by casting themselves as the heroes rather than chumps. 

Copar owner Phil Armetta (Middletown Eye
photo by Stephen H. Devoto 

As readers may recall, a guy who did federal jail time for racketeering, Phil Armetta, re-launched the Copar quarry on the Westerly-Charlestown line in 2013. He hired a convicted grifter, Sam Cocopard, to run it for him. 

All of this had predictable results for the neighbors and the environment as well as itself. Copar went bankrupt in 2015 after its principals started stealing from each other.

Even though our own Town Solicitor advised the then CCA-controlled Council the town has broad police powers to invoke public health and safety to curb the quarry and certainly to deny them a permit to expand into Charlestown by taking over the Morrone sand pit on Route 91, the CCA Council decided they needed state legislation.

They wasted time dithering at the State House, putting their faith in our useless ex-state Representative Blake “Flip” Filippi.

As the CCA describes it, they created an ordinance in 2014 that was “fought and killed by the very people appointed on March 13, 2023.”

That’s a lie. The only quarry-related matters passed by the then CCA-controlled Town Council during the Copar crisis were a string of resolutions asking the General Assembly to give Charlestown the authority to regulate quarries and sand pits.

The CCA withdrew all town efforts to control quarries until years after Copar was gone and then, they only affected future quarries and specifically exempted existing ones. Charlestown is currently in litigation with the new owners of the Morrone sand pit, fighting over whether this is a new mine or a old "grandfathered" one.

The CCA’s diatribe tries to convince you that the new Town Council majority are nefarious agents for the hordes of developers and mining companies with convoys of construction equipment parked along Route One just waiting for the go-ahead to despoil Charlestown’s “rural character.” And as usual, only the CCA can save us from this fate worse than death.

But if you read to the end of their screed and the comments, the real cause of their angst becomes clear. They claim the newly appointed committees will “change the town charter to have an appointed rather than an elected Planning Commission. An elected Planning Commission has to be responsible to the voters. An appointed Planning Commission is controlled by the same Town Council that puts developers in charge of local land use law.”

Rhode Island law requires Planning Commissions to be appointed. Charlestown is the only municipality in Rhode Island that still elects its Planning Commissions. 

The state law requires appointment over election to de-politicize municipal planning. However, the CCA likes things the way they are because it gives their leader Ruth Platner the role of most powerful elected official in Charlestown.

OMG! A bus stop! The end of Rural Character
as we know it

Behind the scenes, Platner exercises the power to obstruct any land use that conflicts with her vision of "rural character." As an example, she is why Charlestown is the only municipality in Rhode Island that has no RIPTA bus route and doesn't want one.

Foster just got approval for bus service. By the end of the year, RIPTA plans to provide Little Compton and Block Island with van service, leaving Charlestown as the sole hold-out.

The CCA is also lying when it claims the Charter Revision Committee can just “change the town charter.” 

First, any changes will have to go through an extensive open and public process, including legal review and public hearings, before Commission recommendations can be approved by the Town Council as ballot questions which then go to the voters. Even then, the General Assembly will have to sign off on any charter changes.

This will take time. The earliest likely time for any proposed charter changes would be the 2024 election.

Speaking of elections, one of the comments published by the CCA is this one from a person who calls themselves “Audrey":

”Perhaps if Non-Resident property owners, who pay enormous amounts of Property Taxes to the Town of Charlestown, such as Summer-Home owners, were allowed to VOTE, there would be no rapacious Town Council members or Administrators!”

Non-resident voting (based on property ownership) is unconstitutional but has been a longtime priority for the CCA and its antecedent, the RI Shoreline Coalition.

And then CCA’s Voice Mikey Chambers chimed in with: “In the end, this Council will probably take away the rights of the voter to elect their own Planning Commission, decide on large town expenditures, and to issue grievances publicly.”

For more than a decade, the CCA routinely purged town commissions and committees of people insufficiently loyal to the CCA, refused re-appointments and denied applications from other non-CCA adherents. They saddled Charlestown with commission members, some incompetent, others hostile to the mission of the commissions on which they served while rejecting applicants who were obviously more qualified.

Mikey Chambers was among that motley crew who benefited from CCA’s purges by getting patronage appointments.

Just about every town body that wielded any kind of power was filled with CCA sycophants. Looking back at the November 8 election, it was the CCA’s arrogance in putting their own political power ahead of the needs of the people of Charlestown that cost them the election.

Based on their substance-free, fact-challenged whining, it's clear they have learned nothing.

Yeah, don't relax

 

Boycott Trump

 

Well, if it works for fish….

Mild fever helps clear infections faster, new study suggests

University of Alberta

How do you take a fish's temperature?
Aren't they cold-blooded?

It may be better to let a mild fever run its course instead of automatically reaching for medication, new University of Alberta research suggests.

Researchers found that untreated moderate fever helped fish clear their bodies of infection rapidly, controlled inflammation and repaired damaged tissue. "We let nature do what nature does, and in this case it was very much a positive thing," says immunologist Daniel Barreda, lead author on the study and a joint professor in the Faculty of Agricultural, Life & Environmental Sciences and the Faculty of Science.

Moderate fever is self-resolving, meaning that the body can both induce it and shut it down naturally without medication, Barreda explains. The health advantages of natural fever to humans still have to be confirmed through research, but the researchers say because the mechanisms driving and sustaining fever are shared among animals, it is reasonable to expect similar benefits are going to happen in humans.

That suggests we should resist reaching for over-the-counter fever medications, also known as non-steroidal anti-inflammatory drugs, at the first signs of a mild temperature, he says. "They take away the discomfort felt with fever, but you're also likely giving away some of the benefits of this natural response."

Feds Move to Rein In Prior Authorization

System Harms and Frustrates Patients

Lauren Sausser 

Except sometimes, prior authorization is denied

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest.

As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist in Los Angeles recommended the 67-year-old undergo an MRI, a high-resolution image that could help spot the disease.

But her MRI appointment kept getting canceled, Chestnut’s son, Jaron Roux, told KHN. First, it was scheduled at the wrong hospital. Next, the provider wasn’t available. The ultimate roadblock she faced, Roux said, arrived when Chestnut’s health insurer deemed the MRI medically unnecessary and would not authorize the visit.

“On at least four or five occasions, she called me up, hysterical,” Roux said.

Months later, Chestnut, struggling to breathe, was rushed to the emergency room. A tumor in her chest had become so large that it was pressing against her windpipe. Doctors started a regimen of chemotherapy, but it was too late. Despite treatment, she died in the hospital within six weeks of being admitted.

Though Roux doesn’t fully blame the health insurer for his mother’s death, “it was a contributing factor,” he said. “It limited her options.”

Few things about the American health care system infuriate patients and doctors more than prior authorization, a common tool whose use by insurers has exploded in recent years.

Prior authorization, or pre-certification, was designed decades ago to prevent doctors from ordering expensive tests or procedures that are not indicated or needed, with the aim of delivering cost-effective care.