Long Waits for Italian Cabs Due to Regulations Limiting More Cabs and Ride-Sharing

(p. A4) Returning to Rome from Naples one Monday afternoon in June [2023], a train trip that takes just over an hour, Daniele Renzoni said that he and his wife waited for more than an hour and a half at Termini station for a cab under a blazing sun.

“Just image a long line of grumbling, frustrated people, complaining, cursing. Hot day, angry tourists, there’s not much else to say,” said Mr. Renzoni, who is retired. “Taxi drivers will tell you there’s too much traffic, too many requests, too much everything, but the fact is, the customer pays.”

The situation is “a disgrace to Italy,” said Furio Truzzi, president of the consumer rights group Assoutenti, one of several associations that protested the shortage.

. . .

Thanks to the taxi lobby, ride-sharing services are almost nonexistent in Italy, where Uber is the only platform in use, with many restrictions.

The government lost an opportunity for real change, said Andrea Giuricin, a transportation economist at a research center at the University of Milan Bicocca. He said the best way to meet consumer needs would be to increase the number of licenses for Italy’s chauffeur services, known as N.C.C., which work with Uber.

“It’s very difficult in Italy” because “there isn’t a culture of liberalization in general,” creating little opportunity for competition, said Professor Giuricin. Taxis “are a small but powerful lobby” that easily influences politics, “which is very weak” in Italy, he said.

Angela Stefania Bergantino, a professor of transportation economics at the University of Bari, pointed out that previous governments had tried to open up the taxi market. But they failed.

“The problem is that taxis are regulated by municipal governments, which can find themselves captive in the sense that it is difficult for City Hall to implement policies that the cab lobby doesn’t like,” she said. “These are lobbies that have effective strike tools,” like wildcat strikes or traffic blockages that can paralyze entire cities, she said.

. . .

Above all, though licenses are issued by the city, they can then be sold by the drivers, for sums that can reach 250,000 euros, or about $276,000, depending on the city — a retirement nest egg for many. With an influx of new licenses, the value of an existing license would depreciate.

City administrators fear cabbies could revolt and strike if the status quo changes. “If I decide to issue new licenses,” said Eugenio Patanè, Rome’s city councilor in charge of transportation, “I’m going to find 1,000 taxis blocking traffic in Piazza Venezia,” the downtown Rome square that taxi drivers habitually clog while protesting.

For the full story, see:

Elisabetta Povoledo. “Getting a Cab in Italy Is Hard. But Remedying That Isn’t Easy.” The New York Times (Friday, August 11, 2023): A4.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Aug. 10, 2023, and has the title “Getting a Taxi in Italy Is Too Hard. Fixing That Is Not Easy.”)

“Persistent Plucky Outsiders” Innovate a Better Way to Stop Bleeding

(p. 20) Charles Barber’s “In the Blood” treats a consequential topic, and contains moments of real insight, drama and humor.

. . .

Though hemorrhage is a leading cause of death in both war and peacetime, we learn, the techniques for stopping it haven’t improved significantly for millenniums. Barber explores the mysteries of the “coagulation cascade” — during which diverse proteins activate in intricately choreographed sequence to facilitate clotting — as well as the “lethal triad” of hypothermia, acidosis and coagulopathy (impaired clotting) that can send the body into shock.

We watch a surgeon at a Navy hospital in Bethesda slit the femoral arteries of a herd of 700-pound pigs, then apply different hemostatic agents to the spurting wounds, to see which substance stops the bleeding best. Most products, backed by biotech and medical companies, fail: The poor beasts bleed out. But zeolite, a simple mineral with hitherto unknown hemostatic properties, saves their bacon every time.

Barber’s earlier books feature persistent, plucky outsiders who strive to change the world, and he finds two more likely subjects in the men who brought zeolite’s lifesaving properties to light. Frank Hursey is the brilliant, nerdy engineer who discovers that this cheap, highly porous mineral, used by industry to absorb radiation, chemicals and bad odors, also happens to accelerate clotting, by mopping up water in the blood and thereby concentrating its coagulation agents. (Later Hursey finds that another inexpensive mineral, kaolin, works even better.)

Barely anyone pays attention to Hursey’s discovery until he partners with Bart Gullong, a down-on-his-luck salesman who rebrands Hursey’s invention “QuikClot” and persuades a military scientist to try it out on people. Hursey and Gullong are soon befriended by iconoclasts within the armed forces medical establishment, more of Barber’s appealing, quirky, determined Davids, who together take on two of the biggest Goliaths around: the military-industrial complex and Big Pharma.

For the full review, see:

Tom Mueller. “The Home Front.” The New York Times (Sunday, Aug. 20, 2023): 20.

(Note: ellipsis added.)

(Note: the online version of the review has the date July 26, 2023, and has the title “A Fight to Save Soldiers, From the Lab to the Battlefield.”)

The book under review is:

Barber, Charles. In the Blood: How Two Outsiders Solved a Centuries-Old Medical Mystery and Took on the Us Army. New York: Grand Central Publishing, 2023.

Phage Therapy Renaissance-“Once Derided as an Idea for Cranks and Commies”

(p. C7) As engaging as it is expansive, “The Good Virus” describes the distinctive biology and murky history of bacteriophage (generally shortened to “phage”), a form of life that is remarkably abundant yet obscure enough to have been termed the “dark matter of biology.”

. . .

In a South London research institute in the early 1910s, the meticulous English bacteriologist Frederick Twort set out to grow the smallpox virus in petri dishes, hoping it could be “observed and studied like bacteria.” He succeeded in growing only contaminating bacteria, but within these colonies he noticed the occasional small clearing, as if something invisible was killing the bacteria. With the outbreak of World War I, Twort lost funding, closed his lab and published his results in 1915, cautiously suggesting that a virus could be the cause of the observed phenomenon. Few took notice.

Twort’s unlikely competitor would be Felix d’Herelle, a free-spirited Frenchman . . .

. . .

He found the same glassy spots that Twort had observed and (with noticeably less restraint) announced in 1917 that he had discovered a new form of life, which he called “bacteriophage.” D’Herelle went on to use phage to treat five sick boys successfully. But his “wild and abrasive style” (in Mr. Ireland’s words) antagonized his peers, who conspired to undermine him.

D’Herelle’s discoveries inspired many, including George Eliava, a microbiologist from the Soviet Union’s republic of Georgia. In 1936, he would establish the first institute (and still one of the few) devoted to bacteriophage research. Unfortunately for Eliava, he soon ran afoul of the Soviet secret police, who disappeared him in 1937. The institute continued to pursue the development of phage therapy and scored many victories—phage helped treat soldiers suffering from gangrene, for example. But there were also frustrating failures, in part because the phage weren’t adequately purified and often because they weren’t appropriately matched to the specific strain of infecting bacteria.

. . .

. . ., the “dubious and unreliable nature of commercial American phage products” in the 1930s, we learn, meant that “whether they worked for a particular patient was a complete lottery.”

During World War II, the West turned decisively to newly discovered penicillin, sharing the formula for it with the Soviets but not the methods of mass production. Thus the Soviets continued to rely on phage as the therapy of choice for bacterial infections. When a Soviet researcher tried to obtain production rights to penicillin in 1949, he was arrested by government authorities and died under interrogation, all for the crime of nizkopoklonstvo—adulation of the West.

. . .

Once “derided as an idea for cranks and commies,” Mr. Ireland writes, phage therapy seems to be enjoying a renaissance. Having been sustained for years by an idiosyncratic global community of true believers, phage-based medicines have now attracted the attention of high-powered biotechnologists and investors.

For the full review, see:

David A. Shaywitz. “The Enemy of My Enemy.” The Wall Street Journal (Saturday, Aug. 5, 2023): C7.

(Note: ellipses added. In the original, the Russian word nizkopoklonstvo is in italics.)

(Note: the online version of the review has the date August 4, 2023, and has the title “‘The Good Virus’ Review: An Unlikely Healer.”)

The book under review is:

Ireland, Tom. The Good Virus: The Amazing Story and Forgotten Promise of the Phage. New York: W. W. Norton & Company, 2023.

To Cut Out Costs of Car Dealership Middlemen, Tesla Is Selling Direct from Indian Reservation Showrooms

(p. D6) Tesla is ramping up efforts to open showrooms on tribal lands where it can sell directly to consumers, circumventing laws in states that bar vehicle manufacturers from also being retailers in favor of the dealership model.

Mohegan Sun, a casino and entertainment complex in Connecticut owned by the federally recognized Mohegan Tribe, recently announced that the California-based electric automaker will open a showroom with a sales and delivery center this fall on its sovereign property, where the state’s law doesn’t apply.

The news comes after another new Tesla showroom was announced in June, set to open in 2025 on lands of the Oneida Indian Nation in upstate New York.

“I think it was a move that made complete sense,” said Lori Brown, executive director of the Connecticut League of Conservation Voters, which lobbied for years to change Connecticut’s law.

. . .

Brown noted that lawmakers with car dealerships that are active in their districts, no matter their political affiliation, traditionally opposed bills allowing direct-to-consumer sales.

. . .

Over the years in numerous states, Tesla sought and was denied dealership licenses, pushed for law changes and challenged decisions in courts.

. . .

Tesla opened its first store as well as a repair shop on Native American land in 2021 in New Mexico. The facility, in Nambé Pueblo, north of Santa Fe, marked the first time the company partnered with a tribe to get around state laws, though the idea had been in the works for years.

For the full story, see:

SUSAN HAIGH, Associated Press. “Tesla to Open Showrooms on Tribal Lands to Circumvent Laws.” Omaha World-Herald (Sunday, Aug. 13, 2023): D6.

(Note: ellipses added.)

(Note: the online version of the story has the date Aug. 5, 2023, and has the title “Automaker Tesla is opening more showrooms on tribal lands to avoid state laws barring direct sales.”)

Allow Us to View the “Artifacts of Human Suffering” That Enable Us to “Appreciate the Epic Achievements of Medicine”

(p. D1) The Mütter Museum, a 19th-century repository of medical oddments and arcana at the College of Physicians of Philadelphia, attracts as many as 160,000 visitors a year. Among the anatomical and pathological specimens exhibited are skulls corroded by syphilis; spines twisted by rickets; skeletons deformed by corsets; microcephalic fetuses; a two-headed baby; a bound foot from China; an ovarian cyst the size of a Jack Russell terrier; Grover Cleveland’s jaw tumor; the liver that joined the original “Siamese twins,” Cheng and Eng Bunker; and the pickled corpse of the Soap Lady, whose fatty tissues decomposed into a congealed asphalt-colored substance called adipocere.

. . .

The celebrity magician Teller, a Philadelphia native, called the Mütter a place of electrifying frankness. “We are permitted to (p. D5) confront real, not simulated, artifacts of human suffering, and are, at a gut level, able to appreciate the epic achievements of medicine,” he said.

But, like museums everywhere, the Mütter is reassessing what it has and why it has it. Recently, the institution enlisted a public-relations consultant with expertise in crisis management to contain criticism from within and without.

The problems began in February [2023] when devoted fans of the Mütter’s website and YouTube channel noticed that all but 12 of the museum’s 450 or so images and videos had been removed.

. . .

Ms. Quinn had tasked 13 unnamed people — medical historians, bioethicists, disability advocates, members of the community — with providing feedback on the digital collection. “Folks from a wide background,” Ms. Quinn said in an interview.

. . .

Blowback to Ms. Quinn’s ethical review was ferocious. An online petition garnered the signatures of nearly 33,000 Mütter enthusiasts who insisted that they loved the museum and its websites as they were. The petition criticized Ms. Quinn and her boss, Dr. Mira Irons, the president and chief executive of the College of Physicians, for decisions predicated on “outright disdain of the museum.” The complaint called for the reinstatement of all web content and urged the college’s board of trustees to fire the two women immediately. (To date, about one-quarter of the videos have been reinstated.)

Moreover, in June [2023], The Wall Street Journal ran an opinion piece entitled “Cancel Culture Comes for Philly’s Weirdest Museum,” in which Stanley Goldfarb, a former director of the college, wrote that the museum’s new “woke leaders” appeared eager to cleanse the institution of anything uncomfortable. Robert Hicks, director of the Mütter from 2008 to 2019, voiced similar sentiments this spring when he quit as a museum consultant. His embittered resignation letter, which he released to the press, stated that Dr. Irons “has said before staff that she ‘can’t stand to walk through the museum,’” and it advised the trustees to investigate her and Ms. Quinn, both of whom Dr. Hicks believed held “elitist and exclusionary” views of the Mütter.

. . .

Dr. Hicks remains unhappy with the new perspective. “Dr. Mütter would have been confused at the dictum that the museum should be about health, not death,” he lamented in his resignation letter. “The principle emblazoned at the entrance of many anatomy theaters, ‘This is where the dead serve the living,’ is readily understood by museum visitors without special guidance by Dr. Irons.”

For the full story, see:

Franz Lidz. “Should a Hall of Human Curiosities Dial It Down?” The New York Times (Tuesday, August 15, 2023): D1 & D5.

(Note: ellipses, and bracketed years, added.)

(Note: the online version of the story has the date Aug. 13, 2023, and has the title “A Museum of ‘Electrifying Frankness’ Weighs Dialing It Down.”)

For more on the innovative surgeon who founded the Mütter Museum, see:

Aptowicz, Cristin O’Keefe. Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine. New York: Gotham Books, 2014.

To Charge EV on Road Required Downloading an App, Which Required Non-Dodgy Cell Service

(p. B5) The adoption of electric vehicles represents the biggest shift in our energy and transportation systems in more than a century—but it’s also the biggest shift in consumer electronics since the debut of the iPhone. On both counts, progress is accelerating in the U.S. And on both counts, we are far from where we need to be.

A recent 1,000 mile road-trip in the longest-range electric vehicle you can buy brought this home for me. That journey was as worrisome as it was thrilling, and it clarified how much more needs to be done for drivers to have a consistent and satisfying experience on par with buying a gasoline vehicle.

. . .

On my trip, there was one moment in particular when the future felt like a big step backward.

It happened when I arrived at a street charging station in Montreal, and discovered that I’d have to download an app and prepay for the electricity I wanted to use. Cell service was dodgy, and I had to find a better signal to download the app. Had I been unable to find a decent signal, I would have been out of luck. (Even once I downloaded the app, the first station I connected to didn’t work—another issue that sometimes comes up at charging stations.)

Unfortunately, having to download an app is common practice for proprietary networks.

For the full commentary, see:

Christopher Mims. “Why America Isn’t Ready for the EV Takeover.” The Wall Street Journal (Saturday, June 10, 2023): B5.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date June 9, 2023, and has the same title as the print version.)

Deregulation “Unleashed Powerful Forces of Innovation and Consumer Benefit”

(p. A13) The railroads harmed small merchants who were tied to the older system of roads and canals. But even those who benefited from railroads—notably farmers and producers of raw materials—feared the power of the enterprises that provided them with large new markets. The anxieties of innumerable small players generated powerful political energy, culminating in the Interstate Commerce Act of 1887, which created the ICC—and with it the template of the independent regulatory commission.

The historian Gabriel Kolko famously argued that the ICC was created by and for the railroads themselves, as a solution to a problem of intense competition. But more-recent research has shown that the interests of shippers were also at play, and by the early 20th century the ICC had essentially been captured by the shippers. The result for the railroads was absurdly low rates of return and an inability to raise capital. The ICC also became a bottleneck through which virtually all railroad business decisions had to pass.

Thus began the long and steady decline of the American railroad industry, which wasn’t arrested until surface freight was deregulated (and the ICC ultimately abolished) in the 1970s. Throughout its life, the ICC repeatedly stood in the way of innovation, including containerized shipping.

. . .

It is fashionable nowadays to dismiss unleashed powerful forces of innovation and consumer benefit of the late 20th century as an unfortunate if fleeting episode of “neoliberalism.” In fact, dismantling some of America’s rigid and retrogressive regulatory institutions unleashed powerful forces of innovation and consumer benefit. Before we attempt to rebuild those structures, we need to examine the lessons of history.

For the full commentary, see:

Richard N. Langlois. “Warren and Graham Emulate History’s Failed Regulators.” The Wall Street Journal (Saturday, Aug. 5, 2023): A13.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date August 4, 2023, and has the same title as the print version.)

Langlois’s commentary can be viewed as an application of the narrative in his book:

Langlois, Richard N. The Corporation and the Twentieth Century: The History of American Business Enterprise. Princeton: Princeton University Press, 2023.

Foundations with an End Date May Honor the Donor’s Intent

(p. C6) This year, the William E. Simon Foundation is closing its doors, or “sunsetting,” in the parlance of modern philanthropy. Since it was founded in 1967 by former Treasury Secretary William E. Simon and his wife Carol, the foundation has given away almost $300 million to the causes that mattered to them—faith, family and education.

. . .

Traditionally, sunsetting a foundation has appealed to more conservative donors. Bill Simon, Jr., who manages the Simon Foundation along with his six siblings, says that his late father set a closing date because he had seen “foundations that seemed to veer off of their donor’s intent.” Simon recalls: “Dad trusted his own seven children to know where he would have put his money…But as much as he loved his grandchildren, he did not know them.”

Indeed, Henry Ford II resigned from the Ford Foundation’s board in 1977, writing that its hostility to capitalism had thrown it off course: “Perhaps it is time for the trustees and staff to examine the question of our obligations to our economic system and to consider how the foundation, as one of the system’s most prominent offspring, might act most wisely to strengthen and improve its progenitor.”

For the full commentary, see:

Naomi Schaefer Riley. “Philanthropists Discover the Value of ‘Sunsetting’.” The Wall Street Journal (Saturday, Aug. 5, 2023): C6.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date August 3, 2023, and has the same title as the print version.)

Blue Cross of California Seeks to End Drug Rebates and Hidden Fees

(p. A3) A major health insurer says it will jettison the complicated system that Americans use to pay for drugs, and create something that aims to be better, with partners including Amazon.com and the entrepreneur Mark Cuban.

Blue Shield of California said it is dropping CVS Health’s Caremark, the pharmacy-benefit manager it currently uses, which negotiates drug prices and wraps in other services such as a mail-order pharmacy.

. . .

Blue Shield said that, working with its partners, it aims to negotiate prices with pharmaceutical makers in a way that is different from the typical approach—with a simple net price structure that is supposed to eliminate rebates and hidden fees.

Blue Shield executives said that with one company handling many aspects of how drugs are procured through the system, it is often hard to track the flow of payments accurately.

“The current pharmacy supply chain is a forest of opacity and profit,” said Paul Markovich, Blue Shield’s chief executive officer, in an interview with The Wall Street Journal. “It is overwhelmingly complex, it is designed to maximize the earnings of the participants.” His company’s new setup, he said, will be “flipping that on its head.”

For the full story, see:

Anna Wilde Mathews. “Health Insurer Revamps Drug Pricing Model.” The Wall Street Journal (Friday, Aug. 18, 2023): A3.

(Note: ellipsis added.)

(Note: the online version of the story was updated Aug. 17, 2023, and has the title “A Big Health Insurer Is Ripping Up the Playbook on Drug Pricing.”)

Nimbly Use What Is Available Now Rather Than Wait for Adoption of Perfect Global Standards

(p. A9) For more than five decades, Don Bateman led teams of engineers at what is now Honeywell International in creating and enhancing technology that warns pilots of impending disasters.

The result is an array of software and equipment, much of it mandatory, that squawks warnings and flashes digital admonitions if a plane is heading into a mountain, a ridge, a radio tower or some other obstacle.

. . .

Rather than waiting years for global industry standards to be adopted, he always wanted to use whatever technology was available immediately. Ratan Khatwa, a former Honeywell colleague of Bateman, recalled his advice: “You’ve got to work like farmers,” using whatever is available now rather than waiting for perfection.

For the full obituary, see:

James R. Hagerty. “Safety Engineer Helped Pilots Avoid Crashes.” The Wall Street Journal (Saturday, June 3, 2023): A9.

(Note: ellipsis added.)

(Note: the online version of the obituary has the date May 30, 2023, and has the title “Don Bateman, Champion of Airline Safety, Dies at 91.”)

Socialist Alexandria Ocasio-Cortez (AOC) Buys Foreign Sunscreens Not Approved by U.S. Government F.D.A.

(p. 2) After months of prompting, I have finally managed to help my husband form a daily sunscreen habit. Whenever I see traces of paper white cream in his dark beard, I think, We’re halfway there.

Hoping to avoid the white cast, heaviness and greasiness common in many sunscreen products available in U.S. drugstores, some Americans, including Representative Alexandria Ocasio-Cortez of New York, have taken matters into their own hands, opting for sunscreens manufactured abroad. In a recent interview, the congresswoman said she toggled between Bioré in the summer and Beauty of Joseon in the winter — two Asian brands that employ active ingredients not approved for use in the United States.

“The technology is very sophisticated,” Ms. Ocasio-Cortez said. “You don’t feel like you have a layer of sunscreen on, and it kind of just feels like you’re putting on a moisturizer in that sense, which makes it easier to use.”

While sunscreen is regulated as a cosmetic in major skin-care hubs like South Korea, Japan and the European Union, in the United States, it falls under the purview of the Food and Drug Administration. Any drug product marketed to American consumers must be approved by the F.D.A., and because sunscreen “makes a drug claim” — namely, that it can prevent sunburn, decrease the risk of skin cancer and mitigate early skin aging — the agency regulates it as an over-the-counter drug.

The last time the Food and Drug Administration approved new active ingredients for use in sunscreens was more than two decades ago, and at times it can feel as if the rest of the world has surpassed the United States in the development of new sunscreen formulations and protocols. Skin-care influencers on TikTok and Instagram are in a near-constant state of frenzy over exciting new products and innovations that are nowhere to be found on American shelves. Currently there are 14 sunscreen filters approved for use by the F.D.A. The European Union employs more than 30.

Frustrated by what seems to be a wealth of more exciting options for sun protection overseas, skin-care-conscious Americans have been quick to point the finger at the F.D.A. for the delay in approving new active ingredients.

For the full story, see:

Sandra E. Garcia. “U.S. Sunscreen Is Stuck in the ’90s.” The New York Times, SundayStyles Section (Sunday, August 13, 2023): 2.

(Note: the online version of the story has the date Aug. 12, 2023, and has the title “U.S. Sunscreen Is Stuck in the ’90s. Is This a Job for Congress?”)