FTC Slows Serendipitously Discovered Blood Test That Detects 50 Types of Cancer

(p. A13) Scientific breakthroughs are sometimes a matter of serendipity. Eight years ago Meredith Halks-Miller, a pathologist at the genetic-screening company Illumina, stumbled on something unusual while running prenatal blood tests for fetal chromosomal abnormalities. In some blood samples, the fetal genes were normal but the maternal DNA wasn’t. Illumina alerted pregnant women’s doctors to the finding. After further investigation, all the women were diagnosed with cancer, though none had symptoms when their blood was drawn.

This discovery led to the development of a blood test that can now detect 50 types of cancer and has the potential to save tens of thousands of lives a year if it becomes widely available. But regulators may slow the process.

The Federal Trade Commission last month wrapped up an administrative trial in which it seeks to block Illumina’s $8 billion acquisition of Grail, which makes the blood test.

. . .

Grail projects its test could prevent 90,000 to 100,000 cancer deaths each year if it were administered annually to all Americans 50 to 79. The sooner people get access to the test, the more lives will be saved. Illumina estimates that 10,000 lives will be saved over the following nine years for every year that it accelerates bringing the test to market. “By accelerating the global rollout of the test in the European Union, into Africa, into Asia, into Latin America, we believe we can save a lot more lives than that around the world,” Mr. deSouza says.

The company’s dominance in the DNA-testing market, however, attracted regulatory scrutiny. In March the FTC sued Illumina and Grail to block the acquisition, arguing that it would “lessen competition in the U.S. multi-cancer early detection (‘MCED’) test market by diminishing innovation and potentially increasing prices.”

Nonsense, Mr. deSouza says. “Today, there is nobody who is even starting the studies to develop a 50-cancer test like Grail, and once you start the study, it’s still a few years before you actually get the test. We think there will also be blood tests for single cancers, for colorectal cancer and other cancers. Those won’t compete with Grail. They will be complementary to Grail.”

For the full interview, see:

Allysia Finley, interviewer. “THE WEEKEND INTERVIEW; Regulatory Hurdles Block a Cancer Miracle.” The Wall Street Journal (Saturday, Oct. 9, 2021): A13.

(Note: ellipsis added.)

(Note: the online version of the interview has the date October 8, 2021, and has the same title as the print version.)

Amazon Hiring 55,000 Workers

(p. B3) Amazon.com Inc. said it is seeking to hire about 55,000 people globally among its corporate and technology ranks during a recruiting event set for Sept. 15, [2021] as the e-commerce giant continues a hiring spree begun at start of the Covid-19 pandemic.

The Seattle-based company is aiming to fill roles in cloud-computing unit Amazon Web Services, as well as in divisions such as Amazon Studios, advertising and its broadband satellite Project Kuiper. The open positions include more than 40,000 roles in the U.S. across 220 locations, including in New York City; Bellevue, Wash.; and Arlington, Va., where the company is opening a large corporate office.

. . .

The company employs about 950,000 people in the U.S. and has said it has made more than 450,000 hires throughout the country since the public-health crisis began.

For the full story, see:

Dave Sebastian. “Amazon Seeks to Hire 55,000 for Office, Tech Roles.” The Wall Street Journal (Thursday, Sept. 2, 2021): B3.

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

(Note: the online version of the story was updated Sept. 1, 2021, and has the title “Amazon Seeks to Hire 55,000 for Corporate, Tech Roles.”)

“The Best Recipe for Economic Growth Is” Freedom and Opportunity

(p. C3) Migration has been central to the American story since the beginning. In the early 19th century, New Englanders left the rocky soil of Massachusetts for the more fertile Ohio River valley. During the Dust Bowl of the 1930s, farmers fled Oklahoma for California. In the early 20th century, millions of African-Americans left the Jim Crow South to find work in the factories of northern cities. Through the 20th century, mobility was an American tradition: In every year between 1950 and 1992, according to the Current Population Survey, more than 6% of Americans moved across county lines.

In recent years, however, the engine of American migration has been grinding to a halt. People often move to get ahead, which makes mobility a reasonable measure of economic dynamism. So it’s a troubling sign that since 2007, geographic mobility has dropped by one-third, with fewer than 4% of Americans changing counties annually. The reason is clear: In the most prosperous cities and regions, insiders have figured out how to use regulations, laws and institutions to make life easier for themselves and harder for everyone else. In the process, they have made the U.S. a far less dynamic society.

. . .

Most important, we need to stop thinking of growth as a zero-sum game. Today, insiders worry about getting their share of the pie instead of growing the economy for everyone. The best recipe for economic growth is the traditional American one: freedom, combined with robust investment in opportunity for the least advantaged.

For the full commentary, see:

Edward Glaeser and David Cutler. “The American Housing Market Is Stifling Mobility.” The Wall Street Journal (Saturday, July 17, 2021): C3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date September 2, 2021, and has the same title as the print version.)

The commentary quoted above is based on the authors’ book:

Glaeser, Edward L., and David Cutler. Survival of the City: Living and Thriving in an Age of Isolation. New York: Penguin Press, 2011.

Walmart Hiring 20,000 Workers

(p. B3) Walmart Inc. is hiring 20,000 workers for its supply-chain operations ahead of the holidays, highlighting the growing role of distribution and delivery as the retailer competes with e-commerce giant Amazon.com Inc.

The new hires will be permanent positions aimed at supporting Walmart through the holiday surge and beyond, the retailer said Wednesday [Sept. 1, 2021]. The full- and part-time jobs range from order pickers, freight handlers and forklift operators to technician and management roles at more than 250 Walmart and Sam’s Club distribution and fulfillment centers and transportation offices.

For the full story, see:

Jennifer Smith. “Walmart Plans to Add 20,000 Workers.” The Wall Street Journal (Thursday, Sept. 02, 2021): B3.

(Note: bracketed date added.)

(Note: the online version of the story was updated Sept. 1, 2021, and has the title “Walmart Will Add 20,000 Workers to Supply-Chain Operations This Year.”)

Insurers Are Paid More When They Negotiate HIGHER Prices for Patients

(p. A1) This year, the federal government ordered hospitals to begin publishing a prized secret: a complete list of the prices they negotiate with private insurers.

The insurers’ trade association had called the rule unconstitutional and said it would “undermine competitive negotiations.” Four hospital associations jointly sued the government to block it, and appealed when they lost.

They lost again, and seven months later, many hospitals are simply ignoring the requirement and posting nothing.

But data from the hospitals that have complied hints at why the powerful industries wanted this information to remain hidden.

It shows hospitals are charging patients wildly different amounts for the same basic services: procedures as simple as an X-ray or a pregnancy test.

And it provides numerous examples of major health insurers — some of the world’s largest companies, with billions in annual profits — negotiating surprisingly unfavorable rates for their customers. In many cases, insured patients are getting prices that are higher than they would if they pretended to have no coverage at all.

. . .

(p. A14) Customers judge insurance plans based on whether their preferred doctors and hospitals are covered, making it hard for an insurer to walk away from a bad deal. The insurer also may not have a strong motivation to, given that the more that is spent on care, the more an insurance company can earn.

Federal regulations limit insurers’ profits to a percentage of the amount they spend on care. And in some plans involving large employers, insurers are not even using their own money. The employers pay the medical bills, and give insurers a cut of the costs in exchange for administering the plan.

. . .

People carefully weighing two plans — choosing a higher monthly cost or a larger deductible — have no idea that they may also be picking a much worse price when they later need care.

Even for simple procedures, the difference can be thousands of dollars, enough to erase any potential savings.

It’s not as if employers can share that information at open enrollment: They generally don’t know either.

“It’s not just individual patients who are in the dark,” said Martin Gaynor, a Carnegie Mellon economist who studies health pricing. “Employers are in the dark. Governments are in the dark. It’s just astonishing how deeply ignorant we are about these prices.”

. . .

Health economists think of insurers as essentially buying in bulk, using their large membership to get better deals. Some were startled to see numerous instances in which insurers pay more than the cash rate.

. . .

“The worrying thing is that the third party you’re paying to negotiate on your behalf isn’t doing as well as you would on your own,” said Zack Cooper, an economist at Yale who studies health care pricing.

. . .

(p. A15) Hospitals and insurers can also hide behind the contracts they’ve signed, which often prohibit them from revealing their rates.

“We had gag orders in all our contracts,” said Richard Stephenson, who worked for the Blue Cross Blue Shield Association from 2006 until 2017 and now runs a medical price transparency start-up, Redu Health. (The association says those clauses have become less common.)

Mr. Stephenson oversaw a team that made sure the gag orders were being followed. He said he thought insurers were “scared to death” that if the data came out, angry hospitals or doctors might leave their networks.

. . .

The new price data is often published in hard-to-use formats designed for data scientists and professional researchers. Many are larger than the full text of the Encyclopaedia Britannica.

And most hospitals haven’t posted all of it. The potential penalty from the federal government is minimal, with a maximum of $109,500 per year. Big hospitals make tens of thousands of times as much as that; N.Y.U. Langone, a system of five inpatient hospitals that have not complied, reported $5 billion in revenue in 2019, according to its tax forms.

For the full story, see:

Sarah Kliff, Josh Katz and Rumsey Taylor. “Hospital Data Reveals Secrets Behind Billing.” The New York Times (Monday, August 23, 2021): A1 & A14-A15.

(Note: the online version of the story has the date Aug. 22, 2021, and has the title “Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why.”)

$80 Billion in 200 Large Projects to Develop Hydrogen as Clean Energy Source

(p. B1) SHEFFIELD, England — Rachel Smith has lived through green hydrogen’s bumpy journey from scientists’ dream to an industry that may be on the verge of a commercial breakthrough. An engineer, she started out two decades ago working in a converted barn on early devices for making the clean-burning gas.

Now she is part of a team racing to build giant machines that will use electricity to separate hydrogen from water for major companies like Royal Dutch Shell and Orsted, the Danish offshore wind developer.

“We have gone through those toddler years,” said Ms. Smith, an executive director at ITM Power, which is run out of an expansive new factory in Sheffield, a faded center for steel mills and coal mining. “We are playing in the grown-up world rather than in research labs.”

A consensus is forming among governments, environmentalists and energy companies that deep cuts in carbon emissions will require large amounts of a clean fuel like hydrogen.

Proponents of hydrogen have identified more than a score of potential applications of the element for cutting carbon emissions. It could be used to power long-haul trucks and train and air travel. Energy companies are experimenting with blending hydrogen with natural gas for home heating and cooking.

All told, more than 200 large-scale projects are underway to produce or transport hydrogen, comprising investments of more than $80 billion. Daimler and Volvo, the world’s largest truck makers, plan in a few years to begin mass producing long-haul electric trucks that run on devices called fuel cells that convert hydrogen to electricity. Water will be the trucks’ only emission.

“You could imagine an economy that is supported almost entirely by very clean electricity and very clean hydrogen,” said Ernest Moniz, secretary of energy in the Obama administration and now chief executive of the Energy Futures Initiative, a research organization.

(p. B5) But he warned that “a lot of things have to happen” for a gas now mainly used in specialty areas to become a “part of the backbone of the energy system.”

Among the obstacles that must be overcome: creating enough of the right sort of hydrogen, at a price industries and consumers can accept.

For the full story, see:

Stanley Reed and Jack Ewing. “The Race to Harvest Hydrogen.” The New York Times (Saturday, July 17, 2021): B1 & B5.

(Note: the online version of the story has the date June 4, 2021, and has the title “Hydrogen Is One Answer to Climate Change. Getting It Is the Hard Part.”)

James Dyson Persevered Through 5,127 Prototypes to Achieve Vacuum Cleaner Success

(p. C7) James Dyson was a less than stellar student at the boarding school he attended in Norfolk, England, where his father was a classics master. Yet he would become the founder of a family-owned global manufacturing empire. Mr. Dyson gained fame—and a peerage—as the inventor of a revolutionary vacuum cleaner that exploits the principle of the cyclone and never needs a replacement bag, among other novel domestic appliances.

. . .

It took Mr. Dyson four years and precisely 5,127 prototypes—as he reminds us in the first paragraph of this book’s introduction and in the last paragraph of its last chapter, as well as several times in between. He points out that his perseverance—abetted by subsequent and continuing failures in the form of rebuffs from the likes of banks, venture capitalists, government agencies, manufacturers, distributors and retailers—was rewarded with ultimate success. The idea of “accepting and even enjoying failure, but going on” is another theme carried throughout Mr. Dyson’s book.

. . .

With success achieved in the United Kingdom, Mr. Dyson looked to sell the fruits of his intellectual property beyond the sceptered shores. In America, he got legally tangled up with Amway, which he was convinced was infringing on his patents. The lessons learned from his failure to protect his patent rights for the Ballbarrow, however, steeled Mr. Dyson and his wife and business partner, Deirdre, against allowing this to happen a second time. Mr. Dyson sued Amway and, after five years of costly litigation, received a favorable settlement. The victory boosted the businessman’s growing reputation as a fighter and a winner.

. . .

. . . , Mr. Dyson tells a story of the struggles of entrepreneurship, and his arduous quests for private capital; suitable manufacturing facilities; building permits; talented and trained employees; and at least moral support from the British government. He reveals the many and continuing obstacles—financial, political, regulatory, sociological, cultural—that frustrated his attempts to expand his manufacturing enterprises within the United Kingdom. This challenge, he explains, eventually drove him to move the bulk of his business to Singapore, where Mr. Dyson’s company is now headquartered.

For the full review, see:

Henry Petroski. “The Inventor’s Dilemma.” The Wall Street Journal (Saturday, Sept. 4, 2021): C7.

(Note: ellipses added.)

(Note: the online version of the review was updated Sept. 3, 2021, and has the title “‘Invention’ Review: James Dyson’s Dilemma.”)

The book under review is:

Dyson, James. Invention: A Life. New York: Simon & Schuster, 2021.

University of Chicago’s Milton Friedman Center Now Run by “Former Obama Staffers Who Cheer” . . . “Moves Toward Socialism”

(p. A15) Colleges’ ideological turn leftward has become sharper. At my own institution, a center dedicated to Milton Friedman is now run by former Obama staffers who cheer on the Biden administration’s moves toward socialism.

These policies reward professors and administrators who can then raise the price of their services. It’s basic economics that subsidizing demand increases the price of the product. Tuition rising as loan subsidies expand is no different. It isn’t a coincidence that education and health care, the industries in which government subsidies are most pervasive, took the highest price increases over the past 15 years—3.7% and 3.1% a year, compared with the 1.8% average across industries.

For the full commentary, see:

Tomas J. Philipson. “College Subsidies Are a Feedback Loop for Bigger Government.” The Wall Street Journal (Friday, June 11, 2021): A15.

(Note: the online version of the commentary has the date June 10, 2021, and has the title “College Subsidies Are a Feedback Loop for Bigger Government.”)

FASTA Is Not Faster at Untangling Red Tape to Sell Surplus Federal Property

(p. B6) The plan sounded simple enough.

The federal government has long owned more real estate than it knows what to do with — buildings that sit empty and sites that are underdeveloped — but it must jump through hoops before it can sell its holdings. So surplus properties languish while taxpayers foot the bill for maintenance.

The solution, springing from legislation passed in 2016, was an independent agency that would quickly identify underused properties and expedite their disposal.

But nothing has been simple about the Public Buildings Reform Board, as the little-known agency is called.

It took three years for the five existing board members to be sworn in, and two empty seats remain, including that of the chairman. The Government Accountability Office reported that the board did not adequately document how it went about selecting properties for sale. The board was sued when it sought to sell a Seattle building that is a repository of important tribal records. The General Services Administration, the agency that disposes of most federal properties, has flouted the board’s advice.

And so far, only a single property that the board has recommended for sale has actually been sold.

. . .

The board’s tribulations are a reminder of how difficult it can be to untangle government red tape.

. . .

In the federal government’s 2015 fiscal year, agencies reported more than 7,000 excess or underutilized properties, according to the Government Accountability Office.

Attempts have been made, through Republican and Democratic administrations, to remedy the problem. A bipartisan breakthrough came in 2016 with the passage of the Federal Assets Sale and Transfer Act, known as FASTA, . . .

. . .

But so far, only eight of the FASTA properties have been put up for auction; of these, a parking lot in Idaho Falls, Idaho, has been sold for $268,000.

For the full story, see:

Jane Margolies. “Surplus Property for Sale, Red Tape Included.” The New York Times (Wednesday, September 15, 2021): B6.

(Note: ellipses added.)

(Note: the online version of the story has the date Sept. 14, 2021, and has the title “Plan to Sell Unused Federal Property Becomes ‘Arm-Wrestling Contest’.”)

“Folly” of $66 Billion Subsidy for Trains, When Americans Prefer Cars and Planes

(p. 9) While long-haul railroads have a beloved place in our history, Americans almost entirely abandoned them more than a half century ago for the greater convenience of cars and the speed of planes.

And yet, not only have we continued to run a hugely loss-making nationwide network of passenger trains, last week’s bipartisan infrastructure plan includes tens of billions more for an Amtrak-based transportation system that will only ever be used by a small sliver of Americans outside of the Northeast Corridor rail line (known as the N.E.C.), which stretches from Washington to Boston.

The folly of another $66 billion — mostly for passenger railroads, one of the biggest allocations in the bipartisan compromise — makes me doubt how well other pieces of the trillions in spending proposed by the administration will be allocated. (President Biden wanted even more for Amtrak.)

. . .

Really? Consider a few stats: In the 2019 fiscal year, when excluding the N.E.C., Amtrak carried just 4.5 million passengers (not including services subsidized by states and cities), roughly 1.4 percent of our population. On average, passengers paid $115 while Amtrak spent $222 to transport each of them.

Unprofitable ticket prices notwithstanding, long-distance train travel dropped by 5.4 percent between the 2010 and 2018 fiscal years, while air travel rose by nearly 24 percent. On average, Amtrak filled only 55 percent of its long-distance seats in 2018. Does that warrant another $66 billion?

. . .

Populous California, where the automobile has reigned for decades, is an example of why betting on an American train travel revival is questionable. High-speed service between Los Angeles and San Francisco — which was approved by voters in 2008 at an estimated cost of $33 billion with completion expected in 2020 — remains a mirage. Completion is unlikely before 2030, while outlays are now projected to total at least $100 billion.

The California fiasco illustrates how execution will be key to implementing any infrastructure projects. But the government’s record is not great.

For the full commentary, see:

Steven Rattner. “Who Needs Amtrak? Not Wyoming.” The New York Times, SundayReview Section (Sunday, July 4, 2021): 9.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 1, 2021, and has the title “Why ‘Amtrak Joe’ Should Pull Back on Train Funding’.” Where the wording of the two versions slightly differs, the passages quoted above follow the online version.)

“Our Cities Protect Insiders and Leave Outsiders to Suffer”

(p. A15) Mr. Glaeser’s “Survival of the City: Living and Thriving in an Age of Isolation,” written with Harvard health economist David Cutler, shares the pleasing style of its predecessor, an engaging mixture of history and analysis. It has none of the triumphalism of its predecessor, however. In the move to social distancing that began in the spring of 2020, Messrs. Glaeser and Cutler see nothing less than “the rapid-fire deurbanization of our world.”

“Uncontrolled pandemic,” the authors write, poses “an existential threat” to the urban world. Nor is the coronavirus the only problem that cities face. “A Pandora’s Box of urban woes has emerged,” they continue, “including overly expensive housing, violent conflict over gentrification, persistently low levels of upward mobility, and outrage over brutal and racially targeted policing and long prison sentences for minor drug crimes.” These are not disparate problems. Rather, they “all stem from a common root: our cities protect insiders and leave outsiders to suffer.”

In Messrs. Glaeser and Cutler’s view, something has gone deeply wrong with how policy is set in many American cities. Insiders have captured control of how cities operate—and used that control to enrich themselves while providing limited opportunities for newer, younger residents. Consider Los Angeles. In 1970, housing costs in Southern California were much the same as those nationwide. By 1990, building limitations and strong demand had sent prices soaring in many coastal cities. The result: a massive redistribution of wealth from the young to the old.

For the full review, see:

John Buntin. “BOOKSHELF; Saving Our Urban Future.” The Wall Street Journal (Friday, Sept. 10, 2021): A15.

(Note: the online version of the review has the date September 9, 2021, and has the title “BOOKSHELF; ‘Survival of the City’ Review: Saving Our Urban Future.”)

The book under review is:

Glaeser, Edward L., and David Cutler. Survival of the City: Living and Thriving in an Age of Isolation. New York: Penguin Press, 2021.