go read a book instead

The cables indicate that the American government has been fighting a pitched battle with intruders who have been clearly identified as using Chinese-language keyboards and physically located in China. In most cases the intruders took great pains to conceal their identities, but occasionally they let their guard down. In one case described in the documents, investigators tracked one of the intruders who was surfing the Web in Taiwan “for personal use.

Moreover, the chargemaster rates are relevant, even for those unlike her who have insurance. Insurers with the most leverage, because they have the most customers to offer a hospital that needs patients, will try to negotiate prices 30% to 50% above the Medicare rates rather than discounts off the sky-high chargemaster rates. But insurers are increasingly losing leverage because hospitals are consolidating by buying doctors’ practices and even rival hospitals. In that situation — in which the insurer needs the hospital more than the hospital needs the insurer — the pricing negotiation will be over discounts that work down from the chargemaster prices rather than up from what Medicare would pay. Getting a 50% or even 60% discount off the chargemaster price of an item that costs $13 and lists for $199.50 is still no bargain. “We hate to negotiate off of the chargemaster, but we have to do it a lot now,” says Edward Wardell, a lawyer for the giant health-insurance provider Aetna Inc.

That so few consumers seem to be aware of the chargemaster demonstrates how well the health care industry has steered the debate from why bills are so high to who should pay them.

But there is an unpalatable truth to face for those of us with a bag of quinoa in the larder. The appetite of countries such as ours for this grain has pushed up prices to such an extent that poorer people in Peru and Bolivia, for whom it was once a nourishing staple food, can no longer afford to eat it. Imported junk food is cheaper. In Lima, quinoa now costs more than chicken. Outside the cities, and fuelled by overseas demand, the pressure is on to turn land that once produced a portfolio of diverse crops into quinoa monoculture.

In fact, the quinoa trade is yet another troubling example of a damaging north-south exchange, with well-intentioned health and ethics-led consumers here unwittingly driving poverty there. It’s beginning to look like a cautionary tale of how a focus on exporting premium foods can damage the producer country’s food security. Feeding our apparently insatiable 365-day-a-year hunger for this luxury vegetable, Peru has also cornered the world market in asparagus. Result? In the arid Ica region where Peruvian asparagus production is concentrated, this thirsty export vegetable has depleted the water resources on which local people depend. NGOs report that asparagus labourers toil in sub-standard conditions and cannot afford to feed their children while fat cat exporters and foreign supermarkets cream off the profits. That’s the pedigree of all those bunches of pricy spears on supermarket shelves.

Soya, a foodstuff beloved of the vegan lobby as an alternative to dairy products, is another problematic import, one that drives environmental destruction. Embarrassingly, for those who portray it as a progressive alternative to planet-destroying meat, soya production is now one of the two main causes of deforestation in South America, along with cattle ranching, where vast expanses of forest and grassland have been felled to make way for huge plantations.