Al's Morning Meeting

The story says:

Statistics from the American Academy of Orthopaedic Surgeons show that more than 418,000 total and partial knee replacements are performed each year, 15 percent of them on baby boomers; of the 328,000 total and partial hip replacements done, boomers are the recipients of more than 20 percent.

Demand for Knee Replacements Will Increase More Than 600 Percent in 25 Years

As we age, the demand for knee and hip replacements is going to grow so much that national studies now predict there will be a shortage of orthopedic surgeons to perform them all. Read this, from the American Academy of Orthopaedic Surgeons:

The demand for total joint replacement is expected to increase so dramatically in the next 25 years that there may not be enough orthopedic surgeons to perform the surgeries, as indicated by results from recent research on the topic. As presented at the 73rd Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the study projects the number of hip- and knee-replacement procedures that will be performed in the United States through the year 2030.

Lead author Steven M. Kurtz, Ph.D., director of the Philadelphia office of Exponent Inc., an engineering and scientific consulting firm, and his research team projected that the number of procedures for primary (first-time) total knee replacement would jump by 673 percent -- to 3.48 million -- in 2030. The number of primary total hip replacements, the authors estimate, will increase by 174 percent -- to 572,000 -- in 2030. Partial joint replacements were projected to increase by only 54 percent. The research team based its projections on historical procedure rates from 1990 to 2003, combined with population projections from the U.S. Census Bureau.

Also expected to become more prevalent is the repair or replacement of the artificial joint, called revision joint replacement. The number of revision surgeries likely will double by 2015 for total knee replacement and by 2026 for total hip replacement, according to the authors. Currently, hip revisions outnumber knee revisions, but knee revisions should surpass hip revisions after 2007, Kurtz stated.

"There's definitely going to be a huge need for more orthopedic surgeons," explained Kurtz, who is also research associate professor at Drexel University's School of Biomedical Engineering in Philadelphia. "If the massive expected demand for total joint replacement is not planned for before 2030, patients may end up waiting a long time for a new hip or knee."

Keeping Track of Dad

I found a Chicago Tribune story about how technology is emerging that allows the families of aging parents to monitor their folks from miles -- even hundreds of miles -- away. The technology, while intrusive, also may help seniors live at home much longer.
 

Illegal Immigrants Who Drive

The marches nationwide point to the passion behind the immigration story. Here is a backstory worth taking a look at. Across the country, police departments arrest illegal workers who drive without a license. They can't get a license, but that does not stop many from buying cars, which they need so they can get to work. Nine states now allow undocumented residents to drive, even if they are not legal residents of this country.

Stateline.org says:

Driver's licenses already are being revamped under a 2005 federal law -- the Real ID Act -- that for the first time dictates how states must document identity when issuing a driver's license and overrides policies in nine states that now allow agencies to license illegal immigrant drivers.

States could opt to follow Tennessee and Utah in issuing "certificates" to illegal immigrant drivers. Tennessee authorities, however, recently suspended their program over fear of fraud. 

The (Santa Rosa, Calif.) Press Democrat reports:

What follows is a cycle that is a way of life in the secretive world of undocumented residents who have easy access to vehicles, but no access to gaining a license to drive.

The car is impounded for 30 days, bringing fees that often exceed its value. Now abandoned, it goes back on the market, often to be purchased by another illegal immigrant who returns to the road with the cheap vehicle, no license and often no insurance.

It is a system that makes financial winners of tow truck operators and used car lots, but takes a toll on law enforcement, puts legal drivers at risk from uninsured motorists and is ineffective at solving the problem of illegal drivers.

It is a microcosm of the national debate now before Congress over whether to penalize or recognize illegal immigrants and illustrates California's contradictory struggle with illegal immigration: The state has satisfied political sentiment by denying driver's licenses to undocumented immigrants, but has put few roadblocks in place to keep them from getting cars essential for the low-wage jobs that help fuel the state's economy.

The story says:

In many cases, undocumented immigrants do not go through with the registration. Police say that a large number of unlicensed drivers they pull over are driving cars registered in someone else's name.

For those who do register, a growing number of insurance companies are insuring illegal immigrants who present out-of-state or Mexican driver's licenses. 

ITIN: A Way for Immigrants to Get Documentation

Another interesting story is about immigrants who, despite being undocumented, still pay U.S. federal taxes. They have obtained ITINs, a federal tax number that gives them an official status as a taxpayer, even though they are not legal residents, as far as the government is concerned.

The Santa Fe New Mexican newspaper reported:

A decade ago, the IRS set up a system to issue tax-identification numbers to foreigners required to pay U.S. taxes. Though the system was originally designed for people living abroad who had investments in the United States, it quickly came to be used by undocumented workers who aren't eligible for Social Security numbers.

Last year 1.4 million people filed tax returns using an Individual Tax Identification Number, or ITIN. That was an increase of 40 percent over the previous year, according to the IRS. In 2003, the most recent year for which data was available, more than 7,600 people in New Mexico requested an ITIN.

The Pork List

Citizens Against Government Waste is out with its 2006 Porker Awards. It will be up to somebody else to decide which of their targets are a waste of money and which ones are useful public service projects.

The "2006 Pig Book" identified 9,963 projects in the 11 appropriations bills that constitute the discretionary portion of the federal budget for fiscal 2006, costing taxpayers $29 billion. A "pork" project is a line-item in an appropriations bill that designates tax dollars for a specific purpose in circumvention of established budgetary procedures. To qualify as pork, a project must meet one of seven criteria.