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The real question raised by “At an Elite Hospital, Huge Bills to Test for Covid” (front page, March 31) is whether the medical delivery system is causing more harm than good. The U.S. medical industry, designed to fulfill a core social need, has become an uncontrolled behemoth. Aided and abetted by a Congress in thrall to corporate interests, it commandeers enormous amounts of money — about $4 trillion a year. A high percentage of that is waste that could fund social programs that improve health. Our current system drives people to bankruptcy or avoiding health care because of the high cost. In other words, it undermines the very reason for its existence. We know that many illnesses are a result of inequality, racism, sexism and other social determinants. We can now add to the list of liabilities the medical-industrial complex itself. Over the past year Northwell Health expanded access to Covid-19 diagnostic testing in its emergency departments, including Lenox Health Greenwich Village (the subject of your article), while also making testing available in urgent care centers and doctor’s offices that are far less expensive to operate. In focusing on the higher billing rates in emergency departments, The Times neglects to explain that payments we receive are based on mandated Medicare/Medicaid rates or payment rates negotiated with commercial insurers. Neither patients nor insurers pay the stated charges typically listed in “explanation of benefits” notices sent to patients by insurance companies, which have generated record profits during this public health crisis. When patients arrive in an emergency department, federal law requires that they be evaluated and treated, regardless of their ability to pay. Patients requesting a Covid-19 test are advised when they walk in — orally, in a written consent form and with signage at the registration desk — that their test is considered an emergency visit. Regardless of where they are tested for Covid, patients incur no co-payments or out-of-pocket costs. Fighting this pandemic has required hospitals and health systems to use every tool at their disposal, including offering testing capabilities in many different treatment settings, and setting up a vast network of vaccine distribution sites. Operational costs incurred by health care providers in running emergency departments far outpace reimbursements they receive from insurers. Source

Many children and teenagers who developed the mysterious inflammatory syndrome that can emerge several weeks after contracting the coronavirus never had classic Covid-19 symptoms at the time of their infection, according to the largest study so far of cases in the United States. The study, led by researchers from the Centers for Disease Control and Prevention, found that in over 1,000 cases in which information about whether they got sick from their initial Covid-19 illness was available, 75 percent of the patients did not experience such symptoms. But two to five weeks later, they became sick enough to be hospitalized for the condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect multiple organs, especially the heart. Published Tuesday in JAMA Pediatrics, the study said that “most MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus. Experts do not yet know why some young people, and a smaller number of adults, respond this way. “It means primary-care pediatricians need to have a high index of suspicion for this because Covid is so prevalent in the society and children often have asymptomatic disease as their initial Covid infection,” said Dr. Jennifer Blumenthal, a pediatric intensivist and pediatric infectious disease specialist at Boston Children’s Hospital, who was not involved in the study. early 58 percent of the patients were male, but the proportion was not the same across all ages. The youngest group — newborn to age 4 — had roughly equal numbers of boys and girls, and the male-to-female ratio increased in the older groups until it was more than two-to-one male to female in the 18-to-20 group. Source

The GLB35 courts the performance- and tech-minded shoppers of the GLB250. Introduced last year, the GLB welcomes new buyers into the family from Stuttgart with a proper, boxy SUV that swapped the GLA’s rally racer profile for something like a lower-case GLS, replete with substantial black cladding and integrated roof rails. The AMG model adds more sinister touches, with a front splitter, a more prominent roof spoiler, and a chunkier rear bumper that houses two round tailpipes clad in black. I recently spent a week with an AMG GLB35 to find out how an SUV of all trades fits in. The tester came upgraded with 20-inch black alloy wheels instead of 19s ($1,050) with four-piston silver AMG brake calipers glinting through. With the Cosmos black metallic coat ($720), the GLB35 looked like a pit bull, striking in its muscularity and with a foreboding presence, despite its small stature. IT PUMPS OUT 302 HP, A HARD CHARGE FROM THE 221 HP IN THE GLB250 The beating heart of this pittie is a ratcheted version of the 2.0-liter turbo-4 in the GLB250. It pumps out 302 hp, a hard charge from the 221 hp in the GLB250, but a far cry from the 382-hp turbo-4 in the AMG GLB45 expected later this year. This AMG-lite SUV balances its power and proportions with aplomb, behaves well enough to road trip in comfort, but manages to be mean enough to snap the chains of boredom. I treated it like it was my own running my two young teens around and denying the temptation to be anything but a model driver. We went away for a long weekend and the AMG GLB35 suited us perfectly. It only got better when I was by myself. The turbo-4 lacks the wallop of larger AMG engines, but launch control comes easy: turn the steering wheel dial to Sport+ mode, mash the brake, rev it until the boost gauge hits the halfway mark, then launch into grins on the way to 60 mph in 5.1 seconds, according to Mercedes. That’s about a half-second slower than the smaller, lighter BMW X2 M35i (4.7 seconds from 0-60 mph). The M35i’s peak torque of 332 lb-ft comes on at 1,700 rpm compared to the GLB35’s 295 lb-ft at 3,000 rpm. The GLB35’s dual nature of acting behaved under watchful eyes only to turn feral when commanded proved fun every time, but it didn’t have that mind-blowing AMG effect that overwhelms the senses. At 3,869 pounds, it weighs about 150 pounds more than the M35i, and if it were a running back, it would plow ahead more like Derrick Henry than dance like the light-footed Alvin Kamara. The 8-speed dual-clutch automatic shifts quickly and predictably, and the metal paddle shifters let you dig a little deeper toward the red line in Sport mode. The standard all-wheel-drive system defaults to the GLB’s front axle, but can shuttle up to 50% of the torque to the rear axle based on speed, steering angle, and acceleration. It was unseasonably dry during my early spring week around Chicagoland, but I didn’t push the handling to extremes on sweeping frontage roads and more tightly wound cloverleaf ramps—more of that self control I talked about, but I wasn’t always an angel. Body roll was limited despite the tall boxy shape, but sharper turns triggered the suggestion of understeer that would get more pronounced the harder I drove. In Sport mode, the suspension firmed up enough that it would dance over road seams, but the ride was never harsh enough to pop out one of my teen’s earbuds or distract them from the world beyond their phones. For the three of us, the GLB35 had plenty of room for a three-day weekend. The reclining 60/40-split rear seats slid 5 inches and helped mitigate complaints when the front passenger reclined her seat. With the rear seats moved all the way back, we fit three carry ons, a small cooler, and two backpacks in the cargo area, and concealed it all with the cargo cover. It specs out to 22 cubic feet, or 62 cubes with the seats folded down. For taller humans, head room is great due to the boxed roof, but stacking two 6-footers front to back could set front and rear occupants against each other as they jockey for space. Of the $14,000 in options, the $800 third row fortunately was not one of them. Based on the five-seat configuration I tested, wedging two more seats in the way back wouldn’t make sense even for rare use cases. It adds weight and cost, trims cargo space, and would make knees nervous in both the second and third rows. The cockpit of the GLB vibes with youth. Large turbine vents separate the upper and lower dash, and 64-way ambient lighting rims the vents and highlights the dashboard. Seemingly wood and metal trim pieces devolve to fancy hard plastic when touched, but Mercedes’ technology couldn’t be more impressive even if the materials were real. A 10.3-inch touchscreen tops the dash and abuts a 10.3-inch digital instrument cluster that is as customizable as a smartphone’s app library. It’s standard, and it’s brilliant. Five different styles of display can be projected, and pretty much everything housed in the touchscreen can be accessed in the cluster, plus readouts for the G-meter, turbo boost, and power bars. Navigation can be limited to one of the digital dials, like Porsche does, or the display can be swapped to have the map take up the bulk of the real estate, like Audi does. The steering wheel features the older thumb pads that are easier to use than the haptic controls on the latest crop of redesigned Mercedes. The left pad controls the cluster, the right pad the touchscreen. Between that and the “Hey, Mercedes” voice assistant, the touchscreen is mostly for the passenger. My tester came with a $400 AMG flat-bottom steering wheel wrapped in nappa leather that was chunky in all the right places. Resistance firms up with speed and adjusts with the five drive mode settings; the tester came with another $400 upgrade that adds suspension tuning and drive mode settings to the steering wheel like hot buttons. The individual settings can also be adjusted on the center console or through the digital cluster. Options beget options. The $1,295 Multimedia Package had navigation with augmented reality that projects front camera views when approaching intersections. Street names and addresses appear, which is super helpful, especially for urban delivery drivers who might not be AMG’s target audience. The GLB35 lacks wireless Apple CarPlay, which is a minor inconvenience, but came with adaptive cruise control that changes the speed based on posted speed limits, which should be destroyed and never resurrected. Of the multitude of settings I fiddled with, I couldn’t figure out how to turn it off until watching a video. I should’ve enlisted the kids for that one. The GLB35 tries hard to satisfy several types of buyers, and justifies itself in the Mercedes lineup. Its quick acceleration, generous interior, and next-level technology create a total package worth the $50,550 starting price. It comes with all the upgrades I’d want over the base GLB250, with a performance edge for about $10,000 more. And it looks so much better than the BMW X2 wagonette. Source

Ask an enthusiast about Mitsubishi, and you’ll hear about flame-spitting, rally-racing Lancer Evolutions, desert-crossing Pajeros, or ultra-capable Delica campervans. Ask the average Canadian consumer what Mitsubishi means, and you might get just a shrug. The all-new Outlander looks to change things up. Mitsubishi has been building cars since 1971 – in fact, they are the first Japanese manufacturer to mass-produce a car – but the company only showed up in Canada in 2002. Nickelback has been around longer. Further, the company’s products seemed more value focused than cutting edge. The previous Outlander had been on sale for almost a decade with minor updates, and felt less fresh than the competition. The exception was the plug-in hybrid variant, but more on that later. First, the new model, which is fully capable of taking on the competition, and has a few advantages over its rivals. A corporate agreement with Nissan means that the new Outlander’s basic architecture is shared with the Nissan Rogue. That’s a smart move: the new Rogue is a smartly-executed and popular crossover. The Outlander is much more stiff and solid than the outgoing model, and feels more substantial as well. Under the hood is a 2.5L engine paired with a CVT that has shift points programmed in to feel more like a conventional automatic transmission. It’s smooth, but mostly unremarkable. Acceleration is acceptable, with the engine producing 181 horsepower and 181 lb-ft of torque. It’s no Lancer EVO, but overall performance feels much more polished. Also hugely improved is the cabin. It’s roomy and unfussy, with a straightforward layout, comfortable seats, and a large touchscreen control. The full digital dashboard adds a nice touch of modernity, and this GT Premium trim got some nice accents. It’s not surprisingly upscale, it just feels up to the task in ways the old version wasn’t. On the move, the Outlander’s unique piece of driveline technology is its Super All Wheel Control. Back in the days when rally-prepped Subaru WRXs and Lancer EVOs battled in the gravel, Mitsubishi’s clever electronically controlled all-wheel-drive system often gave its teams and edge. Here, S-AWC comes with the ability to select from six different terrain modes. Our test days were bright and sunny, but the previous Outlander’s S-AWC system made it quite surefooted in snow. Mostly, though, the Outlander didn’t whisper of Mitsubishi’s motorsport heritage. It was instead a comfortable, sensibly packaged, modern family vehicle. It wasn’t built to appeal to a Mitsubishi enthusiast, but to the average consumer. That average consumer will no doubt be reassured by Mitsubishi’s excellent warranty. Most other Japanese marques offer three and five year comprehensive and powertrain warranties on their vehicles. Mitsubishi offers five and ten year coverage, respectively, and five years of unlimited mileage roadside assistance. Taken all together, the Outlander presents a solid choice. It’s perhaps not as exciting as Mitsubishi’s past, but not everyone is familiar with that past. This new Outlander is for everyone, not just Mitsubishi fans. Tech Specs Base Price: $31,998 Price as tested: $43,978 Engine: 2.5L inline-four Transmission/Drive: continuously variable automatic, all-wheel-drive Fuel economy (litres/100kms; city/hwy): 9.7/7.9 Alternatives: Honda CR-V, Nissan Rogue, Subaru Forester Looks By embracing an ultra-futuristic front end, Mitsubishi risks offending customers looking for something a little more conventional. The styling might not be to everyone’s taste, but it is at least a bold statement, and the practicality of the squared-off profile gives a bit of extra room in back. 20″ wheels are fitted to the mid-grade trims. Interior The Outlander is pretty much the only vehicle in its segment to offer a third row of seats. Think of them more as short-trip jump seats rather than a minivan replacement, as they are quite cramped, and best for smaller children. However, once it’s safe to start ferrying your kids’ friends home from school for a playdate, having the extra capacity will come in handy. Performance Alongside this new Outlander, Mitsubishi will continue selling their Plugin Hybrid Vehicle (PHEV) older version. While an older design, the Outlander PHEV is very popular for its economical operating costs. The technology will come to the new car soon enough, broadening its appeal. Technology Safety-related river assists like forward collision warning, blind-spot detection, and rear automatic emergency braking are all standard on the base model Outlander. Without having to go to the fully loaded GT models, the mid-grade LE gets some convenience-related features like automated cruise control, 360-degree parking camera, and even navigation. Cargo The folding third row seating does take up a bit of trunk space, but there’s still 950L of space on offer with them folded. The verdict A solid bread-and-butter family crossover that packages useful features with a modern driving feel and great warranty coverage. Source

Nissan has announced price drops across its Leaf EV range, including big reductions for high-spec models that keep them in range of the UK Government's plug-in car grant. The price of e+ spec cars, which have 62kWh batteries, in both N-Connecta and Tekna equipment grades, has been cut so that once the grant is applied they now cost £30,445 and £32,445 respectively, which Nissan says is a saving of more than £5,000 on what they would have cost otherwise. The government reduced the maximum price for grant-eligible cars to £35,000 last month, and also cut the value of the grant from £3,000 to £2,500. Prices drops have also been announced for the regular 40kWh battery Leaf range, with an Acenta model now priced including the grant at £25,995 (a £1,350 reduction), an N-Connecta at £27,995 (-£650), a 10 Special Version at £28,670 (-£650), and a Tekna at £29,995 (-£665). Spirce

Cyborn B.V. has announced a new VR sci-fi action-adventure game, called Hubris. Hubris will be coming to PC in Q4 2021 and in order to celebrate this announcement, the team also released its debut gameplay trailer. In this game, you’ll assume the role of a recruit in training to become an agent of the mighty and feared Order-Of-Objectivity, also known as the ‘OOO’. Together with the pilot Lucia, you are sent to Twin Planetary System, to search for the mysterious agent Cyanha. Here are also the game’s key features: Enjoy a full VR experience with free movement, climbing, swimming and jumping. Become part of the unique and intriguing Sci-Fi world of Hubris. Savour some of the best and most immersive graphics in VR available. Fight alongside colourful epic characters against a mix of alien wildlife, humanoids and mechanised enemies, each of them requiring unique tactics to defeat. Gather and salvage resources, craft weapons and tools, control vehicles and mechanical devices. Unravel the OOO’s long-forgotten secrets. Earn your place as an agent of the Order-Of-Objectivity. Source

Ingredients 2 tbsp. EVOO 1 onion, finely chopped Salt 4 cloves garlic, chopped or sliced 1 cup vodka 1 can (28 oz.) crushed Italian tomatoes or 2 cans (14 oz. each) Italian cherry tomatoes A handful of basil leaves, torn 4 to 5 ounces ‘nduja (spreadable spicy salami) 1 lb. short-cut pasta, such as penne About 3/4 cup heavy cream 1 cup grated pecorino, Parmigiano-Reggiano, or Grana Padano, plus more for serving 1 tsp. chopped fresh oregano 2 tbsp. chopped fresh flat-leaf parsley Preparation Bring a large pot of water to a boil for the pasta. In a large deep skillet, heat the EVOO, two turns of the pan, over medium. Add the onion, season with salt, and cook, stirring, until softened, about 4 minutes. Add the garlic and stir for 1 minute. Stir in the vodka and let it cook until reduced by about a third, about 3 minutes. Add the tomatoes and simmer the sauce until slightly reduced 10 to 12 minutes. Stir the basil into the sauce. In a medium bowl, whisk the ’nduja with 1/2 cup of boiling water until smooth. Stir the mixture into the sauce. Salt the boiling water, add the pasta and cook 1 minute less than the package directions. Stir the cream into the sauce, then reduce the heat to low. Reserve 1/2 cup of the pasta cooking water, then drain the pasta. Remove the sauce from the heat and toss with the pasta and cheese, adding pasta cooking water as needed to keep the sauce velvety. In a small bowl, mix the oregano and parsley. Divide the pasta among four shallow bowls. Top with the herbs. Serve more cheese alongside. Source

A standard hot sauce on tables in Burma, this chile-garlic sauce for every occasion is hot, tart, and a little sweet. If possible, make it at least a day before you first want to serve it.–Naomi Duguid HOW DO I USE CHILE GARLIC SAUCE? This hot Burmese chile-garlic sauce also has notes of tartness and sweetness. The author, Naomi Duguid, reach for it whenever she’s eating rice or noodles, fried eggs, grilled meat, and almost anything savory that’s deep-fried. Once you have a stash of it in your refrigerator, you’ll never want to bother with store-bought Sriracha or other commercial hot sauces again. 1 cup tightly packed dried red chiles (just about any kind will work) 3/4 cup cold water 1/4 cup coarsely chopped garlic 1/4 cup fish sauce 1/4 cup granulated sugar 3/4 cup rice vinegar (or substitute cider vinegar) DIRECTIONS Wearing gloves and being mindful not to touch your eyes (!), break the chiles in half, break off the stems, and rid the chiles of some or all of the seeds (there’s heat in them their seeds). Place the chile pieces in a small pot with the water. If your garlic is somewhat dried out and harsh tasting, add it now, too. Bring to a boil, cover, reduce the heat, and simmer for 3 to 5 minutes, until the chiles are softened and have swelled up a little. If your garlic is young and fresh, add it for the last minute of cooking. Remove from the heat and let cool slightly. In a food processor, carefully combine the cooled chiles, garlic, cooking liquid, fish sauce, and sugar and process or grind to a coarse paste. Scrap down the sides of the processor bowl as necessary with a rubber spatula. Add the vinegar and process again. The sauce may seem sorta watery but that’s okay. Transfer the sauce to a clean, dry glass jar and store it in the refrigerator, preferably for at least a day before using it and up to several weeks. (When you make the sauce, it will seem watery, but letting it settle for a day gives it time to thicken. It also allows the flavors to meld nicely.) Originally published May 29, 2013. Source