health care
denialism | March 27, 2012The NYTimes reporting suggests a 5-4 split against ACA is likely:
Justice Kennedy, along with Justices Samuel A. Alito Jr. and Antonin Scalia and Chief Justice John G. Roberts Jr. all asked questions suggesting that they had a problem with the constitutionality of the mandate requiring most Americans to buy insurance. Justice Clarence Thomas, as usual, did not ask any questions, but he is widely expected to vote to overturn the mandate.
As does CNN's Toobin's analysis:
This is interesting. Part of the issue is how much of the law would fall if they turn against it? Would we still be able…
denialism | March 26, 2012With the Supreme Court hearing arguments for the next three days on the Affordable Care Act, many commentators, including Dahlia Lithwick appear to have so much contempt for the Roberts court that they believe the issue will likely be settled on politics rather than law.
The first proposition is that the health care law is constitutional. The second is that the court could strike it down anyway.
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The law is a completely valid exercise of Congress' Commerce Clause power, and all the conservative longing for the good old days of the pre-New Deal courts won't put us back in those days as if…
jtoney | March 25, 2012
Photo source.
"There's an African saying: When the elephants fight, the grass suffers."
Dartmouth College President Jim Yong Kim on the greatest challenge in global health, in a recent interview with Charlie Rose, pointing out that the "poorest of poor suffer the most."
Such wisdom will serve Dr. Kim well as he prepares to lead the World Bank, in response to President Obama's nomination. Dr. Kim is a physician and human rights advocate, whose research was initially bolstered by a major grant from George Soros to treat drug-resistant tuberculosis.
The recent interview by Charlie Rose also…
denialism | March 23, 2012We've already extensively discussed why it costs twice as much for the US to provide healthcare for it's citizens all the while failing to cover health care for all. Most recently, we discussed the hidden tax of the uninsured and the perverse incentive structure of US healthcare which encourage costlier care, more utilization, and more procedures.
To summarize, the US spends more on healthcare compared to other industrialized nations because
We deliver it inefficiently
Without universality problems present when critical and in the ER
Fee-for-service incentives in the form of excessive…
denialism | March 22, 2012With the impending, and unprecedented, 3 days of arguments over the Affordable Care Act occurring early next week, it's interesting to see that the test case being used to challenge the law has now become a test case demonstrating the necessity of the law.
Mary Brown, the woman who asserts no one has the authority to make her buy health care is now bankrupt, at least in part due to medical bills. From theLA Times article:
Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama's healthcare…
denialism | March 7, 2012Ed Yong demands higher accountability in science journalism and has made me think of how in the last two days I've run across two examples of shoddy reporting. These two articles I think encompass a large part of the problem, the first from the NYT, represents the common failure of science reporters to be critical of correlative results. While lacking egregious factual errors, in accepting the authors' conclusions without vetting the results of the actual paper, the journalist has created a misleading article. The second, from Forbes, represents the worst kind of corporate news hackery,…
denialism | March 4, 2012We've discussed it before, why are costs so much higher in US healthcare compared to other countries? The Washington Post has a pointless article which seems to answer with the tautology costs are high because healthcare in America costs more. How much more? Well, we spend nearly twice as much per capita as the next nearest country while failing to provide universal coverage:
In the WaPo article they make a big deal of the costs of individual procedures like MRI being over a thousand in the US compared to $280 in France, but this is a simplistic analysis, and I think it misses the point…
denialism | February 19, 2012Hot Air and the daily caller are excited to pronounce socialized medicine dead as the British NHS plans to contract with private hospitals and providers on top of socialized care. From The Caller:
Joseph A. Morris, a former Reagan White House lawyer who now serves on the board of the American Conservative Union, told TheDC that socialized medicine has turned out to be a threat to Britons' health, and to their economy as well.
"Europe's message to the world is no longer that the socialist dream of the cradle-to-grave welfare state is an easy achievement," Morris said. "Rather, it is the…
denialism | February 16, 2012**Update, the NYT has an editorial in their Sunday edition recommending the passage of two bills in congress requiring advanced notice from drug manufacturers in event of likely shortage.
Health affairs discusses the increasingly frequent shortages of critical, life-saving, generic drugs. This is a serious problem that seems mostly limited to the U.S. healthcare system, and may adversely affect you or someone you know.
Many of the same drugs are not in such short and unpredictable supply in Europe, where in some cases they carry higher prices. This provides one major clue to the root cause…
denialism | February 13, 2012We've written quite a bit about single payer health care systems as well as other models that are a mixture of public and private spending.
We've also analyzed some of the sources of excess cost of US healthcare to other countries. What is uniformly true about universal health care systems is that they all spend less on medical care per capita than the US. The next nearest country in spending to us, France, spends 50% of what we do per capita while providing top notch care, possibly the best in the world. And while the cause of our excess costs are multifactorial, one of the greatest…
denialism | February 12, 2012Many are linking to this story around the blogosphere and I encourage everyone to read it. In it, a Ob/Gyn describes her emergency care of a woman who arrived in her ED in hemorrhagic shock from a botched illegal abortion. Though clearly it was touch and go and there was some panicky action, our heroine thought fast and saved a life. My mother once worked in a labor and delivery ward to put herself through medschool in the days before Roe v Wade and this type of situation was common.
This is a great story because it illustrates two points. One, the war on abortion by the right wing is…
jtoney | January 29, 2012
Diffusion MRI Tractography in the brain white matter.
Some drugs work well because they are designed to hit a single, well understood target. Consider penicillin.
In a simplified sense, penicillin destroys a single enzyme that bacteria need to divide and to infect you, thereby killing the harmful bacteria. But what about psychiatric drugs? Is there a comparable, single target in the brain to treat depression, anxiety, attention deficit disorder (ADD)? No.
So, it is no wonder that the popular drug Ritalin, used to treat ADD for millions of children and adolescents is, by some standards…
milhayser | January 24, 2012What's better than an answer to a question? More questions, perhaps? ScienceBloggers have been very quizzical the last few days, beginning with Jason Rosenhouse on EvolutionBlog. After co-authoring Taking Sudoku Seriously with Laura Taalman, Rosenhouse wondered if 17 is really the minimum number of clues needed to solve a Sudoku puzzle. Although no one has ever generated a workable 16-clue puzzle, proof has been out of reach—until now?
On Starts With a Bang, Ethan Siegel considers the possibilities when a supernova remnant has nothing to show at its center. It could be the result of two…
jtoney | January 17, 2012
A "holy grail" in spinal injury research is to repair the spinal cord with newly minted nerve cells. This study published in the journal ACS Chemical Neuroscience takes us a major leap forward, with the first evidence that cells from an umbilical cord -- not from a fetus -- can be transformed into active nerve cells. This eliminates any ethical concerns about using a fetus for medical applications.
From the Abstract:
Umbilical cord stem cells would be a favorable alternative to embryonic stem cells for therapeutic applications. In this study, human multipotent progenitor cells (MLPCs)…
jtoney | January 14, 2012
Tim Tebow Foundation
Tim Tebow with Jacob Rainey, one of the many people dealing with health problems Tebow hosted at Broncos games this season.
Photo source.
Denver Broncos Quarterback Tim Tebow has become a popular culture phenomenon not only because of his extraordinary athletic skills but because he lives out the values of his religious faith - displayed publicly and shamelessly - everyday (more on that later.) But something that has not received much coverage in the news media is that three years ago, Tim Tebow had a "mysterious pain in his throwing shoulder" and he sought out some…
jtoney | January 12, 2012
The are many reasons not to use recreational drugs and this story is likely one of the scariest.
So called "bath salts," which have nothing to do with bathing, are widely available and legal to acquire. A study that was just published in the journal Orthopedics reveals for the first time a link between use of these salts and the flesh-eating bacteria or necrotizing fasciitis. It is caused by a variety of bacteria including Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, Vibrio vulnificus, Clostridium perfringens and Bacteroides fragilis). While these bacteria can…
jtoney | January 10, 2012
Mac Users Guide Flickr Photostream
As a technophile, I do love my iPhone and iPod as portable portals to new media, the web and entertainment. But everything comes at a price. I was reminded of this, starkly, by a brilliant commentary by Mike Daisy, featured recently on NPR's This American Life. That sausage may be delicious, but few of us want to be reminded of how it came to be. So it goes for iPhones, even for something as mundane as to how their screens are cleaned in the factory.
From This American Life broadcast, "Mr. Daisy and The Apple Factory:"
Mike Daisey performs an excerpt…
denialism | January 9, 2012As Chris discussed Saturday the WSJ had a silly article in which a woman demands a prescription drug from a flight attendant, asking for the wrong drug to treat her problem acutely, and then shockingly was refused this service. Worse, Nexium is mentioned by name, multiple times, and Nexium is actually a drug which should never have even been approved by the FDA. It really is only prescribed because of intense marketing because, logically, it has no business on the market and is no different than an existing drug, prilosec. Why would doctors irrationally prescribe this drug then? Because…
jtoney | December 23, 2011
Photo source.
Sometimes science can sound strange, at least until you understand its drive to understand nature at a deeper level. Mayo Clinic researchers wanted to test whether blocking a particular protein would be useful in treating heart failure, and ended up testing elderly dogs on viagra. Let me explain.
Published in the journal Circulation, and described in a press release: {with my emphasis}
Viagra against heart failure: Researchers at the RUB and from Rochester throw light on the mechanism
How sildenafil, the active ingredient in Viagra, can alleviate heart problems is reported…
jtoney | December 20, 2011
Photo source.
With the news of availability of generic Lipitor, a cholesterol lowering drug, sales of the prescription brand have plummeted, as expected. Is generic Lipitor really the same as prescription Lipitor? Consider this:
"Generic drugs are identical to brand name drugs." True or False?
We know that generic drugs cost less than their brand name equivalents, offering a savings of 50% or more. But are they "identical"?
Behind every pill is a story. US patents grant the inventor a 20 year property right; only the inventor can manufacture and sell the medicine. When the patent…