This is the first whooping cough death the county has seen in decades. Officials said it’s been at least 20 years or more since someone died of the disease.
Whooping cough, also called pertussis, and other diseases are making comebacks, because so many parents are deciding not to vaccinate their kids.
“It’s really unfortunate. We’re saddened to hear that an infant died of something like this,” said Dain Weister with the Florida Department of Health in Orange County.
Officials said the family chose not to vaccinate their child. Some parents are choosing not to fully vaccinate their children because they worry there is a link between the vaccinations and autism.
Steven Brill in Time, with a long article about the medical profession.
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.
Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.
Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children…
In 2005, the George W. Bush administration launched a $7 billion effort to prepare for pandemic influenza. It was inspired in part by concerns about avian flu and the SARS outbreak of 2002, but also by John M. Barry’s “The Great Influenza,” which Bush had read during a summer vacation. The plan centered on improvements in vaccine technology, countermeasures such as antivirals, domestic preparedness and international cooperation.
As a result of this effort, the government had a flu plan in place when the 2009 H1N1 outbreak occurred. As the New York Times noted, the Obama team’s response to H1N1 was built “on concrete preparations made during the tenure of President George W. Bush that have won praise from public health experts.”
Naturally, Obama went out of his way to note Bush’s contribution.
While we are better off today than we were a decade ago on this front, concerns over the recent outbreak show the need to develop more flexible platforms for manufacturing flu vaccines, as well as to educate Americans about the importance of getting a dose before flu season hits and staying home when sick. The government should also improve distribution of antivirals and accelerate the development of home medical kits that people can use when instructed by public health officials. Perhaps then, we’ll be as ready as we can be for another great epidemic.
Bush, dismissed as a dunce by the left, was (and I assume still is) an avid reader. For all the fawning over Obama’s supposed intelligence, it’s hard to imagine him doing something like that.
Bush saved a couple millions lives in Africa with his AIDS initiative. He no doubt saved several thousand lives in the USA — way more than Obama’s pointless gun rules will.
“Oh then maybe there won’t be enough painkillers for the poor who use the emergency rooms as their primary care doctor,’” the mayor said on his weekly radio show with John Gambling.
“Number one, there’s no evidence of that.
How could there be? The policy is brand new.
Number two, supposing it is really true so you didn’t get enough painkillers and you did have to suffer a little bit. The other side of the coin is people are dying and there’s nothing perfect… There’s nothing that you can possibly do where somebody isn’t going to suffer and it’s always the same group [claiming], ‘Everybody is heartless.’ Come on, this is a very big problem.”
By that reasoning, his gun control measures are foolish because they attempt to make perfect (no gun deaths) by imposing laws. And those very laws may actually cause more innocent people to die at the hands of criminals.
That’s not just heartless, it is stupid.
A day after an exhaustive national report on cancer found the United States is making only slow progress against the disease, one of the country’s most iconic – and iconoclastic – scientists weighed in on “the war against cancer.” And he does not like what he sees.
James Watson, co-discoverer of the double helix structure of DNA, lit into targets large and small. On government officials who oversee cancer research, he wrote in a paper published on Tuesday in the journal Open Biology, “We now have no general of influence, much less power … leading our country’s War on Cancer.”
On the $100 million U.S. project to determine the DNA changes that drive nine forms of cancer: It is “not likely to produce the truly breakthrough drugs that we now so desperately need,” Watson argued. On the idea that antioxidants such as those in colorful berries fight cancer: “The time has come to seriously ask whether antioxidant use much more likely causes than prevents cancer.”
That, and a whole host of questions.
But does that heightened risk of early death apply across the board to those who are merely overweight?
A new analysis of nearly 3 million people suggests maybe not.
The finding, published online Tuesday in the Journal of theAmerican Medical Assn., pooled data from 97 studies encompassing adult men and women in the United States, Canada, Europe, Australia, China, Taiwan, Japan, Brazil, India and Mexico.
A total of 270,000 people died of any cause during the studies. When the scientists crunched the numbers, they found, as expected, that people who were significantly obese — with a body mass index, or BMI, of 35 or more — had shorter life spans on average than those who were of normal weight, defined as having a BMI of 18.5 to 24.9.
But the scientists also found that people classified as overweight, with a BMI of 25 to 29.9, died at slightly lower rates — not higher — than those of so-called normal weight. And they found that those who were mildly obese, with a BMI of 30 to 34.9, died in no greater numbers than did their normal-weight peers.
Clostridium difficile infections could pose a big problem for patients staying at hospitals. The Centers for Disease Control and Prevention calls the infection caused by the bacteria — dubbed C. diff — a healthcare-associated infection, because some of those most at risk are people who get medical care.
New research backs a type of therapy that may sound odd to some – fecal microbiota therapy, also known as fecal transplants.
C. difficile causes diarrhea linked to 14,000 American deaths each year, says the CDC. Those infected with the bacteria have symptoms that may include diarrhea, fever, loss of appetite, nausea and abdominal pain.
The bacteria are found in feces, and people can get infected if they touch contaminated items or surfaces then touch their mouths. Health care workers may especially transfer the bacteria to patients.
Studies presented this week at American College of Gastroenterology’s annual meeting in Las Vegas found the bacteria is associated with serious problems in hospitalized children and might be helped by the fecal transplant therapy…
Some links from open tabs:
Western Lifestyle Disturbing Key Bacterial Balance? — more on the science of our guts. I see more on this subject all the time.
Welcome to the Modern-Day Depression — Publisher and onetime Obama supporter Mort Zuckerman spells out the disaster of the past four years.
How the Elites Built America’s Economic Wall — from Bloomberg news.
Testing Obama’s Promise of Transparency — also from Bloomberg. Hint: he flunked.
Apparently CNN was touting a “big story” that a “Cancer Cure is within Reach.”
This CNN report is inherently misleading in multiple ways.
The story leads viewers to believe something truly novel is happening, but the claim that cancer cases and deaths can be dramatically reduced by applying existing knowledge is a statement that is almost a cliché in the cancer world. Here’s one example I reported more than five years ago: Dr. Brian Druker, the researcher behind Gleevec, made a similar statement as he stepped into the top job at what’s now called the OHSU Knight Cancer Institute. “It’s already estimated that we could lower mortality rates from cancer by about a third if we implemented what we know. Implementing what we know encompasses a lot of things. It encompasses both screening and prevention, as well as optimizing therapy,” he told me for a profile story I wrote in 2007.
I’m not claiming I scooped Sanjay Gupta by five years. Indeed, he has reported this claim before. For example, the transcript of a CNN report from 2007 includes this quote from Dr. Harold Freeman, medical director of the Ralph Lauren Center for Cancer Care and Prevention in New York, “[W]e’re not applying to what we know to all American people. If we close that gap, that would be the biggest thing we could do to improve the results for cancer.” In that same transcript, Lance Armstrong states that applying existing knowledge about cancer could prevent 200,000 cancer deaths a year in the United States, about a third of the annual total at the time.
The story about MD Anderson Cancer Center does not make clear what makes this time any different.
And I’ll wager that any survey of viewers would find that most believe that Gupta’s report said that a big part of a decline in cancer deaths would come from new discoveries about cancer. The report did not make that claim. Several times it reported that most of the hoped-for improvements would come from applying existing knowledge about preventing cancer, but then the specific examples highlighted, and the video used, implied a different story of promise from new approaches.
After saying that the biggest advances against cancer would come from applying existing knowledge, MD Anderson Cancer Center President, Dr. Ronald DePinho, told Gupta that screening smokers with lung CT scans would have “an impact on 170,000 deaths per year.” Gupta says proper screening could have “a huge impact.” I would forgive viewers for thinking that the report is claiming that lung cancer screening could save hundreds of thousands of lives a year. It didn’t actually make that claim, but the presentation was confusing. Actually, the biggest study of CT scans indicates you would have to test more than 300 heavy smokers to prevent just a single lung cancer death. And I will spare you a detailed explanation of how the story bungled references to the potential benefits of early detection, while failing to explain that if a disease takes 10 years to kill you, finding it in year 5, instead of year 9, can give the appearance of longer survival without necessarily changing the date of death…
I read this when first published. It’s still stands out.
‘There’s No Place Like Home’
What I learned from my wife’s month in the British medical system.
BY DAVID ASMAN
Wednesday, June 8, 2005 12:00 a.m.
“Mr. Asman, could you come down to the gym? Your wife appears to be having a small problem.” In typical British understatement, this was the first word I received of my wife’s stroke.
We had arrived in London the night before for a two-week vacation. We spent the day sightseeing and were planning to go to the theater. I decided to take a nap, but my wife wanted to get in a workout in the hotel’s gym before theater. Little did either of us know that a tiny blood clot had developed in her leg on the flight to London and was quietly working its way up to her heart. Her workout on the Stairmaster pumped the clot right through a too-porous wall in the heart on a direct path to the right side of her brain.
Hurrying down to the gym, I suspected that whatever the “small” problem was, we might still have time to make the play. Instead, our lives were about to change fundamentally, and we were both about to experience firsthand the inner workings of British health care.
We spent almost a full month in a British public hospital. We also arranged for a complex medical procedure to be done in one of the few remaining private hospitals in Britain. My wife then spent about three weeks recuperating in a New York City hospital as an inpatient and has since used another city hospital for physical therapy as an outpatient. We thus have had a chance to sample the health diet available under two very different systems of health care. Neither system is without its faults and advantages. To paraphrase Thomas Sowell, there are no solutions to modern health care problems, only trade-offs. What follows is a sampling of those tradeoffs as we viewed them firsthand.
As I saw my wife collapsed on the hotel’s gym floor, my concern about making the curtain was replaced by a bone-chilling recognition that she was in mortal danger. Despite her protestations that everything was fine, her left side was paralyzed and her eyes were rolling around unfocused. She was making sense, but her words were slurred. Right away I suspected a stroke, even though she is a young, healthy nonsmoker. Over her continuing protests, I knew we had to get her to a hospital right away.
The emergency workers who came within five minutes were wonderful. The two young East Enders looked and sounded for all the world like a couple of skinhead soccer fans, cockney accents and all. But their professionalism in immediately stabilizing my wife and taking her vitals was matched with exceptional kindness. I was moved to tears to see how comforting they were both to my wife and to me. As I was to discover time and again in the British health system, despite the often deplorable conditions of a bankrupt infrastructure, British caregivers–whether nurses, doctors, or ambulance drivers–are extraordinarily kind and hardworking. Since there’s no real money to be made in the system, those who get into public medicine do so as a pure vocation. And they show it. In the case of these EMTs, I kick myself for not having noticed their names to later thank them, for almost as soon as they dropped us off at the emergency room of the University College of London Hospital, they disappeared.
Suddenly we were in the hands of British Health Service, and after a battery of tests we were being pressured into officially admitting my wife to UCL. As we discovered later, emergency care is free for everyone in Britain; it’s only when one is officially admitted to a hospital that a foreigner begins to pay. I didn’t know that. But I did know that I was not about to admit my wife to a hospital that could not diagnose an obviously life-threatening affliction. And even after having given her an MRI, the doctors could not tell if she had a stroke.
Now, the smartest thing I did before we left the hotel was to delay the ambulance driver long enough to run back to my room and grab my wife’s cell phone. With that phone I began making about a thousand dollars worth of trans-Atlantic calls, the first of which was to the world-renowned cardiologist Dr. Isadore Rosenfeld, who I’m lucky enough to have as my GP. As it turned out, not only did Izzy diagnose the problem correctly, he even suggested a cause for the stroke, which later turned out to be correct. “There’s no reason for her to have a stroke except if it’s a PFO.” I didn’t know what Izzy meant, but I wrote down the initials and later found out that a PFO (a patent foramen ovale) is a flap-like opening in the heart through which we get our oxygen in utero. For most of us, the opening closes shortly after birth. But in as many as 30 percent of us, the flap doesn’t seal tight, and that can allow a blood clot to travel through the heart up to the brain. Izzy agreed that I should not admit my wife to UCL but hold out for a hospital that specialized in neurology.
As it happened, the best such hospital in England, Queen’s Square Hospital for Neurology, was a short distance away, but it had no beds available. That’s when I started dialing furiously again, tracking down contacts and calling in chits with any influential contact around the world for whom I’d ever done a favor. I also got my employer, News Corp., involved, and a team of extremely helpful folks I’d never met worked overtime helping me out.
Suddenly, a bed was found in Queen’s Square, and by 2 a.m. my wife was officially admitted to a British public hospital. The neurologist on call that night looked at the same MRI where the emergency doctors had seen nothing and immediately saw that my wife had suffered a severe stroke. It was awful news, but I realized we were finally in the right place.
That first night (or what was left of it) my wife was sent off to intensive care, and the nurses convinced me that I should get a few hours sleep. We found a supply closet, in which there was a small examination table, and the nurses helped me fashion fake pillows and blankets from old supplies. The loving attention of these nurses was touching. But the conditions of the hospital were rather shockingly apparent even then.
The acute brain injury ward to which my wife was assigned the next day consisted of four sections, each having six beds. Whether it was dumb luck or some unseen connection, we ended up with a bed next to a window, through which we could catch a glimpse of the sky. Better yet, the window actually opened, which was also a blessing since the smells wafting through the ward were often overwhelming.
When I covered Latin America for The Wall Street Journal, I’d visit hospitals, prisons and schools as barometers of public services in the country. Based on my Latin American scale, Queen’s Square would rate somewhere in the middle. It certainly wasn’t as bad as public hospitals in El Salvador, where patients often share beds. But it wasn’t as nice as some of the hospitals I’ve seen in Buenos Aires or southern Brazil. And compared with virtually any hospital ward in the U.S., Queen’s Square would fall short by a mile.
The equipment wasn’t ancient, but it was often quite old. On occasion my wife and I would giggle at heart and blood-pressure monitors that were literally taped together and would come apart as they were being moved into place. The nurses and hospital technicians had become expert at jerry-rigging temporary fixes for a lot of the damaged equipment. I pitched in as best as I could with simple things, like fixing the wiring for the one TV in the ward. And I’d make frequent trips to the local pharmacies to buy extra tissues and cleaning wipes, which were always in short supply.
In fact, cleaning was my main occupation for the month we were at Queen’s Square. Infections in hospitals are, of course, a problem everywhere. But in Britain, hospital-borne infections are getting out of control. At least 100,000 British patients a year are hit by hospital-acquired infections, including the penicillin-resistant “superbug” MRSA. A new study carried out by the British Health Protection Agency says that MRSA plays a part in the deaths of up to 32,000 patients every year. But even at lower numbers, Britain has the worst MRSA infection rates in Europe. It’s not hard to see why.
As far as we could tell in our month at Queen’s Square, the only method of keeping the floors clean was an industrious worker from the Philippines named Marcello, equipped with a mop and pail. Marcello did the best that he could. But there’s only so much a single worker can do with a mop and pail against a ward full of germ-laden filth. Only a constant cleaning by me kept our little corner of the ward relatively germ-free. When my wife and I walked into Cornell University Hospital in New York after a month in England, the first thing we noticed was the floors. They were not only clean. They were shining! We were giddy with the prospect of not constantly engaging in germ warfare.
As for the caliber of medicine practiced at Queen’s Square, we were quite impressed at the collegiality of the doctors and the tendency to make medical judgments based on group consultations. There is much better teamwork among doctors, nurses and physical therapists in Britain. In fact, once a week at Queen’s Square, all the hospital’s health workers–from high to low–would assemble for an open forum on each patient in the ward. That way each level knows what the other level is up to, something glaringly absent from U.S. hospital management. Also, British nurses have far more direct managerial control over how the hospital wards are run. This may somewhat compensate for their meager wages–which averaged about £20,000 ($36,000) a year (in a city where almost everything costs twice as much as it does in Manhattan!).
There is also much less of a tendency in British medicine to make decisions on the basis of whether one will be sued for that decision. This can lead to a much healthier period of recuperation. For example, as soon as my wife was ambulatory, I was determined to get her out of the hospital as much as possible. Since a stroke is all about the brain, I wanted to clear her head of as much sickness as I could. We’d take off in a wheelchair for two-hour lunches in the lovely little park outside, and three-hour dinners at a nice Japanese restaurant located at a hotel down the street. I swear those long, leisurely dinners, after which we’d sit in the lobby where I’d smoke a cigar and we’d talk for another hour or so, actually helped in my wife’s recovery. It made both of us feel, well, normal. It also helped restore a bit of fun in our relationship, which too often slips away when you just see your loved one in a hospital setting.
Now try leaving a hospital as an inpatient in the U.S. In fact, we did try and were frustrated at every step. You’d have better luck breaking out of prison. Forms, permission slips and guards at the gate all conspire to keep you in bounds. It was clear that what prevented us from getting out was the pressing fear on everyone’s part of getting sued. Anything happens on the outside and folks naturally sue the hospital for not doing their job as the patient’s nanny.
Why are the Brits so less concerned about being sued? I can only guess that Britain’s practice of forcing losers in civil cases to pay for court costs has lessened the number of lawsuits, and thus the paranoia about lawsuits from which American medical services suffer.
British doctors, nurses and physical therapists also seem to put much more stock in the spiritual side of healing. Not to say that they bring religion into the ward. (In fact, they passed right over my wife’s insistence that prayer played a part in what they had to admit was a miraculously quick return of movement to her left side.) Put simply, they invest a lot of effort at keeping one’s spirits up. Sometimes it’s a bit over the top, such as when the physical or occupational therapists compliment any tiny achievement with a “Brilliant!” or “Fantastic!” But better that than taking a chance of planting a negative suggestion that can grow quickly and dampen spirits for a long time.
Since we returned, we’ve actually had two American physical therapists who did just that–one who told my wife that she’d never use her hand again and another who said she’d never bend her ankle again. Both of these therapists were wrong, but they succeeded in depressing my wife’s spirits and delaying her recovery for a considerable period. For the life of me, I can’t understand how they could have been so insensitive, unless this again was an attempt to forestall a lawsuit: I never claimed you would walk again.
Having praised the caregivers, I’m forced to return to the inefficiencies of a health system devoid of incentives. One can tell that the edge has disappeared in treatment in Britain. For example, when we returned to the U.S. we discovered that treatment exists for thwarting the effects of blood clots in the brain if administered shortly after a stroke. Such treatment was never mentioned, even after we were admitted to the neurology hospital. Indeed, the only medication my wife was given for a severe stroke was a daily dose of aspirin. Now, treating stroke victims is tricky business. My wife had a low hemoglobin count, so with all the medications in the world, she still might have been better off with just aspirin. But consultations with doctors never brought up the possibilities of alternative drug therapies. (Of course, U.S. doctors tend to be pill pushers, but that’s a different discussion.)
Then there was the condition of Queen’s Square compared with the physical plant of the New York hospitals. As I mentioned, the cleanliness of U.S. hospitals is immediately apparent to all the senses. But Cornell and New York University hospitals (both of which my wife has been using since we returned) have ready access to technical equipment that is either hard to find or nonexistent in Britain. This includes both diagnostic equipment and state-of-the-art equipment used for physical therapy.
We did have one brief encounter with a more comprehensive type of British medical treatment–a day trip to one of the few remaining private hospitals in London.
Before she could travel back home, my wife needed to have the weak wall in her heart fortified with a metal clamp. The procedure is minimally invasive (a catheter is passed up to the heart from a small incision made in the groin), but it requires enormous skill. The cardiologist responsible for the procedure, Seamus Cullen, worked in both the public system and as a private clinician. He informed us that the waiting line to perform the procedure in a public hospital would take days if not weeks, but we could have the procedure done in a private hospital almost immediately. Since we’d already been separated from our 12-year-old daughter for almost a month, we opted to have the procedure done (with enormous assistance from my employer) at a private hospital.
Checking into the private hospital was like going from a rickety Third World hovel into a five-star hotel. There was clean carpeting, more than enough help, a private room (and a private bath!) in which to recover from the procedure, even a choice of wines offered with a wide variety of entrees. As we were feasting on our fancy new digs, Dr. Cullen came by, took my wife’s hand, and quietly told us in detail about the procedure. He actually paused to ask us whether we understood him completely and had any questions. Only one, we both thought to ask: Is this a dream?
It wasn’t long before the dream was over and we were back at Queen’s Square. But on our return, one of the ever-accommodating nurses had found us a single room in the back of the ward where they usually throw rowdy patients. For the last five days, my wife and I prayed for well-behaved patients, and we managed to last out our days at Queen’s Square basking in a private room.
But what of the bottom line? When I received the bill for my wife’s one-month stay at Queen’s Square, I thought there was a mistake. The bill included all doctors’ costs, two MRI scans, more than a dozen physical therapy sessions, numerous blood and pathology tests, and of course room and board in the hospital for a month. And perhaps most important, it included the loving care of the finest nurses we’d encountered anywhere. The total cost: $25,752. That ain’t chump change. But to put this in context, the cost of just 10 physical therapy sessions at New York’s Cornell University Hospital came to $27,000–greater than the entire bill from British Health Service!
There is something seriously out of whack about 10 therapy sessions that cost more than a month’s worth of hospital bills in England. Still, while costs in U.S. hospitals might well have become exorbitant because of too few incentives to keep costs down, the British system has simply lost sight of costs and incentives altogether. (The exception would appear to be the few remaining private clinics in Britain. The heart procedure done in the private clinic in London cost about $20,000.)
“Free health care” is a mantra that one hears all the time from advocates of the British system. But British health care is not “free.” I mentioned the cost of living in London, which is twice as high for almost any good or service as prices in Manhattan. Folks like to blame an overvalued pound (or undervalued dollar). But that only explains about 30 percent of the extra cost. A far larger part of those extra costs come in the hidden value-added taxes–which can add up to 40 percent when you combine costs to consumers and producers. And with salaries tending to be about 20 percent lower in England than they are here, the purchasing power of Brits must be close to what we would define as the poverty level. The enormous costs of socialized medicine explain at least some of this disparity in the standard of living.
As for the quality of British health care, advocates of socialized medicine point out that while the British system may not be as rich as U.S. heath care, no patient is turned away. To which I would respond that my wife’s one roommate at Cornell University Hospital in New York was an uninsured homeless woman, who shared the same spectacular view of the East River and was receiving about the same quality of health care as my wife. Uninsured Americans are not left on the street to die.
Something is clearly wrong with medical pricing over here. Ten therapy sessions aren’t worth $27,000, no matter how shiny the floors are. On the other hand my wife was wheeled into Cornell and managed to partially walk out after a relatively pleasant stay in a relatively clean environment. Can one really put a price on that?
Health News Review is a good source for sober, factual analysis of medical news.
The announcement by Johnson & Johnson and Pfizer that they were pulling the plug on clinical testing of the Alzheimer’s drug Bapineuzumab after two failed clinical trials, got a lot of mainstream news media coverage– as it should have to balance some of the earlier breathless hype about the drug’s potential.
But not many stories that we saw got at a core issue. Bloomberg News did a good job when it reported:
While companies have focused on developing drugs to hinder the amyloid deposits,scientists aren’t certain whether the clumps cause or are a minor contributor to the disease or merely a consequence.
“Alzheimer’s is a tough nut for any drug company to crack,” said Erik Gordon, a professor at the University of Michigan’s Ross School of Business, in an e-mail. “We don’t know for sure what causes it or even what it really is. There will be more failures before we see a success.”
Numerous reasons may account for the bapineuzumab trial failures, said Lon Schneider, director of the University of Southern California Alzheimer’s Disease Research and Clinical Center in Los Angeles. It could be that intervening earlier in the disease process is necessary, or that researchers need to attack amyloid in a different way, he said.
“My wish is that the investor and scientific community doesn’t interpret this as something to the effect that the amyloid hypothesis for treatment is invalid or dead,” Schneider said in a telephone interview. “That’s not the way I’m interpreting it.”
…Right now amyloid is a surrogate marker. Journalists who build up hope over experimental drugs – and then report on drug failures – need to keep that in mind and should help readers understand the core issue as well. And, yes, we know that some of the stories above are “business” stories, but as we’ve written in the past, online news surfers find business stories just as they find consumer health news stories and the differentiation is almost irrelevant online.
ObamaCare’s illusions are starting to fall like autumn leaves, even among some liberals, and what they’re discovering are things that have happened over and over again in Massachusetts. Beacon Hill “reformed” health care four years before Capitol Hill, and ever since it has reliably predicted the national trend—on surging costs, price controls, physician shortages and so much else.
So Boston’s latest adventure deserves particular scrutiny, since odds are its methods are coming soon to a hospital near you. After more than a year and a half of debate, last week the legislature passed a far-reaching “cost containment” bill that Democratic Governor Deval Patrick is about to sign. It is the inevitable postscript to the model that Mitt Romney introduced in 2006.
Editorial board member Joe Rago on Massachusetts’s legislature passing price controls to hold down health costs. Photos: Getty Images
The claim then, as with the Affordable Care Act, was that health care would be less expensive if everyone had insurance. Soon Massachusetts Democrats leaked that their political strategy all along was to expand coverage only, because had RomneyCare seriously squeezed providers it never would have overcome industry opposition. “Bending the curve” on costs could be saved for another day, once a vast new government liability was locked in.
Sure enough, 79% of the newly insured are on public programs. Health costs—Medicaid, RomneyCare’s subsidies, public-employee (more…)
Theodore Dalrymple, a retired British doctor, writes about the Olympic opening ceremony:
..of course it was impressive, as anything staged on a sufficiently large scale and well-organized is impressive. The fear of almost all Britons, amounting virtually to an expectation, that the games would at once descend into chaos was not fulfilled. On the contrary, the choreography was impeccable, and thousands participated without mishap, with the precision of a military parade. There were even moments of genuine wit, which distinguished the ceremony from the North Korean equivalent.
Nevertheless, the inclusion of happily dancing nursing staff from the National Health Service was precisely the kind of stunt that an ideological state would pull. Who would have guessed that only a few days before in the NHS, here presented as among the greatest of all British achievements, some doctors had gone on strike, not to improve conditions for their patients but to preserve their own generous pensions—of the kind that those unfortunate enough to work in the private sector can only dream about? Western Europeans must either have puzzled over or laughed at this: Britain is universally acknowledged in Europe to have the worst health care on the continent—health care that European residents flee except in extremis. And here were people dancing to celebrate it!
Last week, a California biotech company announced that its human stem cells restored memory in rodents bred to have an Alzheimer’s-like condition—the first evidence that human neural stem cells can improve memory.
The company, called StemCells, is betting that its proprietary preparation of stem cells from fetal brain tissue will take on many different roles in the central nervous system. The company and its collaborators have already shown that its stem-cell product has potential in protecting vision in diseased eyes, acting as brain support cells, or improving walking ability in rodents with spinal cord injury.
This metamorphic ability is not so surprising—they are stem cells, after all. But experts say the quality of scientists involved in StemCells and the interesting properties of its cells sets the company apart. “They’ve really been steadfast in their work to get these cells into clinical trials. That is a tough road and they’ve done it,” says Larry Goldstein, a neuronal stem-cell researcher and director of UC San Diego’s stem-cell program.
The company discovered the technique to isolate these cells from brain tissue in 1999 and has since spent some $200 million improving the technology. “Now we are really in the exciting phase, because now we are looking at human clinical data, as opposed to just small animals,” says StemCells CEO Martin McGlynn.
The state began moving Medi-Cal patients to a managed care system to save money, but many with serious illnesses have had to give up doctors or delay treatment.
One year ago, California began moving certain Medi-Cal patients into a managed healthcare system with the goal of saving money while better coordinating treatment.
But for some of these low-income seniors and disabled patients, the transition has been anything but smooth, forcing severely ill patients to give up their doctors, delay treatment and travel long distances for specialty care.
As of this month, the state has transitioned 333,000 people, many with diseases such as multiple sclerosis, lupus and metastatic cancer. State health officials said managed care oversees all of the patients’ treatment and guides them through the healthcare system, helping prevent unnecessary procedures and hospital visits.
Patients could apply for temporary exemptions if they wanted to stay on a fee-for-service plan, where the state pays doctors based on the specific treatment provided instead of a managed care general rate that is usually less. But the patients had to meet a high bar: They had to be in ongoing care for a serious illness and any change could cause their condition to deteriorate.
“The criteria is met by very few people,” said Susan McClair, senior medical consultant with the state Medi-Cal Managed Care Division.
Nearly 18% of the 19,684 people who applied for exemptions between June of last year and April were approved, according to the state. Almost 32% were denied and the rest had their papers sent back as incomplete.
Maria Blancarte, 61, who has rheumatoid arthritis and must use a wheelchair, spends about 22 hours a day in a hospital bed at her Eagle Rock home. She lives in constant pain. Blancarte applied for an exemption with the support of her doctor, who submitted a letter saying that she needs monthly evaluation, adjustments in medication and physical therapy.
“The disease renders her totally and permanently disabled,” the letter said. “She should be allowed to continue her medical follow-up with the physicians who have cared for her in the past many years.”
The state Department of Health Care Services denied Blancarte’s application, saying her medical condition didn’t qualify her for an exemption. The state did let her stay with her doctor for one year, but Blancarte said he fears that the state won’t pay him for all the services he provides.
“I don’t know who made up this system, but it has no heart in it,” she said. “It’s one-size-fits-all managed care.”
When you’re at the mercy of the government, you get what you get and do what you’re told. Period.
Yes, that really happened to me.
I am writing this post not for our regular audience, but as a contribution to the global hive mind, accessed via Google and others. It helped me and I owe it this.
On 9/11/2011 I rose from a crouch while taking a photo and got what felt like a blast of bright light in my left eye. It was as if I had accidentally popped my camera’s flash in my own face. Startled, I waited about 20 seconds for my eye to clear.
I was rattled for the rest of the day, and of course, told no one about it. Especially my wife.
A couple days later I was leaning over on a photo shoot and the same thing happened. Then a few days later, it happened again as I was leaning over my fish pond.
Concerned that I might have a detached retina — a medical emergency– I saw an eye doctor who checked me out thoroughly and said my eye was in fine physical shape.
For about ten years, I’ve had ocular migraines a couple times a year. They don’t hurt, they just produce a temporary light show in one or both eyes that lasts about 20 minutes. For me, it’s a twinkling pulse in my left eye. It is a brain generated event — I can cover my eye but the show goes on.
Knowing that, I started Googling migraines and was surprised to learn that bending over was a migraine trigger. One link led to another and I found someone with my symptoms:
I have never been an experiencer of migraines. Out of the blue I’ll
now occasionally bend over to pick something up, and I’ll feel a bit
of a head rush sensation. I’ll feel pressure in my eyes and get sort
of star bursts in my left eye (always the left) Within a few moments,
my vision in that eye will go completely grey (as though looking
through a curtain – totally blind except for perhaps a brighter area
if I look directly at a strong light source. Within 5-15 minutes,
vision slowly returns. Initially in patchy grey scale, and eventually
colours come back and all is totally normal. No pain through any of
I tried emailing the guy to see what he’d learned, but his address was dead. Was he? I wondered.
One morning I started seeing a bright halo around things, reminiscent of what migraine sufferers describe before they get slammed with a monster headache.
This went on for a couple of hours and then I sneezed. This time my left eye went completely black and didn’t clear up quickly. After 15 minutes I got my son to drive me back to the eye doc. Again, there was nothing for him to see. About an hour later, my vision cleared up.
Eventually I had a name for my condition, “Recurrent Transient Monocular Blindness” and that led to Amaurosis fugax. Doctor Wiki warned that I could be at risk for stroke.
So it was off to a neurologist and MRIs of the brain, carotid artery, a heart test etc. Everything turned up clean. Meanwhile the condition had become chronic. but milder: I’d tie my shoes and I’d get a fuzzy eye for five seconds.
The neurologist concluded there was probably a microscopic something interfering with the blood flow to the optic nerve and there was nothing more to do. By then I’d accepted the fact that it was something I’d have to live with — no big deal considering health issues others live with.
It was near the end of October. My wife and I went on a long weekend to central California. We hiked, took photos etc. I had no symptoms the entire time.
When we returned, the condition was gone. As suddenly as it came, it went. How or why no one knows. (And if you’ve read this far, you might be thinking, “And no one cares.”)
If this happens to you, I hope this account helps.
Could obesity be cured by injecting our guts with fecal bacteria from ancient mummies?
It sounds outrageous, but King Tut’s stomach bacteria might hold the cure for obesity.
Researchers have recently discovered that modern use of antibiotics has wreaked havoc on the health and content of our gut bacteria. In turn, these changes have altered how our metabolisms work, possibly making us more prone to getting fat.
Now scientists from the University of Oklahoma have proposed an unexpected solution: Why not replenish our gut flora using fecal bacteria from ancient mummies as a guide?
Since ancient mummies lived in an era before antibiotics, it’s worth a look to see how their intestinal bacteria differed from modern gut flora, to discover what has changed. For the study, researchers not only performed DNA analysis on samples collected from the intestines of mummies found in North and South America, but they also hunted for preserved feces left in ancient cave soil, reports NineMSN.
Here’s the pitch for a new horror movie franchise: kids at fat camp each mummy turds, turn into ravaging gangs of psycho killers.
Christopher Conover argues in the LA Times that our healthcare system wasn’t “broke.”
The epic debate over President Obama’s controversial individual health insurance mandate finally reaches the Supreme Court this month. Stripped of legal jargon, the administration’s defense of the mandate — and the broader Affordable Care Act — boils down to this: The U.S. healthcare system was badly broken, so we had to fix it.
Indeed, the fierce battle over reform was based on the perception that Americans did not get good value for their money. Many of the global comparisons that informed this view, however, were flawed, incomplete or misleading. It’s time to set the record straight.
The U.S. spends too much compared to other countries.
This is a pervasive misconception encouraged by reformers who sought to argue that other countries, especially those with single-payer systems such as Canada or Britain, outperform the United States. Thus it was feasible to imagine that the U.S. could dramatically expand access to care without spending more money.
But throughout the world, as income rises, so does willingness to pay for healthcare. In fact, differences in income per capita explain about 85% of the variation in health expenditures per capita across industrialized countries.
Conventional models purportedly show that the U.S. spends 60% more on healthcare than it should given its level of per capita income. These models treat all nations the same so that the United States and its 300 million people is compared with very small countries such as Iceland, population 500,000. But a more precise model that compares apples to apples shows that the U.S. spends only 1.5% more than it should. By contrast, France spends about one-fifth too much, while Canada and Britain spend about one-fifth too little.
Other countries are doing better at controlling health spending growth.
Since 1960, the U.S. has been about in the middle of its economic peers in terms of the rate of growth in real (inflated-adjusted) health spending per person. But surely the single-payer countries have done best in controlling costs? Not so. Since 1990, growth in the rates of per capita spending in Canada and Britain have exceeded the U.S. rate.
What really matters is how much the average person has to spend on everything else once healthcare has been purchased. And on this score, Americans have a huge advantage. In real dollar terms, the U.S. margin of advantage in nonhealth spending increased between 1960 and 2007 compared with every country in the (more…)
Why are so many medicines only available by prescription in the US?
If Obama wanted to cut costs, he could order the feds to liberate thousands of medicines from prescription only status.
I use an anti-fungal cream from time to time. The one that really works requires a prescription. Why? How could anyone possibly abuse it? Smear it on crackers?
A few years ago, Heather Bresch, the sparky chief executive of Mylan, a generic and speciality drugs company, visited Disneyland with her four children. As she entered the theme park, what caught her eye was not Mickey Mouse but a collection of “defibrillator stations” tucked between the rides, ready to provide emergency resuscitation to anybody who suffered a heart attack.
It sparked, Bresch says, an “Aha!” moment. Mylan owns the patent on a device known as an EpiPen, a retractable syringe that administers epinephrine to anyone suffering a severe allergic reaction. Until recently, these were not marketed aggressively. But as Bresch looked at those defibrillators, she wondered why EpiPens were not there, too? Both devices only work if they are used quickly, so why not have anti-allergy devices placed everywhere, ready for easy use if a child reacts to nuts, a bee sting or anything else? It is an intriguing question – and not just for Mylan, which is trying to make a profit by flogging those EpiPens. For behind this piece of plastic there is an odd saga which not only illustrates some of the paradoxes of American healthcare, but also stirs up strong emotions, particularly from the parents of allergy-prone kids…
It’s nice the Feds finally noticed.
Federal officials say they have taken down the largest Medicare fraud scheme investigators have ever discovered: a $375 million dollar home healthcare scam operating in the Dallas, Texas area.
The alleged “mastermind” of the fraud, Dr. Jacques Roy, is charged with certifying hundreds of fraudulent claims for Medicare reimbursement, and pocketing millions in payments for services not needed, or never delivered. Prosecutors say the 54-year-old Dr. Roy, who was arrested today and could be sentenced to life in prison, operated a “boiler room” to churn out thousands of phony Medicare claims and recruited homeless people as fake patients.
“Today, the Medicare Fraud Strike Force is taking aim at the largest alleged home health fraud scheme ever committed,” said Assistant Attorney General Lanny Breuer. “According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services, and billing Medicare for those services.”
For Roy’s billing to have made sense, he’d have to been treating a million patients.
You’d expect the government’s computer system to have a means to red flag such abuses.
Knowing the cause of death is critical in our justice system. Was a crime committed that must be investigated or not? One would expect the people making that critical call would be highly trained.
But no, not if you believe what you see in this episode of Frontline. The show argues subtly for a federal standard for coroners, which ignores our federalist system of government. But it’s a minor quibble.
“Don’t be evil” is Google’s motto.
But, using a con man in a sting, the Feds found them being bad.
Over four months in 2009, Mr. Whitaker, a federal prisoner and convicted con artist, was the lead actor in a government sting targeting Google Inc. that yielded one of the largest business forfeitures in U.S. history.
“There was a part of me that felt bad,” Mr. Whitaker wrote in his account of the undercover operation viewed by The Wall Street Journal. “I had grown to like these people.” But, he said, “I took ease in knowing they…knew it was wrong.”
The government built its criminal case against Google using money, aliases and fake companies—tactics often used against drug cartels and other crime syndicates, according to interviews and court documents. Google agreed to pay a $500 million forfeiture last summer in a settlement to avoid prosecution for aiding illegal online pharmaceutical sales.
Google acknowledged in the settlement that it had improperly and knowingly assisted online pharmacy advertisers allegedly based in Canada to run advertisements for illicit pharmacy sales targeting U.S. customers.
“We banned the advertising of prescription drugs in the U.S. by Canadian pharmacies some time ago,” the company said in its sole comment on the matter. “However, it’s obvious with hindsight that we shouldn’t have allowed these ads on Google in the first place.”
The half-billion dollar forfeiture, although historically large, was small change for Google, which holds $45 billion in cash. But the company’s acceptance of responsibility opened the door to potential liability for taking ads from other people involved in unlawful acts online, such as distributing pirate movies or perpetrating online fraud…
The number of prescription drug shortages shot up to a record 267 in 2011, nearly four times the level of just seven years ago, a new report says. It’s a shortage made in Washington.
The number of drug shortages rose by 56 in 2011 from 211 in 2010, according to a study by the University of Utah Drug Information Service. As recently as 2004, just 58 drugs were in short supply.
“The inability to get crucial medicines has disrupted chemotherapy, surgery and care for patients with infections and pain,” the Associated Press reports.
What happened? As is often the case, government price and output controls are largely to blame for shortages, which have killed at least 15 people since 2010.
Take Medicare. It limits the prices it pays for drugs. But in Medicare’s Plan B, reimbursements to drugmakers often don’t cover the cost of a drug — or shrink profits to such low levels it’s no longer worth making it.
Of course, hospitals still need those drugs. A recent survey found more than half of hospitals routinely buy scarce drugs on the black market — often at exorbitant cost, but without improving the quality of care.
Just as bad, the Food and Drug Administration imposes strict controls on pharmaceutical companies’ output.
As John Goodman of the National Center for Policy Analysis wrote recently: “(A) drug manufacturer must get approval for how much of a drug it plans to produce, as well as the time frame. If a shortage develops (because, say, the FDA shuts down a competitor’s plant), a drug manufacturer cannot increase its output of that drug without another round of approvals.”
But, as we know, central planning doesn’t work…
Before Al Gore, a Nobel prize was awarded to the man who invented the frontal lobotomy.
Most of us recall lobotomies as they were depicted in the movie “One Flew over the Cuckoo’s Nest”— horrifying operations inappropriately used to control mentally ill patients. But in the 1950s, surgeons also used them to treat severe pain from cancer and other diseases.
Now a Yale researcher has uncovered surprising new evidence of a famous patient who apparently received a lobotomy for cancer pain during that time: Eva Perón, the first lady of Argentina, who was known as Evita. The story is an interesting, sad footnote in the history not only of lobotomy, but of pain control.
The nature of Perón’s illness was initially shrouded in silence. Her doctors diagnosed advanced cervical cancer in August 1951, but as was common at the time, the patient was told only that she had a uterine problem. According to the biographers Nicholas Fraser and Marysa Navarro, secrecy was so paramount that an American specialist, Dr. George Pack, performed Perón’s cancer operation without her or the public ever knowing. He entered the operating suite after she was under anesthesia.
Despite surgery, radiation and chemotherapy, Perón gradually worsened, dying in late July 1952 at age 33. Only then was it revealed that she had died of cervical cancer, although details of her treatment, including Dr. Pack’s involvement, remained concealed.
In a 1972 biography, Erminda Duarte, Perón’s sister, claimed she had suffered intense pain and distress.
When used for psychiatric illness, lobotomy was once seen as a huge advance. Dr. Egas Moniz, a Portuguese neurologist who developed the procedure in the 1930s, was awarded the Nobel Prize in Physiology or Medicine in 1949. Surgeons performed many types of lobotomies, but most involved severing nerves that ran from the frontal lobes to other parts of the brain to disrupt supposedly faulty connections that had developed in schizophrenia or depression…
The largest, most serious threat to the solvency of the USA is Medicare.
Republican Rep. Paul Ryan unveiled a new Medicare proposal Thursday that would give future seniors the choice of purchasing private insurance coverage or staying in the traditional federal plan.
The concept, which is backed by Democratic Sen. Ron Wyden of Oregon, steps back from the House budget chairman’s previous plan to end the traditional fee-for-service Medicare program for future retirees and replace it with subsidies starting at $8,000 that seniors would use to purchase private health plans.
That subsidy wasn’t guaranteed to keep pace with the rate of health-care inflation, leaving beneficiaries potentially to face higher out-of-pocket costs.
Ryan’s first plan had been attacked by Democrats, who were preparing to portray Republicans in 2012 elections as trying to do away with the popular program.
Messrs. Ryan and Wyden would allow private plans to compete alongside the traditional Medicare plan. Seniors could sign up for any of the plans offered through a Medicare exchange, which would have specific requirements for what the plans must cover.
The government would pay some or all of their premiums, with lower-income seniors receiving a full subsidy and higher-income seniors receiving less money. The proposals would only take effect in 2022 and wouldn’t apply to seniors currently in the program.
“The more the national conversation about the future of Medicare deteriorates into partisan attacks that our opponents will ‘cut Medicare’ versus superficial campaign pledges to ‘make no changes’ to a 45-year-old program, the harder it gets to have a serious debate about the best way to ensure that seniors can rely on a strengthened Medicare program for decades to come,” the two lawmakers wrote in the summary of their proposals.
From the Fred Kavli Foundation website.
Using skin cells from patients with mental disorders, scientists are creating brain cells that are now providing extraordinary insights into afflictions like schizophrenia and Parkinson’s disease.
FOR MANY POORLY UNDERSTOOD MENTAL DISORDERS, such as schizophrenia or autism, scientists often wish they could turn back the clock to uncover what has gone wrong in the brains of these patients, and how to right it before much brain damage ensues. But now, thanks to recent developments in the lab, that wish is coming true.
Researchers are using genetic engineering and growth factors to reprogram the skin cells of patients with schizophrenia, autism, and other neurological disorders and grow them into brain cells in the laboratory. There, under their careful watch, investigators can detect inherent defects in how neurons develop or function, or see what environmental toxins or other factors prod them to misbehave in the petri dish. With these “diseases in a dish” they can also test the effectiveness of drugs that can right missteps in development, or counter the harm of environmental insults.
“It’s quite amazing that we can recapitulate a psychiatric disease in a petri dish,” says neuroscientist Fred (Rusty) Gage, a professor of genetics at the Salk Institute for Biological Studies and member of the executive committee of the Kavli Institute for Brain and Mind (KIBM) at the University of California, San Diego. “This allows us to identify subtle changes in the functioning of neuronal circuits that we never had access to before.”
There’s a Q&A at the link.
Tests on a protein taken from the venom of the sharp-nosed viper have shown it can reduce the size of colorectal tumours in mice by up to 28 per cent within a month.
The six-month study involving 18 cancerous mice was carried out by researchers at Hong Kong Baptist University.
In a separate study involving chicken embryos, researchers also discovered the protein, called ZK002, could reduce the growth of capillaries which feed nutrients to cancer tumours helping them grow.
Project coordinator Wendy Hsiao Wen-luan said suppressing these capillaries would have the effect of starving the tumour.
The preliminary findings have won the research team a further 3.9 million Hong Kong dollars (500,000 US dollars) in funding from the government’s innovation and technology fund and Lee’s Pharmaceuticals Holdings Ltd.