John Derbyshire at The Corner:

Healthcare:   The entire problem with healthcare is that it’s a risk-reward curve. How far do you want to (or: can afford to) let people go along the curve? About 95 percent of the healthcare that people need can perfectly well be supplied by nursing assistants with a couple of years’ training, or Third World providers like the ones I discussed.

When you climb up into the remaining five percent, you are in the zone where real doctors and expensive equipment are needed. Keep going and you enter the zone of million-dollar drugs, teams of specialists, experimental technology, and months of intensive care. A billionaire can of course travel all the way along the curve. Should the rest of us be able to? Our system is organized around the answer “yes.” This is probably untenable. Sooner or later you’re going to die. Get used to it.

Nutrition recommendations have lifted the cloud over eggs and the thinking now is that an egg a day is OK.

For much of the past 40 years the public has been warned away from eggs because of the risk of heart disease. Unhealthy serum cholesterol levels have, after all, been linked to increased risk of cardiovascular disease, and eggs are relatively high in dietary cholesterol.

The food police were wrong? Science isn’t perfect? Oy!

Some research has even questioned the connection between egg consumption and cardiovascular disease. A study published in the Journal of the American College of Nutrition showed that risk of cardiovascular disease in men and women did not increase with increasing egg consumption. In fact, it showed quite the opposite. From their findings of analyzing more than 27,000 subjects, they indicated that the egg consumers actually had lower serum cholesterol levels than those subjects who abstained from eggs.

The Harvard School of Public Health’s research showed the dietary cholesterol in eggs does not have a negative effect on blood cholesterol levels of healthy people. This and numerous other studies have shown there is no link between eating eggs and a higher risk of heart disease or stroke for healthy adults. Some recent studies have even shown that HDL (good) cholesterol increased when people ate an egg-supplemented diet.

* This is the operative statement. The others are inoperative.
— Ron Ziegler, press secretary to President Richard Nixon

Ryan Secrest told the American Idol audience last night that the country was suffering one of the worst flu outbreaks “in history.”

Dunno dawg, that sounds kinda pitchy, know what I’m sayin’? Let’s keep it real.

So far, 15 children have been hospitalized in Los Angeles County with the flu. And California has reported one death, of an Orange County child.

In 1918, a Spanish flu pandemic killed more people that WWI, some 50-100 million people (estimates have been raised in recent years.) In October of that year, 195,000 Americans fell victim.

One upside: crime rates in Chicago dropped by 43% as crooks were too sick to “work.”

If publicly-funded and operated healthcare is so much more efficient than the private sector, then why this?

Los Angeles County healthcare officials unveiled a draft cost-cutting plan Wednesday that calls for closing all but one of the county’s dozen clinics and reduces services at its six comprehensive outpatient health centers.

Officials said a $195-million deficit makes the cuts necessary even under a “best-case scenario” for the badly strapped public healthcare system. The county faces the threat of more reductions in state and federal aid in the next few months. Health department officials have privately floated the possibility of deeper cuts if the projected deficit grows.

The current proposal, if approved by the Board of Supervisors, would dramatically retreat from the county’s longtime role in providing primary care to the indigent. The clinics and comprehensive centers get about 400,000 primary care visits a year, nearly two-thirds from uninsured patients.

Officials said they plan for private, nonprofit clinics to step into the gap and provide care to most of the displaced patients for a lower cost than the public system. The county currently has contracts with private clinics, and those would be expanded.

Up to $400 million has been spent on new computers and software for classrooms, but the Los Angeles Unified School District has not tracked where all of the new technology has gone, officials said Monday.

Since 2004, the district has purchased 129,000 personal computers. But because of haphazard tracking, some classrooms still do not have enough computers for students, while others have computers but not enough software. Meanwhile, some school computers still are operating with outdated systems.

But officials have begun pushing for all district schools to have up-to-date instructional computer facilities, a plan to ensure that obsolete technology is quickly replaced, and tracking on how many personal computers are in which classrooms.

“Once we figure out what’s out there, then we can know how to fill the gaps,” said school board member Tamar Galatzan, who will introduce the resolution today. “We have software in one place and computers in another.”

I know…let’s turn over healthcare to the government because government monopolies are so efficient.

Oh, that’s harsh! But wait, there’s another $400 million LAUSD boondoggle — the high school built atop a toxic site.

And that’s not all — the very same LAUSD cannot pay its employees properly.

In the weeks leading up to the launch of a new payroll system, Los Angeles Unified School District officials had plenty of warning that the $95-million technology project would have serious problems.

Critical hardware had failed numerous times. Flawed data collected over decades proved difficult to clean up and input into the new system. Payroll clerks complained that training had fallen far short — more than 60 schools didn’t have a single staff member who’d received any training.

Still, consultants hired to implement the system urged the district to proceed as scheduled in early January 2007. Three days before the system was to begin, they urged the district in a report to “Go! Proceed . . . and go-live on January 1!”

Go live they did, plunging the district into a crisis from which it is only now emerging. Over the course of last year, taxpayers overpaid an estimated $53 million to some 36,000 teachers and others, while thousands more went underpaid or not paid at all for months.

$95 million plus $36 million to fix it. In the real world, where losing money means losing your job or your company, heads would roll.

Jay at Wizbang Politics: 

Universal health care coverage is one of the Democrats’ big agenda items. They’ve been pushing for it for a very, very long time; Hillary Clinton did NOT invent the concept back in 1993. But now their longe efforts may be coming to fruition. They’ve managed to pull it off in one state — Massachusetts.

By any criteria, Massachusetts ought to be the perfect political laboratory for the Democrats. A fairly small state with a fairly stable population (they are so far behind the population trend, they are expected to lose at least one and possibly two Congressional seats after the next census), and Democrats holding a near-monopoly on political power. They have both US Senate seats, all ten US House seats, the governorship and every other state-wide elective office, and over 85% of each House of the state legislature. The only place where their influence might appear checked is in the Judiciary, where most judges were appointed by the Republican governors who held office from 1991 to 2007, but even there they had a “say” — all those Republican appointees had to be approved by the always-overwhelmingly-Democratic legislature.

So, Massachusetts concocted a plan to guarantee all its residents health insurance.

No, that’s not quite fair. The residents were not “guaranteed” access to health insurance, they were REQUIRED to get it — under penalty of fines that will, in a couple of years, vastly outstrip the cost of the cheapest coverage. Everyone who did not get insurance from their employer or the government as a form of welfare would have to buy it on their own, with some state subsidies if they qualified. The legislature whipped up this magic plan, Governor Mitt Romney read the writing on the wall (it WAS going to be passed, and he could either get behind it and try to get rid of some of the worst aspects or get steamrollered) and threw his support for it, and it passed.

And they all lived happily ever after. The end.

Whoops. I forgot this wasn’t a fairy tale. (And in the state that gave the nation Gerry Studds, Barney Frank, and gay marriage, one isn’t allowed to use the term “fairy tale,” lest ye be charged with “hate speech.”) This is the real world.

So, Massachusetts is well on its way towards bringing health insurance to everyone. How’s that working out?

Well, newspaper people are finding a fringe benefit no one expected. They have a new standing headline they can use — “Costs of universal health care plan higher than predicted.”

Of course, with the digital age, changing a headline nowadays is only a matter of a few keystrokes. No one has to mes around with lead blocks engraved with letters any more. Thus they can be considerably more specific in their headlines.

Here’s how the Commonwealth messed up, and how they plan to fix it:

State projections obtained by the Globe show the program reaching 342,000 people and $1.35 billion in annual expenses by June 2011. Those figures would far outstrip the original plans for the Commonwealth Care program, largely because state officials underestimated the number of uninsured residents.The state has asked the federal government to shoulder roughly half of the program’s cost from 2009 through 2011, but there is no guarantee of that funding. Commonwealth Care provides free or subsidized insurance for low- and moderate-income residents.

The solution most favored by Massachusetts thus far is to seek more federal money. They originally asked the federal government to pick up half the projected tab for the state-subsidized “entry level” health plan, and the federal government agreed. But the state negotiated a flat fee, not a percentage of actual costs, so the federal government’s initial contribution of $300 million has dwindled as a percentage as the actual costs come in. So they want more federal money.

Americans as far away at Nome, Alaska already help pay for Boston’s Big Dig, so hide your wallets folks.

Don Surber: 

Nicola Sturgeon, health secretary, announced that at long last, Scotland has solved its problem of long waiting lists for health services. No one is waiting more than 18 weeks for services, she said.

That’s five months.

Real speedy there.

The day after her announcement, Nicol Stephen, the leader of the opposition party, announced that he discovered how this was done: People were being kicked off the list. He cited a woman who had been promised liposuction, but later received notice that she was being turned down for services.

Apparently she received a letter from her doctor that said:

“I am afraid I am writing to inform you of some bad news.

“I have been instructed by hospital management to remove your name from my waiting list. The prime reason for this decision relates to the 18-week target for patient treatment which is now in enforcement.

“I currently have a significant number of patients in breach of this and the simple solution by management is to reduce my waiting lists by removing patients’ names.”

Liberals keep telling Americans how having government take over health care will “save” money. I am a conservative. I would rather have a health system that saves lives.

The story is here.

Let’s hope he won’t be baaack with this idea again.

Arnold Schwarzenegger’s “universal” health-care plan died in the California legislature on Monday, in what can only be called a mercy killing. So let’s conduct a political autopsy, because there are important lessons here for the national health-care debate.

It’s especially useful to compare today’s muted obituaries to the page-one melodrama that surrounded the Governor when he announced his plan a year ago. Endless media mash notes were bestowed on the “post-partisan” Republican trying to get something done.

The idea was that Mr. Schwarzenegger would set a national precedent, leading to a groundswell for reform in Washington. Not to mention that the Schwarzenegger plan was a near-copy of the one Mitt Romney pioneered in Massachusetts, and the one Hillary Clinton now favors. A leading author of the California plan was Laurie Rubiner, who directed health policy at the New America Foundation before becoming Senator Clinton’s legislative director in 2005.

But a dose of reality killed it.

An independent analysis confirmed the plan would be far more expensive than proponents admitted. Even under the most favorable assumptions, spending would outpace revenue by $354 million after two years, and likely $3.9 billion or more. “A situation that I thought was bad,” Mr. Perata noted, “in fact was worse.”

This reveals that liberal health-care politics is increasingly the art of the impossible: You can’t make coverage “universal” while at the same time keeping costs in check — at least without prohibitive tax increases. Lowering cost and increasing access, in other words, are separate and irreconcilable issues.

Of course Washington might be able to disregard these practicalities, because the states are prohibited from running deficits while the feds aren’t. But the California experience also reveals some of the ideological differences among Democrats, which would also divide in the Beltway.

The centerpiece of the Schwarzenegger plan was the “individual mandate,” which is also the heart of HillaryCare 2.0. Such a law would compel everyone to acquire insurance, with subsidies for those who couldn’t afford it. But the individual mandate incited a liberal revolt. Many Democrats and some unions argued the subsidies weren’t generous enough to cover lower-income families, and it wasn’t fair to penalize them for coverage they couldn’t afford. One state Senator called the plan “a knife in the throat of the working poor.” So the plan failed because it was too expensive — and because for some Democrats it wasn’t expensive enough.

Opposition also arose because the plan didn’t do enough to punish the left’s health-care villains. While it greatly expanded regulation of insurers — requiring them to accept all applicants, and prohibiting premium differences based on health status — it didn’t cap how much they could charge consumers, or regulate their profits. Democrats also complained that the taxes the plan imposed on business, as high as 6.5% of payroll, weren’t high enough.

When Bush got drug benefits added to Medicare, he was criticized by Democrats for not allowing the government to negotiate drug prices with pharmaceutical companies. Given that liberals regard profits as exploitation, they assumed Bush was in the pocket of drug companies.

But there was a very sensible reason for not giving the Feds a strong arm against pharmaceutical companies — in time, there would be fewer new drugs coming to market.

Megan McArdle explains:

People who think that there will be continuing R&D in the pharmaceutical industry are basically thinking of it as a budgeting problem. They think of the pharmaceutical industry’s gross income as a budget to be allocated between various functions, such as marketing and R&D. They may concede that by changing the size of the budget, you may shrink the amount of money to fund R&D, because there will be less money in the kitty. (Though many or most hope that shrinking the size of the pie will force pharmaceutical companies to transfer money from the advertising budget to R&D¹). But, their reasoning goes, there will still be money in the kitty; if you allow pharmaceutical companies 1/3 as much gross income, you will get 1/3 as much R&D. Or perhaps they will cut their advertising budgets to zero, and then you will get 2/3 as much R&D. But still, you will get something.

I don’t think of R&D as a budgeting problem; I think of it as an investment problem. After all, even if the pharmaceutical industry has no profits right now, they can borrow the money in the financial markets at fairly attractive rates.

The main obstacle to R&D, then, is not the current state of pharmaceutical industry profits; it is the potential return on the investment in R&D. After all, Merck doesn’t have to make drugs; it could generate a nice, safe return of 5% a year in government bonds. Or it could get into some other business, such as making soap. If you drive down the profits on new drugs too far, it stops making sense to invest in new drugs, even if there is a small profit to be made on current production.

Developing new drugs is very, very risky. Depending on what you think constitutes a drug candidate, somewhere between one in one thousand, and one in ten thousand drug candidates makes it from a lab bench to clinical trials. Each of the failed drugs was very expensive, particularly if it got partway through clinicals, which run about $500 million per course.

The problem is, once you’ve developed a drug, it’s easy to copy. It’s also usually trivially cheap to produce. And your patent is rapidly running out. This gives a monopsony buyer a lot of leverage to force down your price–you’re almost always better off taking something. This is particularly true if the monopsony buyer has the power to break your patent and license its generic manufacturers to turn out cheap but near-perfect imitations of your product². This is, in fact, what Europe has done; they make pharmaceutical firms sell to them at cost plus. The lion’s share of the profits on any drug come from the United States; what they get in Europe and Canada and the rest of the world is (thin) gravy, a price that is just a little bit better than not selling any drugs there.

Now imagine that America drives drug prices down to that sort of “cost+10″ or “cost+20″ level. The pharmaceutical firms will keep making the drugs they already have, because there will still be a little profit there. But they would have to be psychotic to invest billions of dollars over a 20 year time horizon in exchange for a one in a thousand chance of making that small a profit. Would you put 20% of your income now into an investment that might yield a profit of 10% of your income–in thirty years?

But they have to invest in R&D, say my interlocutors; otherwise they won’t have any drugs to sell! This makes the odd assumption that they can’t do anything else. But history is full of companies that used to do something else entirely–and also, of companies that went out of business when their market collapsed.

European nations bully the drug companies to sell at their price, thus America indirectly subsidizes their wonderful “single payer” healthcare plans — something to remember when liberals whine about how expensive our healthcare is.

Scientific American:

Schizophrenia is famous for its symptoms of hallucinations and delusions, but sufferers also face debilitating cognitive impairment—and standard treatments with antipsychotic medications do little to compensate for intellectual loss. Seeking improved mental clarity, many patients turn to a seemingly mundane source: cigarettes. The extraordinarily high incidence of smoking in individuals with schizophrenia—about 85 percent of patients smoke compared with some 20 percent of the general population—has spurred researchers to investigate the therapeutic effects of nicotine in the diseased brain.

Every schizophrenia patient suffers some degree of deficit in memory, attention and thought organization, but no medication currently exists to treat these cognitive impairments. According to patients who smoke, cigarettes alleviate some of these symptoms, but research has found that the effect is short-lived and detrimental to overall health. The receptors to which nicotine binds in the brain quickly become desensitized, rendering smoking ultimately ineffective. And while the positive effects are disappearing, addiction is under way.

ScienceDaily (Jan. 18, 2008) — Findings from what is believed to be the largest comparison of blood samples collected from healthy individuals and people with schizophrenia suggest that infection with the common Toxoplasma gondii parasite, carried by cats and farm animals, may increase the risk of schizophrenia.

[Boston] Mayor Thomas M. Menino embarked on a highly public campaign yesterday to block CVS Corp. and other retailers from opening medical clinics inside their stores, an effort that exposed a rift between Menino and the state’s public health commissioner, a longtime ally.

Menino blasted state regulators for paving the way Wednesday for the in-store clinics, which are designed to provide treatment for sore throats, poison ivy, and other minor illnesses.

The decision by the state Public Health Council, “jeopardizes patient safety,” Menino said in a written statement. “Limited service medical clinics run by merchants in for-profit corporations will seriously compromise quality of care and hygiene. Allowing retailers to make money off of sick people is wrong.”

Sit with that thought a moment.

Do surgeons beg for bread crumbs on street corners? Does medicine grow on trees? Do liberals know any shame?

CVS, which operates the Minute Clinics, said they:

…would be happy to talk to Mayor Menino about any of his concerns.”

“We at MinuteClinic are committed to providing convenient, affordable access to quality health care.”

The nerve!

(For those too young to remember Banned in Boston, read here.)

Live Science: 

Part of the magic of modern tissue research is just how deftly an experienced biologist can look at an image of cells in a dish and know immediately which cells are healthy or not, differentiated or not. These qualitative—and in both labs, uncannily accurate—assessments not only confound the former physicist/entry-level culturist, but also place a concrete limit on the number of cells that can be evaluated in a day, and require valuable human resources –resources which periodically become susceptible to inaccuracies after long days, nearing lunch hours, or the hustle-and-bustle of a busy lab environment.

Merging statistical pattern recognition and computer vision to cell imaging, I am addressing the problem of cell sorting with novel quantitative methods. By processing hundreds of cell images, and extracting salient parameters of cell size, morphology, and structure, I seek to rigorously and objectively determine a stem cell’s status. Experimental purity dictates that I devise my algorithm “blinded”, i.e. on cell images generated by my mentors without my involvement, which is probably for the better: their cells were markedly more photogenic than mine (the only trustworthy qualitative statement this amateur can make!).

When I am finished, a computer will be able to acquire, save, filter, and scan cell images, and process them for an online categorization cell-by-cell (freeing the biologists to spend their workday innovating). The idea is to either automate the cell sorting process, increasing the through-put of cell passage, or to complement the biologist’s subjective assessments. These principles underlie a number of fields of biomedical study, including automated diagnostics, pharmoaco-theraputics, and even forensics.

Scientific American Mind:

Mind-altering psychedelics are back—but this time they are being explored in labs for their therapeutic applications rather than being used illegally. Studies are looking at these hallucinogens to treat a number of otherwise intractable psychiatric disorders, including chronic depression, post-traumatic stress disorder, and drug or alcohol dependency.

The past 15 years have seen a quiet resurgence of psychedelic drug research as scientists have come to recognize the long-underappreciated potential of these drugs. In the past few years, a growing number of studies using human volunteers have begun to explore the possible therapeutic benefits of drugs such as LSD, psilocybin, DMT, MDMA, ibogaine and ketamine.

Much remains unclear about the precise neural mechanisms governing how these drugs produce their mind-bending results, but they often produce somewhat similar psychoactive effects that make them potential therapeutic tools. Though still in their preliminary stages, studies in humans suggest that the day when people can schedule a psychedelic session with their therapist to overcome a serious psychiatric problem may not be that far off.

What do we want? Everything!

When do we want it? Now!

Who should pay for it? Somebody else!

That, folks, is today’s liberalism in a nutshell. Take the case of Nataline Sarkisyan, a 17-year old girl who died after not receiving a liver transplant. John Edwards, who knows all about making the personal both political and profitable (he made his millions suing doctors and hospitals.)

“Just a few weeks ago in America, Nataline Sarkisyan, a 17-year-old girl, … needed a liver transplant, and (her) insurance company decided they wouldn’t pay for her liver transplant operation,” Democratic presidential candidate John Edwards said last week after placing second in the Iowa Caucus.

American people spoke up on her behalf by marching and picketing in front of her health insurance carrier. And, finally, the insurance carrier caved in and agreed to pay for her operation. And when they notified the family just a few hours later, she died. She lost her life. Why? Why?”

Perhaps it was the liver. But Edwards and those beating up on Cigna fail to note that Nataline was a very sick girl who had recurrent leukemia and was in a coma.

Three things we know: 1) there are insufficent organs to meet demand, thus candidates for transplants are screened for viability 2) transplants are expensive procedures and money is finite 3) no one likes to be told “no.” 

The very people saying American healthcare is “broken” and too expensive for many Americans to afford, insist that insurance companies throw away money on heartbreaking cases. Often to ill effect.

In the 1990s, for example, patients pushed for insurance companies to cover a certain type of procedure called autologous bone marrow transplants for women with late-stage breast cancer.

But years later, research found it was only helpful in a small percentage of women, Ghose said.

Let’s face it: insurance companies must be heartless. If they bent the rules for every sad case –and aren’t they all? — no one could afford coverage. That liberals believe a medical bureaucracy will be less heartless is frightening.

Seldom discussed is that national healthcare programs make the bad life-choices of others your business. Why should your taxes pay the costs of some tubby’s gluttony or some stinky smoker’s vice? (Smokers die early and probably save the system $$, but never mind.)

You shouldn’t. Which means you have a right, at least theoretically, to tell others how to live, including what to eat and how much of it. But I don’t want to live that way. Let people make their own choices and live with their consequences. Freedom includes the right to fail and the right to act stupid.

If that seems farfetched, consider Jolly Ole England:

Patients could be required to stop smoking, take exercise or lose weight before they can be treated on the National Health Service, Gordon Brown has suggested.

In a New Year message to NHS staff, the Prime Minister indicates people may have to fulfil new “responsibilities” in order to establish their entitlement to care.

The new conditions could be set out in a formal NHS “constitution”, Mr Brown says.

In his open letter to doctors, nurses and other health workers, the Prime Minister promises to press on with Tony Blair’s reforms of the NHS, pledging more personalised care for all patients.

He adds: “We will also examine how all these changes can be enshrined in a new constitution of the NHS, setting out for the first time the rights and responsibilities associated with an entitlement to NHS care.”

The National Institute for Health and Clinical Excellence already considers so-called self-induced illnesses in setting the criteria that determine which patients should qualify for new or expensive health treatments.

And this year Leicester City Primary Care Trust was given Government approval to ask smokers to quit before they are given places on waiting lists for operations such as hip replacements and heart surgery.

 

 

by J.C. Phillips 

Recent events illustrate how hope and death hang over our discussions of health care like shadows whose influence is ever present though seldom seen. Two competing specters: one so intensely focused on the present moment that it occasionally reeks of desperation; the other smugly confident that no matter how many battles it may lose in the short term eventually it will win the war. 

On December 20, at the UCLA medical center, 17 year old Natalie Sarkisyan lost her life after a valiant battle with cancer. She had been in critical condition for two weeks, lying in a vegetative state before finally succumbing to her illness. Her leukemia reappeared this summer. After receiving a bone marrow and kidney transplant from her brother, she developed complications that caused her liver to fail. Her doctors recommended a liver transplant but the Sarkisyan’s insurance company, CIGNA Healthcare, denied coverage. CIGNA determined that the procedure was too experimental and there was not sufficient evidence that it would work in Natalie’s case. Following a week of protests by supporters of the family, CIGNA reversed its decision, alas, too late to benefit Natalie.

Mark Geragos, attorney for the family, is seeking to have the insurance company charged with murder, a dubious threat not likely to do much more than garner a few headlines and stoke the embers of grief smoldering in the Sarkisyan household. CIGNA, of course, was not responsible for Natalie’s death; blood cancer killed her. CIGNA merely refused to pay for a procedure the family hoped would give their dying daughter a few more months of life. Having lost family members to illness, I know all too well that the pain seems unbearable, the grief overwhelming. As a parent, I also know that, like the Sarkisyans, were one of my children dying, I would reach with both hands for whatever hope I could find – no matter how small — and hold on tight. 

My heart and prayers go out to the family.

The reality, however, is that hope costs, and while hope may spring eternal, resources do not. The fact is that whether it is a private insurance company or the federal (or state) government, there is not enough money to pursue each and every medical procedure for everybody that wants one, no matter how low the chances of success — to pursue hope to the inevitable end. It is telling that in spite of Natalie’s doctors’ opinions and the pressure of media coverage, UCLA Medical Center did not simply go ahead and perform the procedure and worry about payment later. It would appear that cost benefit analysis is not reserved for insurance companies.

It is certainly reasonable to ask the insurance company exactly what circumstances determine whether or not they approve payment and if the decisions the insurance company makes are based on objective criteria or are they, in fact, squishy guidelines subject to the influence or pressure of individual citizens. In other words, after a few days of public pressure, CIGNA reassessed their position and approved the payment for Natalie’s liver transplant. If these decisions are based on objective criteria, how does the protest of a few dozen concerned citizens change that objective equation? And what of the next family? Does their inability to bring public relations to bear on the insurance company mean that their child will receive no consideration? 

When it comes to our health, we not only want care, we also demand hope. Sadly, politicians and other proponents of universal health care are all too willing to invoke Natalie’s name followed by promises to provide both hope and care in abundance. The problem, they claim, is greedy insurance companies choosing profit over life. Only they possess the compassion and righteousness to hold the bogey man at bay. In truth they will control finite resources through rationing of care and, like insurance companies, will look at the numbers. Today, it is an insurance adjuster at CIGNA. Tomorrow, it will be a mid-level government bureaucrat weighing the relative prospects of a particular procedure’s success versus the cost and the potentially better application of those same resources towards other patients that are also in need. The specter of death bides his time knowing that at some point someone will and must say, “enough” – must for all intents and purposes make the decision as to who will live and who will die. 

Ideally, these decisions are best left to doctors, their patients and their families. To pretend that adding a disinterested third party into the mix empowers families is an offer of hope, but it is hope of a specious kind.

Buffalo Bills tight end Kevin Everett was hurt, and thought paralyzed for life, in a game early in the season. Not so, and Sports Illustrated tells the story.

Every step is precious now. Every movement is a gift. Every morning brings another sunrise, full of sweet promise. When Kevin Everett was a little boy growing up in Port Arthur, Texas, he would sit with his grandpa James Nico, and the older man would explain to him life’s lessons. One of them was this: Don’t ever be bitter. Just keep doing your best, even when things aren’t looking so good.

Even when you are lying, helpless and twitching, on the floor of a football stadium, unable to move your limbs and unable to take a deep breath. Even when you drift to the surface from a deep, chemically induced sleep two days later and find yourself in a hospital bed, with tubes in your throat and in your groin and machines beeping in every corner of the room and your mother gently rubbing your forearm, asking you through her tears, Baby, can you feel this? Please blink your eyes once if you can feel this.

You know I love you, don’t you, baby? Please blink once if you know. And you slowly blink once, though you don’t remember it.

Even when you’re at a rehabilitation hospital almost a month later and an occupational therapist puts a tiny, one-pound weight in your right hand and asks you to do one biceps curl with the same arm that once blocked NFL linebackers on Sunday afternoons. And you just can’t do it. Even when your life is unfathomably changed at the age of 25. Even then.

Here is Kevin Everett now, sitting at a breakfast table in a corner of the house the Buffalo Bills’ tight end bought last year for his family in the Houston suburb of Humble. His fiancée, Wiande Moore, a sprinter whom Kevin met when both were athletes at the University of Miami, sits to his left, and the two of them pick at the remnants of supper. His mother, Patricia Dugas, is in the kitchen putting the finishing touches on a Christmas gingerbread house with Kevin’s youngest sister, Davia, 11. His other two sisters — Herchell, 15, and Kelli, 14 — are sitting nearby on family room couches in front of a wall-mounted TV tuned to MTV but muted because Herchell is tapping out a social studies paper on her laptop. It is a family place at a family time.

Forty years ago today, South African surgeon Christiaan Barnard performed the first human-to-human heart transpant. To say that it was a very big deal is an understatement. Although the patient only lived 12 days after the operation, it began a new era in medicine.

Until then, if your heart degenerated past a certain point, well, that’s life. People accepted their fate because they had no choice.

But not now. Knowing that a heart transplant is possible has come to mean that such a procedure is every human’s due. Thus health care costs rise.

In 2002, the state of California spent $1 million to give a prison inmate a new heart.

A California prison inmate serving 14 years for robbery received a heart transplant earlier this month, renewing a debate about who deserves to get desperately needed organs.

The taxpayer-supported transplant, expected to cost $1 million with follow-up care, occurred as 500 Californians waited for hearts. The operation saved the 31-year-old inmate from dying of a viral heart condition, said Russ Heimerich, spokesman for the California Department of Corrections.

Citing two court rulings in favor of inmate care, Heimerich said, “Our hands are pretty much tied. It’s not a question for this department to decide.”

He pointed to a 1976 U.S. Supreme Court ruling declaring it “cruel and unusual punishment” to withhold necessary medical care from inmates.

Scientists from Queen Mary, University of London, have discovered a new way to separate the therapeutic benefits of cannabis from its mood-altering side-effects.

Cannabis contains a chemical called THC, which binds to, and activates, proteins in the brain known as ‘CB1 cannabinoid receptors’. Activating these receptors can relieve pain and prevent epileptic seizures; but it also causes the mood-altering effect experienced by people who use cannabis as a recreational drug.

Now, Professor Maurice Elphick and Dr Michaela Egertová from Queen Mary’s School of Biological and Chemical Sciences may have found a way of separating out the effects of cannabis – a discovery which could lead to the development of new medicines to treat conditions such as epilepsy, obesity and chronic pain. The research is described in the December issue of the journal Molecular Pharmacology.

Using a novel imaging technique to study autistic children, researchers have found increased gray matter in the brain areas that govern social processing and learning by observation.

“Our findings suggest that the inability of autistic children to relate to people and life situations in an ordinary way may be the result of an abnormally functioning mirror neuron system,” said lead author Manzar Ashtari, Ph.D., from the Children’s Hospital of Philadelphia in Pennsylvania.

MIT scientists have devised remotely controlled nanoparticles that, when pulsed with an electromagnetic field, release drugs to attack tumors. The innovation could lead to the improved diagnosis and targeted treatment of cancer.

In earlier work the team, led by Sangeeta Bhatia, M.D.,Ph.D., an associate professor in the Harvard-MIT Division of Health Sciences & Technology (HST) and in MIT’s Department of Electrical Engineering and Computer Science, developed injectable multi-functional nanoparticles designed to flow through the bloodstream, home to tumors and clump together. Clumped particles help clinicians visualize tumors through magnetic resonance imaging (MRI).

With the ability to see the clumped particles, Bhatia’s co-author in the current work, Geoff von Maltzahn, asked the next question: “Can we talk back to them?”

The answer is yes, the team found. The system that makes it possible consists of tiny particles (billionths of a meter in size) that are superparamagnetic, a property that causes them to give off heat when they are exposed to a magnetic field. Tethered to these particles are active molecules, such as therapeutic drugs.

Today’s LA Daily News:

City worker costs up 7.5% a year, but revenue up just 5.7%

Salaries, pensions and benefits for Los Angeles city workers have soared in the past seven years, outstripping revenue growth and pushing the city toward a serious budget crisis, according to a Daily News study.Since 2000, Los Angeles workers’ costs have surged 53 percent - to $4 billion a year - rising an average 7.5 percent every year.

General fund revenues also grew strongly but only at an average 5.7 percent a year.

The result is a swing of almost $1 billion, pushing the city from a surplus to an anticipated shortfall of $300 million next year.

“It’s almost like we’re working for them; they aren’t there to serve us. The situation has gotten badly out of whack,” said Jack Kyser, chief economist for the nonprofit Los Angeles County Economic Development Corp.

Why the large gap between employee costs and revenue growth? It’s the power of city employee unions to get politicians elected to office, said Alice Rivlin, a former director of the Congressional Budget Office and now a senior fellow at Brookings Institution, a highly respected think tank based in Washington, D.C.

The education unions have gotten their stooges elected to the school board, and the LAUSD is such a model of accomplisment and efficiency, right?

Let’s go all the way and turn over healthcare to these people.

 Maggie’s Farm pointed us toward this:

Cranberry sauce is not the star of the traditional Thanksgiving Day meal, but when it comes to health benefits, the lowly condiment takes center stage.

In fact, researchers at Worcester Polytechnic Institute (WPI) have found that compounds in cranberries are able to alter E. coli bacteria, which are responsible for a host of human illnesses (from kidney infections to gastroenteritis to tooth decay), in ways that render them unable to initiate an infection…

• The chemical changes caused by cranberry juice create an energy barrier that keeps the bacteria from getting close to the urinary tract lining.
• Direct measurements show that the adhesive forces between E. coli and cells of the urinary tract are greatly reduced when at least a 5 percent solution of cranberry juice cocktail is present.
• Cranberry juice causes tiny tendrils (known as fimbriae) on the surface of the type of E. coli bacteria responsible for the most serious types of UTIs to become compressed, reducing the bacteria’s ability to latch onto the lining of the urinary tract.
• E. coli grown in cranberry juice or the isolated PACs are unable to form biofilms. Biofilms, clusters containing high concentrations of bacteria, are required for infections to develop. Biofilms are the source of infections associated with indwelling catheters and other biomedical devices.
• When E. coli are cultured over extended periods in solutions containing various concentrations of either cranberry juice or PACs, their cell membranes undergo changes that hinder the bacteria’s ability to attach to cells of the urinary tract.

Linda Halderman, M.D., FACS

Senator Hillary Clinton recently released her plan to reform U.S. healthcare and ensure universal coverage. Spectators to her unsuccessful 1990s efforts to achieve the same goal may be reminded of the line from Poltergeist II:

“They’re ba-aack.”

Senator Clinton insists that her plan is anything but recycled.

“This is not government-run,” she asserts. “Don’t let them fool us again.”

This statement is baffling, considering a concept at the heart of her proposal.

The Senator’s New Idea

Hillary Clinton aims to impose a government mandate on every man, woman and child in the United States to buy or be given government-subsidized health insurance. Except for the very rich, plans would be paid for from taxes and employer mandates in addition to individual payments based on ability to pay what Senator Clinton describes as a “reasonable” amount.

Despite Senator Clinton’s claim of originality, individual and employer government mandates are nothing new.

Before supporting any plan based on this principle — that forcing people to buy health insurance increases access to care — the track record of mandates should be considered.

In order for an individual government mandate to compel the purchase of health insurance, another government requirement for something called “Guaranteed Issue” must first be enacted.

Guaranteed Issue forces every insurance company to sell health insurance to every applicant regardless of health history, lifestyle or risk factors. This is in fact another part of Senator Clinton’s proposal that she reports is critical to achieve universal coverage.

In theory, this appears sound. If health insurance companies can’t “just say no” to high-risk applicants, no one will be left without access to coverage.

Unfortunately, the law of unintended consequences trumps this logic.

Mandates Guarantee Higher Premiums

In New Jersey and Massachusetts, unlike in California, laws were passed to force every insurance carrier to sell plans to every individual applicant. Individual insurance premiums in New Jersey and Massachusetts are three times higher than those in California.

Washington State tried Guaranteed Issue. With no way to mitigate risk, insurance carriers in the state suffered severe financial losses related to high-risk patients. They then exited the individual market; no individual health insurance plans were accessible to Washington residents at any price.

Senator Clinton was not a New Yorker in 1993. But that was the year New York State forced Guaranteed Issue on the health insurance market. 500,000 New Yorkers then cancelled their health insurance plans; rates for a third of all those insured had skyrocketed by 20-59%.

Alternatives to Guaranteed Issue exist and have proven effective. When a risk pool is created, the expense associated with covering high-risk patients is spread across an entire industry instead of forcing unsustainable losses on a few that cover a disproportionately large number of such individuals.

Daily Mail:

Record numbers of Britons are travelling abroad for medical treatment to escape the NHS - with 70,000 patients expected to fly out this year.

And by the end of the decade 200,000 “health tourists” will fly as far as Malaysa and South Africa for major surgery to avoid long waiting lists and the rising threat of superbugs, according to a new report.

How humbling for once-imperial Britain to see its residents fly off to the Third World to find clean hospitals and avoid superbugs.

The first survey of Britons opting for treatment overseas shows that fears of hospital infections and frustration of often waiting months for operations are fuelling the increasing trend.

Patients needing major heart surgery, hip operations and cataracts are using the internet to book operations to be carried out thousands of miles away.

India is the most popular destination for surgery, followed by Hungary, Turkey, Germany, Malaysia, Poland and Spain. But dozens more countries are attracting health tourists.

A microscopic robot small enough to travel through blood vessels has been built by scientists.

Less than a millimetre in size, the robot walks like a crab on six legs and has been designed to clear blocked arteries.

It was produced by researchers at Chonnam National University in Korea, who found the robot was able to travel 55 yards in a week.

In his drive to kick-start the French economy by creating a culture of hard work, Nicolas Sarkozy believes those who chose to retire early - under 65 - should not benefit from free health care.

During his election campaign earlier this year Mr Sarkozy said: “If you think 53 makes you old enough to retire, then fine, go ahead and retire. But don’t expect the state to pay for it.”

As a result, thousands of Britons living across France were sent “brutal” letters last week from the department of social security informing them that they would no longer be welcomed as non-paying customers of France’s hugely efficient - and traditionally extremely generous - national health service.

The letter stated that, under a change of rules which is due to take effect on Sept 30, any foreign resident who had retired early would lose their right to free state health care.

All expatriates who have taken advantage of the rise in British property prices to take early retirement in France, where houses are much cheaper, will have to surrender their documents entitling them to state health care.

They will face potentially crippling private health care bills.

Although those over the normal retirement age are unaffected, as many as 100,000 Britons who have lived in France for more than two years will be affected.

It is after two years that those who have lived in France must become resident and lose the right to NHS care.

Fox News:

Mothers in British Columbia are having a baby boom, but it’s the United States that has to deliver, and that has some proud Canadians blasting their highly touted government healthcare system.

“I’m a born-bred Canadian, as well as my daughter and son, and I’m ashamed,” Jill Irvine told FOX News. Irvine’s daughter, Carri Ash, is one of at least 40 mothers or their babies who’ve been airlifted from British Columbia to the U.S. this year because Canadian hospitals didn’t have room for the preemies in their neonatal units.

“It’s a big number and bigger than the previous capacity of the system to deal with it,” said Adrian Dix, a British Columbia legislator, told FOXNews.com. “So when that happens, you can’t have a waiting list for a mother having the baby. She just has the baby.”

The mothers have been flown to hospitals in Seattle, Everett, Wash., and Spokane, Wash., to receive treatment, as well as hospitals in the neighboring province of Alberta, Dix said. Three mothers were airlifted in the first weekend of October alone, including Carri Ash.

“I just want to go home and see my kids,” she said from her Seattle hospital bed. “I think it’s stupid I have to be here.”

Canada’s socialized health care system, hailed as a model by Michael Moore in his documentary, “Sicko,” is hurting, government officials admit, citing not enough money for more equipment and staff to handle high risk births.

Sarah Plank, a spokeswoman for the British Columbia Ministry of Health, said a spike in high risk and premature births coupled with the lack of trained nurses prompted the surge in mothers heading across the border for better care.

“The number of transfers in previous years has been quite low,” Plank told FOXNews.com. “Before this recent spike we went for more than a year with no transfers to the U.S., so this is something that is happening in other provinces as well.”

Critics say these border crossings highlight the dangers of a government-run health care system.

“The Canadian healthcare system has used the United States as a safety net for years,” said Michael Turner of the Cato Institute. “In fact, overall about one out of every seven Canadian physicians sends someone to the United States every year for treatment.”

Darn hosers.

Apparently, the family used by the Democrats as their proxy for the SCHIP program is not as well off as some bloggers assumed. For example the $19,500 private school tuition is being paid by a scholarship.

So the family appears to be more middle-class than some center-right bloggers charged.

So when Democrats enlisted 12-year-old Graeme Frost, who along with a younger sister relied on the program for treatment of severe brain injuries suffered in a car crash, to give the response to Bush’s weekly radio address earlier this month, Republican opponents quickly accused them of exploiting the boy to score political points.

Then, they wasted little time in going after him to score their own.

In recent days, Graeme and his family have been attacked by conservative bloggers and other critics of the Democrats’ plan to expand the insurance program, known as SCHIP.

No one attacked the kid or his family. They attacked the policy, which the Democrats used the family to represent. Arguing about policy is called democracy. Saying otherwise is to “hide beneath the skirt” of the family.

If they cannot grasp democracy 101, perhaps it’s time Democrats stop calling themselves Democrats.