Health – Page 41 – artdiamondblog.com

Cuban Health Care Checkup

(p. A17) . . . it’s a good time to check in on the state of the Cuban health-care system. That’s just what Laurie Garrett, a senior fellow at the Council on Foreign Relations, does in the current issue of Foreign Affairs magazine.
. . .
Slightly more than half of all Cuban physicians work overseas; taxed by the Cuban state at a 66% rate, many of them wind up defecting. Doctors who remain in the country earn about $25 a month. As a result, Ms. Garrett writes, they often take “jobs as taxi drivers or in hotels,” where they can make better money. As for the quality of the doctors, she notes that very few of those who manage to reach the U.S. can gain accreditation here, partly because of the language barrier, partly because of the “stark differences” in medical training. Typically, they wind up working as nurses.
As for the quality of medical treatment in Cuba, Ms. Garrett reports that hospital patients must arrive with their own syringes, towels and bed sheets. Women avoid gynecological exams “because they fear infection from unhygienic equipment and practices.” Rates of cervical cancer have doubled in the past 25 years as the use of Pap tests has fallen by 30%.
And while Cuba’s admirers love to advertise the country’s low infant mortality rate (at least according to the Castro regime’s dubious self-reporting) the flip-side has been a high rate of maternal mortality. “Most deaths,” Ms. Garrett writes, “occur during delivery or within the next 48 hours and are caused by uterine hemorrhage or postpartum sepsis.”

For the full commentary, see:
BRET STEPHENS. “Dr. Berwick and That Fabulous Cuban Health Care; The death march of progressive medicine.” The Wall Street Journal (Sat., JULY 13, 2010): A17.
(Note: ellipses added.)

Reference to the Garrett article:
Garrett, Laurie A. “Castrocare in Crisis; Will Lifting the Embargo Make Things Worse?” Foreign Affairs 89, no. 4 (July/August 2010): 61-73.

Feds’ Sugar Quotas Lead to More Demand for Obesity-Causing Corn Syrup

Source of graph: online version of the Omaha World-Herald article quoted and cited below.

The federal government puts quotas on the amount of sugar that can be imported from abroad, with the result that U.S. consumers pay higher prices for sugar. One result, as taught in economics micro principles courses, is that demand increases for sugar substitutes, such as corn syrup.
Evidence is accumulating (see below) that corn syrup is worse for our health than sugar.
Michelle Obama is leading a drive to reduce obesity. If she is serious, she can begin by asking her husband to ask his congress to remove import quotas on sugar.

(p. 2A) Well-publicized research also has suggested that high fructose corn syrup poses an even greater threat of obesity and other health problems than regular table sugar.
. . .
Researchers at Princeton University made headlines earlier this year when they released the results of a study that found rats drinking a high fructose corn syrup beverage for six months showed abnormal weight gain and other factors indicating obesity. The study concluded that overconsumption of the sweetener “could very well be a major factor in the ‘obesity epidemic,’ which correlates with the upsurge in the use of HFCS.”
A related study found that rats drinking the high fructose corn syrup solution gained more weight than rats drinking a basic sucrose solution.
“The conclusion from that is that high fructose corn syrup and sucrose are not the same after all,” said Bart Hoebel, the professor who worked on the study.

For the full story, see:

Ross Boettcher and Joseph Morton. “Is Corn Syrup Slump Healthy? ConAgra, Farmers Divided.” Omaha World-Herald (Wednesday, July 26, 2010): 1A-2A.
(Note: ellipsis added.)
(Note: the online version of the article is dated July 26, 2010 and has the title “Consumers sour on sugars.)

Reid on Ben Nelson’s Cornhusker Kickback: “He Got This for Himself; He Wanted It”

(p. 5A) WASHINGTON — Senate Majority Leader Harry Reid this week defended the now-defunct Nebraska Medicaid exemption that was tucked into the Senate health care bill as Reid sought the support of Sen. Ben Nelson, D-Neb.

Nelson has said that he never asked for the exemption and that his goal all along was to provide relief for all states.
Tagged with the derisive moniker “Cornhusker kickback,” the arrangement quickly proved politically toxic.
. . .
Asked why he didn’t offer the same deal to every state from the start, Reid said, “Because I didn’t have it for everybody at that time. I thought I could get it as we moved along in the legislation, and I did.”
Van Susteren said: “You’re telling me that when Ben Nelson got that, when the two of you sat down together, you said, ‘Ben, we’ll do it this way. … Nebraska’s got it now, but after we get this passed we’re going to go for everybody?’ ” “No, no, no. He got this for himself. He wanted it,” Reid said.

For the full story, see:
JOSEPH MORTON. “Reid thought Nelson should boast of ‘kickback’; The Senate leader says it was a “terrific” Medicaid deal that all states now share.” Omaha World-Herald (Weds., April 7, 2010): 5A.
(Note: first ellipsis added; second ellipsis in original.)

After Health Care Plan, Are There Any Limits to What the Government Can Mandate?

(p. A10) As they constructed the requirement that Americans have health insurance, Democrats in Congress took pains to make their bill as constitutionally impregnable as possible.

But despite the health care law’s elaborate scaffolding, attorneys general and governors from 20 states, all but one of them Republicans, have now joined as confident litigants in a bid to topple its central pillar. In the process, they hope to present the Supreme Court with a landmark opportunity to define the limits of federal authority, perhaps for generations.
In the seven weeks since the legislation passed, at least a dozen lawsuits have been filed in federal courts to challenge it, according to the Justice Department. But the case that could carry the most weight, and may be on the fastest track in the most advantageous venue, is the one filed in Pensacola, Fla., by state officials, just minutes after President Obama signed the bill.
Some legal scholars, including some who normally lean to the left, believe the states have identified the law’s weak spot and devised a credible theory for eviscerating it.
The power of their argument lies in questioning whether Congress can regulate inactivity — in this case by levying a tax penalty on those who do not obtain health insurance. If so, they ask, what would theoretically prevent the government from mandating all manner of acts in the national interest, say regular exercise or buying an American car?
. . .
Jonathan Turley, who teaches at George Washington University Law School, said that if forced to bet, he would predict that the courts would uphold the health care law. But Mr. Turley said that the federal government’s case was far from open-and-shut, and that he found the arguments against the mandate compelling.
“There are few cases in the history of the court system that have a more significant assertion of authority by the government,” said Mr. Turley, a civil libertarian who acknowledged being strange bedfellows with the conservative theorists behind the lawsuit. “This case, more than any other, may give the court sticker shock in terms of its impact on federalism.”

For the full story, see:

KEVIN SACK. “Florida Suit Rated Best As Challenge to Care Law.” The New York Times (Tues., May 11, 2010): A10 & A11.
(Note: the online version of the article is dated May 10, 2010 and has the slightly different title “Florida Suit Poses a Challenge to Health Care Law.”)
(Note: ellipses added.)

Senile Mice Benefit from Cellphone Radiation

“Mice seem to reap cognitive benefits from cellphone electromagnetism.” Source of caption and photo: online version of the WSJ article quoted and cited below.

(p. D4) Alzheimer’s and Cell Phones: Radiation associated with long-term cellphone use appears to protect against and reverse Alzheimer’s-like symptoms in mice, according to a study in the Journal of Alzheimer’s Disease. Mice genetically engineered to develop brain impairments similar to Alzheimer’s in humans were divided into two groups. One group was exposed twice daily to hour-long electromagnetic fields akin to those created during cellphone use. Mice in the other group were not exposed to the radiation. After seven months, young mice in the first group fared significantly better on cognitive tests than their unexposed littermates. Older mice, which had already developed symptoms of Alzheimer’s, exposed to the radiation for eight months in a subsequent experiment also performed better than older nonexposed mice. Mice, younger and older, not engineered to develop Alzheimer’s also appeared to benefit from the radiation. Biopsies suggested such exposure might fight Alzheimer’s by inhibiting the buildup of certain protein plaques in the brain, the researchers said.

For the full story, see:
JEREMY SINGER-VINE. “RESEARCH REPORT; NEW MEDICAL FINDINGS; Cellphone Radiation Aids Sick Mice.” The Wall Street Journal (Tues., JANUARY 12, 2010): D4.

World’s Poor Care More About Food and Illness than Global Warming

(p. A21) The saddest fact of climate change–and the chief reason we should be concerned about finding a proper response–is that the countries it will hit hardest are already among the poorest and most long-suffering.

In the run-up to this month’s global climate summit in Copenhagen, the Copenhagen Consensus Center dispatched researchers to the world’s most likely global-warming hot spots. Their assignment: to ask locals to tell us their views about the problems they face. Over the past seven weeks, I recounted in these pages what they told us concerned them the most. In nearly every case, it wasn’t global warming.
Everywhere we went we found people who spoke powerfully of the need to focus more attention on more immediate problems. In the Bauleni slum compound in Lusaka, Zambia, 27-year-old Samson Banda asked, “If I die from malaria tomorrow, why should I care about global warming?” In a camp for stateless Biharis in Bangladesh, 45-year-old Momota Begum said, “When my kids haven’t got enough to eat, I don’t think global warming will be an issue I will be thinking about.” On the southeast slopes of Mt. Kilimanjaro in Tanzania, 45-year-old widow and HIV/AIDS sufferer Mary Thomas said she had noticed changes in the mountain’s glaciers, but declared: “There is no need for ice on the mountain if there is no people around because of HIV/AIDS.”

For the full commentary, see:
BJORN LOMBORG. “OPINION; Time for a Smarter Approach to Global Warming; Investing in energy R&D might work. Mandated emissions cuts won’t..” The Wall Street Journal (Tues., DECEMBER 15, 2009): A21.

Heart Disease Is Not Just a Malady of Modern Societies, But “Is Part of the Human Condition”

“Scientists scanned 20 mummies, and examined scans of two more, for the study.” Source of caption and photo: online version of the WSJ article quoted and cited below.

(p. A5) ORLANDO, Fla. — Researchers said they found evidence of hardening of the arteries in Egyptian mummies dating as far back as 3,500 years, challenging longstanding assumptions that cardiovascular disease is mainly a malady of modern societies.

A team of heart-imaging experts and Egyptologists examined 22 mummies from the Egyptian National Museum of Antiquities in Cairo in a CT scanning machine, looking for evidence of calcium buildup that could indicate vascular disease.
They were able to identify the hearts, arteries or both in 16 of the mummies, nine of whom had deposits of calcification. An analysis determined the deposits were either definite or probable evidence of atherosclerosis, the condition that leads to heart attacks and strokes.
“Not only do we have atherosclerosis now, it was prevalent as long as 3,500 years ago,” said Gregory Thomas, a cardiologist and imaging specialist at University of California, Irvine, who was principal investigator of the study. “It is part of the human condition.”
The research was presented Tuesday at the American Heart Association scientific meeting here. A report is also scheduled to appear in Wednesday’s issue of the Journal of the American Medical Association.

For the full story, see:
RON WINSLOW. “Heart Disease Found in Egyptian Mummies.” The Wall Street Journal (Weds., NOVEMBER 18, 2009): A5.
(Note: the online version of the article has a date of NOVEMBER 19, 2009 and is titled “Heart Disease Found in Egyptian Mummies.”)

Malaria “Weakly Related to Temperature”; “Strongly Related to Poverty”

(p. A17) In the West, campaigners for carbon regulations point out that global warming will increase the number of malaria victims. This is often used as an argument for drastic, immediate carbon cuts.

Warmer, wetter weather will improve conditions for the malaria parasite. Most estimates suggest that global warming will put 3% more of the Earth’s population at risk of catching malaria by 2100. If we invest in the most efficient, global carbon cuts–designed to keep temperature rises under two degrees Celsius–we would spend a massive $40 trillion a year by 2100. In the best case scenario, we would reduce the at-risk population by only 3%.
In comparison, research commissioned by the Copenhagen Consensus Center shows that spending $3 billion annually on mosquito nets, environmentally safe indoor DDT sprays, and subsidies for effective new combination therapies could halve the number of those infected with malaria within one decade. For the money it takes to save one life with carbon cuts, smarter policies could save 78,000 lives. . . .
Malaria is only weakly related to temperature; it is strongly related to poverty. It has risen in sub-Saharan Africa over the past 20 years not because of global warming, but because of failing medical response.

For the full commentary, see:

BJORN LOMBORG. “Climate Change and Malaria in Africa; Limiting carbon emissions won’t do much to stop disease in Zambia.” The Wall Street Journal (Mon., NOVEMBER 2, 2009): A17.
(Note: ellipsis added.)
(Note: the online version of the article was dated Nov. 1st.)

Government to Decide Who Lives and Who Dies

“The Reaper Curve: Ezekiel Emanuel used the above chart in a Lancet article to illustrate the ages on which health spending should be focused.” Source of caption and graph: online version of the WSJ article quoted and cited below.

(p. A15) Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs. Many physicians find that view dangerous, and most Americans are likely to agree.

The health bills being pushed through Congress put important decisions in the hands of presidential appointees like Dr. Emanuel. They will decide what insurance plans cover, how much leeway your doctor will have, and what seniors get under Medicare. Dr. Emanuel, brother of White House Chief of Staff Rahm Emanuel, has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research. He clearly will play a role guiding the White House’s health initiative.
. . .
In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a “complete lives system” for the allocation of very scarce resources, such as kidneys, vaccines, dialysis machines, intensive care beds, and others. “One maximizing strategy involves saving the most individual lives, and it has motivated policies on allocation of influenza vaccines and responses to bioterrorism. . . . Other things being equal, we should always save five lives rather than one.
“However, other things are rarely equal–whether to save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each–is unclear.” In fact, Dr. Emanuel makes a clear choice: “When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated (see Dr. Emanuel’s chart nearby).
Dr. Emanuel concedes that his plan appears to discriminate against older people, but he explains: “Unlike allocation by sex or race, allocation by age is not invidious discrimination. . . . Treating 65 year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.”

For the full commentary, see:
BETSY MCCAUGHEY. “Obama’s Health Rationer-in-Chief; White House health-care adviser Ezekiel Emanuel blames the Hippocratic Oath for the ‘overuse’ of medical care.” The Wall Street Journal (Thurs., August 27, 2009): A15.
(Note: first ellipsis added; second and third ellipses in original.)

The article that was the original source for the graph above, is:
Persad, Govind, Alan Wertheimer, and Ezekiel J. Emanuel. “Principles for Allocation of Scarce Medical Interventions.” The Lancet 373, no. 9661 (Jan. 31, 2009): 423-31.

Videos of Routines Are Better than Focus Groups and Surveys

Source of book image: http://bobsutton.typepad.com/.a/6a00d83451b75569e20120a5fa1e26970c-800wi.

(p. W8) Mr. Brown argues . . . emphatically for the close observation of users in their natural habitats. Traditional market-research tools–focus groups, surveys–rarely produce breakthrough findings, he claims. IDEO and others follow users around–making video recordings of them as they go about their routines, recording conversations with them–to build an understanding of what they really need. An IDEO employee in the health-care area, for instance, pretended to have a foot injury and checked himself into an emergency room with a hidden video camera to get a better view of the patient experience. This anthropological form of market research, Mr. Brown notes, has been adopted by companies such as Intel and Nokia.

For the full review, see:
DAVID A. PRICE. “The Shape of Things to Come; Design is more than aesthetics and ease of use. It’s a way of doing business.” The Wall Street Journal (Fri., OCTOBER 9, 2009): W8.
(Note: ellipsis added.)

Reference the book being reviewed:
Brown, Tim. Change by Design: How Design Thinking Transforms Organizations and Inspires Innovation. New York: HarperBusiness Publishers, 2009.