Category: Health

Insurers Are Paid More When They Negotiate HIGHER Prices for Patients

(p. A1) This year, the federal government ordered hospitals to begin publishing a prized secret: a complete list of the prices they negotiate with private insurers.

The insurers’ trade association had called the rule unconstitutional and said it would “undermine competitive negotiations.” Four hospital associations jointly sued the government to block it, and appealed when they lost.

They lost again, and seven months later, many hospitals are simply ignoring the requirement and posting nothing.

But data from the hospitals that have complied hints at why the powerful industries wanted this information to remain hidden.

It shows hospitals are charging patients wildly different amounts for the same basic services: procedures as simple as an X-ray or a pregnancy test.

And it provides numerous examples of major health insurers — some of the world’s largest companies, with billions in annual profits — negotiating surprisingly unfavorable rates for their customers. In many cases, insured patients are getting prices that are higher than they would if they pretended to have no coverage at all.

. . .

(p. A14) Customers judge insurance plans based on whether their preferred doctors and hospitals are covered, making it hard for an insurer to walk away from a bad deal. The insurer also may not have a strong motivation to, given that the more that is spent on care, the more an insurance company can earn.

Federal regulations limit insurers’ profits to a percentage of the amount they spend on care. And in some plans involving large employers, insurers are not even using their own money. The employers pay the medical bills, and give insurers a cut of the costs in exchange for administering the plan.

. . .

People carefully weighing two plans — choosing a higher monthly cost or a larger deductible — have no idea that they may also be picking a much worse price when they later need care.

Even for simple procedures, the difference can be thousands of dollars, enough to erase any potential savings.

It’s not as if employers can share that information at open enrollment: They generally don’t know either.

“It’s not just individual patients who are in the dark,” said Martin Gaynor, a Carnegie Mellon economist who studies health pricing. “Employers are in the dark. Governments are in the dark. It’s just astonishing how deeply ignorant we are about these prices.”

. . .

Health economists think of insurers as essentially buying in bulk, using their large membership to get better deals. Some were startled to see numerous instances in which insurers pay more than the cash rate.

. . .

“The worrying thing is that the third party you’re paying to negotiate on your behalf isn’t doing as well as you would on your own,” said Zack Cooper, an economist at Yale who studies health care pricing.

. . .

(p. A15) Hospitals and insurers can also hide behind the contracts they’ve signed, which often prohibit them from revealing their rates.

“We had gag orders in all our contracts,” said Richard Stephenson, who worked for the Blue Cross Blue Shield Association from 2006 until 2017 and now runs a medical price transparency start-up, Redu Health. (The association says those clauses have become less common.)

Mr. Stephenson oversaw a team that made sure the gag orders were being followed. He said he thought insurers were “scared to death” that if the data came out, angry hospitals or doctors might leave their networks.

. . .

The new price data is often published in hard-to-use formats designed for data scientists and professional researchers. Many are larger than the full text of the Encyclopaedia Britannica.

And most hospitals haven’t posted all of it. The potential penalty from the federal government is minimal, with a maximum of $109,500 per year. Big hospitals make tens of thousands of times as much as that; N.Y.U. Langone, a system of five inpatient hospitals that have not complied, reported $5 billion in revenue in 2019, according to its tax forms.

For the full story, see:

Sarah Kliff, Josh Katz and Rumsey Taylor. “Hospital Data Reveals Secrets Behind Billing.” The New York Times (Monday, August 23, 2021): A1 & A14-A15.

(Note: the online version of the story has the date Aug. 22, 2021, and has the title “Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why.”)

“Our Cities Protect Insiders and Leave Outsiders to Suffer”

(p. A15) Mr. Glaeser’s “Survival of the City: Living and Thriving in an Age of Isolation,” written with Harvard health economist David Cutler, shares the pleasing style of its predecessor, an engaging mixture of history and analysis. It has none of the triumphalism of its predecessor, however. In the move to social distancing that began in the spring of 2020, Messrs. Glaeser and Cutler see nothing less than “the rapid-fire deurbanization of our world.”

“Uncontrolled pandemic,” the authors write, poses “an existential threat” to the urban world. Nor is the coronavirus the only problem that cities face. “A Pandora’s Box of urban woes has emerged,” they continue, “including overly expensive housing, violent conflict over gentrification, persistently low levels of upward mobility, and outrage over brutal and racially targeted policing and long prison sentences for minor drug crimes.” These are not disparate problems. Rather, they “all stem from a common root: our cities protect insiders and leave outsiders to suffer.”

In Messrs. Glaeser and Cutler’s view, something has gone deeply wrong with how policy is set in many American cities. Insiders have captured control of how cities operate—and used that control to enrich themselves while providing limited opportunities for newer, younger residents. Consider Los Angeles. In 1970, housing costs in Southern California were much the same as those nationwide. By 1990, building limitations and strong demand had sent prices soaring in many coastal cities. The result: a massive redistribution of wealth from the young to the old.

For the full review, see:

John Buntin. “BOOKSHELF; Saving Our Urban Future.” The Wall Street Journal (Friday, Sept. 10, 2021): A15.

(Note: the online version of the review has the date September 9, 2021, and has the title “BOOKSHELF; ‘Survival of the City’ Review: Saving Our Urban Future.”)

The book under review is:

Glaeser, Edward L., and David Cutler. Survival of the City: Living and Thriving in an Age of Isolation. New York: Penguin Press, 2021.

Public Transit Subsidies Reduce Incentives to Innovate

(p. A4) The bipartisan infrastructure bill approved by the Senate this month is the latest effort to inject federal money into public transit agencies. But all that money likely won’t buy what transit really needs: more riders.

Unless ridership recovers from its pandemic-induced drop, agencies will again confront large budget deficits once the federal money runs out in three or four years, analysts say. That could mean service cuts and fare increases, according to transit agencies.

“As soon as the money stops flowing, transit agencies are going to be in the same position as they were before,” said Baruch Feigenbaum, a transportation policy expert at the libertarian-leaning Reason Foundation.

New York’s Metropolitan Transportation Authority, for instance, expects to use up its $14.5 billion allocation of federal aid by 2024, at which point it will face a $3.5 billion two-year shortfall.

. . .

Some experts say agencies’ financial struggles during the pandemic should prompt Congress to help fund agencies’ day-to-day costs.

. . .

Other analysts, however, say agencies need to find ways to adapt instead of living off federal subsidies.

“The problem with free money is it does not encourage innovation, and that’s really what transit agencies need to be encouraged to do right now,” said the Reason Foundation’s Mr. Feigenbaum. “It’s just postponing the reckoning.”

For the full story, see:

David Harrison. “Public Transit Is Flush With Cash, But Not Riders.” The Wall Street Journal (Monday, Aug. 23, 2021): A4.

(Note: ellipses added.)

(Note: the online version of the story has the date August 22, 2021, and has the title “Transit Got Billions in Relief From Congress but Still Faces Deficits.”)

Precise Decisions Can Be Fairer (But Can You Be Precisely Wrong?)

There’s a famous quote, usually wrongly attributed to Keynes that ‘it’s better to be vaguely right than precisely wrong.’ In a new book “noise” refers to inconsistent decisions, that need not be biased in any consistent way. But consistency is not the only value that matters. Academics are sometimes evaluated on the basis of the number of articles they publish. If this is done conscientiously, then the evaluation is consistent, and in that sense “fair.” But maybe there are other criteria that are harder to measure, but that matter more, like the profundity and insight of what is published. Evaluating on the basis of well-measured criteria, that matter less, rather than poorly-measured criteria, that matter more, may increase unfairness in a deeper sense.

(p. 10) A study at an oncology center found that the diagnostic accuracy of melanomas was only 64 percent, meaning that doctors misdiagnosed melanomas in one of every three lesions.

When two psychiatrists conducted independent reviews of 426 patients in state hospitals, they came to the equivalent of a tossup: agreement 50 percent of the time on what kind of mental illness was present.

. . .

Doctors are more likely to order cancer screenings for patients they see early in the morning than late in the afternoon.

. . .

In a study of the effectiveness of putting calorie counts on menu items, consumers were more likely to make lower-calorie choices if the labels were placed to the left of the food item rather than the right.

“When calories are on the left, consumers receive that information first and evidently think ‘a lot of calories!’ or ‘not so many calories!’ before they see the item,” Daniel Kahneman, Olivier Sibony and Cass R. Sunstein explain in this tour de force of scholarship and clear writing. “By contrast, when people see the food item first, they apparently think ‘delicious!’ or ‘not so great!’ before they see the calorie label. Here again, their initial reaction greatly affects their choices.” This hypothesis is supported, the authors write in a typically clever aside, by the “finding that for Hebrew speakers, who read right to left, the calorie label has a significantly larger impact if it is on the right rather than the left.”

These inconsistencies are all about noise, which Kahneman, Sibony and Sunstein define as “unwanted variability in judgments.”

. . .

As the authors explain in their introduction, a team of target shooters whose shots always fall to the right of the bull’s-eye is exhibiting a bias, as is a judge who always sentences Black people more harshly. That’s bad, but at least they are consistent, which means the biases can be identified and corrected. But another team whose shots are scattered in different directions away from the target is shooting noisily, and that’s harder to correct. A third team whose shots all go to the left of the bull’s-eye but are scattered high and low is both biased and noisy.

Despite its prominence in so many realms of human judgment, the authors note that “noise is rarely recognized,” let alone counteracted. Which is why the parade of noise examples that the authors provide are so compelling, and why gathering the examples in one place to demonstrate the cost of noise and then suggesting noise reduction techniques, or “decision hygiene,” makes this book so important. We are living in a moment of rampant polarization and distrust in the fundamental institutions that underpin civil society. Eradicating the noise that leads to random, unfair decisions will help us regain trust in one another.

“Noise” seems certain to make a mark by calling attention to the problem and providing a tangible guide to reducing it. Despite the authors’ intimidating academic credentials, they take pains to explain, even with welcome redundancy, their various categories of noise, the experiments and formulas that they introduce, as well as their conclusions and solutions.

For the full review, see:

Steven Brill. “No Chance.” The New York Times Book Review (Sunday, May 30, 2021): 10.

(Note: ellipses added.)

(Note: the online version of the review has the date May 18, 2021, and has the title “For a Fairer World, It’s Necessary First to Cut Through the ‘Noise’.”)

The book under review is:

Kahneman, Daniel, Olivier Sibony, and Cass R. Sunstein. Noise: A Flaw in Human Judgment. New York: Little, Brown Spark, 2021.

20 Startups Are Developing Senolytics to Slow Cell Senescence

(p. A17) Some species of tortoises, . . ., have a risk of death that doesn’t seem to change with age in adulthood. Though these wrinkly, lumbering beasts might not seem like ideal ambassadors for aging well, by the statistical definition of aging—how fast your risk of death increases with time—these tortoises hardly age at all.

. . .

A secret of the tortoises’ longevity is that their cells can divide more than twice as many times as human cells before becoming aged or “senescent.”

. . .

Already, therapies to combat cell senescence—senolytics—are undergoing human trials. Senescent cells build up in our bodies as we get older and seem to accelerate the aging process as they accumulate. Drugs and genetic modifications that periodically remove them have been shown to make mice biologically younger: They live longer and healthier than untreated mice, with stronger muscles and hearts; delayed cancer, cataracts and cognitive decline; and even plumper skin and thicker, glossier fur.

There are currently at least 20 startups trying to transfer senolytics from the lab to the clinic. These efforts target specific diseases in which senescent cells are known to be key villains. A company called Unity Biotechnology is targeting these cells to combat age-related sight loss, while a team including scientists at the Mayo Clinic who first demonstrated senolytics in mice is working to use the same drug cocktail to treat age-related lung fibrosis.

The average 80-year-old is suffering from five different diagnoses and taking a similar number of medications to treat them.

Senolytics are the vanguard but close behind are dozens of different ways to slow or reverse aging in the lab, ranging from drugs and diets to gene and stem cell therapies. These treatments intervene in the molecular, cellular and biological underpinnings of the aging process, from the smallest scale in our biology (damage to DNA and protein molecules) to the largest (dysfunction across the immune system). They are aimed at slowing down multiple aspects of the process and at wide-ranging rejuvenation.

There have been some high-profile failures in the field. One was resveratrol, found in grapes and other sources. A company working on resveratrol, Sirtris, was acquired by drug giant GSK for $720 million in 2008 but closed down five years later. The path from lab bench to pill is filled with obstacles, and we can expect further setbacks, but with so many different therapies and a deeper understanding of the biology of aging, at least some of the new ideas are likely to succeed.

For the full commentary, see:

Andrew Steele. “The Best Remedy for Our Diseases? Aging Less.” The Wall Street Journal (Saturday, April 10, 2021): A17.

(Note: ellipses added.)

(Note: the online version of the commentary was updated April 10, 2021, and has the same title as the print version.)

Steele’s commentary, quoted above, is related to his book:

Steele, Andrew. Ageless: The New Science of Getting Older without Getting Old. New York: Doubleday, 2021.

RSV and Other Common Viruses Now Surge as Unintended Consequence of Covid-19 Masks, Distancing, and Lockdowns

(p. A6) Doctors in France are calling it the immunity debt: When people avoided each other during the pandemic, they failed to build up the immunity against viruses that comes from normal contact.

As regular life resumes, society may find payments on that debt coming due, in the form of worse-than-normal viral disease outbreaks.

. . .

Figures recently released in Japan show the profound effect exposure to viruses such as flu and RSV can have on a nation’s health.

Deaths caused by pneumonia—a common complication of viral infections—last year in Japan fell by more than 17,000, far outweighing the 3,466 deaths attributed to Covid-19. As a result, Japan’s overall mortality fell for the first time in more than a decade.

It may have been borrowing from the future by creating greater room for viruses to run rampant later. Robert Cohen, a professor at a pediatric research center near Paris called Activ, calls this “immunity debt.”

Dr. Cohen said the hygiene measures adopted during the pandemic bring “an immediate and indisputable benefit” because common illnesses have been suppressed. But at some point almost all children are going to get RS virus, chickenpox and viruses that cause colds, which could mean larger outbreaks when the bugs make up for lost time, he said.

For the full story see:

Miho Inada. “Common Viruses Make a Comeback.” The Wall Street Journal (Tuesday, June 29, 2021): A6.

(Note: ellipsis added.)

(Note: the online version of the story has the date June 28, 2021, and has the title “Post-Covid-19, World Risks an ‘Immunity Debt’.”)

Center-Left Biothreat Expert Says Many Scientists Rejected Wuhan Lab Origin, Not Due to Evidence, but Due to Trump

(p. A13) A few months before Covid-19 became a pandemic, Filippa Lentzos started reading about unusual flu cases in Wuhan, China. Ms. Lentzos, a social scientist who studies biological threats, belongs to an email group she describes as consisting of “ex-intelligence, bioweapons specialists, experts, former State Department diplomats” and others “who have worked in arms control, biological disarmament.”

As Chinese authorities struggled to contain the outbreak, she recalls, the expert circle asked questions about the pathogen’s origin: “Is this security related? Is it military? Is there something dodgy going on? What information are we not getting here?”

. . .

. . . in February 2020, a group of scientists had published a statement in the Lancet calling out “conspiracy theories suggesting that COVID-19 does not have a natural origin.” The New York Times and Washington Post dutifully attacked Mr. Cotton as unhinged. Media, with an assist from some virologists, dismissed the lab-leak theory as “debunked.”

Ms. Lentzos, who places her own politics on the Swiss “center left,” thought that conclusion premature and said so publicly. In May 2020, she published an article in the Bulletin of the Atomic Scientists weighing whether “safety lapses in the course of basic scientific research” caused the pandemic. While acknowledging there was, “as of yet, little concrete evidence,” she noted “several indications that collectively suggest this is a serious possibility that needs following up by the international community.”

. . .

The article barely made a ripple. “If you look at the argumentation that’s used today, it’s exactly the same basically as what I laid out, which was, accidents happen,” she says. “We know that they’re having questions around safety. We know they were doing this field work. We see videos where they’re in breach of standard biosafety protocol. We know China is manipulating the narrative, closing down information sources—all of that stuff. All of that is in there. But it didn’t get much traction.”

. . .

American liberals—including many scientists—conflated open-mindedness about the question with support for Mr. Trump. Ms. Lentzos was one of the few who could separate their distaste for him from their analysis of the pandemic.

. . .

The most significant problem came from the scientific community. “Some of the scientists in this area very quickly closed ranks,” she says, and partisanship wasn’t their only motive: “Like most things in life, there are power plays. There are agendas that are part of the scientific community. Just like any other community, there are strong vested interests. There were people that did not talk about this, because they feared for their careers. They feared for their grants.”

Ms. Lentzos counsels against idealizing scientists and in favor of “seeing science and scientific activity, and how the community works, not as this inner sacred sanctum that’s devoid of any conflicts of interests, or agendas, or any of that stuff, but seeing it as also a social activity, where there are good players and bad players.”

Take Peter Daszak, the zoologist who organized the Lancet letter condemning lab-leak “conspiracy theories.” He had directed millions of dollars to the Wuhan Institute of Virology through his nonprofit, EcoHealth Alliance. A lab mistake that killed millions would be bad for his reputation. Other researchers have taken part in gain-of-function research, which can make viruses deadlier or easier to transmit. Who would permit, much less fund, such research if it proved so catastrophic? Yet researchers like Marion Koopmans, who oversees an institution that has conducted gain-of-function research, had an outsize voice in media. Both she and Mr. Daszak served on the World Health Organization’s origin investigation team.

. . .

Ms. Lentzos has experience working with United Nations agencies, including the World Health Organization. “It was incredibly exciting to finally go in. And then you become more disillusioned when you see how things operate, how things don’t operate,” she says. “Like any large organization, they are slow, and inflexible, and bureaucratic.”

For the full interview see:

Adam O’Neal, interviewer. “THE WEEKEND INTERVIEW; A Scientist Who Said No to Covid Groupthink.” The Wall Street Journal (Saturday, June 12, 2021): A13.

(Note: ellipses added.)

(Note: the online version of the interview has the date June 11, 2021, and has the same title as the print version.)

Dog Sniffs Identify Covid-19 Faster, Cheaper, and More Accurately than Antigen Tests

(p. A6) A growing body of research by scientists and dog trainers from the U.S. to the United Arab Emirates suggests that dogs can use their powerful sense of smell to sniff out Covid-19 infections, including in people without symptoms.

With more than 300 million scent receptors (compared with roughly five million in humans), dogs can do this with a high degree of accuracy by detecting compounds the human body releases in secretions like sweat and saliva as it reacts to the coronavirus, according to scientists.

Dogs have long been trained to detect odors associated with drugs or explosives and have also been used to identify diseases such as cancer, malaria and diabetes.

. . .

One dog can screen 250 to 300 people a day, according to the WHO.

Prof. Grandjean calculated that dog screenings in France could cost as little as one euro, equivalent to about $1.20, per person, as opposed to roughly €75 for a polymerase chain reaction, or PCR, test, a highly accurate test that involves a nasal swab.

. . .

Studies have shown that dogs can be trained to identify Covid-19 infections with roughly 82% to 99% sensitivity and 84% to 98% specificity, Prof. Grandjean said. A test’s sensitivity indicates its ability to correctly detect an infection, while its specificity shows how well it can avoid giving false positives.

Researchers at the University of Veterinary Medicine in Hannover, Germany, trained eight dogs for one week to detect respiratory secretions from infected patients with an average detection rate of 94%, according to a study published recently in the journal BMC Infectious Diseases

In a study of 21 dogs led by Prof. Grandjean, 15 of the animals were able to detect Covid-19 with a sensitivity of 90% or more, with six dogs showing a sensitivity of 71% to 87%. The study was published in April in the Open Access Journal of Veterinary Science and Research.

Such results mean dogs may be more precise than many rapid antigen tests, which correctly identify Covid-19 infections in an average of 72% of people showing symptoms and 58% of asymptomatic people, according to a recent review from Cochrane, a U.K.-based nonprofit that evaluates scientific research.

For the full story see:

Ruth Bender and Rachel Bachman. “Dogs Deployed to Sniff Out Covid.” The Wall Street Journal (Thursday, May 20, 2021): A6.

(Note: ellipses added.)

(Note: the online version of the story has the date May 19, 2021, and has the title “Your Next Covid-19 Test Could Be a Dog’s Sniff.”)

The articles mentioned in the passages above are:

Jendrny, Paula, Claudia Schulz, Friederike Twele, Sebastian Meller, Maren von Köckritz-Blickwede, Albertus Dominicus Marcellinus Erasmus Osterhaus, Janek Ebbers, Veronika Pilchová, Isabell Pink, Tobias Welte, Michael Peter Manns, Anahita Fathi, Christiane Ernst, Marylyn Martina Addo, Esther Schalke, and Holger Andreas Volk. “Scent Dog Identification of Samples from Covid-19 Patients – a Pilot Study.” BMC Infectious Diseases 20, no. 1 (2020). DOI:10.1186/s12879-020-05281-3

Grandjean, Dominique, Dana Humaid Al Marzooqi, Clothilde Lecoq-Julien, Quentin Muzzin, Hamad Katir Al Hammadi, Guillaume Alvergnat, Kalthoom Mohammad Al Blooshi, Salah Khalifa Al Mazrouei, Mohammed Saeed Alhmoudi, Faisal Musleh Al Ahbabi, Yasser Saifallah Mohammed, Nasser Mohammed Alfalasi, Noor Majed Almheiri, Sumaya Mohamed Al Blooshi, and Loïc Desquilbet. “Use of Canine Olfactory Detection for Covid-19 Testing Study on U.A.E. Trained Detection Dog Sensitivity ” Open Access Journal of Veterinary Science & Research (OAJVSR) 6, no. 2 (May 2021). DOI: 10.23880/oajvsr-16000210.

Dinnes, J., J. J. Deeks, S. Berhane, M. Taylor, A. Adriano, C. Davenport, S. Dittrich, D. Emperador, Y. Takwoingi, J. Cunningham, and et al. “Rapid, Point‐of‐Care Antigen and Molecular‐Based Tests for Diagnosis of Sars‐Cov‐2 Infection.” Cochrane Database of Systematic Reviews, no. 3 (2021). DOI: 10.1002/14651858.CD013705.pub2

Slow FDA Feeds Skepticism of mRNA Covid-19 Vaccines

(p. A19) In December 2020, the F.D.A. approved the distribution of mRNA coronavirus vaccines made by Pfizer and Moderna under the agency’s emergency use authorization provision, which permits an accelerated approval process for medications and treatments during a public health emergency.

. . .

In theory, full approval should be imminent, since Pfizer applied for full approval in early May, and Moderna asked for full approval on June 1. This process is often long, requiring the agency to inspect manufacturing plants and review considerable amounts of documentation for vaccine production. But in this case, because of the urgency of the pandemic, the vaccine makers began to submit this material, called a biologics licensing application, in late 2020, and they’ve continued to submit more information. The F.D.A. has already reviewed some of the submissions and has provided feedback to the manufacturers. The emergency authorizations were granted more than six months ago. That’s more than ample time for the agency to conduct plant inspections and review the applications.

. . .

Fortunately, two doses of the mRNA vaccines appear to provide nearly full protection from Covid-related hospitalization and death, and the shots substantially reduce infections.

The lives and health of millions of Americans rest on the F.D.A.’s decision to fully license these vaccines.

For the full commentary see:

Eric J. Topol. “Vaccines Need Full Approval.” The New York Times (Monday, July 5, 2021): A19.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 1, 2021, and has the title “It’s Time for the F.D.A. to Fully Approve the mRNA Vaccines.”)

Evolution Did Not Design an Optimal Human Body

(p. A15) In Alex Bezzerides’s entertaining “Evolution Gone Wrong: The Curious Reasons Why Our Bodies Work (or Don’t),” the author’s quest is to determine the origins of the “aches and pains of the masses and why they happen”—not the mechanical causes of our maladies but the evolutionary ones.

. . .

. . ., according to Mr. Bezzerides, . . . four million years ago our ancestors transitioned from a fruit- and leaves-based diet to one of grasses and sedges. Their molars ballooned out to gargantuan proportions, which was not at first problematic, since their substantive jaws readily accommodated the newly enlarged teeth. But as humans controlled fire, learned to cook, became cooperative, and developed hunting techniques and an accompanying armamentarium of cutting implements, the requirement for robust dentition diminished. We were nevertheless stuck with the legacy of “a mouth full of large teeth.”

. . .

One requires no better evidence of our design’s lack of metaphysical oversight than the absurd configuration of our esophagus and trachea—so near each other as to invite trouble. A benign creator would surely have designed a respiratory system in a way that did not leave us in perpetual fear of choking. But once again this apparently bizarre arrangement results both from our evolutionary origins—the lungs began as an offshoot of the digestive system—and from the requirement for a descended larynx. This “clunky anatomical fault” may give us a fright every time a “hot dog takes a wrong turn at the intersection,” as Mr. Bezzerides writes, but it also facilitated the origin of human speech.

. . .

. . . , he has provided us with a timely reminder that we, as a species, may be outgrowing our evolutionary history and the biology we are constructed from. The emerging technology of genome writing may offer an opportunity to take human design back to first principles.

For the full review, see:

Adrian Woolfson. “BOOKSHELF; Our Fallible Bodies.” The Wall Street Journal (Tuesday, June 1, 2021): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date May 31, 2021, and has the title “BOOKSHELF; ‘Evolution Gone Wrong’ Review: Our Fallible Bodies.”)

The book under review is:

Bezzerides, Alex. Evolution Gone Wrong: The Curious Reasons Why Our Bodies Work (or Don’t). Toronto, Canada: Hanover Square Press, 2021.

Men Are More Likely to Risk Their Lives for Others

(p. A15) “T” does what all superb popular science must do: It entertains as it educates.

. . .

Ultimately, “T” is a vigorous defense of the scientific method itself. Ms. Hooven summarizes: “Multiple independent sources of evidence can combine to strongly support a hypothesis, whether it’s about the cause of a rattle in your car, why your soufflé has collapsed, or why someone blocked you on Twitter. It’s just like that in science.”

. . .

. . . she’s emphatic that high T levels do not lead inexorably to rape and murder; mountains of data disprove this fallacy. She also gives testosterone its due: Men are far more likely “to put their lives on the line for others, and are massively overrepresented in the most dangerous occupations.” She lauds the men who protected her while she conducted fieldwork in the jungles; heroism, for her, thrives at the molecular level.

For the full review, see:

Hamilton Cain. “The Hormone of the Hour.” The Wall Street Journal (Tuesday, July 13, 2021): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date July 12, 2021, and has the title “‘T’ Review: Hormone of the Hour.”)

The book under review is:

Hooven, Carole. T: The Story of Testosterone, the Hormone That Dominates and Divides Us. New York: Henry Holt and Co., 2021.