Health – Page 83 – artdiamondblog.com

The War on Drugs Likely “Increased the Rate of Addiction”

Source of graph: online version of the WSJ commentary quoted and cited below.

(p. C1) President Richard Nixon declared a “war on drugs” in 1971. The expectation then was that drug trafficking in the United States could be greatly reduced in a short time through federal policing–and yet the war on drugs continues to this day. The cost has been large in terms of lives, money and the well-being of many Americans, especially the poor and less educated. By most accounts, the gains from the war have been modest at best.

The direct monetary cost to American taxpayers of the war on drugs includes spending on police, the court personnel used to try drug users and traffickers, and the guards and other resources spent on imprisoning and punishing those convicted of drug offenses. Total current spending is estimated at over $40 billion a year.
These costs don’t include many other harmful effects of the war on drugs that are difficult to quantify. For example, over the past 40 years the fraction of students who have dropped out of American high schools has remained large, at about 25%. Dropout rates are not high for middle-class white children, but they are very high for black and Hispanic children living in poor neighborhoods. Many factors explain the high dropout rates, especially bad schools and weak family support. But another important factor in inner-city neighborhoods is the temptation to drop out of school in order to profit from the drug trade.
The total number of persons incarcerated in state and federal prisons in the U.S. has grown from 330,000 in 1980 to about 1.6 million today. Much of the increase in this population is directly due to the war on drugs and the severe punishment for persons convicted of drug trafficking. About 50% of the inmates in federal prisons and 20% of those in state prisons have been convicted of either selling or using drugs. The many minor drug traffickers and drug users who spend time in jail find fewer opportunities for legal employment after they get out of prison, and they develop better skills at criminal activities.
. . .
(p. C2) It is generally harder to break an addiction to illegal goods, like drugs. Drug addicts may be leery of going to clinics or to nonprofit “drugs anonymous” groups for help. They fear they will be reported for consuming illegal substances. Since the consumption of illegal drugs must be hidden to avoid arrest and conviction, many drug consumers must alter their lives in order to avoid detection.
Usually overlooked in discussions of the effects of the war on drugs is that the illegality of drugs stunts the development of ways to help drug addicts, such as the drug equivalent of nicotine patches. Thus, though the war on drugs may well have induced lower drug use through higher prices, it has likely also increased the rate of addiction. The illegality of drugs makes it harder for addicts to get help in breaking their addictions. It leads them to associate more with other addicts and less with people who might help them quit.
. . .
The decriminalization of both drug use and the drug market won’t be attained easily, as there is powerful opposition to each of them. The disastrous effects of the American war on drugs are becoming more apparent, however, not only in the U.S. but beyond its borders. Former Mexican President Felipe Calderon has suggested “market solutions” as one alternative to the problem. Perhaps the combined efforts of leaders in different countries can succeed in making a big enough push toward finally ending this long, enormously destructive policy experiment.

For the full commentary, see:
GARY S. BECKER and KEVIN M. MURPHY. “Have We Lost the War on Drugs? After more than four decades of a failed experiment, the human cost has become too high. It is time to consider the decriminalization of drug use and the drug market.” The Wall Street Journal (Sat., January 5, 2013): C1 & C2.
(Note: the online version of the commentary has the date January 4, 2013.)

Lichen Fungi May Never Age

“ANNUAL VISITOR; For the last eight years, Anne Pringle of Harvard has been collecting data about the lichens on the gravestones at a cemetary in Petersham, Mass.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. D3) PETERSHAM, Mass. — On a sparkling New England afternoon, as hawks coasted overhead and yellow leaves drifted to the ground, Anne Pringle stood before a large granite obelisk that marked the graves of a family called French.
. . .
For eight years, Dr. Pringle, 42, has been returning to this cemetery each fall, to measure, sketch and scrutinize the lichens, which belong to the genus Xanthoparmelia. She wants to know whether they deteriorate with the passage of time, leaving them more susceptible to death.
. . .
Lichens are not individuals but tiny ecosystems, composed of one main fungus, a group of algae and an assortment of smaller fungi and bacteria.
. . .
While lichens are communities, Dr. Pringle is largely interested in the fungi. Mycologists, the scientists who study fungi — not the most glamorous corridor of biology — have long assumed that many of these organisms don’t age.
. . .
“What you know is based on the organisms you study,” she said. “What would you say about the evolution of senescence if instead of working with insects, you worked with modular organisms, which is what lichen are?”
Daniel Doak, a University of Colorado ecologist, agrees that the question is worth asking. Research like Dr. Pringle’s — along with other studies of species including the bristlecone pine tree and the wandering albatross, a bird, both of which may avoid senescence — suggests another possible path.
“It’s saying something fundamental,” Dr. Doak said, “that senescence is not an inevitable part of life. Which means there might be ways to prevent it.” That idea could eventually have implications for human medicine.
. . .
Dr. Pringle’s preliminary results show that as a lichen grows older and larger, it is less likely to die. “If you made me answer the question now,” she said, “I’d say there can be senescence of parts of an individual. But I don’t think an individual ever senesces.”

For the full story, see:
HILLARY ROSNER. “In a Place for the Dead, Studying a Seemingly Immortal Species.” The New York Times (Tues., January 1, 2013): D3.
(note: ellipses added.)
(Note: the online version of the story has the date December 31, 2012.)

“THRIVING; Dr. Pringle’s initial results show that as a lichen grows older and larger, it is less likely to die.” Source of caption and photo: online version of the NYT article quoted and cited above.

Dr. William House “Faced Stern Opposition” to Bring Cochlear Implants to the Deaf

“Dr. William F. House in 1981 with Tracy Husted, the first pre-school-age child to get a cochlear implant.” Source of caption and photo: online version of the NYT obituary quoted and cited below.

(p. 34) Dr. William F. House, a medical researcher who braved skepticism to invent the cochlear implant, an electronic device considered to be the first to restore a human sense, died on Dec. 7 at his home in Aurora, Ore. He was 89.

. . .
Dr. House pushed against conventional thinking throughout his career. Over the objections of some, he introduced the surgical microscope to ear surgery. Tackling a form of vertigo that doctors had believed was psychosomatic, he developed a surgical procedure that enabled the first American in space to travel to the moon. Peering at the bones of the inner ear, he found enrapturing beauty.
. . .
More than a decade would pass before the Food and Drug Administration approved the cochlear implant, but when it did, in 1984, Mark Novitch, the agency’s deputy commissioner, said, “For the first time a device can, to a degree, replace an organ of the human senses.”
One of Dr. House’s early implant patients, from an experimental trial, wrote to him in 1981 saying, “I no longer live in a world of soundless movement and voiceless faces.”
But for 27 years, Dr. House had faced stern opposition while he was developing the device. Doctors and scientists said it would not work, or not work very well, calling it a cruel hoax on people desperate to hear. Some said he was motivated by the prospect of financial gain. Some criticized him for experimenting on human subjects. Some advocates for the deaf said the device deprived its users of the dignity of their deafness without fully integrating them into the hearing world.
. . .
When his brother returned from West Germany with a surgical microscope, Dr. House saw its potential and adopted it for ear surgery; he is credited with introducing the device to the field. But again there was resistance. As Dr. House wrote in his memoir, “The Struggles of a Medical Innovator: Cochlear Implants and Other Ear Surgeries” (2011), some eye doctors initially criticized his use of a microscope in surgery as reckless and unnecessary for a surgeon with good eyesight.

For the full obituary, see:
DOUGLAS MARTIN. “Dr. William F. House, Inventor of Pioneering Ear-Implant Device, Dies at 89.” The New York Times, First Section (Sun., December 16, 2012): 34.
(Note: ellipses added.)
(Note: the online version of the obituary has the date December 15, 2012.)

Dr. House’s memoir is:
House, William F. The Struggles of a Medical Innovator: Cochlear Implants and Other Ear Surgeries. CreateSpace Independent Publishing Platform, 2011.
(Note: the copyright page of the book gives neither city nor name of publisher; the publisher in the reference is as given by Amazon.com.)

“Dr. William F. House sitting at an operating microscope.” Source of caption and photo: online version of the NYT obituary quoted and cited above.

Rupert Murdoch and Steve Jobs “Hit It Off Well”

(p. 508) Murdoch and Jobs hit it off well enough that Murdoch went to his Palo Alto house for dinner twice more during the next year. Jobs joked that he had to hide the dinner knives on such occasions, because he was afraid that his liberal wife was going to eviscerate Murdoch when (p. 509) he walked in. For his part, Murdoch was reported to have uttered a great line about the organic vegan dishes typically served: “Eating dinner at Steve’s is a great experience, as long as you get out before the local restaurants close.” Alas, when I asked Murdoch if he had ever said that, he didn’t recall it.

Source:
Isaacson, Walter. Steve Jobs. New York: Simon & Schuster, 2011.

The Project Entrepreneur: Never Say Die

(p. 485) . . . [Jobs] chafed at not being in control, and he sometimes hallucinated or be-(p. 486)came angry. Even when he was barely conscious, his strong personality came through. At one point the pulmonologist tried to put a mask over his face when he was deeply sedated. Jobs ripped it off and mumbled that he hated the design and refused to wear it. Though barely able to speak, he ordered them to bring five different options for the mask and he would pick a design he liked. The doctors looked at Powell, puzzled. She was finally able to distract him so they could put on the mask. He also hated the oxygen monitor they put on his finger. He told them it was ugly and too complex. He suggested ways it could be designed more simply. “He was very attuned to every nuance of the environment and objects around him, and that drained him,” Powell recalled.

Source:
Isaacson, Walter. Steve Jobs. New York: Simon & Schuster, 2011.
(Note: ellipsis and bracketed “Jobs” added.)

David Koch Institute for Integrative Cancer Research

“Dr. Robert Langer’s research lab is at the forefront of moving academic discoveries into the marketplace.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. 1) HOW do you take particles in a test tube, or components in a tiny chip, and turn them into a $100 million company?

Dr. Robert Langer, 64, knows how. Since the 1980s, his Langer Lab at the Massachusetts Institute of Technology has spun out companies whose products treat cancer, diabetes, heart disease and schizophrenia, among other diseases, and even thicken hair.
The Langer Lab is on the front lines of turning discoveries made in the lab into a range of drugs and drug delivery systems. Without this kind of technology transfer, the thinking goes, scientific discoveries might well sit on the shelf, stifling innovation.
A chemical engineer by training, Dr. Langer has helped start 25 companies and has 811 patents, issued or pending, to his name. More than 250 companies have licensed or sublicensed Langer Lab patents.
Polaris Venture Partners, a Boston venture capital firm, has invested $220 million in 18 Langer Lab-inspired businesses. Combined, these businesses have improved the health of many millions of people, says Terry McGuire, co-founder of Polaris.
. . .
(p. 7) Operating from the sixth floor of the David H. Koch Institute for Integrative Cancer Research on the M.I.T. campus in Cambridge, Mass., Dr. Langer’s lab has a research budget of more than $10 million for 2012, coming mostly from federal sources.
. . .
David H. Koch, executive vice president of Koch Industries, the conglomerate based in Wichita, Kan., wrote in an e-mail that “innovation and education have long fueled the world’s most powerful economies, so I can’t think of a better or more natural synergy than the one between academia and industry.” Mr. Koch endowed Dr. Langer’s professorship at M.I.T. and is a graduate of the university.

For the full story, see:
HANNAH SELIGSON. “Hatching Ideas, and Companies, by the Dozens at M.I.T.” The New York Times, SundayBusiness Section (Sun., November 25, 2012): 1 & 7.
(Note: ellipses added.)
(Note: the online version of the story has the date November 24, 2012.)

Students Protest (and Toss) Federally Mandated “Healthy” (“Gross”) Food

“Lunch hour at Middle School 104 in Manhattan, where, on Friday, several seventh graders pronounced vegetables “gross.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A1) Outside Pittsburgh, they are proclaiming a strike, taking to Twitter and Facebook to spread the word. In a village near Milwaukee, hundreds staged a boycott. In a small farming and ranching community in western Kansas, they have produced a parody video. And in Parsippany, N.J., the protest is six days old and counting.

They are high school students, and their complaint is about lunch — healthier, smaller and more expensive than ever.
The Healthy, Hunger-Free Kids Act of 2010, which required public schools to follow new nutritional guidelines this academic year to receive extra federal lunch aid, has created a nationwide version of the age-old parental challenge: persuading children to eat what is good for them.
Because the lunches must now include fruits and vegetables, those who clamor for more cheese-laden nachos may find string beans and a peach cup instead. Because of limits on fat and sodium, some of those who crave French fries get baked sweet-potato wedges. Because of calorie restrictions, meat and carbohydrate portions are smaller. Gone is 2-percent chocolate milk, replaced by skim.
“Before, there was no taste and no flavor,” said Malik Barrows, a senior at Automotive High School in Brooklyn, who likes fruit but said his classmates threw away their mandatory helpings on the cafeteria floor. “Now there’s no taste, no flavor and it’s healthy, which makes it taste even worse.”
Students organized lunch strikes in a suburb of Pittsburgh, where in late August the hashtag “brownbagginit” was trending on Twitter, and outside Milwaukee, where the Mukwonago High School principal, Shawn McNulty, said participation in the lunch program had fallen 70 percent.
. . .
(p. A3) In Sharon Springs, Kan., lunch protesters at Wallace County High School posted a video on YouTube, “We Are Hungry”; in it, students faint in the hallways and during physical education class, acting as if they had been done in by meager helpings of potato puff casserole and chicken nuggets. To the tune of the song “We Are Young” by Fun, one student on the video sings, “My friends are at the corner store, getting junk so they don’t waste away.”
Since it was uploaded three weeks ago, “We Are Hungry” has had nearly 900,000 views.
Callahan Grund, a junior who stars in the video, said, “My opinion as a young farmer and rancher is that we produced this protein and it’s not being used to its full advantage.” He wakes up early every morning to do chores, stays after school for two hours of football practice and returns home for another round of chores. If it were not for the lunches his mother now packs him, he said, he would be hungry again just two hours after lunch.
In New York City, where school officials introduced whole-wheat breads, low-fat milk and other changes several years ago, the most noticeable change this year is the fruit and vegetable requirement, which has resulted in some waste, according to Eric Goldstein, the Education Department official who oversees food services. It is not hard to see why. At Middle School 104 in Gramercy Park on Friday, several seventh graders pronounced vegetables “gross.”
“I just throw them out,” said Danielson Gutierrez, 12, carrying a slice of pizza, which he had liberally sprinkled with seasonings, and a pear. He also offered his opinion on fruit: “I throw them out, too. I only like apples.”

For the full story, see:
VIVIAN YEE. “No Appetite for Good-for-You School Lunches.” The New York Times (Sat., October 6, 2012): A1 & A3.
(Note: ellipsis added.)
(Note: the online version of the article has the date October 5, 2012.)

“Dissatisfied with healthier school lunches, some Kansas students made a video parody.” Source of caption and photo: online version of the NYT article quoted and cited above.

Chernobyl May Have Caused No Long-Term Increase in Cancer

Source of book image: http://luxuryreading.com/wp-content/uploads/2012/07/9781605294452.jpg

(p. C11) . . . Andrew Blackwell, a journalist and self-described “sensitive, eco-friendly liberal,” deserves praise for producing an environmentalist book that avoids the usual hyperventilation, upending stubborn myths with prosaic facts.
. . .
His Geiger counter convulses on a visit to the abandoned areas around Chernobyl, but Mr. Blackwell reacts soberly. While the initial disaster provoked a justifiable public panic, it also inspired scare-mongering from groups like Greenpeace, which claimed that the fallout would cause 270,000 cancer cases. He points to a study commissioned by the United Nations concluding that, after an initial spike in thyroid cancer, “no measurable increase has yet been demonstrated in the region’s cancer rates.” The author is also sure to irritate certain readers with the claim that “paradoxically, perversely, the accident may have actually been good” for the local environment, since the evacuation created an accidentally verdant nature reserve.

For the full review, see:
MICHAEL C. MOYNIHAN. “A Guided Tour of Catastrophe” The Wall Street Journal (Sat., May 26, 2012): C11.
(Note: ellipses added.)
(Note: the online version of the review has the date May 25, 2012.)

The book being reviewed, is:
Blackwell, Andrew. Visit Sunny Chernobyl: And Other Adventures in the World’s Most Polluted Places. New York: Rodale Books, 2012.

Why Health Care Costs So Much in McAllen

(p. 235) Atul Gawande lays out “The Cost Conundrum: What a Texas town can teach us about health care.” “It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. ‘Lonesome Dove’ was set around here. McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami–which has much higher labor and living costs–spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.”

Gawande as quoted in:
Taylor, Timothy. “Recommendations for Further Reading.” Journal of Economic Perspectives 24, no. 2 (Fall 2009): 231-38.

The full Gawande article can be viewed online at:
Gawande, Atul. “Annals of Medicine; the Cost Conundrum; What a Texas Town Can Teach Us About Health Care.” The New Yorker 85, no. 16 (June 2009): 36-44.

A later Gawande article, that asks why the health care system cannot be run as well as The Cheesecake Factory, can be viewed online at the link below. (Spoiler alert: I haven’t read this article yet, but I’m guessing it has something to do with the feedback and incentives provided by the free market.)
Gawande, Atul. “Annals of Health Care; Big Med; Restaurant Chains Have Managed to Combine Quality Control, Cost Control, and Innovation. Can Health Care?” The New Yorker 88, no. 24 (August 2012): 52-63.

Health Care Costs Can Be Lowered by Less Waste and More Cost-Reducing Innovation

(p. 234) Melinda Beeuwkes Buntin and David Cutler discuss “The Two Trillion Dollar Solution: Saving Money by Modernizing the Health Care System.” “Two sorts of savings are possible in health care. The first is eliminating waste and inefficiency. The most commonly cited estimate is that 30 percent of the money spent on medical care does not buy care worth its cost. Medicare costs per capita in Minneapolis, for example, are about half those in Miami, yet Miami does not have better health outcomes. International comparisons yield the same conclusion. . . . Second, reform might stimulate cost-reducing innovation instead of the continuous cost increases that accompany current innovation. For nearly 20 years, scholars have argued that generous reimbursement policies for medical care have led to innovations that almost always increase health care costs. Changing that dynamic by investing in research about what works and rewarding health care providers who choose efficient treatments could have a dramatic effect on cost growth. . . . Reducing costs by 30 percent will take time and effort, but it is not inconceivable over the long term. Experience in the health care sector and other industries suggests that cost reductions on the order of 1.5-to-2.0 percentage points per year are within reach.”

Buntin and Cutler as quoted in:
Taylor, Timothy. “Recommendations for Further Reading.” Journal of Economic Perspectives 24, no. 2 (Fall 2009): 231-38.
(Note: ellipses in original.)

The Buntin and Cutler report is:
Buntin, Melinda Beeuwkes, and David Cutler. “The Two Trillion Dollar Solution: Saving Money by Modernizing the Health Care System.” Washington, D.C.: Center for American Progress, 2009.

DaVita Threw Out Medicine and Billed Taxpayer: Huge Medicare Fraud

I saw this clip broadcast on Wolf Blitzer’s “Situation Room” broadcast on 11/29/12 (if memory serves–it might have been the day before).
The clip shows the magnitude of the fraud, but also emphasizes that there were significant incentives for those who knew about the fraud to keep their mouths shut.
This is one huge case of over-billing, but over-billing happens all the time. Taxpayers could have used that money for other purposes. The opportunity cost is huge.

A link to the clip posted on CNN, is:
http://ac360.blogs.cnn.com/2012/11/29/company-accused-of-giant-medicare-fraud/?iref=allsearch
(Note: I believe the November 29, 2012 date in the image above is the date that Drew Griffin posted the clip to the CNN blog, not necessarily the date of the broadcast.)