Health – Page 95 – artdiamondblog.com

Native Americans Suffer from Government Health Care

(p. A11) Native Americans have received federally funded health care for decades. A series of treaties, court cases and acts passed by Congress requires that the government provide low-cost and, in many cases, free care to American Indians. The Indian Health Service (IHS) is charged with delivering that care.

The IHS attempts to provide health care to American Indians and Alaska Natives in one of two ways. It runs 48 hospitals and 230 clinics for which it hires doctors, nurses, and staff and decides what services will be provided. Or it contracts with tribes under the Indian Self-Determination and Education Assistance Act passed in 1975. In this case, the IHS provides funding for the tribe, which delivers health care to tribal members and makes its own decisions about what services to provide.
. . .
Unfortunately, Indians are not getting healthier under the federal system. In 2007, rates of infant mortality among Native Americans across the country were 1.4 times higher than non-Hispanic whites and rates of heart disease were 1.2 times higher. HIV/AIDS rates were 30% higher, and rates of liver cancer and inflammatory bowel disease were two times higher. Diabetes-related death rates were four times higher. On average, life expectancy is four years shorter for Native Americans than the population as a whole.
. . .
Personal stories from people within the system reveal the human side of these statistics. In 2005, Ta’Shon Rain Little Light, a 5-year-old member of the Crow tribe who loved to dress in traditional clothes, stopped eating and complained that her stomach hurt. When her mother took her to the IHS clinic in south central Montana, doctors dismissed her pain as depression. They didn’t perform the tests that might have revealed the terminal cancer that was discovered several months later when Ta’Shon was flown to a children’s hospital in Denver. “Maybe it would have been treatable” had the cancer been discovered sooner, her great-aunt Ada White told the Associated Press.
. . .
The Chippewa Cree Band runs its own hospital and has hired a registered dietician who has gotten the local grocery store to implement a shelf-labeling system to improve consumer nutritional information. They’ve also built a Wellness Center with a gym, track, basketball court, and pool. These are small steps that won’t immediately eliminate heart disease or diabetes. But they move in the direction of local control and better health.
At a time when Americans are debating whether to give the government in Washington more control over their health care, some of the nation’s first inhabitants are moving in the opposite direction.

For the full commentary, see:
TERRY ANDERSON. “OPINION: CROSS COUNTRY; Native Americans and the Public Option; After decades of government-run care, some Indians are finally saying enough.” Wall Street Journal (Sat., August 29, 2009): A11.
(Note: ellipses added.)
(Note: the online version is dated Fri., Aug.28, 2009)

Small Business Sceptical of Big Government Health Plan

“No, I mean it,” said Ms. Brigugulio, “I expect you to keep your word on this.” Source of the photo and caption: http://boss.blogs.nytimes.com/2009/07/30/mr-prez-meets-ms-biz-the-story-behind-the-photo/

(p. A11) Patty Briguglio thinks President Obama may have a public relations problem selling his health care plan to small-business owners.
And Ms. Briguglio, who was photographed exchanging a wagging finger with the president at his health care forum Wednesday in Raleigh, N.C., should know: she runs her own small business, MMI Associates, a public relations firm in Raleigh.
Ms. Briguglio pays much of the cost of health insurance for her firm’s 19 employees, though she does not offer a group plan. Because the members of her staff are so young, it is cheaper simply to provide an allowance for them to buy individual policies.
When Mr. Obama called on Ms. Briguglio at Wednesday’s forum, she asked, ”What current long-term social program created and run by the government should we look to as a model of success and one that we as taxpayers should be confident that a new government-run health care system would be better than the current system in place?”
The president suggested Veterans Affairs hospitals and Medicare, both of which, he said, ”have very high satisfaction rates.”
And, he added, ”Medicare costs have gone up more slowly than private-sector health care costs.”
Ms. Briguglio was not completely satisfied. ”I’ve never associated any government program with ‘cost effective’ or ‘efficient,’ ” she said in a telephone interview on Thursday. ”I don’t believe that the government will be a better steward of the money that I set aside for health care for my employees than I will be.”

For the full story, see:

ROBB MANDELBAUM. “To Challenges For Obama, Add Another.” The New York Times (Fri., July 31, 2009): A11.
(Note: the online version of the article does not have the photo of Briguglio wagging her finger, that was published in my print version of the paper. The photo above is from later in the exchange, and appeared on the NYT blog.)

“The Voluntary Slaves of a ‘Compassionate’ Government”

Thomas Szaz has been defending liberty for many decades. It is good to see him still eloquently at it:

(p. A13) If we persevere in our quixotic quest for a fetishized medical equality we will sacrifice personal freedom as its price. We will become the voluntary slaves of a “compassionate” government that will provide the same low quality health care to everyone.

For the full commentary, see:
THOMAS SZASZ. “Universal Health Care Isn’t Worth Our Freedom.” Wall Street Journal (Weds., JULY 15, 2009): A13.

Experiments Suggest We Can Live Longer

“Rhesus monkeys, 27-year-old Canto, left, and Owen, 29, are among the oldest surviving subjects in a study of the links between diet and aging.” Source of photo and caption: online version of the WSJ article quoted and cited below.

(p. A3) A study published Wednesday found that rapamycin, a drug used in organ transplants, increased the life span of mice by 9% to 14%, the first definitive case in which a chemical has been shown to extend the life span of normal mammals.

Anti-aging researchers also expect a second study, to be released this week, will show that sharply cutting the calorie intake of monkeys extends their lives substantially. The experiment is said to be the first technique shown to retard aging in primates.
The prospect of a reliable human longevity pill is still distant. A commentary released with the rapamycin study strongly cautioned against taking the drug to prolong life because of potentially deadly side effects. Rapamycin suppresses the immune system and carries strong warnings about the resulting risk of infections and death.
But the mouse and monkey findings appear to mark the most substantial scientific progress yet in the search for ways to extend human life spans — once viewed as a fringe area of study.
“It’s time to break out of our denial about aging,” said Aubrey de Grey, a British gerontologist who has drawn controversy for his suggestions on how to forestall death. “Aging is, unequivocally, the major cause of death in the industrialized world and a perfectly legitimate target of medical intervention.”

For the full story, see:
KEITH J. WINSTEIN. “”Two Mammals’ Longevity Boosted; Transplant Drug Lengthens Lives of Mice, and Fewer Calories Benefit Monkeys.” The Wall Street Journal (Thurs., JULY 10, 2009): A3.

Source of graphic: online version of the WSJ article quoted and cited above.

Free-Range Pork Carries More Disease

(p. A19) Is free-range pork better and safer to eat than conventional pork? Many consumers think so. The well-publicized horrors of intensive pig farming have fostered the widespread assumption that, as one purveyor of free-range meats put it, “the health benefits are indisputable.” However, as yet another reminder that culinary wisdom is never conventional, scientists have found that free-range pork can be more likely than caged pork to carry dangerous bacteria and parasites. It’s not only pistachios and 50-pound tubs of peanut paste that have been infected with salmonella but also 500-pound pigs allowed to root and to roam pastures happily before butting heads with a bolt gun.

The study published in the journal Foodborne Pathogens and Disease that brought these findings to light last year sampled more than 600 pigs in North Carolina, Ohio and Wisconsin. The study, financed by the National Pork Board, discovered not only higher rates of salmonella in free-range pigs (54 percent versus 39 percent) but also greater levels of the pathogen toxoplasma (6.8 percent versus 1.1 percent) and, most alarming, two free-range pigs that carried the parasite trichina (as opposed to zero for confined pigs). For many years, the pork industry has been assuring cooks that a little pink in the pork is fine. Trichinosis, which can be deadly, was assumed to be history.
. . .
Let’s not forget that animal domestication has not been only about profit. It’s also been about making meat more reliably available, safer to eat and consistently flavored. The critique of conventional animal farming that pervades food discussions today is right on the mark. But it should acknowledge that raising animals indoors, fighting their diseases with medicine and feeding them a carefully monitored diet have long been basic tenets of animal husbandry that allowed a lot more people to eat a lot more pork without getting sick.

For the full commentary, see:
JAMES E. McWILLIAMS. “Free-Range Trichinosis.” The New York Times (Fri., April 10, 2009): A19.
(Note: ellipsis added.)

Drug Innovation Funding Slashed in Economic Crisis

Source of graphic: online version of the WSJ article quoted and cited below.

(p. B1) Big pharmaceutical companies have spent billions of dollars to buy other drug giants lately, leaving behind small biotech companies that can no longer find investors.

The biotech industry had thrived as a new-drug incubator for big pharma companies, which poured money into acquisitions and partnerships to build up their biotech-drug product line. Some of that is still happening, but most sources of investment funding have dried up in recent months.
Since November, 10 biotechs have declared bankruptcy, says Ellen Dadisman, a spokeswoman for the Biotechnology Industry Organization. Meanwhile, 120 of the 360 publicly traded biotechs have less than six months of cash left, compared with just 12 companies in that position a year ago, according to Burrill & Co., a venture-capital concern in San Francisco that follows the industry.

For the full story, see:

KEITH J. WINSTEIN. “Cash Dries Up for Biotech Drug Firms.” Wall Street Journal (Mon., MARCH 16, 2009): B1.

Government Regulators Again Suppress Entrepreneurial Innovation

Source of photo: http://images.quickblogcast.com/82086-71861/pedicurex_large.jpg

(p. A1) Until Mr. Ho brought his skin-eating fish here from China last year, no salon in the U.S. had been publicly known to employ a live animal in the exfoliation of feet. The novelty factor was such that Mr. Ho became a minor celebrity. On “Good Morning America” in July, Diane Sawyer placed her feet in a tank supplied by Mr. Ho and compared the fish nibbles to “tiny little delicate kisses.”

Since then, cosmetology regulators have taken a less flattering view, insisting fish pedicures are unsanitary. At least 14 states, including Texas and Florida, have outlawed them. Virginia doesn’t see a problem. Ohio permitted fish pedicures after a review, and other states haven’t yet made up their minds. The world of foot care, meanwhile, has been plunged into a piscine uproar. Salon owners who (p. A12) bought fish and tanks before the bans were imposed in their states are fuming.
The issue: cosmetology regulations generally mandate that tools need to be discarded or sanitized after each use. But epidermis-eating fish are too expensive to throw away. “And there’s no way to sanitize them unless you bake them for 20 minutes at 350 degrees,” says Lynda Elliott, an official with the New Hampshire Board of Barbering, Cosmetology and Esthetics. The board outlawed fish pedicures in November.
In Ohio, ophthalmologist Marilyn Huheey, who sits on the Ohio State Board of Cosmetology, decided to try it out for herself in a Columbus salon last fall. After watching the fish lazily munch on her skin, she recommended approval to the board. “It seemed to me it was very sanitary, not sterile of course,” Dr. Huheey says. “Sanitation is what we’ve got to live with in this world, not sterility.”
. . .
State bans have disrupted Mr. Ho’s plans to build a nationwide franchise network. Currently, he has four active franchises, in Virginia, Delaware, Maryland and Missouri. But others have terminated franchise agreements. In Calhoun, Ga., Tran Lam, owner of Sky Nails, says she paid Mr. Ho $17,500 in exchange for fish and custom-made pedicure tanks. A few weeks later, in October, the Georgia Board of Cosmetology deemed fish pedicures illegal. “I’m very mad,” says Ms. Lam. “I lost a lot of money and the economy is so bad.”

For the full story, see:
JOHN SCHWARTZ. “Ban on Feet-Nibbling Fish Leaves Nail Salons on the Hook; Mr. Ho’s Import From China Caught On, But Some State Pedicure Inspectors Object.” Wall Street Journal (Mon., MARCH 23, 2009): A1 & A12.
(Note: ellipsis added.)

Our “Patently Absurd” Patent System

(p. A15) The Founders might have used quill pens, but they would roll their eyes at how, in this supposedly technology-minded era, we’re undermining their intention to encourage innovation. The U.S. is stumbling in the transition from their Industrial Age to our Information Age, despite the charge in the Constitution that Congress “promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries.”
. . .

Both sides may be right. New empirical research by Boston University law professors James Bessen and Michael Meurer, reported in their book, “Patent Failure,” found that the value of pharmaceutical patents outweighed the costs of pharmaceutical-patent litigation. But for all other industries combined, they estimate that since the mid-1990s, the cost of U.S. patent litigation to alleged infringers ($12 billion in legal and business costs in 1999) is greater than the global profits that companies earn from patents (less than $4 billion in 1999). Since the 1980s, patent litigation has tripled and the probability that a particular patent is litigated within four years has more than doubled. Small inventors feel the brunt of the uncertainty costs, since bigger companies only pay for rights they think the system will protect.
These are shocking findings, but they point to the solution. New drugs require great specificity to earn a patent, whereas patents are often granted to broad, thus vague, innovations in software, communications and other technologies. Ironically, the aggregate value of these technology patents is then wiped out through litigation costs.
Our patent system for most innovations has become patently absurd. It’s a disincentive at a time when we expect software and other technology companies to be the growth engine of the economy. Imagine how much more productive our information-driven economy would be if the patent system lived up to the intention of the Founders, by encouraging progress instead of suppressing it.

For the full commentary, see:
L. GORDON CROVITZ. “OPINION: INFORMATION AGE; Patent Gridlock Suppresses Innovation.” Wall Street Journal (Mon., JULY 14, 2008): A15.
(Note: ellipsis added.)

To Cure Fatal Diseases We Need More Financial Incentives and Fewer F.D.A. Restrictions

“JOSHUA THOMPSON with his sons, Wyatt and Jordan, after his diagnosis, top, and before, with his wife, Joy, and Wyatt.” Source of the photos and caption: online version of the NYT article quoted and cited below.

(p. 1) VIRGINIA BEACH — As Lou Gehrig’s disease sapped Joshua Thompson of his ability to move and speak last fall, he consistently summoned one question from within the prison of his own body. “Iplex,” he asked, in a whisper that pierced his mother’s heart. “When?”

Iplex had never been tested in people with amyotrophic lateral sclerosis, the formal name for the fatal disease that had struck Joshua, 34, in late 2006. Developed for a different condition and banished from the market by a patent dispute, it was not for sale to the public anywhere in the world.
But Kathy Thompson had vowed to get it for her son. On the Internet, she had found enthusiastic reviews from A.L.S. patients who had finagled a prescription for Iplex when it was available, along with speculation by leading researchers as to why it might slow the progressive paralysis that marks the disease. And for months, as she begged and bullied biotechnology companies, members of Congress, Italian doctors and federal drug regulators, she answered Joshua the same way:
“Soon,” she said. “Soon.”
At a time when terminally ill patients have more access to medical research than ever before, and perhaps a deeper conviction in its ability to cure them, many are campaigning for the chance to be treated with drugs whose safety and effectiveness is not yet known.
. . .
(p. 19) “Josh’s sadness is unbearable,” his mother wrote one night in her journal, nearly a year after her son’s diagnosis.
Unexpected encouragement came in a Mother’s Day note from her ex-husband. “You have given me some peace of mind that all potential options for Josh are being researched and acted upon,” Bruce wrote. “Thank you.”
Kathy’s boyfriend accompanied her to Insmed’s headquarters in Richmond, Va., offering to raise several million dollars to underwrite a compassionate use program for Iplex in the United States with A.L.S. patients. But the couple came away with a new understanding: F.D.A. regulations, they were told, prohibit any company from profiting on compassionate use. Even if Insmed could wriggle free of restrictions in the patent agreement, there was little financial incentive for it to invest in making the drug solely for compassionate use by A.L.S. patients.
. . .
On Jan. 16, when Dr. Werwath called to tell her the application had been rejected, she stood up in disbelief.
“How could that be?” she asked, dazed.
Kathy’s friend Mrs. Reimers had received a call with the same news.
“He said they had safety concerns,” Mrs. Reimers said. “This for a drug that was approved for children!”
“Safety,” Kathy repeated. “And what, exactly, is safe about A.L.S.?”

Appealing an F.D.A. Denial
Before the F.D.A.’s decision, Kathy had spared little thought for any broader meaning of her quest for Joshua. But when she met with Richard A. Samp, a lawyer with the Washington Legal Foundation a week later, her outrage went beyond her son, and beyond Iplex.
“The F.D.A. is supposed to protect American citizens,” Kathy fumed over an iced tea in Williamsburg, Va. “How does denying dying patients access to this drug serve the common good?”
Mr. Samp had handled a lawsuit by a patient advocacy group, the Abigail Alliance, that had sought to establish a constitutional right for terminally ill patients to use experimental drugs. In the case, which the group had lost on appeal in 2007, the F.D.A. claimed that it granted “nearly all” requests for compassionate use.
They would first make an administrative appeal, Mr. Samp told Kathy, asserting that the F.D.A. had violated its own guidelines. If that failed, they could pursue litigation that might allow them to raise the constitutional question again in a federal court in Virginia.
. . .
Kathy was pouring milk for her cereal on the morning of March 10 when Dr. Werwath’s number flashed on her phone. The F.D.A. had just reversed itself, he said.
Before she could take a breath, Senator Mark Warner’s office called. E-mail bleeped in as the news seeped out.
In the weeks after the appeal, Kathy learned, the F.D.A. had reached out to Insmed. The agency had persuaded the company to run a clinical trial for Iplex with several dozen A.L.S. patients, and permitted it to recoup the hefty costs directly from participants. In the trial, some of the participants would get a placebo. That way, the F.D.A. wrote on its Web site, the next wave of A.L.S. patients would learn whether the drug was in fact beneficial or harmful.
But for now, the agency had ruled, Joshua and 12 other patients would be given Iplex outside of the trial, on a compassionate use basis, if they agreed to read all the data about the risks.

For the full version of a very long story, see:
AMY HARMON. “Months to Live; Fighting for a Last Chance at Life; One Family’s Tenacious Campaign for Access to an Unproven Drug.” The New York Times, First Section (Sun., May 17, 2009): 1, 18-19.
(Note: ellipses added.)

“IN MARCH, Joshua Thompson received his first Iplex injection, from Dr. David L. Werwath. Thereafter Joshua’s wife, Joy, left, and mother, Kathy, took over the daily duties.” Source of the photo and caption: online version of the NYT article quoted and cited above.

“Don’t Kill the Goose”

(p. A11) I think there are two major but not fully formed or fully articulated fears among thinking Americans right now, and the deliberate obscurity of official language only intensifies those fears.

The first is that Mr. Obama’s government, in all its flurry of activism, may kill the goose that laid the golden egg. This is as dreadful and obvious a cliché as they come, but too bad, it’s what people fear. They see the spending plans and tax plans, the regulation and reform hunger, the energy proposals and health-care ambitions, and they–we–wonder if the men and women doing all this, working in their separate and discrete areas, are being overseen by anyone saying, “By the way, don’t kill the goose.”
The goose of course is the big, messy, spirited, inspiring, and sometimes in some respects damaging but on the whole brilliant and productive wealth-generator known as the free-market capitalist system. People do want things cleaned up and needed regulations instituted, and they don’t mind at all if the very wealthy are more heavily taxed, but they greatly fear a goose killing. Economic freedom in all its chaos and disorder has kept us rich for 200 years, and allowed us as a nation to be generous and strong at home and in the world. But the goose can be killed–by carelessness, hostility, incrementalism, paralysis, and by no one saying, “Don’t kill the goose.”

For the full commentary, see:
PEGGY NOONAN. “What’s Elevated, Health-Care Provider? Economy of language would be good for the economy.” Wall Street Journal (Sat., MAY 15, 2009): A11.

Medical Care is Much Advanced Since Victorian Era of Mid-1800s

In the final sentences quoted below, note the under-appreciated role of air conditioning, and electric light, in advancing medical education.

(p. W6) “Gray’s Anatomy” is one of the most famous medical books of all time, but if a picture is worth a thousand words, then the man most responsible for the success of the book was its long-forgotten illustrator, Henry Vandyke Carter. In “The Making of Mr. Gray’s Anatomy,” Ruth Richardson shows how Carter and Henry Gray came together to produce a classic that originally bore neither of their names — it was published as “Anatomy Descriptive and Surgical” — but she also affords us a remarkable glimpse of science in the 19th century.
. . .
Not much of a paper record exists regarding Henry Gray’s life. Ms. Richardson speculates that his possessions were burned in the “Victorian terror” stirred by smallpox, the disease that would kill him at age 34. Henry Carter kept a diary, but its contents are not exactly a trove of detail about his life and times. . . .
. . .
Describing their methods, Ms. Richardson reminds us of what we now take for granted in medicine by relating what wasn’t feasible back then. The “dissecting season” was the colder months, January-March, to make the most of the cadavers’ preservation. And the work day had to begin soon after dawn because sunlight was so much better for close observation than any other light source.

For the full review, see:
MARK F. TEAFORD. “Dissecting an Unheralded Alliance; A classic medical text bears one man’s name, but it was the product of a true collaboration.” Wall Street Journal (Fri., MARCH 27, 2009): W6.
(Note: ellipses added.)

The reference to the reviewed book is:
Richardson, Ruth. The Making of Mr. Gray’s Anatomy. Oxford, UK: Oxford University Press.