Sunday, October 01, 2006

The New PTA

Dear Concerned Parent,

We are writing to urge you to take action RIGHT NOW to protect your child's future. The public school system your child attends is a cesspool of temptation, sin, and tainted spinach - and it is only a matter of time before your angelic god-fearing child (if not, please send him/her here next summer. Trust us.) falls in. But wait! There's no need to move to move to Colorado Springs just yet. The PTA of America (Pro-life Theistic Acolytes of America) is forming a new chapter in your child's school district, and you have been chosen (to join it)! If you're morally outraged about the prospect of your child seeing "the naughty bits" at an art museum, boy are we the organization for you! Join now before your kid becomes a drug addict, a thief or a prostitute. We're serious.

Sincerely,
the (new) PTA of America

Wednesday, September 27, 2006

The (Benefits of the) High Cost Cost of Health Care

David Leonhardt, writing in today's New York Times, argues that the skyrocketing cost of health insurance isn't a bad thing: it's actually helping us live longer. Leonhardt makes a good point - with the constant rhetoric over the "spiraling costs of health care" there is a real tendency to look at health care as simply a necessary cost with its value divorced from its price; Leonhardt analogizes it to gas which is appropriate.

And while Leonhardt does acknowledge that the current "solution" to high health care costs is to drop expensive patients from the health care rolls altogether, I believe he is too sanguine about the actual benefits conferred by our increasingly costly health care. In the last four decades health insurance has increased an average of $5,500 per person per year. How much of that money actually increases our longevity and improves our health? And at what point is that money better spent on other health-promoting activities (better food, more education, etc.) in lieu of traditional health insurance?

I know what I'm doing next summer

Saturday, September 02, 2006

Revisiting The High Cost of End-of-Life Care

Almost six months ago I wrote about the exorbitant cost of certain life-saving drugs. At the time I argued that, in cases where a high-priced drug might extend a patient's life by a matter of some months, it might be rational to forgo treatments that came packaged with near bankruptcy as a side effect.

Six months later my opinion hasn't changed. And, as the Washington Post reports, there are others - actual cancer patients, not armchair bloggers - who are coming to the same conclusion: some drugs just aren't worth the price tag. While Americans as a group remain increasingly inclined to ignore the price tag when it comes to end-of-life expenses, it appears that the tide is starting to shift ever so slightly:
Despite official denials, the federal Medicare program makes subtle cost evaluations, says Dr. William Maisel, a Boston heart specialist who chairs a federal committee on cardiac devices. "I think they are concerned about people using the term `rationing' or `withholding therapies,'" says Maisel, at Beth Israel Deaconess Medical Center.

One way to control costs, without saying "no," is to keep reimbursements low. For example, Medicare's $140,000 reimbursement last year for heart pumps is widely acknowledged as below-market.

"We can't say, `No,' explicitly. We say, `Yes, but,'" explains Peter Neumann, who runs a Tufts University center on medical cost-effectiveness in Boston.

Yes, but start with a cheaper drug, get prior authorization, or make a bigger co-payment.

Cost-benefit analyses that include the value of individual human lives are a reality in the world today. It should be only a matter of time, one would think, before similar analyses find their way to end-of-life care as well.

Personalized Medicine's High Cost of Entry

A recent Chicago Tribune article canvasses the difficulties that academics and drug manufacturers alike are encountering in their attempts to make personalized medicine, or pharmacogenomics, profitable enough to pursue.

An interesting side note: the Tribune article touts Herceptin, an anti-breast cancer drug, as one of the few success stories of personalized medicine to date. Unfortunately, a recent study has found that Herceptin carries a greater heart damage risk than previously thought.

While this news doesn't repudiate Herceptin's therapeutic value it does serve as a careful reminder: even personalized medicine is not perfect medicine.

Cigarettes: Now More Addictive than Ever!

The Massachusetts Department of Public Health has discovered that cigarettes are more addictive than ever. The MA DPH study found "that tobacco companies increased levels of nicotine in most cigarette brands by an average of 10 percent between 1998 and 2004."

There might not be the political willpower to make cigarettes illegal, but it need not come to that. Amos Hausner, chairmen of the Israel Council for the Prevention of Smoking, is recommending that nicotine be removed from cigarettes entirely. Sounds like a good idea to put into play in this country as well.

And then, of course, there's always the brute force solution. Throw enough money at the problem and maybe it will go away. Kudos to Mayor Bloomberg, but I think that Chairman Hausner's plan, if implemented, would have much greater staying power.

Cigarettes: Now More Dangerous than LSD!

Not only are cigarettes more addictive than ever before, they've also been declared more dangerous than ecstasy, LSD, and cannabis, according to the UK Science and Technology Select Committee.

Anybody else noticing a trend here?

Friday, September 01, 2006

Taking the Fight for Evolution Overseas

Apparently, evolution isn't under attack only in Kansas. Now it's Kenya too. The leaders of the Kenyan Pentecostal congregation want to remove Dr. Richard Leakey's collection of hominid bones, which are real, tangible evidence of the power of evolution, from Kenya's national museum.

The group's rationale for the proposed removal: "Our doctrine is not that we evolved from apes, and we have grave concerns that the museum wants to enhance the prominence of something presented as fact which is just one theory." Of course.

Evolution, Faith, and Ignorance

A little bit late with this post, but Lawrence Krauss wrote an excellent editorial a few weeks ago in the New York Times on why the Kansas school board victory was only a minor one, and why a larger battle must be waged against scientific ignorance.

As Krauss puts it, "We must hold our elected school officials to certain basic standards of knowledge about the world. The battle is not against faith, but against ignorance." I certainly agree. And I wonder, as I've wondered so often in recent years, just how long it will take before evolution is left in peace, not just in Kansas but across the entire country.

The Hinxton Group

The Hinxton group is endeavoring to establish an international consensus on stem cell research guidelines and regulations. One of the most interesting aspects of the site is a database on policy and guidance documents which allows users "to search for the guidelines and laws that govern and regulate stem cell research, and related fields, on the national, state and/or institutional level" in nations around the world.