Recently in Health / Medicine Category
I've blogged in this space before about the many ways in which modern life promotes bigness--in business, government, finance, health care and so forth. Here's another: the New York Times is reporting that a new federal law requiring safety testing of toys, adopted in response to an influx of unsafe toys from overseas, may be a threat to artisanal toy-makers who use maple, beeswax and other wholesome stuff. It seems they can't afford the testing. We've seen situations like this many times before. People are horrified to discover the dangers of some sensitive product--say, milk--and government reacts with legislation. But that legislation requires new equipment, testing and procedures. The result, often, is rapid consolidation into a handful of much bigger providers. It's just very difficult to bear the burden of expensive new requirements unless you happen to be doing a great deal of business.
This toy controversy is an example of how difficult it can be to balance the desire for regulation ("there oughta be a law!") against the desire for niche products (uncured ham, progressive education, handmade toys) that often run afoul of even the best-intended legislation.
Photo Credit: Flickr User monozygotic
Photo Credit: Flickr User monozygotic
Today I went to see a very capable podiatrist who really had no idea that he had ever seen me before. His office has only paper records, ships them off-site after three years and gets rid of them after five, at least according to what they told me. So I whipped out my ancient, steam-powered Treo 650, performed a global search that took perhaps two seconds, and said: "February 20, 2003 at 2 pm." Voila, electronic medical records.
A new Harvard study estimates that lack of health insurance kills about 45,000 Americans annually, which is 2.5 times as many as the previous best estimate commonly cited in the health care debate. This is a big difference (27,000 additional lives). But it still pales in comparison with the more than one million Americans who die annually by their own hands--which they use to light cigarettes, lift forks and convey too many alcoholic beverages to their lips. That so many die as the result of behavioral causes is no argument against universal health coverage, and the new Harvard study bolsters the case for covering everyone, which I suspect we could do just by harvesting some of the incredible waste in the system today. But the vast loss of life associated with bad habits does suggest that we could do vastly more good by changing people's behavior, whether by exhortation, better education or sumptuary taxes.
Tobacco offers a promising precedent; smoking is down by something like half since mid-century, as I recall, and while this has contributed (perhaps significantly) to our national weight gain, on net this reduction in smoking has saved many lives and much suffering and expense. Further reductions in tobacco, as well as an assault on over-eating and unhealthy foods, might produce similarly large gains.
A pdf of the study is here (it's quite brief) and an even briefer essay on the whole subject, from the Wall Street Journal, can be found via my earlier Atlantic posting about the devastation we inflict on ourselves by our unhealthy lifestyles. There is vast room for improvement in this area, and progress in it could be a major force for reducing our runaway health-care costs--not to mention saving the lives of so many of our fellow citizens. President Obama has rightly called on students to work harder in school. Why not rally the rest of us to save ourselves from early death?
(Photo: Flickr User Siege N. Gin)
For years Hollywood has peddled crappy, simplistic movies about a heroic little person standing up to greedy corporations, unfeeling bureaucrats and other such stock villains. So it's hard not to feel there's some kind of poetic justice in the attacks leveled at the Motion Picture and Television Fund (and it's many rich and famous trustees) over plans to close the organization's venerable home for the aged.
You can read all about it here. The problem is that the Fund's geriatric center takes care of a tiny number of people at enormous expense. It runs huge deficits. And the costs are borne by the many thousands of other beneficiaries who rely on the Fund for benefits.
But since the people in the geriatric facility are quite old, and since the charity's various boards includes such zillionaires as Jeff Katzenberg and David Geffen, the battle over whether to close the facility is shaping up to be a Hollywood classic complete with plucky victims, cold-hearted tycoons--and a cast of thousands of invisible losers in the form of other Fund beneficiaries who need services and are no less entitled to them than the oldsters who are soaking up millions by their refusal to move. (Like any good picture, this one is rich with social metaphor.)
Never mind. Who cares about all those other people and the justice of their claims? What matters here is finding the cranky but lovable leader of the old-timers. It's Home Alone meets The Sunshine Boys! Let's just hope there's a hot young nurse for our hero to team up with.
You can read all about it here. The problem is that the Fund's geriatric center takes care of a tiny number of people at enormous expense. It runs huge deficits. And the costs are borne by the many thousands of other beneficiaries who rely on the Fund for benefits.
But since the people in the geriatric facility are quite old, and since the charity's various boards includes such zillionaires as Jeff Katzenberg and David Geffen, the battle over whether to close the facility is shaping up to be a Hollywood classic complete with plucky victims, cold-hearted tycoons--and a cast of thousands of invisible losers in the form of other Fund beneficiaries who need services and are no less entitled to them than the oldsters who are soaking up millions by their refusal to move. (Like any good picture, this one is rich with social metaphor.)
Never mind. Who cares about all those other people and the justice of their claims? What matters here is finding the cranky but lovable leader of the old-timers. It's Home Alone meets The Sunshine Boys! Let's just hope there's a hot young nurse for our hero to team up with.
Bedbugs are getting more and more attention lately, which makes me wonder if anyone is ever going to test my pet theory about this -- that the growth of the problem is related to the ability of the Internet to bring together buyers and sellers of used stuff. Craigslist would seem to offer the ideal natural experiment. Some enterprising economics grad students needs to look at the dates on which Craigslist established itself in various locales, and then see if there is any correlation with the rise of bedbugs in those cities. (For those who aren't aware of it, Craigslist is hugely popular for buying and selling used furniture, including beds, futons etc.)
But why stop at bedbugs? Craigslist is also commonly used for sexual hook-ups. I wonder if there is any city-by-city correlation with STDs? More mundanely, Craigslist is draining the lifeblood of newspapers by grabbing their classified ads, which on Craigslist are free. Is there a correlation between the arrival of Clist in a city and the decline of the local paper?
This bedbug business threatens to short-circuit what seemed an economical and environmentally sound trend: buying all kinds of things (furniture and clothes especially) second-hand on Craigslist, eBay or at garage sales. We've done a lot of this at our house, but I suspect a moratorium is about to descend.
(Photo: Wiki Commons)
The Associated Press has a fascinating story about an unrepentant man who says he sold a kidney for $20,000, saving the life of a guy on Long Island who allegedly posed as his cousin. Legal questions aside, I can't imagine what's wrong with any of this. I hope black market kidneys will be available if I ever need one. Better yet, I hope we abolish the black market by establishing a sensible, regulated marketplace so that people needn't become criminals to save their own lives.
Journalists love anniversaries, but I'm surprised that hardly anyone has noticed a significant one: this month is the centennial of Freud's first and only visit to America.
Sigmund Freud hated America. He couldn't stand being called "Sigmund" by his informal hosts. He believed that Americans had channeled their sexuality into an unhealthy obsession with money. And he seethed at his own need for the dollars that we had in such unseemly abundance. "Is it not sad," he wrote to a German friend after World War I, "that we are materially dependent on these savages, who are not a better class of human beings?"
But while Freud loathed all things American (except its currency), the feeling was anything but mutual. "No nation outside of Germany and Austria was more hospitable to psychoanalysis than America," notes Mark Edmundson in "The Death of Sigmund Freud" (2007). Freud may even have anticipated the eagerness with which Americans would embrace his theories. "We are bringing them the plague," he reportedly told colleagues when disembarking in New York. "And they don't even know it."
Read the rest here.
Law enforcement authorities have arrested an alleged dealer in forbidden commodities, and the condemnations are flying thick and fast. What is the dastardly crime with which this individual is charged? Saving people's lives by bringing together buyers and sellers of kidneys.
It's illegal in this country to buy or sell organs for transplant. This is an unjust law made and enforced by people who desperately need neither organs nor money. It condemns kidney-disease sufferers to death and potential organ donors to poverty. It's a law that I will unhesitatingly break if one of my children needs a kidney, and I hope you will have the decency to do the same if a member of your family is in a similar situation.
The AP story I linked to above discusses some of the ills that supposedly flow from a market in organs. It quotes a medical ethicist at my own alma mater arguing that it's better for people to die than buy organs:
The sanctimony of those who condemn these transactions strikes me as outrageous. If someone has the right to abort her own fetus, why does she not have the right to sell her own kidney? By what authority does the state tell me I cannot save myself or my family members by paying money I earned to a willing seller of a surplus item? In fact, why wouldn't a system of national health insurance include a provision for organ purchases? These transactions should not just be legal for the rich but subsidized for the poor, all in a carefully designed and closely regulated marketplace serving buyers, sellers and even medical ethicists. It's a shame that even one more person has to die before this law is changed.
UPDATE: From the July 27 Wall Street Journal:
It's illegal in this country to buy or sell organs for transplant. This is an unjust law made and enforced by people who desperately need neither organs nor money. It condemns kidney-disease sufferers to death and potential organ donors to poverty. It's a law that I will unhesitatingly break if one of my children needs a kidney, and I hope you will have the decency to do the same if a member of your family is in a similar situation.
The AP story I linked to above discusses some of the ills that supposedly flow from a market in organs. It quotes a medical ethicist at my own alma mater arguing that it's better for people to die than buy organs:
"There is a black market, almost exclusively in kidneys," Caplan said. "All international medical groups and governments ought to condemn any marketing in body parts. It's simply too exploitative of the poor and vulnerable. The quality of the organs is questionable. People lie to get the money. The middle men are irresponsible and often criminals. They don't care about the people who sell."Yet it seems to me that all these supposed problems (none of which deterred the defendant's alleged kidney-patient clients) are the result of the ridiculous prohibition on organ sales. The middle men, for example, are only criminals because of the stupid law, just as sellers of bourbon were during Prohibition. The lying is also related to the ban. A legal, regulated and transparent market could solve the problems of exploitation and organ quality. The huge buy/sell price spread apparent in Mr. Rosenbaum's alleged operation would collapse if the risk, subterfuge and bribery were taken out of the trade.
The sanctimony of those who condemn these transactions strikes me as outrageous. If someone has the right to abort her own fetus, why does she not have the right to sell her own kidney? By what authority does the state tell me I cannot save myself or my family members by paying money I earned to a willing seller of a surplus item? In fact, why wouldn't a system of national health insurance include a provision for organ purchases? These transactions should not just be legal for the rich but subsidized for the poor, all in a carefully designed and closely regulated marketplace serving buyers, sellers and even medical ethicists. It's a shame that even one more person has to die before this law is changed.
UPDATE: From the July 27 Wall Street Journal:
More than 80,000 Americans now wait for a kidney, according the United Network for Organ Sharing. Thirteen of them die daily; the rest languish for years on dialysis. The number of donors last year was lower than in 2005, despite decades of work to encourage people to sign donor cards and donate to loved ones.
A new study tells you what you already suspected, particularly if you are short.
...taller people live better lives, at least on average. They evaluate their lives more favorably, and they are more likely to report a range of positive emotions such as enjoyment and happiness. They are also less likely to report a range of negative experiences, like sadness, and physical pain, though they are more likely to experience stress and anger, and if they are women, to worry. These findings cannot be attributed to different demographic or ethnic characteristics of taller people, but are almost entirely explained by the positive association between height and both income and education, both of which are positively linked to better lives.If you want to read way more about all this, there is a pretty good book out on the whole subject. You can read a review before you buy it (I can't vouch for the writer). Or, if you're short, you can put your money toward a pair of elevator shoes.
Hat tip to marginalrevolution...
Jake Weisberg has a good piece in Slate on the way our health care system reflects the best and worst of our national character--and how to fix it without pretending we're going to become Brits or Finns. One of his central points is that we need to get the whole business out of the workplace. People don't spend their whole career at one place anymore. He might also have mentioned the many disadvantages of workplace-based coverage, including that it discourages entrepreneurship. Besides, the arrangement is a historical accident. It's got nothing but inertia going for it, as I made clear in this New York Times column from 2003. Here's the heart of it:
Why should we hate the employer-financed system? Let us count the ways:
It makes it difficult or sometimes even impossible for people to change jobs, not only damping economic efficiency but reducing the competition for labor and, therefore, reducing wages. Without alternative health coverage, there is "strong evidence for job lock," wrote two economists, Jonathan Gruber and Brigitte C. Madrian, in a National Bureau of Economic Research study released this year.
It suppresses the creation of new businesses because, for many potential entrepreneurs, quitting a job means forgoing health insurance, a risk too big to take.
It handicaps traditional industries like autos and steel, whose medical burden for retirees is staggering. The estimated lifetime expense for today's steel retirees alone is $14 billion. In the auto industry, General Motors alone provides coverage to nearly one-half of 1 percent of the American people; One analyst, Gary Lapidus of Goldman Sachs , calls Detroit's Big Three "H.M.O.'s with wheels."
It unfairly excludes the unemployed, the self-employed and low-skilled workers. And it can shortchange single people, whose employers effectively pay higher wages to workers with families when providing dependent coverage.
On top of everything else, our employer-based system seriously obscures who is paying what, making cost controls difficult.
Daniel Akst
