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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

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    Wednesday, September 26, 2007

    The Power of the Gods: Medical infallibility.

    posted by Sydney on 9/26/2007 08:20:00 AM 1 comments

    The Universal Pander: There's nothing like a presidential election to bring out the healthcare crisis. And, since the presidential primary process is stretching into a two year long spectacle, there's been no shortage of proposals on how to fix our current system. Recently, Dennis Kucinich pointed out that his ideas are the closest thing to what the American people want:

    In a CNN poll this spring, 64 percent of respondents said the government should "provide a national insurance program for all Americans, even if this would require higher taxes," and 73 percent approve of higher taxes to insure children under 18. Those results track New York Times and Gallup polls last year, in which about two-thirds of respondents said it is the federal government's responsibility to guarantee health coverage to all Americans.

    Such polls allow Kucinich to joke that, far from being in the loony left, "I'm in the center. Everyone else is to the right of me."

    Ask the American public a different question about the healthcare system, and you'll get a different answer:

    For the fifth time in six years, Harris Interactive has asked the insured public to rate their own insurance plans. Two thirds of them continue to give their plans an A or a B, with only 10% giving them a D or an F. Substantial but not overwhelming majorities continue to say that they would recommend their own health plans to family members who are basically healthy (76%) or who have a serious or chronic illness (68%).

    Health insurance companies are like politicians. We dislike all but our own. We should be careful what we wish for, however, for it won't just be our own politicians designing a nationalized health insurance plan; it will be all the others that we dislike, including politicians who believe hospital pork is a public service, that healthcare and personal autonomy are mutually exclusive, and that the right to earn a living takes second place to health insurance.

    What are people really wishing for when they say they wish for a single nationalized health insurance program? Security. Our current employer-provided system means that most of us are just a pink slip away from losing our insurance coverage. It also means that, deprived of the bargaining power of large corporations and unions, the self-employed are left with fewer choices and higher premiums. Handing over the whole kit and kaboodle to the government is a seductively simple solution. But it would also be a very expensive solution.

    The British are often held up as the standard to which we should aspire. But we don't live under a British style of government. We live under a government that's truly government of the people, by the people, for the people. And what the people want, the people get. Witness the influence of disease activism even now on disease specific government funding and treatment mandates. In England, the government only pays for colonoscopies to check for colon cancer if there are symptoms suggestive of cancer or a family history of colon cancer. In the United States, the Medicare pays for a colonoscopy every ten years for everyone over 50, regardless of symptoms or risk. So do many insurance companies., sometimes if not by choice, by mandate. In England, mammograms are only covered for women between the ages of 50 and 70, and then only every three years. In the United States, we pay for mammograms beginning at age 40, yearly, and with no upper age limit. We just don't have the heart for rationing that they have in other countries.

    A common theme in politician crafted health care schemes is that by paying for prevention we will save money, and thus be able to offer limitless healthcare services without bankrupting the country. Both Hillary Clinton and John Edwards have explicitly emphasized the importance of preventive healthcare in their plans- even to the point of patient-directed mandates in the case of Edwards. But if preventive services save money and lives, then why is the United Kingdom, which offers less expansive preventive services than the United States, both healthier and cheaper? (Hint: Dead people neither spend health insurance dollars nor complain about their health.)

    Don't be fooled by the promises of health and wealth to be found in government-provided, or even mandated, health insurance coverage. It may bring you health, but it will be at a very steep price - both in money and liberty.

    (Note: Next installment, a look at the Republican candidates approach to "universal coverage.")
    posted by Sydney on 9/26/2007 08:09:00 AM 5 comments

    Saturday, September 08, 2007

    Zing the Body Electric: Treating high blood pressure, circa 1907 (click images to enlarge and read the text):

    A close-up view of the blood pressure machine:

    - from Scientific American, August 24, 1907.

    The report sounds so confident:

    The important feature is that the cure - the reduction of arterial pressure to the normal value - is permanent, and that the progress of the arteriosclerosis is arrested by the removal of the excess of blood pressure.

    Seems kind of silly today, but look - one hundred years on and we're still flirting with the idea.

    Here's what else was going on in 1907, and here's an early twentieth century text on treating diseases with electricity.

    posted by Sydney on 9/08/2007 11:25:00 PM 2 comments

    Tuesday, September 04, 2007

    Predicting the Flu Future: How will this year's flu season be? We've been remarkably lucky for the past several years with very little activity and relatively mild strains. But if Australia and New Zealand's experience this summer is any indication, this winter we may be in for a bad flu season:

    Confirmed influenza cases reached 3,017 in the first seven months of the year, compared with 1,121 in 2006, according to the ministry's notifiable disease surveillance system.

    In July, 2,111 cases were confirmed by laboratory tests, the highest monthly tally in at least six years.

    "Sadly, some influenza infections have resulted in deaths this season, including in a small number of children,'' said John Horvath, Australia's chief medical officer, in an e-mailed statement today.

    The latest Australian flu data is available here. After peaking at the end of July and beginning of August, the number of cases has begun to decline. Our flu season in the northern hemisphere is often smilar to the southern hemisphere's, just six months later. Look for our season to peak at the end of January and beginning of February - and plan your flu shot accordingly - in late October or early November.

    P.S. There's a Flu Wiki!

    posted by Sydney on 9/04/2007 08:05:00 AM 3 comments

    Monday, September 03, 2007

    Orwell's England: In the here and now:

    A pregnant woman has been told that her baby will be taken from her at birth because she is deemed capable of "emotional abuse", even though psychiatrists treating her say there is no evidence to suggest that she will harm her child in any way.

    Social services' recommendation that the baby should be taken from Fran Lyon, a 22-year-old charity worker who has five A-levels and a degree in neuroscience, was based in part on a letter from a paediatrician she has never met.

    ...Under the plan, a doctor will hand the newborn to a social worker, provided there are no medical complications. Social services' request for an emergency protection order - these are usually granted - will be heard in secret in the family court at Hexham magistrates on the same day.

    From then on, anyone discussing the case, including Miss Lyon, will be deemed to be in contempt of the court.

    How did the good doctor come to that conclusion if he never met her?

    Miss Lyon came under scrutiny because she had a mental health problem when she was 16 after being physically and emotionally abused by her father and raped by a stranger.

    She suffered eating disorders and self-harm but, after therapy, graduated from Edinburgh University and now works for two mental health charities, Borderline and Personality Plus.

    ....Despite this support, endorsed by other psychiatrists and Miss Lyon's GP, social services based their recommendation partly on a letter from Dr Martin Ward Platt, a consultant paediatrician, who was unable to attend the meeting.

    He wrote: "Even in the absence of a psychological assessment, if the professionals were concerned on the evidence available that Miss Holton (as Miss Lyon was briefly known), probably does fabricate or induce illness, there would be no option but the precautionary principle of taking the baby into foster care at birth, pending a post-natal forensic psychological assessment."

    That takes "risk assessment" to dangerous levels.

    posted by Sydney on 9/03/2007 08:00:00 PM 4 comments

    Sunday, September 02, 2007

    Google Surprise: Looking for varieties of morning glories on Google got this.

    posted by Sydney on 9/02/2007 06:24:00 PM 0 comments

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