Healthcare in the United States

We have pointed out on here many of the reasons the US health care system is distorted, monopolistic, and inefficient. Obviously there are many things wrong that we did not address. We largely avoided discussing the demand side of the equation, including brokerage services like insurance. From what we have seen, those demand side elements are all that was tweaked in the latest legislation. Thus there remains the entire other side of the equation needing legislative redress.

We are most happy for the moment though that a passage of this bill will finally mean people will stop talking about "Health Care". The protraction of the issue in the public forum with little to no substantive progress has been excruciating. Let us celebrate the end to the collective insanity.

Film Review: Sicko

The propagandist Michael Moore, perhaps partly responsible for the Bush reelection, has produced a new film. Google's ratings suggest it is being received extremely well. Like all of his work, Sicko appeals much more to emotion than to reason. In seducing the American populace with the conveniences of socialism, he completely whitewashes the costs paid in high taxation, lower economic growth, high unemployment, and reduced technological advancement. Perhaps this is why country after country in Europe has been electing conservative governments; they have learnt the lessons of socialism the hard way. I agree that for poor, unproductive, and unambitious people such as those featured in Sicko, socialism is an absolutely fantastic deal. Goods and services are provided at someone else's expense. Michael Moore would lead one to believe that it is the greed of megacorporations who are responsible for all human suffering in the United States. The problem of unaffordable health care in the United States does not come from competing insurance companies. It is a problem of monopoly.

The American Medical Association, the State union of doctors, maintains medical school quotas and strictly suppresses the licencing of foreign trained doctors. This medical monopoly also maintains the sole ability to prescribe medication. Prescription fraud such as trying to fill a prescription in a higher amount than ordered by a doctor, is a felony punishable by prison sentencing. Doctors tend to prescribe medicines in artificially low quantity so as to encourage more overpriced visits for a refill. On top of this the medicine which is prescribed is sold at a large premium because of the lack of regulation in drug pricing as well as the overprotective intellectual property inherent in the American patent system.

Medical expenses are further inflated by the inordinate costs of doing business. Malpractice insurance is extremely expensive. There is no upper limit to the damages in a medical malpractice suit. Merck was famously ordered to pay USD 253 million for the death of one marathon runner. With 33% cuts, over-educated and overpaid lawyers are all too happy to help recover alleged damages. Lawyers such as John Edwards make fortunes preying upon the misfortunes of others.

There are of course some delightfully positive aspects of the US system. With the supply of doctors kept artificially small, the competition to be one of those doctors is increased so that American doctors, after they have been paid, are some of the best in the world. Maltreated patients do have the recourse to sue. Overprotected intellectual property drives innovation in medicine saving countless lives and improving quality of life in the long term. With drug price regulation in most other countries, America effectively subsidises medicine for the rest of the World.

Unfortunately, Michael Moore does not address any of these real issues. He is long on sob stories and short on understanding. American medicine is no doubt expensive and long overdue for anti-trust and tort reform, but calls for a medical socialist revolution are entirely inappropriate.

Another Reason Not to Smoke

If you are still a tobacco smoker, you may wish to take note of a new study out of Hellas, the country where tobacco consumption AVERAGES one pack per day per person making it the highest per capita. Tobacco absorbs large quantities of radionuclides making the deadly smoke not just chemically harmful, but also radioactive.

Caloric Restriction versus Obesity

This is my response to David Friedman's thought that a parent who does not enforce a Calorie Restricting diet (ie provides a standard diet) on their children is nearly as unfit a parent as one who overfeeds their children because in both cases lifespan is being shortened.

Infectious Disease in Prison

Yet again, civilised society owes safety, decent treatment, and proper medical care to all its prisoners. In this case, Susan Oakie writes in the NEJM about public health in US prisons. Clearly, much more needs to be done to prevent the spread of deadly infectious diseases among inmates. Russian prisons have managed to breed extremely deadly multi-drug resistant tuberculosis which kills 40-60% of those infected. In addition to the measures recommended in Oakie's article, I suggest that all prisoners placed in general population should have compulsory testing for transmissible diseases and those who are infected should be publicly labeled as such if not quarantined while regularly educating prisoners on modes of transmission. Moreover, prison managers - in many cases private corporations in the United States - should be held to pay damages to families of prisoners who die as a result of infections they received in prison. Clearly making sex, drugs and tattooing in prisons 'illegal' is not getting the job done; they are prisoners after all. The human rights situations in prisons are tenuous enough without the possibility for prisoners to be infected with pathogens.

Contraception

Perhaps one of the most important inventions of the 20th Century was the development of effective contraception technology especially the birth control pill. The hormone-free male version of this pill currently under research could make women much healthier with minimal impact on male health and long term fertility. Let us hope that this drug proves safe and effective.

Cocaine

It is amazing how much crime and human destruction occurs owing to the illegality of certain substances. This article from the BBC shows that now poisoning, fraud, and abuse of animals can be added to the normal crimes of trafficking, possession, and sale of a controlled substance. Moreover, consumers of the recreational "champagne" drug, cocaine, are now ingesting carcinogenic additives. Traditionally, cocaine was cut with caffeine. Now it seems dealers whose objective is to maximise profits and whose product is unregulated and untestable because of illegality are moving on to more pernicious cutting agents, ie Phenacetin.

While I would be someday interested in trying traditional coca tea or chewing coca leaves especially in the mountains, ingesting processed cocaine whose dosage is about 1000 times higher is very unhealthy causing cardiovascular and brain damage. Processed cocaine is also extremely addictive. The hydrochloric acid in processed cocaine destroys nasal passageways, mucous membranes, and sinuses.

Despite such drawbacks, adults who are educated about the risks of cocaine should have the right to buy it from licenced distributors and consume it at their discretion. At the very least, laws worldwide should be made to reflect the policies of Bolivian president and former coca farmer Evo Morales: Yes to coca, no to cocaine. As with most illegal drugs, legalisation of cocaine would dramatically reduce crime by lowering the price, legitimising the producers and distributors, and lowering the associated health risks by ensuring a clean supply. Cheap processed cocaine would likely reduce the demand for cheaper more destructive forms of the the drug including crack and freebase.

The ongoing war by the US in Columbia against FARC which includes the use of chemical weapons against farmers and their crops is simply immoral.

In the wake of Milton Friedman's passing, let us remember that human freedom to control one's own life, beliefs, and economic behaviour also includes the freedom to alter ones own body chemistry or mental processes. With freedom comes responsibility. Irresponsible self-destructive personal behaviour affecting only the user and those emotionally affected by the user is no grounds for a general government interdiction on drugs.

Healthcare and Human Rights in Prisons

The Fyodor Dostoevsky quote from this post is again pertinent. The ruling in this case to compensate prisoners who were not given proper access to treatment for opiate addiction while in prison was a sensible decision by the court (relative to the unspecified amount of compensation).

One could argue that the provision of extremely expensive noncritical care , such as brain surgery, is above and beyond the financial responsibility of a state which does not already provide universal care. However, where socialised medicine exists, such as the UK, all prisoners deserve the same level of medical care as everyone else including drug treatment programmes. To deny medicine or access to care to a prisoner is a violation of human rights and compensation is due in such cases.

Diabetes

Knowing many people with life-threatening Type 1 juvenile diabetes, I hail the development of artificial pancreas technology.

Vita Vinum Est

Yesterdays post about caloric restriction relates to today's post on the health benefits of vino rosso. Resveratol, a chemical in red wine affects one of the key ageing genes, SIRT1, to slow the process of ageing and extend lifespan in mammals. Besides being healthy, red wine is also very pleasant to drink bringing physical, mental and social well-being.

Caloric Restriction

Caloric Restriction, the limiting of caloric intake while maintaining normal levels of all other vital nutrients, has been shown to be the only reliable method to significantly extend an animal's lifespan by slowing the process of ageing. A new NY Times article about CR explains the idea fairly well. This is a short FT article from June.

Many people have begun CR diets in an attempt to extend their best years. The Caloric Restriction Society is an organisation which promotes and supports CR.

As touched on in the NY Times article, CR research has the potential to reveal many of the genetic pathways for senescent processes, and in turn, new anti-ageing drugs may come from such research.

Possible Treatment for Alzheimer's Disease

In research by Gary Wenk on Alzheimer's model rats funded by the US Government, a synthetic cannabinoid agonist with anti-inflammatory properties was shown to improve memory and orientation. The study reveals further medical uses of cannabis, a plant whose usefulness has been understood for millenia.

Do not Abuse Your Children

In the West, the tendency has been moving away from parents beating their children. While this is a positive step in a civilised society which has lost touch with the harsh realities of survival in the wilderness, many parents have substituted verbal and mental chastisement and abuse for physical punishment. While no marks are left and the effect is more subtle than a corporal attack, mental scars do result such as impaired verbal, speech, and brain development.

The culture and legal system currently dictate that one may not physically abuse their children, but unusual deference is otherwise given to the parents in raising their child. Most natural families are not nuclear, but are more tribal, with extended family having at least as much to do with raising the children as the biological parents. Therefore in natural families, children tend to be more protected from the excesses of their parents than modern families whose dominance has resulted from advances in transportation and housing technology and the economic drive to migrate to maximise buying power.

I therefore reject this modern notion of "Don't tell me how to raise my kids!" Nobody is perfect and we all make mistakes, most often without realising them. Qualified reproduction may be a human right, but abusing your progeny is not.

Bottom Line: Neither physically nor verbally abuse your children.

(I do not nor would I suggest a legal mechanism to enforce restraint in verbally abusing one's children. I aim simply to educate.)

New Berry Juice May Be Available Soon

Indian scientists have designed a way to extract the juice of the sea buckthorn, berries which are very high in antioxidants.

The Seeds of Revolution

If anything could destabilise the French state and lead ultimately to la 6eme République, it is the restriction of tobacco consumption. French Prime Minister Dominique de Villepin has announced just such a move in new policies designed to ban tobacco consumption in certain public locations. Vive la Revolution!

Psychos

This article in wired argues that psychopathy deserves more respect and sympathy as is currently granted other mental disorders such as schizophrenia. I have known a few psychopaths in my day, and have witnessed how quickly the rest of society will shun them once the word gets out about their condition. Indeed, we all know how "psycho" is used in common parlance as a derogatory term.

However, let us not forget that psychopathy, which implies a lack of empathy for other people, can make a person potentially dangerous. Unfortunately, many such people also tend to rise quickly in corporate or political situations and so their destructive potential can be multiplied. Organisations should put significant effort into preventing people with such untreated conditions from gaining positions of authority over others.