There is an excellent piece in the New Yorker on two Texas hospitals, in similar towns, with similar health. One hospital bills twice the other, since the doctor's are over-prescribing and over-treating in the expensive hospital. Obama thinks this is the big deal and this article reflects a lot of what the hew health plan may have in it.
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail
My own rebuttals:
1. Medicare is at present about twice as much per procedure as private medicine. The real expense comes when doctors get paid by over-treating under Medicare and Medicaid.
2. Who should prevent me from spending my own money or a luxury insurance policy if I want hi-tech and complete care?
3. The article implies that the new medicine is not much use. The small benefits are counteracted by the risks of additional procedures. This lie is almost criminal.
4. The author claims that malpractice insurance is not an important factor is playing it safe with extra tests, and this is also a lie.
5. The article suggests that government should interfere with medical decisions when it is exactly that government interference that has caused so much trouble.
Saturday, June 27, 2009
Tuesday, June 23, 2009
ht newsmax
Statins, noted for reducing cholesterol levels that can increase the risk of heart disease, also can protect nerve cells against brain damage that occurs in patients with Alzheimer's disease, according to new research.
The results of the research of Amalia Dolga of the University of Groningen, The Netherlands, and her co-investigators is published in the June issue of the Journal of Alzheimer's Disease.
High cholesterol levels are a risk factor not only for cardiovascular disease, including stroke, but also for the development of Alzheimer's disease Therefore, many cholesterol-lowering drugs, including statins, have been developed in recent years.
The process that kills nerve cells of patients with Alzheimer's disease is complex, but the cells eventually die because they are strongly overstimulated, a process called excitotoxicity.
Dolga and colleagues overstimulated such nerve cells and clearly demonstrated that treatment with a statin called Lovastatin could prevent the death of nerve cells under these conditions.
The statins not only prevented cells from dying but also prevented the loss of memory capacity that normally occurs after such cell death. In a previous study, Dolga had showed that these statins stimulate the protective capacity of tumor necrosis factor, which is a key player in the brain's immune response.
Dolga has demonstrated in animal experiments that this tumor necrosis factor has a strong beneficial effect on nerve cells and can protect nerve cells against death. A widely prescribed drug like statins can activate this protective pathway revealing strong beneficial effect.
Statins, noted for reducing cholesterol levels that can increase the risk of heart disease, also can protect nerve cells against brain damage that occurs in patients with Alzheimer's disease, according to new research.
The results of the research of Amalia Dolga of the University of Groningen, The Netherlands, and her co-investigators is published in the June issue of the Journal of Alzheimer's Disease.
High cholesterol levels are a risk factor not only for cardiovascular disease, including stroke, but also for the development of Alzheimer's disease Therefore, many cholesterol-lowering drugs, including statins, have been developed in recent years.
The process that kills nerve cells of patients with Alzheimer's disease is complex, but the cells eventually die because they are strongly overstimulated, a process called excitotoxicity.
Dolga and colleagues overstimulated such nerve cells and clearly demonstrated that treatment with a statin called Lovastatin could prevent the death of nerve cells under these conditions.
The statins not only prevented cells from dying but also prevented the loss of memory capacity that normally occurs after such cell death. In a previous study, Dolga had showed that these statins stimulate the protective capacity of tumor necrosis factor, which is a key player in the brain's immune response.
Dolga has demonstrated in animal experiments that this tumor necrosis factor has a strong beneficial effect on nerve cells and can protect nerve cells against death. A widely prescribed drug like statins can activate this protective pathway revealing strong beneficial effect.
Saturday, June 20, 2009
No mention under healthcare about liberty, freedom, the right to live my own life without some government bureaucrat making rules about my health habits. Once the single payer system is in, every rule can be based on my habit costs the system money. Freedom is waning and authoritarian government is growing like wildfire. There is still a chance. When the Republicans return to office, they can fund Medicaid and Medicare with built in delays such as Canada, and assigned physicians. The private care industry should have almost all rules removed so they can compete effectively.
Friday, June 19, 2009
The new Healthcare emphasis scares me a bit. It makes sense to spend money on prevention, except that it won't save a dime. To take a smoker who will die at an early age, of a disease that is uncurable and quick, and transform them into a healthy person, who lives for years, has numerous and expensive treatments over a long life, is a good thing, but it doesn't save money. Also, our best new diagnosis tools are the high tech scanners, and our best strategy is to permit lots of these to drive the price of a scan down. That won't happen.
The key to lowering health care cost is to persuade someone headed to the emergency room for a toothache or an upset stomach to go to a CVS clinic instead. Another key is for all Medicare and Medicaid service to be HMO programs, where unnecessary treatments are not reimbursed.
The final solution to the cost problem is to have a very inexpensive catastrophic very high deductible insurance policy available for everyone
The key to lowering health care cost is to persuade someone headed to the emergency room for a toothache or an upset stomach to go to a CVS clinic instead. Another key is for all Medicare and Medicaid service to be HMO programs, where unnecessary treatments are not reimbursed.
The final solution to the cost problem is to have a very inexpensive catastrophic very high deductible insurance policy available for everyone
Tuesday, June 16, 2009
ht ny times 6-16-09
“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. On the other hand, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”
The association was first made in the early 20th century. In 1924, a Johns Hopkins biologist, Raymond Pearl, published a graph with a U-shaped curve, its tall strands on either side representing the higher death rates of heavy drinkers and nondrinkers; in the middle were moderate drinkers, with the lowest rates. .....Alcohol is believed to reduce coronary disease because it has been found to increase the “good” HDL cholesterol and have anticlotting effects. Other benefits have been suggested, too. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. A report from the Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Researchers have reported that light drinkers are less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.
The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. And the summary was written by him and Marjana Martinic, a senior vice president for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals, The American Journal of Medicine and The American Journal of Cardiology.
In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”
Dr. Fillmore and the co-authors of her analysis posted an online commentary saying the summary had glossed over some of the deep divisions that polarized the debate at the conference. “We also dispute Ellison and Martinic’s conclusions that more frequent drinking is the strongest predictor of health benefits,” they wrote.
Still, some small clinical trials are already under way to see whether diabetics can reduce their risk of heart disease by consuming alcohol. In Boston, researchers at Beth Israel Deaconess Medical Center are recruiting volunteers 55 and over who are at risk for heart disease and randomly assigning them to either drink plain lemonade or lemonade spiked with tasteless grain alcohol, while scientists track their cholesterol levels and scan their arteries.
“But this is a really important question,” he continued. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”
“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. On the other hand, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”
The association was first made in the early 20th century. In 1924, a Johns Hopkins biologist, Raymond Pearl, published a graph with a U-shaped curve, its tall strands on either side representing the higher death rates of heavy drinkers and nondrinkers; in the middle were moderate drinkers, with the lowest rates. .....Alcohol is believed to reduce coronary disease because it has been found to increase the “good” HDL cholesterol and have anticlotting effects. Other benefits have been suggested, too. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. A report from the Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Researchers have reported that light drinkers are less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.
The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. And the summary was written by him and Marjana Martinic, a senior vice president for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals, The American Journal of Medicine and The American Journal of Cardiology.
In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”
Dr. Fillmore and the co-authors of her analysis posted an online commentary saying the summary had glossed over some of the deep divisions that polarized the debate at the conference. “We also dispute Ellison and Martinic’s conclusions that more frequent drinking is the strongest predictor of health benefits,” they wrote.
Still, some small clinical trials are already under way to see whether diabetics can reduce their risk of heart disease by consuming alcohol. In Boston, researchers at Beth Israel Deaconess Medical Center are recruiting volunteers 55 and over who are at risk for heart disease and randomly assigning them to either drink plain lemonade or lemonade spiked with tasteless grain alcohol, while scientists track their cholesterol levels and scan their arteries.
“But this is a really important question,” he continued. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”
Sunday, June 14, 2009
ht http://www.israelnationalnews.com/News/News.aspx/131839
Putting statins out of business?
But the Israeli team finds it could work in heart disease as well: iron corroles are also able to provide reversal effects of arterial sclerosis, or hardening of the arteries, says Gross. With a different mode of action than gallium corroles, "We took mice prone to develop arterial sclerosis and treated them with the same family of compounds. It's a very potent antioxidant," he says. "It's interfering with the process causing arterial sclerosis."
"We already know about green tea, red wine, or pomegranate," he explains, noting that his innovation is better than natural antioxidants that at same stage can also attack vital biomolecules. The therapy was shown to work in successful pre-clinical studies, while the medicinal value of corroles, says Gross, was something his Technion lab initiated 10 years ago.
"We discovered how to synthesize corroles and are the main people pushing forward the fundamentals of science," says Gross, noting the applications are wide and three-fold in catalysis, in medicine, and in renewable energy.
Funding for the research was provided by the United States-Israel Binational Science Foundation, the National Science Foundation in the US, the National Institutes of Health, the US Department of Defense, Susan G. Komen for the Cure, the Donna and Jesse Garber Award, the Gurwin Foundation, and the U.S. Navy Bureau of Medicine and Surgery.
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