Medicine

Markets in everything: discomfort furniture

by on December 15, 2014 at 1:55 pm in Medicine | Permalink

Sitting for longer than four hours a day increases a person’s chance of suffering chronic disease.

Now, inspired to address the lack of physical activity in modern work life, one French designer believes he might have created the answer.

With just two legs, the ‘Inactivite’ chair relies on the user engaging the muscles in their core to keep it upright.

Benoit Malta, the man behind the creation, said he wanted to encourage movement for those office workers who spent around 70 per cent of the day sitting down.

There is video and further description at the link, and for the pointer I thank Mark Thorson.

*Do No Harm*

by on December 12, 2014 at 1:35 am in Books, Medicine, Science | Permalink

I loved this book, which is written by a neurosurgeon with a knowledge of behavioral economics (he even has designed a talk  “All My Worst Mistakes,” based on Daniel Kahneman’s work).  The subtitle is Stories of Life, Death, and Brain Surgery and the author is Henry Marsh.  Here is one bit:

…as the brain has the consistency of jelly a sucker is the brain surgeon’s principal tool.

Here is another:

All that really matters is that I am as sure as I can be that the decision to operate is correct and that no other surgeon can do the operation any better than I can.  This is not as much of a problem for me now that I have been operating on brain tumours for many years, but it can be a moral dilemma for a younger surgeon.  If they do not take on difficult cases, how will they ever get any better?  But what if they have a colleague who is more experienced?

And another:

Few anaesthetists believe what surgeons tell them.

How about this one?:

‘There are operations where one really doesn’t know what’s going to happen,’ I muttered to Mike.

Highly recommended, it is already out in the UK, in the U.S. coming out in May 2015.  It has made many best of the year lists in the UK.  Here are some related videos.

Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report.

“Half of providers could not offer appointments to enrollees,” the investigators said in the report, which will be issued on Tuesday.

Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services. The study raises questions about access to care for people gaining Medicaid coverage under the Affordable Care Act.

That is from Robert Pear, there is more here.  And about one-quarter of actual providers had wait times of over a month.  Once again, it is the supply-side problems in American medicine which are paramount.

Some of the White House economists were dubious and privately called Mrs. Clinton’s health care team “the Bolsheviks.” In return, according to Ms. Rivlin, the economists were “sometimes treated like the enemy.” Their suggested changes were ignored. “We could have beaten Ira alone,” said Mr. Blinder. “But we couldn’t beat Hillary.”

There is more here from the NYT, mostly about Hillary, not about that episode.

The mainland – which has long been criticised by international human rights groups for using organs harvested from executed prisoners as its main source of organ transplants – will completely ban the practice from next year.

All organs used in future transplants must be from donors, the Southern Metropolis News quoted Dr Huang Jiefu as saying. Huang is former deputy director of the health ministry and director of the China Organ Donation and Transplant Committee.

Major transplant centres had already stopped using executed prisoners’ organs, said Huang, who chaired an industry forum in Kunming on Wednesday.

There is more here, via Mark Thorson.  The article notes China has one of the lowest voluntary organ donation rates in the world.  0.6 individuals out of a million sign up to donate their organs after they die, and that means the number of actual donors is lower yet.  If you google around, you will find some ambiguity as to whether the donation rate or the “register to donate rate” is that low, but as far as I can tell (try this Chinese source) it is the actual register to donate rate, in part because they just aren’t many ways to register right now.  Please let us know if you have additional information on this point.

Wikipedia by the way reports:

The wait times for organ transplants for organ recipients in China are much lower than elsewhere in the world, and there is evidence that the execution of prisoners for their organs is “timed for the convenience of the waiting recipient.

Here are some of Alex’s earlier posts on a market for transplanted organs.

The value of an NFL roster spot

by on December 5, 2014 at 2:03 am in History, Medicine, Sports | Permalink

One of the most self-sacrificing—read: craziest—players from that era, Jack Youngblood, played through the 1979 playoffs and 1980 Pro Bowl with a broken leg. (That’s right: he played through a severe injury in the Pro Bowl). Last year, Youngbloodtold the New York Post that guys who missed time with an injury back then didn’t just have to explain themselves to their untrusting employers—they had to explain themselves to their own teammates. Rather than fake injuries to swindle their way into bogus workers’ compensation claims, it has always been much more common for NFL players to fake health.

In the same New York Post story, Antrel Rolle says he hid not one, but two rotator cuff tears from team doctors. In 1974, the team doctor for the Los Angeles Rams told the Washington Post that he’d learned to check both legs for injuries because limping players liked to trick him by presenting the wrong one. The marginal guys, it is generally understood, are the most likely to fake good health, knowing how tenuous their hold on a roster spot can be.

Most of the rest of the quite interesting article details a case of a player who was administered truth serum in 1986.  The full article, by Andrew Heisel, is here.

This passage is from Gao Wenqian’s Zhou Enlai: The Last Perfect Revolutionary:

Doctors in China could not conduct major medical procedures on top leaders without the approval of the Politburo Standing Committee.  Such was the long-standing rule.  Thus, in 1975, Deng Ziaoping and Marshal Ye Jianying, leaders among the old CCP cadres who had generally despised the Cultural Revolution and had shown little enthusiasm for the political style of the mercurial Jiang Qing, now had to negotiate emergency surgery for Zhou Enlai with her allies Wang Hongwen and Zhang Chunqiao.  For once, these tough political adversaries managed to see eye-to-eye.  They all gave their consent to surgery and sent their decision to Mao, who always had the final say.

Zhou Enlai had four operations before dying of cancer.  For the last two operations, however, Mao instructed the doctors to tell Zhou that in fact he was being cured and the tumors were removed.  He ceased to believe that when the unbearable pain arrived.

Is it up to three cynical tapes about Obamacare now?   I’ve lost track.

I’m not so interested in pushing through the mud on this one.  It’s a healthy world where academics can speak their minds at conferences and the like without their words becoming political weapons in a bigger fight.  Or how about blogs?: do we want a world where no former advisor can write honestly about the policies of an administration?  I’ve disagreed with Gruber from the beginning on health care policy and I thought his ObamaCare comic book did the economics profession — and himself — a disservice.  But I’m simply not very interested in his proclamations on tape, which as far as I can tell are mostly correct albeit overly cynical.  (If anything he is overrating the American voter — most people weren’t even paying close enough attention to be tricked.)  Criticisms of Gruber are not criticisms of a policy, and it is policy we should focus upon and indeed there is still a great deal of health care policy we need to figure out.  It’s hardly news that intellectuals who hold political power, even as advisors, very often do not speak the truth.  If anything, I feel sorry for Gruber that he has subsequently felt the need to so overcompensate by actively voicing such ex post cynicism, it is perhaps the sign of a soul not at rest.

In the meantime, I’d like to see more open discourse, not less.  Perhaps we should subsidize people who end up looking foolish, rather than taxing them.

Scott Sumner directs us to this passage from Michele Martinez Campbell:

A fascinating new national poll from Quinnipiac University shows that men and women disagree markedly on the question of marijuana legalization.  While men surveyed strongly favor legalization by a margin of 59 to 36 percent, women oppose it by a clear majority of 52-44 percent.  This 15-point gender gap in support for marijuana legalization –let’s call it the “pot gender gap” — is not quite as large as the 20-point gender gap in support for President Obama in the 2012 presidential election, but it is striking.  What’s most interesting, though, is how it confounds the expectations set by the voting gender gap.  In voting, women trend more liberal and Democratic, while men trend more conservative and Republican.  Yet with the pot gender gap, we see women taking the more conservative, law-and-order approach.

The article is here, Scott’s post, with commentary, is here.

Here is the new paper by Michael Reay in Social Forces:

Analyses of the multiple cognitive structures and social effects of humor seldom look at why these tend to center on particular topics. The puzzle of how humor can be highly varied yet somehow constrained by its source “material” is explored using a corpus of over 600 incidents, not of deliberate jokes, but of the “wilder,” unplanned laughter that occurred during a set of interviews with economists—professionals who at the time (1999–2000) enjoyed an unprecedented degree of status and influence. The analysis finds that the source material for this laughter typically involved three kinds of socially structured contradiction: between ideals and reality, between different socially situated viewpoints, and between experiences occurring at different times. This illustrates how particular kinds of content can have a special laughter-inducing potential, and it suggests that wild laughter may at root be an interactional mechanism for dealing with social incongruity—even for members of relatively powerful groups. It is argued that this could not only help solve the larger puzzle of simultaneous variety and constraint in deliberate comedy, but also explain why the characteristic structures of humor are associated with a particular range of social effects in the first place.

Reading that abstract caused me to engage in some unplanned (silent) laughter.

For the pointer I thank the excellent Kevin Lewis.

From Diana Carew at the Progressive Policy Institute:

…the number of ‘restrictions’ on drug companies increased by 767, or 40% since 2000. This represents a substantial rise in the overall regulatory burden of pharmaceutical companies, which must allocate resources to ensure regulatory compliance. The word “restriction” refers to command clauses such as “shall” and “must,” as contained in sections of the Code of Federal Regulations related to the FDA.

The full study is here (pdf).

I don’t myself care about the event, I just liked the headline.

A related study is here, and I thank CK for the pointer.

Sentences to ponder

by on October 30, 2014 at 7:28 am in Current Affairs, Medicine | Permalink

Here is Jody Lanard and Peter M. Sandman on the risks of an Ebola pandemic in the developing world:

The two of us are far less worried about sparks landing in Chicago or London than in Mumbai or Karachi.

Do read the whole thing, via Andrea Castillo.

Loren Adler and Adam Rosenberg report:

…the disproportionate role played by prescription drug spending (or Part D) has seemingly escaped notice. Despite constituting barely more than 10 percent of Medicare spending, our analysis shows that Part D has accounted for over 60 percent of the slowdown in Medicare benefits since 2011 (beyond the sequestration contained in the 2011 Budget Control Act).

Through April of this year, the last time the Congressional Budget Office (CBO) released detailed estimates of Medicare spending, CBO has lowered its projections of total spending on Medicare benefits from 2012 through 2021 by $370 billion, excluding sequestration savings. The $225 billion of that decline accounted for by Part D represents an astounding 24 percent of Part D spending. (By starting in 2011, this analysis excludes the direct impact of various spending reductions in the Affordable Care Act (ACA), although it could still reflect some ACA savings to the extent that the Medicare reforms have controlled costs better than originally anticipated.) Additionally, sequestration is responsible for $75 billion of reduced spending, and increased recoveries of improper payments amount to $85 billion, bringing the total ten-year Medicare savings to $530 billion.

The full piece is here, via Arnold Kling.

Ebola plush toys have been selling so fast in response to this year’s outbreak that a Connecticut manufacturer, Giantmicrobes Inc., can’t keep them in stock.

The company, which was founded a decade ago, makes stuffed toys based on the appearance of microbes like Ebola, Chicken pox, bed bugs, and even non-harmful microscopic organisms things like brain and red blood cells.

The items are meant to be educational tools for young children, Laura Sullivan, vice president of operations, told CBS News.

There is more here, and for the pointer I thank James Lynch.  Via Tim Harford, here is GiveWell on whether you should donate to Ebola response causes.  Here is how Nigeria and Senegal beat back Ebola, let’s hope we can do the same.  It is a good example of how developing economies can innovate based on cheap labor costs and lots of available labor resources.