Healthcare policy
ddobbs | September 30, 2009
But every version of reform fails to deal with the root cause the uninsurance problem: millions of employers in our "employer-based" system do not provide their workers with health insurance. Why isn't there more discussion about the free rider distortions in that state of affairs?
Instead putting the mandate on employer free riders, the bills now before Congress put it on people with minimal penalties for employers who refuse to provide coverage.
Then, on the subsidy side, the bills offer help only to the poorer of the poor (working, but not on Medicaid). They do nothing for two-earner…
ddobbs | September 29, 2009At Gene Expression, Razib casts a skeptical eye on a study of the neuroanatomical variability of religiosity.
The brain areas identified in this and the parallel fMRI studies are
not unique to processing religion [the study states], but play major roles in social
cognition. This implies that religious beliefs and behavior emerged not as sui generis evolutionary adaptations, but as an extension (some would say "by product") of social cognition and behavior.
May
be something to that, Razib says -- but it would be nice "get in on the
game of normal human variation in religious orientation
(as…
ddobbs | September 22, 2009
Eric Michael Johnson contemplates the hearts, minds, teeth, and claws of bonobos and other primates.
Tara Smith explains why she'll be getting her kids their (seasonal) flu vaccines. Revere does likewise
Daniel Menaker, former honcho at Random House, defends the midlist. (Where was he when my book was getting so much push?)
Just in case you missed it, lack of insurance is killing 45,000 people a year (Times) in the U.S. This doesn't include preventable deaths among the underinsured (like yours truly, who is sitting on some surgery that he'd rather put behind him). You can download the…
ddobbs | September 22, 2009
"One in six patients 'wrongly diagnosed by NHS doctors'," shouts the Daily Mail (via EvidenceMatters. This should not surprise us: Autopsies have been finding a similar percentage of misdiagnosis among the dead for decades. Doctors will always miss some diagnoses. Progress is a matter of ever narrowing the list of things doctors miss -- so the other problems can be diagnosed and treated, letting the patients live longer (till they did of something incurable -- or something we still haven't learned to diagnose. Learn to properly diagnose, say, appendicitis, and you can save the life of a10-…
ddobbs | September 17, 2009
My latest piece for Slate examines the unsettling consequences of the United States' choice of swine flu vaccines.
The good news about these vaccines is that, to judge by the first vaccine trial results, published last week, they appear to work fast, safely â and at about a half to a quarter of the doses that the CDC expected. This means we effectively have about two to four times as many vaccines as we had figured we would. Since we ordered 195 million doses, we could vaccinate damn near the whole country.
If the fast-tracking efforts continue to work and the flu peaks closer to Christmas…
ddobbs | September 17, 2009A couple observers â one on Olbermann, one in a biz publication â think Baucus's plan is so bad, and his dead-end path so disastrous, that it could generate a response that includes either a robust public option or even (longer-term) a single-payer plan.Â
From The 5 Must-Read Takes of Health Care Bill From Baucus at the Atlantic Wire
A 'Gift' for Insurance Industries ... And Maybe for the Public Option? On Countdown with Keith Olbermann, Wendell Potter, the former Vice President of Corporate Communications at health insurance company CIGNA, said the bill was so favorable to his…
ddobbs | September 14, 2009I regret I can't treat at more, um, length, the following weighty matters:
Size Matters; So Do Lies Nate Silver finds that Matt Kibbe, the president of FreedomWorks, speaking of the 9/12 tea party rally in DC, " did the equivalent of telling people that his penis is 53 inches long."
Dr. Nobody Again Questions JAMA Disclosure Policies in which Philip Dawdy and Jonathan Leo, a dangerous combination, butt heads with JAMA
Self-Destruct Button, Activiated! Baucus and Conrad decide maybe Joe Wilson had a point after all. Swine Flu Mystery in Healthy Young Puts Focus on Genetics, Deep Inhaling (…
ddobbs | September 12, 2009
via youtube.com
As Gooznews (h/t) put it, "This says it all."
My own rant will come later.
Posted via web from David Dobbs's Somatic Marker
ddobbs | September 10, 2009
photo: Philip Todeldano for the New York Times
Part of any real healthcare reform will be improving practices in hospitals, and -- as Obama's proposed commission on comparative effectiveness would do -- identifying what works and what doesn't. Knowing what works and why people get better or not is vital to good medicine. But amid the talk on improving such knowledge as part of healthcare reform, a vital and fairly cheap way to generate some of it -- the autopsy -- is going ignored. This is too bad, as autopsies yield incredibly good information about the quality of both diagnosis and…
ddobbs | September 10, 2009This debate has become a test of whom we will trust. Are we going to trust the Republicans, with their predictions of dark disasters that will result from going along with a President they do not believe should be allowed even to speak to our schoolchildren?
Atul Gawande, on Obama's speech, via the New Yorker
ddobbs | September 8, 2009
Matt Taibbi tells us what he really thinks.
Let's start with the obvious: America has not only the worst but the dumbest health care system in the developed world :
via Rolling Stone, and well worth a read.
ddobbs | September 8, 2009From my wanderings. We'll start with the happy stuff
Salmon return to Paris! (photo: Charles Bremner, deep in Paris)
Mind Hacks tours some really old brains.
Zuska speaks wisely of health care reform.
The Guardian serves up some glass viruses (smallpox is pictured above).
Neuroskeptic covers a paper that is both encouraging, in its finding that EEG seems to predict antidepressant response, and infuriating, in that it withholds the information anyone else would need to replicate it. NOT GOOD.
The Wall Street Journal checks out cool tools to track the flu.
ddobbs | September 2, 2009You can't make this stuff up. As PharmaGossip (among others, including the Times) reportst, a drug company pays $2.3 billion in fines to settle charges of unprecedented seriousness about practices that directly put patients at risk, and that came out of a four-year federal investigation. And some yahoo right-winger asserts this fine -- years in the works, unprecedented in scope, settling allegations rising from an investigation that started during the Bush Administration -- is really part of Obama's effort to "federalize" medicine and cut costs.
Here's the video of the DOJ's press conference…
ddobbs | August 11, 2009Massive feature finished, should be in print this November ... but more on that later. By way of returning to blogdom, a few of the few notables I've had time to read lately:
Effect Measure, usually quite restrained about predictions, joins quite a few others in predicting the swine flu will hit us pretty hard this fall. (The U.S. has already had 6,506 hospitalized cases and 436 deaths, despite it not being flu season. And while we've been tracking health-care debacles debates and pondering Palin, the flu has been hitting the southern hemisphere pretty hard.) Now, not later, when you're sick…
ddobbs | July 4, 2009In case you missed them (or miss them, and want to read again ...)
The (Illusory) Rise and Fall of the "Depression Gene"
DIY circumcision with nail clippers Go figure.
Oliver Sacks meets Jon Stewart
Wheels come off psychiatric manual; APA blames road conditions
Alarming climate change chart of the day
Swine flu count in US hits 1 million; can't wait till flu season!
Will government involvement drive up health-care costs?
What if you could predict PTSD in combat troops? Oh, who cares...
ddobbs | July 3, 2009It's been 26 years since health-care reform failed. Does the debate reflect anything that's happened since?
From The Columbia Journalism Review:"The idea that we've made a great breakthrough just isn't so," says Jonathan Oberlander, a health-policy expert at the University of North Carolina. "Most of the plans today are direct descendants of what was proposed for the '93-'94 debate. The debate reminds me of one of my favorite movies, Groundhog Day.
With few exceptions, like the fine series last summer by NPR that explained how a number of other countries handle health care, the press has…
ddobbs | July 3, 2009Opponents of a public health-insurance plan pose two main objections: that it will create an 'unlevel playing field' that will harm the private market for insurance (an odd objection, since that playing field already tilts quite sharply away from patients' pockets and health and toward the wallets of the health-insurance industry); and that government involvement will raise costs.
These objections seem to hold sway to the degree we limit our discussion to what already exists in the U.S. As with squabbles about the problems with our educational (non)system, the picture gets clearer if we…
ddobbs | July 2, 2009An article from the Standard ponders why, despite widespread recognition that the country needs health care reform, we may not get it.The relatively new field of behavioral economics--a blending of psychology and economics--helps makes sense of these clashing views. One major tenets of this sub-discipline is that people value a "loss" about twice as much as they value a "gain." And as a result, people are more risk averse than might be suggested by traditional, rational economic theory. In other words, instead of "rationally" weighing risks and rewards equally and then forming a judgment,…
ddobbs | July 2, 2009What's been distracting me lately from the big story I really really need to finish writing ...
A splendid, rich fracas over Chris Anderson's Free, set off particularly by a pan from Malcolm Gladwell in the New Yorker. The net fairly exploded -- search, and ye shall find -- with many noting that a pot was calling a kettle black. E.g., Itâs like War of the Speakerâs Bureaus and a more gently titled but equally damning (to Gladwell) post by Anil Dash. ,And one young writer accused Anderson of being a feudal lord. Anderson himself has been remarkably unfiltered in his tweet-pointers to reviews,…
ddobbs | June 24, 2009Nate Silver makes George Will clear:
Will's argument is apparently this: The government does not need to make a profit and will have greater leverage with providers; therefore it will deliver the same service for less money. That's unfair!
Is this really the best argument that one of the most prominent intellectual conservatives can mount against the public option?
Post is a bit longish for tweetish attention spans -- but a great exposure of the real objection to public plans (Congressional conflicts of interest notwithstanding), and of why no real competition exists in the insurance…