Monday, July 21, 2008
The New York Times reports on a new experiment by federal and state government agencies as well as many insurers around the country that propose to cut health costs by paying doctors more. Milt Freudenheim writes,
Cutting health costs by paying doctors more?
That is the premise of experiments under way by federal and state government agencies and many insurers around the country. The idea is that by paying family physicians, internists and pediatricians to devote more time and attention to their patients, insurers and patients can save thousands of dollars downstream on unnecessary tests, visits to expensive specialists and avoidable trips to the hospital.
Writing for the New York Times, Tyler Cowen suggests that cutting back payments to the relatively wealthy is a more efficient way to allocate government benefits. For health care costs, this could be done by expanding Medicaid and making it an entirely federal program, and also by limiting Medicare. Cowen writes,
Right now, the United States is in the midst of a financial crisis, but even more pressing problems may lie ahead — and the presidential candidates aren’t addressing them.
No matter who sits in the Oval Office next year, there won’t be many degrees of freedom in the federal budget. That’s because spending on entitlement programs is largely locked into place, and the situation will become much worse as Americans age and health care costs rise. Even if the government is conservative in its spending, just paying out promised benefits implies that tax rates will rise to a crushing level — a range of 60 to 80 percent of income — well before the end of this century.
The main problem is Medicare, which reimburses the elderly for many of their health care expenses. As Mark V. Pauly, professor of health care systems at the University of Pennsylvania, has said, “Medicare as we know it today cannot be sustained over the next 50 years and probably will run into financial difficulties within the next 15.”
Time magazine reports on a Canadian study finding that 90% of foods professed to be healthy for children did not meet established nutritional standards. Kathleen Kingsbury writes,
Most parents already know that sugary sodas and greasy potato chips are not the healthiest food choices for children. But what about the hundreds of other widely available and kid-friendly packaged foods — pastas, frozen dinners, granola bars — that at least appear to be more wholesome?
A new Canadian study suggests that even these foods — most of which make nutritional claims on their packaging — aren't all they profess to be. University of Calgary researchers analyzed the nutritional benefit of more than 360 such products, often marketed as "fun foods," which are aimed at children either through kid-friendly package graphics or tie-ins with children's TV shows and movies. Three-quarters of these foods, for example, came in packages bearing cartoon images. Researchers did not include junk food in their analysis, but they found that nearly 90% of kid products still did not meet established nutritional standards. What's more, 62% of the foods that researchers deemed to be of "poor nutritional quality" made positive nutritional claims on the package — such as being low-fat, containing essential nutrients or being a source of calcium. "If a parent sees a product that makes specific nutritional claims, they may assume that the whole product is nutritious," says author Charlene Elliott, a communications and culture professor at the University of Calgary. "Our study has shown that that is definitely not true in the vast majority of cases."
The Los Angeles Times reports on the toll the salmonella scare had on consumers and the agricultural industry with tomatoes: It cost the industry about $100 million and left people questioning the safety of foods. Ricardo Alonso-Zaldivar writes,
The tomato scare may be over, but it has taken a toll — it's cost the industry an estimated $100 million and left millions of people with a new wariness about the safety of everyday foods.
An Associated Press-Ipsos poll finds that nearly half of consumers have changed their eating and buying habits in the past six months because they're afraid they could get sick by eating contaminated food.
They also overwhelmingly support setting up a better system to trace produce in an outbreak back to the source, the poll found.
Sunday, July 20, 2008
The Washington Post reports that doctors in South Dakota must now tell women seeking an abortion that they will terminate a "unique living human being." The Court of Appeals for the 8th Circuit last week lifted a preliminary injunction that prevented the language from taking effect. Peter Slevin writes,
In a victory for antiabortion forces, doctors in South Dakota are now required to tell a woman seeking an abortion that the procedure "will terminate the life of a whole, separate, unique living human being."
The Chicago Tribune reports on how consumers will be affected regarding the recent cigarette tax increase in New York. Lisa Anderson writes,
If you think it's expensive to visit New York City, it's become even pricier to light up here.
The Big Apple now carries the nation's highest-priced cigarettes: $10 a pack, more than twice the nation's average price of $4.22. In Chicago it's about $7.50 a pack. But New York also boasts a lower proportion of adult smokers than the rest of the country — 17.5 percent compared with 19.7 percent nationally.
When it comes to smoking, apparently money talks. Dr. Thomas Frieden, the city's health commissioner, certainly thinks so. After a decade in which smoking prevalence stayed the same, the city's smoking rate dropped 21 percent among adults and 52 percent among public high school students in the five years following cigarette tax increases in 2002. Following last month's addition of a new state cigarette tax of $1.25 a pack, Frieden expects more of the city's 1 million smokers to quit.
US News reports on how some neurologists are prescribing music for conditions from Parkinson's and Alzheimer's to stroke and depression. Matthew Shulman writes,
Rande Davis Gedaliah's 2003 diagnosis of Parkinson's was followed by leg spasms, balance problems, difficulty walking, and ultimately a serious fall in the shower. But something remarkable happened when the 60-year-old public speaking coach turned to an oldies station on her shower radio: She could move her leg with ease, her balance improved, and, she couldn't stop dancing. Now, she puts on her iPod and pumps in Springsteen's "Born in the U.S.A." when she wants to walk quickly; for a slower pace, Queen's "We Are the Champions" does the trick.
Music therapy has been practiced for decades as a way to treat neurological conditions from Parkinson's to Alzheimer's to anxiety and depression. Now, advances in neuroscience and brain imaging are revealing what's actually happening in the brain as patients listen to music or play instruments and why the therapy works. "It's been substantiated only in the last year or two that music therapy can help restore the loss of expressive language in patients with aphasia" following brain injury from stroke, says Oliver Sacks, the noted neurologist and professor at Columbia University, who explored the link between music and the brain in his recent book Musicophilia. Beyond improving movement and speech, he says, music can trig ger the release of mood-altering brain chemicals and once-lost memories and emotions.
Parkinson's and stroke patients benefit, neurologists believe, because the human brain is innately attuned to respond to highly rhythmic music; in fact, says Sacks, our nervous system is unique among mammals in its automatic tendency to go into foot-tapping mode. In Parkinson's patients with bradykinesia, or difficulty initiating movement, it's thought that the music triggers networks of neurons to translate the cadence into organized movement. "We see patients develop something like an auditory timing mechanism," says Concetta Tomaino, cofounder of the Institute for Music and Neurologic Function in New York City. "Someone who is frozen can immediately release and begin walking. Or if they have balance problems, they can coordinate their steps to synchronize with the music," improving their gait and stride. Slow rhythms can ease the muscle bursts and jerky motions of Parkinson's patients with involuntary tremors.