Blogs / Reality Base

What would happen if the U.S. government announced a new obesity-fighting initiative whereby every chronically obese person in the country was given up to two federally-funded Big Macs a day? That’s basically the plan of attack Switzerland is taking with its heroin addicts. The BBC reports that the Swiss have passed a “radical” health policy that allows long-term addicts to receive the drug at government clinics, free of charge.

A whopping sixty-eight percent of voters supported the policy, which would allow addicts to inject the drug up to twice a day under medical supervision. Granted, the scheme has some benefits: it increases control of needle use and disposal, provides incentives for addicts to come into clinics regularly and be treated for other medical or psychological problems, and removes the need for them to resort to crime to pay for their habit. Part of the bill’s popularity also comes from the fact that the scheme has already been underway in Zurich for 14 years, and many consider it successful.

Still, at the end of the day, the bill is exactly what it sounds like: a plan to have the government pay to shoot its citizens up with expensive and extremely dangerous drugs.

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• The New York Times advises us to approach the Thanksgiving meal “the way a CEO might.” Uhh, not even sure where to start on that one.

• Some good news this holiday: Cancer diagnoses are on the decline.

• The newest in medical technology: A barcode chip that tests your blood for disease.

• The latest in climate change research: A shrimp on a treadmill. Seriously.

• You know it’s bad out there when gaming companies are seeing their stock take a hit.

• And to top it off, the financial crisis hits Google. It’s official: No one is immune.

• Sketchy study finds that more people believe in aliens and ghosts than God. Or perhaps they just think God is an alien?

• And here’s a fun idea in the obesity era: health waivers for Thanksgiving dinner guests. More casserole, anyone?

Newsweek reports that the children displaced by Hurricane Katrina who spent the longest amount of time in government-provided temporary housing—a.k.a. FEMA’s toxic trailers—are “the sickest I have ever seen in the U.S.,” according to Irwin Redlener, Children’s Health Fund president and a professor at Columbia University’s Mailman School of Public Health.

The ailments, according to a study of 261 post-Katrina kids, range from mental health disorders to anemia, and are astonishingly widespread: Forty-one percent of the children are anemic—twice the rate found in minors in New York City homeless shelters—and 42 percent have respiratory infections and other problems likely linked to the excessive formaldehyde in the trailers.

As we’ve discussed on Discoblog, formaldehyde is a probable carcinogen as well as an allergen, and is used in many products, including the wood used to build these disaster homes. The formaldehyde gas levels in FEMA’s trailers were so toxic that Katrina victims began complaining of illnesses, including breathing difficulties, bloody noses, and even gas-linked deaths, almost immediately after they moved into them.

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• Just when you thought it was safe to put the abortion debate to rest: Bush tries to sneak in additional “protections” for hospital employees who don’t wish to perform the procedure.

• Practicing physicians aren’t the only ones on the take from drug companies; now it’s radio hosts as well.

• A new survey finds bad news for China’s soil—and its food supply.

• All that technology love can work both ways: Verizon employees are caught peeking at Obama’s private cell phone records.

• Could HIV prevention come in the form of a pill?

• And are “climate-smart chickens” worthy of their name?

• And finally, one of the best, and most honest, run-downs of what’s really happening with women in science.

Now that the worldwide euphoria over Obama’s victory is abating, it’s time to look at some dismal facts: The air is still thick with pollution, the globe is still warming, and the science community is in a frenzy over who the president-elect will choose to head up the battered, broken EPA.

The short and distinguished list of candidates includes include former Pennsylvania Department of Environmental Protection head Kathleen McGinty; California Air Resources Board chairwoman Mary Nichols; Massachusetts Department of Environmental Protection head Ian Bowles; Kansas governor Kathleen Sibelius; New Jersey environmental commissioner Lisa Jackson; and, finally, environmental lawyer, activist, and prolific blogger Robert F. Kennedy Jr.

While all are talented and have the potential to breathe life into the foundering agency, the one receiving the biggest pounding is Kennedy. Across the Internet, science writers have lambasted the longtime environmentalist for his alleged “anti-science” views—in particular, his public criticism of vaccines.

There’s no question that Kennedy has been vocal in his campaign against the CDC, particularly regarding its stance on Thimerosal, a mercury-based preservative. In 2005, he published a controversial piece in Salon charging that the government had concealed data showing that Thimerosal-containing vaccines were harmful. Critics excoriated the article, and Kennedy has since been labeled a traitor to science and affixed with the anti-vaxer label.

Still, the reality isn’t quite so simple. While Kennedy has indeed pointed accusatory fingers at certain vaccine practices—and has fallen victim to the “hand-picked studies” effect on at least one occasion—the charges that he’s a full-on anti-vaxer are incorrect and arguably irrelevant.

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Not only are doctors becoming increasingly, frighteningly scarce, but they’re also hating life. A recent survey of 11,950 primary care docs and specialists done by the Physicians’ Foundation found that 60 percent would not recommend medicine as a career, while 42 percent said professional morale is either “poor” or “very low.”

The reasons for all this depression can be boiled down to insurance companies and policy headaches:

“The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships.”

Food for thought, Obama? As for all those Medicare cut proposals being thrown around, 82 percent said their practices would be “unsustainable” if pay cuts were made. A whopping 94 percent reported that the time they spend on non-clinical paperwork has gone up in the past three years, with 63 percent saying the paperwork leads to less time spent on each patient.

And of course, there’s the shortage, which is already alive and well: 78 percent of the physicians surveyed believe there’s an existing dearth of primary care doctors, while 49 percent say they plan to reduce the number of patients they see, or even stop practicing over the next three years. Yikes.

Related:
RB: Get Thee to Medical School!

• Transition! Transition! (Insert music here). So here’s the question of the day: Will Obama create a National Energy Council?

• Just in time for winter: A complete history of the flu through the ages.

• The military fought the whales… and won.

• What, “Global Warming Poobah” was already taken? Gore offered (but turned down) job as White House “Climate Czar.”

• We can’t decide if this is heartening (drivers are being safe!) or mortally depressing: California air pollution kills more people per year than car crashes.

• A soldier-blogger gets his moment in the spotlight—though the real question is, what does he think of Trooptube?

It’s inevitable that some laws meant to solve a problem will surprise us with unintended consequences that lead to new, potentially bigger problems. And other laws are just doomed from the start.

Case in point: A report from the International Planned Parenthood Federation finds that more and more countries are criminalizing the spreading of HIV, in a (hopelessly-misguided, destined-to-fail) effort to halt the disease. According to the AP:

Since 2005, seven countries in West Africa have passed HIV laws. In Benin, simply exposing others to HIV is a crime, even if transmission doesn’t occur. And in Tanzania, intentional transmission of the virus can lead to life imprisonment…

In the U.S., 32 states have laws criminalizing HIV transmission. Experts estimate that thousands of people have been charged across the country with spreading HIV.

Since 2001, 16 people in the United Kingdom have been prosecuted for spreading HIV.

Why is this such a bad idea? you may ask. Despite all the medical advances in treating and curbing the spread of HIV/AIDS, there are still an estimated 3 million new cases of HIV a year, and nearly all of them are the result of risky (and therefore preventable) behavior. Shouldn’t those who fail to take precautions be punished for endangering the lives of others?

Well no, not if it means driving said risky behavior underground to avoid criminal prosecution. Which is precisely what is likely to happen, and thereby make things even worse:

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• A new administration, a new direction, and maybe—just maybe—a clean divorce between science and political ideology.

• And of course, the debate has already started: Who will Obama pick to head up the EPA?

• Meanwhile, we’re zooming straight into a “health care perfect storm.”

• Which makes it all the more admirable (or crazy, or excessively symbolic) that Wisconsin Democratic Rep. Steve Kagan has elected to go without health insurance as a gesture of solidarity towards his uninsured constituents. Stay healthy, Steve!

• China demands international action on climate change—let’s just hope they practice what they preach.

• And not to judge or anything, but videos like this one certainly don’t inspire confidence.

• The “net energy” debate gets serious. Is the whole thing a load of bull? We’ll leave it to the experts to decide.

You’d think that recent news about autism—i.e., the increasing amount of definitive evidence proving it’s not linked to vaccines—would be vindication for Paul Offit, the prominent pro-vaccination advocate and medical director of the Vaccine Education Center at The Children’s Hospital of Philadelphia. As you might recall, Offit sounded off earlier this year on the Hannah Poling case, offering an opinion that led to all sorts of name-calling and borderline hysteria.

Now, it appears, the hysteria has made a sharp right into psychosis. ABC News reports that Offit has been receiving death threats (as in, more than one) from anti-vaxers. On a recent “Today Show” appearance, Offit revealed that “the threats [he] received included a ‘phone call from an unidentified man who mentioned specific and private details’ about Offit’s family.”

And he’s not the only one: Flu vaccine advocate Gregory Poland, director of the Mayo Vaccine Research Group at the Mayo Clinic in Minnesota, describes the following:

“Among the most egregious things — I got a letter once railing against my involvement in vaccines and hoping that something serious would happen to me and hoping that something serious would happen to one of my children,” he said. “I had people come to the door of my home and harass my wife and kids, so I no longer have my address listed in the phone book.”

And at one point, Poland said, someone broke into his lab and attempted to hack into his computers. As a result, Poland’s lab is now locked down for security purposes.

Granted, leaders of anti-vax groups respond that they’ve also been the victims of harassment, with taunts like “baby-killer” hurled their way.

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Michael Crichton, one of the world’s most popular authors and a pioneer of modern science fiction, died yesterday at age 66 following a long battle with cancer. His ubiquitous books, including Jurassic Park and The Andromeda Strain, helped elevate science to a new status in pop culture, and ushered new technologies such as cloning into the mainstream. A graduate of Harvard Medical School, he also brought medicine to the forefront of entertainment by creating the TV show “ER,” which won him an Emmy, a Peabody Award, and a Writer’s Guild of America Award.

But while his career was unparalleled and his brilliance unquestionable, Crichton inspired a good deal of controversy concerning a crucial issue: global warming. His skepticism over the threat of climate change was so great that it culminated in a novel, State of Fear, published in 2004. The book, a typical Crichton-style thriller, revolves around an evil environmentalist mastermind who commits terrorist acts to center attention on climate change. It features footnotes, graphs, and other references culled from the three years the author spent researching the topic—all reflecting Crichton’s view that the current rising global temperatures aren’t necessarily a result of human action.

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Just how likely is it that McCain will die of cancer in the next few years? Do a little Web surfing, and you’ll find around a gazillion (and that’s a low estimate) different answers, very few of which rely on clear, unbiased fact. To cut through the jargon and get the real picture, check out my feature story on the truth about the Arizona Senator’s melanoma risk. (Spoiler: It’s low.)

It’s worth noting that not every member of the medical establishment was willing to discuss the Republican nominee’s health. In particular, the communications director of a prominent cancer foundation informed us that if the word “McCain” would be mentioned anywhere in the piece, not a single physician or expert would agree to comment. When pressed, she said that if she set up any interviews for a piece on McCain, even just to talk about melanoma on background without answering specific questions about the Senator’s condition, she would “definitely be terminated.”

So much for the freedom of medicine from political influence (not that we ever really thought it existed).

Related:
RB: The Truth About McCain’s Melanoma: He Faces a Very Low Risk

If you’ve picked up a newspaper, watched a TV, or checked your 401K in the past few months, there’s a near-perfect chance that you’ve experienced the full miasma of fear, anxiety, and helplessness that accompany loss of control. We hate that feeling—it’s a trait embedded in the human condition. And we’ll go to any lengths—including “developing” the ability to talk with the dead, see invisible patterns, and read the stars—in order to avoid it.

Sharon Begley at Newsweek writes that a whopping 90 percent of Americans either think they’ve experienced a paranormal event, or believe that they can happen. And when occurrences—like oh, say, worldwide financial crises—remind us just how futile our desire for order and control really are, our “ability” to see the future in tea leaves by no coincidence begins to rise. As Begley puts it:

Historically, such times have been marked by a surge in belief in astrology, ESP and other paranormal phenomena, spurred in part by a desperate yearning to feel a sense of control in a world spinning out of control.

There’s also the study in this month’s issue of Science finding that lack of control directly increases our “invisible pattern-seeing” ability (or perception of one). People primed with a sense of powerlessness saw more images in static, found more conspiracies in written stories, and imagined more patterns in financial markets than those who were left alone.

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Massachusetts Senator and former presidential candidate John Kerry, former Speaker of the House and conservative icon Newt Gingrich, and Oakland A’s manager and minority owner Billy Beane aren’t a trifecta you’d expect co-penning op-eds in the Times. But co-penning they are, on behalf of a common cause: health care.

Specifically, they’re making the argument that just as baseball has profited from a “data-driven approach” to recruiting and payrolls, we need to up our use of “evidence-based” technology—as opposed to the current practice of “informed opinion”—in the U.S. health care system. The crux of the argument is this:

Remarkably, a doctor today can get more data on the starting third baseman on his fantasy baseball team than on the effectiveness of life-and-death medical procedures. Studies have shown that most health care is not based on clinical studies of what works best and what does not —be it a test, treatment, drug or technology. Instead, most care is based on informed opinion, personal observation or tradition.

It is no surprise then that the United States spends more than twice as much per capita on health care compared to almost every other country in the world—and with worse health quality than most industrialized nations. Health premiums for a family of four have nearly doubled since 2001. Starbucks pays more for health care than it does for coffee. Nearly 100,000 Americans are killed every year by preventable medical errors. We can do better if doctors have better access to concise, evidence-based medical information.

Sound points, all—though many doctors might be less than pleased to hear their careers’ worth of experience described as “informed opinion.” Still, as the doctor shortage looms, the need for databases containing accurate records and medical information will likely become more important than ever. After all, somebody/thing’s gotta keep track of all those boomer hip X-rays.

The American health care rule for prescription drugs is generally: Ask (or just go online) and ye shall receive.

But with an economic meltdown comes serious resource reallocation, and lost jobs and slashed earnings/net worths mean less money to pay for all those Trazodone and Ativan refills. Consequently, as the New York Times reports, consumers are cutting back on prescription drug use in an effort to curb spending. And the effects are already hitting drug companies: Pfizer says that sales of Lipitor, the world’s largest-selling prescription med, has seen sales drop 13 percent in the third quarter, and Merck just announced it’s slashing 7,200 jobs.

Of course, there are plenty of reasons why this is bad:

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