Washington Post

How Obama Would Cut Medicare and Medicaid

April 14th, 2011 | 2 Comments | Source: MedPageToday, Washington Post

Yesterday, President Obama finally entered the debate about the national debt with a proposal to reduce US government borrowing by $4 trillion over the next 12 years. The proposal called for higher taxes on rich folks as well as deep cuts in military and domestic spending, including Medicare and Medicaid.

But unlike an earlier proposal by Representative Paul Ryan (R-Wisconsin), the Big O’s plan did not include making fundamental changes to the 2 US health entitlement programs, nor did it scale back the primary objective of the health reform law passed last year (the Affordable Care Act, or ACA), which is to provide health-care coverage for millions of uninsured Americans.

“We don’t have to choose between a future of spiraling debt and one where we forfeit investments in our people and our country,” he said. “To meet our fiscal challenge, we will need to make reforms. We will all need to make sacrifices. But we do not have to sacrifice the America we believe in. And as long as I’m president, we won’t.”

Ryan’s plan calls for Medicare beneficiaries to select from a pool of private insurance programs, and for the feds to pay a fixed amount of premium funds to the insurer chosen by each beneficiary. Additional costs would have to be borne by the beneficiary.

The president’s plan calls for $480 billion in cuts to Medicare and Medicaid by 2023, and a beefed-up role for the Independent Payment Advisory Board (IPAB), the new independent panel formed by the ACA as a watchdog against health cost escalations.

Responding to the Ryan proposal, Obama said, “Let me be absolutely clear: I will preserve these healthcare programs as a promise we make to each other in this society. I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs.”

The cornerstone of Obama’s proposal was a provision that empowers the IPAB to make cost reduction recommendations to Congress in the event that Medicare costs grow faster than the per-capita Gross Domestic Product plus 1%. The provision requires that these recommendations must not impede beneficiaries’ access to appropriate services. Now, Congress wouldn’t have to follow the advice from the IPAB. It could institute its own solution so long as it achieved the target reductions. In the event that Congress failed to act however, the Secretary of HHS would be required to develop and implement a plan that hit the target. (more…)



Like ’em or not, Red Light Cameras Save Lives

March 9th, 2011 | No Comments | Source: Washington Post

Most people don’t like them. Privacy advocates abhor them. But really, how many things can you name that save lives AND generate revenues for cash-strapped local and state governments?

Red light cameras are one such item.

A recent study by the Insurance Institute for Highway Safety has shown that red light cameras saved 159 lives over a 4-year period in the 14 large US cities where the study took place.

The scientists claimed that more than 800 traffic fatalities would have been prevented during the course of the study if the cameras had been deployed in all large US cities.

The scientists compared fatal car crash rates in US cities with populations of at least 200,000 for two 4-year periods: 1992-1996 and 2004-2008. They excluded cities that had already deployed red light cameras in the earlier period, and cities that instituted cameras during the later period.

In the 14 cities that used red light cameras during 2004-08, the rate of fatal red light running crashes was 35% lower than in 1992-96. The crash rate did drop in cities that never deployed camera programs, but only by 14%.

Based on these data, the scientists determined that the rate of fatal red light running crashes was 24% lower in cities with cameras in 2004-08 than it would have been had they not deployed the cameras.

In fact, the benefits of red light cameras were actually larger than this. The rate of all fatal crashes at intersections with signals (not just red light running crashes) dropped by 14% in cities that deployed red light cameras, whereas it increased by 2% in other cities. (more…)



Can Pets Improve Your Health?

February 10th, 2011 | 1 Comment | Source: Pediatrics, Washington Post

Most people accept that pets can make the home a more inviting, relaxed place to be. Owners enjoy uncomplicated relationships with their pets, and unlike most humans, pets provide unconditional love and support. But can a pet actually improve your health?

A pioneering, 1980 study by Erika Friedmann, then of Brooklyn College, suggested this was indeed the case. Friedman and colleagues showed that people with “animal companions” had significantly improved one-year survival following discharge from a coronary care unit. Moreover, the survival benefit was not attributable to increased exercise associated with, say, walking a dog. Instead, it appeared to be driven by improved psychological functioning and reduced levels of stress.

Several recent studies support Friedmann’s observation. For example, a 2002 study by Karen Allen’s group at the University of Buffalo showed that pet owners had lower resting heart rates and blood pressure levels, and smaller rises from baseline levels when they were exposed to stress-producing situations. Furthermore, the stress-related rises in these parameters were blunted to the greatest extent when pets were present during the stressful situations.

Other studies have shown that pets seem to reduce annual visits to the doctor, and are associated with a lower incidence of obesity.  In addition, preliminary studies suggest a link between pet ownership and higher circulating levels of oxytocin, a hormone that directly counteracts the effects of stress-related hormones. These findings, if validated, would help provide a physiological explanation for the proposed link.

However, many studies have reached the opposite conclusion. For example, Australian scientists recently reported that pet ownership, particularly cat ownership, was associated with increased cardiac morbidity and mortality in the year following hospital admission for acute coronary syndrome. Another study suggests that cat ownership significantly increases the risk for developing eczema in kids who are allergic to cats. Beyond this of course, is the obvious increase in the risk for sustaining animal bites, and the rare but real risk that the pet owners will contract diseases like toxoplasmosis and cat scratch fever from their pets. (more…)



Tears Send Sexual Message

February 9th, 2011 | No Comments | Source: NY Times, Science, Washington Post

Humans are the only living things that cry when they are overcome with emotion. Why do we do this?

A study by Noam Sobel and colleagues at the Weizmann Institute provide part of the answer, at least as it relates to women. The scientists showed that when men get a whiff of women’s tears, they experience a temporary, generalized loss of libido and a dip in testosterone. Really.

(And you thought that red, runny nose was the turn-off, didn’t you?)

Scientists have known for decades that the chemical composition of “emotional tears” differs from tears shed due to simple irritation. But now, it appears that some of the chemicals contained in the former are actually pheromones; biological substances that create behavioral changes in others who are exposed to them. Such chemicals were known to exist in urine in anogenital gland secretions (dont ask), but not in tears.

Sobel’s team began its study by posting ads on Israeli college campus bulletin boards in which they sought volunteers who cried easily. Seventy-one people responded. All but one were women. From that group, the scientists identified 6 who were, like, seriously profuse criers and who could return to their labs every other day.

The scientists then asked each one to select a movie that was guaranteed to make them break down, to watch it in private, and to collect their tears in a vial. For the controls, Sobel’s group trickled a saline solution down the same women’s cheeks and collected that.

Sobel’s group subsequently asked male volunteers to sniff the contents of the 2 vials and ran a battery of psychological and physiological tests to measure their responses.

The men could not distinguish the odorless, colorless liquids, but boy oh boy did their responses differ! In one study, men rated women in photos as less sexually attractive after sniffing “emotional tears” than after they sniffed the saline solution. In another study, men watched scenes from a sad movie after sniffing either the real stuff or saline. They were equally sad regardless of which mixture they sniffed, but the tear-sniffers had lower sexual arousal and lower testosterone levels. (more…)


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Too Drunk to Drive? There’s a Car for That

February 2nd, 2011 | No Comments | Source: Washington Post

Drunk driving continues to be a serious problem. In 2009 for example, alcohol was a factor in more than 10,000 highway deaths. The same year, a stunning 10% of respondents to a survey of US adults said they had operated an automobile while drunk during the previous year. Nearly 6% said they had done it more than once.

So how would you feel about a car that can instantly detect whether a driver is drunk and prevent that person from starting the car?

You better make up your mind quickly, because scientists are close to perfecting this technology.

“We’re five to seven years away from being able to integrate this into cars,” Robert Strassburger, the VP for safety at the Alliance of Automobile Manufacturers told the Washington Post. The AAM, an automotive trade group, is on the development team for the new technology which is being spearheaded by the Automotive Coalition for Traffic Safety and National Highway Traffic Safety Administration.

The anticipated sensing device will look nothing like the breathalyzer machines currently used by police in the field. Instead, it will be comprised of tiny, passive, touch-sensitive sensors that are permanently affixed to a key fob or a starter button. The sensors can determine blood alcohol levels in seconds.

From a technical standpoint, the biggest challenge is to craft a sensor that analyses and responds to tactile information within about a third of a second. Current versions of the sensor take 20-30 seconds to do this. Team members are confident however, that advancements in solid-state electronics and infrared technology will help them achieve their goal.

After that lies the most nettlesome problem of all. Will car buyers purchase vehicles with these devices? Obviously, cost will be a concern, but more important will be the fears people have that the newly empowered vehicles will prevent them from driving home after enjoying a drink or two. (more…)



New Superbug Alert

December 3rd, 2010 | 1 Comment | Source: Washington Post

Scientists have discovered a new, highly transmissible gene that could, quite easily in fact, open a frightening new front in the ongoing global war against superbugs.

The antibiotic resistance gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections and blood stream infections.

NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.

The gene has been identified in 3 US patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists,” that is, people seeking less expensive medical care in India.

“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.”

The NDM-1 gene does not appear to be transmitted by coughing or sneezing, but rather through exposure to contaminated sewage, water and medical equipment. Inadequate hand-washing also likely plays a role. The CDC has advised doctors to look for it and isolate patients that have it.

The scientists who discovered NDM-1 warned that it had become endemic in many areas of India and Pakistan.

“What we saw (in south-Asian hospitalized patients) is the tip of the iceberg,” Timothy Walsh, a Cardiff University professor of microbiology told the Post. “For every person in the hospital, you can imagine there are a vast majority of people out there carrying NDM around.”

Meanwhile, the Indian government denounced the news as a scare tactic designed to discredit the nation’s exploding medical tourism industry. That industry attracts 450,000 patients per year and will likely generate $2.4 billion in revenue in 2012.



Biotech Grant Program: Are a Few Crumbs Better Than No Crumbs At All?

November 17th, 2010 | No Comments | Source: Washington Post

After assuming control of the House in the mid-term elections, Republicans vowed to eviscerate the Affordable Care Act, the health reform law signed by the Big O last March. Thank heavens therefore, that the Boehners were too busy congratulating themselves to even notice those federal helicopters dumping $1 billion in cash on some needy biotech companies just as the election results were being tallied.

Yep, it happened. Federal disbursements in the form of grants and tax credits were made last week, as required by a provision in the reform law known as the Qualifying Therapeutic Discovery Project Program. According to the terms of this Program, biotech and life sciences companies with less than 250 employees could apply for federal funds to cover research costs they had incurred in the last 2 years, so long as the research focused on the prevention, diagnosis and treatment of chronic diseases.

The Program amounted to nod by the Feds to biotech and life sciences, 2 industries that had been battered to near oblivion by the Great Recession of 2008-2010. Biotech and life sciences fared worse than most industries because the core of their business, research and development, consumes enormous capital early-on and there are long delays before these projects hit pay-dirt–if they ever do. Early-stage companies in these industries are therefore high risk investments, the sort VCs steer clear from when the going gets tough.

Unfortunately for the targeted industries, the Program turned out to be a small nod, indeed. It attracted 5,600 applications, far more than expected, and by rule all 4,600 that met congressional requirements had to be funded. With the pool capped at a bil, qualifying projects attracted far fewer dollars than requested.

The maximal allowed disbursement was supposed to be $5 million per project. As it turned out, no project received more than $244,000 (some firms received more than this because they submitted proposals for multiple projects). 

The grant requests were reviewed by the National Institutes of Health and Internal Revenue Service. “It was an indication of the great opportunity and interest that there were so many applications received,” NIH Director Francis Collins told the Washington Post.

“Of course, with a $1 billion total amount of money available and with so many of the applicants being judged appropriate for this program, it was not possible to make awards as large as $5 million.”

The Fallout
Biotech CEOs are thankful for the pittance, but they’re back on the street, in search of serious cash. For many of them, it’s already too late.

The Pelosis are kicking themselves for not allocating more than $1 billion to fund the Qualifying Therapeutic Discovery Project Program in the first place. It’s the same mistake they made with the stimulus package–they underfunded that one too, by golly.

The Boehners, are, arms crossed, not permitting any more “government handouts” like this. Not on their watch. It doesn’t matter that biotech and life sciences are among the few industries in which the US maintains a competitive advantage over international economic rivals. It doesn’t matter that firms in these industries can serve as a legitimate source of job creation for decades to come…if only they can survive the Great Recession and that may only happen with, you guessed it, federal support.

A right-minded idea, yet it seems nobody’s happy with the outcome. Back to the drawing board!


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Obesity Drug Woes Continue

November 16th, 2010 | No Comments | Source: MedPageToday, Washington Post

Amid the burgeoning worldwide epidemic of obesity, scientists and pharmaceutical companies have spent hundreds of millions of dollars to develop drugs to help people lose weight. The effort has failed spectacularly so far, and 2 recent setbacks have fueled increasing pessimism that things will change for the better anytime soon. 

The first setback occurred last month when the FDA put the kibosh on Arena Pharmaceuticals’ New Drug Application for lorcaserin, an investigational weight loss drug. In rejecting the application, the FDA  cited several concerns including low efficacy and the results of animal studies which suggested that it increased the risk of breast cancer.

In its letter to the San Diego-based drug company, the FDA said “the weight loss efficacy of lorcaserin in overweight and obese individuals without type 2 diabetes is marginal.” The letter also said the regulatory agency needed more information from a study that is now underway before considering the matter further, and that if Arena could not provide data to “alleviate concern regarding clinical relevance of the tumor findings in rats, additional clinical studies may be required to obtain a more robust assessment of lorcaserin’s benefit-risk profile.”

The FDA’s snub of lorcaserin was followed in short order by an announcement by Abbott Laboratories that it was withdrawing the diet drug Meridia from the market. Abbott’s decision was prompted by FDA findings that showed the drug’s limited efficacy was outweighed by significant risks associated with the drug.

Meridia had long-since been known to increase blood pressure, but the death knell came in the form of a European study which showed it was associated with a 16% increased risk of cardiovascular problems including heart attacks, strokes and death.

Nearly 100,000 Americans take Meridia at the moment. The FDA advised all of them to stop taking the drug, and instructed physicians to stop prescribing it. European regulators had taken Meridia off the market in January.

“It’s been very frustrating,” Jennifer Lovejoy, the incoming president of the Obesity Society told the Washington Post. “We desperately need safe new drugs so we can begin to have something effective against this public health epidemic.”

Meanwhile, experts continue to emphasize that the best way to stay healthy is to avoid gaining weight in the first place by eating well and exercising regularly…


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Income Inequality: The Campaign Issue Nobody Talks About

November 1st, 2010 | No Comments | Source: Washington Post

Last month, House Republicans released a “Pledge to America” which outlined the agenda they’d push if they won back control of the chamber in tomorrow’s mid-term elections. The agenda covered a wide range of social issues, but its primary focus was the nation’s economy.

The Pledge called for a permanent extension of Bush-era tax cuts and renewed efforts to balance the budget and reduce the national debt. It promised to prevent any further allocations that had been set-aside by the economic stimulus bill of 2009, and so forth. One thing it didn’t address however, was our nation’s appalling rise in income inequality over the last 40 years.

This is a glaring oversight, since income inequality poses an enormous threat to our economy and indeed our nation’s ability to remain competitive on a global scale.

According to studies by Thomas Piketty and Emmanuel Saens, nearly 50% of our nation’s pretax income is accumulated by the top 10% of earners. Between the end of World War II and 1976, a period many consider to have been the “golden era” for the US economy, the top 10% of earners made less than one third of the nation’s income.

And income growth among the nation’s top 1% of earners was responsible for nearly all of this shift. In 2007, the top 1% of earners copped 23% of the national income. This kind of skew is reminiscent of what we see in third-world economies.

Why does income inequality reduce our global competitiveness and impede our prospects for long-term economic growth? The Washington Post’s Steven Pearlstein suggests there are 2 reasons.

First, concentrating wealth into the hands of so few people leads to spectacularly unproductive spending patterns. The super-rich buy art and fancy cars, overpay to get their kids into private schools and prestigious universities, employ the services of high-end hairdressers and landscape architects, and bid up prices for real estate in trendy spots like the Upper East Side of Manhattan and so forth. These things do not create sustainable economic growth on a national scale. The super-rich also invest in hedge funds and other arcane financial vehicles which drive speculative financial bubbles including the ones for junk bonds in the ’80s, Web and technology stocks in the late ’90s and yes, the calamitous credit bubble from which we have yet to recover.

That’s not the biggest problem, however. The biggest problem is that marked income inequality subverts the unity of purpose that is necessary for any nation, indeed any company to thrive over the long haul. It’s just common sense that people won’t work hard, make sacrifices or take risks when they see rewards flowing to others.

Ironically, Republicans who authored the Pledge to America use a similar argument to defend tax cuts for the super-rich, yet they look the other way when the subject turns to the incomes of everybody else.

The causes of accelerating income inequality in the US are many. Technological advancements have radically altered the labor market to favor people fortunate enough to have received advanced degrees, but our educational systems don’t produce enough such employees. Globalization and multi-national corporate structures assure that goods are produced where labor is the cheapest, and that will never again be in the US. Unions have lost much of their power. The deregulation of the private sector assures an unfair playing field for less skilled workers. And then of course, there’s been a pernicious change in social norms towards a culture that accepts widening income inequality in the first place.

Republicans—and all politicians actually—should not forget that rising income inequality is a central problem facing our economy right now. They need to refocus policy-making toward the creation of shared prosperity because without it, we can have no prosperity at all.



DNA of Chocolate Almost in the Bag

October 18th, 2010 | No Comments | Source: Washington Post

A team of scientists at the Mars candy company announced recently that it has almost completed a project to sequence the genome of the cacao tree, whose seeds are used to produce chocolate. The team hopes its contributions will help scientists create cacao trees that are less vulnerable to disease and easier to grow.

Mars makes all-time favorite candies like Snickers and M&Ms. The company spent nearly $10 million on the project, yet it intends to make its findings public once the work is done.

“The information is so rich and so accurate we felt there was no reason to hold back,” Howard-Yana Shapiro, Mars’ global staff officer of plant science and research told the Washington Post.

Traditional cacao tree breeding methods involve a time-consuming, hit-or-miss process in which plant scientists try to find the trees with the best traits (for example, producing the sweetest chocolate or a tendency to be disease-free) and reproduce them. That process can require 15 years to complete because it takes that long to be sure the tree can defend itself against diseases.

But once the cacao tree’s DNA has been sequenced, scientists hope they can complete this process in 2-3 years. For example, by studying the genetic code from a young tree, they can find out quickly whether it possesses genes that can help it fend off diseases.

It’s possible the Mars group’s discovery might lead to better-tasting chocolate as well. According to Shapiro, the amount of fatty acids in the cocoa is key to the taste of the end-product. “Now finally, we have insight on how to stabilize it and raise it over time,” Shapiro told the Post.

Nearly 70% of the world’s chocolate comes from the cacao trees of West Africa, particularly Cote d’Ivoire and Ghana.



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