The map on the left purports to track the increase in the percentage of obese persons in the U.S. over the past 20 years. I don’t know about the methodology of the statistical analysis, but the map is pretty darn cool.
Fit Nation Map
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Category Archives: Health Care
Good news for Dr. Pou
An old saying in criminal defense circles is that a prosecutor could persuade a grand jury to indict a ham sandwich if the prosecutor is inclined to do so.
Fortunately, that was not the case in regard to former Houston area resident, Dr. Anna Pou (previous posts here). Dr. Pou served on the faculty of the University of Texas Medical Branch in Galveston from 1997-2004, where she was the Director of the Division of Head and Neck Surgery from 1999 to 2004. Kevin, M.D. has been doing a good job of tracking developments and comments regarding the case against Dr. Pou, and here is the link to the website that has been established to help raise funds for Dr. Pou’s defense.
Following on this recent post on developments in Dr. Pou’s case, a New Orleans Parish grand jury today declined to indict Dr. Pou for second-degree murder in connection with the deaths of several elderly patients in the horrifying aftermath of Hurricane Katrina. The decision ends a two-year long criminal investigation into Dr. Pou’s heroic treatment of patients at Memorial Medical Center in New Orleans, which was turned into a sweltering, powerless hellhole on Aug. 29, 2005 when the levees failed after the hurricane. Inasmuch as the hospital was not evacuated until several days after the storm, 24 out of 55 elderly and infirm patients died.
The case against this distinguished academic had all the earmarks of a political lynch mob from the beginning. It became quickly apparent that Dr. Pou’s arrest was the result of the highly questionable accusations of three employees of LifeCare Hospitals, the company that owned the hospital and whose top administrator and medical director didn’t even show up at the hospital during those chaotic days after Katrina. Inasmuch as the accusing LifeCare employees made no effort to evacuate the elderly and sick patients before or after the hurricane, it quickly became clear to any reasonably objective observor that they were attempting to divert attention (and perhaps prosecution) from their own appalling inaction.
But the facts didn’t matter to an elderly Louisiana attorney general named Charles Foti, who had campaigned on a plank of “cracking down on abuse of the elderly.” Foti engineered the arrest of Dr. Pou and two of her nurses while publicly referring to them as murderers, a charge that he repeated in an episode of 60 Minutes several months later. Although Dr. Pou’s lawyer had told Foti that she would surrender to authorities if an arrest warrant were issued for her, Foti had his investigators arrest Dr. Pou and haul her into Orleans Parish Prison on the evening of July 17, 2006, where she was booked on four counts of second-degree murder. Thankfully, the decision on whether to prosecute Dr. Pou was not Foti’s, but that of New Orleans District Attorney Eddie Jordan and the local grand jury, which was undoubtedly persuaded by the New Orleans coronor’s report that earlier this year concluded that no compelling evidence of homocide existed. But that did not stop Jordan from recently granting immunity to the two nurses who were charged with Dr. Pou in an effort to induce them to testify against Dr. Pou before the grand jury. Sheesh!
So, when does the investigation of the public officials begin who were responsible for attempting to organize this lynch mob?
Dr. Pou’s defense goes on the offensive
The state’s threat to prosecute Dr. Anna M. Pou for murder is a sad reflection of the incompetence in the Louisiana state government that permeated the preparations for and the aftermath of Hurricane Katrina. After almost two years now of legal limbo, Dr. Pou’s defense team is fighting back:
Dr. Anna Pou – the physician arrested in the deaths of four patients at a New Orleans hospital after Hurricane Katrina – filed suit against the Louisiana Attorney General on Monday, accusing him of using her arrest to fuel his re-election bid.
The suit, filed in state court in Baton Rouge, also seeks to force the state to provide a legal defense for Pou against civil lawsuits filed by families of three of the patients.
Last year, State Attorney General Charles Foti claimed Pou and two nurses killed four people with a ëëlethal cocktail” at Memorial Medical Center during the chaotic conditions after the August 2005 storm. The four were among at least 34 who died at the sweltering, flooded hospital in the days following Katrina. Pou, who is free on bond, has not been formally charged. A New Orleans grand jury is looking into the case.
Foti had Pou arrested, ëëcalled an international press conference the next day to announce the arrest, made extra judicial comments totally contrary to the Rules of Professional Responsibility, and culminated the week’s activity with an attorney general fund raiser to showcase his ëachievements’ in the arrest of Dr. Pou and the two nurses,” the suit says.
Foti was not immediately available for comment . . .
Go Dr. Pou!
More on the myth of healthy long distance runners
This earlier post noted development of research indicating that long distance running over a long term may be hazardous to your health.
Thus, this article from earlier in the week about arguably the greatest American marathoner caught my eye:
Alberto Salazar, the former champion marathoner who collapsed over the weekend, had his condition upgraded Monday from serious to fair.
A cardiologist at Providence St. Vincent Medical Center said tests now indicate that Salazar had a heart attack while coaching distance runners Saturday at the Nike campus outside Portland, said Lisa Helderop, a hospital spokeswoman.
Salazar, who is alert and talking with his family, told a doctor at the hospital that he has a family history of heart conditions, Helderop said. [. . .]
Salazar, a University of Oregon graduate, won the New York City Marathon three straight years (1980-82) and the 1982 Boston Marathon. He has set six U.S. records and one world record. He is a longtime Nike employee and consultant who trains elite distance runners and has a building named for him on campus.
This recent University of Maryland Medical Center study addresses another health risk of long-distance running. And none of the foregoing even touches on the heightened risk of joint and ligament damage that results from long distance running. Take note, runners.
The search for a cure
Yale University School of Medicine neurologist Steven Novella, the editor of the Scientific Review of Alternative Medicine, provides this insightful NeuroLogica post that addresses the issue of why medical research has not discovered a cure for cancer despite the enormous resources dedicated to cancer research. In so doing, he clears up several common misconceptions about cancer and the incentives involved in finding a cure. He concludes as follows:
The overall reality is that the standard of scientific medicine is not a monolithic entity, controlled by any one institution, agency, or industry. It is a complex and dynamic set of many forces and interests. It is ultimately driven by science, which is a transparent and public process, and prevents any big brother type of control (this is partly why it is so important that healthcare be based upon science).
Cancer is a very difficult type of disease to treat, and the public has a very distorted view of the nature of cancer and of medical scientific progress in general. This has lead to unrealistic expectations of progress in curing cancer, which then in turn leads to thoughts that cancer research is somehow not working.
I find the same to be true in medicine in general ñ the public thinks of scientific progress in terms of dramatic ìbreakthroughs.î Media hype feeds this misconception. The reality is that medical scientific progress is largely a series of very small steps, with a cumulative effect of slow steady improvement in treatments. We have not cured Alzheimerís disease, ALS, Multiple Sclerosis Parkinsonís disease, and many other diseases as well. But treatments are slowly improving. Slow steady progress does not make good headlines, however, so the myth of miracle medical breakthroughs will likely continue to be promoted by the media.
Read the entire post. Hat tip to Sandy Szwarc.
An important distinction in the health care finance debate
Clear Thinkers favorite Arnold Kling, who appears to be everywhere these days in regard to discussions over reform of America’s health care finance system, reminds us in this Washington Times op-ed of an important distinction in the health care finance debate — despite the problems in health care finance, American medical care and research remains the hope of the world:
On one side of me at the graduation [of my daughter] sat [my wife], a breast cancer survivor. On the other side was my father, whose heart condition and blood pressure threatened to take his life before my daughter was ready to graduate kindergarten, much less college. Finally, there was my daughter herself, who since high school has had a chronic intestinal illness sufficiently contained that she could graduate on schedule.
None of these three stars would have been there without medical treatments that only became available since my daughter was born. New drugs played a significant role in each case. In fact, some pharmaceuticals critical for my daughter only were approved for her condition a few years before she was given them. Drugs in the pipeline are likely to play an important role in her future.
In other countries, would the same state-of-the-art medicines and equipment have been available to my father, my wife and my daughter? Perhaps. But it is a safe bet these technologies were not invented elsewhere.
Much of the medical innovation that the world enjoys comes from America. While as an economist I find much to criticize about our health-care system, America’s role in medical innovation is crucial not just for Americans, but for the entire world.
Read the entire op-ed.
A primer on insulin, blood sugar and Type 2 diabetes
Mark Sisson (earlier post here) is now blogging on nutrition and exercise issues, and one of his first posts provides this good overview of the often misunderstood interrelationship between insulin, blood sugar and Type 2 diabetes. As Sisson notes, “we are all, in an evolutionary sense, predisposed to becoming diabetic.”
Steroids, home runs and variables
This post about Barry Bonds from a week or so ago prompted an interesting exchange in the comments between me and Gary Gaffney, a University of Iowa physician who blogs about steroid use over at Steroid Nation. Following on that exchange is this Michael Salfino/Grand Rapids Press article that raises questions regarding the conventional wisdom these days that steroid use dramatically increased home run totals in Major League Baseball:
Between 1995 and 2003, the era where, [steroids critics contend that] home run totals were inflated dramatically by alleged steroid use, each team hit, on average, 173 homers.
Unfortunately for [the steroids critics’ argument], home run totals per team post-steroid testing are actually up, not down: 176 homers for the average team in the average year.
Leaguewide, there were 5,250 homers hit on average between 2001 and ’03; 5,290 between ’04 and ’06.
One argument is that between ’00 and ’02, seven batters slugged 50 or more homers. Between ’03 and ’05, just one did.
But two batters, Ryan Howard and David Ortiz, hit more than 50 homers last year, and another, Albert Pujols, just missed with 49.
We again share the great insight by Art De Vany, professor emeritus of economics at the University of California-Irvine, that hitting home runs is an act of genius.
So, De Vany concludes, we must expect wide variance in the best years of athletes just like we accept wide variance in the best films of directors, albums of musicians or books by authors relative to their main body of work.
De Vany also concludes that large swings in individual home run performance are irrelevant to the steroids debate.
This year, teams are hitting homers at a 4,632 pace, which would be the lowest, by far, per team, in all the years cited by Kriegel except for ’95. The homer rate thus far could be a fluke that will correct itself going forward.
Still, it would be surprising if the year-end total cracked 5,000, about where it stood in ’02 and ’05. Swings of 10 percent are common in every era. In the modern context, that means a range of anywhere between 4,800 and 5,800 homers should be considered normal.
Investing in fat people?
Following on earlier posts here and here on how the U.S. anti-obesity industry often misrepresents the nature and extent of the health problems related to widespread obesity in American society, Laura Vanderkam reviews NY Times nutrition columnist Gina Kolata’s new book, Rethinking Thin: The New Science of Weight Loss–and the Myths and Realities of Dieting (Farrar, Straus, and Giroux, 2007) in which Kolata challenges the conventional wisdom that an obese person’s capacity to lose weight and maintain that reduced weight is merely a question of an individual’s willpower.
Despite Kolata’s book and a growing body of research that questions the anti-obesity crusade, investing in anti-obesity appears to be a potentially lucrative investment opportunity. A case in point is this Merrill Lynch research report on how best to invest in “the emerging obesity epidemic.” Table 5 presents “stocks that represent the ML Obesity Theme” which, by the way, includes Whole Foods and Wild Oats Markets.
“The developed world is getting older and fatter,” writes ML analyst Jose Rasco. “People are increasingly eating more proteins and processed foods, leading more sedentary lives and gaining weight.” Inasmuch as ML projects that the number of obese people worldwide will increase to 700 million in 2015 from 400 million in 2005, there’s money to be made in those companies that are fighting obesity or, as ML might say, “why not monetize a trend of more fat people?”
Snow Fall
Robin Moroney over at The Wall Street Journal’s Informed Reader blog picks up on this interesting Ken Dermota/Atlantic ($) article that reports on the weird economics relating to the demand, the supply and the price of cocaine:
Demand for cocaine stays steady, Colombiaís coca fields are destroyed, yet the drugís street price in the U.S. continues to fall . . . [as] drug smugglers and dealers have eked out efficiencies in their operations to keep their prices low. The U.S. Coast Guard has been able to catch only a small percentage of the drugs entering the country since President Nixon declared a ìwar on drugsî in 1971. In 2000, the U.S. decided to switch tactics and take the fight to Colombia, which produces 90% of the cocaine sold in the U.S. Since then, it has spent $4.7 billion fighting rebels who grow and sell the crop, as well as spraying coca fields from the air.
The price of cocaineóthe pure version, not crackóhas kept falling. In the early 1980s, the price of a gram of cocaine was about $600. By the late 1990s the price had fallen to about $200. According to the Drug Enforcement Administration, the street price of a gram of cocaine in 2005 was $20-$25 in New York, $30-$100 in Los Angeles and $100-$125 in Denver.
Some of the price decrease has come from more efficient distribution networks. Some New York smugglers have chosen to eliminate the middleman and pick up their drugs directly from Colombia, offering ìfactory-to-youî prices. The surging trade with Mexico has increased the nooks and crannies for drugs to be hidden as they cross the border, making smuggling both safer and cheaper.
Labor costs also have decreased. Street vendors take a smaller cut of the drugís proceeds. A lot of the drug dealers who fell prey to an aggressive imprisonment campaign in the 1990s are now leaving prison. Their felony conviction and minimal job experience means they have few other ways to make money and are willing to take a pay cut.
The falling street price also reflects the lower risk of handling the drug. The violence of the 1980s crack boom has faded and, since 2001, federal drug prosecutions have fallen 25% as agents get diverted to the hunt for terrorists.
While the Atlantic article focuses on why the price of cocaine continues to drop even though the supply sources are declining, what’s particularly interesting is that the demand for cocaine is not rising dramatically as the price declines. Given its addictive nature, it makes sense that the demand for cocaine would be somewhat price inelastic, but it seems logical that demand would increase at least to some extent as the price falls. This does not appear to be happening. Sounds like a good exam question for an economics course.