If China Can Do It....

Even China's moving toward universal health care: "China Health Reform to Give Every Village a Clinic," (AP, April 8, 2009). Of course, they are communist....

Jeffrey Sachs brings to our attention the President's attention to agricultural development in developing areas: "Homegrown Aid," (NYT, April 9, 2009). His comments about the traditional way aid is handled versus his recommendations for how it should be handled are important to note, if we really want our money to make a difference, that is.

The Fun (Fight) Begins

The Times signals that the debate over the shape that healthcare reform will take has commenced: "A Public Plan for Health Insurance?" (NYT, April 7, 2009). The bottomline of their perspective is worth considering: if the government launches a public insurance program that one can opt into voluntarily, and more people opt into it than opt into private health care...isn't that a sort of referendum, a sort of voting? In other words, as they say, "If, over time, a vast majority decides the government plan is superior, so be it." I agree. That's democracy in action. It'd be nice if many folks in this country would actually support democracy rather than just pay lip service to it.

Here's Uwe Reinhardt's explanation of it: "A Medicare-like Plan for the Non-Elderly," (Economix, April 6, 2009).

And an important corrective to the tired lines about socialized medicine: "More on Healthcare Rationing," (Economix, April 7, 2009).

Oh, and before I forget, a couple of very interesting pieces about socialism from this past weekend's Journal-Sentinel: "Here, Socialism Meant Honest, Frugal Government," (MJS, April 4, 2009). And, "Obama Isn't a Socialist, and Here's Why," (MJS, April 2, 2009). I like the first piece because it shows what socialism can look like in action in the United States, using real, historical data. Now, obviously there is a spectrum among "socialists," especially since the folks written about in the first article don't look like the folks written about in the second article. But what is at the center of both pieces is a strong, vibrant sense of the public good -- the "goods" that the public holds in common, that cannot simply be held privately because they are common to all persons, which is, of course, a very Catholic idea.

Now this raises all sorts of interesting ethical questions (not to mention movie plots): "Brain Researchers Open Door to Editing Memory," (NYT, April 7, 2009). Yes, this could be used therapeutically....could it be used any other way?

Med Students with a Conscience

Here's a truly useful site for most of you: "Health Student Network." The name of the site doesn't exactly convey its purpose, which was summarized when it was sent to me as follows: "This is a news and social network for health students, researchers and professionals. It's just starting. Its niche is global health and development rather than how to pass first year anatomy. We hope that by combining news and comment with social networking, the site may be used by a wide range of health students and practitioners around the world. It may even help to get medical students and student nurses interested in public health and development issues! "

If you know of more sites like this, send them on to me and I'll post them.

Beyond Greed

The Times ran a number of interesting items in their business section today on executive compensation, and they're just worth noting.

First, "Who Moved My Bonus? Executive Pay Makes a U-Turn," (NYT, April 5, 2009). Even down 50%, these pay scales are still obscene.

Second, here's a very nice accounting of executive compensation. It should make your stomach turn: "The Pay at the Top," (NYT, April 5, 2009).

Third, the blame goes a long way: "Executives Took, but the Directors Gave," (NYT, April 5, 2009).

Fourth, a map of the recession as of a month ago, via unemployment: "The Geography of a Recession," (NYT, March 3, 2009).

The Pope May Be Right

I am steadfastly not watching basketball tonight, ergo, I shall post. That, and I have been spurred out of my over-taxed silence by an interesting article just sent me by a former student. I have vented to some on my annoyance with the media's coverage of the Pope's visit to Africa. One might think that the only word he uttered on his multi-day tour was the word "condom." Here, at last, is a more sane perspective: "The Pope May Be Right," (Washington Post, March 29, 2009). Nuance, facts -- they're so refreshing.

Speaking of Africa, and the 'third world' generally, Nicholas Kristof remains on the case, bringing a new issue to the attention of the west: "Pssst. Pneumonia. Pass It On," (NYT, April 4, 2009). Given some of my current research interests, this article was particularly of interest. And relatedly, no great surprise, but to keep it on the radar: "HIV Infection Sharply Raises Risk for TB, Report Says," (NYT, March 30, 2009).

The latest post from Uwe Reinhardt: "Defining 'Health Care Reform," (Economix, March 27 2009). I plan to refrain from posting articles about current proposals for healthcare reform until we actually have something concrete and not just hypothetical. This post is helpful, though, for defining what the parameters of any proposal will have to include.

Something to think about for down the road: "Treating an Illness is One Thing: What About a Patient With Many?" (NYT, March 30, 2009). This is why we need more geriatricians -- a specialty you all should consider. Not only are more and more patients finding themselves in this situation, doesn't it figure that: "Doctors are Opting Out of Medicare," (NYT, April 1, 2009). Just when people need them, the docs turn the other direction. Gotta love contemporary medicine. Especially when it has results like this: "Study Finds Many on Medicare Return to Hospital," (NYT, April 1, 2009).

How will you learn to talk to your patients about dying? Will you avoid it by going into a 'safe' profession like family practice? Is it essential to the medical profession to know how to have these conversations? "At the End of Life, Denial Comes at a Price," (NYT, April 3, 2009).

And last but not least, most timely since my current research projects are on research ethics in developing countries, they've finally settled this Pfizer suit that has been going on since, I think, 1996 (yes, 13 years): "Deal in Pfizer-Nigeria Drug Suits," (BBC, April 3, 2009). More on this topic soon.

Are We Living in an Exponential Age?

Here's a thought-provoking video: "Did You Know?" Some of this is probably based on somewhat skewed data, but an interesting thought, that we live in "an exponential age." But of course, the exponential growth in these technologies are not distributed with geographic equity. What might it mean to see "exponential growth" in the economic status of poor countries, in the health status of the poor? It seems theoretically possible that that could happen, given some of the data in this video.

And all it would take is 'will.' As this story shows, the work is not rocket science -- it's not hard (conceptually) to figure out: "Surgeon Heals Patients and Their Violent Ways," (CNN, March 30, 2009). It just takes one person who cares to start the engine, to capture a team of people who also care and who can make a real difference in the lives of real people.

Today's final story brings together a previous conversation, on these pages, about reproductive technologies with the recent economic scandals: "Another Despicable Financial Scandal," (Freakonomics, March 30, 2009). How low can one go? But also -- how will this be resolved? Of course, perhaps it points to one of the (many, many, many) problems with the commodification of reproductive technologies that took place in the 1980s and 1990s (alongside the happenings that caused the current economic debacle. Hm....could they be related?).

Doing the Right Thing

Here are two stories about doing the right thing, just in case all the economics gets you down. Granted, these are not pollyanna stories -- not all sunshine. But they're good stories to meditate on.

First, from Minneapolis: apparently it's becoming quite the international city and this is causing issues for healthcare because most of these international folks are immigrants and refugees and have endured really awful life experiences. Yet, they need medicine. So what does a city like Minneapolis do?: "Foreign Ways and War Scars Test Hospital," (NYC, March 29, 2009). Well, maybe not Minneapolis, but at least Hennepin County Medical Center, a hospital with a long-standing reputation as being a really good place. Now we see why.

And second, a story from Haiti. I didn't realize Haiti was on Nicholas Kristof's radar. I'm glad it is: "A Boy Living in a Car," (NYT, March 29, 2009). These composting toilets are one of the most interesting recent inventions I've come across. They certainly could solve a number of problems at once. This story reaffirms the fact that the solution to the global problems related to health and nutrition are not, really, all that complicated.