How to Prepare for Coronavirus in the U.S.

According to this article in Scientific American, stockpiling and hoarding supplies is not a solution.

The reality is that there is little point “preparing“ for the most catastrophic scenarios some of these people envision. As a species, we live and die by our social world and our extensive infrastructure—and there is no predicting what anybody needs in the face of total catastrophe. In contrast, the real crisis scenarios we’re likely to encounter require cooperation and, crucially, “flattening the curve” of the crisis exactly so the more vulnerable can fare better, so that our infrastructure will be less stressed at any one time.

. . .

The infectiousness of a virus, for example, depends on how much we encounter one another; how well we quarantine individuals who are ill; how often we wash our hands; whether those treating the ill have proper protective equipment; how healthy we are to begin with—and such factors are all under our control. After active measures were implemented, the R0 for the 2003 SARS epidemic, for example, went from around three, meaning each person infected three others, to 0.04. It was our response to SARS in 2003 that made sure the disease died out from earth, with less than a thousand victims globally.

Continue ReadingHow to Prepare for Coronavirus in the U.S.

Disrupting the Healthcare System

This morning I attended a conference titled “Disruption and Innovation in Healthcare 2.0“ at Washington University in St. Louis. I was humbled at how well informed and nuanced the speakers were. They included Alex Gorsky (CEO of Johnson and Johnson), I certainly learned a lot. My main concern is that the ability to understand the complexity of the health care system is well beyond the ability of most people. The simplistic positions of our politicians are a great disservice to our country. For example, it is absolutely clear that our health care system is NOT a functional market, meaning that the Ayn Rand/Free-Market conservatives are deceiving us when they claim that all we need to do is “get government off our backs” to fix healthcare. I admire that progressive politicians are calling for universal access (something that almost all developed countries have, but not the U.S.). That said, how do we square that universal access with the need to incentivize future innovations, in addition to ongoing care? Any big changes to the current system could have disasterous ramifications.

The stakes could not be higher. To the extent we are tempted to implement broad new changes, we need to keep in mind (as one of today’s speakers said), “This is not a dress rehearsal. It’s the real deal.”

[On the right] Johnson and Johnson CEO, Alex Gorsky

The speakers somberly delivered the following shocking information: There is currently no payment model for many current (and anticipated) extremely expensive curative therapies. Thus, people who can be CURED of horrific diseases will languish under the status quo because we can’t figure out how to give them more than palliative treatment, even when palliative treatment is sometimes more expensive in the long run. I dare you to read previous sentence a few times and then shrug and try to convince yourself that we, as a country cannot do better.

Here’s another fact was mentioned several times today: 75% of our health care budget is the result of bad choices made in early life by individual Americans. Preaching at people to get their act together shouldn’t offend reasonable people. For instance, urging that children should eat healthier food should be applauded, even though some conservatives ridicule Michelle Obama’s urgings in that direction. But what about more? To what extent should we, must we, put some skin in the game for people who are actively self-destructing their bodies? I think we need to seriously look at some low-hanging fruit and make some people uncomfortable for their own well being and for the greater good of the United States. The overall health of the United States is most definitely a public good. The ill-health of any of us affects all of us.

These issues are ultra-complex, highly nuanced, in addition to being critical important. Anyone pretending otherwise should be promptly yanked off the political stage.

Here’s more information about this event. It was being video-recorded and hope that it will be made available to anyone interested in these issues. “2nd Annual Olin Business School Healthcare Symposium: 'Disruption and Innovation in Healthcare 2.0'

Continue ReadingDisrupting the Healthcare System
Read more about the article Why Flu Shots Rarely Match the Current Flu, and Why You Should Get One

Why Flu Shots Rarely Match the Current Flu, and Why You Should Get One

As any science guy recognizes, evolution is a fact of life. If an environment is inhospitable to a population, that population dwindles and another prevails. Flu shots are designed every year to prevent the premier emerging strains that are likely to become dangerous, either through virulence in the body, or…

Continue ReadingWhy Flu Shots Rarely Match the Current Flu, and Why You Should Get One

The cost of asthma inhalers in the United States compared to other countries

I'm traveling abroad, a trip centered on teaching law school for a week in Istanbul. On the way out of the U.S., I had an asthma attack while walking through the perfume area of a Duty Free store in Atlanta. I had an inhaler, but it was getting low (my inhaler is the red Albuterol inhaler on the left. It costs about $70 or $80 WITH the insurance price. My first stop overseas was in Beirut, Lebanon, where I entered a pharmacy without a prescription. They didn't have Albuterol but the pharmacist sold me the Lebanese equivalent called Salres. Total price was $5. When I arrived at Istanbul Turkey, I visited a pharmacy and paid less than $2 for their equivalent, "Butalin," the one in the middle Again, no prescription needed, and the pharmacist assured me that this was an equivalent prescription. I am now in Madrid. Yesterday, I visited a pharmacy here, no prescription, and they sold me the "equivalent," the inhaler on the right. Price was 2.5 Euros (about $2.85). I spoke with the pharmacist in Spanish. I told her that in the United States, my inhaler costs about $80 with the insurance rate, $300 without. Her immediate reaction was shock at the price. The she became angry, and asked "What do children do when their families cannot afford the medicine?" I told her that I don't know, and that it is a terrible situation and that there is no excuse for it.

Continue ReadingThe cost of asthma inhalers in the United States compared to other countries