Archive for the ‘Health Care’ category

Monday Morning Dolan News Fix

12-03-07

Sorry to have been such a quiet poster the past few days…been under the weather.

Here are a few stories from Dolan Media I wanted to get out of bed for.

The state-run Healthcare Group Arizona was supposed to be a self-sufficient health insurance plan for small businesses. Instead, “it’s in financial meltdown,” according to a state rep quoted in Arizona Capitol Times.

And the Department of Insurance seems to agree with(Rep. Kirk) Adams’ assessment. Preliminary results from a report that will be finalized in February show Healthcare Group does not collect the data needed to predict health care trends and adjust its premiums accordingly, said Director Christina Urias.

If Healthcare Group was a private insurer, she told the panel Nov. 27, her department would have shut it down.

“In my view, this is a situation…very, very similar to an insolvent insurer operation because it’s relying on subsidies from the Legislature to keep itself going,” Urias said.

Even Kevin Nolan, deputy director of Healthcare Group, told the committee the program may be entering the beginning stages of what is known in the insurance world as a “death spiral,” in which recently increased premium costs drive healthy people from the system, leaving only those with serious illnesses.

Another state Rep. thinks the situation is salvageable — that restrictions on eligibility and on marketing the service could get the program “back on good footing.” The full story is available to subscribers….

If you’re on top of the global warming issue, you’ve doubtless heard the litany of environmentally-friendly sustainable sources of energy: Solar power, wind energy, geothermal…and now “wave parks.” The Daily Journal of Commerce in Portland surveys the seascape, and reports that Oregon’s bid to be the world’s leader in commercializing the technology faces a surge in competition from Nova Scotia, British Columbia and neighboring Washington state.

Oregon… is working to expand Oregon State University’s wave research to a national in-water wave energy research center where companies around the world can bring their technologies for testing. And the state already has two test devices in the water – Canada-based Finavera Renewables’ Aquabuoy and OSU’s wave energy buoy – with six more permit applications on file at the Federal Energy Regulatory Commission.

Finavera suffered a setback last month, however, when the Aquabuoy off the coast of Newport began leaking and sank to the ocean floor. And public perception of wave energy parks as threats to ocean life and fishers could set back the state, energy consultant Justin Klure said.

“Oregon needs to accelerate our efforts for community outreach and education,” Klure said, “so wave energy projects are seen as positive instead of a threat.”

Also on the water… If you’re in Baltimore today or tomorrow, you can catch a glimpse of a very cool-looking high-speed Navy ship, on display in the Inner Harbor as part of the Army-Navy game festivities.  Go to On the Record to see it….

Slow home sales in New Orleans have some owners resorting to auctions, writes Deon Roberts in New Orleans City Business. But it seems like the auctions are serving to illustrate that sellers and buyers remain far apart on what they think properties are worth.

(David) Gilmore, president of Sperry Van Ness/Gilmore Auction, said New Orleans-area home auctions are attracting fewer buyers than for commercial properties or lots. Also, many sellers have not been satisfied with residential auction bids, he said.

“There are still buyers in the market,” Gilmore said. “We had bidders at every one of our auctions for 12 different sales three weeks ago. But I’ll tell you, on the residential homes, there was a price differential between which the sellers were wiling to accept and the buyers are willing to give, and that tells you we have market issues.”

Of the 12 properties Gilmore’s firm featured three weeks ago, three homes did not sell because the sellers rejected the offers, he said. There was a 30 percent average difference in what the sellers wanted and the buyers offered.

What one word comes to mind when you think of New York? Did you say “politeness?”  Me too!  But apparently the Long Island Railroad has concerns about its passengers hogging seats with their bags and gabbing on the cell phone, so they’ve launched an anti-rudeness campaign, according to LI BizBlog….

Three thousand gallons of chicken fat from a Perdue poultry plant. An unlatched tanker. Twenty miles of Virginia highway. Yuk.  And a few auto accidents, according to the VLW Blog…. Talk about rude….

Placebos, Pharma and Government Drug Approvals

11-02-07

What does it mean for the FDA’s drug-approval process if, as this Economist article implies, the placebo effect is responsible for the apparent effectiveness of some of the drugs it approves?

The story triggering this thought is about sports medicine. It describes a study comparing painkilling effects of morphine with a placebo on athletes. The World Anti-Doping Agency bans the use of morphine during competition because “its painkilling properties would give users an unfair advantage.”

Killing pain, however, is one of the things that the placebo effect is best at. In 1999 Dr Benedetti himself showed that someone who is injected with morphine for two days in a row experiences a powerful analgesic response not only on those days but also on the next, if the morphine is replaced by a placebo without his knowledge. That led (University of Turin professor Dr. Fabrizio) Benedetti to wonder if the effect of legally administered pre-competition morphine might, perfectly legally, be carried over into a competition by giving a placebo.

In their new experiment, published this week in the Journal of Neuroscience, he and his colleagues simulated a sporting competition by pitting four teams of ten athletic young men against each other in a pain-endurance test. With a tourniquet strapped around one forearm, these men had to squeeze a hand-spring exerciser repeatedly until pain forced them to stop. Their scores, measured by the time they managed to keep going, were averaged over the whole team.

One of the teams received a morphine injection just before training sessions held two weeks and one week before the contest, and an injection of saline solution on the big day, along with the suggestion that it was morphine. Another received the same regime, but the saline was combined with naloxone, an opiate-blocking drug. The remaining teams received either no treatment at all, or the placebo on competition day alone.

Members of the team that received morphine followed by a placebo were able to endure significantly more pain during the competition than any of their rivals. In particular, those injected with naloxone did no better than the other two control groups. This finding supports the theory that placebos reduce pain by encouraging the brain to produce more natural opiates than usual.

The Economist thinks aloud about the implications. What if a doctor told an athlete he was being administered an illegal painkiller, and the athlete believed it. The placebo effect kicks in. Is that athlete cheating?

But the bigger picture is the power of the placebo effect. How much mainstream, FDA-approved medication was approved based on placebo-effect-fueled results from human tests? How many approved drugs are effective because of a feedback loop reinforced by doctors’ assurances, advertising and word-of-mouth? Is “the placebo effect” merely a pejorative term for the body’s ability to heal itself? Is healing-by-placebo any less valid than healing-by-drugs?  Do drugs interfere with self-healing/placebo effect, or are they enhanced by it?

Obviously, pharma companies need to have some level of testing and approval, if only to assure that their drugs don’t poison people. But when a drug seems to be effective but the placebo effect is suspected, the FDA considers that drug to have failed. Is that really the right way to look at it?

Taking it further, should the FDA be working with health practitioners on ways the government can help drug manufacturers create the basis of belief that would support the placebo benefits? And shouldn’t the government find a way to support homeopathic and other alternative medications, rather than — as they do now — trying to ruin users’ faith in them?

Placebo might be just another word for healing, in some instances. What are the implications of that?