Health Culture Daily Dose #4

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In today’s Dose:

Health care reform
(Public option; Gawande’s article)

Health news
(Parkinson’s and pesticide)

Sleep
(Sleep and mental illness)

Social networking technology
(The digital brain and higher education)

Health care reform

  • The Washington Post reports that there is no ‘public option’ in the Senate’s health care draft.

The absence of a “public option” marks perhaps the most significant omission. Obama and many Democrats had sought a public option to ensure affordable, universal coverage, but as many as 10 Senate Democrats have protested the idea as unfair to private insurers.

  • In a roundtable discussion at Health Affairs, panelists talk about Atul Gawande’s New Yorker article on McAllen, Texas and about geographical variations in health care costs (the Dartmouth Atlas Project).
    One of the first questions discussed is why the Gawande article has aroused so much interest. Other questions addressed: Have things changed enough since Nixon’s time so that health care reform can succeed this time around? Can physicians be moved away from fee-for-service payments? Can we change how specialists and primary care physicians are paid?

[S]ome of the finest, most well-respected multispecialty groups will acknowledge in confidence that they’re able to ask for 200 or even 250 percent of Medicare [costs] to do what they are doing very well. … this issue of market power is a real one. …
I agree we need to strengthen primary care, but I think it’s a little bit of a chicken and egg issue as well. Who would want to go into primary care in the current work environments?

Nobody said this was going to be easy. So quit whining about “bipartisanship”, quit wringing your hands over how dreadfully difficult it’s going to be, and get on with it. Solving America’s very large and very real health insurance crisis is more important, and even prominent Democrats are shrugging their shoulders in defeat before the first real shots have been fired.

Health news

A cause-and-effect relationship between environmental neurotoxins and Parkinson’s is difficult to prove. As with many other scientific efforts to establish disease causation through population studies, there will probably never be a smoking gun that settles things once and for all. … In the case of Parkinson’s and the environment, however, there has been a steadily mounting consensus about such a connection, and the pace has quickened in the past year or so.

Sleep

It’s long been known that people with psychological problems such as anxiety, depression, paranoia, bipolar disorder, and attention-deficit hyperactivity disorder (ADHD) don’t sleep well. Until recently, it was assumed their sleep difficulties were a product of the psychological problem. But research suggests that the process may also work in the opposite direction: persistent sleep problems may help cause and exacerbate a number of common mental illnesses….
A number of studies indicate that children who don’t get enough sleep are prone to the sorts of behavioural problems that can look like the signs of ADHD….
“Insomnia is like hiccups,” Bob Dylan once commented. “Everybody has a cure but none of them work.” For once the great man is wrong.

Social networking technology

Young Americans under 30 are the first to have grown up digital. Growing up at a time when cell phones, the Internet, texting and Facebook are as normal as the refrigerator. This interactive media immersion at a formative stage of life has affected their brain development and consequently the way they think and learn….
“[Higher education is] more like health care. We’re challenged by obstructive, non-market-based business models. We’re also burdened by a sense that doctor knows best, or professor knows best.”

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