A WEEK AGO, the NY Times ran
a front-page article presenting three case histories of people who sustained
MRI’s.  The article by Janny Scott, “Life at the top in America isn’t just
better, it’s longer,” is part of an ongoing series examining the effects of
social class in the US.  I highly recommend it to all THCB readers as the
real heart and soul of what health care analysis is all about, or at least
should be.It will come as no surprise that Scott finds social class
determines every aspect of each patient’s episode, “from the circumstances of
their heart attacks to the emergency care each received…It shaped their
understanding of their illness, the support they got…[and] their relationships
with their doctors.  It helped define their ability to change their lives
and shaped their odds of getting better.”  In the best traditions of
feature journalism, Scott supplies copious detail to illustrate that the
enormous treatment differences meted out to patients and the commensurate
outcome disparities varied according to social class.Just within the
realm of health care services, the same disparities apply to stroke, cancer,
diabetes, chronic viral infections (HIV, hepatitis C) and a raft of other
episodes and conditions.  Of course, we could examine most of the other
issue areas at the core of contemporary life — education, retirement, child
care, leisure, on and on — and find in these that social class is also at the
root of discrepant life chances and life styles.The Times’s
article also underscores a point that you and I have both made on TCHB several
times, namely that the holy-of-holies under Reagan-Bush-Bush, the omnisciently
unregulated market, is a piss poor way of delivering goods and services that
have such enormous impact upon the length and quality of lives.  Markets
stratify the public into segments, they often require long periods to
self-correct, and they tend to evolve in ways that subvert the very
preconditions for a market.  Some of those market system shortcomings,
within moderate limits, may be acceptable for consumer packaged goods, luxuries
and certain other sectors.  Health care is too important, however, to leave
in the hands of the oligopolists and plutocrats who run markets.

The Los Angeles Times has an excellent piece on Health Savings Accounts (HSAs) this week, which almost sounds as though whoever wrote it read some of the comments in the threads here! No surprises in the conclusions :  employers kind of like HSAs (go figure), employees are kind of confused (ditto) and some people are ending up paying a little bit more for their medical bills than they had reckoned on. BusinessWeek also has an article on the topic this week, which has a more positive take on HSAs, including some interesting wrinkles in place at one plan.  Hat tip Ezra Klein.

The House appears to be on its way to approving legislation which would relax federal rules on stem cell research.  The debate on both sides has been emotional, as was to be expected.  Ever popular House Majority Leader Tom DeLay is quoted by the Associated Press as saying stem cell research equates to the "dismemberment of living, distinct human beings."  In an effort to sway the undecided, President Bush spoke out against the legislation again this afternoon. "This bill would take us across a critical ethical line," Bush said "by creating new
incentives for the ongoing destruction of emerging human life."

In a carefully orchestrated demonstration of political spontaniety, the White House arranged to have a group of children adopted through fertility clinics appear with the president, all wearing t-shirts which say "former embryo."

UPDATE: As most people were predicting, the House passed the Castle-DeGette bill by a vote of 238-194, which is not a wide enough margin to withstand a presidential veto.  The alternative legislation favored by some Republican leaders, which encourages stem cell research using umbilical cord blood, passed 430-1. Rep. Ron Paul of Texas was the lone dissenter.

Last week’s news that Korean scientists have been able to develop an efficient technique for harvesting stem cells is creating quite a stir. Over the weekend, President Bush made it clear that he would veto any legislation which leads towards cloning, or as he put it "destroys life in order to preserve life" despite the arguments from researchers who say the experiments have nothing to do with cloning babies. That sets up a fight on Tuesday in Washington between supporters of therapeutic cloning and opponents who  say stem cell research is morally wrong.  There are two bills in Congress aimed at easing restrictions, both of which have "strong bipartisan support" in the estimation of the New York Times.   Many researchers are saying neither bill accomplishes particularly much.

The Castle-DeGette Bill would allow limited use of embryos left over from fertility treatments for scientific research. .S.681 The Cord Blood Stem Cell Act of 2005, would attempt to get around the moral issues involved in cloning by creating a national stockpile of cord blood stem cells and bone marrow for futher research.   

Indications are strong that Bush will use his veto to try to kill Castle-DeGette if it
passes. Supporters of Castle-DeGette are arguing that because the legislation authorizes research only on embryos that otherwise would "go to waste", no harm is being done. The Pro-Life camp meanwhile, is basically saying no way, it doesn’t matter.  We’re not interested.  This is not for us.  This is evil.

Interestingly, this seems to be one fight which is increasingly dominated by Republicans. The loudest voices on both sides, both for and against, are Republicans. Democrats are
supporting the measure, but rather quietly. That is probably a sign of the times. 

The thinking on the Democrats’ part is clearly that this is another round like the Schiavo battle. Polls show the majority of Americans support stem cell research.  Very few seem all that worked up about the story.  America will watch Tom DeLay and his team take the issue all the way, and will be disgusted. That may or may not be the way it happens. We’ll have to wait and see.  Meanwhile in Korea, the government shows no signs of slowing down. Over the weekend, health officials announced they will
seek funding for an international consortium which would bring foreign researchers in to work on further research. Initial reports are that one of those involved, will be Ian Wilmut, the man who created Dolly the sheep.  In another move, the Korean government unveiled plans over the weekend to create a "tax-free" international zone on the island of Cheju, where a medical center will be set up to attract foreign patients. 

One government official is quoted as saying the experiment gives South Korea a "two year head start."