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Tag: Merrill Goozner

What’s The Worst Case Scenario In Japan Nuke Crisis?

This from John Beddington, the United Kingdom’s chief science advisor at its Tokyo embassy:

Let me now talk about what would be a reasonable worst case scenario.  If the Japanese fail to keep the reactors cool and fail to keep the pressure in the containment vessels at an appropriate level, you can get this, you know, the dramatic word “meltdown”.  But what does that actually mean?  What a meltdown involves is the basic reactor core melts, and as it melts, nuclear material will fall through to the floor of the container. There it will react with concrete and other materials … that is likely… remember this is the reasonable worst case, we don’t think anything worse is going to happen.  In this reasonable worst case you get an explosion.  You get some radioactive material going up to about 500 metres up into the air.  Now, that’s really serious, but it’s serious again for the local area.  It’s not serious for elsewhere even if you get a combination of that explosion it would only have nuclear material going in to the air up to about 500 metres.  If you then couple that with the worst possible weather situation i.e. prevailing weather taking radioactive material in the direction of  Greater Tokyo and you had maybe rainfall which would bring the radioactive material down do we have a problem?  The answer is unequivocally no.   Absolutely no issue.  The problems are within 30 km of the reactor.  And to give you a flavour for that, when Chernobyl had a massive fire at the graphite core, material was going up not just 500 metres but to 30,000 feet.  It was lasting not for the odd hour or so but lasted months, and that was putting nuclear radioactive material up into the upper atmosphere for a very long period of time.  But even in the case of Chernobyl, the exclusion zone that they had was about 30 kilometres.   And in that exclusion zone, outside that, there is no evidence whatsoever to indicate people had problems from the radiation.  The problems with Chernobyl were people were continuing to drink the water, continuing to eat vegetables and so on and that was where the problems came from.  That’s not going to be the case here.  So what I would really re-emphasise is that this is very problematic for the area and the immediate vicinity and one has to have concerns for the people working there. Beyond that 20 or 30 kilometres, it’s really not an issue for health.

Merrill Goozner has been writing about economics and health care for many years. The former chief economics correspondent for the Chicago Tribune, Merrill has written for a long list of publications including the New York Times, The American Prospect and The Washington Post. His most recent book, “The $800 Million Dollar Pill – The Truth Behind the Cost of New Drugs ” (University of California Press, 2004) has won acclaim from critics for its treatment of the issues facing the health care system and the pharmaceutical industry in particular. You can read more pieces by Merrill at GoozNews, where this post first appeared.

The Message Is The Medium

GooznerEmory University psychologist and political consultant Drew Westen in the weekend Washington Post offers a troubling view of the public’s role in health care reform. While reform’s reality involves complicated technical issues like insurance exchanges, public plan governance, physician and hospital payments and who will pay higher taxes, the public’s understanding of these issues is virtually non-existent, Westen assumes.

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FDA Regulation of Tobacco Called ‘Death Sentence’

Goozner Legislation
headed for President Obama's desk that would give the Food and Drug
Administration regulatory authority over tobacco was called a "death
sentence" for agency morale by longtime FDA observer Jim Dickinson,
editor of FDA Webview (subscription required). 

The impact of this bill internally will be like a death
sentence, steadily killing the agency's old public health spirit and
replacing it with a strange hybrid. This new ethos will have to blend
public health and safety with toleration for and husbandry of
death-dealing products that have no plausible relationship to the
diverse family of other products regulated by FDA.

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Health costs increase despite recession

The latest one- and ten-year outlook for health care spending from
the Center for Medicare and Medicaid Services projects health care
spending growing 50 percent faster than growth in the overall economy.
By 2018, health care will account for fully one in every five dollars
of gross domestic product, according to the projection. The biggest
jump in health's share of economic activity will come in the next two
years as the sector continues to grow while the rest of the economy
shrinks.

And that's the good news.

There were several unrealistic assumptions built into the
projections. First, the CMS economists assumed Medicare's physician
payments will be cut by 20 percent at the end of next year when the
current payment fix expires. As anyone who follows that issue closely
knows, that never happens. Congress always steps in and restores the
cuts.

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Daschle out at HHS – Sharfstein in at FDA?

Oie_090203_daschle_634The early stages of the Obama administration are beginning to
resemble the Clinton years, which I 
observed from afar (I was a foreign
correspondent in Tokyo at the time). Take Zoe Baird and substitute Tom
Daschle, who dropped out of the running for Secretary of Health and
Human Services today because of tax and conflict-of-interest problems.
Take gays in the military and substitute putting in charge of the bank
bailout a man (Tim Geithner) who knows all the bankers from his years
at the New York Fed, seems overly solicitous to their needs, and has
his own tax problems.

Once again, a new Democratic president appears to have a semi-automatic weapon semi-permanently aimed at his foot.

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Is Medicare backpedalling on evidenced-based medicine?

Note: This post first appeared at Gooznews.com

Both the New York Times and the Wall Street Journal
carried stories today on Medicare's expansion of the number of
drug-listing compendia that can now be used to justify reimbursement
for the off-label use of anti-cancer drugs. This expansion, which
GoozNews covered last summer (see posts here, here, and here), will sharply increase Medicare spending on anti-cancer drugs of questionable medical value.

It has also provided drug companies with an alternative system for
getting reimbursed that won't require their going to the Food and Drug
Administration to prove that the regimens listed in the compendia
actually benefit patients.

The effects of this new system were understated in the articles. The Times
estimated that the higher spending by Medicare will come on top of the
$2.4 billion the senior citizen health care program spent on cancer
drugs in 2007. But according to this 2006 testimony
by Center for Medicare and Medicaid Services official Herb Kuhn,
Medicare spent about $10 billion on "Part B" drugs in 2005 (these are
drugs administered in physicians' offices, which includes most cancer
drugs), and about half of that went to oncologists.

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