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.