Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Saturday, November 13, 2010

Healthier Eating Will Hurt Developing Economies

From "Eat a carrot, hurt the economy? Sometimes" by Maria Cheng, AP Medical Writer, November 10, 2010:
British researchers modeled what could happen if people in Britain and Brazil adopted healthier diets as defined by the World Health Organization, including more fruits and vegetables and less meat and dairy products.

In Britain, experts estimated that fixing the country's bad eating habits might prevent nearly 70,000 people from prematurely dying of diet-related health problems like heart disease and cancer. It would also theoretically save the health system 20 billion pounds ($32 billion) every year.

In Brazil, however, the rates of illnesses linked to a poor diet are not as high as in the U.K. So Brazilians would get relatively few health benefits while their economy might lose millions.
Read the complete AP article here.

The news article is based on a paper published in the Lancet, Volume 376, Issue 9753, Pages 1699 - 1709, 13 November 2010, Published Online 11 November 2010, "Health, agricultural, and economic effects of adoption of healthy diet recommendations" by Karen Lock PhD, Prof Richard D Smith PhD, Alan D Dangour PhD, Marcus Keogh-Brown PhD, Gessuir Pigatto PhD, Corinna Hawkes PhD, Regina Mara Fisberg PhD, Zaid Chalabi PhD.

The full text of the Lancet paper is available free with registration for a username at the Lancet website.

Thursday, November 4, 2010

Americans Sicker But English Die Quicker

From Reuters "Americans sicker but English die quicker says study" by Kate Kelland and Julie Steenhuysen:
"If you get sick at older ages, you will die sooner in England than in the United States," said James Smith, an economist with RAND in Santa Monica, California, who co-authored the study with James Banks and Alastair Muriel of the IFS.

"It appears that at least in terms of survival at older ages with chronic disease, the medical system in the United States may be better than the system in England."
Read the complete article here.

Monday, October 25, 2010

The Marginal Value Of US Medical Service Is High So Medical Prices Are High

A comment I posted to "Health Care Prices: Ignored Once Again?" by Chris Fleming on HealthAffairs Blog:
It is the prices stupid, but if researchers only look at the cost of the medical service, as the authors mentioned above do, they miss the total economic price that a patient pays.

Opportunity costs to patients have to be included. Opportunity costs help explain the value of medical services to patients and why prices for US medical services appear to be high. As long as the price of a medical service has a positive marginal value to the patient, the patient will be willing to pay the higher price.

The US has very high productivity and high GDP per worker. A lost day's work has a very high opportunity cost to an American worker. Even if the worker receives sick pay, a day's absence from work often means for many a backlog of work when they return. An extra few day's work missed by going to the doctor more often for treatment or staying in the hospital longer is very expensive to an American worker. It is also not just the number of visits, but also the lost productivity due to the time it takes a patient to get better. For example, imagine a patient with a bad knee who can get knee surgery in a couple of weeks versus one who has to wait a few months for the surgery. The longer waiting time surgery might be cheaper, but the opportunity cost of the lost worker productivity until the surgery has to be included in the comparative cost. Medical costs studies as a rule do not include these opportunity costs to the patient and the employer.

American workers are willing to pay more for medical services because US medicine is more efficient and reduces the number of days of wait until treatment, of missed work due to doctor visits, uncured illness and hospital stays. This is why we visit the doctor less and have fewer days of hospital stay.

Opportunity costs extend to relatives of the patients. Often a parent is taking a child to the doctor or staying home with the child until the child gets well. Likewise, adult children often assist with the care of their elderly or sick parents.

I would say that the reason these studies were ignored is that they presented an interesting fact but also an incomplete story. Show me a comparative study that analyzes medical prices that includes patient (or caregiver) opportunity costs.

My gut feeling is that prices of medical services in the US are at a level where the marginal value to patients equals the marginal costs, including opportunity costs, to patients.
Also see my later post, "Health Care Costs And Worker Opportunity Costs" relating to this topic.

Friday, October 22, 2010

Obesity Is Rising Around The World: McKinsey & Co.

From McKinsey Quarterly, the business journal of McKinsey & Company, "Why governments must lead the fight against obesity" by Jeffrey Algazy, MD, MPH, Steven Gipstein, MD, Farhad Riahi, MD and Katherine Tryon, MD:
The world is getting fat. In many countries, the proportion of people at an unhealthy weight has more than doubled in the past few decades. Globally, at least 1.3 billion adults and more than 42 million children are overweight or obese.
***
Source: McKinsey & Co.
Read the complete McKinsey Quarterly article here.

Tuesday, October 19, 2010

Placebos In Drug Studies Contain Biologically Active Compounds

From "Study: That 'placebo effect' may have a hidden meaning" by John Carroll on FierceBiotech:
in the vast majority of cases, developers never disclose what they put in the phony therapy, which is supposed to be made up of harmless materials. But in the few cases when researchers did find the ingredients, they amazingly concluded that researchers may have hurt as well as helped the chances of their experimental therapies.

Case in point: In one study "olive oil and corn oil have been used as the placebo in trials of cholesterol-lowering drugs. This may lead to an understatement of drug benefit: The monounsaturated and polyunsaturated fatty acids of these 'placebos,' and their antioxidant and anti-inflammatory effects, can reduce lipid levels and heart disease."
Read the complete article about the study published in the Annals of Internal Medicine here.

Friday, October 1, 2010

Healthy Food Options Are More Expensive Than Unhealthy Options In US: US Tariffs On Fruits And Vegetables And Sugar Subsidies Are A Cause Of US Obesity

One of the reasons for unhealthy eating in the US, excessive sugar consumption and insufficient consumption of fruits and vegetables, is due to the higher cost of healthy foods, according to a recent nutritional study discussed below. Household affordability overrides nutritional education, the food pyramid, posted caloric count information, etc.

There is a logical, unstated strategy of this nutritional research that will promote healthy eating in the US and reduce obesity. The US government needs to undo US laws and policies that increase the cost of healthy foods, such as fruits and vegetables, and lower the costs of foods eaten in excess to unhealthy levels in in the US, such as sugars, carbohydrates and fats.

To effectively reduce obesity, the US needs to remove tariffs on imported fruits and vegetables to lower their costs to US consumers. The US also need to remove subsidies to US sugar producers, which lowers the price of sugar in the US. Additionally, since the poor are most affected by relative high food prices, modifying the Food Stamp Program to increase healthy eating, by either raising the income cutoff for this benefit, or by increasing the dollar amount of food stamps will increase healthy eating, consumption of fruits and vegetables, and decrease obesity.

From ScienceNews, "Pernicious influences on dietary choices: Many economic, sensory and lifestyle factors can subtly influence food consumption" by Janet Raloff:
... Adam Drewnowski of the University of Washington and his colleagues have for years been linking dietary choices and food costs. On a weight basis, grains and fats tend to be quite affordable. So it should come as no surprise, they’ve noted, that low-income families tend to rely on wheat, corn and fat as dietary staples at home — and the basis of entrees purchased in fast-food restaurants.

In a new paper, Drewnowski now analyzes the market prices for more than 1,375 foods on a per-calorie basis. Again, grains, sugars and fats were about the cheapest; fruits and veggies proved comparatively expensive. His findings appear in the American Journal of Clinical Nutrition, available online ahead of print.

“The fact that healthful foods cost more than less healthy options is a formidable real-world challenge for nutrition interventions,” he points out.
From the abstract of the Adam Drewnowski research paper, "The cost of US foods as related to their nutritive value" in The American Journal of Clinical Nutrition:
Results: Grains and fats food groups supplied the lowest-cost dietary energy. The energy cost for vegetables was higher than that for any other food group except for fruit. Serving sizes increased with water content and varied inversely with energy density of foods. The highest prices per serving were for meats, poultry, and fish, and the lowest prices per serving were for the fats category. Although carbohydrates, sugar, and fat were associated with lower price per 100 g, protein, fiber, vitamins, and minerals were associated with higher price per 100 g, after adjustment for energy.

Conclusions: Grains and sugars food groups were cheaper than vegetables and fruit per calorie and were cheaper than fruit per serving. These price differentials may help to explain why low-cost, energy-dense foods that are nutrient poor are associated with lower education and incomes.

Tuesday, July 27, 2010

Medical Competition Saves Lives Without Raising Costs

From "Death by Market Power: Reform, Competition and Patient Outcomes in the National Health Service" by Martin S. Gaynor, Carnegie Mellon University, Carol Propper, University of Bristol and Rodrigo Moreno-Serra, University of York, July 2010.
we estimate the impact of the introduction of competition on not only clinical outcomes but also productivity and expenditure. Our data set is large, containing information on approximately 68,000 discharges per year per hospital from 162 hospitals. We find that the effect of competition is to save lives without raising costs. Patients discharged from hospitals located in markets where competition was more feasible were less likely to die, had shorter length of stay and were treated at the same cost.
Ungated, free copy of the research paper is available here.
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Thursday, August 27, 2009

Is Government Mandated Health Insurance Constitutional?

In an August 22, 2009, Washington Post article, "Illegal Health Reform," David B. Rivkin Jr. and Lee A. Casey argue that Congress cannot mandate the purchase of healthcare insurance.

President Obama's proposal to reform the medical system requires every individual to obtain medical insurance.

Rivkin and Casey write:
But can Congress require every American to buy health insurance?

In short, no. The Constitution assigns only limited, enumerated powers to Congress and none, including the power to regulate interstate commerce or to impose taxes, would support a federal mandate requiring anyone who is otherwise without health insurance to buy it.
Read the complete Washington Post article by Rivkin and Casey here.

Tuesday, August 25, 2009

Hidden Costs Of Free Government Health Care: The French Example

City Journal has an article about the true cost of having free government health care in France. Read "Paying for Le Treatment" by Guy Sorman, City Journal, 24 August 2009.

Sorman writes:
France’s costly national health insurance is mostly financed by taxes on labor. A Frenchman making a monthly salary of 3,000 euros will pay approximately 350 of them (deducted by his employer) for health insurance. Then the employer will add approximately 1,200 euros, making the total monthly cost to the employer of this individual’s services not 3,000 euros but 4,200. High labor costs in France affect not only consumer prices but also unemployment rates, since employers are reluctant to pay so much for low-skill workers. Economists agree that unemployment rates and the cost of national health insurance are directly related everywhere, which partly explains why even in periods of economic growth, the average French unemployment rate hovers around 10 percent.

High as they are, taxes on wages are not enough to cover the constant deficits that national health insurance runs. France imposes an additional levy to try to close the insurance deficit—the CSG (contribution sociale généralisée)—which applies to all income, including dividends, and which Parliament increases every year.
The French system negatively affects employment in France and increases the cost of drugs in the US for Americans.

Read the entire article here.