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Source of book image: http://www.simplenomics.com/wp-images/settingthetable-1.jpg

(p. R7) Most successful entrepreneurs like rattling on about how they did it.

The bookshelves have never been more crowded with such exploits from consultants, real-estate moguls and retailers. And publishers say there are more on the way. With layoffs and cutbacks dominating the headlines, demand for advice books based on true-life stories is peaking.

. . .

So what does it take to succeed?

"Pragmatic advice, [a book written by] somebody with a fairly high public profile, and a person who can hit the lecture circuit after the first rush of publicity and keep the book selling," says Grand Central's Mr. Wolff.

Those factors have contributed to the staying power of restaurateur Danny Meyer's book, "Setting the Table: The Transforming Power of Hospitality in Business."

News Corp.'s HarperCollins Publishers first published 30,000 copies in October 2006. (News Corp. also publishes The Wall Street Journal.) Mr. Meyer's work, chatty personal anecdotes wrapped around a core message that emphasizes hospitality as the key to creating satisfied customers, proved a hit.

. . .

"The most surprising thing was the interest from the hospital community," Mr. Meyer says. "That's an industry in turmoil based on the absence of hospitality. They over-focus on the metrics of stays and cure rates rather than how they make people feel."

For the full story, see:

JEFFREY A. TRACHTENBERG. "Running the Show; Me, Me, Me; So many entrepreneurs are writing books about how they made it. Their books, though, aren't nearly as successful." The Wall Street Journal (Mon., June 16, 2008): R7.

(Note: ellipses added.)

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Source of table: online version of the NYT article quoted and cited below.

(p. C1) On Wal-Mart's Web site, you can buy a walker for $59.92. It is called the Carex Explorer, and it's a typical walker: a few feet high, with four metal poles extending to the ground. The Explorer is one of the walkers covered by Medicare.

But Medicare and its beneficiaries aren't paying $59.92 for the Explorer or any similar walker. In fact, they're not paying anything close to it. They are paying about $110.

. . .

(p. C5) In the abstract, fixing the health care system sounds perfectly unobjectionable: it's about reducing costs (and then being able to cover the uninsured) by getting rid of inefficiency and waste. In reality, though, almost every bit of waste benefits someone.

Doctors who perform spinal fusion surgeries, despite decidedly mixed evidence that they're effective, are making a nice living. Hospitals that order $1,000 diagnostic tests, even when a cheaper one would work just as well, are helping their bottom line. Medical equipment makers selling walkers for $110, while Wal-Mart sells them for $60, are fattening their profits.

The current fight to protect those profits is a microcosm of what you can expect to see if a larger effort to rein in health costs ever gets going. The defenders of the status quo won't say that they are protecting themselves. Instead, they'll use the same arguments that the medical equipment makers are using -- that a change will destroy jobs, bankrupt small businesses and, above all, harm patients.

. . .

But this is a case in which the market can clearly do a better job than a government-mandated fee schedule. Just look at Wal-Mart's Web site or, for that matter, the bids that Medicare has already received.

By standing in the way of this competition, Congress is really standing up for higher health care costs.

For the full commentary, see:

DAVID LEONHARDT. "ECONOMIC SCENE; High Medicare Costs, Courtesy of Congress." The New York Times (Weds., June 25, 2008): C1 & C5.

(Note: ellipses added.)

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"Aurora Johnson, left, a dental therapist, filled cavities for Paul Towarak, 10, in the village of Unalakleet, Alaska. For more involved procedures, Ms. Johnson refers patients to a dentist." Source of caption and photo: online version of the NYT article quoted and cited below.

Clayton Christensen (and co-authors) have suggested that disruptive technologies could reduce the cost and improve the quality of health care. One pathway for this to occur is new technologies that permit effective treatment to be carried out by para-professionals with less education than MD's.

The article below illustrates Christensen's idea, and also highlights the main obstacle to its implementation: professional organizations asking the government to regulate and restrict competition from the lower-cost para-professionals.

(p. A1) UNALAKLEET, Alaska -- The dental clinic in this village on the edge of the Bering Sea looks like any other, with four chairs, a well-scrubbed floor and a waiting area filled with magazines.

But to the Alaska Dental Society and the American Dental Association, the clinic is a place where the rules of dentistry are flouted daily. The dental groups object not because of any evidence that the clinic provides substandard care, but because it is run by Aurora Johnson, who is not a dentist. After two years of training in a program unique to Alaska, Ms. Johnson performs basic dental work like drilling and filling cavities.

Some dentists who specialize in public health, noting that 100 million Americans cannot afford adequate dental care, say such training programs should be offered nationwide. But professional dental groups disagree, saying that only dentists, with four years of postcollegiate education, should do work like Ms. John-(p. A15)son's. And while such arrangements are common outside the United States, only one American dental school, in Anchorage, offers such a program.

. . .

(p. A15) In Alaska, the A.D.A. and the state's dental society had filed a lawsuit to block the program that trained people like Ms. Johnson, who are called dental therapists. The groups dropped the suit last summer after a state court judge issued a ruling critical of the dentists. But the A.D.A. continues to oppose allowing therapists to operate anywhere in the lower 49 states. Currently, therapists are allowed to practice only in Alaska, and only on Alaska Natives.

. . .

Therapists are a low-cost way to provide care to people who might not otherwise have access to it, according to Dr. Ron Nagel, a dentist and consultant for the Alaska Native Tribal Health Consortium, a nonprofit group financed mostly by federal money that provides medical and dental care to tribal communities. "There's a huge need for these basic services," Dr. Nagel said.

. . .

Since 1990, the number of private dentists has remained roughly flat, at 150,000, even as the United States population has increased 22 percent. As a result, dentists can easily fill their appointment books without seeing people who cannot meet their fees, and patients who have decayed teeth are suffering needlessly, said Tammy Guido, 50, who is one of seven students now training in Anchorage to become a therapist.

"We're meeting a need that is not being met," Ms. Guido said.

Alaskan tribal organizations sponsor Ms. Guido and the other students in Anchorage for the program. To be accepted, students must have a high school diploma or equivalency degree; for the newest class, 7 of 18 candidates were accepted.

In interviews, the students in this year's class all said they were enthusiastic about the chance to serve communities that have little access to care. All seven had quit full-time jobs and must now get by on a $750 monthly stipend during the two years of training.

"Anybody who's ever had a toothache can tell you it hurts," said Ben Steward, 24, the only man in this year's class. "But talk to someone who's had a toothache for a year."

For the full story, see:

ALEX BERENSON. "Dental Clinics, Meeting a Need With No Dentist." The New York Times (Mon., April 28, 2008): A1 & A15.

(Note: ellipses added.)

One source of Christensen's views on health care can be found in a chapter in:

Christensen, Clayton M., Scott D. Anthony, and Erik A. Roth. Seeing What's Next: Using Theories of Innovation to Predict Industry Change. Boston, MA: Harvard Business School Press, 2004.

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Source of graph: online version of the NYT article quoted and cited below.

The most interesting part of the article quoted below, was the above graph, that dramatically shows health care's large and growing share of disposable personal income.

(p. 28) Among employers, the hardest pressed may be small businesses. Their insurance premiums tend to be proportionately higher than ones paid by large employers, because small companies have little bargaining clout with insurers.

Health costs are "burying small business," said Mike Roach, who owns a small clothing store in Portland, Ore. He recently testified on health coverage at a Senate hearing led by Ron Wyden, Democrat of Oregon.

Last year, Mr. Roach paid about $27,000 in health premiums for his eight employees. "It's a huge chunk of change," he said, noting that he was forced to raise his employees' yearly deductible by 50 percent, to $750.

For the full story, see:

REED ABELSON and MILT FREUDENHEIM. "Even the Insured Feel Strain of Health Costs." The New York Times, Section 1 (Sun., May 4, 2008): 1 & 28.

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"A grid in the monkey's brain carried signals from 100 neurons for the mechanical arm to grab and carry snacks to the mouth." Source of caption and photos: online version of the NYT article quoted and cited below.

(p. A1) Two monkeys with tiny sensors in their brains have learned to control a mechanical arm with just their thoughts, using it to reach for and grab food and even to adjust for the size and stickiness of morsels when necessary, scientists reported on Wednesday.

The report, released online by the journal Nature, is the most striking demonstration to date of brain-machine interface technology. Scientists expect that technology will eventually allow people with spinal cord injuries and other paralyzing conditions to gain more control over their lives.

The findings suggest that brain-controlled prosthetics, while not practical, are at least technically within reach.

In previous studies, researchers showed that humans who had been paralyzed for years could learn to control a cursor on a computer screen with their brain waves and that nonhuman primates could use their thoughts to move a mechanical arm, a robotic hand or a robot on a treadmill.

The new experiment goes a step further. In it, the monkeys' brains seem to have adopted the mechanical appendage as their own, refining its movement as it interacted with real objects in real time. The monkeys had their own arms gently restrained while they learned to use the added one.

For the full story, see:

BENEDICT CAREY. "Monkeys Think, Moving Artificial Arm as Own." The New York Times (Thurs., May 29, 2008): A1 & A18.

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"One of a handful of 2,000-year-old seeds (top) from the fortress of Masada in present-day Israel grew into a date palm plant (bottom) called Methuselah in 2005." Source of caption and photos: online article quoted and cited below.

The oldest-sprouted seed in the world is a 2,000-year-old plant from Jerusalem, a new study confirms.

"Methuselah," a 4-foot-tall (1.2-meter-tall) ancestor of the modern date palm, is being grown at a protected laboratory in the Israeli capital.

In 2005 the young plant was coaxed out of a seed recovered in 1963 from Masada, a fortress in present-day Israel where Jewish zealots killed themselves to avoid capture by the Romans in A.D. 70.

For the full story, see:

Anne Minard. ""Methuselah" Tree Grew From 2,000-Year-Old Seed." National Geographic News online (June 12, 2008), downloaded on 6/19/08 from: http://news.nationalgeographic.com/news/2008/06/080612-oldest-tree.html

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(p. C6) The American Medical Association is hulking mad at Marvel Studios.

Last week, the advocacy arm of the powerful physicians' group unleashed a tsk-tsk campaign against "The Incredible Hulk," a Marvel film that opened on Friday and is distributed by Universal Pictures. The complaint was of "gratuitous depictions of smoking."

In the movie, which drew a PG-13 rating from the Motion Picture Association of America, Gen. Thunderbolt Ross, a bad guy played by William Hurt, is rarely seen without a smoke-spewing cigar. (Presumably, the physicians' association worries that children who identify with the authoritarian general -- who wants to annihilate the Hulk, played by Edward Norton -- may be tempted to pick up the habit.)

For the full story, see:

BROOKS BARNES. "Physicians' Group Furious at Cigars in 'Hulk' Movie." The New York Times (Mon., June 16, 2008): C6.

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"Sam Houston." Source of caption and photo: online version of the WSJ commentary quoted and cited below.

(p. A9) When Sam Houston was still hanging his hat in Tennessee in the 1830s, it wasn't uncommon for fellow Tennesseans who were packing up and moving south and west to hang a sign on their cabins that read "GTT" - Gone to Texas.

Today obstetricians, surgeons and other doctors might consider reviving the practice. Over the past three years, some 7,000 M.D.s have flooded into Texas, many from Tennessee.

Why? Two words: Tort reform.

In 2003 and in 2005, Texas enacted a series of reforms to the state's civil justice system. They are stunning in their success. Texas Medical Liability Trust, one of the largest malpractice insurance companies in the state, has slashed its premiums by 35%, saving doctors some $217 million over four years. There is also a competitive malpractice insurance industry in Texas, with over 30 companies competing for business. This is driving rates down.

The result is an influx of doctors so great that recently the State Board of Medical Examiners couldn't process all the new medical-license applications quickly enough. The board faced a backlog of 3,000 applications. To handle the extra workload, the legislature rushed through an emergency appropriation last year.

For the full commentary, see:

JOSEPH NIXON. "CROSS COUNTRY; Why Doctors Are Heading for Texas." The Wall Street Journal (Sat., May 17, 2008): A9.

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"Paul Metzger, holding the Handler, an anti-microbial device that helps users avoid touching surfaces that might carry germs." Source of caption and photo: online version of the NYT article quoted and cited below.

(p. C5) With so many people worried about getting sick -- whether from the common cold and flu or exotic new strains of antibiotic-resistant bacteria -- Paul and Jeffrey Metzger had every reason to hope that the germ-fighting key fob they invented would be a runaway hit.

Their device, known as the Handler, began selling last year online and in stores like Duane Reade pharmacies for about $11. It features a pop-out hook so germophobes can avoid touching A.T.M. keypads, door handles and other public surfaces where undesirable microbes may lurk. As added protection, the Handler's rubber and plastic surfaces are impregnated with tiny particles of silver to kill germs that land on the device itself.

But those little silver particles have run Maker Enterprises, the Metzger brothers' partnership in Los Angeles, into a big regulatory thicket. The Metzgers belatedly realized that the Environmental Protection Agency might decide that a 1947-era law that regulates pesticides would apply to antimicrobial products like theirs.

The agency ruled last fall that the law covered Samsung's Silvercare washing machine. Samsung was told it would have to register the machine as a pesticide, a potentially costly and time-consuming process, because the company claims the silver ions generated by the washer kill bacteria in the laundry.

The Metzgers halted production of their key fob while they sought legal guidance on how to avoid a similar fate.

Their quandary highlights a challenge facing the growing number of entrepreneurs who have ventured into nanotechnology, a field that gets its name from its reliance on materials so small their dimensions are measured in nanometers, or billionths of a meter.

. . .

"They don't really know how they want to register these particles," said Tracy Heinzman, a lawyer in Washington who deals frequently with the E.P.A. "There's no clear path forward."

More broadly, the limbo into which the Handler has tumbled shows how the limited resources of agencies like the E.P.A. can combine with creaky regulations to act as a brake on innovation. "The marketplace is always ahead of the E.P.A.," Ms. Heinzman said.

For the full story, see:

BARNABY J. FEDER. "Small Business; Fighting Germs and Regulators; Pesticide Rules May Apply to Tiny Particles That Kill Microbes." The New York Times (Thurs., March 6, 2008): C5.

(Note: the title of the online version was "Small Business; New Device for Germophobes Runs Into Old Law.")

(Note: ellipsis added.)

"Production of the Handler has ceased for the time being." Source of caption and photo: online version of the NYT article quoted and cited above.

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(p. A1) Red wine may be much more potent than was thought in extending human lifespan, researchers say in a new report that is likely to give impetus to the rapidly growing search for longevity drugs.

The study is based on dosing mice with resveratrol, an ingredient of some red wines. Some scientists are already taking resveratrol in capsule form, but others believe it is far too early to take the drug, especially using wine as its source, until there is better data on its safety and effectiveness.

The report is part of a new wave of interest in drugs that may enhance longevity. On Monday, Sirtris, a startup founded in 2004 to develop drugs with the same effects as resveratrol, completed its sale to GlaxoSmithKline for $720 million.

. . .

(p. A16) Separately from Sirtris's investigations, a research team led by Tomas A. Prolla and Richard Weindruch, of the University of Wisconsin, reports in the journal PLoS One on Wednesday that resveratrol may be effective in mice and people in much lower doses than previously thought necessary. In earlier studies, like Dr. Auwerx's of mice on treadmills, the animals were fed such large amounts of resveratrol that to gain equivalent dosages people would have to drink more than 100 bottles of red wine a day.

The Wisconsin scientists used a dose on mice equivalent to just 35 bottles a day. But red wine contains many other resveratrol-like compounds that may also be beneficial. Taking these into account, as well as mice's higher metabolic rate, a mere four, five-ounce glasses of wine "starts getting close" to the amount of resveratrol they found effective, Dr. Weindruch said.

Resveratrol can also be obtained in the form of capsules marketed by several companies. Those made by one company, Longevinex, include extracts of red wine and of a Chinese plant called giant knotweed. The Wisconsin researchers conclude that resveratrol can mimic many of the effects of a caloric-restricted diet "at doses that can readily be achieved in humans."

For the full story, see:

NICHOLAS WADE. "New Hints Seen That Red Wine May Slow Aging." The New York Times (Weds., June 4, 2008): A1 & A16.

(Note: ellipsis added.)

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Source of the graphic: online version of the NYT article cited below.

The most interesting part of a recent David Leonhardt column, was not what he wrote, but the graphs that were included with the article, especially the one at the top of this entry. Notice that the price of education and medical care have increased much more dramatically than other categories of consumer spending. (And remember how heavily government is involved in those two sectors, both directly through government run institutions, and indirectly through regulations and subsidies.)

For the full commentary, see:

DAVID LEONHARDT. "ECONOMIC SCENE; Seeing Inflation Only in the Prices That Go Up." The New York Times (Weds., May 7, 2008): C1 and C11.

Source of the graphic: online version of the NYT article cited above.

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Medical entrepreneur Tom Harold.    Source of photo:   http://www.scyfix.org/management.php

(p. 1D) ScyFix, a Chanhassen, Minn., startup, has developed a device it claims treats diseases such as glaucoma and macular degeneration by shooting electric currents into the eye. The company, which is conducting clinical trials in India and the United States, hopes to sell the first device approved by the Food and Drug Administration designed to restore eyesight.

"To me, this is the pacemaker for the eye," said Dr. Darrell DeMello, ScyFix president and a former executive at Boston Scientific Corp.

ScyFix hopes to eventually raise $60 million to $70 million to finish its clinical trials.

. . .

(p. 2D) Thomas Harold first came up with the idea for ScyFix in 2002. An Internet entrepreneur and a former executive at General Mills, Harold became interested in studies that showed electricity could restore sight. Drugs, however, could only slow the effects of some diseases.

. . .

Specifically, the studies showed electricity could stimulate the production of neurotrophins, a family of proteins that can instruct optic nerve, retinal neurons and photoreceptor cells not to die. In addition, neuromodulation can also repair cell membranes, allowing cells to absorb nutrients, release wastes, improve blood flow to the eye and rewire faulty nerve connections.

Working with doctors and engineers, Harold, who has no medical background, developed a device that releases low-intensity electric currents into the eyelids through electrodes. A complex mathematical equation programmed into the device controls the amount and frequency of the electricity. Patients can administer the treatment at home twice a day for 20 minutes.

Harold says he is encouraged by the results so far: Since 2002, the device has halted progression of diseases in 95 percent of the 1,000 patients tested in 29 countries, according to ScyFix.

"Everything stopped getting worse," Harold said. "That was a win in itself."

In addition, 80 percent of the patients reported vision improvement. There were no side effects, the company said.

For the full story, see:

Lee, Thomas (The Star Tribune). "'Pacemaker' for eyes shows initial promise." Omaha World-Herald (Sunday, March 9, 2008): 1D & 2D.

(Note: ellipses added.)

Below I have pasted a couple of paragraphs from the ScyFIX web site. Note that Europeans are free to try the therapy, if they so desire. But citizens of the United States are not free to try the therapy, due to the regulations of the Food and Drug Admininstration (FDA) of the U.S. government.

Buy ScyFIX 600 and Accessories on-line!

Welcome to ScyFIX international web shop where you can order products, choose payment method, including a secure on-line credit card payment service (SSL), and check your delivery status on-line. Buying on-line is safe and easy and you will be guided all the way. All prices are in € (Euro). Place your order and your credit card company will convert the amount in € to your own currency. We accept Visa, Master Card, EuroCard and most bank cards connected to VISA or Master Card. Follow the instructions to take you through the pages, and then onto a secure site in which you will input your credit card and shipping details. When bank authorization has been attained, you will get a confirmation on-line, as well as a confirming e-mail. If at any stage you wish to change your order, just click the "Remove"-button.

Please note that ScyFIX can not ship devices to US addresses, until the ongoing FDA trials have resulted in an approval to market the product in the USA. US customers who mistakenly order and pay for a therapy kit over the web, will be contacted and refunded. However, ScyFIX will deduct 100€ (Euros) covering banking fees and handling costs. If you are a US resident and want to know more about our therapy, please send an inquiry by e-mail to our European office support@scyfix.org, or fill in your personal information in our Clinical Trial & Purchase Interest Form by clicking here www.scyfix.org/clinical_trial_form.htm.

The paragraphs were accessed on 3/9/08 from:

http://www.scyfix.org/shop/

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"Climbing stairs is a challenge for George Allen." Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A1) WASHINGTON -- On a bluff overlooking the Potomac River, George and Anne Allen, both 82, struggle to remain in their beloved three-story house and neighborhood, despite the frailty, danger and isolation of old age.

Mr. Allen has been hobbled since he fractured his spine in a fall down the stairs, and he expects to lose his driver's license when it comes up for renewal. Mrs. Allen recently broke four ribs getting out of bed. Neither can climb a ladder to change a light bulb or crouch under the kitchen sink to fix a leak. Stores and public transportation are an uncomfortable hike.

So the Allens have banded together with their neighbors, who are equally determined to avoid being forced from their homes by dependence. Along with more than 100 communities nationwide -- a dozen of them planned here in Washington and its suburbs -- their group is part of a movement to make neighborhoods comfortable places to grow old, both for elderly men and women in need of help and for baby boomers anticipating the future.

"We are totally dependent on ourselves," Mr. Allen said. "But I want to live in a mixed community, not just with the elderly. And as long as we can do it here, that's what we want."

Their group has registered as a nonprofit corporation, is setting membership dues, and is lining up providers of transportation, home repair, companionship, security and other services to meet their needs at home for as long as possible.

Urban planners and senior housing experts say this movement, organized by residents rather than government agencies or social service providers, could make "aging in place" safe and affordable for a majority of elderly people. Almost 9 in 10 Americans over the age of 60, according to AARP polls, share the Allens' wish to live out their lives in familiar surroundings.

. . .

(p. A18) The first village in the Washington area is expected to be on Capitol Hill. When it opens for business on Oct. 1, annual memberships will be $750 for a couple and $500 for an individual.

Among those eager to join are Marie Spiro, 74, and Georgine Reed, 78, who share a rambling house that they insist they will only leave "feet first." Between them, Ms. Spiro, an emeritus professor of art history and archaeology, and Ms. Reed, a retired designer of museum exhibits, have already endured three knee replacements and an array of other ailments.

Ms. Spiro describes huffing and puffing while grocery shopping; Ms. Reed is increasingly reluctant to visit friends across town. Both women, who are childless, would already welcome help with meals, transportation and paperwork. If they need home care, Capitol Hill Village will be able to organize that.

"I've never had to rely on other people, and I never wanted to," Ms. Spiro said. "But I'd rather pay a fee than have to ask favors."

For the full story, see:

JANE GROSS "A Grass-Roots Effort to Grow Old at Home The New York Times (Tues., August 14, 2007): A1 & A18.

(Note: ellipses added; caption for the George Allen photo is the online caption, not the different one in the print version of the article.)

"Georgine Reed, 78, right, and Marie Spiro, 74, share a Capitol Hill home and are joining a group that will help them stay there. "I'd rather pay a fee," Ms. Spiro said, "than have to ask favors."" Source of caption and photo: online version of the NYT article quoted and cited above.

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"Alicia Ledlie, senior director of health business development for Wal-Mart, said walk-in medical clinics would look like the mockup behind her, in a warehouse in Bentonville, Ark." Source of caption and photo: online version of the NYT article quoted and cited below.

(p. C4) Moving to upgrade its walk-in medical clinic business, Wal-Mart is set to announce on Thursday plans for several hundred new clinics at its stores, using a standardized format and jointly branded with hospitals and medical groups.

. . .

Walk-in medical clinics are a growing industry, with numerous competitors that include big-box retailers, drugstores and even grocery chains around the country. Industry executives say 1,500 to 1,800 clinics will be open by the end of the year.

Propelled by the drugstore chains CVS and Walgreens, by far the biggest sponsors of the clinics to date, more than 700 clinics have opened in the last 15 months. But the business model is unproven so far.

Few, if any, clinics are profitable, according to industry analysts, and only a handful have broken even on daily operations. Most have been open a year or less, and executives say it takes up to three years for a clinic to become profitable enough to recover start-up costs.

Medical societies are inclined to be skeptical of the clinics. The American Academy of Pediatrics opposes them, saying they add to fragmentation in the health care system.

Dr. Edward Zissman, a pediatrician in central Florida, said he had qualms about hospitals that hook up with the clinics. "Putting their name on a product that I don't think has the highest quality," he said, "is going to cost them dearly with physicians."

The American Academy of Family Physicians and the American Medical Association have set forth principles for clinics to observe, including sending patients' medical record to their doctors and finding doctors for patients who do not already have them. Most states require varying degrees of physician supervision of the clinic nurses. Clinic operators say they are complying.

Many patients have said they like the convenience of the walk-in clinics' weekend and evening hours, the short waiting times to see a nurse practitioner, and the posted price lists for a limited menu of care like tests and prescriptions for sore throats and ear infections and seasonal flu shots.

. . .

"The clinics are the latest big example of how you could think about consumers and what their needs are, rather than a health care system exclusively designed around the needs of providers," said Margaret Laws, director of an innovations program at the California Health Care Foundation, an independent group that finances health policy research.

For the full story, see:

MILT FREUDENHEIM. "Wal-Mart Will Expand In-Store Medical Clinics." The New York Times (Thurs., February 7, 2008): C4.

(Note: ellipses added.)

"The design of the Wal-Mart medical clinic is intended to look like a doctor's office, complete with the usual medical hardware." Source of caption and photo: online version of the NYT article quoted and cited above.

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(p. 12) FROM the very beginning of the nation's modern social welfare system -- even before Michael Moore began to explore the issue -- there was a tension in it: What should the government be expected to provide? What should be left to the individual? How much government is too much?

The questions were asked even in 1935, not exactly a time to instill confidence in the resilient power of private markets. Senator Thomas Pryor Gore, Democrat of Oklahoma, put it bluntly when Frances Perkins, the secretary of labor, testified on Capitol Hill that year about President Franklin D. Roosevelt's plan for a new program called Social Security.

''Isn't this socialism?'' Senator Gore demanded. When Ms. Perkins denied it, he asked again: ''Isn't this a teeny-weeny bit of socialism?'' In recent days, on Capitol Hill and on the campaign trail, a new version of that debate has been flaring, this time around an issue that the New Dealers decided (perhaps wisely) to put off for a later date: health care.

For the full commentary, see:

Robin Toner. "IDEAS & TRENDS; Less, Less, Less! More, More, Moore!" The New York Times, Week in Review section (Sun., August 5, 2007): 12.

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(p. A16) Environmental leaders must join the 21st century, acknowledge the mistakes Carson made, and balance the hypothetical risks of DDT with the real and devastating consequences of malaria. Uganda has demonstrated that, with the proper support, we can conduct model indoor spraying programs and ensure that money is spent wisely, chemicals are handled properly, our program responds promptly to changing conditions, and malaria is brought under control.

Africa is determined to rise above the contemporary colonialism that keeps us impoverished. We expect strong leadership in G-8 countries to stop paying lip service to African self-determination and start supporting solutions that are already working.

For the full commentary, see:

Sam Zaramba. "Give Us DDT." Wall Street Journal (Tues., Jun 12, 2007): A16.

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Shannon Brownlee is the author of "Overtreated" which "diagnoses the big flaw in medical spending." Source of caption and photo: online version of the NYT commentary quoted and cited below.

(p. C5) Fortunately -- if that's the right word -- there is an obvious candidate for cost-cutting: all that care that brings no health benefit. It's not hard to find examples. Scientific studies have shown that many treatments, including spinal fusion, routine episiotomies and neonatal intensive care, are overdone. These procedures often help specific subsets of patients. But for a lot of people, and "Overtreated" is full of stories, the treatments are a modern-day version of bloodletting.

"We spend between one fifth and one third of our health care dollars," writes Ms. Brownlee, a senior fellow at the New America Foundation and former writer for U.S. News & World Report, "on care that does nothing to improve our health."

Worst of all, overtreatment often causes harm, because even the safest procedures bring some risk. One study found that a group of Medicare patients admitted to high-spending hospitals were 2 to 6 percent more likely to die than a group admitted to more conservative hospitals.

For the rest of the commentary, see:

DAVID LEONHARDT. "ECONOMIC SCENE; No. 1 Book, And It Offers Solutions." The New York Times (Weds., December 19, 2007): C1 & C5.

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(p. A22) When my Labrador retriever became acutely lame, we were able to locate a veterinary orthopedic expert in Atlanta within 48 hours who was able to repair a ruptured tendon within one week. But my prospects of identifying an endocrinologist who can care for my daughter's diabetes when she turns 18 are much less promising.

The limited number of endocrine specialists is a not a consequence of limited demand -- everyone is aware of the epidemic of diabetes we are facing. There are also shortages of generalists and other specialists, and the reason is the absence of market signals -- i.e., market-based prices -- for influencing the supply of physicians in various specialties.

The roots of this problem lay in the use of administrative pricing structures in medicine. The way prices are set in health care already distorts the appropriate allocation of efforts and resources in health care today. Unfortunately, many of the suggested reforms of our health care system -- including the various plans for universal care, or universal insurance, or a single-payer system, that various policy makers and Democratic presidential candidates espouse -- rest on the same unsound foundations, and will produce more of the same.

. . .

One important lesson of the 20th century is that, while markets are far from perfect, more choices are available when people are able to use free markets to interact with each other. Markets may not get the prices exactly correct all the time, but they are capable of self- correction, a capacity that has yet to be demonstrated by administrative pricing.

It tells you something when the supply of and demand for specialist veterinary care is so easily matched when the prices of these services are established on the market -- while shortages and oversupplies are common for human medical care when the prices of these services are set by administrators in the public sector. Will health-care reformers -- and American citizens -- get the message?

For the full commentary, see:

Robert A. Swerlick. "Our Soviet Health System." Wall Street Journal (Tues., Jun 5, 2007): A22.

(Note: ellipsis added.)

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Source of photo: screen capture from slide show on online version of the NYT article quoted and cited below.

(p. C1) Part David Attenborough, part Indiana Jones, Mr. Kilham, an ethnobotanist from Massachusetts who calls himself the Medicine Hunter, has scoured remote jungles and highlands for three decades for plants, oils and extracts that can heal. He has eaten bees and scorpions in China, fired blow guns with Amazonian natives, and learned traditional war dances from Pacific Islanders.

But behind the colorful tales lies the prospect of money, lots of money -- for Western pharmaceutical companies, impoverished indigenous tribes and Mr. Kilham.

. . .

(p. C5) In Peru, Mr. Kilham is betting on maca, a small root vegetable that grows here in the central highlands -- "a turnip that packs a punch," he says, adding "it imparts energy, sex drive and stamina like nothing else."

That view is supported by studies carried out at the International Potato Center, a Lima-based research center that is internationally financed and staffed. Studies there show maca improves stamina, reduces the risk of prostate cancer and increases the motility, volume and quality of sperm.

Some peer reviewed studies published in the journal Reproductive Biology and Endocrinology backed up those findings.

. . .

One product, Maca Stimulant, is sold in Wal-Mart under Mr. Kilham's Medicine Hunter brand. Mr. Kilham earns a retainer from both Naturex and Enzymatic Therapy, in addition to royalties from another Medicine Hunter-branded product at Wal-Mart.

Mr. Kilham says he earns around $200,000 each year in retainers, and sales are so buoyant he expects to make "in the mid-six figures" in royalties next year.

Mr. Kilham insists he is not in the business simply for financial gain. His motivation comes from promoting herbal medicines and helping traditional communities, he said.

"I have financial security and don't need to make money from this," he said. "I believe trade is the best way to get good medicines to the public, to help the environment and to help indigenous people."

He and Mr. Cam pay growers here in Ninacaca a premium of 6 soles (about $2) for a kilo of maca, almost twice the going rate of 3 to 3.40 soles a kilo. They have set up a computer room at the Chakarunas warehouse and a free dental clinic, the town's first.

Mr. Kilham is clearly adored by the locals in these desolate, wind-swept villages. On a recent visit here, shamans, maca growers and their families flocked to him. Since only maca and potatoes grow at this altitude, they are thankful Mr. Kilham is helping them sell their produce.

For the full story, see:

ANDREW DOWNIE. "On a Remote Path to Cures." The New York Times (Tues., January 1, 2008): C1 & C5.

(Note: ellipses added.)

Source of photo: screen capture from slide show on online version of the NYT article quoted and cited above.

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In the full version of the commentary quoted below, the authors mention four lines of research that they believe hold promise for the future: vaccines, epigenetics, targeted therapies, and cancer "stem cells."

(p. A17) This week, the National Cancer Institute, in conjunction with other organizations that track cancers, reported that the death rate from cancer declined from 2002-2004 by an average of 2.1% per year. This is an improvement over the 1.1% annual declines from 1993-2002 and is very good news indeed. Each 1% decline represents 5,000 people living rather than dying, and, of course, this figure is compounded each year.

While some part of the declining death rate from cancer is the consequence of screening, much is the result of greatly improved treatments. And we believe that the successes achieved to date are only the modest beginning of a revolution in the research into and treatment of cancer.

During the last half of the 20th century, almost all treatments of cancers involved forms of chemotherapy in which cancerous and normal tissues were bombarded with nonselective cytoxic drugs. These drugs killed all cells, healthy as well as malignant. Worse, they did not kill all cancer cells, so the cancer progressed -- leading to the pessimism dominant in people's minds today, a reflection of years of articles and opinion pieces in the popular press expressing the view that "the war on cancer" has been waged incorrectly, if not lost.

Now, however, new therapeutic modes are in play, based on better understandings of cancers and great advances in technologies.

. . .

The danger is that misconceived pessimism might result in a loss of popular moral support for the revolutionary new approaches to cancer research and treatment.

For the full commentary, see:

Samuel Waxman and Richard Gambino. "The New Ways We Fight Cancer." Wall Street Journal (Oct 18, 2007): A17.

(Note: ellipsis added.)

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The passage below is from a WSJ summary of an article that appeared in the December 2007 issue of Discover:

(p. B12) Scientists are increasingly hopeful that controlling inflammation will allow them to turn back the clock on aging, writes Kathleen McGowan in Discover magazine.

Inflammation is already a well-established predictor of many chronic illnesses, such as diabetes, atherosclerosis and Alzheimer's disease.  . . .

. . .

Many prominent gerontologists reason that if these chronic diseases are the product of an overactive immune system, then they can be countered with the right anti-inflammatory drug.    . . .

"The research is really to prevent the chronic debilitating diseases of aging," says Nir Barzilai, a molecular geneticist and director of the Institute for Aging Research at the Albert Einstein College of Medicine in New York. "But if I develop a drug, it will have a side effect, which is that you will live longer."

For the full summary, see:

"The Informed Reader; Health; How Scientists Hope to Shrink Aging Effects." Wall Street Journal (Weds., Nov. 14, 2007): B12.

(Note: ellipses added.)

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"Braided hair is intact on a Peruvian mummy like those used in a study. Scientists say lice in the Americas predated Columbus." Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A10) When two pre-Columbian individuals died 1,000 years ago, arid conditions in the region of what is now Peru naturally mummified their bodies, as well as the lice in their long, braided hair.

That was all scientists needed, they reported Wednesday, to extract well-preserved louse DNA and establish that lice had accompanied their human hosts in the original peopling of the Americas, probably as early as 15,000 years ago. The DNA matched that of the most common type of louse known to exist worldwide now and also before Europeans colonized the New World.

The findings absolve Columbus of responsibility for at least one wrong unintentionally wrought on the people he found in the Americas and called Indians. The Europeans who followed Columbus to America may have introduced diseases, namely smallpox and measles, but not the most common of lice, as had been suspected.

For the full story, see:

JOHN NOBLE WILFORD. "Scientists Say Mummies' Lice Show Pre-Columbian Origins." The New York Times (Thurs., February 7, 2008): A10.

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  Moving water is easier with the 20-gallon rolling drum.  Source of photo:  online version of the NYT article quoted and cited below.

(p. D3)  . . . , the Cooper-Hewitt National Design Museum, . . . , is honoring inventors dedicated to “the other 90 percent,” particularly the billions of people living on less than $2 a day.

Their creations, on display in the museum garden until Sept. 23, have a sort of forehead-thumping “Why didn’t someone think of that before?” quality.

. . .

Interestingly, most of the designers who spoke at the opening of the exhibition spurned the idea of charity.

“The No. 1 need that poor people have is a way to make more cash,” said Martin Fisher, an engineer who founded KickStart, an organization that says it has helped 230,000 people escape poverty.  It sells human-powered pumps costing $35 to $95.

Pumping water can help a farmer grow grain in the dry season, when it fetches triple the normal price.  Dr. Fisher described customers who had skipped meals for weeks to buy a pump and then earned $1,000 the next year selling vegetables.

For the full story, see: 

DONALD G. McNEIL Jr.  "Design That Solves Problems for the World's Poor."  The New York Times  (Tues., May 29, 2007):  D3.

(Note:  ellipses added.)

   The photo on the left shows a woman safely drinking bacteria-laden water through a filter.  The photo on the right shows a "pot-in-pot cooler" that evaporates water from wet sand between the pots, in order to cool what is in the inner pot.  Source of photos:  online version of the NYT article quoted and cited above.

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  Moving water is easier with the 20-gallon rolling drum.  Source of photo:  online version of the NYT article quoted and cited below.

(p. D3)  . . . , the Cooper-Hewitt National Design Museum, . . . , is honoring inventors dedicated to “the other 90 percent,” particularly the billions of people living on less than $2 a day.

Their creations, on display in the museum garden until Sept. 23, have a sort of forehead-thumping “Why didn’t someone think of that before?” quality.

. . .

Interestingly, most of the designers who spoke at the opening of the exhibition spurned the idea of charity.

“The No. 1 need that poor people have is a way to make more cash,” said Martin Fisher, an engineer who founded KickStart, an organization that says it has helped 230,000 people escape poverty.  It sells human-powered pumps costing $35 to $95.

Pumping water can help a farmer grow grain in the dry season, when it fetches triple the normal price.  Dr. Fisher described customers who had skipped meals for weeks to buy a pump and then earned $1,000 the next year selling vegetables.

For the full story, see: 

DONALD G. McNEIL Jr.  "Design That Solves Problems for the World's Poor."  The New York Times  (Tues., May 29, 2007):  D3.

(Note:  ellipses added.)

   The photo on the left shows a woman safely drinking bacteria-laden water through a filter.  The photo on the right shows a "pot-in-pot cooler" that evaporates water from wet sand between the pots, in order to cool what is in the inner pot.  Source of photos:  online version of the NYT article quoted and cited above.

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(p. A1) Researchers in New York believe they have solved one of the great mysteries of the flu: Why does the infection spread primarily in the winter months?

The answer, they say, has to do with the virus itself. It is more stable and stays in the air longer when air is cold and dry, the exact conditions for much of the flu season.

. . .

(p. A22) To his surprise, Dr. Palese stumbled upon a solution that appeared to be a good second best.

Reading a paper published in 1919 in the Journal of the American Medical Association on the flu epidemic at Camp Cody in New Mexico, he came upon a key passage: "It is interesting to note that very soon after the epidemic of influenza reached this camp, our laboratory guinea pigs began to die." At first, the study's authors wrote, they thought the animals had died from food poisoning. But, they continued, "a necropsy on a dead pig revealed unmistakable signs of pneumonia."

Dr. Palese bought some guinea pigs and exposed them to the flu virus. Just as the paper suggested, they got the flu and spread it among themselves. So Dr. Palese and his colleagues began their experiments.

. . .

As for Dr. Palese, he was glad he spotted the journal article that mentioned guinea pigs.

"Sometimes it pays to read the old literature," he said.

 

For the full story, see:

GINA KOLATA. "Study Shows Why the Flu Likes Winter." The New York Times (Weds., December 5, 2007): A1 & A22.

(Note:  ellipses added.)

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    Source of image:  online version of the WSJ article quoted and cited below.

(p. D1)  As part of the government's focus on energy and the environment, Americans are urged to buy compact fluorescent light bulbs, which use only about 25% of the energy and last up to 10 times as long as traditional incandescent bulbs. Nearly 300 million such bulbs were sold in U.S. in 2007, compared with 100 million two years earlier, according to the Department of Energy.

. . .

Yet unlike traditional incandescent bulbs, these bulbs contain mercury, a metal hazardous to human health and the environment. Consumers are urged not to toss them in the trash. In some states, such as California, it's illegal to throw them away; they must be recycled. Still, many cities and towns don't have recycling programs for the bulbs, and consumers aren't sure what to do with them.

For the full story, see: 

SARA SCHAEFER MUÑOZ.  "The Dark Side Of 'Green' Bulbs Disposing of Fluorescents, Electronics Releases Toxins; Companies Tout Recycling." The Wall Street Journal  (Thurs., January 24, 2008):  D1.  

(Note:  ellipsis added.)

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    Source of graph:  online version of the NYT article cited below. 

(p. C1)  In politics, every serious candidate for the White House has a health care plan. So too in business, where the two leading candidates for Web supremacy, Google and Microsoft, are working up their plans to improve the nation’s health care.

. . .

(p. C8)  If the efforts of the two big companies gain momentum over time, that promises to accelerate a shift in power to consumers in health care, just as Internet technology has done in other industries.

Today, about 20 percent of the nation’s patient population have computerized records — rather than paper ones — and the Bush administration has pushed the health care industry to speed up the switch to electronic formats. But these records still tend to be controlled by doctors, hospitals or insurers. A patient moves to another state, for example, but the record usually stays.

The Google and Microsoft initiatives would give much more control to individuals, a trend many health experts see as inevitable. “Patients will ultimately be the stewards of their own information,” said John D. Halamka, a doctor and the chief information officer of the Harvard Medical School.

Already the Web is allowing people to take a more activist approach to health. According to the Harris survey, 58 percent of people who look online for health information discussed what they found with their doctors in the last year.

It is common these days, Dr. Halamka said, for a patient to come in carrying a pile of Web page printouts. “The doctor is becoming a knowledge navigator,” he said. “In the future, health care will be a much more collaborative process between patients and doctors.”

Microsoft and Google are hoping this will lead people to seek more control over their own health records, using tools the companies will provide.

For the full story, see: 

STEVE LOHR.  "Dr. Google and Dr. Microsoft."  The New York Times  (Tues., August 14, 2007):  C1 & C8.

(Note:  ellipsis added.)

  Medical records.  Source of photo:  online version of the NYT article cited above.

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   Source of graph:  online version of the Omaha World-Herald article quoted and cited below.

The article quoted below summarizes a seminar by Dr. John Abramson.  He was right to highlight the high costs of health care in the U.S., though he didn't show any special insight in suggesting solutions.