Pop Economy!

This Persevering Actress Managed To Overcome An Unfortunate Handicap.

As any schoolboy will tell you, sometimes when you stretch your hand under the blouse you’ve been ogling all night, you find out to your disappointment that it’s been padded.  The same can be said of the “botax” itself: when piloted previously in New Jersey, it delivered a mere A-cup worth of revenue instead of the C-cup which had been projected.

Besides the economic sag, the new law brought controversy: some customers chose to leave New Jersey for their procedures, while others charged discrimination on the basis that middle-class women were being unfairly targeted.  Said Joseph Cryan, the Assemblyman who first proposed the tax and now wants it repealed, “We essentially discouraged the business from happening at all.”  I hate to think this was a revelation: taxing an activity discourages people from engaging in it, and will tend to depress the revenues received from the tax.  Mr. Cryan continued, “It was a real education.”  Not Belmont Abbey College’s finest hour.

According to the American Society of Plastic Surgeons, 90% of cosmetic surgery recipients are women, but the Senators who dreamt up the “botax” don’t view it as discriminatory.  Even Sen. Barbara Boxer’s office came to its defense, insisting that men chose “more and more” to get cosmetic surgery, while complaining that the comparison to their use [and therefore, a tax] of Viagra was ill-considered and inappropriate.

Since the New Jersey law– as will the proposed federal law– distinguishes between elective (taxed) and medically-necessary (untaxed) procedures, determining which is which can be nettlesome.  Pat McMenamin, a surgeon in Sacramento, said “cosmetic surgery can be as much about mental health as it is about physical well-being” and went on to describe a young patient who was practically suicidal about his nose.  Another surgeon described the minefield of HIPAA privacy violations which might occur in revealing medical decisions and rationale to the IRS.

All things considered, I’m underwhelmed by what we at PopEconomy! are calling the Tit Tax (although my fiancee strongly encourages me to stop using that term).  Ironically, while amendments I thought would surely pass (re-importation of prescription drugs) have failed, and amendments that must die for the greater good (CLASS Act) have survived, this moronic thing seems to have flown under the radar.

This is either a genetically-engineered protein with the potential to save millions of lives, or the molecular structure of a highly toxic nerve agent-- so help me I've lost my notes and can't remember which.

They say we share more DNA in common with other species than with each other.  If there’s any chance it means I’m not related to this guy, I’m all in favor.  Having said that, you need to patent your own double-helix my friends, because personalized medicine is the wave of the future.  According to this Special Report from Genetic Engineering and Biotechnology News (did you get your copy yet this month?) the cost-saving potential of just three demonstration projects might exceed $6.2 Billion per year.

For example, according to the study’s authors “Genomic Health’s Oncotype Dx is a test with compelling cost-saving potential. It is used to predict chemotherapy benefit for patients who have node-negative, estrogen receptor positive (node-, ER+) breast cancer. By averting unnecessary chemotherapy, the test has been shown to save about $2,000 per patient. Extending this cost savings to the roughly 100,000 new cases of node-, ER+ breast cancer in the U.S. each year, this test could save the U.S. healthcare system up to approximately $200 million a year.”

The report continues, “Genentech/Roche’s Avastin costs $50–$100,000 per year of treatment but works in fewer than 50% of patients. Given that Avastin may generate $12 billion in peak sales, this low rate of efficacy translates into billions of dollars in misdirected healthcare spending. A test for Avastin response, such as that in discovery by BG Medicine, could save the system as much as $6 billion per year if all nonresponders could be removed from the treatment pool. Assuming that a test of this sort is introduced at the beginning of 2013 and is 100% adopted, cumulative savings of $40 billion could be realized by 2019.  This scenario, in which a drug with high sales but low efficacy is targeted by diagnostics companies, may become a pattern in the near future, multiplying cost savings.”

Youth in Asia: Does your healthcare plan cover it?

According to a July 23^rd CNN.com [TWX] article, a whopping $76 Million could be saved each year if half the people who die from cancer annually had end-of-life conversations with their doctors. (They were quoting from a 3/09 study by the Archives of Internal Medicine, which found that such individuals incurred 36% lower healthcare costs during the final week of life.)  By bridging the disconnect between patient and doctor, such conversations—particulary when held early on—can drastically improve one’s quality of life and lower the cost of care.  It can mean the difference between dying in a hospital, running up bills in the tens or hundreds of thousands of dollars, or choosing “comfort care” at home.  It can mean the difference between “full-scale lifesaving efforts” and “do not resuscitate orders”.  We at Pop Economy! are not surprised by this revelation, considering that nearly 30% of Medicare’s costs are devoted to beneficiaries during their last year of life; a number which has not changed much in the last decade. 

So imagine a proposal which would pay physicians to “counsel elderly or terminally ill patients about what medical interventions they would prefer near the end of life and how to prepare instructions such as living wills.  Under the plan, Medicare would reimburse doctors for one session every five years to confer with a patient about his or her wishes and how to ensure those preferences are followed. The counseling sessions would be voluntary.”  (The Seattle Times, 8/1/09)  Sounds like a pretty innocuous idea, right? 

No—it’s a terrible idea!  It’s been described as “guiding you in how to die,” “an ORDER from the Government to end your life,” promoting “death care,” and, in the words of anti-abortion leader Randall Terry, an attempt to “kill granny.”  House Minority Leader John Boehner, R-OH, and GOP policy-committee Chairman Thaddeus McCotter, R-MI, said they object to the idea because it “may start us down a treacherous path toward government-encouraged euthanasia.”  I hate to think these distinguished gentlemen get their information from Pop Economy! but if they do, I am happy to educate them that Living Wills and Advance Directives do exactly the opposite of that which they fear: they restore choice, dignity, and sovereignty to the individual so that doctors, family, and the State must subordinate themselves to one’s own personal beliefs and final wishes.  However, their ignorance is our gain: we’ll post $76 Million in savings to our Ledger.

Update: Although we were equipped to discuss this issue sensibly way back on July 23rd, unless you’ve been living under a rock you may have noticed the country is in the middle of a Civil War right now over the Alaskan word for doctor: “death panel”.  If you need some comic relief from the angry mobs, I suggest you hop on over to Comedy Central’s take on things [VIA].  It’s a debate between “private death panels” and a “public option death panel”.  Something for everyone!

In the Guinness Book of World Records for the most durable motorcycle frames.

While this is not an update to the Pop Economy! Ledger per se, it has come to our attention courtesy of the July 21st edition of USA Today that you can now be charged with criminal neglect and your kids taken from you and put in foster care if they get too fat.  It’s not so much that I care about the children, but I need my readers to remain un-incarcerated with free wi-fi if this blog is to thrive.

According to the article, one of the problems the State grapples with is that the health problems tied to childhood obesity don’t become chronic until adulthood, which makes it difficult to charge the parents with neglect.  They sound frustrated by this.  Since it’s pretty clear where we’re headed as a society in terms of both obesity and incarceration rates, I’m not sure why we don’t simply cut to the chase and lock-up the both the parents and their newborns as they emerge from the delivery room. (Sigh)

Fortunately, the story may have a happy ending for Jerry Gray, the 14-yr old’s mother.  Showing true American spirit and resilience, the victim is fighting for her son’s health!  She has signed an exclusive deal with a documentary film company.

Update: In an update to my update, I’ve come across a great piece of reading at Time Magazine [TWX], “Why Exercise Won’t Make You Thin,” in which it is postulated that “If you’re more physically active, you’re going to get hungry and eat more.”  Seems common-sensical when you stop and think about it, but most people reach the counterintuitive conclusion: we believe we can burn more than we consume.  Trouble is, in the real world it works out just the opposite.  “In their 18-month study…when kids start to exercise, they end up eating more– not just a little more, but an average of 100 calories more than they had just burned.”  The article is full of fun factoids like that, and it’s worth reading before we start basing public policy on wishful thinking.

If current trends continue, all dogs will look like this in the future.

You need to put down those Hersheys® Chocolate Dunkers® (really? Pizza Hut), because the Ventura County Star just reported that health problems and lost productivity linked to overweight, obesity and inactivity cost the state of California $41.2B in 2006.

“I was astounded,” said Dr. Harold Goldstein, executive director of the California Center for Public Health Advocacy, a nonpartisan, nonprofit organization designed to draw public attention to critical health issues.  He should be!  We at PopEconomy! went back to the original study to locate their projections through 2011, then extrapolated those costs from CA to the entire USA using a per-capita calcuation for 2009.  Results?  Our fat asses are costing the economy $392,966,583,157 in lost productivity and health problems this year.

The study does not subscribe to the “fat but fit” mantra, I’ll tell you that.  Read the rest of this entry »

Factoid: with $250 Billion you could build 1,497 "New Comiskey Parks" or buy 6.3M pairs of "mom jeans".

“The federal government would reap about $250 billion a year if it treated healthcare benefits given to employees like wages and taxed them.”  If you receive employer-provided health insurance (not that you do, right? AFLAC sells ducks as far as I know) then this is probably of interest to you.  Technically this is something which is just “on the table, it’s an option,” according to Senate Finance Committee Chairman Max Baucus (D-MT), and it does skew a little more heavily towards the “Economy” side than the “Pop” side which I favor on this site.  Still, a boy can dream, can’t he?  I’ll keep an eye on this story as it develops and if it looks like it’s going down, I’ll remove it from the ledger.  We’re raising money hand-over-fist at this site anyway, and hardly need to tax healthcare benefits to raise a paltry $1.1T!  Washington, are you paying attention?

Medicare is so deep underwater AARP believes at the very bottom they'll find a treasure chest.

“If we could develop a care plan to support patients when they return home, we could save $17.4 billion in one year.”  The kernel of this story comes from a study which found that more than 20% of New York seniors were re-hospitalized within 30 days of discharge between 2003 and 2004. On the face of it you’d think they’re off to a good start because re-admissions seem like a preventable form of waste.  The problem here is that further scrutiny of the story unveils a classic AARP agenda of broadened Medicare benefits, including an expansion of the Part D Prescription Drug program.  This for a program which is already staggeringly underwater to the tune of $89 Trillion (with the letter T) in unfunded liabilities.  Even Pop Economy! can’t find that much scratch in the seat cushions.