Health Care

Worthwhile Reading – Science and Technology Edition

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It seems that octopuses have the ability to edit their RNA dynamically.

An interesting piece on FDA regulation and medical device innovation.

Zymergen has automated part of the drug discovery process via a combination of robotics and machine learning.

Was big data analytics (more specifically, excess faith in same) a major cause of Hillary Clinton’s electoral loss?

Is there an artificial intelligence misinformation epidemic?

Cotton spinning – a quintessential technology of the Industrial Revolution – returns to England.

But to what degree will spinning, as well as weaving, cutting, and sewing, be replaced by 3d printing of clothing?

James L Taylor Manufacturing, a 106-year-old company making clamps and other woodworking tools sold to producers of furniture, flooring, and cabinets, recently introduced a robotic nester…it replaces the work of a human nester who “snatches boards coming off a conveyer belt in random lengths, hastily rearranges them so that each row of one to five pieces is so long, and bundles the rows into a stack.” One mill in Mississippi placed an urgent order for 3 of these (at $115K each) with the explanation: “I have eight nesters and four of them just called in sick.”

What is especially interesting about this is that the robotics system was not developed by hiring consultants from MIT or Silicon Valley; the company’s chief engineer (also part-owner of the company) designed the machine himself and wrote the 7000 lines of C++ code to run it.  Reminds me of the cucumber sorting machine developed by a Japanese guy to help out on his parents’ cucumber farm..although that system was developed for the family’s own use rather than as a saleable product as with the robotic nester.

Dodd-Frank, Obamacare grew out of same faulty reasoning

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The current partisan war over the Dodd-Frank Act is just one dispute in a broader ideological divide about the government’s role in industry. This dispute, which has deep historical roots, includes a similar battle over Obamacare. The common disagreement at issue with both laws — now in the cross hairs of a GOP-controlled Washington — is the extent to which politicians should subsidize their constituents indirectly through regulation of private companies.

The Affordable Care Act governing health insurers was about 1,000 pages, and Dodd-Frank governing most other financial institutions was more than twice that. Both stopped short of nationalizing their respective industry, instead generating more than 10 pages of regulation for every one page of legislation, although many view nationalization as an eventual but inevitable consequence, particularly for health care.

The distinction between public control and public ownership is the primary distinction between the competing mid-20th-century ideologies of fascism and communism. In contemporary terminology, this distinction is between crony capitalism and nationalization, neither of which can be reconciled with competition and freedom of choice.

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Hillary Clinton’s Alinskyite Attacks on Pharma Companies

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“Pick the target, freeze it, personalize it, and polarize it.” (Saul Alinsky)

Hillary is clever to go after individual companies. If she attacked the pharma industry as a whole, it could unite politically in response and perhaps gain political support from other industries that would reasonably see themselves as similarly vulnerable. But individual companies have no defenses against this kind of attack. By singling out one victim she discourages other industry players from doing anything in response, because any company or industry group that responds risks being targeted in the future.

She has done this kind of thing before. She will probably keep doing it because it’s politically effective. Her attack on Mylan destroyed a large amount of wealth, and probably not just for Mylan’s shareholders. Today Mylan’s CEO is groveling in the media. As with past political attacks by Hillary and others on vaccine manufacturers, yesterday’s attack on Mylan will discourage pharma companies from introducing valuable new products and will reduce the availability of current products. We will probably see more of this kind of extortionate behavior by the federal govt if she is elected, because that’s how the Clintons operate and because a Hillary administration would appoint more lefty judges and DOJ and regulatory officials who would go along with it.

Why Importing Foreign Doctors May Not Solve the Shortage.

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MoS2 Template Master

The coming doctor shortage that I have previously written about might be dealt with as Canada did with theirs some years ago, by importing foreign medical graduates. Britain has adopted a similar plan as thousands of younger doctors plan to leave Britain.

How is the plan to import foreign doctors working out ?

Not very well.

Nearly three-quarters of doctors struck off the medical register in Britain are foreign, according to shocking figures uncovered in a Mail on Sunday investigation.
Medics who trained overseas have been banned from practising for a series of shocking blunders and misdemeanours.
Cases include an Indian GP who ran an immigration scam from his surgery, a Ghanaian neurosurgeon who pretended he had removed a patient’s brain tumour, and a Malaysian doctor who used 007-style watches to secretly film intimate examinations with his female patients.

First of all, foreign medical schools are often limited in real experience and students often graduate with nothing beyond classroom lectures.

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The Doctor Shortage revisited.

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33 - Lister

I have previously written posts about a coming doctor shortage.

They assume that primary care will be delivered by nurse practitioners and physician assistants. They are probably correct as we see with the new Wal Mart primary care clinics.

The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic in Palestine, Tex., on Friday and another six by the end of the year. The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so acute care clinics leased by hospital operators at Walmarts across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Walmart is marketing itself as a primary medical provider.

This is all well and good. What happens when a patient comes in with a serious condition ?

The health policy “experts” have been concerned to train “lesser licensed practitioners” and have pretty much ignored primary care MDs except to burden them with clumsy electronic medical record systems that take up time and make life miserable.

I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing. Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.

I proposed years ago, a health reform that resembled that of France where medical school is free. It could be arranged that service in primary care, low income clinics would give credit against student loans. Nothing happened. Except physician income has declined. And tuition has increased.

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