This won't hurt a bit

Barack has showed us that it's okay to bad mouth your opponents. It's the Chicago way, the way Saul Alinsky taught all radicals, and the way Harry Reid conducts himself in the Senate.

So in that spirit, I hope all of you who voted for Hussein enjoy the coming chaos in our medical care. What you've done will make my life a lot harder. Thank you!

Michael Tanner, a senior fellow at the Cato Institute, writes:

Under ObamaCare, employers with 50 or more full-time workers must provide health insurance for all their workers, paying at least 65% of the cost of a family policy or 85% of the cost of an individual plan. Moreover, the insurance must meet the federal government’s requirements in terms of what benefits are included, meaning that many businesses that offer insurance to their workers today will have to change to new, more expensive plans, 

ObamaCare’s rules make expansion expensive, particularly for the 500,000 US businesses that have fewer than 100 employees. 

Suppose that a firm with 49 employees does not provide health benefits. Hiring one more worker will trigger the mandate. The company would now have to provide insurance coverage to all 50 workers or pay a tax penalty. 

In New York, the average employer contribution for employer-provided insurance plans, runs from $4,567 for an individual to $ 12,748 for a family. Many companies will likely choose to pay the penalty instead, which is still expensive — $2,000 per worker multiplied by the entire workforce, after subtracting the statutory exemption for the first 30 workers. For a 50-person company, then, the tax would be $40,000, or $2,000 times 20. 

That might not seem like a lot, but for many small businesses that could be the difference between survival and failure. 

Under the circumstances, how likely is the company to hire that 50th worker? Or, if a company already has 50 workers, isn’t the company likely to lay off one employee? Or cut hours and make some employees part time, thus getting under the 50 employee cap? Indeed, a study by Mercer found that 18% of companies were likely to do exactly that. It’s worth noting that in France, another country where numerous government regulations kick in at 50 workers, there are 1,500 companies with 48 employees and 1,600 with 49 employees, but just 660 with 50 and only 500 with 51.

Blogger Rick Moran adds to the joy:

Individuals and families who will be forced to buy their own insurance when companies drop their health insurance plans will be in for a shock. Even with subsidies, some families will end up paying nearly 10% of their gross income for health insurance. 

The bottom line is mass confusion. Put simply, the American people are unprepared for such a massive change in their lives. Most people don’t realize that their current insurance coverage is inadequate. They actually believed the president when he looked into the cameras during his 2010 State of the Union address and assured citizens that they could keep the insurance plan they have now. Instead, government-mandated coverage for a wide variety of services that many current insurance plans don’t cover will radically alter health insurance for millions.

Good luck!

The rise of tick-borne diseases

Researchers from the Centers for Disease Control and Prevention announced the discovery of a new tick-borne virus this week, one of several newly identified pathogens that ticks are passing to humans. Why are so many new tick-borne diseases being reported?

Improvements in medical technology, mostly. The newly discovered tick-borne diseases have probably been infecting humans for years, but they’re not easy to spot. Many victims never realize a tick has bitten them, and the symptoms, such as fevers, aches, and fatigue, are not distinctive and mirror those of common summer viral infections. The patient’s immune system usually fights off the illness unassisted, so doctors don’t bother running the battery of tests required to identify a new pathogen.  

Only in the rare cases when a patient struggles with the infection are physicians likely to make a genuine discovery. (The disease identified this week, a member of the phlebovirus family, hospitalized two men in Missouri.) They order blood smears or antibody tests to identify the presence of a pathogen, and genetic analyses—which were either inefficient or completely unavailable to doctors just a few years ago—alert researchers to the presence of the previously unidentified bug. Researchers have also become more aggressive recently, with some searching within ticks themselves for evidence of new pathogens.

Lyme disease is a classic example of how long a disease can exist in a population without being identified.

Genetic research has suggested that the pathogen responsible for Lyme disease has afflicted humans for more than 5,000 years. Examinations of a mouse specimen collected from Central Park in the late 1800s suggest that the disease has been present in the United States for more than a century, and case reports indicate that Europeans were carrying the disease at about the same time.  

In the early 1970s, fishermen in Long Island complained of a form of arthritis they called “Montauk knee,” but it wasn’t until later in the decade that doctors figured out that it was caused by an infectious agent. In 1982, researchers finally identified the spirochete that carried the illness. And Lyme disease, with its telltale bull’s-eye rash, is usually easier to identify than many other tick-borne illnesses.

Read the full article for more.

What we're learning about Obamacare

“We have to pass the bill so that you can find out what is in it.”

-- Nancy Pelosi

What we're finding out:

"Why don't you just bend over."

Take a rain check: Get ready for healthcare gridlock. Once the new healthcare law fully takes effect, all Americans will be entitled to a long list of preventive services with no out-of-pocket costs, but the healthcare system won’t have enough doctors to provide them. The shortage will create longer waiting periods that some patients will be able to cope with better than others. Lower income patients will be worse off, according to the Independent Institute.

Someone always gets rich. It turns out that Obamacare is going to be a very lucrative gig for a new crop of government bureaucrats. A subcommittee of the board charged with establishing a healthcare exchange is considering creating 24 positions and pay those employees a total of more than $3 million annually. The average annual salary of a health benefits exchange employee would exceed $125,000 under the plan. The highest salaries would be paid to the CEO ($200,400) and chiefs of finance, operations and communications would make $165,000 each.

Bad hospital, bad: A provision of ObamaCare is set to punish roughly two-thirds of U.S. hospitals evaluated by Medicare starting this fall over high readmission rates, according to an analysis by Kaiser Health News. Starting in October, Medicare will reduce reimbursements to hospitals with high 30-day readmission rates -- which refers to patients who return within a month -- by as much as 1 percent. The maximum penalty increases to 2 percent the following year and 3 percent in 2014.

This would be your death panel: Peter Orszag, the former White House budget director, derieds  the idea that better incentives can reduce costs. Mr. Orszag's alternative: the Independent Payment Advisory Board composed of 15 philosopher kings who will rule over U.S. health care. Who are these Orszag 15? Well, nobody knows. The board was supposed to be up and running by the end of September, but the White House is avoiding naming names for Senate confirmation until after the election. No one knows, either, what this group of geniuses will propose, but that too is part of the grand Orszag plan.

How it works in Canada: There are two tiers of men with advanced prostate cancer in Ontario: Those who get access to a remarkable drug through private insurance, and those who get a death sentence. The grim news is often delivered at the London Regional Cancer Program to men whose shoulders sag and jaws drop when told Ontario's Health Ministry has for 15 months refused to pay for a medication covered by every other Canadian province.

Alive but dumb: Parents and students facing sky-high state-run college tuitions aren't likely to be thinking about ObamaCare. But perhaps they should, since  ObamaCare will likely end up making college still more expensive. Why? Because ObamaCare relies heavily on Medicaid — the federal/state program that provides health insurance for the poor — to expand coverage. But Medicaid is already swallowing up state budgets, forcing states to cut back on everything else, especially support for public colleges.

Miracles and wonders: lab in a shoebox

Checking to see if she has a brain.

A scientific instrument featured on CSI and CSI: Miami for instant fingerprint analysis is forging another life in real-world medicine, helping during brain surgery and ensuring that cancer patients get effective doses of chemotherapy.

The instrument, called a "desorption electrospray ionization" mass spectrometer, or DESI, is about the size of a shoebox. Students have  carried it into a grocery store and held it close to fruits and vegetables to detect pesticides and microorganisms. 

It has also been used to identify biomarkers for prostate cancer and to detect melamine, a potentially toxic substance that showed up in infant formulas in China in 2008. In addition, DESI can detect explosives on luggage.

Now scientists want to  test the instrument in the operating room during brain cancer surgery, comparing it with traditional analysis of tissue samples by pathologists.

DESI can analyze tissue samples and help determine the type of brain cancer, the stage and the concentration of tumor cells. It also can help surgeons identify the margins of the tumor to assure that they remove as much of the tumor as possible.

 Innovations in medicine like this are happening all the time, and we are hardly aware of them.

If your'e a chicken, don't smoke

Smoked fish.

If you were annoyed to learn recently that eggs are once again bad for you, relax.

A study looked at patients with an average age of 62, some of whom really loved eggs and some of whom really loved cigarettes. Researcher David Spence then measured the amount of plaque in their arteries.

The results? Both smoking and eating eggs were independently associated with plaque increases, and eggs were almost as bad as cigarettes. “The effect size of egg yolks appears to be approximately 2/3 that of smoking,” Spence wrote. “Probably egg yolks should be avoided by persons at risk of vascular disease.” 

The problem is that the conclusion is based on self-reported lifetime history of smoking and egg-eating  -- and only smoking and egg-eating.

While it’s entirely possible that people who ate a bunch of eggs filled the rest of their diets with kale and dust and steel-cut oats, it’s just as possible they were eating those eggs alongside bacon and sausage and Hollandaise sauce. In other words: Maybe eggs aren’t solely to blame here.

In fact, we have no way of telling, based on this study, what role eggs specifically played in the development of these arterial plaques.

Antonis Zampelos, a nutrition professor, told Canada’s CBC News that these results lack validity. “The results are not as strong as the statement that came out … I’m not saying that this is not an interesting study. I’m saying that you can’t really make such a strong statement about smoking.”

“This is very poor quality research that should not influence patient’s dietary choices,” Steven Nissen, chair of the department of Cardiovascular Medicine at the Cleveland Clinic Foundation, told ABC News. “It is extremely important to understand the differences between ‘association’ and ‘causation’.”

So maybe you can take care of me

I've been doing some retirement planning this week, and I'm not too far away from signing up for Medicare. I sure hope they have some good-looking nurses.

It is discomforting to absorb the impressions in the media -- President Obama has cut $716 billion from the program; Republican Veep nominee wants to "end Medicare as we know it."

I'm less concerned with how my retirement portfolio is doing than where I'll get healthcare. (Note to financial advisor: ignore this.)

So which is which? You should care, too, because you don't want me knocking on your door in a few years and asking for help with a catheter.

(That is just disgusting. I can't believe you said that.)

It looks as though it's correct that Obama is cutting funds to Medicare to fund Obamacare. The Washington Post, which no one will accuse of having a Republican bias, confirms it. The article's headline: "Romney’s right: Obamacare cuts Medicare by $716 billion. Here’s how."

And it shows where the cuts will come from in this chart.

That's not encouraging. Moreover, a bureaucratic panel of 15 men and women will enforce a spending cap by decreeing how medicine should be practiced and how doctors and hospitals are organized. Did anybody say "Death Panel?" How about "Catheter Committee?"

So what do Romney and Ryan have in mind? I use as sources FactCheck.org and the Kaiser Family Foundation for this:

• For seniors who are now in Medicare, nothing changes. They can stay with the traditional program as it is.
• Beginning in 2023, 65-year-olds would have their choice of insurance plans — private and traditional — on a new Medicare exchange. A premium-support payment, like a subsidy, would be sent to the plan of their choice.
• If the chosen plan costs more than the premium-support, the senior would pay the difference.
• The Medicare eligibility age would be slowly raised to 67 by 2034.
• All plans on the Medicare exchange would offer a base level of benefits, and they would be regulated by the Centers for Medicare and Medicaid Services.
• The premium-support payments would be tied to the second-cheapest plan, which can’t grow more than gross domestic product plus 0.5 percentage points. If the cost does grow faster, Congress would be required to step in and take some action to keep costs down.

I know that if Medicare "as we know it" isn't changed, it's going to collapse on top of my head, pretty nurses and all.

I'll take my chances with Romney and Ryan.

Miracles and wonders: swallow this, touch that

Take two and call me in the morning.

I don't think we fully appreciate that we're in the midst of a revolution in medicine.

According to the mortality tables, there’s a two-thirds chance that a male who’s age 55 today will live to age 80. If you  plan on being among those who die before age 80, but don’t. Some saying that you should plan on living to age 105, or at least 30 years in retirement. One expert: a 65-year-old husband with a 60-year-old wife would require a 40-year planning horizon to be 90% confident of covering the last to die.

The US Food and Drug Administration has approved a grain-sized ingestible digital sensor that can be swallowed in a pill to track health data from inside the body. The idea is that the data can be used not only by patients themselves, but also by caregivers and doctors to individualize their care. The signal that it sends from the stomach travels through the patient's body to a patch worn on the skin. The patch contains technology that senses the signal and records the exact time the ingestible sensor was swallowed.

University of Florida researchers have moved a step closer to treating diseases on a cellular level by creating a tiny particle that can be programmed to shut down the genetic production line that cranks out disease-related proteins. By combining a protein enzyme and a DNA molecule on gold nanoparticles to mimic the gene regulatory mechanism called RNA interference, a “nanozyme” was able to destroy hepatitis C virus in human liver cells and in the livers of mice.

It is clear that all kinds of products and services  would be available online if we had the bandwidth. Programs that involve massive transfers of data or frequent two-way video communications would be two obvious examples. What’s interesting is how many of these new products and services involve healthcare: Jeff Pfaff of Overland Park, Kan., says he hopes to use the service to “push the limits” of a health-monitoring system he’s building. It would enable at-home patients to teleconference with doctors and family members via a camera hooked up to a TV set and a remote control.

European researchers say they have developed the world's first real-sized, five-fingered robotic hand able to grasp and manipulate objects with human-like dexterity. The team  built a hand using strings that are twisted by small, high-speed motors in five fingers, each with three segments. The device was able to handle a delicate Easter egg and lift a five kilogram load. Light sensors were attached to the hand, making it possible to calculate the force required for the fingers to grasp an object without squashing it or losing its grip.