Welcome back, American readers, from what we hope was a long and leftover-filled weekend. The news was slow, but here are a few stories you might have missed while still in your post-dinner food coma.
Frustrated by your teenager? Scan his brain — Actually, that probably wouldn’t help, although Arthur Toga has given it a try. Sort of. Toga, director of UCLA’s Laboratory for Neuro Imaging, has scanned the brain of his daughter Elizabeth ‘s every year or so since she was six. The results of those scans, plus similar scans of Toga’s other two children, have produced one of the longest chronological sequences of brain development ever attempted. That and other work have produced some fascinating findings on the way child and adolescent brains develop, “transforming our understanding of what it means to come of age,” WSJ science columnist Robert Lee Hotz wrote in his Friday column. Unfortunately, as Toga himself attests, knowing more about your teen’s neural development doesn’t necessarily help you deal with adolescent rebellion.
Gates takes on genetic genealogy — Harvard scholar Henry Louis Gates, that is, who recently launched his own DNA-ancestry company, African DNA, after he became convinced that existing firms that claim to help African-Americans trace their country of origin were potentially misleading customers. An NYT story yesterday uses Gates’ experience to expound on the limitations and potential pitfalls involved in genetic genealogy, a subject we touched on here. As it turns out, however, the WSJ wrote substantially the same story a week earlier, which you can check out here (subscription required).
Healthcare economics 101 — The NYT editorializes on the high cost of U.S. healthcare in a lengthy piece, one that touches upon many of the usual suspects — patient demand for the latest, most expensive treatments, the overspecialization of the medical profession, perverse insurance incentives and high overhead costs associated with the fragmented and inefficient insurance industry — that we’ve noted in occasional pieces (here and here, for instance). The NYT’s proposed solutions, however, are a real mixed bag. More evidence-based medicine to ensure that drugs, devices and surgical procedures actually work is certainly a good idea, as would be wider deployment of IT and electronic medical records. It’s far from clear exactly what the NYT editorial board is expecting from the greater use of “managed care,” which particularly in its for-profit incarnation became a synonym for extracting greater investor returns at the expense of patient care.
And finally the editorial simply dissolves into incoherence. It favors letting Medicare negotiate lower drug prices, for instance, but doubts that doing so would produce big savings. So why bother? Paying doctors closer to what they earn in other countries — far less than the U.S., that is — would save money, but might be politically impossible. So is it part of the solution or not? Consumer-driven healthcare could reduce what people spend on unnecessary care — but they might also cut necessary care. And so on. Ultimately, the paper’s august editors conclude that there is “no silver bullet” for the problem, and that a “wide range of contributing factors needs to be tackled simultaneously.” While that’s almost certainly true, the NYT has managed to turn a challenging and timely subject into an object lesson on how not to write a convincing editorial. It might as well have been titled: “Confused about healthcare costs? So are we.”
Healthcare economics 201 — Meanwhile, an NYT news story brought the surprising news that the Medicare “doughnut hole” — a big financial gap in the program’s prescription-drug coverage — may actually have a silver lining by encouraging wider use of generic drugs. Similarly, Rite-Aid drugstores have started selling a genetic paternity kit made by Sorenson Genomics, and psychiatrist Daniel Carlat writes in the NYT Magazine about how he came to grips with the often-subtle influence wielded by pharmaceutical drug reps.