While driving through Texas on a recent research trip, I was trying to find a radio station with weather alerts, due to the incredibly sudden build-up out in West Texas of huge cloud formations. These clouds massed out of nowhere into astounding mushroom-shaped anvils, with a strong resemblance to thermo-nuclear explosions.
Scanning the FM dial, I noticed there didn’t seem to be a public-radio station around. At least, I couldn’t find one. Funny, I thought, for a region with a campus as large as Texas Tech’s in Lubbock. Public radio seems to include frequent weather bulletins in the mix around the country, but no, nothing on the airwaves like that, more a smattering of religious, norteño music and farm-commodity stations. I found one non-religious talk station, and thought I’d hang there for the weather. Never came on.
I don’t usually listen to talk radio, so perhaps I’m naive about what it’s like, but I spent the better part of a half-hour on the road, watching the clouds gather menacingly while listening to some angry nut whale on the Obama administration for their temerity in suggesting a better health care system in the United States.
Of course, I understand people are showing up armed for the “discussions” going on out there. Geez.
However, just the morning before, I’d seen a telling graph in the newspaper ranking the U.S., France, Singapore, and the U.K. Our health care system had the biggest “circle” for cost - i.e., it was the most expensive - and had the worst performance on most other measures, including infant mortality. A sorry record to be sure. Something clearly needs to be done.
This talk jock had got onto a postal analogy, based on something Obama must have said - I missed the first part, but he had himself pretty wound up. He simply could not believe anyone would bring up the U.S. Postal Service, for heaven’s sake, as an example of anything except government inefficiency, cost overruns and waste.
I happened to go to my local Post Office yesterday, to mail a book-on-tape (It arrived the next day) and so I asked the gentleman behind the counter, What is this all about?
Actually, what I asked him was a more specific question. I said: “Do UPS or Fedex have any services you know of that cost less than 50 cents?” He said no, he didn’t think so. I mentioned the radio host’s tirade. He informed me that the global package delivery companies don’t actually work the way the post office does.
“We have to go to every address,” he said. “If we only went to the addresses we wanted to, we’d be profitable.” I also didn’t know that UPS and Fedex actually use the U.S. Postal Service to move some of their freight when it’s convenient for them, or so he told me.
It made me think about health care. I have been reading that the Mayo Clinic here in Minnesota is an exemplary case in point. Don’t get me wrong, I like and admire the Mayo, I’ve given them money. However, as a private non-profit in three locations - Rochester, Minn.; Jacksonville, Fla.; and Scottsdale/Phoenix, Ariz – I’m suspicious when I hear that they can deliver better health care for less per person. I wonder, is that figure corrected for age distribution, race, past medical history, English-speaking? Isn’t there a difference in any service-based sector when you’re only in a few small- to mid-size cities away from the American northeast industrial corridor?
I mean, I’ve been to Rochester, and to some of the charming communities nearby, including the Amish farming area, and I can’t see comparing it in medical-needs terms to something like a downtown public-emergency medical research and training hospital in Queens.
Mayo doesn’t “go to every address,” right? They treat rock stars and Saudi sheiks. They’re more Cedars-Sinai than UCLA Medical Center, which was the unfortunate comparison in the articles.
More about Mayo: I’m intrigued by the fact that George Bush’s former director of the National Institutes of Health, Dr. Elias Zerhouni, has quietly landed there, joining the Mayo Board of Trustees. (When I was in Texas, I learned that Alberto Gonzales had landed there, in Lubbock, Texas, a far cry from Washington.)
Anyway, Elias Zerhouni is an Algerian immigrant who seems like a kind of businessman’s medical researcher. A millionaire from inventing several radiological devices, he filled the vacant NIH post during a controversial period, because of the president’s dislike for such things as open stem cell research and research on sexual behaviors. Zerhouni was a man willing to tow an unpopular line - pardon the pun. stem. cell. line. Never mind!
“NIH provides an enormous opportunity for sustaining economic activity,” is a Zerhouni quote from a newspaper profile. A crackpot web site says he was a “notorious Pentagon yes-man on anthrax bio-defenses.”
My favorite quote today comes from a blogger I ran across recently who wrote, “We have met the enemy, and he is Us (and Them, too)”:
This guy, a self-proclaimed former Goldwater Republican from “when conservatism meant trusting in the creativity and initiative of individual human beings free to choose and act on their own,” is a researcher himself who charges that biomedical research has suffered after “a takeover of the Republican Party by a coalition of fundamentalist yahoos and multinational corporate profiteers.”
I love this quote: “The Republicans’ policies impact the public health in two ways: they have reduced available funds for research at a time when research dollars have the greatest potential ROI in history, and they have politicized science at many levels, subordinating objectivity to administration policy.”
Could it be that’s what all the concerted yelling at town halls is really about? Money and politics, as usual.
The League of Women Voters just freaked me out by reporting on the millions in lobbying fees paid by the pharmaceutical industry. I don’t know if you happened to read Bob Herbert’s column, This is Reform? on the sweetheart deal the Obama Administration has likely made with Big Pharma. Another recent NY Times piece showed “court documents provide a paper trail showing that Wyeth contracted with a medical communications company to outline articles, draft them and then solicit top physicians to sign their names, even though many of the doctors contributed little or no writing.”
To his credit, Zerhouni is against that kind of thing.
It is my belief that our personal knowledge of the technological changes taking place in medicine has lagged behind the discoveries, so we need good, objective coverage by people who understand biomedical research and how to challenge statistics. If the average Joe and Jane knew the truth of the matter, I suspect, what’s going on right now, they would be thrilled, appalled, excited, hopeful, and - as the movies said, “be very, very afraid.”
Amazing things are possible, on the horizon, but so are really awful ripoffs. We’ve had a decade of people focused on ROI - return on investment - in research. People have arrived in positions of authority in healthcare administration who think that’s what health care is all about. I for one find that worrying.