Health Politics

The House GOP’s AHCA Health Care Bill is Cruel. Because it Had to Be.

Let’s all remember how we got here.

Before Obamacare, before the Tea Party, before the election of Barack Obama, we had a healthcare crisis. Premiums were skyrocketing. Insurance companies were cutting off access to expensive procedures. The bottom line was: health insurance as we’d enjoyed it for decades was going away with nothing left in it’s wake. Nobody disagreed with this assessment.

Ross Perot once famously quipped of Social Security, “Social Security made sense when the age to collect ws 65 and the average person lived to be 60.” Whatever you think of his or anyone else’s policy prescriptions for SS, the truth of this statement was pretty undeniable. As our lifespans lengthen, it gets more and more expensive to take care of each other.

And as people lost insurance, they didn’t lose their diseases. Which meant people ended up in the most expensive part of the hospital – the Emergency Room – instead of taking care of issues early with a primary care physician. Because hospitals have an ethical responsibility to fix broken people, the cost of those emergency visits was necessarily passed on to the rest of us.

Neither are cost and advanced age the only issues. In the last few decades, we’ve seen a shocking rise in the rate of Non-Communicable Diseases (NCDs) such as diabetes, Crohn’s disease and heart disease. It isn’t just that we’re getting older: we’re getting sicker when we’re young. All of this adds up to a pretty incredible burden on a health insurance system. Especially one that is market- and profit-driven.


Obamacare sought to address the fundamental issues of the health insurance industry by bringing more people into the system. Similar to Social Security, the more participants are paying into the system, the more money there is to pay for the more expensive needs of other members. Better still, by bringing people into the health insurance system and giving them access to preventative care, Obamacare sought to lower the overall cost of taking care of sick people.

In exchange for new business and more profit, Obamacare required insurers to adhere to a list of demands like insuring people regardless of their “pre-existing conditions,” which is just a way of saying you know they have potentially expensive issues, but you’re going to cover them anyway. In fact, Obamacare eliminated “insurance underwriting,” which means insurance companies are not allowed to demand a complete medical history to cover you.

Much of what Obamacare was meant to address did work. We got 24m more Americans covered by health care. Insurance companies honored the commitment to cover all comers. But the largest concern of most Middle Americans, the cost, didn’t stop rising. It rose at a much slower pace, but that’s cold comfort to someone already feeling the pinch of rising costs.

I would argue that, given that a big component of Obamacare was wrestling with pre-existing conditions and lack of preventative care, there probably was never a chance that the cost curve could be reversed overnight. Or even in seven years. Sick people don’t stop being sick. A lifetime lack of care doesn’t get that much better right away. Nevertheless, Obamacare promised lower healthcare costs and didn’t deliver fast enough for America’s patience, it seems.

Because if President Obama ran on the promise of Obamacare, to the extent that President Trump’s campaign was “about” anything, it was once again the promise of way better healthcare.


So Republicans are tasked with reversing Obamacare. And they’re tasked with creating a new system that allows health insurance to be a profitable business at a lower cost, because the one thing Obamacare didn’t deliver on was lowered premiums.

Go back and reread the first few paras of this article. Our healthcare crisis is a logical conclusion of living longer and getting sicker as a species. It wasn’t an institutional crisis – it wasn’t that insurance companies were changing policy without reason. We have a genuine crisis of a demand for coverage that drives costs through the roof. Lowering costs, then, can only mean one thing: lowering demand by cutting off access.

If we’re not going to stick it out with Obamacare, then as harsh and cruel as the AHCA is, it is exactly what is necessary. If we’re not going to do our best to increase participation, our only other alternative is to make what insurance companies previously tried to do quietly a matter of national health care policy. We need to decrease demand.

Cruelty isn’t a bug: it’s a feature.

The cruelty of the AHCA is hard to take in. The expansive ways in which Republicans chose – completely on their own – to take a sledgehammer to the very idea of health insurance is breathtaking. As the ACLU points out, the AHCA basically makes being a woman a pre-existing condition. VoteVets points out that it bumps millions of veterans out of the health insurance markets by denying them the tax credits “granted” to the rest of us and shunts them into an already overwhelmed VA system.

Cruel though these things may be, supply and demand economics requires that either there is way more supply or way less demand. No other thing will reduce costs. Democrats essentially tried to buoy supply by increasing participation and in so doing, raise the capital required to expand the supply side. Republicans have now fully bought into the idea that slashing demand will work.

And the worst part of all this is, again, that sick people don’t stop being sick because they don’t have health care. They’re going right back to the emergency rooms. And they’re going to jack up the price of health care. And – brace yourselves – there will be no cost savings. There will be no lowered premiums. And we know this, because we already lived through this once.

But Republicans have spent eight years decrying Obamacare. They can’t just walk away now. And there is absolutely no way of “improving” this bill. The Senate will not be our saviors. Because to alter this bill is self-defeating. The only thing to do is let it die. Do we believe Republicans have the strength to do that alone? Or should we help them come to the logical conclusion?


U of R boffins discover wrinkle therapy chem may cure cancer in naked mole rats

The husband and wife team of Seluanov and Gorbunova at the University of Rochester may be one step closer to discovering a practical cancer treatment. They have isolated a specific chemical in the naked mole rat which seems to gird the rodent Lothario’s cells against tumors. And as it turns out, curing wrinkles may have been better for your health than previously thought:

Seluanov and Gorbunova then showed that when HMW-HA was removed, the cells became susceptible to tumors, confirming that the chemical did play a role in making naked mole rats cancer-proof. The Rochester team also identified the gene, named HAS2, responsible for making HMW-HA in the naked mole rat. Surprisingly, the naked mole rat gene was different from HAS2 in all other animals. In addition naked mole rats were very slow at recycling HMW-HA, which contributed to the accumulation of the chemical in the animals’ tissues.

The next step will be to test the effectiveness of HMW-HA in mice. If that test goes well, Seluanov and Gorbunova hope to try the chemical on human cells. “There’s indirect evidence that HMW-HA would work in people,” said Seluanov. “It’s used in anti-wrinkle injections and to relieve pain from arthritis in knee joints, without any adverse effects. Our hope is that it can also induce an anti-cancer response.”

It was this same husband and wife team that, in November of last year, announced that they’d discovered a protein which may prevent run-away cell growth in NMR. Unchecked cell growth is the hallmark of cancer.

HMW-HA is known to help vascular health by maintaining the integrity of Endothelial cells, which line the inside of veins and arteries. It is this property that makes it desirable in wrinkle therapy. Seluanov and Gorbunova discovered the same chemical in a “goop” that seemed to clog up testing equipment while the scientists tested other properties of the NMR.


No, no, no, wait, seriously: Cuomo is right. Medical marijuana is teh dum.

Don’t get me wrong. Do I think marijuana has plenty of perfectly legitimate medical purposes? Absolutely yes, I do believe that. I also fully believe that it makes an excellent fuel source, footwear and legal documents. Well, ok. It could make perfectly good legal documents.

However, I have also discovered another use for marijuana that you might find interesting. It turns out that, if you put the buds of the marijuana plant into a pipe and smoke it, you get high. I find this really interesting, myself.

Mind you: I don’t know any of this first-hand. Some kids in bible study told me about it. But in fairness, they were right about the number of K’s on a Marlboro pack and the image of the burning Twin Towers on the $20 bill. So I’m going to assume they’re right about this.

And being that we live in a state that doesn’t just celebrate – doesn’t just market or advertise – alcohol production and consumption, but spends millions of dollars nearly fetishizing the whole affair, it seems reasonable that we should want to also make marijuana consumption equally safe and legal. Don’t you agree?

That other states have been able to open the discussion of legal marijuana by legalizing it for medical purposes is something we can all thank them for. But the idea that legalizing marijuana for medical purposes isn’t going to just put doctors in a bind, having to either piss off and lose patients or else prescribe marijuana for a host of otherwise-curable diseases is just a farce. We all know why marijuana legalization is popular. Let’s just get on with it.

Please don’t make me seek out a prescription for fun. Please don’t turn the medical profession into a rubber stamp for the proper enjoyment of Pink Floyd and Monty Python (c’mon, dude, be honest). Let’s at least start by decriminalizing reasonable quantities of weed in the state.

Or if we are going to make this a medical thing, let’s also require insurance companies to pay for lava lamps, Doritos and Christmas lights that change color to the beat of music. In for a penny, in for a pound.

Health Technology

Before your next MRI: the nanoparticles that may be poisoning your body

Gold nanoparticles are used in a variety of medical applications, including delivery of drugs and also in what are known as “MRI contrast agents.” Basically, to make certain organs stand out among the noise of your innards, techs pump a little gold dust in you.

But new research at Stony Brook University suggests that those nanoparticles – once thought harmless – actually disrupt cell production and functioning:

 The scientists discovered that the human adipose-derived stromal cells—a type of adult stem cells—were penetrated by the gold nanoparticles almost instantly and that the particles accumulated in the cells with no obvious pathway for elimination.

The presence of the particles disrupted multiple cell functions, including movement, replication (cell division), and collagen contraction—all processes that are essential in wound healing.

Oh, and the fun doesn’t stop there! It turns out that the introduction of nanoparticles seems to veer into the Incredible Hulk territories:

The most disturbing finding was that the particles interfered with genetic regulation, RNA expression and inhibited the ability to differentiate into mature adipocytes or fat cells.

So in summary, pumping your body with gold dust may actually turn you into Midas. For realzies. Or maybe not. This is just one study…


UofR researchers demonstrate potential MS cure using skin cells

Myelin is the sheathing that surrounds each and every nerve cell, allowing their electrochemical signals to correctly pass through the cell to their intended targets. Without this shielding, signals get lost and that leads to all sorts of neurological disorders. The most common of these is Multiple Sclerosis, or MS.

Photo courtesy the University of Rochester

The University of Rochester is doing a lot of work with myelin, including recently proving that stem cells found within the “white matter” part of the brain are responsible for creating myelin naturally. But today, boffins announce that they’ve been able to produce myelin by converting skin cells into human induced pluripotent stem cells (hiPSC) cells capable of producing myelin and repairing damage to brains. At least, in mice, that is. Why couldn’t the white matter cells have been used in the same fashion? It turns out, that gets more complicated than they anticipated:

The source of the myelin cells in the brain and spinal cord is cell type called the oligodendrocyte. Oligodendrocytes are, in turn, the offspring of another cell called the oligodendrocyte progenitor cell, or OPC.  Myelin disorders have long been considered a potential target for cell-based therapies. Scientists have theorized that if healthy OPCs could be successfully transplanted into the diseased or injured brain, then these cells might be able to produce new oligodendrocytes capable of restoring lost myelin, thereby reversing the damage caused by these diseases.

However, several obstacles have thwarted scientists. One of the key challenges is that OPCs are a mature cell in the central nervous system and appear late in development.

“Compared to neurons, which are among the first cells formed in human development, there are more stages and many more steps required to create glial cells such as OPCs,” said Goldman. “This process requires that we understand the basic biology and the normal development of these cells and then reproduce this precise sequence in the lab.”

The secondary problem of using either this type of “tissue specific” or even embryonic stem cells is that, once cell therapy becomes a common practice, either type of cell can be guaranteed available in the quantities that may be required. By contrast, every patient is going to have an ample supply of skin cells that are just ready, willing and able to be reprogrammed  back into stem cells and implanted where they’re needed.


Your heart and a worm’s butt: besties?

You know, when you think about it – I mean, really think about it – there is… really nothing obvious about the connection between a worm’s pooper and your ticker. But things are not always as they seem.

In science, they rarely are. For example, having grown up on the notion that bones are made of calcium, we could be forgiven for thinking that this is where calcium’s usefulness in the body ends. That is not the case, however. Calcium is one of the most ubiquitous signaling chemicals in the body, facilitating everything from flexing your muscles to that squirt of endocrine reward you get for having worked out in the first place.

Calcium also governs the proper beating of your heart. Researchers are not yet aware of the mechanism by which calcium regulates how the heart works, but researchers at the U of R may be a step closer to an answer. And they got there by studying the digestive systems of worms.

Because the worm’s digestive system basically works as a series of muscle contractions pushing the food through the system, they wondered what was causing the muscles to move in such an organized wave. They wondered what made the muscles contract so rhythmically:

The team’s analysis revealed that a molecule called a microRNA is required for the entire waste removal process to run smoothly. microRNA-786 is present in the two most posterior intestinal cells of worms and tags these cells as the pacemakers or leaders. These pacemakers dictate when and where the primary calcium spike occurs, activating the movement of waste through the worm’s body. When the team removed microRNA-786 from worms the process went awry; the calcium wave started in the wrong place and the waste cycle was irregular and longer than normal.

So the presence of a single molecule of microRNA in a worm’s butt is what makes him crap real good. It is what creates a chain of command that allows the muscles to work as a team. And some similar type of “teamwork gene” might be present in human hearts as well. Or at least, studying the relationship between microRNA-786 and the pacemaker cells may reveal other clues to the heart’s regulation.

Or maybe they just create the world’s most efficient laxative. I think that avoiding a “waste cycle” that is “irregular and longer than normal” is a goal we all share. Here’s to science!


U at Buffalo boffin may have the Middleton cure

Those of you who have been waiting on pins and needles to hear about the next trial of Kate Middleton are surely breathing a sigh of relief that she’s out of the hospital.

But as much as the media’s obsession with the Royal Bump is a bit over wrought for a country that does not have royalty, Kate Middleton’s morning sickness problem is in fact quite common. And the proper relief for such severe morning sickness has eluded doctors up until now.

One researcher at the University of Buffalo may have struck on that solution, using a drug normally administered as an anti-seizure medication. Doctor Thomas Guttuso has been working with a drug called gabapentin and cancer patients when he hit on the idea that the same drug might prove effective dealing with hyperemesis gravidarum (severe morning sickness in pregnant women):

“But when they started with gabapentin, all of them showed a dramatic improvement,” he says. “Within two hours of taking the first pill, most of the patients were feeling much better and several were able to start eating and drinking again. It was a pretty amazing thing to see.

“The study showed that after two weeks of gabapentin therapy, the seven women experienced an average 80 percent reduction in their nausea and a 94 percent reduction in their vomiting and near normal levels of eating and drinking,” Guttuso says. After this study was published, Guttuso knows of five more women with hyperemesis gravidarum that tried gabapentin and all experienced excellent relief.

Tests with the drug showed obvious promise, but they are in fact very small clinical tests. More work will need to be done to prove that the drug can be considered safe and effective.

And as much as we all enjoy laughing at the media’s constant hovering over Middleton, this rarely-discussed yet common problem for pregnant women is very serious indeed. Like Middleton, many women find themselves in the hospital on fluids because they can neither eat nor drink while suffering. In fact the article notes a remarkable 15% of women suffering with hyperemesis gravidarum terminate the pregnancy because they are unable to continue.

Rochester Science

Need cash? Sneeze on a boffin. It pays!

It’s that time of year again: the season in which the University of Rochester exchanges quick cash (for you and your whole family!) in exchange for research into why you feel so shitty. It’s a sweet deal, if you can stand going to a hospital four times in the next month.

The U of R has released a presser announcing that anyone who comes down with a flu virus who qualifies can get $25 cash money for showing up to the hospital to let a boffin poke them. If anyone else in your household is also sick, they want them too! Same deal, $25 per visit.

The research is part of a collaborative effort from the awesomely-named New York Influenze Center of Excellence, made up of researchers from the U of R, Cornell and quite inexplicably, the University of Tennessee.


the research is part of the NYICE’s broader mandate to analyze the pathogenesis of flu viruses. This means the route by which infection happens and the life-cycle of the flu while it is in an infected host.

Bonus Excellence:  The NYICE website also links to an article interviewing a “metaphysical healer” named Louise L. Hay who suggests that, if you’d like to avoid sneezing on boffins, your best defense is a positive attitude. I have no idea how this gets linked to from that website. But there you have it.


The Nap Nanny meets the Nanny State

As we go, scientists and doctors find out more and more about the mystery that is childhood. Particularly in those months before the child can communicate with their parents in anything more than cries, figuring out what is right or wrong about the little one can be a terrifyingly-ineffectual exercise, but science is beginning to fill in the gaps.

For example, “colic” is a term we often hear applied to babies that display a particular penchant for screaming in their early months. What “colic” is, however, is the doctor’s catch-all term for “I don’t know what the hell is wrong with him.” That’s not an exaggeration: like a “syndrome,” colic is simply the doctor’s term for a condition for which there’s no real answer. It is a clinical shrug.

But one chief driver of colic appears to be pain associated with gastrointestinal issues in the newly-operable digestive systems of babies. We don’t often think about it, but for nine months, the baby’s digestive system (and lungs, and nearly every other organ) develops without ever being used. Then at birth, the switch is thrown on the whole system all at once, while the former lifeline of the placenta is suddenly and summarily cut off. Its like ripping the diver’s mask off his face ten feet from the surface. Better hope everything goes according to plan.

That newly-minted GI tract is a fraction of its adult size and completely without practice, so any small problem the baby has digesting quickly becomes a huge problem. One small burp for you is a giant case of acid reflux for the kiddo.

Holding the baby more or less upright – or at least, the esophagus raised above the stomach – is one sure-fire way to alleviate the acid reflux thing. This is especially helpful[1. Fuck that: it’s a goddamned godsend] at night, which is why one enterprising new mother came up with the idea of the Nap Nanny: a solid piece of foam out of which is cut a small seat angled at a perfect 30 degrees to keep the kid’s head elevated during those formerly brief sleep periods.

God, how I love you, Nap Nanny.

The Nanny is a thing of genius, really. Made of a light-weight foam, it may not strike you as very stable at first glance. But the physics of its design cannot be denied: the baby’s weight is held directly in the center of the squared foam, thus making the whole package extremely stable. The straps hold the wee one in place securely while being soft and comfortable enough for him to sleep in. My kid likes to really rock and roll in the Nanny both before he goes to sleep and immediately after waking up and at no time have I ever seen it move enough to even come close to tipping over. In a wide landscape filled with children’s toys and accoutrement, rarely does one find an object of greater security.

There. It says it right fucking there.

Now it appears that, because of five tragic deaths associated with the Nap Nanny, the federal government is asking that this miracle in foam not be sold in stores until an investigation is complete. This, despite the fact that clearly:

That the recliners seem to have been used contrary to manufacturer’s instructions does not absolve Baby Matters, Wolfson said.

In four of the five deaths, none of them local, the Nap Nanny was placed in a crib – precisely what the warning labels on the seats say should not be done. Those instructions say the seats are to be used on the floor, with babies strapped into the three-point harness.

Here’s the thing: there are only five horrible deaths associated with the Nap Nanny. In each case, the parents were using the Nanny against the warnings placed right on the side of the foam – even my kid likes to play with the little silk warning tag. And the implication is that, in some cases, the Nanny was used in a crib with a crib liner, yet another explicitly warned-against practice. And if the kid is falling out of the Nanny and getting stuck where he/she could suffocate, clearly, the child cannot have been strapped into the seat.

I can’t imagine losing my child in this manner. Or any manner. But these are extremely rare cases of extremely bad luck – even violating the warning against using it in a crib, I can’t imagine there being any real trouble in 99.9999% of cases where this undoubtably happens.

And for these few cases, a good product is getting smeared. Good parents are going to stop using the thing and babies with horrible problems getting sleep are going to go right back to where they started. This is especially true because many networks – and I point our Rochester’s own 13WHAM as one case in point – say that the Nap Nanny is being recalled because of “a substantial product defect,” without actually specifying what the “defect” is. Why not begin the show with the announcement that “news happened,” and just go to commercial for the rest of the show?

Our son will continue to use the Nanny until he’s ready for his own crib – which won’t be long now, anyway. You should read the instructions carefully when buying any product and don’t let edge-case fears ruin your baby’s childhood.

Late update: The makers of the Nap Nanny now say they’ve gone out of business because of having to deal with the lawsuits.

Rochester Science

Your next pair of contacts may wear better thanks to RIT

There I was, sitting in the chair at a local eye-glass and contacts company, trying my damnedest to get my new contacts in. As a dude, we’re not anywhere near as often playing around with our eyeballs. You ladies have been putting pencils near your orbits since about a year or two before your moms allowed it, don’t lie.

But me? Well, I couldn’t stop blinking the little bastards straight off my finger and away from their intended targets. Eventually, the woman who was “helping” me got frustrated, tipped my head back and put the damned thing in herself in about two seconds. Fully-extended arm, I’m lucky I’m not blind.

For the rest of you, contacts are a must-wear. But they come at a cost to your health: dry eye syndrome is quite common amongst contact lens wearers, in part because contacts can get in the way of the eye’s natural ability to keep itself lubricated. This has to do with the way the contact is formed to sit on your eye, a design process which has until now been done largely as guess-work.

But researchers at RIT aim to change all that with a new set of mathematical algorithms born out of the wizardry known to many as fluid dynamics:

Ross, who researched fluid mechanics with Eastman Kodak Co. before becoming a professor at RIT, says that the research is a new, purely mathematical approach to looking at the tear film of the eye. “We initially envisioned the lens floating in a sea of tear film, when in fact, this is not the case,” Ross says. “The lenses are 100 to 200 microns thick, while the tear film is only 5 microns thick.”

Maki and Ross hope that Bausch & Lomb will eventually be able to implement their research into new design processes for their contact lenses.

So in short, your new contact lenses could very soon make your eyes a whole lot less itchy to wear. Which is a great comfort, especially to those one or two of you who have accidentally fallen asleep with them in…


U of R boffins isolate the “suicide protein” that may be the key to curing cancer.

The cure for cancer may be closer than we know.

At least that is what University of Rochester Professor Vera Gorbunova and Assistant Professor Andrei Seluanov think.

The blind mole rat was known to be one of two mammals that never develop cancer. It was only until recently that University of Rochester scientists found out how the blind mole rat had developed such an immunity.

For their test, the two professors isolated blind mole rat cells and forced them to grow at an accelerated rate. During this process, the scientists witnessed the rapidly growing cells rearrange themselves and secrete a “suicide protein” that halted the abnormal growth. They also found that the adjacent cells that were at at risk for developing cancer were also killed off, stopping any potential for cancer.

Gorbunova said that the next step in their research is to find out why the protein is released in the first place. Once this final secret is discovered, it could be the final piece of the puzzle that will allow scientists to prompt human cells to release a similar “suicide protein” that would allow people to be able to fight off some cancers.

Despite the excitement among the University of Rochester scientists, Jerry Shay, who studies cellular aging at University Texas, does not hold the same optimistic opinion. Shay says that the protein may not actually be what prevents cancer in blind mole rats. He suggests that researchers have simply not found a way to keep the test cells alive for a long enough time.

Even if scientists have not figured out how blind mole rats have managed to prevent cancer to grow, it still does not take away from the fact that they are mammals and that they are immune to it. This means that humans still have a future of becoming resistant to cancer for good as well.

Rochester Science Technology

Remember: fall means hunting season, but hunting season doesn’t have to mean falling.

Hooray for hunting season! Yes, that time of year is once again upon us. Bring on the beer, guns, and climbing birds-eye-view tree stands all before the crack of dawn! Nothing could possibly go wrong with that recipe for disaster, right?

According to URMC, usually not; to be specific, only about 10% of the time do hunters find themselves injured in a given year. Well, that’s not so bad, right? Actually, it’s downright terrible, considering the solution to preventing these injuries is an extremely simple one: wear a safety harness. Sounds easy enough, but how long did it take people to get in the habit of wearing seat belts in the car? For some reason, we humans just don’t like being inhibited by contraptions meant to protect us from life altering – or ending – accidents.

According to Jason Huang, M.D., URMC neurosurgeon specializing in head and spine injuries,

“We are still seeing hunters who have taken unnecessary risks by not wearing the safety belt or harness and endure significant injuries from a fall. Compared to a decade ago, we have made no progress in preventing these neurological injuries, despite safety advances – which is unacceptable.”

In a review of 54 hunting accidents or falls between the years of 2003 and 2011, neurosurgeons saw injuries ranging from cervical spine fractures, traumatic brain injuries, collapsed lungs, internal damage to the spleen, liver, and kidneys, and even paraplegia and quadriplegia. According to Huang, most of these accidents would have been prevented if the hunters had worn a safety harness.

Let’s be honest:  hunting season is a great time! Where I grew up in Pennsylvania, they even close schools and businesses during the first day of each game season because they know everyone wants to participate – but let’s make sure we can all make the most of the day without falling 30+ feet to the hard ground. Remember: if you fall, the deer wins!