New Kindling For The Fires of Healthcare

I love my Kindle. It has changed how I read -- in fact, I read faster, in more places, with a greater diversity of topics.

The ability to download and carry a small New York Public library of books is amazing.

On Metro-North I read War and Peace (the new translation) one-handed while standing (try that, even in paperback). At the car repair shop, while getting my Subaru tuned, I was able to fine tune my thoughts about Andrew Jackson's presidency. And, sitting by the pool, I basked in the sun while exploring Bleak House.

The device is far more friendly to read from than my net book. And, though the internet browser is not very robust, the 3G reception is excellent.

Now what if everyone had such a device. How much easier would it be to carry around your health records, research different health states, even reach out and touch a medical professional?

Maybe webmd or Pfizer or Aetna could offer a free Kindle to everyone to help manage and answer their healthcare issues.

Okay, I confess, I was also reading Chris Anderson's Free, which I downloaded free on my Kindle.

Wouldn't a Kindle be a great freemium for healh care.

I need to ask my doctor about this.

As the cost of health care continues to rise and the government and private enterprise seeks to manage it, let's let the information and the patient devices be fee and allow the procedures and the drugs to cost what they need to cost. The more you know, I bet the more judicious the use will be.

Now that's some kindling to light the fire of healthcare.

One piece of birthday cake too many

Ever have a parent or a friend end up in the emergency room with a heart attack?

In the US, chronic diseases account for more than 75 cents of every dollar spent on healthcare, and are the #1 cause of death and disability.

Yet the amount spent in the US on prevention is $10 per person. That is about the cost of my monthly no-frills gym membership.

An ounce of prevention here is worth a pound of cure.

We can only hope that the new healthcare bill wending its way through the halls of Congress will put more of an incentive behind prevention and wellness.

As we see, the best way of moderating the cost of interventional healthcare is not to use it at all.

According to the Almanac of Chronic Disease, 4 out of 5 Americans would rather spend on preventive measures than on treating diseases after detection. Then how come my gym wasn't very crowded today? I bet there were more people at the local ER than on the elliptical this afternoon.

Let's hope that Congress gets the message and allocates more money to improve the health literacy and the coverage of the average American.

There are 46 million good reasons (the number of uninsured in America) to give more people coverage and that gym membership.

Sonia Sotomayor: Please Free the iPhone

Back in 1984, oh, all of 25 years ago (which is about the age of many iPhone users), Stewart Brand, at the first Hacker’s Convention, said, information wants to be free.

That truism has continued to be borne out over the intervening years, as company after company struggling to monetize their information and web sites. The foamy successes of some web-based successes (I will include Google, FaceBook, Wall Street Journal here) lord it over the wet troughs filled with so many failures (just too many to list).

So what about that lovely iPhone, the newly classical kouros of mobile phones?

Why is it stilled tied to one carrier? Because that was the deal that Apple made with AT&T.

Now consider the irony here:

Part of the marvelous success of the iPhone is its software architecture that allows so many applications to be created for it. The monetized Apple store is a cornucopia of creative uses digitized to mobile broad band.

But the iPhone itself? Tied to one carrier in the US. (But not overseas).

Where are the FTC and FCC when you really need them?

Capitalism is a wonderful thing in that here some manufacturers can decide what they want to sell and how they want to sell it.

I am sure that Apple knows it will sell more devices if it adds additional carriers like say my carrier, Verizon (hint, hint).

Mobile broadband will be the Next Big Thing. And if mobile broadband devices are to be truly successful than they need to be free to follow the airwaves like a bird.

(Come to think of it, how come there are now mobile phones named after birds?)

If the US government can own General Motors, why doesn’t it just take over Apple and free the iPhone? Oh yeah, Apple is making money. Well, then what are the FTC and FCC good for? What about Supreme Court decisions on Interstate Commerce?

I just got Sonia Sotomayor’s iPhone cell number. I think I will give her a ring just before her hearings.

Science advances one funeral at a time

I am going to with Max Planck and James Montier of the Financial Times.

Planck said that “science advances one funeral at a time.”

So we can now safely see that the Efficient Market Theory is dead. As we know, the EMH theory postulated that all information is reflected in current market prices. Well, as we slog our way through this financial meltdown with economic lava pulling at our heels and ankles, we recognize that the EMH theory holds less water than my grandmother’s sieve.

Hmmn, now what about clinical trials? We all would hesitate to say that science advances one funeral at a time, even though that is what sometimes happens. Max never worked at a pharmaceutical company nor was he a clinical investigator. However, his view reflects the dark underside of participating in a clinical trial.

I have recently been ruminating on rheumatoid arthritis for a client. The variability of results for the clinical trials for different drugs is astounding and confounding. As a result, it is critical to evaluate each Randomized Clinical Trial in the context of demographic and baseline disease characteristics of each population as no two trials have similar patient populations, even with similar designs.

Unfortunately, there is still a lot of suffering out there in RA. There are 4.5 million cases of RA in the US, EU and Japan, with 200,000 new cases diagnosed every year. Treatment goals in RA are reduction in signs and symptoms, prevention of structural damage, and induction of remission. Nothing is going to stop the pain, but, with the drugs currently available, methotrexate, Enbrel, Remicade, Humira, etc., sufferers can still enjoy a reasonably good of quality of life.

The other good news is that the pipeline of new drugs is very active with some promising new drugs.

The challenge, though, is that there is no efficient market theory. Even with all the information available, the heterogeneity of the disease itself and the diverse patient population and their individual sufferings indicate that there is no one drug cures all.