It's The Prices, Stupid

Uwe Reinhardt, one of the foremost economists focusing on US healthcare, points out that the reason that the US spends so much on healthcare per capita compared to other countries is not because US citizens use more healthcare resources (in fact, it's the opposite), but rather because the price of healthcare in the US is far higher than in other countries.

This article is worth reading and opening the numerous links if you've ever wondered why it's so hard to find out how much a medical visit, test or procedure is going to cost you before it's done.  Gotta agree: our healthcare system is like getting a pair of pants at two different stores with prices that are 10-fold different.  Stores that don't have price tags, that is.

So, for all those patients who think I've been kidding about those exoskeletons...

Slate has a great article on developments in medical exoskeletons.  The fellow in the picture is paraplegic since an industrial accident.  Now he can walk (but not fly).

Why do so many people do a gluten free diet?

Slate has a pretty good article on this question.

Long story short, it fall into a category of medical problems where a true medical condition is not common, but not rare either (celiac disease or gluten enteropathy affects 1% of the population and is not that hard to definitively diagnose). However, symptoms can occur that mimic the condition leading to potential for over-diagnosis and/or self-diagnosis (gluten intolerance may be "real" in a third of people who describe symptoms after gluten ingestion).  In other words, if 25% of the population is on or has been on a gluten free diet, and only 1% of the population has celiac disease, there's a lot of people who are either mis-labeled with celiac disease, or just prefer not to eat gluten for a variety of reasons.

Anyhow, the Slate article is very comprehensive without rushing to judge.

More on the subject of the high cost of hospital care

Uwe Reinhardt, a well-known economist who is particularly knowledgeable in the area of medical care, responds in an economics blog to Steven Brill's brilliant article on the high cost of hospital care in the U.S. (I posted on this last week and linked to the article).

In his response, he praises the thoroughness of the article though also points out that this is not the first news coverage on the subject, and that the news media silence and general public unawareness of this over the last ten years is surprising.

Additionally, he responds to Mr. Brill's list of proposed improvements by pointing out an already existing law in New Jersey that caps billing of uninsured patients by hospitals as a percent of MediCare reimbursement plus X.

Sounds reasonable to me: Mr. Reinhardt provides a link to the assembly bill in question for those who are interested.

Why is Junk Food so addictive?

Why is it that even though we all know that carbs, grease and salt are not good for you, they are so irresistable?  Why do some junk foods (Cheetos, I'm talking to you) just beg you to eat more of them?  Why do others seem perfectly designed to make you feel okay about eating them (pita chips, ahem)?

It turns out this is not coincidental, but rather the result of decades of research on the science of producing foods with these characteristics and on the marketing of them to consumers.

This article looks at the history since the early 1990's when it was starting to be recognized that obesity was becoming pandemic of the food industry's efforts to head off possible lawsuits or governmental regulations.  To their credit, there was serious discussion and effort at producing healthier snack foods.  In many cases these failed compared to less healthier options.  At the same time, the snack food makers were pouring millions of dollars into devising ways to make their products literally irresistible.

Interviews with some of the people involved over the years are also revealing of motivations and conflicts both at the corporate and personal levels. The last interview about the successful marketing of plain baby carrots by selling them like junk food (but not as junk food) is worth the read.