What I'm Reading (Aug. 18)

By Chuck Dinerstein, MD, MBA — Aug 18, 2022
Is the climate crisis a population problem or a poverty problem? Are you more disabled as a composer if you are blind or deaf? A Dutch pastime - Uitwaaien Medicare can negotiate prices; what might go wrong?
Image by 132369 from Pixabay

 

 

“Researchers have come to realize that the population of our planet is far less important than how we live upon it. Fertility rates and carbon emissions are not spread evenly across the globe.”

 

The Anthropocene asks a fascinating question, is the changing climate due to our vastly increased population or from poverty and the choices we then need to make to survive? Is the climate crisis a population problem or a poverty problem?

 

“Deaf or blind creators in different fields provide a natural experiment, evidence for what kind of the skill -- including social skill-- is the specific ingredient of creativity in music, and what are specific to other fields.”

It is surprising but at least from two examples, loss of sight is more critical to composing music than loss of hearing. From The Sociological Eye, Deaf Or Blind: Beethoven, Handel

 

“Uitwaaien is something you do to clear your mind and feel refreshed—out with the bad air, in with the good,” she tells me. “It’s seen as a pleasant, easy, and relaxing experience—a way to destress or escape from daily life.”

From forest bathing to uitwaaien, getting out into the fresh air provides a spiritual lift. From Nautil.us, The Simple Dutch Cure for Stress

 

The latest federal legislation requires that Medicare negotiate drug prices, which should bring prices down. Now the pharmaceutical companies have argued that reducing prices will reduce R&D; after all, US patients pick up the global tab for these costs in the higher prices we pay for every drug. But are there unintended consequences?

“The biggest issue with the bill is that it makes small molecule drugs eligible 9 years after approval, while biologic drugs are eligible after 13 years. This is based on some silly misconception that small molecule drugs are quicker and cheaper to develop and therefore have shorter payback periods. That may have been true when we were tackling relatively low-hanging fruit like high cholesterol, but small molecule drugs that tackle unmet needs today are nothing less than miracles. An oral pill that treats cystic fibrosis, like Vertex’s Trikafta, or sickle-cell disease, like Global Blood Therapeutics’ Oxbryta, is incredibly challenging to develop.

This is going to hurt returns for small molecule drugs and skew R&D efforts away from them to biologics.”

From Marginal Revolution, From my email, on the new health care provision

Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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