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The Unforseen Health Benefits of Scarcity, the Right to Die, and Health Care

Hey, it’s Friday all. I hope your week has gone well. Scanning the headlines this morning a few particularly controversial pieces caught my eye. Both studies are a bit of a testament to the fact that truth isn’t always comfortable – in health or any other area of human endeavor. Add politics into the mix as happens with public health issues and it really gets interesting. So I’d like to hear what you have to say (don’t tell me don’t have an opinion).

First, the unintended consequences of major scarcity and a 40% shrink in the economy in Cuba during the 1990s evidently resulted in a much sleeker and healthier population. Diabetes and heart disease dropped significantly, so on balance, mortality rates declined. Johns Hopkins researchers [1] are calling it a rather positive, if unexpected side effect of the collapsed Soviet pull out, but I’m not so sure the Cubans would agree with that rosy perspective as it required a decade of misery to arrive at. Without intending to diminish that period’s notorious difficulty on Cuban citizens, I can’t help but think about our bloated caloric supply in this country. And we wonder why we’re so disease-addled and obese? What we have are illnesses of depressing excess.

Second, the BMJ [2] has a study that concludes that some arguments against euthanasia – e.g. the “slippery slope” debate and the concerns that vulnerable individuals or the uninsured might be euthanized by health care and government agencies putting efficiency and cost over human life – are unfounded. Whew. That’s a debate that’s not going to be easy, and while it’s not a situation I hope to ever have to think about (does anyone?)…you ought to know what evidence those in medicine and health care are looking at when it comes to establishing practices regarding patient care and terminal illness. If we don’t stay informed they’ll decide for us…

And finally, it’s interesting to see how the 2008 presidential race is shaping up in terms of health care. The plans being presented [3] already are surprisingly detailed. Like it or not, this is going to be a paramount issue in the campaign. I personally believe it’s our most important one, as many of you know, so I’ll be following the various candidates’ plans carefully (read my own health care proposal here [4]). Republicans are focusing on reducing costs, tax breaks, and a movement away from employer-provided coverage, while the Democrats are hammering out various universal coverage plans. Health care will be forced into an overhaul, but just how it will shift remains to be seen…

The Bees will be in later with a terrific piece on the latest developments in cholesterol research (the food pyramid and statins take another hit). So stay tuned. I think we’ve got plenty to talk about for now!

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