Chart of day: Rapidly falling under-5 mortality across Africa

From Global Development blog via Craig Nordin:

Under-5 mortality (per 1,000 live births) in selected
sub-Saharan African countries surveyed since 2005

Go to the blog post for analysis. My point:  interesting how opening up to globalization coincides with this.  Not arguing initial causality, which is multivariate.  Point is:  opening up to globalization certainly doesn't "impoverish" along these crucial lines.

This joyous development begets a demographic dividend, which sets a clock a'ticking.  How Africa handles this historic opportunity is crucial of course, but clearly this is the best problem yet for the continent.

And what is progress other than moving off worse problems to better ones?

This story is nothing new.  We saw doubling of human life expectancy across 20th century (started in low 30s in 1900 and reached 65 by 2000) and that was almost all about reducing under-5 mortality - and that was overwhelmingly due to vaccines, with clean(er) water a crucial second.

WPR's The New Rules: Extended Life Expectancy Globalization's Next Political Battleground

Human life expectancy at birth, which remained stunningly fixed for thousands of years before suddenly doubling over the course of the 20th century, now seems destined to experience a similarly bold leap across the 21st century. When it does, it will shift human thinking about population control from its present focus on the outset of life to the increasingly delayed final curtain. The problem is that the technological advances that will make extending life expectancy possible are likely to come far faster than our political systems -- including the democracies -- can handle. 

Read the entire column at World Politics Review.

Deficit myths: it's still all about healthcare, so Obama was right to work it. And yet, I want him gone in 2013 [WITH ADDENDUM]

Got asked in Belvoir this last week about the present situation in US and what must be done.  I answered by citing my own household economy as microcosm:

• Far more competitive world means earning potential is harder to achieve;
• That income "haircut" means past debt patterns unsustainable, thus the deleveraging that continues (done better by individuals, families, firms, everybody but the Fed Gov!);
• Housing is key (our move to short sale old house was big financial achievement of 2011), and curing that is key to allowing workers to move (that's why we did it this year, while the right constellation of circumstances presented themselves, in preparation for eventual 2014 move back East for job-related purposes);
• Education is key (I pay 7 tuitions: 2 preschool, 2 grade school, 1 HS, 1 undergrad and 1 grad) to maintaining future possibilites, so investment trumps damn near everything; and yet,
• Healthcare is huge drain (I pay my own now and the pre-tax cost, by my estimate, is between $30-40,000, meaning that's how I gotta earn to cover it all from stem to stern).

So larger reality for US not unlike my family: we had to scale back everything to preserve what matters, which is healthcare and education; we had to solve the housing situation to allow for renewed labor mobility; we haven't really seen our standard of living go down at all, and yet we've made wrenching changes to be able to live on a much smaller consumption footprint. All tough adjustments, but incredibly worthwhile.

But again, healthcare is huge and seemingly unassailable from my perspective. We are exceedingly careful about how we spend those dollars, even as that's the last thing - besides education - that we want to scrimp on.

Of course, if we don't have six kids, then my life is dramatically simpler on all scales, but there again, what keeps America strong?  Demographics, so that's worthwhile too.

Citation here is Alan Blinder op-ed in WSJ.  Great stuff.

"Four deficit myths":

1. Americans now demand deficit reduction like never before. Not true.  Jobs matter far more now, as does healthcare and housing. Just understand, polls on this subject are no more definitive than they were 20-30 years ago.  This is not our current obsession.
2. Our deficit is so bad right now that massive cuts are required immediately. Also not true. We have no trouble selling debt in this global economy. Yes, long-term deficit issue is acute, but key is setting in place conditions for long boom that takes care of that. See Europe for austerity approach.
3. The ten-year reduction focus makes sense. Bad thinking. Little can and will be accomplished in any 10-year plan. The problem if far longer in scope - see demographics, and thus the solutions must be similarly gauged.
4. America has a generalized problem of runaway spending. Very untrue. The only part of the Fed budget that's really exploding is Medicare and Medicaid, so it's still mostly about healthcare.

In short, "we have a humungous healthcare problem."

Anybody familiar with the US defense budget has long said the same thing: we don't have operations or acquisition or training or personnel crises. The "imperial overstretch" argument remains complete academic bullshit.  We primarily have a healthcare crisis that is extended into pension system. Everything else pales.

In my family right now, the biggest short-term threat, now that we're mortgage free and successfully deleveraging across the board, is healthcare. Huge drain.  Big uncertainty. Encourages self-defeating avoidance behavior on many levels (which we try desperately to be smart about). Leaks into everything.

When GOP says Obama went off deep end on healthcare because country didn't want that or didn't elect him for that, they miss the mark.  It is clearly the biggest internal challenge we face - short and long term. It is the hidden villain on everything. Saying it was a diversion is - itself - a diversionary election-centric tactic.  

But still, I would trust a Romney to finesse its implementation better than an Obama, whose political and negotiating skills I no longer respect, and whose stunning ignorance of, and antipathy toward, business has become an unacceptable leadership flaw - given the tough adjustments still to come.

And yes, I LOVE that Romney did it first in Massachusetts - and did it intelligently. That is a huge credentializer in my mind.

Americans' distrust and anger toward globalization and big business is stunningly misplaced. Globalization has made the world so much better, but it now challenges us in ways we've long gotten used to avoiding because of our long-term privileged position in the global economy, which itself reflected gross historical injustices stemming from colonialization, WWII, socialism in the East, etc. None of those things were our fault, and we took the lead in overcoming them all, but we did live in a pretend world of superiority on that basis across the second half of the 20th century.

That world is gone, and good riddance, say I, because it was supremely unfair to the majority of the planet, and I don't want to live in this world by exploiting others unnecessarily.

So our succees in spreading American-style globalization now comes back to haunt us, demanding we adjust. That's not about demonizing business, even as it is about cleaning up some incredibly bad form on Wall Street (a regular task, just bigger this cycle). It's also not about demonizing China, who is our biggest ally in the global economy going forward - like it or not.

Romeny will say stupid things on China to win the GOP nomination. Obama is already doing stupid things. On the business, it's clear who's hostile and who's not.

Looking ahead, I want a dealmaker, a difference-splitter, a realist on business who acts based on experience and not sterile theory. I also want somebody who can rationalize our military budget and global presence without resorting to idiotic, default targeting of the Chinese.

Romney is far from ideal on all those scores, but he does beat Obama, in my mind, on every one of them.

I stil maintain Obama was the best choice of the two in 2008. I would still vote for him all over again, given the repeated chance. I do think America, however, would have been much better served by a Hillary presidency (I voted for her in the primary), and since I can't get that this time around, I'll make do with the alternative, who I think will have a far better chance of working with a Republican House and Senate than Obama will - given overall Boomer political proclivities (most Boomer politicians are just above cartoon-grade in their motivations, skills and intelligence).

No, I would take Obama over the two jokers (Santorum and Paul) and the complete wild card (Gingrich). And yes, this would be my first vote for a GOP presidential candidate in my entire life.

And my logic on all this if decidedly unemotional (can I toss in that I'm the father of two African-come-to-America daughters, just to be safe?).

This isn't personal in the least; this is strictly business.

LATER ADDENDUM DUE TO MIKE RUSSELL'S COMMENT ABOUT GOP'S CHARGE THAT OBAMA IS "ANTI-BUSINESS":

I don't use that political term of art (anti-business), because I don't think it's true. I don't think his policies have been particularly anti-business.

I think he doesn't understand business (ignorance) and on that basis tends to vilify and scapegoat business (antipathy) for our continuing poor recovery. The silliness over "taxing millionaires and billionaires" is, to me, just rhetorical nonsense. Those people pay plenty, but no matter how much more we tax them (I am indifferent on the subject), it won't change our fundamental issues. So, to me, rolling with political gamesmanship like that says serious change isn't what he's looking for, otherwise he would have gone with Bowles-Simpson and not ignored what everyone said were sound recommendations.

I also cite the ignorance issue for what I consider to be generally bad-for-business-but-bad-for-everybody-else-too policies in combating the crisis. The administration just hasn't done enough to encourage deleveraging throughout the economy, instead preferring stimulus spending to cure a financially-driven overhang crisis, which, per Rogoff, is the wrong medicine chasing the wrong disease.

I won't claim to have tracked the US economy enough to have said, I told you so way back when, because I most certainly did not. But it's hard for me to accept that a guy as smart as Obama couldn't find enough people around him who were smart enough to realize that stimulus splurging after a financial crisis only gets you a follow-on fiscal crisis without actually improving the financial hang-over/debt overhang. They still don't seem to get that, and as long as they don't, I think business will hold off on investment and hiring because consumers are forced to keep their spending low (I certainly am).

So all I am left assuming is that he doesn't know business (ignorance) and made patently bad choices out of some antipathy to business (it is hard to advise the guy who's certain he's always the smartest guy in the room). I say that because business has largely argued for a far stronger deleveraging focus versus the path Obama has taken. That path did include bailouts for Wall Street firms (not sure history will be kind there) and Detroit (am certain history will be kind there and have said that throughout in posts and speeches - but there I cite the global car industry, which is something I have tracked).

Finally, if Obama were both smart on business and less into his business-can't-be-trusted mode, I think he would have pursued opening up the US economy to Chinese investment instead of staying stuck on the RMB's value and this bizarre strategic "pivot" to East Asia, where apparently our weaponry and national "will" is going to keep us economically engaged in the region despite openly targeting the biggest economy there, a country, by the way, that we expect to finance this military buildup in the Pacific. But that's just me saying I don't trust how he views or understands global business.

In general, I do think Obama is a smart guy, but he's displayed enough dumb/antipathy WRT business for me to want him swapped out versus keeping him another four years. The global economy right now is in fairly precarious shape, and I don't see his administration being able to work with a GOP congress over the next four years any better than he has the past 3. We can say it's all GOP hostility but Bill Clinton managed that, and Reagan did with the Dems. Obama is just not that guy. He matches the GOP's Manichean view with too much of his own, along with a pride and self-confidence in his supreme intelligence that I think is his biggest weakness.

We've have world-class brain presidents (Hoover, Carter, Obama) and they manage to have attract hard economic times. I have come to greatly prefer emotionally intelligent presidents (FDR, Reagan, Clinton) or incredible dealmakers (Johnson, Nixon). That's why I will take Romney and his blandness and his difference splitting and flip-flopping and non-agenda. I want a manager who moves the process along for the next four years, rather than the perceived/actual ideologue who attracts more fight than he's worth and isn't clever enough to realize when he needs to bend instead of stand proud.

Time's Battleland: "Does al-Qaeda go the way of AIDS?"

Nice piece in WAPO about Ayman al-Zawahiri taking over al-Qaeda from the recently assassinated Osama bin Laden. Story leads with remembrances from a guy who knew him back in the day:

He was arrogant, angry and extreme in his ideas,” said Azzam, 40, son of a radical Palestinian ideologue who had become bin Laden's mentor. “He fought with everyone, even those who agreed with him.”

Thus, experts are now saying that al-Qaeda will suffer under his leadership:

U.S. intelligence officials, terrorism experts and even the Egyptian's former cohorts say a Zawahiri-led al-Qaeda will be far more discordant, dysfunctional and perhaps disloyal than it was under bin Laden.

Just to cover rear-ends, though, the story's next statement leaves open the question whether or not the group will be more or less effective (terrorism experts must always do this to make sure they can win big when the next strike comes and they told us so!).

Read the entire post at Time's Battleland.

Under the knife: revision tympanoplasty

Illustration found here.

A tympanoplasty, as defined by Wikipedia:

Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles). The term 'myringoplasty' refers to repair of the tympanic membrane alone^[1].

There are several options for treating a perforated eardrum. If the perforation is from recent trauma, many ear, nose and throat specialists will elect to watch and see if it heals on its own. After that, surgery may be considered. Tympanoplasty can be performed through the ear canal or through an incision behind the ear. The surgeon takes a graft from the tissues under the skin around the ear and uses it to reconstruct the eardrum. One of the most common graft sites is from the tragus. The surgery takes ½ to 1 hour if done through the ear canal and 2⅓ to 3 hours if an incision is needed. It is done under localor general anesthesia. It is done on an outpatient basis and is successful 85-90% of the time.

Both my eardrums fell apart in my youth, after countless ear infections.  I had my right ear drum grafted big-time in high school, and my left one done in college.  Both surgeries were successful.

I have never had any trouble with the left one, but about six months ago I got a perforation on the right.  At first, it was thought to be a cyst, since it was high up on the membrane versus the usual hole at the bottom. CT said otherwise, so just a simple hole requiring a patch and no work on the bones behind.

What I have today is thus defined as a revision of a previous tympanoplasty. I am eager to have it done, because the hole creates a certain amount of dizziness and constant ringing in my right ear - two things I remember from the previous situation. 

No complaint, as the original graft held for over three decades.

A good measure of social stress in China--and rising expectations

Great reporting piece in the NYT.

The guts:

Forget the calls by many Chinese patients for more honest, better-qualified doctors. What this city’s 27 public hospitals really needed, officials decided last month, was police officers.

And not just at the entrance, but as deputy administrators. The goal: to keep disgruntled patients and their relatives from attacking the doctors.

The decision was quickly reversed after Chinese health experts assailed it, arguing that the police were public servants, not doctors’ personal bodyguards.

But officials in this northeastern industrial hub of nearly eight million people had a point. Chinese hospitals are dangerous places to work. In 2006, the last year the Health Ministry published statistics on hospital violence, attacks by patients or their relatives injured more than 5,500 medical workers.

“I think the police should have a permanent base here,” said a neurosurgeon at Shengjing Hospital. “I always feel this element of danger.”

In June alone, a doctor was stabbed to death in Shandong Province by the son of a patient who had died of liver cancer. Three doctors were severely burned in Shanxi Province when a patient set fire to a hospital office. A pediatrician in Fujian Province was also injured after leaping out a fifth-floor window to escape angry relatives of a newborn who had died under his care.

Over the past year, families of deceased patients have forced doctors to don mourning clothes as a sign of atonement for poor care, and organized protests to bar hospital entrances. Four years ago, 2,000 people rioted at a hospital after reports that a 3-year-old was refused treatment because his grandfather could not pay $82 in upfront fees. The child died.

Such episodes are to some extent standard fare in China, where protests over myriad issues have been on the rise. Officials at all levels of government are on guard against unrest that could spiral and threaten the Communist Party’s power.

Doctors and nurses say the strains in the relations between them and patients’ relatives are often the result of unrealistic expectations by poor families who, having traveled far and exhausted their savings on care, expect medical miracles.

But the violence also reflects much wider discontent with China’s public health care system. Although the government, under Communist leadership, once offered rudimentary health care at nominal prices, it pulled back in the 1990s, leaving hospitals largely to fend for themselves in the new market economy.

By 2000, the World Health Organization ranked China’s health system as one of the world’s most inequitable, 188th among 191 nations. Nearly two of every five sick people went untreated. Only one in 10 had health insurance.

Over the past seven years, the state has intervened anew, with notable results. It has narrowed if not eliminated the gap in public health care spending with other developing nations of similar income levels, health experts say, pouring tens of billions of dollars into government insurance plans and hospital construction.

The World Bank estimates that more than three in four Chinese are now insured, although coverage is often basic. And far more people are getting care: the World Bank says hospital admissions in rural counties have doubled in five years.

“That is a steep, steep increase,” said Jack Langenbrunner, human development coordinator at the World Bank’s Beijing office. “We haven’t seen that in any other country.”

Still, across much of China, the quality of care remains low. Almost half the nation’s doctors have no better than a high school degree, according to the Organization for Economic Cooperation and Development. Many village doctors did not make it past junior high school.

Primary care is scarce, so public hospitals — notorious for excessive fees — are typically patients’ first stop in cities, even for minor ailments. One survey estimated that a fifth of hospital patients suffer from no more than a cold or flu. Chinese health experts estimate that a third to a half of patients are hospitalized for no good reason.

Once admitted, patients are at risk of needless surgery; for instance, one of every two Chinese newborns is delivered by Caesarean sections, a rate three times higher than health experts recommend.

Patients appear to be even more likely to get useless prescriptions . . ..

There are plenty of such Marxian dynamics on the road of rapid development--when rising expectations outstrip the ability of the state to respond.

And when that state is non-democratic, the public tends to go to extremes to express its displeasure.

Chart of the Day: The Wild East is counterfeit central

Economist story:  global seizures of fake drugs way up, and Asia leads the way--by a ways.

No great surprise with LATAM not far behind.

The recently settled frontier economies are naturally environments where counterfeiters shine--the proverbial snake-oil salesman of the American Wild West.

The Economist's warning:  fake drugs have always bedeviled developing countries, but now, because of the new and expanding connectivity between Old and New Core (my terminology), such vulnerabilities are being exported to our neck of the woods.

I will readily admit to this vulnerability:  when we buy Xyzal through a Canadian online pharmacy, sometimes it comes from Britain, sometimes from Mumbai, sometimes from South Africa or Brazil.

As for those drugs made here in America?  A safe bet is that half the ingredients likewise come from New Core economies.

Chart of the Day (4): Trimming the real fat in the U.S. economy

FT full-pager analysis.

The tale of the tape.

We're not way out of proportion (pun intended), but why should we lead on this one?

The weird factoids:  Rich men are more likely to be fat than poor men, but poor women are significantly more likely to be fat than rich women.

So the classic rich couple is the heavy-set man with the thin wife and the classic poor couple is the skinny guy with the chunky wife.

The second chart seems to explain the epidemic:  we've just changed our diet considerably since the 1960s, because when I was growing up, being overweight was really fairly uncommon.  Now, you walk around and its the skinny people who stick out--really a stunning turn in just a couple of generations (1970-2010).  

Gotta believe it can be reversed if it happened that fast.

I recently dropped 20 pounds and it feels great.  The biggest driver for me? I'm just getting bored with food, especially when I travel because so much of it is so tasteless that you just start wondering, "Why bother?"

Stealing from Africa: China's aggressive pursuit of Global Fund health grants

Foreign Policy piece, by way of WPR's Media Roundup, that rightfully accuses China of stealing from Peter (Africa) to pay Paul (it's own interior rural poor) in its aggressive pursuit and winning of "Global Fund to fight AIDS, tuberculosis and  malaria" health grants to the tune of $1B.

Chow points out that China has donated only $16m to the fund over 8 years, compared to $5.5B by the U.S. 

Particularly egregious:  $149m in health grants to battle malaria, when last year China suffered 38 deaths from that disease.

Meanwhile, a lot of African countries with far worse health burdens are getting crumbs compared to China, which ranks #4 in the world for Global Fund grants.

No one says China still doesn't have issues, but with $2.5T in money from the West already in terms of trade-surplus-generated reserve currency holdings, it's hard to argue that China should still be shoving aside more worthy African recipients.

Policing the web: brain burnout for the cops

Interesting NYT story on the mental health toll suffered by people who work for screening companies and monitor the web for depraved content.

Reminds me of that old University of Wisconsin study that my brother participated in when he was a student:  shown loads of graphic and nasty stuff over a lengthy period, he increasingly expressed more ambivalence about it—the toll deadening his normal sense of revulsion.

That profound desensitizing exacts its pound of mental flesh.  In one company, 50 workers review 20m photos a week!  The effect is compared to battle fatigue.

Chinese in the Rear View Mirror May Appear Larger than They Are

FT story on how the West’s diet industry “drools over China’s desire to lose weight.”

Fat Chinese?  Yup.  A stunningly fast outcome of the one-child policy is the supersizing of the “little emperors,” who are supposed to fight over insufficient number of Chinese women WRT marriage AND take care of their parents and grandparents in their old age AND (according to whack-job Western demographers) somehow be willing to join the military and fight overseas wars because of their “surplus” status AND (according to this story) will have to do all these things while fighting their own personal battles of the bulge.

These poor fellows.

Better read Paul French’s book, already out:  “Fat China:  How Expanding Waistlines are Changing a Nation.”

Remember such trends when you scan all these “China will rule the world” tomes and fend off the litany of expert predictions of why we must go to war with China over developing region resources.  China isn’t merely moving up the production scale with speed, it’s likewise moving up the Western scale of social problems with equal speed.

I mean, how many “literate peasants” do you expect will be willing to lay down their lives in overseas adventures for these chubby little emperors back home?  Given China’s loooong history of military adventurism distant from its shores (hmm, where did I put that volume?)?

Many-fat destiny beckons . . . 

Getting hospitals ready for a WMD event

pic here

Bernadine Healy piece in Newsweek catches my eye because of Enterra’s emerging/ongoing work with major hospitals in the NYC area (and now in TX) regarding this very same issue:  how to maximize and coordinate cooperation among major hospitals in the event of WMD terrorism.

Healy cites a Thomas Tallman, head of emergency services at the fabled Cleveland Clinic on 4 key points:

First, hospitals must be ready to respond to any large-scale terrorist attack via robust contingency plans for patient flow (something Enterra works on a lot).

Second, all healthcare workers are trained up on WMD drills and can rely on plans posted throughout the facility.

Third, and most importantly in our minds, “networks of local and regional hospitals have been created to work closely with public authorities so resources can be shared.”  This is what the exercises are for, making everyone aware of and conversant in the network established.

Fourth, the chain of command is clear and practiced ahead of time—another key aspect of exercises, in my experience.

All really basic stuff but hard to achieve in facilities that operate—as a rule—as close to 100% capacity all the time in order to save money.

Healy’s point:  even if you do all four, no plan will survive contact with an actual WMD event, due to the immense complexity.

That’s where Enterra comes in with its focus on rules smart enough to rule themselves and change in response to altered conditions (altered as far as the plans are concerned). 

Bottom line:  your plans have to be reconfigurable on the fly.

India's pharma industry grows up

NYT story on how India's pharma industry is both moving up the ranks and consolidating its position as a low-cost manufacturer. The development recalls Andy Grove's arguments about losing manufacturing and thereby losing the long-term innovation edge. This piece gives you the sense of how hard--if not impossible--it will be to stem such losses in existing mature industries, which says we do best to follow his advice in new industries.

The gist of the piece:

India’s drug industry — on track to grow about 13 percent this year, to just over $24 billion — was once notorious for making cheap knockoffs of Western medicines and selling them in developing countries. But India, seasoned in the basics of medicine making, is now starting to take on a more mainstream role in the global drug industry, as a result of recent strengthening of patent law here and cost pressures on name-brand drug makers in the West.

And while the Indian industry has had quality-control problems, it nonetheless benefits from growing wariness about the reliability of ingredients from that other historically low-cost drug provider — China. The United States is India’s top export customer for drugs.

India is becoming a “base for manufacturing for the global market,” said Ajay G. Piramal, the chairman of Piramal Healthcare, a drug maker based in Mumbai. Eventually, in Mr. Piramal’s perhaps overly optimistic forecast, only the very first and very last steps of the business — molecular drug discovery and marketing — will be run by the West’s global drug giants.

Those companies “don’t create much value” in the steps in between, he said.

It is not only Indian executives, though, who are bullish about the pharmaceuticalsindustry here. Analysts, research groups and consultants have been making similar predictions in recent months.

Big pharmaceutical companies have come calling, too. This year, Mr. Piramal sold his generic drug business to Abbott Laboratories for $3.7 billion, the latest in a string of takeovers and joint ventures here.

Like China, India seeks to move up production chains as rapidly as possible:

The shift to pharmaceuticals is part of a subtle, broader shift in the Indian economy. Moving beyond less sophisticated, outsourced services like telephone call centers, India has been advancing up the business value chain, particularly in law and medical diagnostics. Now it is showing a flair for manufacturing, particularly in goods demanding high-skill production and superlow prices.

Which says we have no alternative but to do the same.

Chart of the day: China shoots up ranks of pharma markets

From FT story on how Japanese pharma Eisai has penetrated China's growing market well before its national competitors.

Reason why is that China is rapidly moving up the ranks from 10th place in 2004 to third, after Japan and the US, by 2014.

Usual bottom-of-the-pyramid reality:

Emerging markets, particularly China, are becoming increasingly important for drugmakers, which have to deal with slowing growth at home.

The big driver in China?  The gov's $125B overhaul of the country's weak health system.

Would you want to know your potential for longevity?

WSJ story on scientists claiming to be able to calculate longevity potential on the basis of studying very old people and discovering "a genetic signature of longevity."

Despite the great complexity of causality here, the lead researcher says "we can compute your specific predisposition to exceptional longevity."  The academic researchers (Boston U) say they have no plans to profit from or patent the technology, and that a test will be made available on the Internet sometime in late July.

People want predictability in all things except the length of their life, where the vast majority prefer ignorance that allows maximum anticipation of possibilities.

There is a distinct difference between those who will die on the low end of the longevity spectrum and the "wellderly" who make it safely to old age and then face the prospect of 2-3 decades more life.

One expert claimed that life insurance policies would be forever altered by such testing capacity, but for now, it requires a several-thousand-dollar layout to have your entire genome profiled.  I guess insurance companies would need to posit their savings to justify the costs either picked up by them and made mandatory for granted coverage or forced upon consumers similarly.

What intrigues me more is the potential for genetic manipulation to "fix" what is missing.  For example:

While a healthy lifestyle is paramount, such genetic factors appear to become more important the longer we live. Indeed, a variation in a single key gene called FOX03A can triple the chances a person may live past 100, researchers at the Pacific Health Research Institute in Hawaii recently reported.

How much would the average person be willing to pay to have FOX03A boosted?

Chart of the day: biotech best Moore's law

From The Economist.

Hard not to expect a serious revolution out of that trend. Economic revolutions follow those in science, and those in science follow those in measurement.

From the article:

The telescope revolutionized astronomy; the microscope, biology; and the spectroscope, chemistry.  The genomic revolution depends on two technological changes.  One, in computing power, is generic--though computer-makers are slavering at the amount of data biology 2.0 will need to process, and the amount of kit that will be needed to do the processing.  This torrent of data, however, is the result of the second technological change that is driving genomics, in the power of DNA sequencing.

The East has fewer qualms about messing with nature

WAPO story on how loose and fast--by our standards--China explores the world of biotechnology.

Centuries after it led the world in technological prowess -- think gunpowder, irrigation and the printed word -- China has barged back into the ranks of the great powers in science. With the brashness of a teenager, in some cases literally, China's scientists and inventors are driving a resurgence in potentially world-changing research.

Unburdened by social and legal constraints common in the West, China's trailblazing scientists are also pushing the limits of ethics and principle as they create a new -- and to many, worrisome -- Wild West in the Far East.

I can't remember if it was captured in PNM or "Blueprint," but I explored this theme years ago in the brief when I'd tell the story of how a genetic therapy for cancer was invented in the U.S. but couldn't get tested for legal reasons. It was thereupon pursued in China, with its looser rule set on such things, and once it was proven out, the Chinese company came to the US to get a patent. That was an eye-opener for me.

Part of it is the difference in philosophy and religion: we have this one-life view of reality but the East is a lot fuzzier on that concept (Buddhism), so it's naturally more relaxed on the subject.

Another reality:  when you're on your way up, you have little regard for the environmental consequences.  In that sense, I've always delighted in Futurama's character of Leo Wong, whose attitude toward the environment is emblematic of a lot of Chinese industrialists right now.  Another good reference:  Daniel Day-Lewis's portrayal of Daniel Plainview in "There will be blood."  Talk about a plain view!

China, with its hundreds of impoverished rural folk, will remain in this "conquering nature at all costs" mindset for a while--or until it gets too expensive. Yes, we'll hear about and see all sorts of efforts to go "green," but even there, you will see corner-cutting bravado that will frighten to no end. 

The rule-set clash heats up on medical pot

 

NYT story on the growing complexity of new rules regarding medical marijuana, with Colorado as ground zero for experimentation.

Opening bit:  don't assume you can get rich quick selling medical pot, because the restrictions are dazzlingly complex.

“You’d never see a law that says, ‘If you want to sell Nike shoes in San Francisco, the shoes have to be made in San Francisco,’ ” says Ms. Respeto, sitting in a tiny office on the second floor of the Farmacy. “But in this industry you get stuff like that all the time.”

As usual, the economics races ahead of the politics, but the politics is struggling to catch up.

One of the odder experiments in the recent history of American capitalism is unfolding here in the Rockies: the country’s first attempt at fully regulating, licensing and taxing a for-profit marijuana trade. In California, medical marijuana dispensary owners work in nonprofit collectives, but the cannabis pioneers of Colorado are free to pocket as much as they can — as long as they stay within the rules.

The catch is that there are a ton of rules, and more are coming in the next few months. The authorities here were initially caught off guard when dispensary mania began last year, after President Obama announced that federal law enforcement officials wouldn’t trouble users and suppliers as long as they complied with state law. In Colorado, where a constitutional amendment legalizing medical marijuana was passed in 2000, hundreds of dispensaries popped up and a startling number of residents turned out to be in “severe pain,” the most popular of eight conditions that can be treated legally with the once-demonized weed.

More than 80,000 people here now have medical marijuana certificates, which are essentially prescriptions, and for months new enrollees have signed up at a rate of roughly 1,000 a day.

As supply met demand, politicians decided that a body of regulations was overdue. The state’s Department of Revenue has spent months conceiving rules for this new industry, ending the reefer-madness phase here in favor of buzz-killing specifics about cultivation, distribution, storage and every other part of the business.

Whether and how this works will be carefully watched far beyond Colorado. The rules here could be a blueprint for the 13 states, as well as the District of Columbia, that have medical marijuana laws.

The rule-set reset unfolds . . .

Today the rat's lung, tomorrow yours

WSJ story on latest in a series of “groundbreaking experiments in the burgeoning field of regenerative medicine,” involving the creation in a lab of lungs for a rat (and I mean a real rat and not some Wall Street banker!).

Described as a “small but tantalizing step,” you have to think that doing this for a rat can’t be all that different than for a human—scale yes, but complexity not so much.  When transplanted into the rates, the lungs exchanged oxygen for CO2 just like they’re supposed to do.

Impressive.

Other labs have already done livers and hearts, to varying degrees of success.

Right now over 100k Americans are on waiting lists for organ transplants (kidneys #1, then livers, then lungs). 

To me, this is the most crucial part of life-extending technologies—not so much the super-extension of a few but the rescuing of a lot of people cut down in the primes and thus allowed to live far longer lives than they otherwise would have been able to.

Finally, some common sense on residents' hours in hospitals

WSJ story on new plan from Accreditation Council for Graduate Medical Education to place limits on the hours worked by residents in hospitals.

Finally!

A 2004 report found that first-year residents working all-night shifts were responsible for half of preventable “adverse events.”

In 2003, the council limited resident work weeks to no more than 80 hours, down from the previous unbelievable norm of 120.  The new guidelines say the youngest residents shouldn’t work more than 16-hour shifts while the more experienced ones can go 24.  The current limit for all is 30 hours.

After the experiences we had with Emily’s long cancer fight in the mid-1990s, I learned to ask any doctor I met on a hospital floor or in an ER how long they had been on the shift, and if anybody said more than 20 hours, then you treated them with kid gloves, because extreme fatigue impairs thinking much like alcohol—you just get stupider with each hour just like with each drink.

Long overdue new rule set.