EclectEcon

Photos from Yesterday in Vienna

As I was wandering around near the Music Institute yesterday, I heard a horn player practicing and thought, "isn't this great! I get to listen to this horn player." I looked around to see where the sound was coming from, and saw this:

This guy was practicing his horn, in a parked (!) van, with the windows up, on a day when the temperature was about 28C! And if you look carefully at the horn, you can see that it is anything but a standard horn. The curves and tubing are quite different.

As I continued walking, I passed a very interesting sculpture. I assume it signifies or leads one to the Pfizer Vienna headquarters.

 

8-) 

Drinking Hoppy Beer Can Help Strengthen Bones

... but the effect likely has a low mean, a negative quadratic term, and a high variance.  At least beer wasn't lumped into this study warning of increased risk of pancreatic cancer from drinking fizzy drinks.

    I'll drink to these studies (but I don't really attach much significance to them).

[h/t JJ]

What Is the Price Elasticity of Demand for the H1N1 Vaccine?

Ms. Eclectic and I lined up with hundreds of other local residents last Monday when the county health authority came to town to provide swine flu shots for us. It was windy, cold, and there was mix of rain and snow blowing as we stood outside the Legion Hall, waiting to join the queue inside the hall.

Overall, people were in good spirits, and the organization was pretty slick. Nevertheless, the wait (especially when we were in the portion of the queue that was outside the building) was uncomfortable. From the time we arrived until the time we left, the total elapsed time was about an hour and a quarter, in contrast with about twenty minutes earlier in the fall when we received our seasonal flu shots. [note: both times included about a ten-minute waiting period following the shot].

As I proceeded from health bureaucrat to health bureaucrat at the H1N1 vaccination site, I asked each of them how long they thought the line would be if people were charged $5 each for the vaccine. Everyone I spoke with volunteered that they thought the line would be much shorter. The implication from this non-scientific survey is that the price elasticity of demand for the H1N1 vaccine is certainly greater than zero. Using arc elasticity calculations and rough guesstimates of the sizes, and supposing that charging $5 for the vaccine would reduce the quantity demanded from 2000 to 1500, then the price elasticity of demand would be approximately .143.

That's still a pretty small number, indicating that the quantity demanded would not be very responsive, in percentage terms, to a change in the price in this region. Nevertheless if 500 people (I know, it's a very rough guess) would give the vaccination a miss just because of a $5 charge, it is difficult to see how the vaccination can be thought of as a dire necessity.

Two additional notes:

1. Most of the health bureaucrats I spoke with didn't twig to the fact that I was asking about how much the quantity demanded would decline with the charge. They just thought that people receiving the vaccine ought to contribute to the costs of producing and providing the vaccinations. I don't have the numbers, but judging from the numbers of computers and health professionals involved, I suspect the cost of delivering the vaccinations was greater than the cost of producing the vaccine itself.
2. While receiving my vaccination, I overhear Ms. Eclectic say, "That's my husband. He turns everything into an economics question."

Three Shots a Day Keeps the Doctor Away

Ms. Eclectic says that now I have a justification for drinking scotch. As if I needed one. From the BBC (among many sources):

Drinking alcohol every day cuts the risk of heart disease in men by more than a third, a major study suggests.

The Spanish research involving more than 15,500 men and 26,000 women found large quantities of alcohol could be even more beneficial for men. 

... For those drinking little - less than a shot of vodka a day for instance - the risk was reduced by 35%. And for those who drank anything from three shots to more than 11 shots each day, the risk worked out an average of 50% less.

My preference: single malt Islay scotches, e.g. LaPhroaig, Lagavulin, and Caol Ila.

The Simple Economics of Health-Care Reform

While some politicians talk about programmes designed to bring more people under the health-care umbrella, others talk about making health care more affordable. The former (combined with an aging population) will shift the demand curve outward; the latter will cause a movement downward along that shifted demand curve (a lower price increases the quantity demanded).

But if the supply curve doesn't shift outward, the above two policies will create more shortages and longer waiting periods (and committees of death, due to the shortages, no matter what they are called).

The only way to shift the demand curve outward, lower the prices to the users AND avoid shortages is to increase the supply.

Starting now, without delay, gubmnts should be encouraging medical schools to admit more students. They should also be encouraging more use of nurse practitioners and prescribing pharmacists. But as the demand increases, the shortages will not go away so long as prices are fixed below the equilibrium level.

Fifty Forever?

Today is my birthday. And possibly in celebration, Jack sent me this link

Centenarians with the bodies of 50-year-olds will one day be a realistic possibility, say scientists.

Half of babies now born in the UK will reach 100, thanks to higher living standards, but our bodies are wearing out at the same rate.

To achieve "50 active years after 50", experts at Leeds University are spending £50m over five years looking at innovative solutions.

They plan to provide pensioners with own-grown tissues and durable implants.

New hips, knees and heart valves are the starting points, but eventually they envisage most of the body parts that flounder with age could be upgraded.

Translating Obama's Speech on Health Care and Deficits

Greg Mankiw does us all a favour by telling us what Obama really meant:

[T]his passage in the President's speech had me scratching my head:

I will not sign a plan that adds one dime to our deficits -- either now or in the future.(Applause.) I will not sign it if it adds one dime to the deficit, now or in the future, period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.

At first, it sounds like the President is threatening to veto the bills being considered in Congress because, according to CBO, they will add significantly to deficits in the out years. If true, that would be a big story. But the provision he mentions in the next sentence seems to suggest he is just passing the buck.

Translation: "I promise to fix the problem. And if I do not fix the problem now, I will fix it later, or some future president will, after I am long gone. I promise he will. Absolutely, positively, I am committed to that future president fixing the problem. You can count on it. Would I lie to you?"

Hermaphrodite Runner

BenS has suggested that the runner from South Africa would attend classes in Middlesex College if taking classes here at the University of Western Ontario.

World 800-metre champion Caster Semenya of South Africa has male and female sexual organs, the Sydney Morning Herald reported Friday, posing an ethical and political quandary for world track and field's ruling body.

The Herald said extensive physical examinations of the 18-year-old runner ordered by the IAAF have shown she is technically a hermaphrodite.

Medical reports indicate she has no ovaries, but rather has internal male testes, which are producing large amounts of testosterone.

Jack suspects lawyers will have a field day with the case. I agree. And Ben adds, "What about 'he said, she said?'"

I'm very happy not to be on the International Olympic Committee or, in this specific case, on the IAAF. This would truly be a tough nut to crack.

Update: for more on the topic, see this in Salon. [h/t Shannon]

A Useful Book on Health Care

Ms. Eclectic tells us that interventions by her sister (a nurse) and support from the rest of us played an important role in her (comparatively) speedy recovery from surgery and cancer more than two decades ago. We have been fortunate since then, but we have ordered this book, The Essential Hospital Handbook: How to Be an Effective Partner in a Loved One's Care, just in case. Here is a brief description from the CBC:

Conlon, a journalist and [the] author who, indeed, became an active participant in [his partner,] Jim's eventually successful treatment, has used the experience to help people who might find themselves in the same situation he did.

His book, The Essential Hospital Handbook: How to Be an Effective Partner in a Loved One's Care, is a straightforward approach to handling a health-care crisis, a time when many people's common sense battles fears for their loved one's life.

The book offers a comprehensive look at emergency rooms, surgery, recovery and the hospice as it takes readers on a tour of the hospital.

Such things as living wills, drugs, hospital equipment and even slang are examined to give a well-rounded picture of what people might encounter.

While directed at caregivers and families, the book is just as helpful for patients.

...

Scotch Therapy!

Ms. Eclectic has long maintained that scotch therapy is the best way to deal with colds or the flu (see this, for example). And now we learn that Russian physicians are advising travelers to drink whiskey to deal with possible swine flu infections:

Russian soccer fans heading to Wales for next month's World Cup qualifier have been urged to take unique precautions to ward off swine flu: drink Welsh whisky

"Welsh whisky is on offer to Russian supporters as a disinfectant," Alexander Shprygin, head of the national team's fan club, said Monday. "This will relieve any symptoms."

We both concur with one of the comments on that story: is there some way to convince our drug plan to cover single-malt scotch if we get the flu?

More: But I guess it is possible to overdo it:

People who consume, on average, more than one alcoholic drink daily face a significantly higher risk of developing six types of cancer, according to sobering new Canadian research.

But as Ms. Eclectic also says, she had cancer before she started drinking much. So maybe the direction of causation is reversed? 8-)

Cannabis and Mental Health:correlation vs. causation

I was reminded of the adage, "Correlation does not imply causation," when I read this abstract.

This paper investigates whether cannabis use leads to worse mental health. To do so, we account for common unobserved factors affecting mental health and cannabis consumption by modeling mental health jointly with the dynamics of cannabis use. Our main finding is that using cannabis increases the likelihood of mental health problems, with current use having a larger effect than past use. The estimates suggest a dose response relationship between the frequency of recent cannabis use and the probability of currently experiencing a mental health problem. [emphasis added]

Many of the serious potheads I have known have struck me as people who would have had mental health problems with or without cannabis use.

Eat Fish

From the NYTimes,

Many studies have suggested that a diet rich in fish is good for the heart. Now there is new evidence that such a diet may ward off dementia as well. One of the largest efforts to document a connection — and the first such study undertaken in the developing world — has found that older adults in Asia and Latin America were less likely to develop dementia if they regularly consumed fish.

And the more fish they ate, the lower their risk, the report found. The findings appeared in the August issue of The American Journal of Clinical Nutrition.

Check Your Prescriptions

JB, my favourite drug dealer, sent me this warning. From the looks of things, the expected incremental benefits of checking your prescriptions would outweigh the expected incremental costs. And it might even be worth paying a bit more in time or money to avoid the really busy and rushed pharmacies.

Medication errors — wrong drug, incorrect dose or improper use — harm at least 1.5 million people every year, according to the Institute of Medicine. Confusion caused by drugs with similar names accounts for up to 25 percent of the reported errors. ...

More than 3 billion prescriptions are filled each year, and the number keeps growing. Errors can be made all along the route from prescribing to dispensing.

A doctor’s illegible writing is misread. A bad phone connection makes a called-in prescription unclear. A busy pharmacy worker grabs the wrong pills off a shelf where inventory is kept in alphabetical order. ...

Horn said that most of the errors he encounters occur where prescription volumes are high, in large chain drugstores and pharmacies at big-box stores.

“Everybody’s in a hurry. Everybody’s under a burden,” he said.

Aspirin: Chewed Gets into the Blood Stream Fastest

Recently, Jack, BenS, JB, and I have been wondering about the best way to take aspirin if a person suspects they might be having a heart attack. Jack then sent us this article that reports the results of some studies of absorption into the bloodstream. Conclusion:

To find out how aspirin works fastest, researchers in Texas asked 12 volunteers to take a standard 325-mg dose of aspirin in three different ways: by swallowing a tablet with 4 ounces of water, by chewing the tablet for 30 seconds before swallowing it, or by drinking 4 ounces of water with Alka-Seltzer. Each subject tried all three methods on an empty stomach on different days. The scientists monitored blood levels of aspirin and its active ingredient, salicylate, at frequent intervals, and they also measured thromboxane B2 (TxB2), an indicator of platelet activation that drops as platelets are inhibited.

By all three measurements, chewed aspirin worked fastest. It needed only five minutes to reduce TxB2 concentrations by 50%; the Alka-Seltzer took almost 8 minutes, and the swallowed tablet took 12 minutes. Similarly, it took 14 minutes for the chewed tablet to produce maximal platelet inhibition; it took Alka-Seltzer 16 minutes and the swallowed tablet 26 minutes... [emphasis added]

"The important lesson here is that we can't leave medical education to chance alone."

Holy Cow! Is that how our physicians have been trained up 'til now? From the Nat'l Post [h/t to Jack],

When physicians at an Alberta hospital asked why so many medical students and residents were using a faulty technique for inserting life-saving breathing tubes in patients, they received an unexpected answer: It's television's fault.

Many of the doctors in training said they had learned the procedure from watching medical dramas. ...

The findings, just published in the journal Resuscitation, revive an intriguing debate over whether entertainment TV has an obligation to portray medicine accurately, and underline what some see as chronic flaws in the system of training Canada's physicians.

"We were a bit shocked," said Dr. Peter Brindley, the critical-care specialist at the University of Alberta Hospital who discovered the students' extra-curricular secret. "The important lesson here is that we can't leave medical education to chance alone."

And in the same article, another condemnation of medical training:

Dr. Brindley said his findings are more evidence that the traditional approach to teaching doctors needs improving. Medical students typically learn about procedures such as intubation in a lecture hall, then find themselves practising on a real, perhaps critically ill patient, often with minimal supervision. Later, the same doctors sometimes train others.

Known as "see one, do one, teach one," the concept does not work so well in an era when the population is ageing, hospitals see more patients with complex health problems and doctors are chronically overworked, Dr. Brindley said.

Jack says the solution is to produce better television shows.

Note: the phrase "see one, do one, teach one" does lead me to wonder about what goes on in medskools.

We Know They're Doing It Only to Improve Their Minds

Over the years, EclectEcon has received a great deal of traffic from people searching for Britney Spears' crotch shots, the nude women of curling calendar, the UWO stripper, the nude female magician, and, of course, Paris Hilton's discourses on string theory (see the links here).

It turns out that searching the internet is good for the mind, especially for older people [h/t John Chilton]:

For middle-aged and older people at least, using the internet helps boost brain power, research suggests.

A University of California Los Angeles team found searching the web stimulated centres in the brain that controlled decision-making and complex reasoning.

The researchers say this might even help to counteract the age-related physiological changes that cause the brain to slow down.

Reducing the Threat of Memory Loss in Advancing Years:Toke Up

It has been decades since I even considered using marijuana. But I'm reconsidering now [from the Globe&Mail]:

[A] daily toke in later-middle and old age can help slow memory loss, or the onset of diseases such as Alzheimer's, Parkinson's and multiple sclerosis, a new study suggests.

It's a pre-emptive strike, one not effective at reversing previous memory loss.

So I guess I'd better start now, eh, before things digress (any further)? And if a toke helps that much, what would a few do for me?

Maybe Canada Can Import a Few Doctors from Iceland

It has long been known and argued by people like Brian Ferguson that Canada's population faces a severe shortage (at the current price of zero) of physicians, and that this shortage will surely grow as the population ages.

An article in the most recent Fraser Forum details the seriousness of this problem. Here is a table from that article, showing (roughly) the number of physicians per 1000 population, adjusting for the age distribution of the population.

Given that Canada is near the bottom (thanks to policies implemented more than two decades ago, limiting medskool enrolments), and given that Iceland is at the top, perhaps the recent financial meltdown in Iceland will induce some of their physicians to move to Canada.

Table 1: Age-adjusted comparison of physicians per 1,000 population for select OECD countries, 2006

1 Iceland 4.5
2 Greece (2005) 4.4
3 Netherlands 4.0
4 Czech Republic 3.8
4 Norway 3.8
6 Belgium 3.7
6 Ireland 3.7
6 Slovak Republic (2004) 3.7
6 Switzerland 3.7
10 Denmark (2004) 3.6
11 Austria 3.4
11 Spain 3.4
13 France 3.2
13 Sweden (2005) 3.2
15 Australia (2005) 3.1
15 Italy 3.1
15 Germany 3.1
18 Portugal (2005) 3.0
19 Hungary 2.9
19 Luxembourg 2.9
21 New Zealand 2.7
22 Finland 2.6
23 Korea 2.4
23 Poland 2.4
23 United Kingdom 2.4
26 Canada 2.3
27 Japan 1.7
28 Turkey 1.6

Just Call Me "Thumper"

Over two months ago, I injured my foot while out hiking with my son and his daughters. The x-rays were negative, and I was told it was a sprain. However, the injury has returned with little provocation several times since then.

Finally I asked Jack (a retired physician) about it, and he pointed out that stress fractures of the foot do not usually show up on an x-ray; he also said that if it was a sprain, the injury would not likely seem to be recurring.

So yesterday I went to see my family physician (what a way to spend one's 87th birthday, eh? -- oh, and thanks to everyone here and on Facebook who sent their greetings!). He agreed that it sounds as if I have a stress fracture. He said that we'd have to do a bone scan to make sure.

Yeah, sure. By the time I get scheduled to have that done in this amazing Canadian medical system, I'll have re-injured my foot several more times. So we (he's a good, collaborative sort of guy) decided to treat it presumptively. He prescribed an Aircast:

It's a neat sort of cast that I can easily remove at night, when showering, and other times, if necessary, and it should help immobilize the foot while it heals. It has little air things on each side that I can inflate to adjust the fit. This is the closest I will ever come to wearing "Air" Nikes.

Meanwhile, getting around with it is quite easy. .... except it thumps a bit on the hardwood floors.

Pharma Profits

The profits earned by pharmaceutical firms are good, not evil, says Stephen Pollard:

Somehow, the idea has taken hold that companies that make a profit by researching and conquering human illness are not a wonderful boon to humanity, but our enemy....

... Everything would be so much better, it is argued, if the state or charities took charge of research, instead of letting big pharma take us for a ride.

Yes, drug firms make profits. That's what makes worthwhile their extraordinary investment in research. In 2003 the Tufts University Centre for the Study of Drug Development calculated that the total cost to research and develop a new prescription drug is $897 million. Only 21.5 per cent of drugs that reach human trials will even be approved for marketing.

The idea that the state or charities can offer a serious alternative is risible. Look at the research record where profit is barred. It wasn't Cuban or North Korean researchers who turned HIV from being a certain death sentence to a disease that can be managed. It was research by pharmaceutical companies.

In all of the Soviet Union's existence, where research was considered a priority, not one [pharmacological] discovery was made that scientists in the free world considered worth using. The only Soviet discovery that had an impact in the West was weaponised anthrax.

Pharma companies are an easy target for some. But God help us if we have to live in a world devoid of their products, and get ill.

Black and White Life Expectancies

Ironman at Political Calculations has a chart showing that for individuals from age 80 onward, the life expectancy of blacks is greater than the life expectancy of whites. Here is one possible explanation for the result:

What if weaker blacks or those blacks less likely to have super long life expectancies are more likely than whites to die at younger ages, leaving only those who are comparatively well-fit and with very long life expectancies still living at age 80.

Alternatively, but related, what if lots of whites reach age 80 in bad shape, physically and/or medically, and what if many of these folks would have died before age 80 but for the intervention of medical care, which is generally thought to be more readily available for whites than for blacks. These weaker whites die earlier than the healthy blacks still alive at age 80.

Jack has an alternative hypothesis that is related to the second one above:

Interesting. But the explanation is clear: since whites have more access to medical care than do blacks, doctors must be hazardous to your health.

Amusing, but I think my hypotheses are more likely to be correct. Anyway, I'm not there yet. ...
yet.

Prediction: the price of watermelon will rise

More precisely, the prediction should be that the demand for watermelon will rise, and, ceteris paribus, (i.e. barring sizable shifts in supply or other, offsetting, shifts in demand) that increased demand will then drive up the price of watermelons.

And it's not just because prices of fuel and grains are rising.

The other day, my son and I were grocery shopping and the man in line in front of us noticed that we had a watermelon in the cart. He said something like,

You make sure you eat the rind, too. Watermelon rind is just as good as viagra! Check it out. Try it.

So we did check it out ... on the internet ... and here is what we found:

A slice of cool, fresh watermelon is a juicy way to top off a Fourth of July cookout and one that researchers say has effects similar to Viagra ...

Watermelons contain an ingredient called citrulline that can trigger production of a compound that helps relax the body's blood vessels, similar to what happens when a man takes Viagra, said scientists in Texas, one of the nation's top producers of the seedless variety.

Found in the flesh and rind of watermelons, citrulline reacts with the body's enzymes when consumed in large quantities and is changed into arginine, an amino acid that benefits the heart and the circulatory and immune systems.

"Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it," said Bhimu Patil, a researcher and director of Texas A&M's Fruit and Vegetable Improvement Center. "Watermelon may not be as organ-specific as Viagra, but it's a great way to relax blood vessels without any drug side effects." ...

More citrulline — about 60 percent — is found in watermelon rind than in the flesh, ....

Citrulline is found in all colors of watermelon and is highest in the yellow-fleshed types, said Penelope Perkins-Veazie, a USDA researcher in Lane, Okla.

She said Patil's research is valid, but with a caveat: One would need to eat about six cups of watermelon to get enough citrulline to boost the body's arginine level.

"The problem you have when you eat a lot of watermelon is you tend to run to the bathroom more," Perkins-Veazie said. ...

Citrulline is present in other curcubits, like cucumbers and cantaloupe, at very low levels, and in the milk protein casein. The highest concentrations of citrulline are found in walnut seedlings, Perkins-Veazie said.

"But they're bitter and most people don't want to eat them," she said.

Does this mean the demand for walnuts has increased, too?