Cancer and economics

http://www.capx.co/the-fight-against-cancer-is-also-an-economic-one/

1/ "Most of all, health expenses increase because of the impact of chronic diseases like diabetes or cancer."
This assumption is simply false. Expenses increased but depending on several factors including diabetes, cancer and other consumptions... Magnitude of the welfare state is of critical importance in this analysis. It explained the wide differences between global amount of expenses among the different countries.

2/"Health expenditures are rising very quickly in nearly all rich countries where they represent between 8% and nearly 20% of the GDP."
More exactly it is 8-16% of GDP. And the most interesting fact is that these expenses do not correlate with LE!

3/ "Some economists have argued that the pharmaceutical market for anti-cancer drugs was not perfectly efficient. Proof is that the increase in price is not justified by inflation and the survival benefits."
The price is influenced by the R&D process which is very costly due to all regulations in Europe, salaries, contracts, high cost of labs and high cost of bureaucracy to fill the process of regulation agencies approval. The only good point which slightly counterbalances those inflating factors is the cost of borrowing which is maintained at a very low level by central banks (http://www.medpagetoday.com/PublicHealthPolicy/FDAGeneral/53650?isalert=1&uun=g432148d4535R5529932u&xid=NL_breakingnews_2015-09-21).

4/ "Third, even if the unit cost of the treatments declines, their rate of diffusion will soar so that the global cost will continue to increase exactly as we saw in the past with coronary stents in heart diseases." 
Comparison with coronary stents is not valid. First the diseases is completely different because the cause is well known in CHD (blocked coronary arteries by atherosclerosis) and is ignored in cancer. Second the use of CS is widely different among cardiology teams and even in the same team among cardiologists. Chemos indications are very pretty the same all over the world. CS are over used because we are dealing with small arteries which are imaged on movies of the beating heart rather than hemodynamic measurable factors. It will change when those data will be available as with FFR. Chemos are used only for cancer patients when the diagnosis is certain.

5/ In this setting the different solutions which are proposed missed the point. The great weakness of healthcare systems in Europe is the lack of market based mechanisms. Monopolies, state based systems are debt addict or impose rationing. The recent example of the german healthcare system is enlightening because it combines market incentives and mechanisms with insurance and a safety net. This system has no financing problems.
Indeed all the systems have to prioritize the allocation of resources to efficient treatments instead of reimbursing a wide range of services which are far from evidence based. Instead public healthcare systems are managed to avoid social clashes with employes and to maintain old rules of reimbursement especially for hospital stays. The connection with politicians leads to delay any change and consequently to a crowding effect within a constrained budget.

6/  Cancer is mainly and always a scientific challenge. It is not the role of healthcare systems to deal with this issue. R&D both public and private is benefitting of the huge amount of research all over the world. But there is a lack of competition and concurrence in a lot of allocation processes especially in countries where research is state owned and financed. A fierce darwinian process is mandatory for allocating funds if we want to hasten arrival of disruptive treatments of cancer. We cannot rely on private research only, that is why we need to improve the efficiency of university research and to increase the participation of hospitals in clinical trials. 

We are not in a battle or war against cancer. This "progressist" vision is a failure since its birth in the Nixon's policy of 1971 (http://legislative.cancer.gov/history/phsa/1971). 
Cancer is an enigma. We are searching to solve it. That is the issue and it has not to be mixed or balanced with other problems at the risk of jeopardizing scientific solutions. Especially cancer research has nothing to share with access to care which is very well solved by market mechanisms and a mandatory but strictly necessary amount of taxing for those who cannot afford an insurance premium.

NYC ties and Cufflinks: Karako

http://www.karakosuits.com/accessories/cufflinks.html

http://www.karakosuits.com/ties/skinny-ties.html

Ramipril does not increase walking distance

http://retractionwatch.com/2015/09/14/fabricated-results-retract-jama-clinical-trial-plus-a-sub-analysis-of-the-data/

Solution for crowded emergency departments: laissez faire

"With the stand-alone ED's I was able to make the appointments on line, fill out the paperwork of a new patient, and be seen in less than 15 minutes after my arrival. Yes, I admit that 15 minutes probably isn't long enough of a wait to share in whatever upper respiratory illness is making the rounds like I would get sitting around in my old clinic's waiting room for 45 minutes to an hour. If I ever miss the experience, I can always go hang out in Wal-Mart."


"This development is no surprise to anyone who has spent Sunday night from 6pm to Monday morning at 9am in a hospital ER with an aunt with a broken hip and dementia, six hours on a Saturday afternoon waiting for someone to see a child's broken arm, or seven hours waiting for kidney stone diagnoses. The emergency medical system is broken. This is a symptom. Or a solution. We will see."

http://www.medpagetoday.com/Washington-Watch/Washington-Watch/53549?xid=nl_mpt_DHE_2015-09-15&eun=g432148d0r

http://www.medpac.gov/documents/september-2015-meeting-presentation-emergency-department-services-provided-at-stand-alone-facilities.pdf?sfvrsn=0

Sternum and rib prosthesis

http://gizmodo.com/the-worlds-first-3d-printed-titanium-rib-cage-is-a-medi-1730034483

Anticoagulants mismanaged in nursing homes

https://www.propublica.org/article/congressional-leaders-ask-fda-about-coumadin-safety

What is the situation in Europe?

Watch your calcium score

http://denversdietdoctor.com/lchf-15-years-coronary-artery-calcium-score-zero/

Les Républicains ont des idées mais elles n'intéressent pas les français

Bertrand: fusionnons la police et la justice. On peut vraiment douter de sa connaissance des classiques, offrez lui Montesquieu.
Raffarin: il faut dépenser plus pour la défense.et l’argent on le trouve où? Sous le sabot d'un cheval de Poitou Charentes?
Le Maire: il faut intervenir au sol en Syrie. Avec quelles troupes? Avec quel argent? Les généraux français ont un plan? Vous êtes prêts à annoncer des pertes rapides et importantes?
Guaino: la primaire n'est pas conforme à l'esprit de la Vème république. Il y a un copyright?  Qui le détient depuis 1958? C'est le peuple français pas des intellos qui écrivent des discours.
NKM: il ne faut pas baisser la dépense publique mais la redistribuer. Magnifique 58% est donc un taux optimal de DP.
Juppé: Je suis préoccupé par la montée de l'islamophobie. Et les morts du terrorisme ne vous empêchent ils pas de dormir?

Mme Merkel a dynamité par deux fois la classe politique française dans son ensemble

Acte un une énorme bourde pleine de culpabilité mal assumée celle du nazisme et du communisme. Je décide que 800 00 immigrés sont attendus en Allemagne. En réalité sans en parler aux autres la chancelière a lancé un appel à migrer. C'est un acte d'une exceptionnelle gravité.
Acte deux une volte face rapide signe de lucidité et de réactivité aux rapports de force politiques. Il est possible de fermer les frontières, la preuve par Merkel et De Mazière qu'Orban n'est pas fou, facho, nazi etc...
What else?
Les polonais, tchèques slovènes slovaques croates ne sont plus isolés. Leur opposition aux quotas va prospérer.
Séisme en France.
Le PS a trahi et Cazeneuve le reconnait , il y a peut être des terroristes parmi les immigrés...
Les R ne proposent rien tétanisés par la presse gauchiste qui les brocarde dès qu'ils ne sont plus assez humanistes, multiculturalistes ou immigrationnistes à leur goût. En effet préconiser de se réunir et  de s'entendre à 27 pour tomber d'accord sur une politique migratoire c'est laisser entrer plusieurs millions de personnes dans l'intervalle... Affirmer que leur statut est celui de réfugiés de guerre et que leur vocation est de rentrer une fois la paix revenue c'est accepter de les accueillir tous pendant plusieurs années. Bref beaucoup de mots pour rien.
Le FN qui nous fait miroiter la sortie de l'euro comme l'entrée dans un monde meilleur en est pour ses frais, on peut s’exonérer de Schengen en restant dans l'Euro et l'UE...
Ceux qui vont sauver ce pays sont nés mais ils ne sont pas encore en mesure de le faire.

40% of food stamps beneficiaries are obese

http://www.fns.usda.gov/sites/default/files/ops/NHANES-SNAP07-10.pdf

Is capitalism immoral or is capitalism moral?

http://palingenesie.com/capitalism-john-plender/

https://youtu.be/fJr2RO7g7jI