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Although the rain fell and floods came with Hurricane Irene, it was not quite on a Biblical scale, but it was certainly devastating to many communities that had never before believed it possible they could be the victims of flooding. Yet, in upstate New York and Vermont, entire communities have been introduced to a new reality of flooding and mudslides. No matter what you think about all these stories of global warming and climate change, there’s an underling reality you can’t deny. This has been a bad year for weather. Read any of the hard news sites and they will all tell you the same story. Property and auto insurance claims have already broken records this year. By the time we’re through December, the year 2011 will have gone into the books as the most expensive for weather-related insurance claims. Read the rest of this entry »

Here’s a scene you’ve seen played out hundreds of times in everyday life. You’re watching TV, surfing the net, doing some reading, and you come across something lecturing you about heart disease – just like this article. So you immediately find your eyes glaze over. Your interest drops to zero and you find better things to think about. After all, everyone knows someone who’s had a heart attack. A couple of days later, they’re out and about, boasting about the number of stents holding their arteries open. Heart attacks are no big deal, right? But suppose we put it the other way round. Suppose we tell you that men with heart disease have a serious risk of erectile dysfunction? Hey, you mean something’s threatening your enjoyment of sex? Now that’s a lot more interesting, right?

So what exactly are we talking about? Its helpful to start with a few numbers.. In men under the age of 60, the rate of erectile dysfunction is about 12% of the adult male population. But this rises up to 42% of men as they add years over 60. In one sense, this is a perfectly natural part of the aging process as the level of testosterone falls in the bloodstream. In giving these simple percentages, we should not forget the body grows more likely to breakdown in other ways. We could list high blood pressure, diabetes, atherosclerosis, etc. If you are also overweight, still smoke, eat an unhealthy diet and largely sit around without exercising, you’re in the zone for serious health consequences. Even the Chinese are growing alarmed. A major new piece of research from Soochow University has confirmed the global trend in China. That aging men who show signs of erectile dysfunction at a relatively young age are lining up for cardiovascular disease, strokes, heart attacks and general death. Now while we might not care very much about a few more Chinese dying, this study involving 36,740 participants sends out a general warning to men everywhere. Lead an unhealthy life, find yourself affected by erectile dysfunction, and this will seriously increase the risk of “all-cause mortality” – a fancy way of saying death. Read the rest of this entry »

Like everything written down, the Affordable Care Act sounds the perfect answer to all our problems. Except, of course, when it comes to turning the words into action, problems can emerge. One of the battlegrounds is turning out to be the insurance marketplaces or exchanges. These are supposed to make it easier and cheaper to buy insurance. They should allow people to compare prices, and discover whether they are entitled to any assistance like tax credits, Medicaid or the Children’s Health Insurance Program (CHIP). Every state is supposed to have one up and running by 2014. Should any state default, the federal government is apparently ready to step in and run one. The principle matches the mandate. If everyone is required to buy a policy, buying a policy should be made as easy as possible.

As we come in the Fall, ten states have already passed the necessary enabling legislation and are on their way toward getting their exchanges in place. Seven more states have bills pending. Legislation has failed in sixteen states. The rest of the states have either decided to take their time or are flatly refusing to make progress. Such is the world of politics with the Republican party dead-set against exchanges. Some GOP governors have sworn oaths on a stack of Bibles they will never sign an enabling bill into law. Yet this is not necessarily good politics.

Because the federal government will impose an exchange if the state refuses to act, the arrival of an exchange is unavoidable. Some GOP governors are therefore interested in negotiating terms. If they have no choice, they might as well try to influence the outcome to their advantage. So this September, health officials from the majority of the states will be attending a conference organized by the Department of Health and Human Services. Most GOP governors are prepared to talk about a partnership approach to give them some political leverage. Equally, if the states actually do less of the work, the budget requirements will be lower. For example, some states are offering to run local call centers to guide people through their choices. This is fairly uncontroversial. More problematic are the offers of some states to run outreach and education programs to bring their citizens into the exchanges. If staff hostile to the notion of the exchanges are involved, the exchanges may not get the expected number of applicants. Read the rest of this entry »

There’s a whole bunch of people who claim we’re the result of intelligent design. That means every aspect of the bodies we now occupy while on this Earth was in the original plan. So, for millennia, we’ve had to put up with pain when the designer could have left out the pain receptors placed all over our bodies or installed a painkiller chemical dispensation system. We got adrenaline to increase the body’s performance. It would have been just as easy to give us something to calm down the pain. Would something as simple as an off-switch be too much to ask for?

So what’s pain for? Well, it’s a basic survival tool. Unlike a few insects that have eyes with all-round vision, we can easily be taken by surprise. As primates, we had a habit of walking through thick grasses and stepping on sharp objects or sleeping snakes. We were also prone to losing concentration at key moments and falling out of our trees. In our modern lives, we have surrounded ourselves with dangerous machinery. The price of not paying attention is injury. We’ve always been accidents waiting to happen. In this, it’s pain that gives us the first warning signals if we’re in trouble. More importantly, it tells us where the problem is and what kind of injury we’re likely to have picked up.

Now you might say this is good so far as it goes, but why can’t we switch it off when we’ve seen a doctor and got the treatment? The answer is simple. You and the doctor need to monitor the pain. If it starts to get worse, the treatment needs to change. It’s the same if the pain starts to spread. If you have switched off the pain, there’s no way you would know something different is needed. More to the point, if you switch off pain because you hurt your leg and then pick up a pan that’s too hot, do you have to wait to smell the cooking flesh? All the rest of your body needs the pain reflexes to be working, otherwise you might accidentally injure yourself and make everything worse.

So let’s be clear. There are no drugs in development that will switch off pain. Actually, no one is trying very hard to develop such a drug. Pain is too useful to want to switch it off altogether. In chronic cases where the pain in an inflamed joint is making life a misery, there’s a legitimate case to be made for a selective pill to turn off the pain receptors at a specific location. But no one has any idea how that would be done. All doctors can do is treat the joint itself and hope the pain will reduce naturally. Read the rest of this entry »