I agree with you on the HFCS front. I would posit you could get the same results without a tax, however: just end corn subsidies. (That’d also probably make meat more expensive, which, too, would serve the public health.)

Opposite of that, though, is going to be the realization that the lifestyle we have become used to is partially a result of hidden costs like crap food that we eat that allow us to buy more TVs and other gadgets.

Wow The Paper ad is so interesting. And to think that we used to get all our information from newspapers and TV!

Thanks for talking up my book and also Brian and Dharmeshs’ book.

Best, David

Secondly, that Sephardic/Israeli pronunciation is closer to ancient Hebrew is something there’s no reason to believe. Yes, the stress was probably more like Israeli stress, but we can be sure that, like Ashkenazic Hebrew and unlike Israeli Hebrew, there were pronunciation differences between kamatz and patach, segol and tzere, and tav with and without a dagesh. That’s why, as you put it, when a word” ends in a ‘t’”, someone might pronounce it “like an ‘s’”.

A few things:

I’m not saying that we haven’t overcome some major health threats, either, but I did mean to suggest that, as you do, many health issues are more cultural and socio-economic and therefore less subject to cure by medicine. All of the diseases you named could be termed “environmental,” depending on a multitude of factors.

Second, as a lifelong sufferer of asthma, I object to the categorization of it as “behavioral.” I’ll take genetic, but it is more environmental; though, I do admit that behavior change can have some salutary effect.

Finally, stroke, being a subset of cardiovascular disease, is behavioral as well as genetic.

Top 5 causes in 1900:
Cardiovascular disease (behavioral/genetic)
Influenza/Pneumonia (contact with others)
Tuberculosis (contact with others)
Gastrointestinal disease (contaminated food/water)
All accidents (behavioral)

Top 5 causes in 2004:
Cardiovascular disease (behavioral/genetic)
Cancer (behavioral/genetic)
Stroke (genetic)
Chronic Lower Respiratory Disease — bronchitis, emphysema, and asthma (behavioral)
All accidents (behavioral)

Three of the top five causes of death in 1900 have been wildly reduced in prevalence, due to better regulations and, especially, medical care. This is, I believe, due to attention from health care R&D. The top five causes of death in 2004 are all either behavioral or genetic — which, at this point, is just bad luck, at least until reliable, less-expensive testing and treatment options are available.

Perhaps the future of R&D is to focus on genetic deficiencies that cause serious health problems, like cancer, stroke, and (some) heart disease. Behavioral factors — smoking, eating too much fatty food, and engaging in other risky behaviors — are much, much harder to overcome, since they are failures of the social system, not the medical system.

I’m not saying that better working conditions don’t play a role in increased health and life expectancy: they certainly do. But better health care, safer public sanitation systems, and safer food supplies play a role as well.

Here’s an interesting image I pulled off Google. It’s from the CDC’s website and shows the percentage of funding for R&D. Nearly 50/50, public-private.

As for the benefits of R&D, though, I am somewhat more skeptical. How much, I wonder, has been dedicated to treatments for “conditions” that didn’t necessarily need treatment rather than cures for true diseases?

A big part of the reason we live longer (though, now that trend is going the other way) is that we no longer work our butts off on farms and in dingy factories with little or no safety regulations.

Now, if there were a female that could compete on a level playing field, I would certainly not stand in her way. I do think, though, that social inertia would provide huge amounts of resistance to her. I think the taboo would prove stronger than her lack of ability in terms of holding her back. Eventually, maybe it would be okay. But, like any other social revolution, it will take time, and it will not be easy.

Health insurance isn’t insurance at all. I’m not really sure what to call it, but it isn’t the same as other insurance at all. Does anyone, besides Mike, ever really read the statements that arrive every month from their health care providers? I don’t know how much an office visit costs; I don’t know how much lab visits cost; I don’t know how much most of my health care costs. All I know is how much I end up paying. This is not a very good system for keeping costs down, and is one of the reasons why America’s health care is so damn expensive.

The other, of course, is Sam’s point — the cost of R&D is rolled into the prices. Just off the top of my head, I know that my Cingulair (or generic knockoff) costs me $10 per month; if I had to pay out-of-pocket it would cost $145 per month. And that’s just one prescription. That’s almost $1800 per year, for just one pill. Now, the average health benefit paid by employers per individual covered is around $9500 per year or so. If I were given $9500, I have no idea if it could cover me for a year or not. But I do know this: if I had $9500, I damn sure would shop around for cost-effective options. Doctors, labs, and hospitals would have to compete for business, and that would benefit everyone.

For example, in DuPage County, where we live, the hospitals have engaged in a battle for patients over the last decade or so. There are actually more than enough hospital beds, so the demand is lower than supply. This has led to many, many benefits for the patients. All the hospitals now feature exclusively single-patient rooms — no more sharing. The amenities throughout the hospitals are radically improved — comfortable chairs, good food, hardwood floors in the public areas, nice parking structures, etc. And all because the patients (read: consumers) have a choice. In this case, choice leads to benefits. In St Clair County, where my parents live, there are two hospitals for the whole county, and they are just as outdated as you might imagine. Even there, though, there is the influence of nearby St Louis to force some modernization. However, without any competition, where is their motivation to modernize, to provide a cost-effective, pleasant experience? I actually think capitalism works in this case. Who knew?

I do have a question, though: if the US companies are not reimbursed for their R&D expenses, will they continue to try to produce better medicines? Or will research stagnate, and slow the rapid progress in life expectancy and quality of life we have all benefited from over the past century?

It’s one thing to drive a car quickly; it’s quite another to play soccer, tennis, or baseball with men. Would the female pitcher, in fact, bat if she were in the National League?