The Economist:

That question can be answered at two levels. An evolutionary biologist would tell you that it is because women get evolutionary bonus points from living long enough to help bring up the grandchildren. Men, by contrast, wear themselves out competing for the right to procreate in the first place. That is probably true, but not much help to the medical profession. However, a group of researchers at John Moores University, in Liverpool, England, has just come up with a medically useful answer. It is that while 70-year-old men have the hearts of 70-year-olds, those of their female peers resemble the hearts of 20-year-olds.

The heart-attack risks of arthritis painkillers Vioxx, Bextra and Celebrex have exposed a regulatory “house of cards” at the Food and Drug Administration, wrote Dr. Eric J. Topol, chairman of cardiovascular medicine at the Cleveland Clinic.
“Unbridled promotion exacerbated the public health problem,” Topol concluded. “The combination of mass promotion of a medicine with an unknown and suspect safety profile cannot be tolerated in the future.” Read more here. Topol’s Journal of American Medicine article: Arthritis Medicines and Cardiovascular Events?”House of Coxibs”
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Drug advertising has truly gone off the deep end. Driving down the beltline and seeing a nonsensical name on a billboard makes no sense.

Malcolm Gladwell pens a very useful look at prescription drug costs:

In the political uproar over prescription-drug costs, Nexium has become a symbol of everything that is wrong with the pharmaceutical industry. The big drug companies justify the high prices they charge–and the extraordinary profits they enjoy–by arguing that the search for innovative, life-saving medicines is risky and expensive. But Nexium is little more than a repackaged version of an old medicine. And the hundred and twenty dollars a month that AstraZeneca charges isn’t to recoup the costs of risky research and development; the costs were for a series of clinical trials that told us nothing we needed to know, and a half-billion-dollar marketing campaign selling the solution to a problem we’d already solved. “The Prilosec pattern, repeated across the pharmaceutical industry, goes a long way to explain why the nation’s prescription drug bill is rising an estimated 17 % a year even as general inflation is quiescent,” the Wall Street Journal concluded, in a front-page article that first revealed the Shark Fin Project.

Harvard Strategy Guru Michael Porter on Solving the Health Care Conundrum. He summarized some key learnings here:

• The U.S. health care system is a paradox in that it has competition yet fails to deliver improving value.
• The root cause of these problems is that the competition taking place has been the wrong kind.
• The key to addressing these problems is moving to value-based, positive-sum competition.
• Moving to value-based competition has important strategic implications for providers as well as health plans and employers.

I had a wisdom tooth pulled last week – unplanned, after a painful few days. The professionals who did the job quickly told me that they do this 30 times per day…. Much, much better now.

Thinking about sinus relief?
I’ve been (happily) using Madison based Sinucleanse for several months. The process seems rather strange, at first, but the results have been excellent. I no longer take any prescription allergy medications! Check it out (they have a very nicely done video that explains the process).
Well worth checking out.

Leslie Walker:

Inventor Ray Kurzweil takes 250 nutritional supplements a day in his quest to live long enough to reap the benefits he expects from biotechnology. He says he’s trying to reprogram his body, as he would his computer.
“I really do believe it is feasible to slow down the aging process,” Kurzweil told Technology Review magazine’s Emerging Technologies Conference at the Massachusetts Institute of Technology here last week. “We call that a bridge to a bridge to a bridge — to the full flowering of the biotechnology revolution.”

1. Over the last year, six California health plans have been monitoring the performance of 45,000 doctors. The top performers will split a bonus pool of $40 to $60 million

2. 35 health plans, covering some 30 million patients, now tie doctor bonuses to performance. Preventive care and measure to encourage “patient follow-up” receive special rewards.

3. Bonus-based coverage is expected to double in size over the next year.

4. Some experts predict that pay-for-performance eventually will account for 20% to 30% of what the federal government pays health care providers.

The insurance companies feel that better doctor performance will lower their long-run costs. Many doctors don’t like these incentives. Their financial risk is increased, and they cannot always control how well the patient sticks to the prescribed regimen. Still, if greater medical skill does not show up in the numbers, over a reasonably large sample of patients, why do we spend so much time and money educating doctors?

I predict that as information technology progresses, and performance becomes easier to measure, the American economy will resort to many more bonuses of this type, across many professions.

Here is the story, WSJ subscription and password required.

By the way, regular MR readers will not be surprised to learn who first wrote up the idea of rewarding doctors for superior performance: our ever-inventive colleague Robin Hanson. More recently Harvard economist David Cutler has promoted the idea as well.

For those who care: Here is a thorough AEI estimate of the cost impacts of the Kerry and Bush health care plans. If you are concerned about our fiscal future, this makes for scary reading.

Tyler Cowan