The Best Health Care System in the World

To better understand one of the most heated U.S. policy debates, we created a tournament to judge which of these nations has the best health system: Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S. 

“Medicare for all,” or “single-payer,” is becoming a rallying cry for Democrats.

This is often accompanied by calls to match the health care coverage of "the rest of the world." But this overlooks a crucial fact: The “rest of the world” is not all alike.

The commonality is universal coverage, but wealthy nations have taken varying approaches to it, some relying heavily on the government (as with single-payer); some relying more on private insurers; others in between.

Experts don’t agree on which is best; a lot depends on perspective. But we thought it would be fun to stage a small tournament.

We selected eight countries, representing a range of health care systems, and established a bracket by randomly assigning seeds.
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Dying: A Memoir

Years ago, a palliative care doctor told me that what he knew of a patient’s personality often had little to do with how he or she coped with dying. Generous people could become ungenerous, and brave people could become frightened. Angry people could become gentle, and controlling people could become Zen. Dying, in other words — like combat, like becoming a parent, like any transformative life event — doesn’t always reveal or intensify aspects of our character. It sometimes coaxes out new ones.

For a long time, the writer Cory Taylor took, by her own admission, “a fairly leisurely approach to life.” That changed in 2005, just before her 50th birthday, when doctors removed a mole on the back of her leg. Melanoma, Stage 4. She wrote the novel she’d always meant to write, then another. Then she wrote “Dying: A Memoir.”

The book rings louder in my imagination the more time I spend apart from it, a kind of reverse Doppler effect. “Dying” is bracing and beautiful, possessed of an extraordinary intellectual and moral rigor. Every medical student should read it. Every human should read it. My own copy is so aggressively underlined it looks like a composition notebook.

“Dying” is short, but as dense as dark matter. There is an electrifying matter-of-factness to it, one that normalizes death, which is part of Taylor’s goal. She deplores the “monstrous silence” surrounding the subject of mortality. “If cancer teaches you one thing,” she writes, “it is that we are dying in our droves, all the time. Just go into the oncology department of any major hospital and sit in the packed waiting room...” (nyt, continues)

Cory Taylor, a fine Australian writer, has died within weeks of the rush-publication of her last book, Dying: A Memoir.

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Australian author Cory Taylor has died aged 61.  

Taylor, who had just turned 61, died peacefully on Tuesday in a Queensland hospice with her family at her side... Sydney Morning Herald

Debunking "What the Health"

There’s a sensational new documentary out on Netflix that seems to have a lot of people talking about going vegan.

In the spirit of so many food documentaries and diet books that have come before, What the Health promises us there is one healthy way to eat. And it involves cutting all animal products from our diet.

Meat, fish, poultry, and dairy are fattening us up, giving us cancer and diabetes, and poisoning us with toxins, Kip Andersen, the film’s co-director and star, tells us.

Reflecting on a youth spent inhaling hot dogs and cold cuts, he asks, “Was this like I had essentially been smoking my whole childhood?”

No, Kip, not really... (continues)
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Q. It seems that many people who are not elite athletes are now hyper-focused on protein consumption. How much protein does the average adult need to consume daily?

A. The recommended intake for a healthy adult is 46 grams of protein a day for women and 56 grams for men. And while protein malnutrition is a problem for millions of people around the globe, for the average adult in developed countries, we are eating far more protein than we actually need.

Most American adults eat about 100 grams of protein per day, or roughly twice the recommended amount. Even on a vegan diet people can easily get 60 to 80 grams of protein throughout the day from foods like beans, legumes, nuts, broccoli and whole grains.

The Hartman Group, a consumer research firm that has been conducting a study of American food culture over the past 25 years and counting, has found that nearly 60 percent of Americans are now actively trying to increase their protein intake. Many are avoiding sugar and simple carbohydrates and turning to protein-rich foods, snacks and supplements. The firm calls protein “the new low-fat” or “the new low-carb,” even “the new everything when it comes to diet and energy.”

“Soccer moms feel they can’t be anywhere without protein,” says Melissa Abbott, the firm’s vice president for culinary insights. “Really it’s that we’ve been eating so many highly processed carbs for so long. Now it’s like you try nuts, or you try an egg again, or fat even” to feel full and help you “get through the day.”

In her research, Ms. Abbott said she always seems to be finding beef jerky in gym bags and purses, and protein bars in laptop bags or glove compartments. Many consumers, she notes, say they are afraid that without enough protein they will “crash,” similar to the fear of crashing, or “bonking,” among those who are elite athletes.

But most of us are getting more than enough protein. And few seem to be aware that there may be long-term risks of consuming too much protein, including a potential increased risk of kidney damage. To learn more, read “Can You Get Too Much Protein?”

Gene editing, techno-optimists

Gene editing threatens to homogenize society, says Atul Gawande. Aberrant yet valuable characteristics are under threat. Think of George Church's narcolepsy... more »

Biology and its discontents. Techno-optimists come in all stripes — scientists, seekers, grifters, con artists. They share a zeal for augmenting their bodies... more »

aldaily
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The Gene Machine: How Genetic Technologies Are Changing the Way We Have Kids—and the Kids We Have
by Bonnie Rochman
Scientific American/Farrar, Straus and Giroux, 272 pp., $26.00
DNA Is Not Destiny: The Remarkable, Completely Misunderstood Relationship Between You and Your Genes
by Steven J. Heine
Norton, 344 pp., $26.95
A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution
by Jennifer A. Doudna and Samuel H. Sternberg
Houghton Mifflin Harcourt, 281 pp., $28.00Graeme Mitchell/Redux

In recent years, two new genetic technologies have started a scientific and medical revolution. One, relatively well known, is the ability to easily decode the information in our genes. The other, which is only dimly understood by the general public, is our newfound capacity to modify genes at will. These innovations give us the power to predict certain risks to our health, eliminate deadly diseases, and ultimately transform ourselves and the whole of nature. This development raises complex and urgent questions about the kind of society we want and who we really are. A brave new world is just around the corner, and we had better be ready for it or things could go horribly wrong.

The revolution began in benign but spectacular fashion. In June 2000, President Bill Clinton and Prime Minister Tony Blair announced the completion of the first draft of the human genome. According to a White House press statement, this achievement would “lead to new ways to prevent, diagnose, treat, and cure disease.” Many scientists were skeptical, but the public (who footed much of the $3 billion bill) probably found this highly practical justification more acceptable than the mere desire to know, which was in fact a large part of the motivation of many of the scientists involved.

During the 2000s, Clinton’s vision was slowly put into practice, beginning with the development of tests for genetic diseases. As these tests have become widespread, ethical concerns have begun to surface. Bonnie Rochman’s The Gene Machine shows how genetic testing is changing the lives of prospective parents and explores the dilemmas many people now face when deciding whether to have a child who might have a particular disease. Some of these technologies are relatively straightforward, such as the new blood test for Down syndrome or the Dor Yeshorim genetic database for Jews, which enables people to avoid partners with whom they might have a child affected by the lethal Tay-Sachs disease (particularly prevalent in Ashkenazis). But both of these apparently anodyne processes turn out to raise important ethical issues... (nyrb, continues)

The Symptoms of Dying

You and I, one day we’ll die from the same thing. We’ll call it different names: cancer, diabetes, heart failure, stroke.

One organ will fail, then another. Or maybe all at once. We’ll become more similar to each other than to people who continue living with your original diagnosis or mine.

Dying has its own biology and symptoms. It’s a diagnosis in itself. While the weeks and days leading up to death can vary from person to person, the hours before death are similar across the vast majority of human afflictions.

Some symptoms, like the death rattle, air hunger and terminal agitation, appear agonizing, but aren’t usually uncomfortable for the dying person. They are well-treated with medications. With hospice availability increasing worldwide, it is rare to die in pain... (continues)

Web MD

“You can’t list your iPhone as your primary-care physician.”

Siddhartha Mukherjee & Sam Harris on the moral complexity of genetics

In this episode of the Waking Up podcast, Sam Harris speaks with Siddhartha Mukherjee about the human desire to understand and manipulate heredity, the genius of Gregor Mendel, the ethics of altering our genes, the future of genetic medicine, patent issues in genetic research, controversies about race and intelligence, and other topics. Listen here.