Posted by scott at November 05, 2007 03:22 PM
Arnold Kling's latest discussion of the economics of health care:
... The demagogues say that we can continue to insulate people from costs using employer-provided health insurance and Medicare, plus insulate more people through "universal coverage," and afford it all.
You remind the demagogues that Medicare and employer-provided health insurance are both unraveling on the financial end. They say, "Oh, right. We have to cut costs."
But cutting costs means changing health care as we know it, in order to reduce the extravagant use of medical procedures with high costs and low benefits.
What the demagogues won't tell you is that they are forcing us down the path of government rationing, when some of us might not like that so much.
You say America's health care system isn't as good as it can be, and I'll agree to that. It's only when you say we should model our health care system after nation X's that I start shaking my head. As far as I'm concerned, nobody has come up with a sustainable health care strategy just yet.
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WORST SCIENCE JOBS
Their work is noninvasive—for the apes, that is . . . "Have I been pissed on? Yes," says anthropologist Cheryl Knott of Harvard University. Knott is a pioneer of "noninvasive monitoring of steroids through urine sampling." Translation: Look out below! For the past 11 years, Knott and her colleagues have trekked into Gunung Palung National Park in Borneo, Indonesia, in search of the endangered primates. Once a subject is spotted, they deploy plastic sheets like a firemen's rescue trampoline and wait for the tree-swinging apes to go see a man about a mule. For more pee-catching precision, they attach bags to poles and follow beneath the animals. "It's kind of gross when you get hit, but this is the best way to figure out what's going on in their bodies," Knott says.
It's a job that separates the boys from the men, OK, OK, their real job title is usually something like "cryobiologist" or "laboratory technician," but at sperm banks around the country, they are known as semen washers. "Every time I interview someone I make sure I ask them, 'Do you know you'll be working with semen?' " says Diana Schillinger, the Los Angeles lab manager at the country's largest sperm bank, California Cryobank. Let's start at the beginning. Laboriously prescreened "donors" emerge from a so-called collection room that is stocked with girlie mags and triple-X DVDs. They hand over their deposit, get their $75, and leave. The semen washers take the seminal goo and place a sample under the microscope for a sperm count. Next comes the washing. The techs spin the sample in a centrifuge to separate the "plasma" from the motile cells. Then they add a preservative, and it's off to the freezer, where it can stay for 20 years. Or not. Thanks to semen washers (and in vitro fertilization), more than 250,000 babies have been delivered in the U.S. since 1995.
"The hardest part is explaining it to friends," Schillinger says. "But we do have stories." Like what? "Like the donor who was in the room for the longest time. We had a big discussion about who was going to check on him. Turns out he thought he had to fill up the entire specimen cup."
The smell is just the start of the nastiness. Almost 1.5 billion tons of manure are produced annually by animals in this country—90 percent of it from cattle. That's the same weight as 14,432 Nimitz-class aircraft carriers. You get the point: It's a load of crap. And it's loaded with nasty contaminants like campylobacter (the number-one cause of acute gastroenteritis in the U.S.), salmonella (the number-two cause) and E.coli 0157:H7, which can cause kidney failure in children and painful, bloody diarrhea in everybody else.
Farmers fertilize their fields with manure, but if the excrement is rife with E.coli, then so will be the vegetables. Luckily for us, researchers at the University of Georgia's Center for Food Safety are knee-deep in figuring out how to eliminate these bacteria from our animals, their poop and our food. But to develop techniques to neutralize the nasty critters, they must go to the source.
"We have to wade through a lot of poop," concedes Michael Doyle, the center's director. "If you want to get the manure, you've got to grab it. Even when you wear gloves, the fecal smell tends to get embedded in your skin." Hog poop smells the worst, Doyle says, but it's chicken poop's chokingly high ammonia content that brings tears to researchers' eyes.
FLATUS ODOR JUDGE
Odor judges are common in the research labs of mouthwash companies, where the halitosis-inflicted blow great gusts of breath in their faces to test product efficacy. But Minneapolis gastroenterologist Michael Levitt recently took the job to another level—or, rather, to the other end. Levitt paid two brave souls to indulge repeatedly in the odors of other people's farts. (Levitt refuses to divulge the remuneration, but it would seem safe to characterize it thusly: Not enough.) Sixteen healthy subjects volunteered to eat pinto beans and insert small plastic collection tubes into their anuses (worst-job runners-up, to be sure). After each "episode of flatulence," Levitt syringed the gas into a discrete container, rigorously maintaining fart integrity. The odor judges then sat down with at least 100 samples, opened the caps one at a time, and inhaled robustly. As their faces writhed in agony, they rated just how noxious the smell was. The samples were also chemically analyzed, and—eureka!—Levitt determined definitively the most malodorous component of the human flatus: hydrogen sulfide.
DYSENTERY STOOL-SAMPLE ANALYZER
In the early '80s, Virginia Tech profs Tracy Wilkins and David Lyerly studied the diarrhea-causing microbe Clostridium difficile in sample after sample after sample of loose stool from the disease's victims. They became such crack dysentery docs that they launched a company, Techlab, dedicated to making stool-analysis kits. Today, Techlab employs 40 people, 19 of whom spend their working hours opening sloppy stool canisters and analyzing their contents in order to test the effectiveness of the company's kits. You'd have to have a pretty good sense of humor, right? Well, fortunately, they do. The Techlab Web site sells T-shirts with cartoons on the front (two flies hover over two blobs of dung; one says to the other, "Pardon me, is this stool taken?") and the company motto on the back: "Techlab: #1 in the #2 Business!"
Researchers who want animal sperm —to study fertility or for artificial insemination—have a suite of attractive options: They can ram an electric probe up an animal's rectum, shove an artificial vagina onto the animal's penis, or simply do it the old-fashioned way—manual stimulation. The first option, electroejaculation, uses a priapic rectal probe to send electricity pulsing through the animal's nether regions. "All the normal excitatory signals that stimulate ejaculation, like touch, sight, sound and smell, can be replaced with the current from the probe," says Trish Berger, professor of animal science at the University of California, Davis. "It's fascinating. Of course, this is a woman talking." Electroejaculation generally requires anesthetizing the animal and is typically used on zoo dwellers. The other two methods—the artificial vagina, or AV, and the good old hand—require that animals be trained to the procedure. The AV—a large latex tube coated with warm lubricant —is used primarily to get sperm from dairy bulls (considered the most ornery and dangerous of bovines). The bull gets randy with a steer; when he mounts the steer with his forelegs, a brave technician, AV in hand, insinuates himself between the two aroused beasts and deftly redirects the bull penis into the mock genitalia, which he must then hold tight while the bull orgasms. (Talk about bull riding!) Three additional technicians attempt to ensure this (fool)hardy soul's safety by anchoring themselves to restraining ropes attached to a ring in the bull's nose. Alas, this isn't always absolutely effective: Everyone who's wielded an AV has had at least one close call, and more than a few have been sent to the hospital. The much safer "digital pressure" is used mostly with pigs, who are trained from an early age to mount a small bench while the researcher reaches around with a gloved hand and provides appropriate pleasure—er, pressure.
Natural history museums display clean white skeletons or neatly stuffed animals, but what their field biologists drag in are carcasses flush with rotting flesh. Each museum's taxidermist has his own favorite technique for tidying things up. University of California, Berkeley, zoologist Robert Jones swears by his strain of flesh-eating buffalo-hide beetles and has no problem reaching his bare hand into a drawer to pull out a rancid shrew skeleton swarming with thousands of these quarter-inch bugs. Jeppe Møhl at the University of Copenhagen Zoological Museum deposits sperm whales and dolphins into vast empty tanks and lets nature take its course. And then there's the boiling method, useful for chemically preserved samples that bugs won't touch—an approach favored by archaeologist Sandra Olsen, who has done her own skeleton work. She recalls a particularly vivid experience boiling down hyena paws: "It felt like inhaling the gases would literally kill us." Nah. It merely gave her a lung infection.