Bio-medical research

Remember how Obama was applauded for his promises to pour more money into biomedical research? Well, it happened--sort of. JAMA reports when the 2011 budget is adjusted for inflation, there is no increase, and there is actually LESS because the ARRA stimulus infusion of $10.4 billion comes to an end.

In the coffee shop I saw a woman with a 30 year old face and the body of a 12 year old. Maybe she has EDNOS? That means she hasn't been diagnosed with anorexia (self starvation) or bulimia (binging and purging), but an "eating disorder not otherwise specified." EDNOS actually has a higher mortality than anorexia or bulimia, but seems to be in a limbo of medical indecision on how to classify it.

In another issue of JAMA I saw an article about race and aggressive treatment at the end of life and survival in long term acute care facilities. It seems that black patients at the end of life prefer a more aggressive treatment. They are less likely to have do-not-resuscitate orders in place at the time of hospitalization and are less likely to favor withdrawal of life sustaining measures in the ICU. Such a dilemma for a progressive, liberal publication. Is this liberal or conservative? Cultural? Religious? Racial? Moral?

The end result is African-American patients are sicker when they transfer to a long term facility and are less likely to survive--the whites who were the sickest with the poorest prognosis died in the acute care hospital! So blacks are more likely to die while ventilator dependent. But then the writers (social workers and PhD types) have to face the fact that this unplanned, unforeseen racial/cultural disparity opens up financial incentives for physician owned specialty hospitals, and home health services. Capitalism! Oh the horror! Better the government panel step in and decide their fate, right?