Category: Doctors

The Illusion of Willpower

WENDY WOOD, professor psychology and business, Marshall School of Business, and DAVID NEIL.

This op-ed originally appeared in the Los Angeles Times on Aug. 9

On a recent doctor’s visit, a compelling health video was looping in the reception room. It incorporated many of the accepted rules for achieving a healthy weight. The motivational video, tailored to the doctor’s clientele, illustrated simple ways to eat more fruits and vegetables and get exercise. It was striking, however, that many of the nursing staff, who must have heard this video a thousand times, didn’t seem to have taken it to heart. Nurses, as a national study revealed, are just as likely to overeat as the rest of the population.

The Outrageous Cost of the Angelina Jolie Test

DAVID AGUS, professor of medicine and engineering, Keck School of Medicine of USC.

This op-ed originally appeared in the New York Times on May 21.

Angelina Jolie’s revelation that she had had a preventive double mastectomy was eloquent and brave. She had learned that she inherited a faulty copy of a gene, BRCA1, that put her at high risk for invasive breast cancer as well as ovarian cancer. Now women everywhere are asking: Should I get the same test? What will it cost?

Only one in about 400 women carry mutations to BRCA1 or to a related gene BRCA2, though such hereditary defects are implicated in between 5 percent and 10 percent of all breast cancers. The majority of the 230,000 cases of breast cancer diagnosed annually in the United States are not related to these genes. But if you’re that one in 400 women, you’d want to know so you could make informed decisions about your health care.

The 2,000-Year-Old Prescription to Control Health Costs

DAVID AGUS, professor of medicine and engineering, Keck School of USC.

This op-ed originally appeared in the New York Times on Dec. 11.

The inexorable rise in health care spending, as all of us know, is a problem. But what’s truly infuriating, as we watch America’s medical bill soar, is that our conversation has focused almost exclusively on how to pay for that care, not on reducing our need for it. In the endless debate about “health care reform,” few have zeroed in on the practical actions we should be taking now to make Americans healthier.

An exception is Mayor Michael R. Bloomberg of New York, who is setting new standards that we would do well to adopt as a nation. In the last several years, he’s changed the city’s health code to mandate restrictions on sodas and trans fats — products that, when consumed over the long term, harm people. These new rules will undoubtedly improve New Yorkers’ health in years to come.

Obamacare Exchanges May Be Too Small to Succeed

DANA P. GOLDMAN, director of USC’s Leonard D. Schaeffer Center for Health Policy and Economics, MICHAEL CHERNEW and ANUPAN JENA, professor of health policy at Harvard University.

This op-ed originally appeared in the New York Times on Nov. 23.

With the re-election of President Obama, the Affordable Care Act is back on track for being carried out in 2014. Central to its success will be the creation of health-insurance exchanges in each state. Beneficiaries will be able to go a Web site and shop for health insurance, with the government subsidizing the premiums of those whose qualify. By encouraging competition among insurers in an open marketplace, the health care law aims to wring some savings out of the insurance industry to keep premiums affordable.

The Medicare Disadvantage

DANA GOLDMAN, director of USC’s Schaeffer Center, ADAM LEIVE, graduate student at University of Pennsylvania and DANIEL MCFADDEN, senior fellow, Schaeffer Center.

This op-ed originally appeared at the New York Times.

One question at the center of the Medicare debate is whether private insurance companies have a future role to play in the huge federal program. Paul Ryan’s 2012 budget proposal gives private health plans a starring role in the form of a voucher program. But some economists would give them the hook, citing the failure of Medicare Advantage to control costs. Some perspective is in order.

Medicare Advantage has historically cost 7 to 12 percent more than traditional Medicare, according to the Medicare Payment Advisory Commission. But to conclude that this cost difference proves that private health plans have no place in Medicare misreads the Medicare Advantage experience in an important way: It ignores the decisive role that government has played in driving up the program’s costs. Medicare Advantage is only partly about reducing costs. It is also designed to increase choice for beneficiaries. And the incentives that government gives private health plans to expand choice end up undercutting efforts to save money.

Heredity, Diet Driving Health Crisis in Hispanic Community

MICHAEL GORAN, director of the USC Childhood Obesity Research Center, Keck School of Medicine, and EMILY VENTURA, fellow, UCLA Department of Cancer Prevention and Control Research.

This op-ed originally appeared at the Huffington Post.

A combination of heredity and diet is driving a potential health crisis of liver disease in the Hispanic community.

Obesity is a growing problem among Hispanics, especially children and adolescents. In Los Angeles County, obesity levels among Hispanics are among the highest (25.5 percent), especially hitting those with low incomes. In some communities, some 35 percent of children are obese.

An Ounce of Prevention Could Save Billions

DANA GOLDMAN, director of USC’s Schaeffer Center for Health Policy and Economics, talked to Gina Kolata about reining in healthcare costs by improving access to preventative care.

The Q&A originally appeared in the New York Times.

How much are we spending on treating diseases that might be prevented?

The most consistent estimates, and most widely cited, seem to come out of the Centers for Disease Control and Prevention, lobbying groups like the Tobacco-Free Kids initiative, and the president’s prevention initiative. Instead of blanket measures, they focus more on diseases relating to “lifestyle” decisions like obesity and smoking, and their estimates include costs for lost productivity in addition to medical expenses.

How Doctors Die

KEN MURRAY, clinical assistant professor of family medicine at the Keck School of Medicine at USC:

This op-ed was originally published at Zocalo Public Square.

“Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.