The caps on chromosomes

It’s Nobel Prize season, a time to salute good scholarship and, even more, to marvel at the structures built into nature that the winners have discovered. This year’s Nobel prize for medicine goes to three scientists who discovered how chromosomes stay together and keep their integrity even after the cells split. It seems the strands of genetic material have little caps on their ends:

Elizabeth H. Blackburn of the University of California at San Francisco, Carol W. Greider of Johns Hopkins University in Baltimore and Jack W. Szostak of Harvard Medical School in Boston were awarded the $1.4 million 2009 Nobel Prize in Physiology or Medicine. It was the first time two women shared the prize. . . .

The scientists won for a series of experiments they conducted in the 1970s and 1980s that showed that the long, intricate molecules known as chromosomes, which carry genes inside every cell, have protective structures on their ends — often likened to the plastic tips on shoelaces — called telomeres, which are replenished with an enzyme dubbed telomerase.

The work “solved a major problem in biology” and has led to groundbreaking insights into the aging process and potentially to new treatments for cancer and many other health problems, the Nobel Assembly said.

“This is a fundamental biological mechanism,” said Rune Toftgard of the Karolinska Institute.

In time and after multitudes of cell divisions, those caps degrade, leading to the degeneration of the cells, as we aging folks are experiencing. Knowing about these caps mean that some of those effects might conceivably be reversed, and knocking off the caps might help us defeat the uncontrolled cell division that is cancer.

But those caps are absolutely necessary for life and reproduction. I suppose an atheist materialist would have to say, “Isn’t it lucky that chromosomes randomly generated those little caps?”

But surely this is an example of irreducible complexity. Those little caps couldn’t have evolved, because to have evolution, you must have reproduction. These are necessary for reproduction, which means they have must have first appeared fully-formed.

Do you have “Cadillac” health insurance?

To help fund the proposed health reform measures, lawmakers are thinking about imposing a stiff tax–up to 35%–on so-called “Cadillac” health insurance plans. Those are defined as individual plans valued at $8,000 per year, or family plans valued at $21,000.

They typically have low deductibles, cover vision, and dental. Such plans are usually just described as “good benefits,” or “I’m really pleased with the health insurance that our company offers.” Such “Cadillac” plans are not just for high-paid executives. They are common in union contracts.

Wouldn’t taxing these good insurance benefits mean that fewer companies would offer them? Wouldn’t this result in people having poorer health care than they currently have? Doesn’t that work against the stated purpose of health care reform? How can taxing excellent plans be justified? Don’t lawmakers understand that the prospect of having worse health care than they did before the reform is what makes people leery about their tampering?

Health care reform as a barrier to abortions?

I posted about this possibility before, but now pro-abortion folks are getting nervous about health care reform. The Atlantic blog reports that the laws against taxpayer money going for abortion may well mean that if health care reform gets passed, insurance companies would have to stop covering abortions:

Some of the supporters of health care reform have rediscovered worries about crowding out.  That’s because it now looks as if the bill may not allow Federal subsidies to be used to buy insurance that covers abortions.  Suddenly, a big chunk of the left sounds like a bunch of Republicans, warning about what happens to insurance markets when the government gets involved:

Abortion opponents in both the House and the Senate are seeking to block the millions of middle- and lower-income people who might receive federal insurance subsidies to help them buy health coverage from using the money on plans that cover abortion. And the abortion opponents are getting enough support from moderate Democrats that both sides say the outcome is too close to call. Opponents of abortion cite as precedent a 30-year-old ban on the use of taxpayer money to pay for elective abortions.

Abortion-rights supporters say such a restriction would all but eliminate from the marketplace private plans that cover the procedure, pushing women who have such coverage to give it up. Nearly half of those with employer-sponsored health plans now have policies that cover abortion, according to a study by the Kaiser Family Foundation.

The question looms as a test of President Obama’s campaign pledge to support abortion rights but seek middle ground with those who do not. Mr. Obama has promised for months that the health care overhaul would not provide federal money to pay for elective abortions, but White House officials have declined to spell out what he means.

Wouldn’t that be a good outcome?

UPDATE: Senators are fighting strengthening the anti-abortion provisions, but, as I understand it, so far the ban against federal funding would stand. See also this.

A cleaned-up Health Care Reform proposal?

So would you support this bill?

The chairman of the Senate Finance Committee said Monday that he will propose an overhaul of the nation’s health-care system that addresses a host of GOP concerns, including blocking illegal immigrants from gaining access to subsidized insurance, urging limits on medical malpractice lawsuits and banning federal subsidies for abortion.

But see a new worry raised in this same story below. . . .

Forcing people to buy insurance

Lawmakers now are worried about the consequences of requiring everyone to buy health insurance. That will mean lots of people are going to have to come up with the equivalent of another month’s rent in their monthly budgets:

But even after Max Baucus (D-Mont.) spoke optimistically of gaining bipartisan backing, lawmakers continued to haggle over a question at the heart of the debate: How can the government force people to buy insurance without imposing a huge new financial burden on millions of middle-class Americans? . . . .

Under the Baucus plan, described in a “framework” he released last week, as many as 4 million of the 46 million people who are currently uninsured would be required to buy coverage on their own, without government help, by some estimates. Millions more would qualify for federal tax credits, but could still end up paying as much as 13 percent of their income for insurance premiums — far more than most Americans now pay for coverage.

People further down the income scale would receive much bigger tax credits, effectively limiting their premiums at 3 percent of their earnings. But experts on affordability say even those families could find it difficult to meet the new mandate without straining their wallets.

“We’re talking about the equivalent of a middle-class tax increase,” said Michael D. Tanner, a health-care expert at the libertarian Cato Institute. “Yes, they’re paying it to an insurance company instead of to the government. But, suddenly, these people are paying more money to somebody.” . . .

Under the Baucus plan, subsidies would be offered to people who earn up to 400 percent of the poverty level ($43,000 for an individual or $88,000 for a family of four) in the form of tax credits that would be paid directly to the insurance company of the person’s choice. The credit would be calibrated on a sliding scale to ensure that people at the bottom of the income range paid no more than 3 percent of their earnings for premiums while those at the top would be liable for as much as 13 percent.

That would amount to more than $700 a month for a family of four making $66,000 a year — significantly more than most people at the same income level now pay, according to research conducted by Linda Blumberg, a senior fellow in the Health Policy Center at the Urban Institute. Families earning less than 300 percent of the poverty level also would be eligible for assistance with deductibles and other out-of-pocket expenses, but families who earn more would be on their own.

Again, if your income is low, you will get a subsidy to help pay for it, but still it’s going to mean a big hit on the household budget. The theory is to help pay for older people’s medical expenses by bringing in all these young and healthy folks who don’t have that many medical bills and who don’t currently have insurance. But is that fair? And are those who are going to be forced to pay insurance premiums which may be close to what they are currently paying for rent willing to go along with this scheme? Do any of you fall into this category? How are you going to swing paying that premium?

Obama’s Health Care Speech

Here is the President’s speech to Congress in which he makes his case for Health Care reform. Are you persuaded?

Here is his explanation of the system he wants to implement:

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

That’s what Americans who have health insurance can expect from this plan – more security and stability.

Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it’s a good idea now, and we should embrace it.

What’s wrong with this? It uses private insurance companies, rather than a nationalized system, so it avoids socialized medicine. I don’t see how this system can possibly reduce the cost of health care or of health insurance, one of the urgent issues he raises in his speech. If we require insurance companies to insure everyone who applies, even if they have pre-existing conditions, and if the companies are not allowed to cap any payouts, how can this not send premiums even higher? The idea of a health insurance exchange sounds like an acknowledgment of the power of free market competition to drive down prices, but prices can’t go lower than the intrinsic cost of the commodity. If someone can explain this or can make even a theoretical case for how this plan could mean lower health care costs, please comment. I really want to know.


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