Consulo Indicium - 3/11/21

Information for your Consideration… 

Slightly Behind But Just As Important – Most everyone knows I’m from North Dakota because I talk about it all the time. However, with the winter storms we’ve been experiencing, I wanted to pass along a tidbit. On February 17, 2007 Bismarck, North Dakota was the site of a historic experience on the grounds of the State Capital. On that date 8,962 North Dakotans made simultaneous “snow angels” on the front park of the capital. The other undocumented record (I’m sure) is that this represented 14.6% of the total population living in Bismarck at the time!! Amazing!! Keep reading for more pertinent information…😊 

Puzzle Mania – If you thought that the only sales mania result of the pandemic was toilet paper, you are woefully wrong. Over the course of 2020, the sale of jigsaw puzzles increased by 300% in the early days moving toward 370% increase in sales for the year. Why puzzles? Anne Williams, Ph.D. served as an economist with the Brookings Institute and Federal Reserve before turning to academia as Economics Chair at Bates College. But, she is better known for her secondary interest and international recognition as an expert in jigsaw puzzles. She notes that these puzzles are popular because “it’s something you can control. It’s a challenge over which you can prevail.” The last time there was a major surge in puzzle mania occurred during the Great Depression. So, we should anticipate that the puzzle manufacturers will take it on the chin in the coming year – if the immunizations work or, better said, if we are successful in getting jabs into the arms of citizens!

Pee Wees Remembered – Back in the days when I was an evolving youngster in Nebraska – before my growing up days in North Dakota – I was a member of the local Pee Wees Baseball team. I remember that our sponsor was Quaker Oats and that we each got to pick the bat we wanted at the local hardware store. My bat was a “Hank Aaron Bat”. I picked it because I intended to hit a lot of homers, drive in lots of runs and be a hero for the team. Well, none of those dreams were ever quite realized but…I did get my Hank Aaron Bat which became one of my childhood prized possessions. With the passing of Hank Aaron on January 22nd at age 86 – another era folded its tent. Aside from Barry Bonds no one has ever hit as many home runs as Hank Aaron. I never quite made to his status as a baseball player but, he nonetheless became – and, still remains – a hero in my book. However, it quickly became obvious that I was never going to follow in Hank Aaron’s footsteps. So, I shifted my allegiance to Albert Schweitzer, MD who healed people in Africa. I never quite made it to his stature but, then again, I did complete medical school and try to make health care better… It was only later in life that I learned of his racial, colonial and paternalistic prejudices which tarnished his reputation in my book despite all he did to help people who have few, if any resources for health. 

Is There A Widening Gap? – You betcha!! I knew there was a gap but did not realize how much there was. According to a recent analysis in The Week (January 22, 2021), 84% of the stock owned in the USA is held by the wealthiest 10% of American citizens. At the same time, 12 million renters owe thousands in utilities and back rent. And, the $2.2 trillion package passed last March had a significant positive impact on reducing poverty primarily due to the $1200 stimulus checks and the $600 weekly federal supplemental payments. But, by August poverty had returned and there is an ongoing debate about the size of a second stimulus package. So, why am I discussing this? Because the “social determinants of health” has increasingly been recognized as one of the most important issues in health care and lack of access to care, lack of adequate diet, lack of access to medications, lack of transportation capabilities and a host of other issues – as a result of inadequate income have been shown to be major contributors to increased health care costs!!

If we look at the 10 richest people in the world, 7 of them are American citizens with a total wealth of $854.8 billion – plus or minus a billion or two (sic). They include:

#1. Jeff Bezos - $192.3 billion
#2. Elon Musk - $182.9 billion
#4. Bill Gates - $121.6 billion
#5. Mark Zuckerberg - $99.8 billion
#7. Warren Buffet - $89.1 billion
#8. Larry Ellison - $86.5 billion
#9. Larry Page - $82.6 billion

Now, if we took a mere 10% of their wealth that would be just about $85 billion. In May, the Foundation for Government Accountability issued a report noting that the shortfall of revenue among the states was anticipated to be $172 billion. Now, that was May 2020 and this is February 2021. So, it’s probably increased.  The point is that $85B is roughly 49% of the state shortfall – just to put it all in perspective. Hmmm? What to do? I really don’t have an answer except that we appear to have a tax problem. I would think the wealthiest would be interested in helping the states. Just remember, I keep pointing out that “health care” as a budget line item in the federal budget is the fastest growing component and will no doubt be a point of attention for changes. We all need to consider how to make health care more efficient and effective. It’s one of our key responsibilities as leaders in the health care community…

Not That I’m Concerned But… – A new study was recently published in the January 25 issue of Aging on research conducted at the University of Tokyo related to cognitive decline. Again, this points to the notion that in medicine we are deeply under-estimating the impact of deep learning and the augmented intelligence associated with its use in health care and medicine. Researchers were able to use deep learning to accurately detect age-related cognitive impairment using only photos of patients’ faces with a 93% accuracy when comparing impaired patients to health volunteers. The accuracy of the AI/ML also correlated closely with the Folstein test, a standardized assessment questionnaire used by neurologists for evaluating cognitive decline. Go here for a full review of the article.

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