Author Archives: JulianaWillifor

Someone Needs to Invent a Great Non-Opioid Painkiller

by JulianaWillifor Posted on December 22, 2014

Mother Jones

Austin Frakt writes about the stunningly widespread use and abuse of narcotic painkillers in the US:

Opioids now cause more deaths than any other drug, more than 16,000 in 2010. That year, the combination of hydrocodone and acetaminophen became the most prescribed medication in the United States. Patients here consumed 99 percent of the world’s hydrocodone, the opioid in Vicodin. They also consumed 80 percent of the world’s oxycodone, present in Percocet and OxyContin, and 65 percent of the world’s hydromorphone, the key ingredient in Dilaudid, in 2010. (Some opioids are also used to treat coughs, but that use doesn’t seem to be a major factor in the current wave of problems.)

When I got out of the hospital a couple of months ago, I was in considerable pain. The answer was morphine. For about two weeks, I took a couple of low-dose morphine tablets each day. Then the pain eased and I stopped.

I resisted the morphine at first, and my doctor had to argue me into using it regularly. “You broke a bone in your back,” she told me. “Your pain is legitimate. We have a lot of experience treating pain with morphine, and you’ll be all right.”

I finally listened, and the morphine did indeed work as advertised. But it somehow got me thinking. Morphine? That’s the best we can do? This stuff was invented 200 years ago. And while there are newer painkillers around, they’re all opioids of one kind or another with all the usual horrible side effects1. How is it that in over a century of research, we still know so little about pain that we haven’t been able to create a powerful, non-opioid painkiller?

I’m not really going anywhere with this. I’m just curious. Are there any good books, or even long magazine articles, about this? Why is that even after gazillions of dollars of effort, we’re still relying on variants of the opium poppy for serious pain relief? It’s the 21st century. How come we can’t do better?

1Addiction, nausea, wooziness, constipation, etc.

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Someone Needs to Invent a Great Non-Opioid Painkiller

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Chart of the Day: Oil Is Getting Harder and Harder to Find

by JulianaWillifor Posted on July 23, 2014

Mother Jones

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Oil expert James Hamilton has an interesting summary of the current world oil market up today, and it’s worth a read. His bottom line, however, is that $100-per-barrel oil is here to stay:

The run-up of oil prices over the last decade resulted from strong growth of demand from emerging economies confronting limited physical potential to increase production from conventional sources. Certainly a change in those fundamentals could shift the equation dramatically. If China were to face a financial crisis, or if peace and stability were suddenly to break out in the Middle East and North Africa, a sharp drop in oil prices would be expected. But even if such events were to occur, the emerging economies would surely subsequently resume their growth, in which case any gains in production from Libya or Iraq would only buy a few more years.

The chart on the right shows the situation dramatically. In just the past ten years, capital spending by major oil companies on exploration and extraction has tripled. And the result? Those same companies are producing less oil than they were in 2004. There’s still new oil out there, but it’s increasingly both expensive to get and expensive to refine.

(And all the hype to the contrary, the fracking revolution hasn’t changed that. There’s oil in those formations in Texas and North Dakota, but the wells only produce for a few years each and production costs are sky high compared to conventional oil.)

In a hypertechnical sense, the peak oil optimists were right: New technology has been able to keep global oil production growing longer than the pessimists thought. But, it turns out, not by much. Global oil production is growing very slowly; the cost of new oil is skyrocketing; the quality of new oil is mostly lousy; and we continue to bump up right against the edge of global demand, which means that even a small disruption in supply can send the world into an economic tailspin. So details aside, the pessimists continue to be right in practice even if they didn’t predict the exact date we’d hit peak oil. It’s long past time to get dead serious about finding renewable replacements on a very large scale.

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Chart of the Day: Oil Is Getting Harder and Harder to Find

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It’s Time to Acknowledge Reality: Obamacare is Working Pretty Well

by JulianaWillifor Posted on June 18, 2014

Mother Jones

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A new paper concludes that “rate shock” under Obamacare has been generally more modest than we thought:

Using data from the Current Population Survey, we find that the average prices increased by 14 to 28 percent, with similar changes in California and the federal exchange states; we attribute the increase primarily to higher premiums in exchanges associated with insurer expectations of a higher risk population being enrolled.

This doesn’t take into account federal subsidies, which would lower this number even further. What’s more, rates most likely would have gone up about 10 percent even if Obamacare had never existed. Taken together, this suggests that the average premium increase thanks to Obamacare has been very small. And of course, that small increase buys you a policy that in most cases is considerably more robust than older policies.

In related news, HHS reports that people who qualify for tax credits are paying an average of $82 per month for their policies. This is roughly a fourth of what they’d pay without subsidies. The chart on the right shows how this breaks down: more than two-thirds of those who qualify for subsidies are paying less than $100 per month. Fewer than 20 percent are paying more than $150. In a nutshell, then, we now know that (a) the system works, (b) enrollment targets were largely met, and (c) health insurance under Obamacare is pretty affordable. Matt Yglesias explains what this means:

These three factors together should end the phony war over Obamacare and let the real debate begin — not the debate over whether the program “works” but the debate over whether economic resources should be devoted to providing health insurance to people at the bottom of the income distribution or to providing tax cuts to people at the top.

….Obamacare is a large-scale effort to improve living standards for people in the bottom half of the income distribution by giving them additional economic resources. One of America’s political parties doesn’t like that idea in any non-health context and they don’t like it for health care either. They think the money it costs to provide those subsidies should be taken away, and it should be given to high-income households in the form of tax cuts.

This is an excellent and important policy debate to have. One of the great ideological issues not just of our time and place, but of democratic politics across eras and countries. Should economic resources be distributed more equally or less equally?

Yep. It’s time to stop arguing over minutiae. Fundamentally, Obamacare “works.” It’s not perfect, but after nine months we can now say that it does indeed provide health coverage to the poor and the working-class in a reasonably efficient manner, and it does this largely by a combination of taxing and/or reducing payments to the relatively well off.

I think this is a good idea. Republicans don’t. But this, rather than the cacophony of nonsense we’ve been subjected to over the past several years, is what we should be arguing about.

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It’s Time to Acknowledge Reality: Obamacare is Working Pretty Well

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WATCH: To Understand the VA Disaster, Just Call the “Health Care Benefits” Toll Free Number. Fiore Cartoon

by JulianaWillifor Posted on May 29, 2014

Mother Jones

Mark Fiore is a Pulitzer Prize-winning editorial cartoonist and animator whose work has appeared in the Washington Post, the Los Angeles Times, the San Francisco Examiner, and dozens of other publications. He is an active member of the American Association of Editorial Cartoonists, and has a website featuring his work.

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WATCH: To Understand the VA Disaster, Just Call the “Health Care Benefits” Toll Free Number. Fiore Cartoon

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