Chimeras: Mice with Human Brain Cells

PnasheadAn AP story today reports on a research project at the Salk Institute in San Diego led by Fred Gage. 100,000 human embryonic stem cells were injected into the brains of 14-day-old mouse embryos. The mice were born with one-tenth of one percent of human cells in their head. The findings are key to modeling human neurological diseases in test animals. A paper will be published in the upcoming Proceedings of the National Academy of Sciences.

A second story is how the news was covered. The New York Times carried a relatively careful headline: "Trace of Human Stems Cells Put Into Unborn Human Mice Brains." The Toronto Star focused on the small percentage involved: "Scientists create mice with brains that are 0.1% human" But the Sydney Morning Herald jumped right ahead to: Mice with human brains[!]

Creating chimeras — combining parts from different animals — has been part of medicine for years. Senator Jesse Helms famously had a pig valve installed in his heart. But combining genes and stem cells creates chimeras that grow into their new states blending human and animal characteristics, prompting what ethicists call the "yuck factor." (See the September article Transgenic Pigs’ Milk to Treat Cancer.)  Sen. Sam Brownback, R-Kan., has introduced legislation banning chimerical research.

Panexa: Ask your doctor [parody]

Panexamug_1
A direct-to-consumer drug advertisement headlines:
Panexa. Ask your doctor for a reason to take it.

The Merd Pharmaceuticals Group’s prescribing information for Panexa (Acidachrome Promanganate) says that the prescription drug "should only be taken by patients experiencing one of the following disorders: metabolism, binocular vision, digestion (solid and liquid), circulation, menstruation, cognition, osculation, extremes of emotion." Side effects are novel: "PANEXA can contribute to developing inhumanly powerful tongue muscles, capable of licking through steel." Pregnant women and squirrels have special warnings, but the best line is about the pediatric use:

Pediatric use: Expired PANEXA
may be disposed of by feeding to children in a bowl with milk.

Of course, it’s all a well-crafted joke. But there’s a Cafe Press gift site where you can buy a Panexa T shirt or mug for the doctor on your list who needs another freebie pharma tshatshke.

We’ll be talking about direct-to-consumer advertising at the Health IC Summit next month in the Healthcare Consumerism session.

Motivated Patient: A Medical Tourist in Beijing

Slatetourism
Under-insured freelance writer Laura Moser writing in Slate — The Medical Tourist: How my shoulder sent me to Chinadescribed her journey to Beijing to get Traditional Chinese Medicine treatment for her bad back. (She got to Beijing with frequent flyer miles.) The results are a little hopeful and a lot inconclusive, but the two-part story offers a peek at the lure of medical tourism:

A bone-marrow transplant costs $2.5 million in the United States.
Doctors in India can do it for $26,000. Heart-bypass surgery runs
$60,000 to $150,000 in this country. In Asia, the average cost is
$10,000. Other less-serious procedures—tummy tucks, face lifts, breast implants, LASIK eye surgery, even MRIs and dental work—can also be had at a fraction of they cost here.

At the Health IC Summit next month, we’ll host a discussion of medical tourism and other new care models with some professionals from the field.

Wal-Mart’s Tough Choices: WNYC Tues, Dec 13 | 10am EST

Susan_chambers76x78A fascinating internal memo by Wal-Mart EVP M. Susan Chambers (at left) describes the company’s healthcare cost crisis and outlines some "limited risk" and some "bold" steps to bring costs under control, make employees happier … and improve Wal-Mart’s public reputation in the face of increasing calls for new state and local regulations. The leaked document, written for the board of directors and based on studies with McKinsey & Company, is brutally honest: older, fatter, sicker, long-employed full-time workers are much more expensive than cheaper, younger, healthier part-time new hires — but they are no more productive. Wal-Mart’s employee benefit costs jumped from $2.8 billion to $4.2 billion in three years. The company earned $10.5 billion on sales of $285 billion last year. (See the recent article by Steven Greenhouse and Michael Barbaro from the New York Times.)

This Tuesday at 10 am EST, Brian Lehrer, host of a talk show on New York’s public radio station WNYC, will present "Who Pays for Healthcare?" discussing the memo with an economist and his New York audience (see box below). No doubt, there will be plenty of public radio hand-wringing about the evil corporation where 5% of employees resort to Medicaid, but memo fairly outlines Wal-Mart’s relative position in the  overall labor market as well as the stingier retail sect, steps like:

  • Health Savings Accounts that reward medical consumerism and build assets year-to-year,
  • wellness training programs to stop going to the hospital emergency room and to better use doctor visits and prescriptions,
  • discounts for healthier foods,
  • in-store clinics like MinuteClinic ,
  • adding more physical activity to jobs to force some on-the-job exercise

Some of the memo’s notes on workforce productivity and recruiting strategy will scare people who’ve never run a business, but the healthcare issues for the country’s biggest employer are the ones every employer — and every employee — will face in the future. There’s a lot of disruption on the way, maybe for the better.


The Brian Lehrer Show: Who Pays for Healthcare?
WNYC New York, Tuesday, December 13, 2005, 10AM on 93.9 FM and AM 820 , rebroadcast at 1AM on AM 820. Available on-line at WNYC.org.
Read the Wal-Mart memo Reviewing and Revising Wal-Mart’s Benefits Strategy: Memorandum to the Board of Directors from Susan Chambers [PDF]