WSU scientist Craig Parks along with Asako Stone set out to figure out exactly how much loutish behavior a group will tolerate before throwing the selfish out. What they discovered is far more interesting:

…we also observed a completely unanticipated and, we argue, more interesting result: Those who give much to the group effort yet take little of its subsequent reward are not applauded but rather targeted for expulsion. The effect was replicated across three subsequent studies. Two of these studies ruled out some rather mundane explanations for the finding (lack of understanding of the task by the benevolent other, the other behaving unpredictably), and a third suggested that people are motivated to expel the benevolent other either for self-image reasons or because the other is not adhering to common rules of behavior. In this article, we report on this series of studies.

What the hell. The authors go on to attempt to explain why:

These data, then, provide potential explanations for why people want to remove a benevolent individual from the group. In some cases, the individual makes others feel they look bad in comparison, and, in other cases, the person is seen as violating rules of social interaction for mixed-motive situations. As we solicited these explanations after the expulsion preference had been stated, it is certainly possible that they represent not motivations for removing a benevolent other but rather rationalizations for why subjects want the benevolent person removed.

If you were looking for an empiric basis for the “Keep the government’s hands off my Medicare” red state, federal subsidy dependent elderly white teapartier, this is a good place to start.

After years of struggle, and some truly distressing failures, this is the one and only successful HIV vaccine trial.

It was definitely took an odd approach. Take two failed vaccines, combine them together, and see if they’ll work. The first vaccine stuffed into a tamed Canarypox virus some of the critical functional proteins of the HIV virus. (Canarypox is in the same broad family of viruses that includes Smallpox. Birds are the desired home of Canarypox; it’s capable of getting into human cells, but not properly replicating itself once in. As such, it has the ideal vaccine combination of really pissing off the human immune system while being incapable of causing injury.) The second, booster, vaccine was simply some of the purified and isolated surface protein (gp120) from the HIV virus. (This booster vaccine is a bit like going around the human immune system with a mugshot of the HIV virus. The isolated protein is incapable of causing disease, but gives the whiff of what the real deal is like.) When the study was first proposed, parts of the scientific community were non-plussed. Isn’t zero times zero still zero?

Nope, it’s one third. What do you do with a vaccine that only works sometimes, or only for some? For a vaccine to be considered clinically useful (i.e, after the shots are done, you can feel confident in telling someone they are vaccinated and protected against the infection), you’d hope to have at least 70-80% of those vaccinated to be protected. (Herd immunity takes care of the rest of the risk, eventually.) Further, this vaccine combination (bizarrely) failed to produce neutralizing antibodies even in the successfully vaccinated.

For the next few months and years, the results of this study will be torn into, trying to answer some of these questions. In the meantime, this is an extremely heartening sign–indicating a real potential to salvage other failed vaccines into successful combination therapies.

Surplus power generated in one interconnection, at this time, cannot be transferred to another. Further, the parts of the continent most promising for wind, solar and geothermal power (i.e. the greenest power choices available right now) are far from where the bulk of power is consumed (the East and West coasts).

Enter the Tres Amigas project–a plant build a superconducting triangle of powerlines to connect these three grids. Using high temperature superconductors allows the power to be transmitted as direct current with similar efficiencies to alternating current. (Mashing together alternating currents from disparate grids is quite problematic, due to issues of phase. Using DC to connect the grids alleviates this problem. Superconductors alleviate some of the inefficiencies of transmitting DC over long distances.)

This is good news from the perspective of green energy. Connecting the East and West coasts to the areas most promising for wind and solar power will boost the economic viability of such projects in the near future. In the negative, this allows for all sorts of new games to be played by energy traders in the largely unregulated energy market.

There really isn’t much to debate.

The US healthcare system, in its present state, is a failure. It fails those with and without coverage. We spend more, care for fewer and are sicker than the citizens of any other industrialized nation.

We’ve studied it. Americans of all socioeconomic strata are less healthy on every measured basis than their UK counterparts–before or after adjusting for the less healthy lifestyles of Americans. Putting it even more bluntly, the richest Americans, lavished with the finest private health insurance our nation can muster, in the epicenter of global medical and biological research, have more diabetes and higher blood pressure than the poorest of English citizens. Even within our country, Americans within the Veterans Affairs system, a little socialized corner of our healthcare system, are similarly healthier than their privately insured doppelgangers.

As far as the uninsured in this country, an unprecedented phenomenon in the industrial world, allow the independent Institute of Medicine to state the case:

Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage.

The case for socialized medicine in this country has been made, and it has won. Back in June of this year, an overwhelming supermajority of Americans were in favor of a public health plan option. After the long summer–filled with hideous farces of Town Hall meetings, Teabaggers and endless anti-reform propaganda–support remained at supermajority levels. The Senate vote on the package seems to be a fait accompli.

The core of the opposition is an all out appeal to selfishness. Think of the taxes you’ll pay. Seniors, think of what you’ll be forced to share with those younger than you. You might have to wait in line for care if anyone can get it. The hideous core throbbing at the center of all this summer’s hysterics is the toddlerization of Americans as selfish and self-centered consumers–relentlessly stripped of any sort of adult notions of empathy, responsibility for others, investment in the future or delayed gratification. The whole movement has been lead by paid-for shills for the moneyed interests endangered by healthcare reform.

The mob of mooks compelled by these appeals to selfishness–capable only of braying about ‘socialism’ and ‘the constitution’ with no sense of what either really represents–are the rhetorical equivalent of suicide bombers. This summer’s protests reminded me of nothing less than Kermit Roosevelt‘s handiwork, undoing Mosaddeq’s attempt to nationalize the Iranian oil industry. The intent was to drive terror into the hearts of the elected representatives Democratic supermajority–to generate the illusion of mass discontent. The absurdity of the arguments posed at the Town Halls–Death Panels! Marxism! Obama is Hitler for trying to provide Americans with healthcare!–was the entire point. The feeling of being strapped to a bomb generated by having these cretinous and credulous fools
as countrymen is best diffused by ignoring it as bad theater.

It’s worth considering why American doctors are so expensive, where the costs of drugs and medical devices arise. Healthcare reform is, astonishingly enough after nearly a century of struggle, about to happen. These are the points we should be debating and struggling with as the end details are being written.

Layers of cost build up as we dive deeper and deeper into the life of a medical drug or device. At the shallowest depths are the most obvious additions to costs, the vast sums of money spent on marketing to consumers and doctors alike. Next down are the costly FDA trials, phase I, II and III that must be completed before a medical device or drug comes to market; it’s these studies that also ensure safety and efficacy. At the beating heart of all of this, typically, is in an idea from a publicly funded academic research lab.

The basic biological research done in the United States is the envy of the world. From the investments of the National Institutes of Health (NIH) an the National Science Foundation (NSF) and even more esoteric government sources (the Department of Energy largely bankrolled the Human Genome Project), legions of academic labs have been pumping out the foundation of the medical revolutions of the past few decades. The massive, freely accessible and well-curated libraries of genes, genomes, proteins and even entire metabolic pathways were built through US government funding. Simply put, it would not be possible to do modern biological or medical research at any level without these tools. It’s from these laboratories that we know how, say, cholesterol is absorbed, made processed, eliminated and even turned pathologic in the human body. This knowledge is how drug companies figure out how to test new drugs, measure their effects and safety.

It’s at this level, in academic labs, where the epiphanies behind new devices and meds occur. The discovery of a new pathway, the teasing apart of a bit of physiology, or simply a new understanding why some are protected from disease when others are not all lead to ideas of new drugs and devices. If it’s a really good idea, if the potential seems ripe, it becomes the core of a startup company.

The idea is teased out. If it really looks good in animals, the phase I human trials start at about this point. (Phase I trials are small scale, and focused on establishing safety and reasonable doses or ways of application.) Money is raised (the first big cut of cash taken by the parasitic financial industry). Most often, the goal is to make the idea look good enough for one of the supersized biotech companies (essentially a pile of money and lawyers blended into the equivalent of the Borg cube) to buy up the whole company, idea and all. (The next major step where the financial industry takes a cut.) Somewhere about this point, Phase II human trials begin (small scale, but now focused on both safety and efficacy.)

The last step before a drug or device can be sold is a phase III human trial, large scale and required to statistically demonstrate in a randomized and controlled trial efficacy and safety of the new idea. A typical phase III trial costs ring up at about a billion dollars. Only the Borg-cube level of biotech can really take them on. For a genuinely new idea–an entirely new kind of drug or device–this is the riskiest step. All sorts of unexpected things happen–sometimes for the better, sometimes for the worst. (Both Minoxidil and Viagra started as entirely new blood pressure pills; they worked terribly at controlling blood pressure, but excellently at helping old men feel better about themselves.) The payoff is an exclusive, time-limited, patent. For a new drug or device that genuinely solves a large and unaddressed problem, this adds up to tens of billions of dollars over the ensuing years of legalized monopoly.

The patents for drugs work as the founders intended; they’re just long enough to make the investment worth it, but not so long as to prevent real competition forming while the drugs are still useful. Generic drugs are those that have gone through this whole process, and been on the market long enough for their patent to expire. These copycats mimic the molecular structure of a drug already proven through the phase I, II and III human trials by someone else. Without the R&D costs (or marketing costs), they become instantly cheaper than their parents.

Most drugs on the market today, including new drugs, are actually based on old ideas. Prozac was followed by a dozen or so drugs that work in the same way. (Viagria was followed by Cialis and Levitra.) It’s here where consumers get soaked. As soon as a lucrative drug is about to go off patent, the parent biotech company will typically come out with a new, improved (in some minor way) version. The repeated phase III trial tends to be much cheaper, and with a near certain outcome. The new drug is then relentlessly marketed, driving as many customers as possible away from the imminent generic competition. For the big biotech companies (heavy on money and lawyers, light on genuine risk taking science), developing new ideas isn’t a strength. Instead, they devote vast sums of money into promoting these derivatives, certain that the government funded labs will keep churning out new ideas worth picking off in the future.

In a somewhat ugly way, the whole process works surprisingly well. At this point, most of the drugs most of us will need to take (statins like simbastatin to reduce cholesterol, ACE receptor antagonists and HCZ for blood pressure, SSRIs for depression) are available in generic form. They work well, are cheap and safe. Find a doctor who still reads, and doesn’t have to learn about new drugs from a rep paid to tout the newest (but not necessarily meaningfully better) and more expensive drug, and you can game it all fairly well. That’s to say, the problem of expensive drugs and devices is as much one of this system as that of the poor continuing medical education of many physicians.

The average family medicine doctor in the United States pulls down about $200,000 a year. The average internist or pediatrician earns about $175,000 a year. A general surgeon earns about $290,000 a year.

In comparison, a primary care physician (comparable to an internist, family doc or pediatrician) in the UK, under the NHS, earns between £53,249 to £80,354, about $90,000 to $130,000 at current currency rates.

The salaries of American doctors are huge, terrifying, for anyone trying to bring down health care costs in the United States. Why are American doctors so damn expensive? Medical school is a big part of the answer.

Per the American Association of Medical Colleges (AAMC), the median cost per year (tuition, fees and health insurace) to attend a private medical school in 2008 was a whopping $42,622. Public medical schools were only slightly cheaper, $41,429 for out-of-state and $22,984 for residents.

Add in at least $15,000 a year in living expenses, and the cost of a four-year bachelor’s degree and a newly minted medical student in the United States is easily hauling around three-quarters of a million dollars of debt by time they saunter out with an MD degree. The obligate first job of any medical school graduate is residency, typically a brutal three to five years of work, paying about $40,000 a year.

Running right down the median costs, paying off that $800,000 or so in debt (financed at about 5% a year) over the next thirty years of work eats up about $4300 a month; paying it off in ten years would cost nearly $8500 a month. A pediatrician or internist can expect to make about $14500 a month before tax; paying off this debt over thirty years will cost them about a third of their gross income. About half of that money will go to the financial services industry, in the form of interest.

If you want physician’s salaries to come down in the United States, without a true reduction in physician compensation, the natural choice would be to aggressively subsidize medical education and ensure young doctors come out of school carrying much less debt. A small amount of public investment up front will reduce a massive and ongoing source of inefficiency in the American medical system.

Ah, turfed. Allow me to introduce you to one of the cherished terms of medical care in the United States. You turf difficult, or undesirable, patients to someone else. The insurance industry has succeeded, more than anything else, at transmitting this hatred and fear of sick people down to the lowliest depths of the health care system–from the mightiest administrator to the lowliest medical student.

People with easily treated maladies–high blood pressure, high cholesterol, high blood sugar and so on–go untreated (despite the huge potential long-term benefits from cheap therapy) because the entire health care system hates the ill with a deep and embittered passion.

Let’s think for a moment what the product of health insurance entails. For a fee, a company will pay your medical costs for a fixed period of time. These contracts are never lifetime–often they are annual. The multitude of insurance companies offering these contracts operate in a genuine market. Being efficient–successful–in such a market means figuring out any way to avoid providing healthcare costs, avoiding providing care. If you know you’ll only be writing a short-term contract, caring about long-term cost savings is a totally losing move.

The market has worked well: Insurance companies (for profit or non-profit) have proliferated a multitude of caps, fees, co-pays, deductibles and ‘preferred provider’ lists all oriented on reducing short term costs, regardless of consequence. The very concept of a “pre-existing condition” was generated to prevent sick people from becoming customers, and whole mechanisms have developed to kick people out of their contracts if they become ill. The better the market for health insurance works, the more these mechanisms become inevitable.

A big part of the proposed reforms floating around congress are attempts to subvert these market forces without fundamentally changing the nature of the market. Laws preventing exclusion based on pre-existing conditions or dropping people from plans due to illness seem like obvious ways to improve the situation. But the dynamic will remain, and the clever people at insurance companies will come up with new ways to turf those who need care that tip-toe right up to the new lines being drawn.

The great turf in the sky, right now, is Medicare. All of us, when we hit that magical age, become eligible. A public option, as proposed and under fire as a part of this reform, would probably end up serving a similar role: a government-chartered floor beneath which no American could fall. Stuck with these patients for the rest of their lives, suddenly the dynamic would change. Any clever administrator of a public option health plan would be tremendously motivated to provide preventative care; success of such a plan would be contingent on reducing long-term, not short-term, costs.

A model for such a plan already exists–the Veterans Affairs system. Patients in that socialized American health care system are demonstrably and objectively healthier than their privately insured compatriots in every measurable way.

Barring requiring private insurers to cover people for the rest of their lifetimes, there is no other way to achieve a similar focus on long-term health and cost-reduction than a public plan.

Science can help. First up, the ideal gas law: PV = nRT. (It’s pronounced peev-nert. Say that to your friendly local mechanical engineer and you’ll likely receive a ’8.31, yo!’ back in return. Plus or minus a fist pump, or high five. Know you’ve done well.)

You probably know this law, at least in a practical sense. Think of the last time you’ve used an aerosol spray can. After a while, it gets cold. Decompressing a gas (from high pressure inside the can to relatively low pressure in the air) requires adding some heat to the gas. The heat is taken from the surrounding environment. The can gets cold. On the flip side, think of the last time you filled up a tire with air. As you compress air into the tire, it gets hot. Compressed gasses need to give off some heat, making the surroundings hotter.

You can think about the molecules in a gas as being like a class worth of kindergartners. At low pressure, it’s like they’re at recess–each running around like a hyperactive lunatic. When compressed, gasses are more like the kids sitting quietly around at story time; some fidgeting is going on, but each must be calmer and closer together. Pressurizing a gas from recess to story time requires a whole bunch of hyperactivity energy to be blown off.

Compressing gasses gives off energy as heat. Decompressing gasses absorbs heat. Air conditioners do this in a constant loop. Inside your house, a gas is depressurized, absorbing heat from the room in the process, cooling the air. The low pressure gas is then pumped outside. Outside, the gas is compressed, releasing the heat energy taken from inside. Then it heads back in. Over and over again.

But this is the 1960′s. Computers are HUGE. Yes, yes, transistors had been invented years before–and are now in wide use. So, at least we’re not talking vacuum tubes. Egads. Tubes! Building computers means wiring a whole bunch of these transistors together. With wire. In other words, the world’s finest computers look a bit like that box of Christmas lights you don’t want to think about in the basement: tangled, ugly, mean and prone to failure if jostled. Not exactly conducive to placement in a rocket.

No biggie, you think. You’ll just have the computer on Earth–nice solid earth–radioing back and forth to the sensors and engines in the rocket. You can even correct for the speed-of-light delays! Problem solved! Light up some Lucky Strikes and call it a day.

But then you think of the return burn. If the Apollo craft are going to get out of lunar orbit and return to Earth, they’re going to need to fire the rocket engine on the far side of the Moon–you know, where radio waves can’t reach. Crap. I guess you’ll have to figure out a way of wiring together all those (4000 or so, egads!) transistors in a way that is small, light and durable enough to survive being rocketed into space. Time to create the first integrated circuit computer–father of every damn computer most of us have used, ever.

Better call MIT.

For the first time, scientists working on NASA’s Cassini mission have detected sodium salts in ice grains of Saturn’s outermost ring. Detecting salty ice indicates that Saturn’s moon Enceladus, which primarily replenishes the ring with material from discharging jets, could harbor a reservoir of liquid water — perhaps an ocean — beneath its surface.

Such an ocean would vastly increase the chance of life elsewhere in our solar system, beyond our own planet.