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The Healthcare Fix: Universal Insurance for All Americans (The\mit Press Ser.)
by Laurence J. KotlikoffA simple, straightforward, and foolproof proposal for universal health insurance from a noted economist.The shocking statistic is that forty-seven million Americans have no health insurance. When uninsured Americans go to the emergency room for treatment, however, they do receive care, and a bill. Many hospitals now require uninsured patients to put their treatment on a credit card which can saddle a low-income household with unpayably high balances that can lead to personal bankruptcy. Why don't these people just buy health insurance? Because the cost of coverage that doesn't come through an employer is more than many low- and middle-income households make in a year. Meanwhile, rising healthcare costs for employees are driving many businesses under. As for government-supplied health care, ever higher costs and added benefits (for example, Part D, Medicare's new prescription drug coverage) make both Medicare and Medicaid impossible to sustain fiscally; benefits grow faster than the national per-capita income. It's obvious the system is broken. What can we do?In The Healthcare Fix, economist Laurence Kotlikoff proposes a simple, straightforward approach to the problem that would create one system that works for everyone and secure America's fiscal and economic future. Kotlikoff's proposed Medical Security System is not the "socialized medicine" so feared by Republicans and libertarians; it's a plan for universal health insurance. Because everyone would be insured, it's also a plan for universal healthcare. Participants—including all who are currently uninsured, all Medicaid and Medicare recipients, and all with private or employer-supplied insurance—would receive annual vouchers for health insurance, the amount of which would be based on their current medical condition. Insurance companies would willingly accept people with health problems because their vouchers would be higher. And the government could control costs by establishing the values of the vouchers so that benefit growth no longer outstrips growth of the nation's per capita income. It's a "single-payer" plan, but a single payer for insurance. The American healthcare industry would remain competitive, innovative, strong, and private.Kotlikoff's plan is strong medicine for America's healthcare crisis, but brilliant in its simplicity. Its provisions can fit on a postcard and Kotlikoff provides one, ready to be copied and mailed to your representative in Congress.
Wednesday Is Indigo Blue: Discovering the Brain of Synesthesia
by Richard E. Cytowic David M. EaglemanHow the extraordinary multisensory phenomenon of synesthesia has changed our traditional view of the brain.A person with synesthesia might feel the flavor of food on her fingertips, sense the letter “J” as shimmering magenta or the number “5” as emerald green, hear and taste her husband's voice as buttery golden brown. Synesthetes rarely talk about their peculiar sensory gift—believing either that everyone else senses the world exactly as they do, or that no one else does. Yet synesthesia occurs in one in twenty people, and is even more common among artists. One famous synesthete was novelist Vladimir Nabokov, who insisted as a toddler that the colors on his wooden alphabet blocks were “all wrong.” His mother understood exactly what he meant because she, too, had synesthesia. Nabokov's son Dmitri, who recounts this tale in the afterword to this book, is also a synesthete—further illustrating how synesthesia runs in families. In Wednesday Is Indigo Blue, pioneering researcher Richard Cytowic and distinguished neuroscientist David Eagleman explain the neuroscience and genetics behind synesthesia's multisensory experiences. Because synesthesia contradicted existing theory, Cytowic spent twenty years persuading colleagues that it was a real—and important—brain phenomenon rather than a mere curiosity. Today scientists in fifteen countries are exploring synesthesia and how it is changing the traditional view of how the brain works. Cytowic and Eagleman argue that perception is already multisensory, though for most of us its multiple dimensions exist beyond the reach of consciousness. Reality, they point out, is more subjective than most people realize. No mere curiosity, synesthesia is a window on the mind and brain, highlighting the amazing differences in the way people see the world.
Selfless Insight: Zen and the Meditative Transformations of Consciousness
by James H. AustinAttention, self-consciousness, insight, wisdom, emotional maturity: how Zen teachings can illuminate the way our brains function and vice-versa. When neurology researcher James Austin began Zen training, he found that his medical education was inadequate. During the past three decades, he has been at the cutting edge of both Zen and neuroscience, constantly discovering new examples of how these two large fields each illuminate the other. Now, in Selfless Insight, Austin arrives at a fresh synthesis, one that invokes the latest brain research to explain the basis for meditative states and clarifies what Zen awakening implies for our understanding of consciousness. Austin, author of the widely read Zen and the Brain, reminds us why Zen meditation is not only mindfully attentive but evolves to become increasingly selfless and intuitive. Meditators are gradually learning how to replace over-emotionality with calm, clear objective comprehension. In this new book, Austin discusses how meditation trains our attention, reprogramming it toward subtle forms of awareness that are more openly mindful. He explains how our maladaptive notions of self are rooted in interactive brain functions. And he describes how, after the extraordinary, deep states of kensho-satori strike off the roots of the self, a flash of transforming insight-wisdom leads toward ways of living more harmoniously and selflessly. Selfless Insight is the capstone to Austin's journey both as a creative neuroscientist and as a Zen practitioner. His quest has spanned an era of unprecedented progress in brain research and has helped define the exciting new field of contemplative neuroscience.
Chaos and Organization in Health Care
by Thomas H. Lee James J. MonganTwo leading physicians' prescription for solving our health care problems: organizing the fragmented system that delivers care. One of the most daunting challenges facing the new U.S. administration is health care reform. The size of the system, the number of stakeholders, and ever-rising costs make the problem seem almost intractable. But in Chaos and Organization in Health Care, two leading physicians offer an optimistic prognosis. In their frontline work as providers, Thomas Lee and James Mongan see the inefficiency, the missed opportunities, and the occasional harm that can result from the current system. The root cause of these problems, they argue, is chaos in the delivery of care. If the problem is chaos, the solution is organization, and in this timely and outspoken book, they offer a plan.In many ways, this chaos is caused by something good: the dramatic progress in medical science—the explosion of medical knowledge and the exponential increase in treatment options. Imposed on a fragmented system of small practices and individual patients with multiple providers, progress results in chaos. Lee and Mongan argue that attacking this chaos is even more important than whether health care is managed by government or controlled by market forces. Some providers are already tightly organized, adapting management principles from business and offering care that is by many measures safer, better, and less costly. Lee and Mongan propose multiple strategies that can be adopted nationwide, including electronic medical records and information systems for sharing knowledge; team-based care, with doctors and other providers working together; and disease management programs to coordinate care for the sickest patients.
Toward the Healthy City: People, Places, and the Politics of Urban Planning (Urban and Industrial Environments)
by Jason CorburnA call to reconnect the fields of urban planning and public health that offers a new decision-making framework for healthy city planning.In distressed urban neighborhoods where residential segregation concentrates poverty, liquor stores outnumber supermarkets, toxic sites are next to playgrounds, and more money is spent on prisons than schools, residents also suffer disproportionately from disease and premature death. Recognizing that city environments and the planning processes that shape them are powerful determinants of population health, urban planners today are beginning to take on the added challenge of revitalizing neglected urban neighborhoods in ways that improve health and promote greater equity. In Toward the Healthy City, Jason Corburn argues that city planning must return to its roots in public health and social justice. The first book to provide a detailed account of how city planning and public health practices can reconnect to address health disparities, Toward the Healthy City offers a new decision-making framework called “healthy city planning” that reframes traditional planning and development issues and offers a new scientific evidence base for participatory action, coalition building, and ongoing monitoring. To show healthy city planning in action, Corburn examines collaborations between government agencies and community coalitions in the San Francisco Bay area, including efforts to link environmental justice, residents' chronic illnesses, housing and real estate development projects, and planning processes with public health. Initiatives like these, Corburn points out, go well beyond recent attempts by urban planners to promote public health by changing the design of cities to encourage physical activity. Corburn argues for a broader conception of healthy urban governance that addresses the root causes of health inequities.
Democratizing Innovation: Reproductive Health And The Environment (The\mit Press Ser.)
by Eric Von HippelThe process of user-centered innovation: how it can benefit both users and manufacturers and how its emergence will bring changes in business models and in public policy.Innovation is rapidly becoming democratized. Users, aided by improvements in computer and communications technology, increasingly can develop their own new products and services. These innovating users—both individuals and firms—often freely share their innovations with others, creating user-innovation communities and a rich intellectual commons. In Democratizing Innovation, Eric von Hippel looks closely at this emerging system of user-centered innovation. He explains why and when users find it profitable to develop new products and services for themselves, and why it often pays users to reveal their innovations freely for the use of all.The trend toward democratized innovation can be seen in software and information products—most notably in the free and open-source software movement—but also in physical products. Von Hippel's many examples of user innovation in action range from surgical equipment to surfboards to software security features. He shows that product and service development is concentrated among "lead users," who are ahead on marketplace trends and whose innovations are often commercially attractive.Von Hippel argues that manufacturers should redesign their innovation processes and that they should systematically seek out innovations developed by users. He points to businesses—the custom semiconductor industry is one example—that have learned to assist user-innovators by providing them with toolkits for developing new products. User innovation has a positive impact on social welfare, and von Hippel proposes that government policies, including R&D subsidies and tax credits, should be realigned to eliminate biases against it. The goal of a democratized user-centered innovation system, says von Hippel, is well worth striving for. An electronic version of this book is available under a Creative Commons license.
Brain and Culture: Neurobiology, Ideology, and Social Change
by Bruce E. WexlerChoice Outstanding Academic Title, 2007. Research shows that between birth and early adulthood the brain requires sensory stimulation to develop physically. The nature of the stimulation shapes the connections among neurons that create the neuronal networks necessary for thought and behavior. By changing the cultural environment, each generation shapes the brains of the next. By early adulthood, the neuroplasticity of the brain is greatly reduced, and this leads to a fundamental shift in the relationship between the individual and the environment: during the first part of life, the brain and mind shape themselves to the major recurring features of their environment; by early adulthood, the individual attempts to make the environment conform to the established internal structures of the brain and mind. In Brain and Culture, Bruce Wexler explores the social implications of the close and changing neurobiological relationship between the individual and the environment, with particular attention to the difficulties individuals face in adulthood when the environment changes beyond their ability to maintain the fit between existing internal structure and external reality. These difficulties are evident in bereavement, the meeting of different cultures, the experience of immigrants (in which children of immigrant families are more successful than their parents at the necessary internal transformations), and the phenomenon of interethnic violence. Integrating recent neurobiological research with major experimental findings in cognitive and developmental psychology--with illuminating references to psychoanalysis, literature, anthropology, history, and politics--Wexler presents a wealth of detail to support his arguments. The groundbreaking connections he makes allow for reconceptualization of the effect of cultural change on the brain and provide a new biological base from which to consider such social issues as "culture wars" and ethnic violence.
Transcranial Magnetic Stimulation: A Neurochronometrics of Mind
by Vincent Walsh Stephen M. Kosslyn Álvaro Pascual-LeoneThe mainstays of brain imaging techniques have been positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and event-related potentials (ERPs). These methods all record direct or indirect measures of brain activity and correlate the activity patterns with behavior. But to go beyond the correlations established by these techniques and prove the necessity of an area for a given function, cognitive neuroscientists need to be able to reverse engineer the brain--i.e., to selectively remove components from information processing and assess their impact on the output. This book is about transcranial magnetic stimulation (TMS), a technique that emerged during the same period as neuroimaging and has made it possible to reverse engineer the human brain's role in behavioral and cognitive functions. The subject areas that can be studied using TMS run the gamut of cognitive psychology--attention, perception, awareness, eye movements, action selection, memory, plasticity, language, numeracy, and priming. The book presents an overview of historical attempts at magnetic brain stimulation, ethical considerations of the technique's use, basic technical and practical information, the results of numerous TMS studies, and a discussion of the future of TMS in the armamentarium of cognitive neuropsychology.
The Computational Neurobiology of Reaching and Pointing: A Foundation for Motor Learning
by Reza Shadmehr Steven P. WiseThis book presents an introduction to the computational neurobiology of reaching and pointing--with emphasis on motor learning in primates--based on an eclectic selection of topics.
The Psychology of Art and the Evolution of the Conscious Brain
by Robert L. SolsoHow did the human brain evolve so that consciousness of art could develop? In The Psychology of Art and the Evolution of the Conscious Brain, Robert Solso describes how a consciousness that evolved for other purposes perceives and creates art.
The Mind Within the Net: Models of Learning, Thinking and Acting
by Manfred SpitzerIn The Mind within the Net, Manfred Spitzer shows how these models can fundamentally change how we think about learning, creativity, thinking, and acting, as well as such matters as schools, retirement homes, politics, and mental disorders.
Building Genetic Medicine: Breast Cancer, Technology, and the Comparative Politics of Health Care
by Shobita ParthasarathyAuthor shows how, even in an era of globalization, national context is playing an important role in the development and use of genetic technologies. Focusing on the development and deployment of genetic testing for breast and ovarian cancer in the U.S and Britain, author develops a comparative analysis framework.
The Health of Nations: Infectious Disease, Environmental Change, and Their Effects on National Security and Development
by Andrew T. Price-SmithSmith investigates the influence of infectious disease on nations' stability and prosperity. He also provides a theoretical and empirical foundation for the emerging field of health security.
Psychiatry in the Scientific Image
by Dominic MurphyIn "Psychiatry in the Scientific Image," Dominic Murphy looks at psychiatry from the viewpoint of analytic philosophy of science, considering three issues: how we should conceive of, classify, and explain mental illness.
Case Studies in Biomedical Research Ethics
by Timothy F. MurphyThis textbook for instruction in biomedical research ethics can also serve as a valuable reference for professionals in the field of bioethics. The 149 cases included in the book are grouped in nine chapters, each of which covers a key area of debate in the field. Some of the case studies are classics, including the famous cases of the Tuskegee Syphilis Study (in which subjects with syphilis were not given treatment) and the Willowbrook hepatitis studies (in which institutionalized subjects were intentionally exposed to hepatitis). Others focus on such current issues as human embryonic stem cell research, cloning by somatic nuclear transfer, and the design and function of institutional review boards. Each chapter begins with a brief introduction that places the issues raised in context; this is followed by a number of cases (each of which is no more than a few pages). Study questions meant to encourage further discussion follow each case. After an introductory discussion of the history and tenets of ethics in medical research, the book's chapters cover the topics of oversight and study design; informed consent; the selection of subjects; conflicts of interest; the social effects of research; embryos, fetuses, and children; genetic research; the use of animals; and authorship and publication. Following these chapters are appendixes with the texts of the Nuremburg Code and the World Declaration of Geneva, two key documents in the establishment of bioethical standards for research. Also included are a glossary, a table of cases by general category, and an alphabetical listing of cases.
Self-Trust and Reproductive Autonomy
by Carolyn McleodThe power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom.
Conflicts of Conscience in Health Care: An Institutional Compromise
by Holly Fernandez LynchIn Conflicts of Conscience in Health Care, Holly Fernandez Lynch finds a way around the polarizing rhetoric associated with this issue by proposing a compromise that protects both a patient access to care and a physician's ability to refuse.
The Healthcare Fix: Universal Insurance for All Americans
by Laurence J. KotlikoffKotlikoff proposes a simple, straightforward approach to the problem that would create one system that works for everyone and secure America's fiscal and economic future. His proposed Medical Security System is not the socialized medicine so feared by Republicans and libertarians.
Bioethics: Ancient Themes in Contemporary Issues
by Mark G. Kuczewski Ronald M. PolanskyThis collection of essays explores themes from ancient Greek philosophy and medicine and their implications for contemporary medicine and bio-medical ethics. Thus the work examines the relationship of two of the most popular areas in the current revival of ethics, namely, classical ethics and biomedical ethics--areas that have seldom been brought together in any serious or sustained way. The essays in this volume are written by established classical scholars and bioethicists.
Decisions, Uncertainty, and the Brain
by Paul W. GlimcherWinner in the category of Medical Science in the 2003 Professional/Scholarly Publishing Annual Awards Competition presented by the Association of American Publishers, Inc. In this provocative book, Paul Glimcher argues that economic theory may provide an alternative to the classical Cartesian model of the brain and behavior. Glimcher argues that Cartesian dualism operates from the false premise that the reflex is able to describe behavior in the real world that animals inhabit. A mathematically rich cognitive theory, he claims, could solve the most difficult problems that any environment could present, eliminating the need for dualism by eliminating the need for a reflex theory. Such a mathematically rigorous description of the neural processes that connect sensation and action, he explains, will have its roots in microeconomic theory. Economic theory allows physiologists to define both the optimal course of action that an animal might select and a mathematical route by which that optimal solution can be derived. Glimcher outlines what an economics-based cognitive model might look like and how one would begin to test it empirically. Along the way, he presents a fascinating history of neuroscience. He also discusses related questions about determinism, free will, and the stochastic nature of complex behavior.
Sex and the Brain
by Gillian EinsteinThis collection of foundational papers on sex differences in the brain traces the development of a much-invoked, fast-growing young field at the intersection of brain and behavior. The reader is introduced to the meaning and nature of sexual dimorphisms, the mechanisms and consequences of steroid hormone action, and the impact of the field on interpretations of sexuality and gender. Building on each other in point-counterpoint fashion, the papers tell a fascinating story of an emerging science working out its core assumptions. Experimental and theoretical papers, woven together by editor's introductions, open a window onto knowledge in the making and a vigorous debate between reductionist and pluralist interpreters. Five major sections include papers on conceptual and methodological background, central nervous system dimorphisms, mechanisms for creating dimorphisms, dimorphisms and cognition, and dimorphisms and identity. Each section builds from basic concepts to early experiments, from experimental models to humans, and from molecules to mind. Papers by such leading scholars as Arthur Arnold, Frank Beach, Anne Fausto-Sterling, Patricia Goldman-Rakic, Doreen Kimura, Simon LeVay, Bruce McEwen, Michael Merzenich, Bertram O'Malley, Geoffrey Raisman, and Dick Swaab, illustrate a rich blend of perspectives, approaches, methods, and findings. Sex and the Brainwill show students how a scientific paper can be analyzed from many perspectives, and supply them with critical tools for judging a rapidly emerging science in a contentious area.
Neural Engineering: Computation, Representation, and Dynamics in Neurobiological Systems
by Chris Eliasmith Charles H. AndersonFor years, researchers have used the theoretical tools of engineering to understand neural systems, but much of this work has been conducted in relative isolation. In Neural Engineering, Chris Eliasmith and Charles Anderson provide a synthesis of the disparate approaches current in computational neuroscience, incorporating ideas from neural coding, neural computation, physiology, communications theory, control theory, dynamics, and probability theory. This synthesis, they argue, enables novel theoretical and practical insights into the functioning of neural systems. Such insights are pertinent to experimental and computational neuroscientists and to engineers, physicists, and computer scientists interested in how their quantitative tools relate to the brain. The authors present three principles of neural engineering based on the representation of signals by neural ensembles, transformations of these representations through neuronal coupling weights, and the integration of control theory and neural dynamics. Through detailed examples and in-depth discussion, they make the case that these guiding principles constitute a useful theory for generating large-scale models of neurobiological function. A software package written in MatLab for use with their methodology, as well as examples, course notes, exercises, documentation, and other material, are available on the Web.
Cannabinoids and the Brain
by Linda A. ParkerThe cannabis plant has been used for recreational and medicinal purposes for more than 4,000 years, but the scientific investigation into its effects has only recently yielded useful results. In this book, Linda Parker offers a review of the scientific evidence on the effects of cannabinoids on brain and behavioral functioning, with an emphasis on potential therapeutic uses. Parker describes the discovery of tetrahydocannbinol (THC), the main psychoactive component of cannabis, and the further discovery of cannabinoid receptors in the brain. She explains that the brain produces chemicals similar to THC, which act on the same receptors as THC, and shows that the endocannabinoid system is involved in all aspects of brain functioning. Parker reports that cannabis contains not only the psychoactive compound THC, but also other compounds of potential therapeutic benefit, and that one of them, cannabidiol (CBD), shows promise for the treatment of pain, anxiety, and epilepsy. Parker reviews the evidence on cannabinoids and anxiety, depression, mood, sleep, schizophrenia, learning and memory, addiction, sex, appetite and obesity, chemotherapy-induced nausea, epilepsy, and such neurodegenerative disorders as multiple sclerosis and Alzheimer's Disease. Each chapter also links the scientific evidence to historical and anecdotal reports of the medicinal use of cannabis. As debate about the medical use of marijuana continues, Parker's balanced and objective review of the fundamental science and potential therapeutic effects of cannabis is especially timely.
Health Economics
by Chee-Ruey Hsieh Frank A. SloanThis book introduces students to the growing research field of health economics. Rather than offer details about health systems without providing a theoretical context, Health Economics combines economic concepts with empirical evidence to enhance readers' economic understanding of how health care institutions and markets function. The theoretical and empirical approaches draw heavily on the general field of applied microeconomics, but the text moves from the individual and firm level to the market level to a macroeconomic view of the role of health and health care within the economy as a whole. The book takes a global perspective, with description and analysis of institutional features of health sectors in countries around the world. This second edition has been updated to include material on the U.S. Patient Protection and Affordable Care Act, material on the expansion of health insurance in Massachusetts, and an evaluation of Oregon's Medicaid expansion via lottery. The discussion of health care and health insurance in China has been substantially revised to reflect widespread changes there. Tables and figures have been updated with newly available data. Also new to this edition is a discussion of the health economics literature published between 2010 and 2015. The text includes readings, extensive references, review and discussion questions, and exercises. A student solutions manual offers solutions to selected exercises. Downloadable supplementary material is available for instructors.
Ebola's Message: Public Health and Medicine in the Twenty-First Century
by Nicholas G. Evans Maimuna S. Majumder Tara C. SmithThe 2013--2015 outbreak of the Ebola virus disease (EVD) was a public health disaster: 28,575 infections and 11,313 deaths (as of October 2015), devastating the countries of Guinea, Liberia, and Sierra Leone; a slow and mismanaged international response; and sensationalistic media coverage, seized upon by politicians to justify wrongheaded policy. And yet there were also promising developments that may improve future responses to infectious disease epidemics: the UN Security Council's first involvement in a public health event; a series of promising clinical treatments and vaccines for EVD; and recognition of the need for a global public health system to deal with epidemics that cross national borders. This volume offers a range of perspectives on these and other lessons learned, with essays on the science, politics, and ethics of the Ebola outbreak.The contributors discuss topics including the virology and management of EVD in both rich and poor nations; the spread of the disease (with an essay by a leader of Médecins Sans Frontières); racist perceptions of West Africa; mainstream and social media responses to Ebola; and the ethical issue of whether to run clinical trials of experimental treatments during an outbreak. ContributorsChristian L. Althaus, Daniel G. Bausch, Adia Benton, Michael J. Connor, Jr., Kim Yi Dionne, Nicholas G. Evans, Morenike Oluwatoyin Folayan, Stephen Goldstein, Bridget Haire, Patricia C. Henwood, Kelly Hills, Cyril Ibe, Marjorie Kruvand, Lisa M. Lee, Maimuna S. Majumder, Alexandra L. Phelan, Annette Rid, Cristine Russell, Lara Schwarz, Laura Seay, Michael Selgelid, Tara C. Smith, Armand Sprecher