Narrator:
The managed care revolution is leaving
some folks in the dust. This is Science Today. More
and more Americans are getting health insurance
through managed care. Health economist James Robinson
of the University of California, Berkeley says that
while it's helping contain costs, it's not doing
anything to help the huge percentage of working
Americans with no health insurance at all.
Robinson: Managed care by itself,
or competition, they do not provide insurance for
the uninsured. For most people, let's face it, that
are uninsured, if they're going to get insured it's
going to have to be through some sort of a subsidy
which is ultimately going to have to come from the
taxpayer. That's really in the end the only way
it's going to happen.
Narrator: But in the short run,
says Robinson, that's not going to happen -- taxpayers
are in no mood to subsidize the uninsured.
Robinson: The only contribution
that managed care could make to that is to the extent
that managed care is successful in slowing or stopping
the growth of costs, then at least the problem's
not getting any worse. Because the root problem
of lack of insurance is that health care costs so
much. If health care didn't cost so much it would
be easier to convince the taxpayer to cover everybody.
Narrator: For Science Today, I'm
Steve Tokar.
B.
Pain Relief: Many Variables
Narrator:
This is Science Today. In a discovery noted around
the world, Dr. Jon Levine of the University of California,
San Francisco found that men and women responded
differently to a type of pain reliever called a
kappa-opioid: it helped women and didn't help men.
It was the first time anyone had linked pain relief
with gender. And Levine says in the future, doctors
who prescribe painkillers might take other variables
into account, too.
Levine: I think it's also important
to know -- and we don't know yet -- whether they
differ as a function of the age of patient. Whether
in children versus older individuals the agents
that we use should be different. We don't know at
this point whether they differ by the race of an
individual.
Narrator: Levine says those characteristics
might be more important than we know.
Levine: In general we've thought,
well, if somebody has cancer pain or arthritis pain,
that determines how we should treat it. And we've
not really taken into the equation whether or not
somebody is female or male, whether or not they
are young or old, and what their racial background
may be.
Narrator: For Science Today, I'm
Steve Tokar.
C.
To Lose Weight,
Treat the Whole Person
Narrator:
To lose weight, treat the whole person. This is
Science Today. Nutritionist Laurel Mellin of the
University of California, San Francisco runs a weight-loss
program called the Solution that, unlike most programs,
apparently keeps working long after it's over. Mellin
says her program teaches behaviors that, ideally,
are learned in childhood -- nurturing and setting
limits.
Mellin: If you don't know how to
nurture yourself, of course you'll go for the third
candy bar. If you don't know how to set limits and
follow through effectively, why on earth would you
be able to set an exercise goal, for example, and
actually follow through with it?
Narrator: Mellin says that once
those basic attitudes are changed, weight loss follows
-- because now there's an internal motivation to
lose weight and keep it off.
Mellin: What comes from that is
once we know how to nurture ourselves, we begin
to have more body pride. So there's the motivation
to get up off the couch and push back from the table.
It's almost natural to follow through with a reasonable
way of eating and a healthful way of exercising
in our lives.
Narrator: For Science Today, I'm
Steve Tokar.
D.
The Strongest Mutant
Wins
Narrator:
This is Science Today. In the last 10 years,
there's been a dangerous rise in drug-resistant
infections in major U.S. hospitals. Epidemiologist
Lee Riley of the University of California, Berkeley
says one bacteria, enterococcus, is now untreatable
by even the strongest known antibiotic, vancomycin.
And that's because vancomycin has been prescribed
so heavily it's knocked out weaker mutations of
enterococcus until only the strongest form remains.
Riley: The original reason for
the use of vancomycin was because of the so-called
staphylococcal infections. Staphylococcal infection
is a very common infection in hospitals. The organism
went through a series of antibiotics, and so vancomycin
eventually became the last resort for treatment
of staphylococcal infections.
Narrator: But in the meantime,
enterococcus appeared in hospitals and went through
a similar series of mutations...
Riley: ... and this organism has
already become resistant to vancomycin. So the concern
right now is -- in all the hospitals this is a major
fear -- is seeing the appearance of staphylococcus
that's become resistant to vancomycin. If that happens,
a lot of people are going to be worried...
Narrator: ...because staph infection
will be untreatable. For Science Today, I'm Steve
Tokar
E.
Oxygen and Evolution
Narrator:
This is Science Today. We take oxygen for granted,
but the amount of it in the air wasn't always the
same. Three hundred million years ago, for example,
in what's called the Carboniferous era, the air
was 35 percent oxygen, according to biologist Jeffrey
Graham of the University of California, San Diego.
Graham:
To put that in scale, the present atmospheric oxygen
level's about 21 percent oxygen. And so a 35 percent
level of oxygen is roughly one and a half times
as much oxygen as there is now.
Narrator:
Graham says that much oxygen had an effect on evolution.
The air was so thick and rich that flying insects
could be a lot bigger than they are today. Dragonflies,
for instance...
Graham:
And these dragonflies were immense compared to modern
day dragonflies. For example, the biggest dragonfly
that we find in nature today might have a wingspan
of about six inches. Whereas the late Paleozoic
or Carboniferous dragonflies had wingspans of close
to over two feet. So they were huge animals, the
size of -- probably of seagulls.
Narrator:
For Science Today, I'm Steve Tokar.
