NIH funding cuts — a ‘what if?’ look back; paying more for less successful surgical outcomes; on choices, habit and health — Morning Medical Update

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What if NIH funding had been cut years ago?

The U.S. Department of Health and Human Services has undergone some major changes under the leadership of (HHS) Secretary. While no one knows exactly what the effects will be, reconsidering the past might indicate what could happen for drug development. A group of authors proposed a “what if” scenario to examine what might have happened over the last 25 years if the National Institutes of Health had a 40% funding cut from 2000 onward. Here’s a summary of the study published in Science.

Pay more for surgery, get less healthy

In the U.S. health care system, inpatient operative expenditures cost more than $500 billion a year. In a new study of major elective operations, researchers found “significant variation” in hospital cost markup around the country. It’s true that hospitals have growing financial pressures from uninsured and underinsured patients, along with other economic factors. But “these challenges do not explain the significant variation in hospital markup” — and the greater morbidity at those hospitals. “Hospital Price Markup and Outcomes of Major Elective Operations” is an original investigation in JAMA Surgery, and here is additional commentary on the results.

Healthy choices or healthy habits?

Do patients (and physicians) make rational choices to pursue the means to good health? Or do people fall back on the repetition of habit, for better or worse? A new study showed 65% of daily behaviors were initiated through habit, rather than conscientious decisions. The findings could have profound influence in medicine, in which patients may engage in actions detrimental to health. "For people who want to break their bad habits, simply telling them to ‘try harder’ isn't enough. To create lasting change, we must incorporate strategies to help people recognize and disrupt their unwanted habits, and ideally form positive new ones in their place," said Co-author Benjamin Gardner, a professor of psychology.