Tax time? Les Ismore

by unshodashish on March 26, 2013

This story from Pro Publica describes how Intuit, the maker of tax-preparation software, has successfully fought efforts to simplify tax-filing (and reduce costs) for tens of millions of Americans. For shame.

And it illustrates a broader point, unfortunately all too common: even when the best solution to a problem is to do less, economic forces invariably will offer a “do more, spend more money” solution, and use their dollars to promote it. Even if your unshod legs could walk or run pain-free down the street, someone will find a way to sell you padded shoes, someone else will give you painkillers for your shin splints and runner’s knee, then the doctor and physical therapist will jump into the fray, now maybe you need treatment for your kidneys, trashed by those NSAIDs, possibly a surgery, and so on.

I don’t have a quick fix, but honesty and transparency are a great start. And, of course, thinking for yourself before each and every purchase. Beware the assumptions that advertising shoehorns into our subconscious.

Kudos to Pro Publica and NPR for their investigation.

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It’s business time

by unshodashish on November 16, 2012

From The Wall Street Journal [paywall - search Google News for "Hepatitis C Drug Derailed by Deal"] yesterday: “Sometimes drugs die not because they don’t work or are unsafe, but because they don’t make business sense.”

The article is an indictment of the medical-pharmaceutical-industrial complex: with revenues so large, and profit so often unaligned with patient outcomes … patients often lose, because the bottom line does not give way.

Where to point the finger of blame? Without a profit motive, who could afford to risk the billions of dollars necessary to bring a new drug to market? And at the same time, what evidence do we have that these billion-dollar projects are improving our health as a society? Not much.

And yes, I have my own horse in the race: I’m claiming that the book you can buy for the price of a Bloody Mary at the St. Regis will save you $6000 in footwear costs, not to mention pain, suffering, ill-health, and untold medical bills. (And, in the interest of full disclosure, you don’t need the book – just take off your shoes. That’s free)

But it’s my word, and the word of a handful of similarly heterodox barefooters, against the advertising and prestige of a multi-billion-dollar shoe industry, a multi-billion-dollar healthcare industry, and a multi-billion dollar drug (painkiller) industry, all of whom make their boat payments off of injured runners, not healthy ones. If running injuries ceased by a decree from Up There, a lot of high-powered MBAs, MDs and PhDs would be out of work. “Managed chronic disease” – that’s what they require to keep the lights on.

So what’s the solution? How can corporate incentives be aligned with good health? How can customers (in my case runners) make better rational decisions for their own long-term benefit? Will Obamacare encourage systems thinking, to optimize long-term outcomes for society? How to balance economics with human (ir)rationality?

The discussion continues …

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Expectations

November 13, 2012

I get lots of questions about stepping on splinters. That’s no surprise. In a given day, most shoe wearers don’t step on a splinter, so “not stepping on a splinter” is the expected condition, and any deviation seems significant, noteworthy, scary. (And, truth be told, I do get a splinter in my foot, probably two […]

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Changing beliefs

August 1, 2012

I just finished reading Dan Ariely’s wonderful The Honest Truth About Dishonesty. Another great read – another book I wish I had written. I’m developing a serious man crush on that guy. Anyway, Dan (I’ve decided we’re on a first name basis since he took the last spot in a grad program for which I […]

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What would you do with an extra $6000?

May 12, 2012

Just how much do you think your running shoes are costing you? Besides your good health, I mean. Runner’s World estimates that runners go through 3.1 pairs of running shoes each year. How much does a pair of these shoes cost? For the sake of simplicity, let’s call it $100, which is actually pretty conservative […]

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No, I don’t mean toe shoes!

April 28, 2012

The almost universal response when people hear about my barefoot running is “oh, do you mean in those toe shoes?” No. No, I do not wear toe shoes, and I’m not recommending them. But how to convey this diplomatically? First I had to practice stifling my frustration, but fortunately years of meditation have worked their […]

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Mud between the toes

April 6, 2012

As winter (meaning rain) finally reaches the Bay Area, almost all of my running these past few weeks has been on the 1K trail by my house, past the library, the new gym, and right along the Caltrain killing tracks. There’s something so wonderful about the sensation of running on wet earth, feeling the dampness […]

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Ryan Hall has plantar fasciitis

March 12, 2012

This week we learned that US marathon record holder Ryan Hall has been suffering from plantar fasciitis for the past four months. He’s dealing with it by taking lots of Aleve (Naproxen), an NSAID effective in reducing inflammation and pain, and in large doses associated with a range of serious side effects, including kidney and […]

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Run barefoot – on your own schedule

March 7, 2012

“How long was your transition to running barefoot?” must be one of my top-5 questions, right behind “do you wear those toe shoes?” and “what about splinters?” If I don’t answer the transition question with a specific number of months, weeks, and days, it’s only partly because I don’t have records of my transition; mostly […]

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Whatever happened to medical curiosity?

February 23, 2012

I like my dentist, Dr. J. Compared to his predecessor (who, bizarrely, was dating my neighbor, but I digress) Dr. J has vastly better bedside manner, and my teeth have generally prospered under his care. For a while, though, my gums weren’t doing so well, and as we now know, gum health may be related […]

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