Brainstorm Health: Ties in Biology, Trump-Pfizer Takeaways, Obamacare Navigator Cuts

No bragging rights. No bar fights. No closure.

Some will look at that and say, “Baseball sucks.” The game that has no mortal limit on foul balls (okay—except for those that follow a two-strike bunt) has given us yet another eternal limbo. No joy for the winner. No agony for the loser. What fun is that?

But from a biological standpoint, such equipoise is standard fare. Within the human body, up and down are forever engaged in a dance to the middle.

Witness the human kidneys, which when healthy, maintain the constancy of “an internal ocean” of bodily fluids, despite the ever-changing nature of what we eat, drink, sweat, and excrete. The British physiologist E. H. Starling, who among his other achievements co-discovered the first hormone (secretin), called this remarkable balance “the wisdom of the body” in a 1923 lecture. A few years later, Walter Bradford Cannon, an American physiology professor at Harvard, coined the term “homeostasis” to capture the body’s uncanny self-stability.

Such balance is maintained not only for the body’s blood, water and chemistry—its pH (a concentration of hydrogen ions that makes a solution more acidic or alkaline), electrolytes, phosphates, sugars, and more—but also for its temperature and energy metabolism. (Melanie Hoenig and Mark Zeidel, of Beth Israel Deaconess Medical Center, have written a lovely essay on this.)

Within the human body, the tie game is the rule, not the exception—the balance of scales that keeps us well.

Friendships are like that, too. Good ones, anyway. There are no winners and losers in a real friendship; the give-and-take is part of our interpersonal homeostasis.

We can (and do) tip the scales in our various alliances—complaining of unevenness of care or attention or compassion or understanding. That’s only human. But in a real friendship or alliance there are no winners or losers. There is only a tie. Something about that just feels right, even if we sometimes forget it.

DIGITAL HEALTH

Medtronic touts early results from UnitedHealthcare deal. Patients who took advantage of a partnership between Medtronic and UnitedHealthcare, established in 2016 and setting the former company's insulin pumps as the preferred devices for patients with diabetes, reportedly experienced a number of medical advantages—including fewer preventable hospital admissions, according to the companies. If the results hold out, they could be a data point in favor of automated insulin pumps over manual daily injections for those with diabetes. (MobiHealthNews)

INDICATIONS

What did we learn from the Trump-Pfizer feud? Pfizer backed down to pressure from President Trump and his administration (at least in the short term) over drug price hikes. But the entire episode highlights a number of issues worth keeping in mind when it comes to drug pricing issues—including the carte blanche drug companies largely have in the matter, and the ultimate effect of the industry's response to public pressure. I've got more on that here. (Fortune)

THE BIG PICTURE

Trump administration cuts Obamacare navigator funds. Another day, another Trump administration cut to the Affordable Care Act, aka Obamacare. This time around, the administration is slashing grants for so-called "navigators" who help people sign up for individual health insurance plans under the law. That will likely make it even more difficult for Americans who want or need health coverage through the markets to navigate what can be a complicated process; but it also raises the question of whether or not the process itself can be simplified so that the navigators aren't a necessity. (Reuters)

REQUIRED READING

These Fortune 500 Companies Are Loved By Both Rural and Urban America, by Grace Donnelly

What's Next for the Rescued Thai Soccer Team? by Ellen McGirt

Here's What's Different About Trump's Latest China Tariffs, by Hallie Detrick

Michigan Approves 11 New Conditions for Medical Marijuana Treatment, by Erin Corbett