Category Archives: Health

ObamaCare Is Slowly Dying

from its birth defects.

A great analogy.

Congress has no authority to grant bureaucrats such discretion either way. It cannot simply hand over its powers to another branch of the government. That is the subject of a recent book by Columbia Law School professor Philip Hamburger, Is Administrative Law Unlawful? Hamburger’s thesis is that federal agencies are under the control of the executive branch and, by definition, have no power to create regulations that legally bind anyone. That is, of course, precisely what HHS attempted when it drew up its list of “must cover” contraceptives.

During oral arguments in Burwell v Hobby Lobby, Justice Kennedy was obviously interested in this issue and its implications for the separation of powers. Among his questions to the government lawyers was the following: “Now, what kind of constitutional structure do we have if the Congress can give an agency the power to grant or not grant a religious exemption based on what the agency determined?” According to Hamburger, it gives us a structure more like that which England’s James I presided over than anything envisioned by the framers.

The latter favored a very weak executive branch. In fact, according to Hamburger, they didn’t want it “bringing matters to the courts or … physically carrying out their binding acts.” This is why the Constitution is so specific about the separation of powers. The framers must have been spinning in their graves when the government lawyers were arguing Burwell v. Hobby Lobby and Halbig v. Burwell. But shady deals like the cornhusker kickback and violations of the separation of powers doctrine are but two of the birth defects with which Obamacare was born.

And, as he notes, the Origination problem will be potentially fatal as well.

Halbig

The appeals court has ruled against the administration. This really guts ObamaCare.

[Update a few minuts later]

Jonathan Adler has some initial thoughts:

If this decision is upheld, it will present some three-dozen states with a choice: Establish exchanges so as to authorize tax credits for state citizens while also triggering penalties on employers and individuals who do not wish to purchase qualifying health insurance. As my co-author Michael Cannon notes, the implications of this decision go beyond its effect on tax credits. How will states respond? Time will tell. As with the Medicaid expansion, it is not entirely clear how states will react now that so much of PPACA implementation is clearly in their hands.

A lot of dominoes could fall from this.

[Update early afternoon]

Thoughts from John Hinderaker:

If the D.C. Circuit does re-hear the case en banc, it may reverse today’s panel decision. If that happens, there will no longer be a split between the circuits, but one would think the Supreme Court will take the case regardless. In that event, we may be back in familiar territory, with Justice Anthony Kennedy deciding what Congress had in mind. If you think that discerning Congress’s intent is, in this case, a fool’s errand, since no one in Congress had read the law before voting on it, you are probably right. Which is one reason why courts look to the words of a statute rather than to the subjective intentions of 535 legislators. Given that Justice Kennedy was willing to deal Obamacare what he thought was a death blow under the Commerce Clause, Democrats cannot view their ultimate prospects with much confidence.

Especially after the election.

Complexity

Frustration with the leftist fools who don’t understand the knowledge problem:

Mr. Bouie insists that he is not simply trying to make an excuse for the president’s revealed incompetence in sundry matters, but of course that is precisely what he and other apologists for the administration are doing. If they were really interested in complexity as such, then they would bring it up on the front end of the policy debate, rather than on the back end.

I’ve seen this happen so many times that every other policy debate looks to me like an ancient rerun of Three’s Company: Do you think there’ll be a comic misunderstanding in this episode, too? It unfolds like this: Politicians on the Barack Obama model promise that they will muster their native intelligence and empirical evidence to bring order to, e.g., the health-care industry, through the judicious application of regulation. People like me tell them that the effects of such regulation are almost certainly going to be other than what was intended, because such markets are too complex to be understandable, predictable, or steerable, even in principle. Even if every bureaucrat who touches health care or the labor market has the brain of an Einstein and the soul of a St. Thomas Becket, it will not turn out the way it is intended. And then, when it doesn’t turn out as intended, Jamelle Bouie et al. protest that the toldya-so chorus “betrays an ignorance of the size and complexity of the federal bureaucracy.”

And they never even consider the question: If the federal bureaucracy is so vast and complex that its behavior cannot be adequately managed, how is it that the phenomena that the bureaucracies are tasked with managing—orders of magnitude more complex than the bureaucracies themselves—are supposed to be manageable? To consider the question with any intellectual rigor is to accept real, meaningful, epistemic limits on what government can do.

Can’t have that. It doesn’t allow them to run other peoples’ lives.

Statins

More junk science, pushed by the drug companies:

History will judge the American Heart Association guidelines by their effect. We currently have a statin epidemic with 25 percent of adults over the age of 45 taking the pills, a large majority of whom do not have heart disease and have not seen the numbers. But they are simple, and available. No doctor should be prescribing a statin and no person should be taking one, unless they have seen them. If more people without heart disease take statins it will be a victory of misinformation.

I try to convince my brother to get off them, but he takes the advice of his doctor.

The Big Fat Surprise

Another review of the book:

The book’s subtitle is Why Butter, Meat & Cheese Belong in a Healthy Diet, which gave me the impression I was about to start reading a hefty science book. There’s plenty of science in The Big Fat Surprise, but it’s more of a history book. It’s the story of how lousy science conducted by arrogant scientists and adopted by equally arrogant policymakers led to lousy decisions that produced lousy consequences. I doubt any Fat Heads out there still believe nutrition science is conducted by impartial researchers who aren’t already wedded to an outcome, but if so, reading this book will disabuse you of that notion. It’s all laid out here in a richly detailed story that runs 340 pages … the egos, the arrogance, the obsession with pursuing and (ahem) proving a single hypothesis, the scientific bullying, the corruption, and of course the ham-handed interference by the 900-pound gorilla known as the federal government.

Gee, in what other field have we seen that sort of thing?

The Big Fat Silence

It’s time to end it:

…if one has been teaching that high-fat diets can lead to heart attacks for 30 years but then finds that this may not be true, or that, indeed, more fat and less carbohydrate in the diet may be beneficial to one’s health and longevity, feelings of discomfort can result. Subconscious mechanisms may then keep enduring convictions firmly in place for extended periods of time, despite evidence to the contrary.

And it’s hard to confront the fact that you may have been responsible for the poor health and lives cut short of people you’ve been advising.

More Blows For Liberty From SCOTUS

Shockingly to union supporters, a union can’t force someone taking care of her disabled son to pay union dues for the privilege.

And there’s another blow to ObamaCare’s attempt to run our lives:

The 5-4 decision is a significant victory for those challenging the constitutionality of the President Obama’s health care law. And it strengthens the argument that for-profit entities, like individuals and churches, have religious rights.

So you don’t lose your religious freedom because you make a profit.

Huh.

[Update mid afternoon]

The funniest thing on Twitter today, amidst all the illogic, hatred and hysteria, is the number of people who think that @SCOTUSblog is actually SCOTUS’s blog (and Twitter feed) and attacking them. The @SCOTUSblog folks are having a lot of fun with it.

Triglycerides

So I heard about this story on the news this morning, and it sounded a little junk sciency:

“What’s exciting about this is it takes that to another place,” said Toni Pollin, an associate professor of medicine at the University of Maryland School of Medicine, who led the 2008 work. “Just as you’d expect from something that prevents coronary artery buildup, there is strong evidence that having [a gene mutation] reduces the risk of having a heart attack.”

Kathiresan and colleagues benefited from the revolution in genome technology, sequencing 18,666 genes in each of 3,734 people in their search for genes that appeared to be linked to triglycerides. Rare mutations in the APOC3 gene stood out.

Once they understood where to look, they searched for four mutations in that gene in more than 110,000 people. They found that people with any one of the mutations — about 1 in 150 people — were 40 percent less likely to have heart disease and had lower levels of triglycerides.

There is no doubt in my mind that that there is a genetic basis for heart-disease risk, but I am not seeing anything in this study that would indicate that trying to reduce triglycerides per se (as statins attempt to lower cholesterol) are doing anything but treating a symptom, and possibly a harmless one. The mutation reduces both triglycerides and heart risk, but doesn’t mean that high triglycerides increase heart risk per se, or that lowering them artificially will reduce it.

But for what it’s worth, since I went partially paleo, my triglycerides have become almost immeasurable.

Miles O’Brien

Life after the loss of an arm:

In my job as a science and technology correspondent, I have covered some of the advances in prosthetic technology in recent years. They are remarkable. But now that I am looking as a customer, I see shortcomings. The devices rely on actuators, which in turn rely on batteries. That makes these arms very heavy, less reliable, and not weatherproof. To make some of them work well, doctors need to move nerves to better connect them with sensors inside the robo-arms. Replicating what the human hand does is a very difficult problem for engineers, much harder than making an artificial leg. I have learned, though, that one hand—with all its dexterity, sensitivity, and opposable-thumb efficiency, along with something much more crude that has the simple ability to grasp—is all you need. For now, the split hook I wear is working well. I’m pretty sure that it’ll allow me, eventually, to return to the cockpit.

My prosthetist assumed I would like to have a cosmetic hand, one that has no real function but looks like the real thing, and so he made a mold of my remaining hand. An artist who produces fake wounds in Hollywood created a clear silicone mirror image. Then she sat with me for six hours, painting it, even embedding bits of hair snipped from my right arm. The result is haunting, and I don’t like looking at it. I’m not sure whom I would be wearing it for. I don’t feel the need to pretend or to make my presence easier on others.

The biggest problem I cope with is phantom pain. My arm has become a ghost, immobilized as if it were in a sling—which is where it was the last time I saw it. If I concentrate, I can move my imaginary fingers. The arm feels as if it’s been asleep and the circulation has just begun once again. First thing in the morning, it’s actually a pleasant, painless feeling. My arm is suspended, almost as if it is weightless. But as the day goes on, it feels as if it is progressively bound tighter and tighter, to the point of excruciating pain. In addition, my fingers often feel as if they’ve been jolted with surges of electricity.

He’s a mensch.

The Big Fat Lie

Another review of Nina Teicholz’s book:

Because the importance of cholesterol as a risk factor for heart disease had been accepted as dogma, it was pretty well impossible to challenge it. For example, one of the outstanding nutrition scientists, David Kritchevsky, suggested in the 1980s that there should be a weakening of the recommendation on dietary fat and encountered hysterical opposition. Here is what he told the author:

“People would spit on us! It’s hard to imagine now, the heat of the passion. It was just like we had desecrated the American flag. They were so angry that we were going against the suggestions of the American Heart Association and the National Institutes of Health.

This meant that anyone who had the temerity to challenge the official line was committing professional suicide. Applications for funds to support research, which might question the prevailing views on fat, were unlikely to be supported. Even if funds were obtained (eg from independent foundations) the researchers would find difficulty in publishing their results in scientific journals and they were rarely invited to serve on expert panels. By stifling opposition, the public was presented with what appeared to be a uniform scientific consensus.

Say, that sounds familiar somehow.

Mad Men Ads

Lileks (who has finally replaced the irreplaceable Jasper with a new puppie) has thoughts on the decline of advertising and the suckitude of the early seventies:

What’s the opposite of nostalgia? What’s the word for an exaggerated dislike of a particular time? I know I am nostalgic for things I did not experience, and only see through the pop-culture elements left behind, which communicate incomplete and occasionally misleading messages. But I have antipathy for things I experienced at the fringe of adolescence – not because it was a bad time, or I didn’t like them then, but because they seem now to be the products of a culture that was getting cheap and lazy; it was full of gimcrack baubles turned out by an exhausted system that tried to adapt to the times, but had no strength to put forth any ideas or uphold any ideas that went before. The period from 1967 to 1975, with some stellar exceptions, was just a horrible time for everything, and you can reduce it all down to one middle-aged balding dude with wet hair plastered over his head in brown polyester pants and a mustard-yellow shirt approving one thing after the other because the kids will go for it.

That’s a generalization. Somewhat. But. I’ve said this before: “Mad Men”’s exploration of the late 60s somehow avoids the fact that advertising in that era was horrible. Compare an issue of Life magazine from 1968 to its 1958 counterpoint – it’s as if style, color, art, romance, seduction, adulthood, and bright-eyed joy had been drained from the world. The ads weren’t about the product anymore; the ads were about the ads.

[Yes, I know it's not fresh material -- I'd gotten behind on my Bleatage.]

Young Blood

Is the secret anti-aging ingredient oxytocin?

The new study provides a new hypothesis for how we get old. When people are young, they produce lots of oxytocin. On top of whatever psychological effects it may have, that extra oxytocin also tells stem cells to turn into muscle cells, keeping people strong. Young people might also produce GDF11 and other molecules at high levels, and in combination, they may keep all the organs young. And once those signals start to fade in old age, the body starts to fall apart.

Theoretically, giving old people compounds like oxytocin or GDF11 may cause their cells to act young again. The compounds could be the basis for an all-purpose treatment for the diseases of old age, from osteoporosis to heart disease to Alzheimer’s.

Theoretically.

Yes, theoretically. As he notes, this is only rat experiments. Nothing with humans yet.

Transfats

Hey, let’s come up with a new poison to replace them with:

“In icings, PHOs provide the air-holding capacity to achieve specific desired gravities, along with the melting and spreading characteristics that allow icings to be evenly spread on cakes,” said Tom Tiffany, senior technical manager, ADM Oils in Decatur, Ill. “The heat stability enables the icing to remain stable when exposed to a variety of transportation and storage conditions.”

Dr. McNeill said icings sold at retail may require a shelf life of up to 1.5 years. If shelf life fails to reach that duration, consumers may open a tub of icing and find it’s “like a piece of concrete,” Dr. McNeill said.

To replace PHOs and still keep the desired shelf life in icings, formulators may use palm oil along with a liquid vegetable oil such as canola oil or sunflower oil that may keep saturated fat as low as possible, he said.

Guys, there’s this thing called “butter.” And “lard.”

As Dr. Meade says:

Dietary Animal Fat

It’s long past time to end the war on it:

The public MUST NOT let TBFS slip slowly into oblivion. Nina’s first story should create an outraged public that demands the following:

  1. Government-sponsored nutrition must be totally terminated.

  2. Freedom of information in valid nutritional sciences must be made widely available.
  3. All citizens must have the right to design their own nutrition plans.
  4. A primary prevention program based on eliminating the causes of diseases must be implemented.

It won’t happen unless we make it happen. It has to become a political issue. Attacking Michelle’s school-lunch tyranny would be a good start.

[Update a few minutes later]

And yet the USDA is still spending millions to propagandize us about low fat:

The USDA also proposed a study on changing how food is described on menus, labeling low-sodium and low-fat versions as “regular,” and “framing regular versions of certain snack products as high-fat or high-sodium.”

I’d like to see someone on the Hill make an issue of this.

Melanoma

I hadn’t realized that they’ve made great advances in treating it:

This seismic shift in melanoma care — largely brought about by enlisting the immune system in the fight — might eventually be used to treat other cancers, researchers said. Smoking-related lung cancers, among others, are now starting to respond to similar treatments, according to research to be presented at this week’s conference.

“We really are in a historical time right now,” said Dr. F. Stephen Hodi, director of the Melanoma Treatment Center at the Dana-Farber Cancer Institute. “Cancer treatment five years ago compared to five years from now — it’s going to be completely different.”

Faster, please.

I found this a little sad, though:

“Someone with metastatic melanoma, I used to tell them to ‘eat whatever you want.’ Now, I’m saying ‘you should watch that cholesterol,’ ’’ said Dr. Patrick Hwu, chairman of the Department of Melanoma Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston.

It’s amazing and frightening how ignorant the medical profession is about diet and cholesterol.

The Next ObamaCare Lie

The Dems don’t really want to “fix it.” Every attempt to make a legislative change has been blocked in the Senate. Don’t let them get away with it.

[Update a few minutes later]

Hey, remember when Dems thought that the VA was a great model for government health care?

But they continue to pine for single payer, and surreptitiously or otherwise hope that the ObamaCare debacle will push us in that direction.

[Update a couple minutes later]

More problems and arguments lie ahead:

…the vast middle ground of “modify the law without repealing it” is terra incognita. It is as accurate as Burns’s formulation, and no less precise, to say that those who want to leave the law as it is are outnumbered more than 5 to 1 by those who want to repeal or change it.

There’s an additional ambiguity: What does it mean to leave the law “unchanged” when the Supreme Court has already struck down parts of it and the administration has declined to follow or enforce others? That’s not a salient question for immediate electoral purposes; in terms of voting intention, “left unchanged” can be taken as a statement of support for the Democrats. But even if the statutory language proves resistant to any effort at modification, there will be a new administration after 2016. That could mean more discretionary (or extralegal) changes and perhaps the end of ObamaCare as we know it.

“ObamaCare as we know it” is also an ambiguous turn of phrase, to say the least, for what do we know of ObamaCare? A few provisions are relatively straightforward, such as the expansion of Medicaid eligibility (in those states that have gone along with it) and the mandate that family insurance plans cover 23-, 24- and 25-year-old children of policyholders.

But the whole of ObamaCare is an insanely complicated scheme that even experts are still struggling to understand. “We have to pass the bill so that you can find out what is in it–away from the fog of the controversy,” then-Speaker Nancy Pelosi famously said in March 2010. We’ll be finding out for many years to come, and there’s no reason to think that “fog” will ever lift.

The only way to lift the fog is to blow it all away.

[Update a few minutes later]

And then there’s this:

“The IRS isn’t likely to bring such proceedings to earn a pittance,” Nicholas Bagley, a law professor at the University of Michigan, tells McIntyre. Then again, it wasn’t money the Obama IRS was after when it embarked on a campaign of harassment against conservative nonprofit organizations. These ObamaCare penalties may be too draconian to be applied generally, but applied selectively, they could be a powerful weapon of an abusive administration.

This administration is nothing if not abusive of the weapons at its disposal.