Category Archives: Health

The Fatal Conceit

of Jonathan Gruber:

The Times reassuringly described Gruber as “the numbers wizard at MIT,” who has “spent decades modeling the intricacies of the health care ecosystem.” Gruber has “brought a level of science to an issue that would otherwise be just opinion.”

I might note that the Soviets used the term “science” for their own “scientific” planning commission. I drew little comfort from Professor Gruber’s scientific-planning credentials, especially when I learned “he’s the only person you can go to for that kind of thing.” Gruber, aided by his brilliant MIT graduate student assistants, is a one-man Gosplan, the name given to the Soviet Union’s state planning committee. That is not much of a recommendation. Science is better served by competing ideas not by a one-person monopoly.

Both Gruber and the USSR’s Gosplan planners believe their planning is “scientific” and executed by “the best of the best.” Both types of planning commissars suffer from F. A. Hayek’s “fatal conceit”—the belief that we can plan incredibly complex economic systems. As Hayek pointed out in his writings, such “scientific” plans inevitably fall apart under the weight of unintended consequences.

Actually, I’m not sure they’re all unintended.

Another Sat Fat Study

No, you don’t increase your saturated fat by eating saturated fat. It’s the carbs, stupid:

The fatty acid called palmitoleic acid, which is associated with “unhealthy metabolism of carbohydrates that can promote disease,” went down with low-carb diets and gradually increased as carbs were re-introduced, the study said.

An increase in this fatty acid indicates that a growing proportion of carbohydrates is being converted into fat instead of being burned by the body, the researchers said.

“When you consume a very low-carb diet your body preferentially burns saturated fat,” Volek said.

“We had people eat two times more saturated fat than they had been eating before entering the study, yet when we measured saturated fat in their blood, it went down in the majority of people,” he said.

The finding “challenges the conventional wisdom that has demonized saturated fat and extends our knowledge of why dietary saturated fat doesn’t correlate with disease,” Volek added.

You don’t say.

Also, how the mindless theory of calorie counting has harmed public health.

[Update a while later]

Nine lies about fat that have destroyed the world’s health.

Orthorexia

When “healthy” eating becomes unhealthy.

There may be reasons to be a vegan, but health is not among them.

[Update late morning]

Both Anne Hathaway and Bill Clinton have given up on their vegan diets:

Hathaway recently confessed that eating endless meals of tofu and garbanzo beans seemed to be sapping her energy. She told the Insider that when she was filming Interstellar, the action-packed scenes overwhelmed her.

Seeking a solution, Hathaway decided to try feasting on fish and shifting to a low-carb diet. The decision to push away those plant-based platters and experiment with an animal protein-powered plan came in the middle of filming a water scene, which required that she suit up in a heavy garment.

“I fell off so hard…. So you imagine what that’s like — what it’s like running through water and then you wear a 40-pound suit on top of it, so for me it was intense. I was facing my life, I don’t know how many days in a row of, like, garbanzo beans on a plate.”

And with an apology to PETA, Hathaway says that she doesn’t plan to return to her vegan lifestyle. She even dug into a plate of eggs and sausage during a recent Harper’s Bazaar interview. Anne noted that the difference between eating a vegan diet and consuming animal protein was notable overnight.

“I just didn’t feel good or healthy,” Hathaway recalled of her vegan days.

You don’t say.

Gruber

Dear Democrats, don’t even think about trying to run away from him.

[Afternoon update]

The epic search of Diogenes for an honest man is over.

[Update a few minutes later]

It gets worse:

I think we’d probably like to get rid of the tax exempt status for health care benefits.

Note that McCain proposed doing just that in the 2008 election. His idea was that we would get rid of this exemption and instead give people an additional tax credit valued at the average cost of health insurance. Thus, people would be held harmless by the change, but we’d get rid of this government-made distortion in how employers pay their employees.

Barack Obama, get this, demagogued that plan and accused McCain of wanting to increase taxes on people.

And meanwhile, he schemed to achieve the same thing, except without that part about giving people an additional tax credit which would offset increased taxes, and, get this, without telling people he was getting rid of the tax exemption.

Once again — subverting democracy by completely destroying the concept of Consent of the Governed.

All in a day’s work.

[Update a while later]

Obama himself was leading the discussion of how to take away the tax benefits.

A Simpler Cheaper Health-Care Policy

It would be a huge improvement over the current mess:

I think that from the libertarian perspective, either of these proposals should be preferable to Obamacare. I’d even argue that they should both be more appealing to progressives. But the administration didn’t want simple, modest and stable; it wanted a massive, transformational legacy. Which is why, four years later, we’re still fighting about it.

Yup.

ObamaCare

…is going back to SCOTUS.

This makes the en bank ruling in DC pointless.

I’m guessing they’ll find that the subsidies aren’t legal. The question is whether or not they’ll strike down the whole law this time, because they’re a pretty fundamental part of it.

[Update a few minutes later]

Here’s an explainer from SCOTUSblog.

[Update a while later]

And here‘s Jonathan Adler’s take:

With this grant, the court has the opportunity to reaffirm the principle that the law is what Congress enacts, not what the administration or others wish Congress had enacted with the benefit of hindsight. Granting tax credits to those who need help purchasing health insurance may be a good idea, and may have bipartisan support, but the IRS lacks the authority to authorize such tax credits where Congress failed to do so. The PPACA only authorizes tax credits for the purchase of insurance on exchanges “established by the State.”

Yup. To grant an agency that kind of discretion would be a form of tyranny.

[Update a few minutes later]

Six potential effects of a ruling against HHS.

Financial Planning For Life Extension

An interview with Joel Garreau. Not sure I agree with this:

Boomer octogenarians in 2030 have “too many hard miles on their chassis” to fully benefit, but younger people may have trouble imagining the onetime prevalence of sickness and death.

I won’t be quite that old, but I think that there’s a good possibility that even for octo/nonoganerians there will be potential reversal of damage, and rejuvenation by then. And current government policies based on Scenario 1 (i.e., pretty much business as usual) are doomed to bankruptcy.

A Medical Breakthrough

An informational one:

…new recommendations regarding dietary fat from “what’s new Family Medicine” section.

Fat intake and coronary risk (April 2014)

Although it is known that there is a continuous graded relationship between serum cholesterol concentration and coronary heart disease (CHD), and that dietary intake of saturated fat raises total serum cholesterol, a 2014 meta-analysis of prospective observational studies found no association between intake of saturated fat and risk for CHD [7]. The meta-analysis also found no relationship between monounsaturated fat intake and CHD, but suggested a reduction in CHD with higher intake of omega-3 polyunsaturated fats; a benefit with omega-6 polyunsaturated fats remains uncertain. Given these results, we no longer suggest avoiding saturated fats per se, although many foods high in saturated fats are less healthy than foods containing lower levels. In particular, we no longer feel there is substantial evidence for choosing dairy products based on low fat content (such as choosing skim milk in preference to higher fat milk). We continue to advise reducing intake of trans fatty acids. (See “Dietary fat”, section on ‘Saturated fatty acids’.)

Better late than never.

Why The CDC Is Failing

It’s forgotten and diffused its mission:

…as the impact of communicable diseases has lessened, public-health medicine—which concerns itself with community-wide solutions to health problems—began to look more intensely at treating and preventing conditions that don’t originate with germs. The focus of researchers and doctors turned especially to conditions thought to underlie cardiovascular disease. But unlike battles against germs, isolating the key cause of such problems has proved elusive, because multiple factors—from genetics to diet to personal habits, like smoking—are all potentially contribute.

Advocates like Frieden have plunged ahead anyway, sometimes proposing simplistic solutions to complex problems, often without much data to back up their claims. As New York City’s health commissioner, Frieden engineered a law requiring food chains to post calorie counts on menus, though there was no evidence that the availability of such information has any effect on eating habits. Frieden also led a campaign to cut salt consumption despite studies that had shown, in fact, that some individuals fared poorly on a salt-restricted diet. Frieden’s campaign led one world-renown hypertension expert to proclaim that New York was attempting to engineer a giant uncontrolled experiment. As time passed, Frieden’s practice of recommending sometimes outrageous solutions to health problems based on few facts grew more disconcerting. In 2007, he even proposed a campaign to persuade uncircumcised adult men in New York to get circumcised to reduce their risk to HIV; a study in Africa had concluded that the practice helped lower infections there. But Frieden’s proposal was widely derided and quickly dismissed because of the vast differences between the two populations and the preliminary nature of the research.

Read the whole thing. This is a microcosm of the more general problem of government getting involved with things that it both has no business doing, and at which it is monumentally incompetent. A small step to fix it would be to can Frieden, and explain why, and refocus the CDC on germs, but that’s far beyond this president’s ideology or ken.

[Update a while later]

Will ebola be good for the CDC?

Public health experts were, in a way, too successful; they beat back our infectious disease load to the point where most of us have never had anything more serious than Human papillomavirus or a bad case of the flu. This left them without that much to do. So they reinvented themselves as the overseers of everything that might make us unhealthy, from French Fries to work stress.

As with the steel mills, these problems are not necessarily amenable to the organizational tools used to tackle tuberculosis. The more the public and private health system are focused on these problems, the less optimized they will be for fighting the war against infectious disease. It is less surprising to find that they didn’t know how to respond to a novel infectious disease than it would have been to discover that they botched a new campaign against texting and driving.

Don’t get me wrong: Fighting infection is still one of the things that the public health infrastructure does, and though I hope it doesn’t come to that, I expect that our system will do a much better job next time. But the CDC did not botch the job because there’s something wrong with Barack Obama, or government, or the state of Texas, or private hospitals. They dropped the ball because the public health system no longer needs to work so many miracles, and consequently hasn’t had much practice. We shouldn’t have let public health give us such an inflated belief in the power of government. But we also shouldn’t forget that with the right task and the right tools, government is still capable of doing some wondrous things.

Only if it is focused on what it does well, and the right incentives are in place. That is not the case for much of the current federal government.

Curing Alzheimer’s

…with a ketogenic diet?

Ketone esters are in a class of supplements called “generally recognized as safe” or GRAS by the FDA. They are expensive, difficult to find, and taste nasty (I’ve smelled some, and it was a bit like salty urine). There are no long term studies of the safety of these supplements in humans, though high ketone levels were maintained in severely obese, fasting patients for 6-8 weeks and there seemed to be no side effects. The main risk might be an exacerbation of gout, but truly, the long term consequences are unknown. For someone with dementia facing an inevitable downward spiral and life in a long term care facility, the question of benefits versus risk is a different calculation than in someone without that condition.

After a few days of escalating doses, Mr. Newport was brushing his own teeth, spontaneously dressing and bathing himself again, had improvements in mood, and was able to recite the alphabet. After 6-8 weeks, his memory improved and he started to do yard work again. After 20 months, he maintained definite improvement, with his cognitive function seeming to wax and wane with rising and falling ketone levels in his blood.

While this report is just a single case study, it does merit more clinical investigation. Given the severity and cost of the disease, the possibility of a far more effective treatment than what we currently have must be explored further.

It actually wouldn’t surprise me at all. Alzheimer’s may be just one more modern illness caused by the awful official dietary advice over the past six decades.

Obama’s Great Ebola Error

The last time a president tried to make a health crisis about national security, fifty million people died.

It’s not surprising, really. Wilson was our first truly fascist president (complete with racism). Obama is simply following in his (and Roosevelt’s) footsteps.

And meanwhile, we don’t really have anything resembling a national response. So I guess ebola is just another thing that the president has no strategy on.

[Update a while later]

Well, this was inevitable. Ebola is the GOP’s fault. Because they’ve been in charge of the CDC, with its emphasis on junk nutrition science and gun control, while its budget rose.

[Update a couple minutes later]

The problem with the argument that it’s Republicans’ fault.

As Glenn says, if Congress was smart, it would force the CDC to shift funding from all the junk science it’s been doing, and start focusing on actual infectious diseases. Unfortunately, we don’t live in a world in which Congress is smart.

[Update a couple minutes later]

The CDC is losing its grip. The country’s in the very best of hands.

The Disintegrating Obama Presidency

Steve Hayes has a long piece (necessarily, because it’s such a target rich environment) on how it is chock full of fail.

[Update a couple minutes later]

This isn’t from the essay, but rather from Jonah Goldberg’s latest “newsletter” (so no link), but it seems apt:

Islamic State took Fallujah and Mosul months ago and he kept calling it the “jayvee team.” As recently as August, he was telling Tom Friedman that it was ridiculous to arm the Syrian rebels. In September, he was wistfully complaining that the Islamic State made a mistake in beheading those Americans because it aroused U.S. public opinion for war. In other words, doing nothing about the Islamic State was Obama’s foreign policy until the domestic political situation made his foreign policy untenable. Chess Masters think many moves ahead, novices respond to whatever their opponent’s latest move is. Total amateurs just move pieces based on shouts from the crowd watching the game. Obama’s like a kid looking for approval every time he touches a piece.

It’s sad because it’s true.