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AFAIC, I don't actually care whether his treatment is fake or not, I really do not care. He seems to have gotten the FDA Trial Phase I and Phase II approvals. So the stuff is safe for consumption, that's all that is actually important to know.

At that point I don't want government being anywhere near the treatments. There are plenty of cases where FDA involvement does one thing only: increase the cost of drugs or worse. If FDA even has to exist, it's role should be limited to questions concerning safety and nothing more, as it's useless in most important cases anyway.

http://en.wikipedia.org/wiki/Mifepristone#FDA_controversy

http://www.youtube.com/watch?v=9QqIN9EfQwM

Given the existence of the placebo effect, in what way do you suppose that the market -- consisting of individuals who operate on limited information -- will be able to tell the difference in efficacy between a non-steroidal anti-inflammatory and acupuncture?

- ha ha, the way it was always done, by doctors sharing information among each other, learning what works and what doesn't - the only real way things are found to be useful or not.

Especially given that so-called "alternative medicines" such as Zicam can effectively compete against science-based medicine even with FDA regulations in place? Do you propose we go back to the patent medicine era?

- I am against all patents altogether. There should be no gov't creating artificial barriers to entry against individuals and for monopolies and there should be no special treatment provided to monopolies, like in case with this, falsifying the results to help out some friends in giant pharma. However FDA routinely denies people in US access to drugs, that are used all over the world, for example the drug RU 386, which was used in Europe and was banned in US by FDA.

Why the fuck should some piece of shit government organization deny you access to drugs, any drugs if you wish so and especially drugs that are known to be effective and are in use in the rest of the world?

The reason we have the regulations we have by the FDA is because we tried working without them and, unsurprisingly, people died and a lot of unscrupulous hucksters made a lot of money.

- no, the reason you have FDA being what it is, is because it has enormous power, which translates into dollars for monopolies, who kill off the small competitors and make sure prices never fall.

We have the same thing going on now with homeopathic medicine.

- there is no reason for FDA to get involved into this homeopathic stuff, especially since it is just placebo.

What we need are good, functional, and smarter regulations, not merely fewer or more regulations.

- seriously? You truly believe that? You truly want government to regulate your life? To tell you, probably a grown ass man, what you can and cannot use in your life as drugs? To ensure that only monopolies can sell you drugs? To make sure you have to pay a small fortune for any real treatment?

Please check your facts before posting; this took me all of a minute with a search engine to find in PLoS.

- I'll give you some facts.

Here is one. A drug that before FDA approval only cost $10/shot (ten dollars), once approved by FDA was immediately repriced at $1500 dollars a shot (one thousand five hundred dollars), as FDA granted a monopoly to the producer company, so nobody could compete with them. This is for a drug that people need to take 20 times, so that's $30,000 for the 20 times instead of $200 as it was prior to FDA 'approval' - in reality granting a monopoly. The orders of magnitude, by which FDA raises costs to the end users are similar with this drug.

And yes, it only takes an Internet search.

I honestly don't know if you're trolling, ignorant, or being overly pedantic.

There isn't much scientific evidence about what kind of diet is "healthy."

How in the hell did you come to that conclusion.

Reading the New England Journal of Medicine, Journal of the American Medical Association, Lancet, BMJ, and Science, going to lectures at medical meetings by nutritionists and other doctors, and having them explain it to me to make sure I understood it correctly.

Studies over the last two decades alone very clearly show what is "healthy"; defined as good health and longer life in better health.

Actually, I think there was only one of healthy people, which found out that healthy people who ate a Mediterranean diet had lower death rates than people who ate a more western diet. http://www.nejm.org/doi/full/10.1056/NEJMp030069 I think that's the only one of a healthy population.

Needless to say, those diets are extremely unpopular.

Mediterranean diets are unpopular? I know a lot of awfully popular Greek restaurants.

Furthermore, studies dating back over the last several hundred years very clearly indicate what is unhealthy.

I'm sure that isn't true. Name one study, besides the NEJM study I cited.

So while we can't authoritatively say, eating x, y, and z will absolutely make you healthy, we absolutely can say, in general, a healthy diet looks like x. But its not like we don't know and acknowledge genetic variance plays a big role here.

But there were many studies (some of them randomized prospective trials) starting in the 1970s, and going on for long stretches of time, that compared *healthy* people eating low-cholesterol and high-cholesterol diet. (One of them was the MRFIT trial, if you want to look it up.) For people without heart disease, there was no difference in the death rates between the two groups.

If anyone knows of a scientific study that shows *healthy* people had better health outcomes long-term on one particular diet compared to a different diet, I'd like to know what it is.

You're conflating several things. Man, I'm using that word a lot today. The conflation is the fact you are specifically pulling out sub-segments of the population to hold against the average.

I don't know what you're talking about. Many of these studies deliberately incorporated a large number of diverse people, like the MRFIT study, the Nurses' study, etc. Even in the community population studies, there was no benefit to healthy people.

Many studies, for decades now, are attempting to better address the issue in more granularity but much of that is only possible with broader genetic studies and understanding of those genetics are it relates to both health and nutrient consumption.

In order for me to tell whether you actually know what you're talking about, could you name any of those studies?

So as I said above, we absolutely, for the broad population, know what an unhealthy diet looks like. Which, that alone is of great benefit. Furthermore, for the broadest of population, we know what a good diet consists of. And really, where this differs is typically about foods which fall outside of what he know is healthy or based on what we know bad foods are.

So yes, being absolutely pedantic, for every specific person, we can not authoritatively say, this is absolutely this most healthy diet for you. Just the same, on average, we can say a healthy diet should look something like this and we can tweak it to better reflect your health needs beyond that. But even more so, we absolutely do know, in general, what a bad diet looks like. That does leave lots of great area and perhaps even some overlap between the extremes, but even with that, t

Did you ever hear of the National Institutes of Health?

http://healthpolicyandreform.nejm.org/?p=13733&query=home

Sounding Board
Biomedical Research and Health AdvancesNEJM | February 9, 2011 | Topics: Other Health Issues
Hamilton Moses, III, M.D., and Joseph B. Martin, M.D., Ph.D.

In 1945, the President’s science advisor, Vannevar Bush, wrote in Science, the Endless Frontier 1 that basic scientific research was “the pacemaker of technological progress” and that “new products and new processes do not appear full-grown. They are founded on new principles and new conceptions, which in turn are painstakingly developed by research in the purest realms of science.” He recommended the creation of what would become the National Institutes of Health (NIH), which was created in 1948, and the National Science Foundation, created in 1950.

The biomedical-research enterprise in the United States soon became the envy of other nations, as well as the primary source of the world’s new drugs and medical devices. Since 1945, biomedical research has been viewed as the essential contributor to improving the health of individuals and populations, in both the developed and developing world.

Financing of research was ensured by the successes in the early 1950s of polio vaccination, antibiotics, and antipsychotic agents. Equally dramatic advances in surgery and medical devices, such as cardiopulmonary bypass, dialysis, and organ transplantation, followed in the 1960s. In the 1990s, the conversion of the acquired immunodeficiency syndrome and some cancers from uniformly fatal diseases to chronic conditions created an expectation that similar advances would occur for other devastating diseases.

P.S. Vannevar is not related to George. He invented the Internet in 1945. http://www.theatlantic.com/magazine/archive/1969/12/as-we-may-think/3881/

I know you're joking, but you could be right! I just ran across a study linking(weakly) lavender to breast growth in prepubescent males. Who the hell would have thought that something like lavender could affect sexual development?

http://www.nejm.org/doi/full/10.1056/NEJMoa064725

The world is probably full of phytochemicals that could have health consequences if consumed in sufficient amounts.

If someone can show a higher complication rate for surgeon, who are sleepy, then I'd consider the above proposal, otherwise it's just over reactionary crap.

Let's see some data, as opposed to truck driver, or pilot studies - 'cause surgery isn't anything like those jobs.

http://www.nejm.org/doi/full/10.1056/NEJMp1007901

Researchers have documented the adverse effects of sleep deprivation and sleep disorders on individual performance.1 In surgery, there is an 83% increase in the risk of complications (e.g., massive hemorrhage, organ injury, or wound failure) in patients who undergo elective daytime surgical procedures performed by attending surgeons who had less than a 6-hour opportunity for sleep between procedures during a previous on-call night.3

1 Ulmer C, Wolman DM, Johns MME, eds. Resident duty hours: enhancing sleep, supervision, and safety. Washington, DC: National Academies Press, 2008.

3 Rothschild JM, Keohane CA, Rogers S, et al. Risks of complications by attending physicians after performing nighttime procedures. JAMA 2009;302:1565-1572

I work a night shift in a hospital. If you've never worked one before, know that some nights you will be absolutely exhausted. I'm sure most night-shifters have fallen asleep at work before, if not on a regular basis. Doctors are not above this. Our hospitalists have on-call rooms to sleep in every night. If you code in a hospital overnight, chances aren't bad that one of the doctors that shows up was woken up by your code seconds before he showed up in your room.

My point is, hospitals are open 24/7. There is a night shift. Those people are usually tired. Also, emergencies happen 24/7. Sometimes patients can't consent to anything.

Imagine this: A patient shows up at 2am with an injury that would kill the patient before the morning shift came in. All the surgeons are asleep. You'd have to wake up an entire surgical team. All of them will be tired when they come in.

All that is true. Doctors often have to perform emergency surgery after inadequate sleep. But the point of the NEJM article http://www.nejm.org/doi/full/10.1056/NEJMp1007901 was that doctors shouldn't schedule elective surgery the day after they're on call. Some hospitals already have that policy. They argue that if they don't adopt that policy, they should at least inform the patient. I think it was more of a way to embarrass doctors and hospitals into adopting the policy rather than a serious solution to an ethical problem of informed consent.

There's a culture in medicine of working heroic hours. The fundamental solution is to change that culture. Surgeons have a culture of working long hours and making lots of money. The sleep research suggests that their outcomes would be better if they worked fewer hours (and made less money). I don't know how you can change that culture. Have woman surgeons?

I agree. If the surgeon's abilities are impaired for lack of sleep, he shouldn't operate, and it's the responsibility of the surgeon and the hospital to enforce that rule.

They can't dump the responsibility on the patient, especially by shoving an informed consent form under his hand in the 15 minutes before surgery. The patient isn't qualified to evaluate that risk.

This wasn't a BusinessWeek article, btw. It was a HealthDay rewrite of a New England Journal of Medicine article http://www.nejm.org/doi/full/10.1056/NEJMp1007901 [free]. The NEJM article more clearly made the important point that hospitals shouldn't get into these situations in the first place by letting surgeons schedule elective surgery after a night of being on call. Here's the hypothetical case from the original article:

A surgeon on overnight call responds to an 11 p.m. call from the hospital, where a patient has presented with an acute abdomen. After working up the patient for several hours, the surgeon decides to call in an anesthesiologist and perform a bowel resection. By the time the procedure is completed and the operative note has been dictated, it is time for morning rounds. The surgeon has not slept all night and is scheduled to perform an elective colostomy at 9 a.m. Does the surgeon have an obligation to disclose to the patient the lack of sleep during the past 24 hours and obtain new informed consent? Should the surgeon give the patient the option of postponing the operation or requesting a different surgeon? Should the hospital have allowed the surgeon to schedule an elective procedure following a night he was scheduled to be on call? Should it allow a surgeon to perform elective surgery after having been awake for more than 24 hours? What potential unintended consequences of disclosing a clinician's sleep deprivation should be considered?

From the New England Journal of Medicine:

"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive."

I've been working on this problem for 10 years (as a software designer, not a neuroscience researcher) and researchers who use our robots have many studies that show patient improvement, but this comes from providing controlled rehabilitation exercises, not just by driving their limbs with an exoskeleton. I think research indicates that the rehab benefit comes from having the patients work to control their own limbs (with assistance and guidance if necessary from a robot or therapist) rather than by just driving the limbs without the patient working the neural paths.

refs:
N Engl J Med 2010; 362:1772-1783 May 13, 2010
http://www.nejm.org/doi/full/10.1056/NEJMoa0911341
http://www.interactive-motion.com/clinical_research.htm

No matter how hard terrorists try, what if there is a disease that will wipe out 1/2 of the world's population in our lifetime anyway? This disease causes people to spontaneously fall into comas, go blind, become covered in open sores, spontaneously lose limbs, and die horrible deaths. And no, I am not talking about AIDS.

The media, public opinion, and policy makers have shown no interest in this incurable disease.

What if scientists say that half of Americans will get this disease in the next 10 years, 1 out of 4 Chinese are already affected by it, and 1 out of 3 Nepalese are affected? Maybe we are in the midst of the 21st Century Black Plague, and nobody realized it.

http://www.medicinenet.com/script/main/art.asp?articlekey=122611
http://www.nejm.org/doi/pdf/10.1056/NEJMoa0908292
http://myrepublica.com/portal/index.php?action=news_details&news_id=25199

Well, maybe you can help me.

Certainly. Thanks for the paper, I look forward to absorbing it.

I'm having serious difficulty finding any serious refutation of in-depth studies of radiation hormesis (which you claim makes someone lose all credibility).

Well first of all, and most obviously, Rockwell draws a long bow to compare "acting like a vaccination to reduce cancer rates and extend lifespan of nuclear workers and atomic bomb survivors" presumably to the paper which you link. Radon is one of the comparably benign radionuclides and a nuclear worker is likely to encounter that and more yet the paper (presumably - as that is the title) only speaks to radon and it's daughter products whose half lifes fall *within* a human life span.

However there is plenty of work surrounding ingested low-energy emitters, in particular Tritium which a nuclear worker is as likely to encounter.

Tritium is biologically mutagenic *because* it's a low energy emitter, like radon. This characteristic makes readily absorbed by surrounding cells. The available evidence from studies conducted journal a list of effects if you are looking for similar studies as refutation. From those works;

Tritium can be inhaled, ingested, or absorbed through skin. Eating food containing radionuclides 3H can be even more damaging than drinking 3H bound in water. Consequently, an estimated radiation dose based only on ingestion of tritiated water may underestimate the health effects if the person has also consumed food contaminated with tritium. (Komatsu)

Studies indicate that lower doses of tritium can cause more cell death (Dobson, 1976), mutations (Ito) and chromosome damage (Hori) per dose than higher tritium doses. Tritium can impart damage which is two or more times greater per dose than either x-rays or gamma rays.

(Straume) (Dobson, 1976) There is no evidence of a threshold for damage from 3H exposure; even the smallest amount of tritium can have negative health impacts. (Dobson, 1974) Organically bound tritium (tritium bound in animal or plant tissue) can stay in the body for 10 years or more.

It's often said "of all the elements in nuclear waste tritium is one of the more harmless ones" and while it's more benign than most other radioactive effluents it's toxicity should not be under-estimated.

Tritium can cause mutations, tumors and cell death. (Rytomaa) Tritiated water is associated with significantly decreased weight of brain and genital tract organs in mice (Torok) and can cause irreversible loss of female germ cells in both mice and monkeys even at low concentrations. (Dobson, 1979) (Laskey) Tritium from tritiated water can become incorporated into DNA, the molecular basis of heredity for living organisms. DNA is especially sensitive to radiation. (Hori) A cell's exposure to tritium bound in DNA can be even more toxic than its exposure to tritium in water. (Straume)(Carr)

First, as an isotope of hydrogen (the cell's most ubiquitous element), tritium can be incorporated into essentially all portions of the living machinery; and it is not innocuous -- deaths have occurred in industry from occupational overexposure. R. Lowry Dobson, MD, PhD. (1979)

Maybe if you're so experienced in debating these issue, you could provide me with such a refutation to Bernard L. Cohen's paper published in Health Physics from 1995 titled "Test of the linear-no threshold theory of radiation carcinogenesis for inhaled radon decay products."

Perhaps you can find that in the paper Histopathologic findings of lung cancer in Navajo men: relationship to U mining and you can read Lung Cancer after Exposure to Radon Daughters and for materials and circumstance background you can read

This is not how vaccination rewards are decided. They are a part of the special VAERS program which is decided by a "vaccine" court NVICP (http://www.hrsa.gov/vaccinecompensation/). There are actually experts who decide compensation.

Yeah, that I understand, but what I don't understand is why the NVICP makes irrational decisions that favor the people who claim that their injury was caused by a "plausable" mechanism.

http://www.nejm.org/doi/full/10.1056/NEJMp0802904

Unfortunately, in recent years the VICP seems to have turned its back on science. In 2005, Margaret Althen successfully claimed that a tetanus vaccine had caused her optic neuritis. Although there was no evidence to support her claim, the VICP ruled that if a petitioner proposed a biologically plausible mechanism by which a vaccine could cause harm, as well as a logical sequence of cause and effect, an award should be granted. The door opened by this and other rulings...

No case, however, represented a greater deviation from the VICP's original standards than that of Dorothy Werderitsh, who in 2006 successfully claimed that a hepatitis B vaccine had caused her multiple sclerosis. By the time of the ruling, several studies had shown that hepatitis B vaccine neither caused nor exacerbated the disease, and the Institute of Medicine had concluded that “evidence favors rejection of a causal relationship between hepatitis B vaccine and multiple sclerosis...."

What is this NVICP and why do they accept these unscientific claims of "biologically plausible mechanism"? Are they ignorant of science? Or are they required by the words of the legislation to accept claims like this?

The current "jackpot jury" system is sot irrevocably broken it's not even remotely funny.

The jury isn't qualified to evaluate the data presented and inevitably comes to ridiculous conclusions. All malpractice/medical injury claims should be decided by a committee of practicing doctors to decide if there was actually malpractice.

But fault and compensation in vaccine cases isn't decided by a jury. It's decided by the Vaccine Injury Compensation Program. It's a no-fault program.
http://www.nejm.org/doi/full/10.1056/NEJMp0802904

Taking the decision away from the jury and giving it to an expert panel isn't necessarily going to give better decisions, and it may give worse decisions.

It may be that the Poling case is unusual, and subsequent cases like this will be rejected. The courts threw out the autism cases.

According to the NEJM it is encephalopathy. http://www.nejm.org/doi/full/10.1056/NEJMp0802904#ref2 The catch is that the ruling mentions autism in the heading as that was the allegation. http://www.uscfc.uscourts.gov/sites/default/files/CAMPBELLSMITH.%20DOE77082710.pdf The government settled with calling it encephalopathy with features of autism spectrum disorder.

The following article from the New England Journal of Medicine has a good summary of why the Vaccine Injury Compensation Program exists, and why some of its recent decisions, including the award in the Poling case, have been problematic. Basically, since 2005 the policy has been to concede cases where petitioners establish a plausible theory by which their injury could have been caused by the vaccine, rather than requiring proof or even scientific evidence that the vaccine caused said injury.

http://www.nejm.org/doi/full/10.1056/NEJMp0802904

See also the Wikipedia article on the program, which also discusses the Poling case.

http://en.wikipedia.org/wiki/Vaccine_court

Thank you. That's Slashdot. Sometimes you get modded up, sometimes you just reach an appreciative audience, which is also nice.

It just goes to show how much you can learn from the New England Journal of Medicine.

Here's another one that you might be interested in:

Perspective

International Medical Aid
Collateral Damage — Médecins sans Frontières Leaves Afghanistan and Iraq

Ingrid T. Katz, M.D., M.H.S. and Alexi A. Wright, M.D.

http://www.nejm.org/doi/full/10.1056/NEJMp048296

The Pentagon repeatedly denied allegations that the provincial reconstruction teams endangered aid workers, but the U.S. government continued to refer to NGOs as partners in the war effort. Secretary of State Colin Powell referred to them as “force multipliers” and members of the “combat team” in a speech delivered before NGO community leaders.1 In May 2004, one month before the murders, coalition forces distributed leaflets in southern Afghanistan showing a man carrying provisions with this message: “In order to continue the humanitarian aid, pass over any information related to Taliban or Al-Qaida to the coalition forces.”

I also posted this on Slashdot, although the ensuing discussion was not always worthwhile.
http://slashdot.org/comments.pl?sid=1740870&cid=33118542

Any enemy of the US is our friend.

I'll bet you'll shut up the next time something bad happens to your country and the U.S. parks a giant hospital ship off your shores and starts dispensing free medical care.

I can tell you don't know anything about hospital ships or the U.S. delivery of health care to the third world. Here's an article by somebody who does, Paul Farmer, who has been helping the Hatians develop their own health care system (not "dispensing free medical care," but giving them the developmental assistance the Haitian doctors told him they need).

http://www.nejm.org/doi/full/10.1056/NEJMp048081
Perspective: Political Violence and Public Health in Haiti
Paul Farmer, M.D., Ph.D.
N Engl J Med 2004; 350:1483-1486 April 8, 2004

... There is no denying that Haiti's 33rd coup d'etat brings an end to constitutional rule. As physicians and health workers, we must note that Haiti's only large public teaching hospital has been paralyzed by violence and dissent. For years, economic pressure resulting largely, though not wholly, from an international embargo on loans and aid has left almost nothing to invest in the care of the destitute sick.

To make that clear, the U.S. government had an embargo on Haiti, preventing them from getting basic economic necessities, including medical supplies and medical services. The Clinton Administration imposed a neoliberal program on Haiti that also helped to destroy the economy:

http://en.wikipedia.org/wiki/Aristide
Noam Chomsky is highly critical of what he calls hidden American imperialist actions in Haiti; "When Clinton restored Aristide--Clinton of course supported the military junta, another little hidden story...he strongly supported it in fact. He even allowed the Texaco Oil Company to send oil to the junta in violation of presidential directives; Bush Sr. did so as well-well, he finally allowed the president to return, but on condition that he accept the programs of Marc Bazin, the US candidate that he had defeated in the 1990 election. And that meant a harsh neoliberal program, no import barriers. That means that Haiti has to import rice and other agricultural commodities from the US from US agribusiness, which is getting a huge part of its profits from state subsidies. So you get highly subsidized US agribusiness pouring commodities into Haiti; I mean, Haitian rice farmers are efficient but nobody can compete with that, so that accelerated the flight into the cities."

As Paul Farmer explained, there is a health care myth that developed nations can "deliver" health care to third-world nations. This provides propaganda pictures of doctors in helicopters and hospital ships, but doesn't help the real problems. What third world countries need is doctors (like Farmer) who will help them develop their own health care system, and make a commitment to stay as long as it takes. Patients in Haiti will have needs for their entire lifetimes. U.S. hospital ships will only be around for a month and then will go home. A country like Haiti needs a coordinated health care system. The U.S. was disrupting the Haitian doctors' attempts to coordinate care by setting up alternative health care providers to compete with the Aristide government. The U.S. was politicizing health care, at the expense of the patients and the Haitian health care system.

According to first-hand accounts that I heard on the radio (but can't find the links to), when the U.S. moved into Haiti during the recent flood, the first thing they did was set up a military beachhead of marines to provide unnecessary "security," not send medical workers out where they were needed.

The Cuban government also sent doctors to Haiti, and they're still there. Since they're familiar with third world conditions (Cuba

"or else you won't get medical care."

You made that up. #fail

That is exactly what they said. The Coalition forces dropped pamphlets saying, “In order to continue the humanitarian aid, pass over any information related to Taliban or Al-Qaida to the coalition forces.”

(It's amazing how right wingers just make up facts without knowing anything about the subject at all. Then they accuse others of making things up. I can never figure out whether they're lying or stupid.)

We sent doctors. We said we'd compensate those who helped us, including by getting them medical care. DWB's resources are limited. Giving people more medical care is not a bad thing, it's a good thing.

Doctors have an ethical obligation to give medical care without conditions.

Giving medical care on the condition that patients inform on the Taliban (and get killed if the Taliban find out) is a bad thing. It's a violation of medical ethics.

Doctors Without Borders is one of the largest medical charities in the world (they've actually told contributors that they didn't need more money). They're far more effective than other organizations because they work closely with local doctors and patients, over decades, and know their needs, rather than parachuting in for a month's third-world charity vacation like some of the U.S. medical charities. The Journal of the American Medical Association had an article about medical crises telling doctors to stay home if they're not part of an experienced program. They get in the way.

This kind of help does more harm than good. Specifically, the Coalition forces' medical "relief" teams took sides among the combatants and turned medical workers into military targets. The Taliban couldn't tell the difference between them and they were getting killed.

The only bad thing here is your bogus characterization of this as politicization of doctors by America. The people who politicized doctors are the Taliban. The people who drove DWB out are the Taliban.

And your source of information is?

(I'll answer for you. Your source is, you made it up.)

The U.S. forces clearly politicized the delivery of medical care. They were open about it.

Here's the NEJM article about it. I'm not sure whether it's available free on line so I'll quote substantially:

Perspective

International Medical Aid
Collateral Damage — Médecins sans Frontières Leaves Afghanistan and Iraq

Ingrid T. Katz, M.D., M.H.S. and Alexi A. Wright, M.D.

N Engl J Med 2004; 351:2571-2573 December 16, 2004

http://www.nejm.org/doi/full/10.1056/NEJMp048296

MSF worked in Iraq for a total of four years over two separate periods but spent more than two decades in Afghanistan — throughout the Soviet occupation, the Taliban regime, and the military action led by the United States. ...

At the same time, many NGOs argued that the work of humanitarian-aid groups was being coopted by the coalition forces to serve as part of its campaign to win “hearts and minds” in both Afghanistan and Iraq. Throughout the reconstruction period in Afghanistan, MSF objected to the blurring of boundaries between the military and humanitarian-aid communities, criticizing the coalition government's strategy of deploying provincial reconstruction teams that placed soldiers and civilians side by side when delivering food, medical care, and economic assistance to the Afghanis. They argued that nationals were unable to distinguish between MSF clinics and clinics built by the military.

The Pentagon repeatedly denied allegations that the provincial reconstruction teams endangered aid workers, but the U.S. government continued to refer to NGOs as partners in the war effort. Secretary of State Colin Powell referred to them as “force multipliers” and members of the

I said how the problem of people starving isn't from lack of food but because of other reasons.For instance Zimbabwe used to to the breadbasket of southern Africa but since Robert Mugabe came to power it has been a basket case. Politics reduced Zimbabwe from a food exporter to a nation that needs food donations.

GM crops with increased yield help no matter what the cause is. Famine though plant blight is common, and GE is the best way to get rid of it.
http://www.africanagricultureblog.com/2010/01/gates-foundation-to-fund-cassava.html

But more importantly, there are many areas of the world where the problem isn't caloric, but nutritional. Golden rice is the poster child for this. Lack of vitamin A leads to blindness and death, so adding it to the rice in places where that is the staple diet can save many.. http://en.wikipedia.org/wiki/Golden_rice

Golden Cassava was developed (patent free, with grants from the Bill and Malinda Gates Foundation)to solve similar problems in Africa. Before the Cassava blight it was starting to be used by World Vision in its aid work.

It is a good sign that the people who understand GM techniques are the least scared of GM food.

I disagree. Though no expert I understand GM techniques, and because I do I am scared of them. For instance I am afraid Monsanto's Roundup Ready crops are creating superweeds.

Pesticide use made that problem(if it turns out to be one), not GE. Without GE other pesticides would be used, and pesticide resistant plants would evolve.

I am afraid allergins will be introduced into food that does not contain it now.

So we made a gene transfer, did tests, and it did what we thought it would? What's the rest of the story? Is the resulting food being marketed?

And I am concerned about the unforeseen. Asbestos used to be called the miracle mineral because of its acid and heat resistance. Well now we know how deadly it is.

I am not calling for an end to genetic engineering, I applaud it's medical potential. What I am calling for is more thorough research being done before it's released into the wild, which is not being done.

Falcon

What research is being done now, how is it insufficient, and how would you change the level of research required?

"Green" campaigns against GM technology that is truely patent and licensing free, created by non-profits for the good of poor nations, is causing people to die of starvation and malnutrition.

Citation needed. You did include a quote from a doctor of plant pathology but does he consider non-GM answers? In a previous post I said how the problem of people starving isn't from lack of food but because of other reasons. For instance Zimbabwe used to to the breadbasket of southern Africa but since Robert Mugabe came to power it has been a basket case. Politics reduced Zimbabwe from a food exporter to a nation that needs food donations.

It is a good sign that the people who understand GM techniques are the least scared of GM food.

I disagree. Though no expert I understand GM techniques, and because I do I am scared of them. For instance I am afraid Monsanto's Roundup Ready crops are creating superweeds. I am afraid allergins will be introduced into food that does not contain it now. And I am concerned about the unforeseen. Asbestos used to be called the miracle mineral because of its acid and heat resistance. Well now we know how deadly it is.

I am not calling for an end to genetic engineering, I applaud it's medical potential. What I am calling for is more thorough research being done before it's released into the wild, which is not being done.

Falcon

New GE plants are tested by the FDA, the NIH, and the EPA

That's what you think, but it in not true. As the NIH's Medline says "Genetically engineered foods are generally regarded as safe. There has been no adequate testing, however, to ensure complete safety. There are no reports of illness or injury due to genetically engineered foods. Each new genetically engineered food will have to be judged individually." Bold added by me.

There have been toxic chemicals found in food sold that have been "traditionally" engineered, but none that have been "on purpose" engineered in in what has become known as GE.

Really? So soya with brazil nut genes, which can cause serious allergy reactions including death, has not been found to be allergic as well? And the military hasn't spend a lot of money developing biological agents, such as anthrax?

GM food is safer then it's counterparts. I'll take the GM food, please..

Citation needed for the safety. As for taking it, go ahead and keep it. Just don't force it on me.

I recommend the Whole Earth Discipline. Where he talks about his expertise (he's an ecologist/biologist by training) he's spot on. I don't agree with him on all the topics included in the book

If his expertise is "spot on" why don't you agree with everything he says? After-all he's an expert. Because the rest doesn't agree with what you want?

Falcon

"Identification of a Brazil-Nut Allergen in Transgenic Soybeans"

Full article from 1996 New England Journal of Medicine

http://content.nejm.org/cgi/content/full/334/11/688

-- Terry

"This leads to people avoiding preventive care, which drives up costs in the long run."

No, you are wrong. As it turns out, preventative care - on average - does not lower cost. So says the NEJM "Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not."

http://content.nejm.org/cgi/content/full/358/7/661

City College, the GI bill, and Andrew Grove were a special case?

Absolutely. Currently, I gather there are somewhere over a hundred million college graduates in the US plus a bunch more with either an associate degree or a few college courses.

The City college system is a drop in a bucket compared to those numbers. When you are discussing programs that are at best a small fraction of the entire group, then calling them a "special case" is not in the least a stretch.

The CCNY was a small system that produced a large number of Nobel laureates (using Nobel laureates as a proxy for all the other accomplished graduates). They also produced leaders in politics, finance, law, and other fields.
Their economic influence wasn't a drop in the bucket. Intel was a major contribution to the U.S. economy. It was replicated in the state university systems of New York and California.

At CCNY, you could walk into your professor's lab and see the research he was doing. You can't do that at a 2-year college with vocational courses taught by adjuncts.

When you have a model that works well, you expand it, not destroy it. But some people oppose public education for ideological reasons.

If you wind up in an emergency room with a heart attack or a stroke, do you want to be treated by a registered nurse who doesn't have a four-year degree?

If a nurse is going to decide on whether to pull the plug on you while you're unconscious, I'd want a nurse who took some philosophy courses.

I can't take this seriously. There's already cut and dry medical "philosophy" that covers this situation. Basically, if I made a "do not resuscitate" document, then they're supposed to pull the plug (by "they" I mean someone with a pay grade above nurse makes the decision to comply with the document). If it's a crisis situation (with lots of injured people), then there is triage where they put me aside while they help someone that can be helped. These things are too important to leave to philosophy.

Boy, if you think the decision on whether to pull the plug is as simple as that Wikipedia article makes it out to be, then you are a walking advertisement for the dangers of a narrow specialized education. If you come into the emergency room unconscious, how can you sign a DNR order? In reality, http://content.nejm.org/cgi/collection/medical_ethics advanced directives are usually useless because there are too many possibilities for any document to cover all of them. These decisions are often made by ethics committees that include nurses.

Suppose a baby is born with a genetic defect and will die right away without resuscitation, and will die anyway after 6 months of painful, expensive treatment. Do you want a right-to-life nurse to impose her own religious beliefs on the couple and take it upon herself to perform resuciation? Or do you want a nurse who has taken a couple of philosophy courses and has had her ideas challenged by someone who believes differently?

Nurses aren't just technicians. They need a liberal arts education to do their job well.

That's a good example of the dangers of downgrading qualifications. If we replace well-educated nurses with 4-year degrees with poorly-educated nurses from 2-year technical schools, we'll have unqualified nurses making bad life-and death decisions. It's important to for a nurse to understand that a medical professional can't impose her own religious beliefs on her patients. I don't think you can teach that lesson in a stripped-down 2-year vocational course.

And the NYT article just repeats the myths. We don't know that college improves salaries or makes better voters. Correlation does not imply causation. The people

In the US, they treat the test results, regardless of the condition of the patient. Outside the US, they treat the patient, using the test results as a tool to that end. That difference alone is a major factor as to why the US has the most expensive health care on the planet, yet a middle of the pack (for industrialized nations) life expectancy.

25% of US healthcare spend is on admin and associated paper pushing, according to these chaps, and this article puts the estimate at over 30%. For the UK, for example, I've seen estimates of between 5% and 15%, and everyone over here thinks the NHS overly bureaucratic.

Actually, as it turns out, we're both right. Short term costs would fall but long-term would rise as people live longer.

Thanks for the motivation to look it up, though. It's intriguing.

Every time I hurt, my wife suggests I go to a chiropractor. But I don't -- because I don't know who I can trust. How do I know it's not some quack? How do you find that "really skilled person" and know you have one of those "very specific problems in the back?"

My current theory is to ask them what they can cure. If they say suggest wacko things like cancer and ear aches, I'll go somewhere else. You'd think there would be a better way, though, wouldn't you?

I suggest finding one who is also a practising MD.

I used the services of Dr. Jeffery Balon (both as an MD and as a chiropractor) when he was working in a clinic near my workplace. I once Googled him on a whim and found out that he was actively involved in debunking the claim that chiropractic manipulation can cure asthma.

Unfortunately, he's back to Ottawa.

The argument isn't that spending less on health care gets you better health care and thus longer life expectancy. It's that there's a pretty strong correlation and causal relationship between spending more on health care and longer life expectancy, yet the U.S. is a huge outlier when plotting the two against each other. The U.S. way overspends for what is objectively worse health care overall.

The specific point about UHC countries spending less and getting longer life expectancy is to counter the uniquely American argument that UHC can't possibly be affordable, that it'll bankrupt any country. That's demonstrably untrue. In fact, there are specific cost efficiencies in a single payer system--starting with administrative costs: From a paper published in the New England Journal of Medicine in 2003:

administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.

So then all laws requiring motor vehicle insurance are unconstitutional? That would be interesting.

The car insurance analogy is like comparing apples and oranges. First of all the government does not make you drive, but if you do drive you need insurance to have the privilege of using public roads. But to further tear up your argument. The government can revoke your license if you drive poorly, can the same be said for health care? Wouldn't that be like telling people who smoke that they can't go to the doctor anymore? Driving a car on public roads is a privilege that can be revoked. Living is not. Simply being born under this bill will require you buy something, and if progressives get a single payer plan, you will most likely buy from the government.

We spend 17% of our GDP on health care right now. Other nations get the same or better overall results spending less than half of this. Yes you might have to wait for some services but there is clearly huge inefficiencies in the current system, so much so that it is easy to argue that even a government run program would be better.

If you are diagnosed with a disease like cancer, time is your #1 enemy, and oftentimes it is how long it takes to get a CT scan or see an oncologist that makes the difference between life and death. So, you see, this is a really major issue. If you had a sucking chest wound would you want to wait more or less time? For that matter, if you had anything wrong with you, would you want to wait a longer time? You say there are huge inefficiencies in our system, but then fail to point out a single one. Here's a link that pretty much blows that whole argument out of the water though: Most Cancer Survival Rates in USA Better Than Europe and Canada. This is due to our better health care system. By the way, can you produce a list of high profile individuals that flew from the U.S. to the U.K. or Canada to receive medical treatment? Because they sure come here in droves! You also fail to point out how out health care system will compare when 1/3 of the doctors quit, and incentives (high pay) to practice medicine decrease.

Other nations get the same or better overall results

I'm going to have to call you on that one. Maybe you can point out another country that has a better medical system, since they are so numerous and all. Be nice if you provided a link. Something real too, I don't want to hear about how the U.K. has more coverage, even if they have to wait for 6 months for a CT scan. Coverage delayed is coverage denied.

it is easy to argue that even a government run program would be better.

I pointed out in my earlier post that medicare is the #1 denier of claims. I pointed out how medicare costs are rising almost 2x as fast as private insurance, And cost estimates were wildly underestimated (predicted $9b actual $67b). How does that jive with your argument that the government run program is better? We have the proof that it is not run better right there! Where is your proof that the government is going to be more effective? Seems like you just want to debate the points you think you have a shot at winning, or so you thought!.

There is quite a bit of evidence that the US has a huge and expensive overcapacity in exotic medical devices brought about by our current insurance system. We also clearly pay far more for the same drugs than people in other countries.

If there is quite a bit of evidence, I'm sure it wo

Let me count the ways:
Constitutionality:
The constitution says people cannot be coerced into signing a contract. By anyone. If you don't like it amend the constitution, but you cannot just make up your own laws. That's called anarchy. So right there the bill is dead. But let me go on.

Common sense
The kings of inefficiency. The same people who spent so much of your social security and medicare money on things besides social security and medicare, to the point that the two programs have unfunded liabilities of over $100 trillion, are now going to, according to the bill, take 500B from medicare to pay for the new program and supposedly expand the roles of people on medicare and the new plan. Do some simple math! If you have a system that's already out of money, and you take more money from it to start a similar system, more than triple the number of people receiving benefits, it's going to cost more not less! You have to be insane if you think adding people to the government's dole will somehow lower costs as progressives claim. Keep in mind that in 1965 lawmakers predicted it would only cost 9$ billion by 1990, unfortuanly the real cost was $67 billion. But don't worry they were only off by A FACTTOR OF 7. I'm sure they are better and more trustworthy in making cost estimates today. Congress would never deceive us!

This bill causes lack of care (not coverage)
Sure the government will cover you for all preexisting conditions, there will just be no faciliteis or doctors to treat you! OH BUT YOU'RE COVERED!!! Tell it to the people in the UK or Canada who are waiting 6 months for a CT scan, where here in the U.S. it's unusual to wait for more than a few days. The New England Journal of Medicine estimates that a full 1/3 of doctors will "QUIT PRACTICING MEDICINE" if the bill passes, further eroding our resources. So ya, you're covered, but you're going to have to wait a few years for that liver transplant now. People other countries will no longer have a "capitalist health care system" to save them, unfortunately nether will we. We will have a government panel deciding who is worth said liver transplant and deciding who gets to live and die, instead of your doctor or a panel of your doctors. A healthy 19 yr/old kid, who hasn't put a dime into the system will be placed higher on the list than say a 60 yr/old man who has paid into the system his whole life. In essence the 60 yr/old man worked his whole life paying into a system that will deem him unworthy and spend his money on someone whom he has never met while he suffers and dies while younger "more economically viable" people will get treatment first. In the existing system, the same 60 yr/old man would be able to do whatever it takes for him to get his liver (insurance,debt,sell car/house etc.). While dems try and portray private insurers as evil for turning down procedures, drugs etc. keep in mind that the number 1 denier of care per capita is medicare! So there's another false argument made to try and pass this bill.

How much is too much?
People in this country continue to live longer and longer. This is attributable not to better diets or healthier living, but as a direct result of having invested such large sums of money into our health care system. I've heard 17% from democrats, decrying the amount. Dems say that our private insurance is increasing at too fast a rate (3%/yr) but they want to change us to a system that is similar to the unfunded medicare, but medicare is increasing at a rate much faste

• Via the Commerce and General Welfare Clauses
• It's really more of a (pretty modest) tax, and not a mandate
• It's filled with exclusions and not actually universal

In 1999, administration cost $1,059 per capita in the US, versus $307 per capita in Canada, per New England Journal of Medicine. So much for private businesses being better than the government. I've lived in Cyprus, UK, Canada, USA, Australia and China, and my experience, the UK has the most encompassing system, and Canada (Ontario at least) the most proactive and efficient. I totally hated the American system, and I can't say I'm much of a fan of what I saw in Melbourne. China was great as an expat because it was so bloody affordable, but that's not what we're discussing here.

Genetic discrimination is a worry, of course, but the risk of it is far outweighed by the benefits which understanding the role of genetics in human health offers. And the Genetic Information Nondiscrimination Act (GINA) is actually a pretty good law.

As for the medical usefulness of genetics ... warfarin (Coumadin) is one of the most widely used clot-busting drugs in the world, and IIRC this has now been incorporated into the dosage guidelines. It isn't quite the same as actually curing a genetic disease, of course, but it is an important advance which has the potential to save a lot of lives.

Even more important,sodium regulates nerve signals, but put that aside for the moment.

I read the New England Journal of Medicine article that was promoting a lot of this, and it made me worry http://content.nejm.org/cgi/content/short/362/7/590

The dietary limits for salt are about 5 grams a day, and you only need 2 or 3 grams a day. American men eat an average of 10 grams a day. We're eating way more salt than we used to 50 years ago. Forget about the hunter-gatherer days.

The evidence isn't irrefutable yet -- nobody has taken a large population and randomly divided them into a high-salt and low-salt group for 15 years, and they probably never will. Excess salt is probably safe for young, healthy people. But nobody stays young and healthy forever.

A huge number of people are getting high blood pressure and strokes, and people on high-salt diets seem to get more strokes. I know people who got strokes. I'd rather be dead than have to live for the last 3 or 4 years of my life ranting at my caretakers without my cognitive facilities, or with the left half my body paralyzed.

Unfortunately for the free-market personal choice crowd, you can't simply reduce salt in your diet by avoiding the salt shaker.

Most salt comes from processed food and restaurant food, and not just potato chips.

I thought I was OK because I was eating chicken, but I read in the NEJM that chicken is injected with salt and water (so that I can buy water at the price of chicken). Nothing on the label about that. Thanks, FDA.

So the only way to reduce salt in your diet is to get to the source -- the manufacturers (and the restaurants) who put salt in your food without telling you. Actually some of the food manufacturers, like Kraft, are cooperating. They say that once people get used to lower-salt food, it tastes fine (like it used to 50 years ago). The European countries did this and it worked well.

Sure, excessive salt can be dangerous, but not nearly as dangerous as not enough

Americans suffering from nutritional deficiency because they don't get enough salt? Ridiculous.

I am unimpressed by that MRI image before-and-after, which simply shows localised swelling resolving later on. Cancer risks have been explored enough in this thread, but what about any randomised testing against placebo or sham surgery? It's not like orthopaedics hasn't had repeated booms in lucrative, minimally invasive "treatments" that RCTs have later shown to be no better than placebo, or worse if you take the risks into account.

I am unimpressed by that MRI image before-and-after, which simply shows localised swelling resolving later on. Cancer risks have been explored enough in this thread, but what about any randomised testing against placebo or sham surgery? It's not like orthopaedics hasn't had repeated booms in lucrative, minimally invasive "treatments" that RCTs have later shown to be no better than placebo, or worse if you take the risks into account.

I am unimpressed by that MRI image before-and-after, which simply shows localised swelling resolving later on. Cancer risks have been explored enough in this thread, but what about any randomised testing against placebo or sham surgery? It's not like orthopaedics hasn't had repeated booms in lucrative, minimally invasive "treatments" that RCTs have later shown to be no better than placebo, or worse if you take the risks into account.

Thus, identical mitochondrial DNA will exist through the maternal hierarchy of families. There have already been found exceptions to this statement. See this: http://content.nejm.org/cgi/content/full/347/8/576 A man with a severe mitochondrial disorder was found to have inherited his father's (not his mother's) mitochrondrial DNA, along with a new mutation unique to the patient which caused his disorder. From that article: "paternal mtDNA inheritance may go unrecognized ... because mitochondrial haplotypes are rarely investigated in diagnostic analyses."

If you take the issue of 'death panels' with an open mind, for example, you will find that there is some substance to the fear that underlies it. In a given system with limited resources, someone has to decide who lives and who dies. In a capitalist system this decision is based on who can pay for the treatments and who cannot. In some other system it would be dealt with in some other way, but with limits on the resources it will have to be dealt with. Since 'socialized medicine' is still a capitalist system with a government payer, then it stands to reason that the government would be deciding who lives and who dies by virtue of what it pays out.

At the risk of being boring, and oversimplifying, I'm a health policy wonk and I know a bit about the "death panels" and rationing.

The person to popularize the idea of "death panels" was Betsy McCaughey, a Republican activist who used similar attacks against the Clinton health care bill. I've read her stuff for years in the Wall Street Journal editorial page. She took up one issue, hand-washing, which is a motherhood-and-apple-pie issue in medicine, and made some good points. She's not a doctor, and she has no particular training in health policy.

A lot of doctors had a recurring problem with patients at the end of their life. They'd wind up with an elderly, very sick patient who was unconscious, deteriorating and unlikely to recover. The family would be waiting day and night in the hospital lounge, the patient would be costing the hospital (or Medicare, or the insurance company, or somebody) $2,000 a day in the ICU, and the family wouldn't know what to do. Families sometimes had arguments that tore them apart. Doctors tell stories about the adult child who hasn't seen the parent in 20 years, who suddenly calls on the phone and insists that they do "everything" for their hopelessly dying parent.

That's probably the way you will die.

Most doctors have always felt that they should have a discussion with their elderly patients *before* they get sick, with their families, to decide how they want to be treated in such a situation. Many of them do have discussions. The problem is Medicare doesn't pay for those discussions. (That's one of the standard criticisms of medical reimbursment: they pay for procedures, but they don't pay for discussions with patients.)

So a pair of Republican and Democratic congressmen got together and offered a bill that would provide for Medicare to pay for those discussions.

That's what Betsy McCaughey blew up into the "death panels." Probably the best discussion of this was Jon Stewart's interview with Betsy McCaughey (which tells you something about the news today). McCaughey took some language from the bill and misinterpreted it with wild speculation, as Stewart pointed out. If you want to plow through the details, the New England Journal of Medicine had several articles about it and I think those articles are free on the http://www.nejm.org/ web site.

It doesn't really have anything to do with limited resources, or rationing, or the economic limits to health care. It was a deceptive political attack. Its purpose was to make the Democratic health reform bill fail, and to replace an honest discussion with a shouting match.

Probably a lot of books written on it -- Atul Gawande did a pretty big "study" with safety checklist prior to OR activation. We have several checklists (independent of anesthesia) before starting any invasive procedure, so this is kind of behind the times. It is more targeted at foreign hospitals or places that have a lot of mid-level providers that are not used to things. If you are interested, the full study can be found here:

http://content.nejm.org/cgi/content/full/NEJMsa0810119

gbutler69 writes:
>Says who? Citation Please?
[snip a bunch of rhetorical questions]

From your questions I infer you are completely out of touch with this field in any sort of form. If you want a citation, do a tad of research on your own and you will discover things; I won't spoon-feed.

Poke around here to start (but some of this might be biased the *other* way.) Do a good deal of academic reading and you will get a good feel of what is going on:

http://www.sickoflawsuits.org/

http://h1n1.nejm.org/

H1N1 killed 3,000 so far in the U.S., almost all of them 45, most of them 30 and a large number of them 5. This is unusual. These are healthy people who would have gone on to live full, healthy lives if they hadn't died of H1N1.

How do you know that? My crystal ball remains cloudy.

New England Journal of Medicine. http://www.nejm.org/ I think most of their articles on the flu are available free. http://h1n1.nejm.org/?ssource=rthome They had a couple of articles in particular reporting on the experience of H1N1 in the U.S. I had some problems inserting the urls when I posted before, and that's my fault.

I'll leave the debate to people who have Citation Manager.

H1N1 killed 3,000 so far in the U.S., almost all of them 45, most of them 30 and a large number of them 5. This is unusual. These are healthy people who would have gone on to live full, healthy lives if they hadn't died of H1N1.

How do you know that? My crystal ball remains cloudy.

New England Journal of Medicine. http://www.nejm.org/ I think most of their articles on the flu are available free. http://h1n1.nejm.org/?ssource=rthome They had a couple of articles in particular reporting on the experience of H1N1 in the U.S. I had some problems inserting the urls when I posted before, and that's my fault.

I'll leave the debate to people who have Citation Manager.

Dude, cherry picking articles that are convenient to preserve ignorant opinion won't get you far with me. Notice the stipulations of that article are exclusive, not inclusive.

I'm not on campus right now but I bet I could dig up a ton of primary published scientific literature with data to support the efficacy of Flu vaccines.

A quick dig with Google Scholar yielded this (if you wanna get to the 'answer' just go to the Conclusions section:

http://jama.ama-assn.org/cgi/content/abstract/281/10/908

http://content.nejm.org/cgi/content/abstract/331/12/778

http://74.125.155.132/scholar?q=cache:ASHZ--Eay88J:scholar.google.com/+flu+vaccine&hl=en

http://journals.lww.com/joem/Abstract/1997/05000/Cost_Effectiveness_of_the_Influenza_Vaccine_in_a.6.aspx (this only shows the abstract, but the last line of the abstract is a short version of the conclusion)

------
And those are just from the first 10 results. I've informed you plenty; from here you can accept new information and begin to learn, or you can ignore it, use selective reading, and maintain ignorance. From here I assume you will become irrational so I will leave this conversation now.

Fyi, light can degrade organic compounds, to include proteins. And while I do not claim to clearly understand the properties of influenza virus, I cannot, like you, purport absolution in an argument for the presence of miniscule anecdotal observation.

"151 dead from Swine Flu in Mexico", on recounting, turned out to be 6.

I don't know where your non-cited figure of "6" deaths from the original swine flu outbreak in Mexico came from, but maybe it was from a misinterpretation of a report detailing the deaths of 7 patients at a single tertiary care hospital in Mexico city during a single month. The New England Journal of Medicine article that detailed the fate of the 98 patients acutely ill with the swine flu in that hospital at that time also references that 85 people in Mexico were known to have died as of May out of 4910 confirmed cases, a fatality rate of 1.7%.

Fortunately only Mexico during the initial outbreak reported such a high fatality rate. This is very fortunate as almost no young person in the world had any kind of immunity to this strain. In all likelihood when you come down with it you will be 'lucky' enough to only have to suffer a few days of bed-bound misery.

I'm a healthy skeptic.

Skepticism is good, but you've jumped way beyond that into conspiracy theories and paranoia.

I'll stick with preventative measures, as opposed to a shot that may or may not be effective this season

Doing nothing does not count as a preventative measure. It is true that usually with the seasonal flu vaccine scientists must guess months beforehand what strains to put in the vaccine and since they don't always guess right the vaccine is usually only about 70% effective, but as for pandemic H1N1 the vaccine is an excellent match and it should give almost everyone who gets it protection.

A 1997 article in the New England Journal of Medicine even seems to indicate that the cost of having a mixed population of nonsmokers and smokers (like we do now) costs less (strange as that sounds to me) than a completly non-smoking population in the long run due to the exact way in which the following factors balance out: (a) smokers do not live as long, but (b) smokers consume more health care resources while still alive. The taxes against smoking has everything to do with promoting a public health policy (the wisdom of which can be supported or denied individually) and not much to do with somehow forcing smokers to pay for the (non-existent, according to NEJM) additional long term social costs of smoking.

Just to be clear though: Smoking cessation is the number one positive thing a smoker can do for their health and I wholeheartedly encourage any smokers to seriously think about if they're ready to quit and speak with their family physician about it.

It does NOT take a village to enforce thinness.

You've raised an interesting point. It DOES take a village to prevent obesity.

Obesity is a classic example of a behavior in which there is good evidence from rigorous scientific studies that the behavior is determined by community influence, rather than individual choice. Nicholas Christakis showed in NEJM that people are far more likely to become obese if they have a close friend, sibling, or spouse who is obese. People in a community become obese together and loses weight together. The most effective weight loss methods are community-based.

Christakis demonstrated the same thing for smoking. He has great computer-generated diagrams of social networks over time, as people gain and lose weight together in nodes.

The only way to deal with obesity effectively is to approach it as a community problem, like sexually transmitted disease.

After extensive studies, they identified soft drinks as one of the worst contributors to the problem (obesity, not STD), and the one most vulnerable to intervention.

That's why they're going after soft drinks.

http://content.nejm.org/cgi/content/full/357/4/370
New England Journal of Medicine
Volume 357:370-379 July 26, 2007

The Spread of Obesity in a Large Social Network over 32 Years
Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D.

Background The prevalence of obesity has increased substantially over the past 30 years. We performed a quantitative analysis of the nature and extent of the person-to-person spread of obesity as a possible factor contributing to the obesity epidemic.

Methods We evaluated a densely interconnected social network of 12,067 people assessed repeatedly from 1971 to 2003 as part of the Framingham Heart Study. The body-mass index was available for all subjects. We used longitudinal statistical models to examine whether weight gain in one person was associated with weight gain in his or her friends, siblings, spouse, and neighbors.

Results Discernible clusters of obese persons (body-mass index [the weight in kilograms divided by the square of the height in meters], â¥30) were present in the network at all time points, and the clusters extended to three degrees of separation. These clusters did not appear to be solely attributable to the selective formation of social ties among obese persons. A person's chances of becoming obese increased by 57% (95% confidence interval [CI], 6 to 123) if he or she had a friend who became obese in a given interval. Among pairs of adult siblings, if one sibling became obese, the chance that the other would become obese increased by 40% (95% CI, 21 to 60). If one spouse became obese, the likelihood that the other spouse would become obese increased by 37% (95% CI, 7 to 73). These effects were not seen among neighbors in the immediate geographic location. Persons of the same sex had relatively greater influence on each other than those of the opposite sex. The spread of smoking cessation did not account for the spread of obesity in the network.

Conclusions Network phenomena appear to be relevant to the biologic and behavioral trait of obesity, and obesity appears to spread through social ties. These findings have implications for clinical and public health interventions.

(In case that link doesn't work http://www.media6degrees.com/about/pdf/Spread%20of%20Obesity%20in%20a%20Large%20Social%20Network.pdf)

Only if the public option allows that:
http://content.nejm.org/cgi/content/full/354/16/1661
http://www.quebecoislibre.org/04/040915-7.htm

Should there be suspicion of bias in the last article, here's the NEJM:

http://content.nejm.org/cgi/content/full/354/16/1661