California Is Screwed

Californians have their head in the sand. They're broke and now pass single payer.

From: McClatchy

The national debate over health care can be summed up in a bill being debated in Sacramento.

Supporters of Senate Bill 810 say the legislation would be the only way to provide medical coverage for every Californian.

Opponents deride the measure as socialized medicine.

The California Universal Healthcare Act was introduced by Sen. Mark Leno, D-San Francisco. The bill would initiate single-payer universal health care for the state of California, Leno said. "What that means in short is Medicare for all," he said.

Supporter Keith Ensminger, a Merced resident and owner of Kramer Translations, said the largest benefit of the legislation probably would be that it would include everyone. "Everybody would have insurance, regardless of their income and regardless of their position in life," he said. "One of the bigger benefits for us is that nobody in the Central Valley would be required to remain poor for Medi-Cal. They would still have their insurance paid."

A high percentage of Central Valley residents are on Medi-Cal.

There would be other positive effects from the bill, said Ensminger, who's a member of Health Care for All, a statewide organization that helped developed the bill. It would lower the cost of insurance for most people, everybody in the state would have a health insurance plan and it would aid people in having medical conditions treated early rather than waiting.

In addition, it would prevent medical bankruptcies, he said.

Dr. Bill Skeen, executive director of the California's chapter of Physicians for a National Health Program, said the organization supports the legislation because it's the only way of providing coverage for everyone and controlling the skyrocketing costs of the health care system.

Ezekiel Emanuel: giving restaurants and individuals the freedom to choose how much food they should eat "adds pounds without even thinking"

From: The Blog Prof

Ezekiel Emanuel, brother of Chicago thug mayor Rahm, was the one that put all the emphasis of ObamaCare on 'comparative effectiveness.' Comparative effectiveness, as per Obama's rationing czar 'Dr.' Ezekiel Emanuel, takes only 2 things into consideration when denying or approving treatment: 1) age, 2) cost. Simple as that. It yields this ghoulish chart:This chart would be page 1 of the "how to" guide of any death panel. Old people are too expensive to be worth keeping alive because they've already paid their taxes and are thus essentially useless to a totalitarian state. The very young too are of little value since they won't be paying taxes for a while yet. The people that should be treated are healthy people that pay taxes, but don't really need it because, well - they're mostly healthy. Welcome to ObamaCare, where people that don't need treatment get it, and those that need it don't.

But that's the bigger picture, a place where totalitarian liberal aren't limited to. Not only is Emanuel insistent on making life and death decisions for you, but he wants to dictate what you eat as well. Via Greg Hengler: Obama's Death Panel Advisor: We Must Make Restaurants Reduce Their Portion Sizes

Chicago school bans some lunches brought from home

That food would have me up in arms too. What is it anyway?

From: Chicago Tribune

Fernando Dominguez cut the figure of a young revolutionary leader during a recent lunch period at his elementary school.

"Who thinks the lunch is not good enough?" the seventh-grader shouted to his lunch mates in Spanish and English.

Dozens of hands flew in the air and fellow students shouted along: "We should bring our own lunch! We should bring our own lunch! We should bring our own lunch!"

Fernando waved his hand over the crowd and asked a visiting reporter: "Do you see the situation?"

At his public school, Little Village Academy on Chicago's West Side, students are not allowed to pack lunches from home. Unless they have a medical excuse, they must eat the food served in the cafeteria.

Principal Elsa Carmona said her intention is to protect students from their own unhealthful food choices.

"Nutrition wise, it is better for the children to eat at the school," Carmona said. "It's about the nutrition and the excellent quality food that they are able to serve (in the lunchroom). It's milk versus a Coke. But with allergies and any medical issue, of course, we would make an exception."

A Great Liberal Expose' on the Fallacy of the "Obesity Epidemic"

From: The Daily Beast

The first lady would be horrified by the idea that her Let’s Move campaign, which is dedicated to creating an America without any fat kids, is a particularly invidious form of bullying. But that’s exactly what it is, says Paul Campos.

Michelle Obama spoke movingly last week at a press conference about how parents agonize over the pain bullies inflict on children. Maybe she should talk to Casey Heynes about that. Heynes is a 16-year-old Australian fat kid who according to his father has been bullied for years by classmates about his weight. A few days ago, some of them decided to record their latest attack on a camera phone.

The First lady would, no doubt, be horrified by the suggestion that her Let’s Move campaign, which is dedicated to trying to create an America without any fat kids, is itself a particularly invidious form of bullying. But practically speaking, that’s exactly what it is. The campaign is in effect arguing that the way to stop the bullying of fat kids is to get rid of fat kids.

The whole Let’s Move campaign is like a Tea Partier’s fever dream of wrongheaded government activism. Now, as a liberal, I believe that government activism is often justified. For more than a generation, this idea has been attacked relentlessly by conservatives, and now the Tea Party movement is subjecting it to fresh assaults. Given our political climate, it’s more important than ever for liberals not to assume that a particular government initiative to stop something from happening is a good idea. Rather, we need to be reasonably certain that a) the something in question is actually happening; b) we know why it’s happening; c) we know how to stop it from happening; and d) the benefits of stopping it from happening are worth the costs.

Any time liberals support an ambitious government program that fails to meet this test, we are empowering the successors of Ronald Reagan, who famously declared that “the nine most terrifying words in the English language are ‘I’m from the government and I’m here to help.’”

The Let’s Move campaign fails this test spectacularly. It has had one notable success, however: According to a Pew Foundation poll, nearly three in five Americans now believe that the government should have “a significant role in reducing childhood obesity.”

Predictably, the prevalence of this belief tends to split along partisan lines: 80 percent of liberal Democrats compared to only 37 percent of conservative Republicans and 33 percent of self-described Tea Partiers.

Fat kids have enough problems without government-approved pseudo-scientific garbage about how they could be thin if they just ate their vegetables and played outside more often.

New York Times columnist Charles Blow sees the poll results as evidence that conservatives will oppose anything proposed by Mrs. Obama or her husband, “no matter how innocuous or admirable.” But there’s nothing innocuous or admirable about this crusade. The “childhood obesity epidemic,” to the extent that concept ever made any sense, may well be over. As Australian scholar Michael Gard points out in his new book, The End of the Obesity Epidemic, over the last decade obesity rates among both adults and children have leveled off or declined all over the world, including in the United States. Contrary to alarmist predictions from just a few years ago that by the middle of this century all Americans would be overweight or obese, the “obesity epidemic” has, for the time being at least, stopped. Americans weigh no more than they did a decade ago.

The fact that Americans did not gain weight in the 2000s merely highlights that we don’t know why body mass levels increased in the 1980s and 1990s, or indeed why they remained basically stable in the 1960s and 1970s. We don’t know if adults or children consume more calories today than they did forty years ago: Even weakly reliable statistics regarding this question don’t exist. Similarly, we don’t know if people today are less active than they were a generation ago. Nor do we know if caloric intake and activity levels have changed over the past 10 years, when the “obesity epidemic” apparently ended.

In the face of all this, public health authorities invoke what people always invoke when they don’t have any good data: “common sense.” They argue that it’s just common sense that Americans got fatter in the 1980s and 1990s because they ate more, or were less active, or both. But these are far from the only explanations for weight gain in populations. For instance dieters tend to gain more weight over time than non-dieters, non-smokers gain more weight than smokers, and people generally gain weight as they age. Since the 1960s, smoking rates have plummeted, the median age of the population has gone up by nearly 10 years, and dieting has become much more common. In addition, even if we assume that weight gain in the 1980s and 1990s was caused exclusively by changes in caloric consumption and/or activity levels, it’s crucial, from a public policy perspective, to have a good idea what the relative contribution of these factors was. If Americans aren’t eating more than they were a generation ago, attempts to get them to eat less are especially likely to fail. But we simply don’t know whether this is the case.

Remarkably, debates about whether the government ought to have a role in making American children thinner almost never acknowledge that we have no idea how to do this. Consider the first lady’s major policy goals: She wants children to eat a healthy balance of nutritious food, both in their homes and at school, and she advocates various reforms that will make it easier for kids to be physically active. These are laudable goals in themselves, but there is no evidence that achieving them would result in a thinner population. Indeed ambitious, resource-intensive versions of Mrs. Obama’s initiatives have been implemented on a smaller scale, for example by the Johns Hopkins University Pathways program, which attempted to improve the diets and increase the activity levels of Native American children in three states, while educating their families about health and nutrition. The program had some success in all these areas, but it produced no weight loss among the children as a group. The same basic results, improved health habits but no weight loss, were obtained in the Child and Adolescent Trial for Cardiovascular Health, a similar program involving thousands of ethnically diverse children in four states. Pursuing comparable initiatives at a national level might be worthwhile-these programs did, after all, result in improved health habits among the children who participated-but there is no reason to think the kinds of reforms Mrs. Obama is advocating will make American children thinner. The perverse result could be that an initiative that might have been judged a success had its primary focus been on producing healthier children will instead end up being used as another example of a failed Big Government program, simply because it did not produce thinner ones.

For the sake of argument, let’s assume there’s actually an ongoing childhood obesity epidemic, that we understand what is causing it, and that we know how to stop it. Even assuming all this, does it make sense to try to make American children thinner, as opposed to merely healthier? Why, after all, is such a goal so important in an age of increasingly scarce public health resources? At this point, we need to consider how the concept of “childhood obesity” got defined in the first place. The Centers for Disease Control website offers these definitions of “overweight” and “obesity” in children:

Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex. · Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex.

These definitions raise a couple of obvious questions in a nation that has been bombarded with claims that childhood obesity is skyrocketing. After all, by this standard, aren’t exactly 10 percent of children always overweight by definition, while another 5 percent are obese? And what’s the justification for these statistical cut-points, anyway?

The definitions were created by an expert committee chaired by William Dietz, a CDC bureaucrat who has made a career out of fomenting fat panic. The committee decided that the cut-points for defining “overweight” and “obesity” in children would be determined by height-weight growth chart statistics drawn from the 1960s and 1970s, when children were smaller and childhood malnutrition was more common. The upshot was that the 95th percentile on those charts a generation ago is about the 80th percentile today-hence, the “childhood obesity epidemic.”

These definitions are completely arbitrary. The committee members chose them not on the basis of any demonstrated correlation between the statistical cut-points and increased health risk, but rather because there was no standard definition of overweight and obesity in children, and so they invented one. In other words, the “childhood obesity epidemic” was conjured up by bureaucratic fiat.

The committee did this despite Americans being healthier, by every objective measure, than they’ve ever been: Life expectancy is at an all-time high, and demographers predict it will continue to climb steadily. This isn’t surprising given that mortality rates from the nation’s two biggest killers, heart disease and cancer, are at historical lows and keep declining, while infectious diseases are under better control than ever. There’s no reason to think that today’s children won’t be healthier as adults than their parents, just as today their parents are healthier than their own parents were at the same age, continuing a pattern that has prevailed since public health records began to be kept in the 19th century. (Tellingly, 50 years ago government officials were issuing dire warnings that a post-World War II explosion of fatness among both American adults and children was going to cause a public health calamity).

And none of this even touches on a subtler and more invidious cost to the Let’s Move campaign: the profound shaming and stigmatization of fat children that is an inevitable product of the campaign’s absurd premise that the bodies of heavier than average children are by definition defective, and that this “defect” can be cured through lifestyle changes. As Casey Heynes’ desperate act of self-defense illustrates, fat kids have enough problems without the additional burden of being subjected to government-approved pseudo-scientific garbage about how they could be thin if they just ate their vegetables and played outside more often.

Michelle Obama’s campaign against childhood obesity is exactly the sort of crusade that liberals who don’t want to give ammunition to conservative critiques of government activism should oppose. It is a deeply misguided attempt to solve an imaginary health crisis by employing unnecessary cures that in any case don’t work. As such, it is almost a parody of activist government at its most clueless. Politically speaking, it deserves the same treatment Heynes gave his tormentors.

Heading Off the Next Pandemic

From: The New Atlantis by Tevi Troy

For years, scientists have warned that the world is overdue for an outbreak of a new global flu infection. Pandemics are cyclical, the argument goes, and over the last dozen decades, the world experienced the Russian Flu of 1889-90, the Great Influenza of 1918-20, the Asian Flu of 1957-58, and the Hong Kong Flu of 1968-69. Although the pattern lacks the reliable punctuality of Halley’s Comet or recurring cicada broods, some observers were convinced that humanity was due for another pandemic when, in the spring of 2009, swine flu — officially known as H1N1 — broke out in Mexico.

General panic never materialized, thankfully, as the death toll for the 2009 outbreak was far lower than the previous ones, all of which claimed over a million victims. The 1918 virus killed a staggering 50 million; the 2009 swine flu, by contrast, killed perhaps fewer than 19,000 people. (See table below.) Though each of those deaths is a tragedy unto itself, the H1N1 virus as it has played out so far clearly does not fit with the “pattern” set by previous pandemics. By August 2010, the World Health Organization announced that H1N1 had moved into a “post-pandemic period,” meaning that even though the virus might continue to cause localized outbreaks, its overall future effects will likely be comparable to seasonal flu.

Pandemic	Date	Estimated Worldwide Deaths	Estimated U.S. Deaths
Russian Flu	1889-90	1 million	250,000
Great Influenza	1918-20	50 million	500,000
Asian Flu	1957-58	1.5 to 2 million	70,000
Hong Kong Flu	1968-69	1 million	34,000
Swine Flu	2009-10	18,500	8,870 to 18,300

[Table compiled from various historical and government sources. The worldwide figure for the swine flu pandemic comes from the World Health Organization, while the U.S. range comes from the Centers for Disease Control and Prevention. The odd discrepancy in the figures for that pandemic — implying that the U.S. suffered a disproportionately high number of deaths — is an artifact of those entities’ different methods for collecting and analyzing data.]

So what happened? Was H1N1 part of the series of cyclical outbreaks at all? Contrary to claims from flu experts, is there actually no cycle to these things? Or was the appearance of H1N1 in fact the expected outbreak, but effectively countered by our new technological ability to attenuate a pandemic’s worst effects? We have no definitive answers to these questions, but there may be some truth to each possibility.

Although much about influenza remains mysterious, scientists have, especially in the last half century, gained important insights into its pathology and new tools for its prevention. So-called seasonal flu epidemics spread around the world among human beings; the responsible viruses are always mutating, so new vaccines must be cooked up each year to counter the strains expected to be most prominent. Meanwhile, animals harbor countless constantly evolving strains of influenza viruses — with birds being particularly susceptible to incubating the viruses and spreading them around the world. Bird-borne flu viruses sometimes mutate into strains that can infect and spread among mammals, including pigs (hence the informal name swine flu), cats, and humans, where they can further mutate and swap genetic material with other flu viruses. Any place where people interact regularly with sick birds — industrial chicken operations, small-time poultry flocks, town markets with live birds for sale, backyard coops, cockfighting rings — could potentially become a point of human infection. In recent years, Asia has for various reasons been the focus of much epidemiological concern, but the ease of international travel and trade means that a small number of human infections anywhere could, if not effectively countered, begin a global pandemic.

In 2005, the U.S. government launched a serious effort to prepare for a possible outbreak of avian flu (H5N1). There had been a number of worrisome events in the early 2000s, including the 2002 outbreak of SARS (Severe Acute Respiratory Syndrome); the anthrax mailings that came on the heels of the 9/11 attacks; and increasing reports of avian influenza devastating poultry flocks beginning in 2004, combined with a disturbing uptick in human fatalities. These developments heightened policymakers’ awareness of the dangers of a flu outbreak and of biological attack, and of the need to be prepared should one or the other occur.

In November 2005, President Bush announced a $7 billion strategy to combat an influenza epidemic, which included investments in vaccines, antivirals, domestic preparedness, and international cooperation. The plan highlighted four key aspects of preparedness: first, rapid diagnosis of the phenomenon, at both the individual and the societal level; second, anti-microbial treatments to address the condition; third, making the vaccine available to promote prophylaxis; and fourth, the ability for public health officials to quarantine carriers. This last is the most difficult in a free society, but there have been instances of semi-voluntary quarantine in the guise of social distancing — the agreement within a community to refrain from large-scale interactions such as parties, community events, and even school — in order to reduce the spread of an infection. According to medical historian Howard Markel, these types of non-pharmaceutical interventions have been remarkably effective at controlling disease outbreaks. In the 1918 epidemic, for example, St. Louis employed social distancing while Philadelphia did not; Philadelphia consequently suffered a much higher death rate.

President Bush pledged to work with Congress “to remove one of the greatest obstacles to domestic vaccine production: the growing burden of litigation,” and succeeded in this pledge. Under the Public Readiness and Emergency Preparedness (PREP) Act of 2006, the government gained the authority to issue “PREP Act Declarations” granting liability protection to manufacturers whose products were used in public health emergencies. When I served at the Department of Health and Human Services (HHS) in 2007 and 2008, the government issued a series of such declarations for the manufacture of influenza vaccines and pandemic antivirals, as well as anthrax, smallpox, and botulism products. These declarations, however, took place only after significant effort from the political leadership (this author included), and in the face of much quiet but persistent bureaucratic opposition. The Obama administration has since issued PREP Act declarations to widen liability protections to some H1N1-related products, but this remains a tool that could and should be used more expansively.

Although the Bush administration was most concerned with H5N1, the administration’s “all-hazards approach” was intended to strengthen the U.S. ability to respond to a range of exigencies. This approach paid off in 2009 when, in the Obama administration’s early days — at a time when not one of its top twenty HHS appointees had yet been confirmed by the Senate — it dusted off the Bush flu plan to address the swine flu outbreak. This plan, which included a robust communications strategy to hold off panic, a stockpiling of 50 million courses of antiviral drugs, and a mechanism for accelerated vaccine production, helped keep the H1N1 outbreak under control.

Still, there were some hiccups. For starters, public health officials were somewhat slow to identify the threat. Veratect, a Seattle-based company that has an early detection system, identified a problem in Mexico as early as April 6, 2009. More than two weeks passed before the Pan American Health Organization (PAHO) and the U.S. Centers for Disease Control and Prevention (CDC) issued public alerts. Earlier identification of the threat by the Mexican government, PAHO, and U.S. agencies could have lessened the spread of the disease.

Another problem arose on the public-relations front. Vice President Joe Biden said on the Today show that he “wouldn’t go anywhere in confined places now.” This statement threatened to drive people away from air travel and public transportation, until White House press secretary Robert Gibbs walked back the remarks by claiming that Biden meant to tell already sick people to avoid confined places. Although this explanation was not supported by the video of Biden’s remarks, Biden’s notoriety for misspeaking helped mitigate his error, as apparently few people took him seriously as a spokesman for administration policy on the issue. By contrast, acting CDC head Dr. Rich Besser was so effective and ubiquitous on the issue that he parlayed his newfound fame into a position as senior health and medical editor at ABC News.

In addition, the Obama administration overpromised and underdelivered when it came to vaccine availability. In July 2009, the government projected having 160 million available doses of H1N1 vaccine by the fall. Yet those predictions did not come true, and HHS officials had to lower the estimates a number of times. When word of the vaccine shortage got out, it also emerged that the government had known for at least a month that the projections were wrong before notifying the public. This was a serious mistake, as trust in government is essential in a public health crisis: it reduces panic and increases the chances that the public will obey the instructions of public health officials.

Unfortunately, as the New York Times’s Andrew Pollack and Donald McNeil Jr. wrote in October 2009, the government found its credibility “undermined by overly rosy projections that did not take account of the vagaries of vaccine production.” Government officials were aware in September 2009 that the vaccine amounts they were promising would not be available, yet waited until the next month, in the face of obvious shortages and people being turned away from clinics, to lower their estimates from 40 million available doses to 28 million. When the vaccine did arrive, much of it came after it could be of any use: it arrived too late for some who needed it, and more generally, it arrived well after the projections of doom were clearly not materializing. In the end, the government had to discard millions of expiring doses of the vaccine.

The government faced another credibility problem, this one not of its own making, with respect to the question of vaccine safety. Dr. Andrew Wakefield’s now-discredited claims linking the MMR (measles, mumps, and rubella) vaccine to autism awakened a wider discomfort regarding vaccine safety. This anxiety affected the public perception of the H1N1 vaccine, even though the seasonal flu vaccine was widely considered to be safe, and the swine flu vaccine only differed from the seasonal flu vaccine in that it included the H1N1 strain. The problem was exacerbated by media figures from both the left and the right who recklessly told their audiences not to get vaccines. One of the worst offenders in this regard was liberal talk-show host Bill Maher, who called people who get flu shots “idiots.” On the right, Fox News personality Glenn Beck directed listeners of his talk-radio show to ignore the Department of Homeland Security’s recommendations on the pandemic, saying, “If somebody had the swine flu right now, I would have them cough on me. I’d do the exact opposite of what the Homeland Security says.”

Another irresponsible critique, leveled by journalist Michael Fumento, was that swine flu was all a “hoax.” Fumento claimed that concerns about H1N1 were overstated and that public health officials, especially at the World Health Organization, used the swine flu outbreak to maintain their credibility in the face of repeated predictions of an avian flu outbreak that did not arrive, and to justify previous high-cost investments in pandemic preparedness.

While Fumento is right that the swine flu pandemic of 2009-10 turned out to be milder than expected, he is wrong in ascribing nefarious motives to public health officials. It is not in their interest to overhype disease scares that turn out to be wrong, as they know that their voices will be ignored if they are seen as having cried wolf too often. In my experience both in the White House and at HHS, U.S. health officials, regardless of party, are concerned with protecting the populace and making sure that we are ready should we face a biological threat, be it natural or manmade. While the H1N1 outbreak was limited, a more serious one could have significant consequences. According to the CDC, a medium-level outbreak in the United States could potentially cause 89,000 to 207,000 deaths, with the cost ranging from $71 to 167 billion. Some economic estimates are even higher, such one from WBB Securities predicting a one-year loss to the U.S. economy of $488 billion. Given this deadly and costly potential, the government will need to address the lingering perception problems — about overhyping, about the safety of vaccines, and about matching vaccine availability with public need — if we are to be ready for the next event.

Overall, while the federal government handled the swine flu crisis well, there were clearly some areas in need of improvement, especially in communications. In the first place, the government absolutely must be forthright about its projections, both of the seriousness of potential diseases and of the government’s own capabilities. The miscommunication regarding vaccine availability led to consternation among those who wanted the vaccine in the fall of 2009 and to the waste of extra vaccine in the spring of 2010. The consequences could have been worse had the outbreak been more severe. In addition, the government needs to recognize public concerns about overhype and not dismiss critics out of hand, but rather to attempt to address complaints with a serious communications plan. Third, the government must continue to encourage new technologies and countermeasures — such as improved detection systems, diagnostics, antivirals, and vaccines — via strategic investments, accelerated approvals when appropriate, and liability protection for essential products. These strategies, combined with our existing plans, should put us on a better footing in the future. The government needs to maintain its preparedness efforts as if the threat remains, while doing its best to use limited resources efficiently and to avoid losing its credibility in case of future emergencies.