California Seeks Socialism in One State

The California Senate recently voted to approve a bill creating a state-level system of single-payer healthcare. It’s doubtful that the bill will become law, because it is opposed by Governor Jerry Brown. But the various left-wing interest groups are nonetheless backing the effort with substantial political resources.

Strictly speaking, single-payer health insurance means that only the government–nobody else–pays for health care. That means no private insurance. So Canada, for example, has banned private insurance. People, however, often use the term single-payer loosely to refer only to a government-paid option–what Nancy Pelosi calls ‘the public option’–that operates alongside private health insurance, as in the U.K. I therefore expected that the California Senate must have voted for a public option, but was surprised to find that, no, they literally meant single-payer. The California Senate actually voted to outlaw private health insurance.

If I like my plan, can I keep it?
Not unless you go to the VA, the only non-Healthy California system that would remain in place. Private insurance would no longer exist. The roughly 50 percent of people who get insurance through their employers would switch over. Medicare, the federal program that provides insurance for the elderly, would cease to operate in the state. So would Medicaid, which insures low-income people. Companies would be banned from selling any form of supplemental insurance that covers the same things as the state’s program. It is single payer after all, with the singular entity being the California government.

Note the distinct rollback in the freedom and autonomy of the individual. If you like your plan, tough luck, you’re forced to enroll in the system whether you want to or not. Your employer might want to offer health coverage as a benefit, and you might be happy to accept it, but the state says no, you can’t do that. Or you might want to purchase private insurance on your own so you won’t have to rely on the state, and an insurance company would willingly sell you an acceptable plan. But the state says no, you can’t carry out that transaction. The citizen is transformed from a paying customer with some degree of autonomy into a supplicant of the state. If that’s freedom, then zoo animals must all be free–they don’t pay for their medical treatment either.

In any event, I still find it hard to imagine that California would ever operate a literal single-payer system, because it would mean that the privileged Hollywood and Silicon Valley elites would have to seek treatment out-of-state. No way would the elites submit to the waiting lists, restricted access, and deteriorating standards that will inevitably accompany a cash-strapped single-payer system. It’s one thing for the peons to go on waiting lists, but not Jimmy Kimmel’s son. So it will be interesting to see how the elites preserve their privileges.

But let’s get back to the actual bill on the table.

The legislation guarantees free government-run health care for California’s 39 million residents—no co-pays, deductibles or insurance premiums—as well as virtually unlimited benefits. Patients could see any specialist without a referral and receive any treatment that their provider says is medically appropriate.

Sure. Just write those provisions into the law and it will all come true. What could go wrong?

How will all this be paid for?

A University of Massachusetts Amherst study commissioned by the California Nurses Association—which favors government-run health care—claims that single-payer would reduce health-care spending by $37.5 billion a year. This miracle would be achieved largely by slashing administrative costs as well as provider and drug reimbursement rates.

So the California Nurses Association is pushing a plan that involves slashing payments to ‘providers.’ Last time I checked, those ‘providers’ also happen to be the employers that most nurses work for. Hard to see how dealing a huge financial blow to their employers will benefit nurses. If I were a nurse in California, I’d be concerned that the union leadership was selling me out. In most countries with single-payer healthcare, nurses get paid a lot less than they do in America. In France, for instance, nurses are paid less than half as much as in the U.S.

The study also asserts that California could reallocate $225 billion a year in Medicaid, Medicare and ObamaCare spending for single-payer assuming a federal waiver. Thus the legislature would only have to come up with $107 billion.

‘Only’ $107 billion. For perspective, California’s entire state budget right now is $124 billion, so even under the nurses’ rosy scenario, the burden of state government would nearly double.

The Power Line blog highlights the comments of Wall Street Journal reader Craig Harrison, a California resident.

Can the state really commandeer my federal Medicare benefits?

Good question.

When it takes 3-6 months to see a physician in California, can the state stop me from going to Nevada, Arizona or Oregon for care? Will they put me in jail if I do?

Assuming the state is not required to reimburse you for your out-of-state expenses, I assume they would welcome being relieved of the burden. They’re happy for you to pay your own way out-of-state while still paying taxes to support the California system you’re not using.

How many miles offshore need a hospital or clinic ship anchor to be outside of the reach of the state?

Maybe the Queen Mary, permanently anchored at Long Beach, can be converted into a hospital ship.

If California ever does install single-payer, they can expect to experience a very bad selection effect on net migration. The most productive citizens will seek to avoid the tax burden by fleeing the state, while poor and sick people flock to California to take advantage of the freebies.

It’s also worth noting that this is not the first attempt by a state to create something like single-payer. Not too many years ago, attempts in Tennessee and in Vermont had to be abandoned due to the very daunting practical difficulties. Despite these failures, California leftists somehow imagine that they can make it work. Cuz they’re special or something.

A Generational Decline in Testosterone

Ever wonder how, in just three generations, American males went from G.I.s who defeated the Nazis and the Japanese Empire to whiny Pajama Boys who think Barack Obama is cool? Well, I’m just throwing this out there: maybe it has something to do with low-T. Several studies have found that contemporary western males have significantly lower testosterone levels than same-age males had roughly 30 years ago. A couple of studies first reported the secular decline in testosterone about ten years ago. One study focused on men in Massachusetts over age 45.

“Male serum testosterone levels appear to vary by generation, even after age is taken into account,” said Thomas G. Travison, Ph.D., of the New England Research Institutes (NERI) in Watertown, Mass., and lead author of the study. “In 1988, men who were 50 years old had higher serum testosterone concentrations than did comparable 50-year-old men in 1996. This suggests that some factor other than age may be contributing to the observed declines in testosterone over time.”

For men 65-69 years of age in this study, average total testosterone levels fell from 503 ng/dL (nanograms/deciliter) in 1988 to 423 ng/dL in 2003.

Another study published the same year found similar results for men in Denmark. But that was 10 years ago, and I was wondering if any follow-up studies had been done since then. All I managed to find was a 2012 study from Finland. This study also found a secular decline in testosterone.

We analysed serum levels of testosterone, gonadotrophin and sex hormone binding globulin (SHBG) in 3271 men representing different ages (25–74 years) and birth cohorts within three large Finnish population surveys conducted in 1972, 1977 and 2002…The more recently born Finnish men have lower testosterone levels than their earlier born peers.

French leftists protesting in skirts

Notably, the fall in T-levels cannot be fully explained by changes in health or lifestyle such as obesity or smoking. Some other environmental factors must be responsible, but nobody knows which. Speculation involves a wide range of possibilities, everything from endocrine disruptors in plastics to tight underwear!

Whatever the cause, I wonder if this change in hormone levels has implications for male behavior and social outcomes. For instance, could low-T have an effect on marriage or divorce rates? And what about birth rates? (There is some mixed evidence suggesting that sperm also has declined in both quality and quantity.)

Right now, violent crime rates in America are at their lowest level in about 50 years. Could the drop in violent crime be caused at least in part by diminished male aggression due to lower testosterone?

Low T might offer some benefits, like maybe lower crime rates, but the fact that some unknown factor is adversely affecting men’s health is nonetheless disturbing. And yet, nobody seems to care. As far as I know, there is no concern among advocacy groups or public health officials regarding the problem of secularly declining testosterone. Some endocrinologists have an academic interest in the issue, but it does not show up on the radar screen of people working in public health.

Imagine, however, if the sexes were reversed, and it were women instead of men who had exhibited a long-term decline in hormone levels. In that case, it would be a genuine public health crisis. We would all know about the problem, and the subject would be discussed endlessly on The View.

But when it happens to men: crickets. Men take note: Society does not care about you.

Healthcare: Right or Privilege?

The latest target of the online leftists’ ‘two-minutes hate’ was Miss USA, who committed heresy in response to the following question about healthcare.

Do you think affordable healthcare for all US citizens is a right or a privilege and why?

New Miss USA: Health Care is a Privilege

Leftists, of course, think the only acceptable answer is that healthcare is a right.

The correct answer to the question, however, is difficult to ascertain because of ambiguity associated with the term ‘affordable healthcare.’ If ‘affordable healthcare’ means that your healthcare is paid for mostly or entirely by others, then no, that is not a right. You have no right to other peoples’ money.

But if instead ‘affordable healthcare’ means that you have a right to purchase with your own money whatever healthcare you can afford, then yes, that is a right. You have a right to pay for your own healthcare; you have no right to force others to pay.

In the United States, however, citizens are not fully able to exercise the right to purchase healthcare because the FDA often prevents patients from accessing particular drugs or treatments that they want, even when their doctors approve. For instance, as we reported last year, parents of children afflicted with deadly Duchenne’s disease literally begged FDA panelists to let them take an experimental drug that might extend their lives. But the FDA panel voted no anyway.

That free-born citizens would have to literally beg for their lives in front of government functionaries is absolutely disgusting.

FDA delenda est.

Furthermore, asserting the phony right to healthcare paid for by others tends to undermine the real right to pay for your own healthcare. The high taxes needed to support the socialist healthcare system leaves people in many cases with not enough income after taxes to afford to purchase their own healthcare outside the system. In that sense, making healthcare more affordable can actually in some cases make healthcare less affordable.

In Canada, for example, the need to keep everybody and their money within the socialist system resulted in a legal ban on all private purchase of healthcare. Hence it is technically illegal in Canada to privately transact in healthcare or in health insurance. That’s right–Canadian law specifically abrogates the citizen’s right to use his own money to purchase healthcare. The phony right extinguishes the real right.

Of course, in practice, many private healthcare clinics do exist in Canada. But technically, these are illegal, and the authorities tolerate them by refusing to enforce the law. The authorities so far have not dared to shut down the private clinics, because they provide people with essential treatment not available from the socialist system. The existence of the illegal private clinics testifies to the unworkability of the socialist system.

But getting back to Miss USA, she eventually had to walk back her statement, which is a sad reminder of the stifling leftist constraints on our public discourse. We now have a situation in the world, as an online wag put it, where China is a ‘communist’ country governed by the principles of capitalism, and the US is a ‘capitalist’ country governed by the principles of communism.

Breaking: Jimmy Kimmel is still an idiot, and so is GOP Senator Bill Cassidy

Jimmy Kimmel is apparently still using the platform of his late-night show to pimp for Obamacare. Earlier this month, he was lionized by America’s stupid and dishonest political and media class for making an incoherent rant filled with inane pronouncements such as this one.

“If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make,” he declared in his first monologue on the issue. “I think that’s something that, whether you’re a Republican or a Democrat or something else, we all agree on that, right?”

This time, Kimmel responded to “critics who noted that doctors would do everything they could to save any child who was born with a heart condition, regardless of ability to pay.”

The critics making exactly that point included us. And so what is Kimmel’s response?

The comedian noted that beyond the immediate emergency intervention, there were plenty of follow-up visits, and that those require time off from work.

And so after all these years we finally discover the true purpose of Obamacare–counteracting the scourge of American parents who deny their children essential follow-up treatment because they won’t take the time off from work.

I know that Obamacare regulations run to thousands of pages, but I must have missed the ‘time off from work’ provision.

This Kimmel guy is almost funny enough to be a comedian.

Look, when it comes right down to it, no honest person who knows the facts and has half a brain could ever find any value in Kimmel’s fatuous declarations. That’s why the task fell to a United States Senator.

Thanks to Republican Sen. Bill Cassidy, the healthcare policy pronouncements of late night comic Jimmy Kimmel are back in the headlines…Cassidy, a Republican senator opposed to repealing much of Obamacare, subsequently went on television and declared that any changes to the healthcare system should pass what he dubbed the “Kimmel test.”

Oh, and what is the Kimmel test? The man himself was kind enough to define it for us.

“Since I am Jimmy Kimmel I’d like to make a suggestion as to what the Jimmy Kimmel test should be,” he told Cassidy. “I’ll keep it simple. The Jimmy Kimmel test I think should be, no family should be denied medical care, emergency or otherwise because they can’t afford it.”

That test, however, is anything but simple, due to the slippery phrase “emergency or otherwise.” Critics forced Kimmel to acknowledge that everybody already receives emergency treatment when they need it, so for him to continue to pretend to have a valid point, he had to add the “or otherwise” bit. That term, however, raises more questions than it answers.

Specifically, which medical procedures are covered by that vague phrase “or otherwise”? Just how much non-emergency medical care are people entitled to?

The answer cannot be ‘however much that patients want or think they need,’ or even ‘however much their doctor thinks they need,’ because there could never be enough resources available to make that true. That’s why, even in countries with socialized medicine, neither patients nor doctors are ever given blank checks to access as much health care as they want, because to do so would quickly drive the system into bankruptcy.

The undeniable fact is that health care is a scarce resource, and so it must be rationed. Exactly how to ration it is ultimately what the health care debate is about.

One way to ration is through the price system. Another is through government. But having the government take over health care does not eliminate the need to ration. That’s why socialist governments all over the world have set up bureaucracies devoted to rationing. That is, the job of the bureaucracy is to deny people medical care, which is what Jimmy Kimmel says should not happen.

[E]ven if the United States were to migrate to a single-payer system, it wouldn’t necessarily meet the Kimmel standard, because any system has to figure out away to divide up scarce resources – there are only so many doctors and hospital beds and waiting rooms and money available – and there is a variation in competence and quality. So in other systems, government plays a central role in deciding what can get covered and in how care is delivered.

In Britain, the government rationing agency is given the Orwellian acronym NICE (National Institute for Health and Care Excellence.) Rationing by NICE goes as far as denying life-extending drugs to cancer patients.

Eight thousand cancer patients are likely to have their lives cut short following a decision to withdraw NHS funding for 25 treatments.
Medication which offers a last chance to patients with cancer a year – including those with breast, prostate and bowel disease – will no longer be funded by the NHS, under plans to scale back spending from April.
Experts said that around two thirds of those who seek NHS treatment for advanced bowel cancer are likely to face an earlier death because of the decision.
Charities accused health officials of taking “a dramatic step backwards” and destroying a lifeline which prolongs the survival of thousands of cancer sufferers.

The bureaucrats decide that eight thousand people have to die. Question: Does that pass the ‘Kimmel test’?

When Kimmel and Senator Cassidy find a health care system that passes the test, I wish they would please let me know. Because without more specifics, the test seems like nothing more than a fatuous denial of scarcity and the necessity of some form of rationing. Denying scarcity is not a contribution to the debate, it’s an evasion of the debate.

In closing, let me just take this opportunity to make a political endorsement. Here at Yet, Freedom! we generally eschew endorsements, but I have decided to make an exception by throwing my full support to Bill Cassidy’s next election opponent, whoever he or she may be. I really don’t care who it is, since just about anybody, even an avowed Trotskyite, would have to be an improvement over Cassidy. The Troskyite would at least be more honest, because he wouldn’t pretend to be a conservative Republican while promoting socialism in America.

Democracy means this dipshit can be a Senator. Second look at hereditary monarchy?

Kimmel the Clueless

This week the whole leftist and establishment (but then I repeat myself) media was fawning over the teary and emotional endorsement of Obamacare by Jimmy Kimmel, who apparently is some sort of television personality.

Jimmy Kimmel delivered an impassioned monologue on Monday night detailing his newborn son’s recent open-heart surgery.

The heartstring-pulling speech, during which Kimmel teared up, detailed the harrowing experience for Kimmel and his family….

Kimmel, in the monologue, said his son’s story also had a lot to do with recent changes to the US healthcare system enacted by the Affordable Care Act.

Yeah I agree with this, if by “a lot to do with” the ACA we mean that Kimmel’s experience had “absolutely nothing to do with” the ACA.

A lot of spergs responded to Kimmel’s diatribe by using 700 words to point out the simple fact that Jimmy Kimmel’s family is not on Obamacare. He is a rich celebrity who can pay for the best health care in the world. His personal experience therefore tells us nothing about whether Obamacare is good public policy.

Other than possibly his maid or gardener, it’s a good bet that Jimmy Kimmel does not even know a single person on Obamacare. But he had a sick kid, so now he’s an expert, apparently.

This reminds me of the British Ruling Class, which constantly reminds the British Peons how the socialist National Health Service is the ‘envy of the world.’ And yet, the individuals in the Ruling Class never actually use the NHS; when they get sick, they pay for private care. Socialist healthcare for thee, private for me. Same with Jimmy Kimmel.

“If your baby is going to die, it shouldn’t matter how much money you make,” Kimmel said. “I think that’s something that whether you’re a Republican, or a Democrat, or something else, we can all agree on.”

Right. But what does that have to do with Obamacare? Obamacare is just a form of insurance. A deathly ill baby needs treatment, not insurance. And the fact is that nobody who is sick is denied treatment because of their insurance status or ability to pay. That was true even before Obamacare. In fact, it has always been true.

Does Jimmy Kimmel really believe that hospitals, doctors, and nurses refuse treatment to sick babies and let them die because the baby’s insurance is not up to scratch? This is frankly a slanderous assertion.

“No parent should have to decide if they can afford to save their child’s life. It just shouldn’t happen. Not here,” Kimmel said.

Is Kimmel really suggesting there are parents out there who let their children die because of financial considerations? Parents that decide a $10,000 bill from the funeral home is preferable to a $150,000 bill from the hospital? GTFO. And anyway, that would be illegal. We have laws against parents denying their sick children medical attention, for whatever reason.

Nothing Jimmy Kimmel said made any goddam sense, but we’re supposed to take him seriously because, hey, his kid was sick and he got teary and emotional! So he must be sincere! But sincerity is overrated. Fools and knaves are often sincere. And emotion is generally the enemy of reason. If we’re going to have sound public policy in this country, we need to rely on reason, not emotion.

In closing, if Jimmy Kimmel really believes that Obamacare is so great, then he should sign his family up for it, and agree that his family will seek treatment only within the plan’s narrow network of healthcare providers. Kimmel should put his money where his mouth is. Put up, or shut up. Otherwise he’s just another out-of-touch elitist telling the little people what’s good for them.

A Nobel Laureate’s Disappointing Policy Advice

We reported previously on the research by Nobel laureate Angus Deaton and his wife Anne Case showing that the death rate has been increasing for the white working class, the only socioeconomic group for which that is true. This finding, which some have dubbed The White Death, has become perhaps the most talked-about recent finding in all of social science.

Deaton and Case are to be commended for their statistical analysis, which appears to be solid. The White Death seems to be real. The question therefore becomes: What can be done about it?

The Washington Post’s Wonkblog wanted to know, so they published a very good interview with Deaton and Case. Their most fundamental argument is that the labor market for unskilled labor has deteriorated badly, and this development has had an adverse impact on the lives of millions of people. I agree with Deaton and Case on this basic point. But Deaton’s specific policy recommendations left me very disappointed.

First, Deaton apparently believes that we need to get more people into college.

Anne and I, I think, differ a little bit on how much education is a solution for this. But it’s certainly clear there are lots of people who are not getting BAs who are capable of it. So we need to do a much better jobs [sic] of getting these into school.

Well, as someone who has spent more than 20 years in the university classroom, I can state with confidence that the problem in higher education is more nearly the exact opposite–too many, not too few, people pursuing BAs. America must have, at Deaton says, at least a few people “not getting BAs who are capable of it.” But there are vastly more people in the opposite situation; pursuing BAs who are not really capable. Higher education is already massively subsidized and over-expanded. Rather than expanding further, higher education needs to contract. More people should consider learning a trade or going to coding school.

On education, Deaton’s wife is more sensible:

Case: But it’s also the case here that there are people who don’t want a four-year BA. We’ve been around this block many times: We do need to think about how we want to train people to enter the 21st century labor force.

Deaton also wants to expand the welfare state.

Deaton: We haven’t really talked about how none of this is happening in Europe…The obvious difference is that the safety net is enormously more generous in Europe. And lot of people in their 50s who lose their jobs can go on retirement. You get a doctor’s certificate and you get paid pretty much your salary until you die.

Wait, if you’re in your 50s and you lose your job for economic reasons, then you can just talk a doctor into saying you’re disabled and collect your check for life, and Deaton thinks that’s a good thing? Am I misreading this, or did Deaton endorse disability fraud?

Deaton and Case also seem to believe that Americans are too reluctant to accept welfare.

Case: The other thing that makes it harder in America rather than Western Europe is that there really is a difference for a large swath of the population in how they feel about receiving government transfers. We’ve all been trained up on the idea that we are individuals and we take care of our families and our neighbors take care of theirs, and that’s the way we like it. It’s very hard to give somebody something when they see it as handout that they don’t want.

What Case says was true about America in the 1950s and 1960s. In those days, there was a strong conscientious aversion, as well as considerable social stigma, to accepting welfare. But I don’t think that’s true today. Half of American households receive some kind of government check, and 30 percent receive a “means tested” benefit, i.e., welfare. When I was a kid, that latter figure was only 7 percent.

Moreover, unlike Deaton and Case, I don’t believe the primary reason why working-class people are dying in America but not Europe is Europe’s somewhat more generous welfare state. Another obvious and possibly more relevant difference is that Europeans do not drink sugary Cokes in 30-ounce servings, nor do they consume Little Debbie Snack Cakes by the box. Maybe before we put millions more on the disability rolls, we should first try to get them to cut back on carbs.

There’s one other policy recommendation that I’ve been pushing. We’re spending about three trillion dollars a year on health care. And our life expectancy is going down. Whereas all these other countries are spending way less, and their life expectancy is going up. For me the implication is if we implemented single payer, we’d get rid of a lot of these costs. Not without screaming and yelling, of course, and not without goring a lot of oxen.

But the crucial thing is recognizing the extent to which these rising health care costs are responsible, at least in part, for the stagnant wages for people without a college degrees. If they’ve got an employer and they’ve got health care, their wages are getting pushed down by the employer paying for that health care. People don’t even realize this. They think it’s for free.

No doubt, the cost of health care is a huge problem, and we need reform. But single-payer is not the way to do it. Those single-payer countries that report lower costs are leaving out a lot of hidden costs. In particular, they don’t count the costs to individuals of suffering due to rationing of health care. They also don’t count the negative impact on the economy of taxes needed to fund the system.

I’m not a left-wing nut pushing for single-payer! It’s not because I like socialized medicine. It’s just because I think this is eating capitalism alive, and if we want a healthy capitalist society in America, we’ve got to get rid of this monster.

Shorter Deaton: “I’m for single-payer, but just don’t call me a left-wing nut!”

So to summarize, Deaton wants to expand higher education, make welfare more generous, and pay for nearly everybody’s health care. This amounts to a massive expansion of government. Deaton intends to help the ‘little guy,’ but as Dennis Prager likes to say, the bigger the government, the smaller the individual.

And Deaton wants all this additional spending when the federal government is already exposed to a $200 trillion fiscal gap. Where will the money come from?

As I said, Deaton’s policy advice is very disappointing.

Beware Big Pharma

As I reported previously, considerable evidence suggests that the most common medications in America are crocs–they either don’t work, or cause more harm than good. Among the dubious classes of medications are anti-cholesterol drugs, anti-depressants, and antacids.

Apparently, I’m not the only one with a jaundiced view of the best-selling products of the pharmaceutical industry. Dr Peter Gøtzsche, a Danish physician and author, argues that medicines kill 200,000 people in the U.S. every year, with approximately half of those deaths occurring even though the medication is used correctly.

One of the drugs that Dr. Gøtzsche strongly argues against is NSAIDs (non-steroidal anti-inflammatories) like ibuprofen. There’s actually quite a bit of evidence that use of ibuprofen–at least in the long-term–can significantly increase the risk of heart attack.

NSAIDs aside from aspirin, both newer selective COX-2 inhibitors and traditional anti-inflammatories, increase the risk of myocardial infarction and stroke.[30][31] They are not recommended in those who have had a previous heart attack as they increase the risk of death and/or recurrent MI.[32] Evidence indicates that naproxen may be the least harmful out of these.[31][33]

NSAIDs aside from (low-dose) aspirin are associated with a doubled risk of heart failure in people without a history of cardiac disease.[33] In people with such a history, use of NSAIDs (aside from low-dose aspirin) was associated with a more than 10-fold increase in heart failure.[34] If this link is proven causal, researchers estimate that NSAIDs would be responsible for up to 20 percent of hospital admissions for congestive heart failure. In people with heart failure, NSAIDs increase mortality risk (hazard ratio) by approximately 1.2–1.3 for naproxen and ibuprofen, 1.7 for rofecoxib and celecoxib, and 2.1 for diclofenac.

On 9 July 2015, the FDA toughened warnings of increased heart attack and stroke risk associated with nonsteroidal anti-inflammatory drugs (NSAID). Aspirin is an NSAID but is not affected by the new warnings.

Dr Gøtzsche argues that Big Pharma is putting profits ahead of people’s health, and that the industry basically has paid off everybody–doctors, researchers, regulators, politicians. Gøtzsche calls Big Pharma essentially a form of organized crime. That rhetoric seems a bit overheated, but I suspect it’s true that the pursuit of profit has caused drugs to be oversold, and that doctors often don’t fully understand the effects and interactions of the drugs they prescribe.

Are Prescription Drugs All Crocs?

Ok, not all drugs are crocs, but a lot. An astonishing 70 percent of Americans take at least one prescription drug. How many of those drugs are useless or even harmful?

Consider the two most prescribed classes of drugs: anti-cholesterol agents (statins) and anti-depressants. The scientific theories underlying both drug classes have more or less been debunked.

The theory underlying statins is the so-called lipid hypothesis of heart disease. This theory has been around for 60 years, but was never supported by very much scientific evidence. The latest and best evidence generally contradicts the lipid hypothesis. Simply put, there is no correlation between cholesterol and heart disease. Heart patients admitted to hospitals have an average cholesterol level no higher than the population as a whole. The overall correlation between cholesterol and life expectancy is positive–people with higher cholesterol live longer on average. Yet reducing serum cholesterol is the intent of the number one class of drugs in America.

The number two class of drugs consists of anti-depressants called selective seratonin-reuptake inhibitors (SSRIs). These drugs are supposed to reduce depression by regulating seratonin in the brain. The problem is that the scientific evidence totally contradicts the seratonin theory of depression.

One of the leading myths that unfortunately still circulates about clinical depression is that it’s caused by low serotonin levels in the brain (or a “biochemical imbalance”). This is a myth because countless scientific studies have specifically examined this theory and have come back universally rejecting it.

So let’s put it to rest once and for all — low levels of serotonin in the brain don’t cause depression.

Regarding SSRIs, there is a growing body of medical literature casting doubt on the serotonin hypothesis, and this body is not reflected in the consumer advertisements. In particular, many SSRI advertisements continue to claim that the mechanism of action of SSRIs is that of correcting a chemical imbalance, such as a paroxetine advertisement, which states, “With continued treatment, Paxil can help restore the balance of serotonin…” [22].

Yet […] there is no such thing as a scientifically established correct “balance” of serotonin. The take-home message for consumers viewing SSRI advertisements is probably that SSRIs work by normalizing neurotransmitters that have gone awry. This was a hopeful notion 30 years ago, but is not an accurate reflection of present-day scientific evidence.

As we reported previously, SSRIs might effectively reduce depression, but only through a placebo effect. Sugar pills also reduce depression, but with the sugar pill you wouldn’t get the nasty SSRI side effects, including increased risk of suicide, stroke, and death. Yet doctors keep handing this stuff out like candy. Perhaps part of the problem is that SSRIs can be prescribed by general practitioners, even though they have no qualifications in psychiatry.

So much for the top two classes of drugs. Just a bit further down the list are antacids known as proton-pump inhibitors (PPIs). Some of the familiar marketing names include Nexium, Prevacid, and Prilosec. As noted in the latest issue of Scientific American, long-term use of these drugs is now being linked to kidney problems as well as dementia.

[T]wo studies linked the regular use of proton-pump inhibitors to conditions that were seemingly unrelated to the acid levels of the stomach. One of the studies, published in JAMA Neurology, found that the drugs increased the risk of developing dementia, including Alzheimer’s disease; the other, published in JAMA Internal Medicine, suggested a greater risk of kidney problems.

The studies reported in 2016 grew out of earlier hints that such chronic use could affect the brain and kidneys. One 2013 study in PLOS ONE, for instance, found that proton-pump inhibitors can enhance the production of beta-amyloid proteins, a hallmark of Alzheimer’s. Three years later the JAMA Neurology study, which included 74,000 Germans older than 75, found that regular PPI users had a 44 percent higher risk of dementia than those not taking PPIs.

Similarly, worries about kidneys emerged from evidence that people with sudden renal damage were more likely to be taking PPIs. In one 2013 study in BMC Nephrology, for example, patients with a diagnosis of kidney disease were found to be twice as likely as the general population to have been prescribed a PPI. The 2016 study of PPIs and kidney disease, which followed 10,482 participants from the 1990s through 2011, showed that those who took the drug suffered a 20 to 50 percent higher risk of chronic kidney disease than those who did not. And anyone who took a double dose of PPIs every day had a much higher risk than study subjects who took a single dose.

Gotta wonder how many of those people who are risking their health by popping purple pills could easily get relief by taking just a relatively harmless Tums.

So statins, antidepressants, and antacids–three of the top eight classes of prescription drugs appear to do more harm than good. How many others?

What a disgrace. The medical profession and the pharmaceutical industry should be ashamed of themselves.

Obamacare: Finally, a Journalist Asks the Right Questions

At this point it is now seven years too late, but a journalist finally asked the right questions about Obamacare. That journalist was Tucker Carlson, and he asked the man who should know the answers as well as anybody–Jonathan Gruber, the MIT economist who was the ‘architect’ of Obamacare.

Tucker Carlson Destroys Obamacare Architect Jonathan Gruber

Carlson specifically asked two good questions that go to the heart of what is objectionable about Obamacare. Here is one of them.

Why should I be forced to buy a plan that offers things that don’t pertain to me in any way?…They’re forcing people to buy things they don’t want and that don’t help them…things that do not apply and will never apply to me such as breastfeeding, prenatal care, substance abuse counseling…why should I have to buy those plans?

Indeed, one of the most objectionable, maybe the most objectionable, provision of Obamacare is that it empowers unelected federal bureaucrats to decide the terms of my health care plan–what it covers and what it does not cover. In a free society, the terms of my insurance policy should be determined through agreement between me and my insurance company. Gruber calls this a “small issue,” but it’s actually an outrageous encroachment on the freedom of the people.

After first dodging the question and forcing Carlson to ask a second time, Gruber offered the following response.

The answer is that basically as a society we have to decide what is going to define fair insurance.

This is another way of saying that people–you and I–should not be free to decide, and so ‘society’ should decide for us. But it turns out that the group of people who decide is not ‘society’ but rather those aforementioned unelected federal bureaucrats. Gruber’s response provides no rational justification for the policy, just an assertion of his belief that people should not be free to decide for themselves. Every time choices and decisions get taken away from individuals and turned over to ‘society,’ it means that the people have less freedom.

Why should it be necessary for ‘society’ to define “fair insurance,” anymore than for ‘society’ to define a “fair golf course,” a “fair gym membership,” or “fair supermarket shopping”? These are all just contractual relationships voluntarily agreed upon by buyers and sellers. Would Gruber propose that federal bureaucrats insure “fair” grocery shopping by dictating to supermarkets which products they should and should not offer for sale?

Carlson’s second fundamental question (although it comes up first in the video) is this one.

Who are the victims? Who’s been hurt by Obamacare?

This is a crucial question, because the great con run by the political class is that they talk only about the benefits of their policies but not the costs. They don’t want to talk about all the people who will be hurt by the policy, because those people might then wake up and go into political opposition.

Gruber in reply identified only two categories of people hurt by Obamacare: “the wealthiest Americans…the top two percent,” and young, healthy people who, prior to Obamacare, benefited from “a discriminatory insurance market.”

What Gruber means by “a discriminatory insurance market” is actually just “an insurance market.” In a free and efficient insurance market, policy premiums are priced according to the risk of the individual. Healthy people with healthy habits therefore pay less than people with unhealthy habits. That’s how insurance is supposed to work–the market prices the risk. Gruber, however, believes that having an actual insurance market is unfair. When it comes right down to it, he is fundamentally opposed to the idea of health insurance. That’s why Obamacare is NOT health insurance, but an abolition of health insurance. Obamacare replaces the insurance market with an elaborate government scheme for rationing care and redistributing wealth.

I’ve always said that a one-line argument against big government is that it always ends up rewarding bad behavior and punishing good behavior. And that is precisely what Gruber advocates. He thinks smokers should be taxed to subsidize non-smokers, that those who eat healthy and exercise should be taxed to subsidize couch potatoes who overeat. As the saying goes, if you tax anything, you get less of it, and if you subsidize anything, you get more of it.

But in any event, Gruber’s list of Obamacare’s losers is far too narrow. In no particular order, the list needs to include all those young white women who go to tanning salons, because Obamacare put a 10% tax on indoor tanning. Other losers include millions of people who purchase insurance on the individual market but who are not eligible for Obamacare subsidies. Those people have seen their premiums soar. And speaking of those subsidies, they consist of tens of billions of dollars of taxpayer money that are needed to (barely) keep Obamacare afloat. So really, the losers also include basically anybody who pays federal taxes. That’s a lot of losers.

Obamacare’s losers also encompass all those who cherish the Constitution and constitutional government. Because in order to save Obamacare, the Supreme Court had to re-write the Constitution by ruling that the government is free to regulate inactivity so long as the penalty is called a ‘tax.’

Gruber’s reaction to the point that Obamacare has created many losers was somewhat fatalistic.

As with any law, the law creates winners and losers.

Sure, but the idea of a free society is that political insiders–in this case, industry lobbyists and Congressional aides–shouldn’t be able to get together and decide to make me a loser.

Gruber is right that the law creates both losers and winners. But he neglected to mention one of the biggest winners from Obamacare: himself. The man has made hundreds of thousands of dollars off of Obamacare.

Socialism Empowers the State, Not the Individual

The Economist, a British publication, recently ran a review of a new book about prostate cancer, written by an American doctor. Reading the review, I was struck in particular by the following paragraph that appeared near the end of the review.

The book is clearly for the patient as consumer. There are repeated calls throughout to check your doctor’s credentials and experience. Have your biopsy results checked by another medical centre, Dr Scardino advises. Be sure that you are treated in a centre that deals routinely with prostate disease. Check how often your surgeon does a radical prostatectomy. All of which is sound advice, if awkward for men who live in countries, such as Britain, where there is still little real choice about where they can receive treatment.

Ah, so the doctor, writing from an American perspective, embarrassed the Brits by presuming that the patient still retained some control over his own healthcare. For most Brits, patient control was long ago extinguished by the socialist system. The patient is no longer a consumer, but merely a supplicant, desperately hoping to receive whatever treatment the state might deign to offer.

Many people still cling to the mistaken notion that socialism is somehow empowering for the individual. The reality is that socialism transfers power from the individual to the state. As Dennis Prager likes to say, whenever the state is big, the individual is small.