Archive for the ‘Health’ Category

Obamacare—A Plan only a Government could Formulate

August 21, 2016

   Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

    Wherein we see that the Elite got together and decided what was best for the public. That’s what Elites do. The public had a different opinion.

An Insurance Giant Has Rung Obamacare’s Death Knell
Diana Furchtgott-Roth

American consumers figured out from the beginning that Obamacare wasn’t worth buying. Now insurance companies are wising up. Aetna is withdrawing from Obamacare exchanges in 11 states, following United Healthcare Group’s decision last April to leave 34 states. Which will be the next domino to fall?

In a well-functioning insurance market, such as for automobile accidents, insurance carriers craft countless plans to meet exactly the needs of millions of different individuals. Typically, only catastrophic unexpected events are covered, not the predictable oil changes. Automobile insurance is real insurance, and automobile owners as well as insurance companies eagerly participate.

Not so for Obamacare, which is not insurance at all. Under Obamacare annual physicals, which are predictable and routine, are covered without charge, but major surgery requires payment of a $6,000 to $12,000 deductible.

Like a Sinking Ship

Aetna spokesman T.J. Crawford said on August 16, “This is a business decision based on higher-than-projected medical costs that resulted in a second-quarter pretax loss of $200 million in our individual products, which we project will grow to in excess of $300 million by the end of the 2016.”

Insurance companies are making losses because fewer Americans are signing up for Obamacare than were predicted, and these Americans are sicker than average. Premiums rose in some markets by 20 percent in 2016, leading to more healthy people dropping out of plans or not enrolling, accelerating the financial imbalance. Premiums are expected to rise by a similar amount—or more—in 2017.

The Obamacare model is not workable.

Fewer than 13 million people signed up for Obamacare in the 2016 enrollment period, compared with the 22 million predicted by the Congressional Budget Office in May 2013.

Young, healthy people are not signing up in great numbers for the expensive policies, even with the threat of penalties. Insurance companies and politicians thought that the premiums from these young people, who do not use much health care because they are rarely sick, would be used to pay for the care of the old and the chronically-ill.

Rather, young people are either on their parents’ plans, or on employer plans, or going without insurance and paying the penalty.

So far Congress has not bailed out the insurance companies. Last year the Department of Health and Human Services moved $362 million to insurance companies to cover losses, rather than the $2.9 billion that they requested. The Congressional Research Service and the U.S. Government Accountability Office have ruled that a congressional appropriation is required before federal agencies can bail out insurance companies for their Obamacare losses.

That Which Cannot Last

The Obamacare model is not workable, as I wrote in a 2009 column. It requires an expensive, comprehensive plan that obligates participants to purchase coverage for maternity care even if they have finished having children, pediatric dental care even if they are childless, mental health coverage even if they do not need it, and drug abuse coverage even if they have never taken any drugs.

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     This is the kind of nonsense only the government would dare require.

Obamacare is collapsing as health insurance companies continue to withdraw from the exchanges.

People are not allowed to buy a simple plan that covers major illnesses such as heart disease, cancer, or falling off a bike in traffic. Furthermore, the deductibles—the amount that has to be spent before people can use the insurance—are so broad as to make coverage practically useless. For 2016, the average deductible for singles for the lowest-cost bronze plan is $5,700, and for families, it is $12,000.

That is why those who are on the exchanges are disproportionally sicker than average and have chronic health conditions that make them more expensive to insure.

Obamacare is collapsing as health insurance companies continue to withdraw from the exchanges. What then? Congress will either convert Obamacare into a public plan—such as Medicare for all—or repeal it altogether.

How Insurance Is Supposed to Work

The path to repeal and reform has been laid out by Speaker Paul Ryan and Republican presidential candidate Donald Trump. Both plans include returning flexibility to insurance companies over what plans are offered while insuring that once people are in the insurance system, they cannot be dropped.

When real insurance is outlawed, neither consumers nor insurance companies benefit.

Rather than hire the same academic consultants who designed the non-insurance program called Obamacare, the next administration would be well advised to listen to the real expert on medical insurance: the American consumer. That consumer is very happy with a wide range of well-functioning insurance markets such as automobile insurance, home-owners insurance, and life insurance. So too are the insurance companies that provide the insurance, all without a dime of federal subsidy.

There is a simple logic to insurance markets. Let businesses freely compete to provide services to consumers with sensible regulations but without government support, and both consumers and insurance companies are well off. In contrast, when real insurance is outlawed, and only non-insurance can be sold, neither consumers nor insurance companies benefit. That’s where America is today.

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    If one wants something done right, keep the government as far away from it as possible.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Power Teaching: How to Find Someone to Teach Your Child when the Education System has Failed.
Cui Bono–Cherchez les Contingencies

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The Errors of Socialism Applied to Medical Treatment

April 27, 2016

Displaying

    Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

    People are generally so excited about dying that any rationality about health care is suspended or reversed. Health care providers are surrounded by the strongest union rules in society commensurate with the belief in the sanctity of their calling. Socialized medicine, like socialized anything leads to higher costs and worse service.

Hospital II
John Stossel

Last week’s column on my lung surgery struck a nerve. Many of you wished me well. Others said I deserve to die.

"He likes free markets?" sneered one Internet commenter. "In a truly free market, society wouldn’t subsidize the cost of his smoking. In a truly free market, he’d be dead."

No, I wouldn’t be dead. In a real free market, I would pay for my own care and that care would be cheaper and better because that’s what market competition does.

Also, I’ve never smoked cigarettes. Some people who don’t smoke get lung cancer, too.

The angriest comments were in The Washington Post: "Stossel should ask for his money back and the doctors should put cancer back into his lungs. That’s what happens in a consumer-driven market, right?"

People can get very unhinged when libertarians argue that markets work better.

"HOW would that work? WHO would pay the nurses and the staff that keep a hospital running?"?

Who do they think pays now? Government and insurance companies paying doesn’t make care "free." Government has no money of its own; it takes it from us. Such third-party payments just hide the cost.

"Is John Stossel’s life worth more than the guy who collects my trash? … (T)urn health care over to his jackboot crew, only the rich will live to old age."

But it’s the shopping around — including shopping by the rich — that fuels the innovation and discounting that extends everyone’s lives, not just the rich. Charity will help the very poor.

"Let’s see him negotiate the price of chemo vs. surgery when he’s in the ambulance on way to hospital. … Medical care is not amenable to usual market forces."

But it is. Patients wouldn’t need to negotiate from the ambulance because such decisions would have already been made for them by thousands of previous patients, especially the 2 percent who pay the closest attention. Word would get around that hospital X is a rip-off but hospital Y gives better treatment for less. Doctors would advertise prices. Rating agencies would evaluate them for quality. Everyone will know more.

A hospital worker complained about this "customer mentality. A hospital is NOT a restaurant. It is not Burger King. You don’t get to have it your way."

Why not? Must we just passively take what we’re handed when it comes to medicine, even though we’d never accept that with hamburgers?

Medical patients tolerate indifferent service the way people tolerate waiting at the post office. The Postal Service, we were told, can’t possibly make a profit, get it there overnight, etc. Then came UPS and FedEx. Competition showed what is possible.

"Stossel may think he’s getting ‘excellent medical care’," writes Cato Institute health care analyst Michael Cannon.

"But he doesn’t know it, and neither do his doctors, because there is no market system to show how much better it could be. … In a market system, competition would push providers to strive to keep patients from falling through these cracks. … In our system, there is no such pressure on providers … because the real customer is government. As a result, few patients know how unsafe American medicine is."

Cannon warns, "Without that information, patients — even when they are smart, skeptical and wealthy like Stossel — are constantly consenting to inferior care."

A few extra-savvy consumers might be aware that my hospital got a "B" rating on The Leapfrog Group’s Hospital Safety Score, and, says Cannon, it rates NewYork-Presbyterian "below average" in nine categories, including collapsed lungs and surgical site infections. "Did Stossel know about these safety measures before he chose NewYork-Presbyterian?"

No, I didn’t.

I am grateful for my hospital’s lifesaving technology and the skills of some of my caregivers. But it would be better if hospitals were as efficient as FedEx and most of what’s offered by the private sector.

My local supermarket is open 24/7. They rarely make me wait, prices are low, there’s plenty of choice, and they rarely poison me.

That’s what competition brings — if people pay with their own money.

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     My only major contact with medical care was with Shouldice Surgery, an organization which repaired the double hernia which is genetically popular in my family. They did a great job with no post-operative problems. Under Canada’s socialized, hysterical medical system, Shouldice could not start up today because only government-sanctioned groups are allowed. The only thing socialized medicine does is to give the comforting appearance that something is being done, just like every other government enterprise.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Power Teaching: How to Find Someone to Teach Your Child when the Education System has Failed.
Cui Bono–Cherchez les Contingencies

The Virtue of Work

November 28, 2015

Displaying

   Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

    Wherein we have an essay on the joys of productive labor. Liberals want to avoid work. Others should embrace and glorify it. The only problem with that is that the collectivists insist we share the fruits of labor with those who worship leisure.

Here’s Something You Should Be Thankful For: Work

Here’s Something You Should Be Thankful For: Work
Michael Barone

Sure, that sounds counterintuitive. Thanksgiving Thursday is the first day of a (for most of us) four-day weekend, a time devoted to gorging on comfort food and nonstop viewing of college and professional football games.

It’s a time as well for contemplation, already primed by overfamiliar songs in shopping malls, of an even longer holiday season. I grew up in Detroit, where the auto assembly lines shut down entirely for last two weeks of the calendar year. Who needs work?

The answer, I believe, is everybody. Arthur Brooks, president of American Enterprise Institute where I’m a resident fellow, has examined the research on what makes people happy and gives them satisfaction, and he boils his answer down to two words: earned success.

That can take many forms. You can measure earned success by the money you earn or the usefulness of your work, and also by the work you do raising a family or joining with others in the multitude of voluntary associations which Alexis de Tocqueville identified 180 years ago as the major strength of America. Looking back over life, most people realize that they derived less satisfaction from the enjoyment of pleasure than from the performance of duty.

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    “I slept and dreamt that life was beauty, I woke and found that life was duty.

Anyone who knows some history understands the reasons people have wanted some liberation from work. For centuries, work, to paraphrase the philosopher Thomas Hobbes, tended to make life nasty, brutish and short. Hard physical labor broke men’s bodies and led to early deaths.

Readers of Willa Cather’s Nebraska novels or Laura Ingalls Wilder’s “Little House on the Prairie” series will remember not only their lyrical descriptions of landscape but also their accounts of how the hard work the pioneers of the Great Plains had to do filled practically every waking moment.

So did the work of laborers in 19th century textile mills and steel factories — and of the wives who stayed home cleaning, laundering, cooking and childrearing constantly. No wonder people looked forward to Saturday night music-making and Sunday sermons.

Vastly increased prosperity created by industrialization made possible the passage of laws establishing the eight-hour day with time-and-a-half overtime and banning child labor. Social Security, enacted in 1935, established old-age pensions for those retiring at 65 (conveniently, a bit older than male life expectancy then).

Later legislation enabled people to collect reduced Social Security at 62. Disability Insurance, established in the 1950s, provided minimal incomes for those judged unable to work.

Over time, these programs have tilted people away from work. More choose to retire at 62 than 65 or later. Disability rolls have nearly doubled in 15 years, with most applicants complaining of unverifiable back pain or mental depression.

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    The problem of free riders, never solved by those who dole out government funds. It’s not their money, of course they’ll waste it.

In the 1930s economist John Maynard Keynes looked forward to a time when people would only work a few hours a week. Visionary labor union leaders prophesied that manual laborers, freed from the assembly line, would spend their days appreciating classical music and great literature.

Things turned out differently. High-education, high-income Americans are working longer hours today than 40 years ago, while low-education, low-income people work less. Some 9 percent of adults in low-growth West Virginia now get by on disability payments of about $13,000 yearly.

Some call for more policies enabling people to work less, such as mandatory paid paternal and family leave. They seem to take increased productivity and economic growth for granted, even though it has been sluggish lately. They ignore the fact that only vibrant economic growth can give people the opportunity to find work that maximizes their own special talents and draws on their own special interests — a sure way to earn success and find satisfaction in life.

The fact is that most retirees and disability recipients are spending less time with Beethoven and Tolstoy than watching low-quality television. And as Princeton economists Angus Deaton and Anne Case have noted, the death rate of non-college-graduating men age 45 to 54 has actually been rising this century, often due to alcohol and drug abuse.

That’s a sharp reversal of a long historic trend, and it resembles the sharp decrease in male life expectancy in the late Soviet Union. It suggests a widespread spiritual unease in people who have been liberated from work but have found no satisfying way to earn success.

So relax on the holidays, if you like — but give thanks if you have found useful and satisfying work.

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  All play and no work makes suicide an attractive option.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Power Teaching: How to Find Someone to Teach Your Child when the Education System has Failed.
Cui Bono–Cherchez les Contingencies

How Government Makes Affordable Less Affordable

November 20, 2015

    Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

   Wherein we see the difference between rhetoric and reality, how the INTENTION (INTEND) of a government system is translated into the IS, what the system really is like and the DOES, what it really accomplishes.

   Health care is the perfect place for government to pretend–people have an irrational belief in physicians and require an unlimited supply of the reassurance provided by “treatment” regardless of the efficacy or efficiency of that treatment.

"Affordable Care": Higher Premiums, Higher Deductibles, Worse Healthcare
The New York Times and Boston Globe unload on Obamacare
Michael F. Cannon

Aside from one necessary clarification (see far below), it would be difficult to improve on what the New York Times, the Boston Globe, and the enrollees they interview have to say about ObamaCare.

First, from yesterday’s New York Times article, “Many Say High Deductibles Make Their Health Law Insurance All but Useless”:

    For many consumers, the sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: sky-high deductibles that are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage.

    “The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.” …

    “We could not afford the deductible,” said Kevin Fanning, 59, who lives in North Texas, near Wichita Falls. “Basically I was paying for insurance I could not afford to use.”

    He dropped his policy. …

    “Our deductible is so high, we practically pay for all of our medical expenses out of pocket,” said Wendy Kaplan, 50, of Evanston, Ill. “So our policy is really there for emergencies only, and basic wellness appointments.”

    Her family of four pays premiums of $1,200 a month for coverage with an annual deductible of $12,700. …

    Alexis C. Phillips, 29, of Houston, is the kind of consumer federal officials would like to enroll this fall. But after reviewing the available plans, she said, she concluded: “The deductibles are ridiculously high. I will never be able to go over the deductible unless something catastrophic happened to me. I’m better off not purchasing that insurance and saving the money in case something bad happens.”

    “While my premiums are affordable, the out-of-pocket expenses required to meet the deductible are not,” said [Karin] Rosner, who makes about $30,000 a year. …

    “When they said affordable, I thought they really meant affordable,” [Anne Cornwell of Chattanooga, Tenn.,] said.

And from today’s Boston Globe article, “High-Deductible Health Plans Make Affordable Care Act ‘Unaffordable,’ Critics Say”:

    “We can’t afford the Affordable Care Act, quite honestly,” said Cassaundra Anderson, whose family canvassed for Obama in their neighborhood, a Republican stronghold outside Cincinnati. “The intention is great, but there is so much wrong. . . . I’m mad.” …

    The Andersons’ experience echoes that of hundreds of thousands of newly insured Americans facing sticker shock over out-of-pocket costs. …

    “This will be an issue at least one more time in the 2016 election. It could absolutely still hurt Democrats,” said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. “Polls about the Affordable Care Act have a considerable amount of middle-income people who say either the program has done nothing for them or actually hurt them.” …

    “Unfortunately, what we are headed toward now is universal crappy health insurance,” said Dr. Budd Shenkin, a California pediatrician. … “It’s just not a good deal for people,” he said.

    “We’re in the process of looking at going without insurance,” [Cassaundra Anderson] said, calculating that the family will be better off financially just paying the $2,000 tax penalty for not abiding by the law’s mandate. “What am I even paying these insurance people for? Why should we reenroll?” …

    “I cannot get anything with this insurance. Nothing,” said [Laura] Torres, who avoids seeking treatment for her thyroid condition and high blood pressure because of cost. “I just pay my monthly payments, try to take care of myself, go to work, and hope something serious doesn’t happen to me.” …

    Amete Kahsay, 53, works as a temporary warehouse packer in Columbus. The Affordable Care marketplace is her only option for health insurance. She and her husband, an airport shuttle driver, pay $275 a month for a “bronze” plan with a $13,200 deductible.

    Shortly after they signed up for insurance last year, her husband rushed her to the emergency room when she experienced dizziness. The visit, which included a CT scan of her brain, cost $1,700. She paid the charge from her savings, then returned to her native Ethiopia, where care is cheaper, to consult a neurologist and seek follow-up care.

    “I support Obamacare. Without it, I wouldn’t have any type of insurance. But I’m not sure it’s worth the money,” said Kahsay, a US citizen who is registered as an independent voter. “Now, unless I get very, very sick, like only if it’s life-threatening, I won’t go to the doctor. I just lay down and take a rest.”

The necessary clarification is that these people are not complaining about high-deductibles in a market system. In a market system, consumers who choose high deductibles save money on their premiums and therefore have more resources to help them pay their out-of-pocket expenses.

ObamaCare, on the other hand, manages to pair high deductibles with higher premiums, stripping many people of this benefit of high-deductible plans and leaving them unable to pay their medical bills.

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    Health care is the perfect example of government regulation driving up cost and then adding more cost to make it “affordable.”

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Power Teaching: How to Find Someone to Teach Your Child when the Education System has Failed.”
Cui Bono–Cherchez les Contingencies

 

First Salt, Now Fat—Bothered By Facts Again

July 28, 2015

https://grantcoulson.files.wordpress.com/2014/04/incentiveseverywherepicturecorrect1.jpg?w=444&h=288

   One of the problems with liberals is that they cannot see order unless it is imposed. If one of the government tribe is not in charge, it’s chaotic. Free markets, of  course, are some of the most  orderly of human activity.

        Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

    It’s not our ignorance, but our incorrect knowledge which does us mischief.

The Latest Science on Fat Will Surprise You

The Latest Science on Fat Will Surprise You
There’s a six decade-old scientific legend that just refuses to die, and researchers such as myself would love to set the record straight. I’m sure you’ve heard it before, probably even from your doctor: High-fat diets are bad for you and saturated fatty acids cause heart problems and make you fat.

A growing body of solid scientific research, however, shows otherwise.

So how did saturated fat earn such a negative reputation? Let me take you back to the early 1900s.

Back then, people used butter, lard, and beef tallow almost exclusively in cooking and baking. (Of note, heart disease was relatively rare, too.) But then two things happened.

First, women began dieting (by counting calories) to stay thin. Since a gram of fat has more calories than a gram of protein or carbohydrate (9 vs. 4), they naturally chose to eliminate the higher-calorie macronutrient in favor of lower-calorie ones.1

In addition, it came to light that mechanically hulling and pressing seeds to make vegetable oil was much cheaper and faster than raising cattle to milk for butter or slaughter for their lard or tallow. The food manufacturing industry quickly entered the picture to patent the creation of hydrogenated vegetable oils and market them as the healthier, more sanitary choice for cooking and baking.

The reduction of dietary fat for slimmer waistlines was pretty commonplace by mid-century, around the time that researchers began searching for answers on a once-rare condition starting to affect more and more people—heart disease.

Ancel Keys was one of the most well-known researchers to introduce the idea that saturated fat may contribute to the development of heart disease. His “Seven Countries Study”—a 20-year trial, starting in the late 1950s, that followed more than 10,000 men in Italy, the Greek Isles, Yugoslavia, Netherlands, Finland, Japan, and the US—was one of the first major studies to link saturated fat consumption with heart disease. He found that countries with the greatest consumption of saturated fat had the highest rates of heart disease.

Even though the study had some serious flaws (for one, it showed a correlation between saturated fat and heart disease, it did not prove cause and effect), the damage was done. The medical establishment adopted the notion that fats are bad for the heart and should be avoided.

The “low-fat for heart health” craze was in full swing by the mid-1980s, when a study published in the journal Circulation concluded that obesity was an independent risk factor for cardiovascular disease.2 Not only did this finding lend further fuel to the “fat is bad for your heart” fire, it also put back into the spotlight the dangers of obesity—and that high-calorie dietary fat may make your waistline fat.

By the 1990s, you couldn’t enter a grocery store without seeing the shelves dominated by low-fat or nonfat food options—from skim milk and nonfat yogurt to low-fat processed snack foods.

Interestingly, though, America was not getting skinnier. In fact, people were heavier than ever and heart disease was more prevalent than ever.

Why? Well, the biggest issue with low-fat diets is that they tend to be high in carbohydrates. Your body converts carbs to sugar. This blood sugar spike initiates an insulin response, which is designed to bring down circulating sugar levels. Additionally, excess sugars get converted into a fat called triglycerides, which get stored as body fat.

The problem is, with carb-heavy diets, blood sugar never has a chance to drop to normal levels. The never-ending stream of insulin triggers a constant state of fat storage and damages the insulin signaling system. Eventually, this relentless sequence of events leads to obesity, insulin resistance, and diabetes in large numbers of people.

Moreover, low-fat foods are almost always high in sugar. Fat adds flavor. Strip the fat, you take away the flavor. (Simply compare the rich flavor of whole milk to watered-down skim milk, and you’ll understand what I’m talking about!) To add flavor back into low-fat or nonfat foods, manufacturers typically add sugar. And you already know what an inflammation-causing health destroyer sugar is on so many levels.

Conflicting Research Revealed
Finally, the medical community was starting to consider that maybe reduction of fat was part of the problem—not the solution.

In one meta-analysis of randomized trials, researchers found that, in the short term, low-fat diets resulted in weight loss. Long term, however, is a different story. They wrote, “in trials lasting one year or longer, fat consumption within the range of 18-40% of energy has consistently had little, if any, effect on body fatness. Moreover, within the United States, a substantial decline in the percentage of energy from fat during the last two decades has corresponded with a massive increase in obesity, and similar trends are occurring in other affluent countries. Diets high in fat do not account for the high prevalence of excess body fat in Western countries; reductions in the percentage of energy from fat will have no important benefits and could further exacerbate this problem. The emphasis on total fat reduction has been a serious distraction in efforts to control obesity and improve health in general.”3

Other research started to cast doubts on the link between saturated fat and heart disease.

A 2010 meta-analysis of 21 studies (and more than 347,000 people) found “no significant evidence for concluding that dietary saturated fat is associated with increased risk of coronary heart disease or cardiovascular disease.”4

And an even more recent 2014 meta-analysis of 80 studies (involving more than 530,000 people), including 27 randomized, controlled trials, concluded that “current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”5

The main reason saturated fat is so vilified is that it can increase low-density lipoprotein (LDL) cholesterol. (It also happens to increase beneficial high-density lipoprotein (HDL) cholesterol.) LDL cholesterol has been linked to higher heart disease and heart attack risk. However, the subtype of LDL that saturated fat raises—LDL pattern A—is actually relatively harmless. LDL pattern B—the smaller, denser form of LDL—is much more dangerous. It causes inflammation, which sets off a chain of events that eventually leads to heart disease and countless other inflammation-related issues. LDL pattern B levels are not elevated by saturated fats. They’re raised by high-sugar, high-carbohydrate diets.

Finally, I think it’s important to note that saturated fat actually plays some pretty critical roles in the body. You can’t completely live without it. It is a component of all cells, and also helps the body digest and use proteins, omega-3 fatty acids, and other fat-soluble vitamins.

I hope this information helps you understand that the scientific evidence now reveals that saturated fat is not as harmful as it has been made out to be over the past several decades. If you’re still avoiding that juicy steak or glass of whole milk for fear that it may give you a heart attack or increase your girth, it’s ok to indulge a little. Don’t go overboard…still practice moderation. But there’s simply not any scientific proof that you should avoid it altogether.

Remember, my promise to you is that I will always provide you with accurate information, based on the latest science.

Be well,
Dr. Ski Chilton

REFERENCES

1. La Berge A. J Hist Med Allied Sci. 2008 Apr;63(2):139-77.
2. Hubert HB, et al. Circulation. 1983 May;67(5):968-77.
3. Willett WC. Obes Rev. 2002 May;3(2):59-68.
4. Siri-Tarino PW, et al. Am J Clin Nutr. 2010 Mar;91(3):535-46.
5. Chowdhury R, et al. Ann Intern Med. 2014 Mar 18;160(6):398-406.

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   Screaming about salt and fat looks pretty stupid now, doesn’t it?

   Just another example of, “If everyone believes it, it’s probably untrue–Does not apply to gravity.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.
Cui Bono–Cherchez les Contingencies

Increasing Dementia By Managing It

June 12, 2015

https://grantcoulson.files.wordpress.com/2014/04/incentiveseverywherepicturecorrect1.jpg?w=444&h=288

       Do not think about, write about or deal with  human behavior without determining the effects of incentives. It’s not their money, of course they’ll waste it.

    Wherein we see that the use of psychopharmaceuticals is a bad idea no matter the context. The drugs may be causing the conditions they are supposed to be ameliorating.

Evidence Strengthening that Common Benzodiazepine Sedatives May Cause Dementia

A meta-analysis of scientific studies found that the risk of dementia increased 22% with every additional twenty daily doses of benzodiazepine medications that people took annually, according to a study in PLoS One.

Researchers from Chongqing Medical University in China analyzed six studies (involving 11,891 dementia cases and 45,391 participants) that provided risk estimates on the association of benzodiazepine use with dementia. They found that long-term benzodiazepine use was associated with about a 50% increase in risk of developing dementia. "The risk of dementia increased by 22% for every additional 20 defined daily dose per year," they added.

The authors noted that early symptoms of dementia such as sleep disturbance, anxiety and depression can often begin ten years before people receive a diagnosis of dementia. For this reason, they stated, some researchers do not believe that benzodiazepines are causing dementia, but instead believe that people’s symptoms of dementia are motivating physicians to prescribe benzodiazepines.

The authors of the meta-analysis then put forth data and arguments to refute that perspective. Adjusting for the presence of symptoms of anxiety and depression did not change their findings, they noted. And comparing people who’d stopped taking benzodiazepines with people who were currently taking them also did not change their findings. Rates of developing dementia were about 50% higher for all of these different groups of past or present long-term users, the authors wrote, and the dose-response relationship they’d found persisted across all of the groups.

Such findings, they wrote, support arguments that there is "a causal relationship between benzodiazepine use and dementia."

"Long-term benzodiazepine users have an increased risk of dementia compared with never users," the researchers concluded. "However, findings from our study should be treated with caution due to limited studies and potential reverse causation. Large prospective cohort studies with long follow-up duration are warranted to confirm these findings."

Zhong, GuoChao, Yi Wang, Yong Zhang, and Yong Zhao. “Association between Benzodiazepine Use and Dementia: A Meta-Analysis.” PLoS ONE 10, no. 5 (May 27, 2015): e0127836. doi:10.1371/journal.pone.0127836. (Full text)
–Rob Wipond, News Editor

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   Psychopharmaceuticals don’t work particularly well anywhere. The drug placebo usually does better.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.”
Cui Bono–Cherchez les Contingencies

Ebola—The Chance To Build More Government Empire

October 18, 2014

https://grantcoulson.files.wordpress.com/2014/04/incentiveseverywherepicturecorrect1.jpg?w=444&h=288

    Do not think about, write about or deal with  human behavior without determining the effects of incentives.

     Wherein we see that once a crisis has occurred, the bureaucracy it engenders will be with us forever.

Washington’s Action Plan for Ebola: Squalid Waste and Pork-Barrel Spending by the CDC and NIH
Daniel J. Mitchell

Years ago, I shared a very funny poster that suggests that more government is hardly ever the right answer to any question.

Yet in Washington, the standard response to any screwup by government is to make government even bigger. Sort of Mitchell’s Law on steroids.

And that’s exactly what’s happening with the Ebola crisis. The bureaucracies that have received tens of billions of dollars over the years to preclude a crisis are now expecting to get rewarded with more cash.

Governor Jindal of Louisiana debunks the notion that more money for the bureaucracy is some sort of elixir. Here’s some of what he wrote for Politico.

    In a paid speech last week, former Secretary of State Hillary Clinton attempted to link spending restraints enacted by Congress—and signed into law by President Obama—to the fight against Ebola. Secretary Clinton claimed that the spending reductions mandated under sequestration “are really beginning to hurt,” citing the fight against Ebola: “The CDC [Centers for Disease Control and Prevention] is another example on the response to Ebola—they’re working heroically, but they don’t have the resources they used to have.” …In recent years, the CDC has received significant amounts of funding. Unfortunately, however, many of those funds have been diverted away from programs that can fight infectious diseases, and toward programs far afield from the CDC’s original purpose. Consider the Prevention and Public Health Fund, a new series of annual mandatory appropriations created by Obamacare. Over the past five years, the CDC has received just under $3 billion in transfers from the fund. Yet only 6 percent—$180 million—of that $3 billion went toward building epidemiology and laboratory capacity. …While protecting Americans from infectious diseases received only $180 million from the Prevention Fund, the community transformation grant program received nearly three times as much money—$517.3 million over the same five-year period. …Our Constitution states that the federal government “shall protect each of [the States] against Invasion”—a statement that should apply as much to infectious disease as to foreign powers. So when that same government prioritizes funding for jungle gyms and bike paths over steps to protect our nation from possible pandemics, citizens have every right to question the decisions that got us to this point.

What Governor Jindal is describing is the standard mix of incompetence and mission creep that you get with government.

Bureaucracies fail to achieve their stated goals, but also divert lots of resources to new areas.

After all, that’s a great way of justifying more staff and more money.

Especially since they can then argue that they need those additional resources because they never addressed the problems that they were supposed to solve in the first place!

Here are some excerpts from a story in the Washington Free Beacon, starting with some whining from the head bureaucrat at the National Institutes of Health, who wants us to be believe that supposed budget cuts have prevented a vaccine for Ebola.

    “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready,” said NIH Director Francis Collins, blaming budget cuts for his agency’s failure to develop a vaccine for the deadly virus.

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    A vaccine for a disease which was not a problem?

Yet take a look at how the NIH has been squandering money.

    However, the Washington Free Beacon has uncovered $39,643,352 worth of NIH studies within the past several years that have gone to questionable research. For instance, the agency has spent $2,873,440 trying to figure out why lesbians are obese, and $466,642 on why fat girls have a tough time getting dates. Another $2,075,611 was spent encouraging old people to join choirs. Millions have gone to “text message interventions,” including a study where researchers sent texts to drunks at the bar to try to get them to stop drinking. The project received an additional grant this year, for a total of $674,590. …The NIH’s research on obesity has led to spending $2,101,064 on wearable insoles and buttons that can track a person’s weight, and $374,670 to put on fruit and vegetable puppet shows for preschoolers. A restaurant intervention to develop new children’s menus cost $275,227, and the NIH spent $430,608 for mother-daughter dancing outreach to fight obesity. …Millions went to develop “origami condoms,” in male, female, and anal versions. The inventor Danny Resnic, who received $2,466,482 from the NIH, has been accused of massive fraud for using grant money for full-body plastic surgery in Costa Rica and parties at the Playboy mansion.

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    Parties at the Playboy mansion. What could be healthier?

Origami condoms?!? I’m almost tempted to do a web search to see what that even means, particularly since there are male, female, and anal versions.

But even without searching online, I know that origami condoms have nothing to do with stopping Ebola.

The Centers for Disease Control also have a long track record of wasting money. Here are some odious details from a Townhall column.

    So now the federal health bureaucrats in charge of controlling diseases and pandemics want more money to do their jobs.

Gee, what a surprise.

    Maybe if they hadn’t been so busy squandering their massive government subsidies on everything buttheir core mission, we taxpayers might actually feel a twinge of sympathy. At $7 billion, the Centers for Disease Control 2014 budget is nearly 200 percent bigger now than it was in 2000.…Yet, while Ebola and enterovirus D68 wreak havoc on our health system, the CDC has been busying itself with an ever-widening array of non-disease control campaigns, like these recent crusades: Mandatory motorcycle helmet laws. …Video games and TV violence. …Playground equipment. …”Social norming” in the schools. …After every public health disaster, CDC bureaucrats play the money card while expanding their regulatory and research reach into anti-gun screeds, anti-smoking propaganda, anti-bullying lessons, gender inequity studies and unlimited behavior modification programs that treat individual vices — personal lifestyle choices — as germs to be eradicated. …In 2000, the agency essentially lied to Congress about how it spent up to $7.5 million earmarked each year since 1993 for research on the deadly hantavirus. …The diversions were impossible to trace because of shoddy CDC bookkeeping practices. The CDC also misspent $22.7 million appropriated for chronic fatigue syndrome and was investigated in 2001 for squandering $13 million on hepatitis C research.

By the way, you may be wondering why we have both the National Institutes of Health as well as the Centers for Disease Control.

Is this just typical bureaucratic duplication?

No, it’s typical bureaucratic triplication, because we also have the Office of the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services.

And as Mollie Hemingway explains in The Federalist, this additional layer of bureaucracy has been MIA on Ebola, perhaps because the head bureaucrats diverted funds to a political crony.

    …nobody has even discussed the fact that the federal government not ten years ago created and funded a brand new office in the Health and Human Services Department specifically to coordinate preparation for and response to public health threats like Ebola. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat. And she’s still on the job even though three years ago she was embroiled in a huge scandal of funneling a major stream of funding to a company with ties to a Democratic donor—and away from a company that was developing a treatment now being used on Ebola patients.

Here are some additional details.

    …one of HHS’ eight assistant secretaries is the assistant secretary for preparedness and response, whose job it is to “lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.” …“Lurie’s job is to plan for the unthinkable. A global flu pandemic? She has a plan. A bioterror attack? She’s on it. Massive earthquake? Yep. Her responsibilities as assistant secretary span public health, global health, and homeland security.” …you might be wondering why the person in charge of all this is a name you’re not familiar with. …why has the top official for public health threats been sidelined in the midst of the Ebola crisis?

Perhaps because of the scandal.

    You can—and should—read all about it in the Los Angeles Times‘ excellent front-page expose from November 2011, headlined: “Cost, need questioned in $433-million smallpox drug deal: A company controlled by a longtime political donor gets a no-bid contract to supply an experimental remedy for a threat that may not exist.”…The donor is billionaire Ron Perelman, who was controlling shareholder of Siga. He’s a huge Democratic donor… The award was controversial from almost every angle—including disputes about need, efficacy, and extremely high costs.

So what’s the bottom line?

    The Progressive belief that a powerful government can stop all calamity is misguided. In the last 10 years we passed multiple pieces of legislation to create funding streams, offices, and management authorities precisely for this moment. That we have nothing to show for it is not good reason to put even more faith in government without learning anything from our repeated mistakes.

And that’s the most important lesson, though a secondary lesson is that big government means big corruption.

Big government is incompetent government.

Writing for The Federalist, John Daniel Davidson puts everything in context, explaining that big, bureaucratic states don’t do a good job.

    The government’s response to the outbreak has exposed the weakness of the modern administrative state in general, and the incompetence of the White House in particular. …The second nurse to contract Ebola, Amber Vinson, traveled from Cleveland to Dallas on a commercial flight Monday and checked herself into the hospital Tuesday with Ebola symptoms. She called the CDC before she boarded the flight and reported she had a temperature of 99.5—yet CDC officials didn’t stop her from boarding the plane. …Thus continues a pattern of crippling naiveté and ineptitude from the White House on…the Ebola outbreak. On the press call, Frieden explained that you can’t get Ebola from sitting on a bus next to someone who’s infected, but if you have Ebola then don’t use public transportation because you might infect someone. …whether it’s funding or regulation, it’s becoming clear that government “everywhere putting its hands to new undertakings” isn’t working out all that well. …In a hundred years, when Americans read about the U.S. Ebola outbreak of 2014 and antiquated government agencies like the FDA that hampered the development of a vaccine, they’ll laugh at us. …Likewise, future Americans will probably scoff at us for thinking our FDA, in its current form, was somehow necessary or helpful, or for how the Department of Health and Human Services could spend almost a trillion dollars a year and yet fail to prevent or adequately respond to the Ebola outbreak.

And if you want a humorous look at the link between bloated government and incompetent government, Mark Steyn nails it.

Since we’ve shifted to humor, somebody on Twitter suggested that this guy is probably in line to become Obama’s new Ebola Czar.

Last but not least, here’s the icing on the cake.

I mentioned above that we have bureaucratic triplication thanks to NIH, CDC, and HHS. And I joked that the guy in the Holiday Inn might become the President’s new Czar, creating bureaucratic quadruplication (if that’s even a word).

Well, that joke has now become reality. The Washington Examiner is reporting that Obama has named an Ebola Czar. But the guy in the video will be sad to know he didn’t make the cut.

    President Obama has chosen Ron Klain, former chief of staff for two Democratic vice presidents, as his Ebola czar, the White House said Friday. …In choosing Klain, Obama is selecting a D.C. insider and veteran of numerous political battles to spearhead a campaign with major implications on his own legacy and how Democrats fare in the November midterms.

Great. I’m sure a lobbyist and former political operative will have just the skills we need to solve this crisis.

I’m going out on a limb and predicting that he’ll say the solution is more money and bigger government. And we know how that turns out.

Yup, it’s a bird, it’s a plane, it’s government man to the rescue!

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   Isolate the infected. How hard is that?

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.”
Cui Bono–Cherchez les Contingencies

Too Much Politics and Too Much Medicine

August 8, 2014

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    Do not think about, write about or deal with  human behavior without determining the effects of incentives.

How do you get 100 New Yorkers out of the pool?
Answer: Say "Every one STAY in the pool!
How do you get 100 Californians out of the pool?
Answer: Say "This pool has been CHEMICALLY TREATED for your protection!
How do you get 100 Republicans out of the pool?
Answer: Say "Being in this pool shows your support for the FEDERAL GOVERNMENT
How do you get 100 Democrats out of the pool?
Answer: Say "This pool will be FUNDED COMPLETELY by the people in the pool!’

The difference between Canadians and Americans?
HOW DO YOU GET 100 CANADIANS OUT OF THE POOL?
ANSWER: SAY "Please get out of the pool."

    About 80% of visits to physicians in North America, it is said, are for digestive complaints. It is probable that most of these complaints in the long run could be solved by eliminating certain foods. The theory behind this is that, in the thousands of generations humans have existed in forms similar to our present form, only the last couple of hundred generations have been subjected to the diet from industrial agriculture with its high input from wheat and dairy. About 75% of adults are allergic or sensitive to lactose with another significant percentage being sensitive, to some degree, to gluten, a wheat protein. The”treatment” for the conditions arising from food sensitivities is simply the elimination of these foods. This does not fit with the HEROIC notion of drugs and surgery which makes up medicine. It also produces no more office visits. For example, my dermatitis and “arthritic” knees stopped almost immediately when I eliminated lactose.

    Politicians have the same problem. Allowing things to work out or, more properly, allowing people to work them out, is not HEROIC. They must have heroic policies to set thing right. As in medicine, these “policies” usually have consequences that are much worse than no policy. The politicians, and many of the public alas, are content because something heroic was done. In politics and medicine, practitioners should do less.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.
Cui Bono–Cherchez les Contingencies

 

We Can’t Identify Or Fix Mass Murderers

June 2, 2014

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    Do not think about, write about or deal with  human behavior without determining the effects of incentives.

     Any tragic mass killing brings out the usual after-the-fact fixes. The solutions are in two categories–take the weapon out of the hands of the offender–or take the hands off the weapon. The first means making the weapon, almost always a gun of some kind, unavailable. The second is treating or incapacitating the offender so that he is not in the position to do his killing.

     Alas, none of this will work. The second is the part I’ll deal with today. Dr. Friedman points out that the first part of the second solution, cannot be done. It is impossible to IDENTIFY those likely to commit a despicable act without misidentifying hundreds of people, false positives, who will not commit such acts. All identification is easier after the fact, that’s why racetracks don’t allow retroactive wagering.

     Unlike many aspects of “mental health”, this aspect is not tainted by political assumptions and desires. Identification of mass murders can’t be done.

National Post
    Richard Friedman Richard A. Friedman is a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College.

A killer’s unknowable mind

A psychiatrist argues that mental-health screening cannot tell us who will become a mass murderer and who won’t

Drug and alcohol abuse are far more powerful risk factors for violence than psychiatric illnesses

Mass killers such as Elliot Rodger — who killed seven people (including himself ) in Isla Vista, Cal. on Friday — teach society all the wrong lessons about the connection between violence, mental illness and guns. One of the biggest misconceptions, pushed by our commentators and politicians, is that we can prevent these tragedies if we improve our mental health care system. It is a comforting notion, but nothing could be further from the truth.

And although the intense media attention might suggest otherwise, mass killings — when four or more people are killed at once — are very rare events. In 2012, they accounted for only about 0.15% of all homicides in the United States. Because of their horrific nature, however, they receive lurid media attention that distorts the public’s perception about the real risk posed by the mentally ill.

Anyone who watched Elliot Rodger’s chilling YouTube video, detailing his plan for murderous vengeance, would understandably conflate madness with violence. While it is true that most mass killers have a psychiatric illness, the vast majority of violent people are not mentally ill and most mentally ill people are not violent. Indeed, only about 4% of overall violence in the United States can be attributed to those with mental illness. Most homicides in the United States are committed by people without mental illness who use guns.

Mass killers almost always are young men who tend to be angry loners. They are often psychotic, seething with resentment and planning revenge for perceived slights and injuries. As a group, they tend to avoid contact with the mental healthcare system, so it’s tough to identify and help them. Even when they have received psychiatric evaluation and treatment, as in the case of Mr. Rodger and Adam Lanza, who killed 20 children and seven adults, including his mother, in Connecticut in 2012, we have to acknowledge that our current ability to predict who is likely to be violent is no better than chance.

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   And the ability to prevent by psychiatric treatment does not exist.

Large epidemiologic studies show that psychiatric illness is a risk factor for violent behaviour, but the risk is small and linked only to a few serious mental disorders. People with schizophrenia, major depression or bipolar disorder were two to three times as likely as those without these disorders to be violent. The actual lifetime prevalence of violence among people with serious mental illness is about 16% compared with 7% among people who are not mentally ill.

What most people don’t know is that drug and alcohol abuse are far more powerful risk factors for violence than psychiatric illnesses. Individuals who abuse drugs or alcohol but have no other psychiatric disorder are almost seven times more likely than those without substance abuse to act violently.

As a psychiatrist, I welcome calls from our politicians to improve our mental health care system. But even the best mental health care is unlikely to prevent these tragedies.

If we can’t reliably identify people who are at risk of committing violent acts, then how can we possibly prevent guns from falling into the hands of those who are likely to kill? Mr. Rodger had no problem legally buying guns because he had neither been institutionalized nor involuntarily hospitalized, both of which are generally factors that would have prevented him from purchasing firearms.

Would lowering the threshold for involuntary psychiatric treatment, as some argue, be effective in preventing mass killings or homicide in general? It’s doubtful.

The current guideline for psychiatric treatment over the objection of the patient is, in most jurisdictions, imminent risk of harm to self or others. Short of issuing a direct threat of violence or appearing grossly disturbed, you will not receive involuntary treatment. When Mr. Rodger was interviewed by the police after his mother expressed alarm about videos he had posted, several weeks ago, he appeared calm and in control and was thus not apprehended. In other words, a normal-appearing killer who is quietly planning a massacre can easily evade detection.

In the wake of these horrific killings, it would be understandable if the public wanted to make it easier to force treatment on patients before a threat is issued. But that might simply discourage other mentally ill people from being candid and drive some of the sickest patients away from the mental health care system.

We have always had — and always will have — Adam Lanzas and Elliot Rodgers. The sobering fact is that there is little we can do to predict or change human behaviour, particularly violence; it is a lot easier to control its expression, and to limit deadly means of selfexpression. In every state, we should prevent individuals with a known history of serious psychiatric illness or substance abuse, both of which predict increased risk of violence, from owning or purchasing guns.

But until we make changes like that, the tragedy of mass killings will remain a part of American life.

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    There are two visions of human activity. The first is the constrained, or tragic vision, which hold that there are some things beyond the touch of intervention. The second is the unconstrained, or utopian vision, which assumes that Human Nature is improvable until such things as murderous intent and sociopathology are eliminated.

     That little can be done about murderous rampages is from the constrained vision. That such things can be prevented by identification and treatment is from the unconstrained vision. Nothing useful can be done.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.”
Cui Bono–Cherchez les Contingencies

 

The Surprising Connection Between Diet And Politics

June 1, 2014

    Do not think about, write about or deal with  human behavior without determining the effects of incentives.

      The basic premise of today’s blog is that we are facing a modern diet and modern technology with a digestive system and social instincts developed under completely different circumstances. Modern life, in terms of our current technology and diet, has been prevalent for only a tiny percentage of human history.

    In terms of diet, our Western farming methods produce grain and dairy products that are “unnatural” in terms of thousands of generations of digestive evolution. This can be illustrated by my experience. Over the past three years I gradually developed non-specific dermatitis, stomach pains and pain in knee tendons. Yes, there is a connection, as will be told. Much later than I should have, I started search the internet for a solution. First, I looked to things to take for stomach pains. In a classic case of asking the wrong question, I tried the usual solutions of peppermint, ginger tea, astragalus and etc. None of these solutions offered any relief, I then asked another question and got a book called “Digestive Health with REAL Food: A practical guide to an anti-inflammatory, low-irritant, nutrient dense diet for IBS & other digestive issues.” by Algaee Jacobs.
     Jacobs explains food allergies and sensitivities and suggests a radical change in diet. Regardless of the theory, this change worked for me. The joint pains and non specific dermatitis were gone in a few days. More importantly, the stomach pains have decreased markedly.

     In terms of diet, I have been searching for a long time for the solution to the question of why socialism, which always produces special favors for the Elite and a drop in the standard of living for the rest of us, has been supported for many centuries. As Thomas Sowell has noted, in spite of continued failure, proponents of socialism are neither discredited nor discouraged.

   This bring us to another source of insight: Why We Bite the Invisible Hand: The Psychology of Anti-Capitalism. Peter Foster. His premise is similar to Jacobs–Thousands of generations have pointed our political instincts towards communalism which clashes with the kind of technology we now enjoy. Porter uses evolution to explain why we, as a species, reflexively want a government “solution” for every problem.

      In terms of the diet hypothesis, both my wife and I, she being extremely gluten sensitive, are living examples of the malignant influence of modern diet.

     In terms of the political hypothesis, socialism always fails, as will its current incarnation in needing World Government to combat the non-existent “Climate Change.” There seems to be something inborn in something so evidently wrong  and immune to being corrected by experience.

   Both the diet problem and the political problem are solved by NOT DOING CERTAIN THINGS. The diet problem by not eating certain foods and the political by not passing most legislation.  Curious indeed.

Government Job or Respect–Which’ll It Be?
Cheerio and ttfn,
Grant Coulson, Ph.D.
Author, “Days of Songs and Mirrors: A Jacobite in the ‘45.”
Cui Bono–Cherchez les Contingencies