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Guess I forgot to link this further article about the uses of SSKI.
http://tahomaclinicblog.com/iodide/
UnHappy Birthday to the Citizens United decision:
http://kmgarcia2000.blogspot.com/2012/01/unhappy-birthday-to-you-citizens-united.html
Some Day One Day (lyrics by Brian May for Queen)
you never heard my song before, the music was too loud
but now i think you hear me well, for now we both know how
no star can light our way, in this cloud of dark and fear
but some day, one day...
funny how the pages turn, and hold us in between
a misty castle waits for you, and you shall be a queen
today the cloud it hangs, over us and all is grey
but some day, one day...
when i was you and you were me, and we were very young
together took us nearly there, the rest may not be sung
so still the cloud it hangs, over us and we're alone
but some day, one day...
we'll come home
Thinkscript coding manuals (nice of them to have 2):
http://team.thinkorswim.com/manual/dark/thinkscript/
https://www.thinkorswim.com/tos/thinkScriptHelp.jsp?laf=dark
The list of TOS pre-made custom PBs and indicators:
http://www.thinkscripter.com/indicators/
The Lotus Touts:
ONE. Give people more than they expect and do it cheerfully.
TWO. Marry a man/woman you love to talk to. As you get older, their conversational skills will be as important as any other.
THREE. Don't believe all you hear, spend all you have or sleep all you want.
FOUR. When you say, 'I love you,' mean it.
FIVE. When you say, 'I'm sorry,' look the person in the eye.
SIX. Be engaged at least six months before you get married.
SEVEN. Believe in love at first sight.
EIGHT. Never laugh at anyone's dreams. People who don't have dreams don't have much.
NINE Love deeply and passionately. You might get hurt but it's the only way to live life completely.
TEN In disagreements, fight fairly. No name calling.
ELEVEN Don't judge people by their relatives.
TWELVE Talk slowly but think quickly.
THIRTEEN When someone asks you a question you don't want to answer, smile and ask, 'Why do you want to know?'
FOURTEEN Remember that great love and great achievements involve great risk.
FIFTEEN Say 'bless you' when you hear someone sneeze.
SIXTEEN When you lose, don't lose the lesson.
SEVENTEEN Remember the three R's: Respect for self; Respect for others; and Responsibility for all your actions.
EIGHTEEN Don't let a little dispute injure a great friendship.
NINETEEN When you realize you've made a mistake, take immediate steps to correct it.
TWENTY Smile when picking up the phone. The caller will hear it in your voice
TWENTY-ONE Spend some time alone.
---------------
PEOPLE ARE ALWAYS BLAMING THEIR CIRCUMSTANCES FOR WHAT THEY ARE. I DON'T BELIEVE IN CIRCUMSTANCES. THE PEOPLE WHO GET ON IN THIS WORLD ARE THE PEOPLE WHO GET UP AND LOOK FOR THE CIRCUMSTANCES THEY WANT, AND IF THEY CAN'T FIND THEM, MAKE THEM. George Bernard Shaw
So, I finally did it:
http://www.glorytrades.collective2.com/
http://investorshub.advfn.com/boards/board.aspx?board_id=18208
I'd like to ask all my old friends on this board who MIGHT be interested in my system (no obligation at all, no spamming) to sign up for e-mail notification at my Blog, http://www.glorytrades.blogspot.com/ (on the left side) so I can notify you when I have my private web site set up.
I will also post week-end reviews at the blog, like I used to, without revealing current open trades or pending trade alerts, as that would not be fair to subscribers.
I am only taking members through C2 right now, and only a very limited number. I want to concentrate on trading and learning the C2 features before I let alot of people join.
Thanks all!
Long Live the Eagle!
Hi gloe
Did go to the photo site.
Best wishes,
The Eagle Concept Had Landed :o)
Sparrow will not do any longer.
Lion is perhaps out of the question for now.
***Fun from the 1st. Market Wizards Book Mark W. interviews***
sbird
sam, was unable to send e-mails to your hot account. What gives? I am going to start another board for my pics.
gloe
Has a double meaning now. What a view from the 25th floor, facing East!!! Central Park, here I come!!!
:o) :o) :o)
Hi sammmmmiiiieeeeeeeee!!!!!!
NYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYCNYC
That Tony must be like the autodidact man from Sartre's Nausea if my memory is some what intact after all this day madness LOL.
Hi gloeeeeeeeeeeeeeeeeeeeeeeeeeee :o)
sb
Thanks for your comments.
Hello
I just read your post re "alternative therapies"!
WAY TO GO!!!!
The cancer "treatment" industry is designed to kill people slowly and painfully while extracting as much profits as possible. The same could be said for much of what passes for the medical establishment for both humans and animals.
I've found that nutrition or lack thereof can make/keep us well or make us sick. There is so much information available about those "alternative" treatments and preventive measures that it is truly a crying shame that there is still so much suffering
(self-) inflicted on those who choose ignorance over self-responsibility.
I'm speaking in generalities, but I've learned so much over the years, through trial and error. And that is what life is about, trying out what works and what doesn't, like a child learning to crawl.
Forgive my rambling post.
How can you have a personal opinion about his training when you know nothing about him?
I know him well. He has been my doctor for almost 16 years.
Let's put this to rest.
g
It is your board so you are free to do what ever you like, I do not control it. You can remove my post if you like, I mentioned the article because he lost all cases mentioned in the article.
I do not know him, seems like you know him better because you mentioned his busy practice.
Millions of people buy useless pills every day it does not mean these are effective treatments for underlying diseases .
I am not against alternative medicine or herbal medicine; they could have there value if practitioner is properly trained. I do not think he is, that is my personal opinion.
So on my part end of discussion. I do not want to start any discussion neither I am an authority on the subject.
Thanks for your kindness.
Excuse me, but Wikipedia is not exactly a good source for accurate information, since anyone can write anything they want there.
"The regimen was reported to be ineffective compared to chemotherapy in a controlled, observational study published in August 2009. No discussion of compliance with the regimen was included in the publication. Patients receiving the Gonzales protocol died three times faster than those receiving conventional chemotherapy, in addition to reporting significantly worse quality of life.[7]"
The exact opposite happened. Conventional doctors, the Cancer Establishment, and those in their pockets, HATE alternative therapies and will attack anyone who advocates their use. The fact is, that except for childhood leukemia and some other rare cancers, the "War on Cancer", which has cost this country probably hundreds of billions of dollars, has been a tragic failure. Sort of like the "War on Drugs" and the "War on Terrorism" (so far).
I don't have cancer, and I don't have to follow all of his treatments, but if I did have cancer I would do his cancer program in a heartbeat, rather than submit to what goes by the name of conventional, modern cancer "treatment." No thanks.
If his treatment is so horrible and ineffective, why is his office flooded with requests from people begging to become a new patient -- and all by word of mouth. He does no advertising or promotion of himself or his work. He is a serious, caring, brilliant doctor and scientist.
If you respond to this with any more inaccuracies about this doctor, I will remove your posts. I merely posted about a new effort in the U.S. Congress to restrict or remove our freedom of choice to take nutritional supplements. I will not get into a pissing match with you or anyone else about "alternative" medicine in general, or any one doctor in particular.
Wikipedia has not very good info about this doctor so I will take his recommendation with grain of salt.
" Gonzalez protocol
The Gonzalez protocol is based on two major concepts: the pancreas (like the liver) provides a detoxification function via pancreatic enzymes that help the body eliminate toxins and help normal cells repair damaged cells, and cancer (and other human illness) are related to physiological imbalances created by toxins from food and the environment.[6]
The Gonzalez protocol is "a complex cancer treatment that is tailored by the practitioner for each specific patient".[6] The protocol involves:
* Pancreatic enzymes, derived from porcine sources,[5] taken orally
* Specific diets, extracts of animal organs, vitamin and mineral supplements, and coffee enemas (twice a day[3])
The large number of pills taken each day (approximately 150) and strict dietary restrictions makes patient compliance difficult.[6]
The regimen was reported to be ineffective compared to chemotherapy in a controlled, observational study published in August 2009. No discussion of compliance with the regimen was included in the publication. Patients receiving the Gonzales protocol died three times faster than those receiving conventional chemotherapy, in addition to reporting significantly worse quality of life.[7]
[edit] Rejection by mainstream medicine
Like his mentor, William Donald Kelley, Gonzalez's treatment method has been "rejected" by the "medical establishment".[1] Gonzalez has been characterized as a quack and fraud by other doctors[3] and health fraud watchdog groups, and in 1994 was reprimanded and placed on two years' probation by the New York state medical board for "departing from accepted practice".[1][3] Forced to submit to psychological examinations and undergo retraining,[3] Gonzalez was given two years of probation with a stipulation that he undergo retraining and do 200 hours of community service, which he completed satisfactorily.[8] He is currently fully licensed to practice in New York.[9]
Gonzalez has lost two malpractice lawsuits. In 1997, a New York court found Gonzalez "negligent" for his cancer treatment;[10][11] according to news reports, Gonzalez "had to pay $2.5 million in damages to a patient he wrongly claimed to have cured" of cancer.[12][13] The former patient had been diagnosed with uterine cancer but "Gonzalez discouraged her from following through on her cancer specialist's advice, instead recommending dietary supplements and frequent coffee enemas".[14] The patient had refused both standard treatment and an experimental protocol, but after the cancer spread to her spine, she discontinued Gonzalez's treatment and received chemotherapy and external beam radiation. Sometime in this period, she began having problems with her eyesight, back and hip, and she eventually became blind.[13][15] In 2000, Gonzalez was found partly liable (49%) in the death of a patient with Hodgkin's disease and ordered to pay $282,000 in damages, due to his use of an unproven cancer screening method instead of standard cancer testing.[16]
The American Cancer Society notes that there is "no convincing scientific evidence that [the Gonzalez treatment] is effective in treating cancer" and that some portions of the treatment may be harmful. A review article from the Journal of Clinical Gastroenterology is cited that notes the clinical efficacy of coffee enemas has not been proven and the therapy is associated with severe adverse effects previously described in a few case reports. Gonzalez's study published in Nutrition and Cancer in 1999 was criticized by an expert in integrative oncology research methods for its small sample size, selection bias, and failure to account for confounders
Threat to nutritional supplements: My alternative doctor has sent an urgent e-mail regarding an new effort in Congress to restrict the availability of over-the-counter vitamins and other nutritional supplements. For all those who feel they benefit from buying vitamins and other nutritional supplements, please take action to preserve our freedom of choice:
"Unfortunately, yet another threat to the availability of nutritional
supplements, and our therapy, has recently reared its head in Congress, this
time courtesy of Senator John McCain. Currently, McCain is trying to
generate support for his legislation, still in its early stages, entitled
The Dietary Supplement Safety Act. The noble wording of the bill may sound
wonderful - as such documents do - but its real purpose seems to be to
enlarge FDA power over supplements and disassemble the Dietary Supplement
Health and Education Act (DSHEA) of the early 1990's which prevented the FDA
from classifying nutrients as drugs, or arbitrary banning particular
supplements at a whim.
Outwardly, the bill claims to be driven by the usual wish to "protect"
consumers from themselves, a stance prompted by the recent cases of a number
of professional athletes misusing certain hormones. Those with knowledge of
Washington suspect that the real motivation is the FDA's universal wish to
severely restrict the availability of most if not all nutritional
supplements.
Below I provide a link to an online article explaining the situation in some
detail. I suggest you read it carefully. If you want your supplement
supply to continue, we all must fight this bill aggressively. Contact
McCain's office, let his staff know how strongly you oppose this bill.
Offer to support his opponent in Arizona in this November election. Contact
your own Senator and express your strong opposition to this legislation.
Calls, faxes and e-mails to your Senators work well. You can obtain contact
information at www.senate.gov. There is a mechanism to identify your
particular Senators by state.
Information about this is available at the website of the Alliance for
Natural Health. The URL is:
http://www.anh-usa.org/new_site/?p=2307
Thanks for your support."
--------------------
from Dr. Nicholas Gonzalez of New York, New York.
Aspirin and Topical Pain Relief Products Revisited
Non-steroid anti-inflammatory drugs (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and acetaminophen (Tylenol) are powerful over the counter drugs. These drugs primarily work by inhibiting the body’s ability to synthesize prostaglandins. Prostaglandins are a family of hormone-like chemicals that are derived from polyunsaturated fatty acids, such as arachidonic acid (concentrated in butter, lard, animal fat, organ meats, egg yolk) and linoleic acid (concentrated in soy, corn, cottonseed, and safflower oils). The common mechanism of action for all NSAID drugs is the inhibition of the enzyme cyclooxygenase (COX). COX is necessary for the formation of prostaglandins. There are two COX enzymes, COX-1, a so-called housekeeping enzyme that is active all the time, and COX-2, which is involved in making prostaglandins important in the induction of inflammation, pain and fever.
Most NSAIDs inhibit both COX-1 and COX-2 enzymes. COX-1 is always active to some extent. COX-2 is only induced during an inflammatory response. Obviously it would be advantageous to have drugs that only inhibited the COX-2 enzyme. Two COX-2 inhibitors have been approved, Celebrex and Vioxx, and extensively marketed as treatments for rheumatoid arthritis, osteoarthritis and acute pain. COX-2 drugs are very expensive. Celebrex wholesales for $2.80 a pill, while Motrin (ibuprofen) can be purchased retail for less than 10 cents a pill. The only benefit of using Celebrex over ibuprofen, aspirin, etc. is that it does not inhibit COX-1 in the stomach thereby inducing gastric inflammation. If NSAID drugs are injected under the skin, they do not cause stomach upset.
It is possible to introduce NSAID and other drugs into the body using topical gels. When 600 mg ibuprofen is taken orally, it is completely cleared from the body in 24 hours (as determined by urine analysis). If ibuprofen is topically introduced, 99.5 % of the drug is still in the body after 24 hours. When a drug enters the body through the skin (without breaking the skin), it enters the lymph before it ever enters the blood. The lymph is actually the fluid that bathes each and every cell in the body. As blood moves through the arteries, and veins the liquid portion of the blood diffuses through the endothelial cells lining the blood vessels and enters the tissue spaces. The lymph fluid transports oxygen, glucose, hormones, amino acids and other nutrients to the tissues. Eventually, the lymph fluid is collected in special lymphatic ducts and returned to the blood. When a molecule is injected into the blood, it is rapidly cleared from the blood by the kidneys or it is degraded in the blood by various enzymes. If the molecule is taken up into the blood from the intestines (as when the molecule is consumed as a food or supplement) the “first pass phenomenon” through the liver results in much of the product being chemically modified and returned to the intestines for disposal as excrement. The cells lining the intestinal wall also rapidly return molecules to the lumen (interior) of the intestines after they are absorbed. In the final analysis, it is difficult to “force” the body to take up medicinal compounds when they are introduced via the oral route. If they are injected, the kidneys clear small compounds from the blood rapidly. There is a better method of introducing medicinal compounds into the body.
Aspirin is a powerful drug, but its half life in the blood is only about two hours. In order to reduce inflammation and pain in the joints, for example, it would be necessary to increase the level of aspirin in the blood to about 5mM. This really isn’t possible. Most studies agree that blood concentrations of aspirin rarely rise above 2mM when orally consumed. Enteric formulations of aspirin and other NSAID (or gel caps) simply slow the release of aspirin into the cells lining the stomach. Most NSAID drugs are poorly soluble in water at neutral pH. The pH of the blood is 7.4. Aspirin and other NSAID drugs are soluble in stomach acid when the pH is about 2. At this pH, these drugs rapidly enter the cells lining the stomach and induce gastritis or inflammation. Herein lies the problem. NSAID drugs are anti-inflammatory but they have to pass through the stomach lining in order to enter the blood. In their passage from the stomach lining to the blood, they inhibit the COX-1 enzyme that maintains the integrity of the stomach lining. In short, these anti-inflammatory agents initiate an inflammatory response in their effort to reach the blood. It sounds like a contradiction in terms, but the problems created by the oral ingestion of NSAID drugs can be quite serious. Stomach cells are very sensitive to very low concentrations of aspirin (one inhibitor of the COX-1 enzyme). In order to inhibit the COX-2 enzyme and other pro-inflammatory mediators, the level of aspirin would have to increase over 20 fold from the level found to induce gastritis. It is obvious that the oral delivery of these drugs is far from medically optimal. Specific COX-2 inhibitors are a step in the right direction, but they are very expensive, and require a prescription. We have adopted a different approach to the control of inflammation and pain that involves the topical introduction of natural molecules, such as the flavonoids found in fruit and vegetables, directly into the body at sites of inflammation and pain.
Flavonoids are nature’s answer to synthetic anti-inflammatory agents. They are very potent anti-inflammatory agents, but they apparently do not directly inhibit the COX-1 enzyme. They do inhibit the COX-2 enzyme and a host of additional pro-inflammatory enzymes and hormones. In fact, flavonoids in general are much more anti-inflammatory than pharmacological doses of NSAIDs (in some case they are 100 times more anti-inflammatory). The ingestion of flavonoids in food or in supplement form does not cause gastric inflammation. Flavonoids are found in virtually all vegetables and fruits. Although there are 4000 different types of flavonoids, one flavonoid is worthy of special mention. There must be 500 to 1000 scientific articles written in the last 30 years on the biochemistry of quercetin. It is an amazing molecule, but bioavailability, or the uptake of quercetin into the blood, is a problem. Quercetin is completely insoluble in water. It is very soluble in alcohol, however, and it readily crosses the skin when the alcohol extract is mixed with certain oils and chemical enhancers. Yellow onions contain the highest concentration of quercetin of any vegetable or fruit. When adults are fed large amounts of onions, only a small amount of quercetin can be found in the blood, approximately 2microM. This concentration is too small to be anti-inflammatory. Remember, most scientific studies are done in a tissue culture dish or in mice. The quercetin doses scientists use cannot be reached in the human body by the oral ingestion of food or most supplements (unless you are ingesting gram quantities of quercetin supplements). I have found that quercetin and many other natural and synthetic molecules can be rapidly carried across the skin at sites of inflammation and pain. This method allows relatively low amounts of flavonoids, aspirin, whatever, to act as site-specific anti-inflammatory/anti-pain agents.
To date, we have made lotions that contain aspirin, ibuprofen, naproxen and various natural compounds such as quercetin and applied them to the skin of people suffering from chronic lower back and neck pain, rotator cuff inflammation, Achilles tendon inflammation, and elbow and foot gout. In each case, the inflammation/pain was either completely eliminated or greatly reduced. This anecdotal evidence is even more significant when you consider that we are applying very low doses to the affected areas. If we add menthol or another vasodilator to the formula, the medicinal compounds enter the body even faster. It is virtually impossible to develop a contact or delayed hypersensitivity reaction to the ingredients in the lotion. Quercetin is quite immunosuppressive, which is exactly what you would expect from a powerful anti-inflammatory agent.
86 million people suffer from chronic pain in the US. Although these lotions were not designed to be treatments for rheumatoid arthritis, they can be reformulated to treat malignant inflammatory diseases as well. FDA approval is not required for a topical pain relief product that is herbal (it is a supplement topically applied), but treating arthritis would require a clinical trial. This should not be difficult since all the ingredients are natural and completely safe. We can manufacture aspirin, ibuprofen, naproxen and acetaminophen creams that are 100s if not thousands of times more powerful than the oral formulation. Medicinal creams can place the NSAIDs directly over the areas of inflammation, such as elbow, knee, lower back, neck, etc. Pain relief products, such as Aspercream, do not actually contain aspirin. Aspirin will not cross the skin without substantial help. These OTC products all contain methyl salicylate or another salicylate, plus menthol, wintergreen, or capsaicin, the “heat” in chili powder. All these products have to be constantly reapplied and produce only a temporary relief of pain. Our products produce a profound, long lasting relief of pain. A formal, FDA approved clinical trial will not be difficult to design and conduct. These NSAIDs are already approved by the FDA as OTC anti-inflammatory products. We are simply reformulating them into products that are both safer (no gastric discomfort) and more efficacious.
Copyright © 2002, Stephen Martin, Ph.D
Chief Scientist, Grouppe Kurosawa
All Rights Reserved
http://grouppekurosawa.com
==================
He used to have the actual formula for making topical pain relievers on the web site. Now they can be found in a book. Available at amazon.com -- just search under Stephen Martin's name. Dear Steve died recently -- a great loss to to those who believe in alternative therapies.
When ibuprofen came out in gelcaps, it made the making of the topical much easier -- IIRC, just open a gel cap, squeeze out the gel, mix with a little DMSO cream (from health food store) and apply topically. One application was supposed to last for days. I might try this. Or just buy topical ketoprofen at amazon.
philg,
um ... I'm not gloe but I thought you would like the information anyway.
I incidentally know a little about sugar. It relates to a relatively serious hobby I've had for a few decades -- the making of wine, champagne, and beer.
Thank you for the post Gloe. This is good stuff to know!
Good advice. Thanks. More people need to know this about fructose.
It's really bad for you and it's in just about ALL "prepared" foods of every kind. Eat mostly at home, and eat food you prepare yourself from scratch. Drink mostly water.
Thanks for those interesting posts Gloe. I didn't know that about Fructose.
Sugar May Be Bad, But This Sweetener Is Far More Deadly
Posted by: Dr. Mercola
January 02 2010 | 50,442 views
http://articles.mercola.com/sites/articles/archive/2010/01/02/HighFructose-Corn-Syrup-Alters-Human-Metabolism.aspx
Scientists have proved for the first time that fructose, a cheap form of sugar used in thousands of food products and soft drinks, can damage human metabolism and is fueling the obesity crisis.
Fructose, a sweetener usually derived from corn, can cause dangerous growths of fat cells around vital organs and is able to trigger the early stages of diabetes and heart disease.
Over 10 weeks, 16 volunteers on a controlled diet including high levels of fructose produced new fat cells around their heart, liver and other digestive organs. They also showed signs of food-processing abnormalities linked to diabetes and heart disease. Another group of volunteers on the same diet, but with glucose sugar replacing fructose, did not have these problems.
Sources:
Grist December 15, 2009
J Clin Invest 2009
Times Online 2009
Dr. Mercola's Comments:
This study takes its place in a growing lineup of scientific studies demonstrating that consuming high-fructose corn syrup is the fastest way to trash your health. It is now known without a doubt that sugar in your food, in all it’s myriad of forms, is taking a devastating toll.
And fructose in any form -- including high-fructose corn syrup (HFCS) and crystalline fructose -- is the worst of the worst!
Fructose is a major contributor to:
Insulin resistance and obesity
Elevated blood pressure
Elevated triglycerides and elevated LDL
Depletion of vitamins and minerals
Cardiovascular disease, liver disease, cancer, arthritis and even gout
A Calorie is Not a Calorie
Glucose is the form of energy you were designed to run on. Every cell in your body, every bacterium -- and in fact, every living thing on the Earth--uses glucose for energy.
If you received your fructose only from vegetables and fruits (where it originates) as most people did a century ago, you’d consume about 15 grams per day -- a far cry from the 73 grams per day the typical adolescent gets from sweetened drinks. In vegetables and fruits, it’s mixed in with fiber, vitamins, minerals, enzymes, and beneficial phytonutrients, all which moderate any negative metabolic effects.
It isn’t that fructose itself is bad -- it is the MASSIVE DOSES you’re exposed to that make it dangerous.
There are two reasons fructose is so damaging:
Your body metabolizes fructose in a much different way than glucose. The entire burden of metabolizing fructose falls on your liver.
People are consuming fructose in enormous quantities, which has made the negative effects much more profound.
Today, 55 percent of sweeteners used in food and beverage manufacturing are made from corn, and the number one source of calories in America is soda, in the form of HFCS.
Food and beverage manufacturers began switching their sweeteners from sucrose (table sugar) to corn syrup in the 1970s when they discovered that HFCS was not only far cheaper to make, it’s also about 20 times sweeter than table sugar.
This switch drastically altered the average American diet.
By USDA estimates, about one-quarter of the calories consumed by the average American is in the form of added sugars, and most of that is HFCS. The average Westerner consumes a staggering 142 pounds a year of sugar! And the very products most people rely on to lose weight -- the low-fat diet foods -- are often the ones highest in fructose.
Making matters worse, all of the fiber has been removed from these processed foods, so there is essentially no nutritive value at all.
Fructose Metabolism Basics
Without getting into the very complex biochemistry of carbohydrate metabolism, it is important to understand some differences about how your body handles glucose versus fructose. I will be publishing a major article about this in the next couple of months, which will get much more into the details, but for our purpose here, I will just summarize the main points.
Dr. Robert Lustig Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, has been a pioneer in decoding sugar metabolism. His work has highlighted some major differences in how different sugars are broken down and used:
After eating fructose, 100 percent of the metabolic burden rests on your liver. But with glucose, your liver has to break down only 20 percent.
Every cell in your body, including your brain, utilizes glucose. Therefore, much of it is “burned up” immediately after you consume it. By contrast, fructose is turned into free fatty acids (FFAs), VLDL (the damaging form of cholesterol), and triglycerides, which get stored as fat.
The fatty acids created during fructose metabolism accumulate as fat droplets in your liver and skeletal muscle tissues, causing insulin resistance and non-alcoholic fatty liver disease (NAFLD). Insulin resistance progresses to metabolic syndrome and type II diabetes.
Fructose is the most lipophilic carbohydrate. In other words, fructose converts to activated glycerol (g-3-p), which is directly used to turn FFAs into triglycerides. The more g-3-p you have, the more fat you store. Glucose does not do this.
When you eat 120 calories of glucose, less than one calorie is stored as fat. 120 calories of fructose results in 40 calories being stored as fat. Consuming fructose is essentially consuming fat!
The metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which drives up blood pressure and causes gout.
Glucose suppresses the hunger hormone ghrelin and stimulates leptin, which suppresses your appetite. Fructose has no effect on ghrelin and interferes with your brain’s communication with leptin, resulting in overeating.
If anyone tries to tell you “sugar is sugar,” they are way behind the times. As you can see, there are major differences in how your body processes each one.
The bottom line is: fructose leads to increased belly fat, insulin resistance and metabolic syndrome -- not to mention the long list of chronic diseases that directly result.
Panic in the Corn Fields
As the truth comes out about HFCS, the Corn Refiners Association is scrambling to convince you that their product is equal to table sugar, that it is “natural” and safe.
Of course, many things are “natural” -- cocaine is natural, but you wouldn’t want to use 142 pounds of it each year.
The food and beverage industry doesn’t want you to realize how truly pervasive HFCS is in your diet -- not just from soft drinks and juices, but also in salad dressings and condiments and virtually every processed food. The introduction of HFCS into the Western diet in 1975 has been a multi-billion dollar boon for the corn industry.
The FDA classifies fructose as GRAS: Generally Regarded As Safe. Which pretty much means nothing and is based on nothing.
There is plenty of data showing that fructose is not safe -- but the effects on the nation’s health have not been immediate. That is why we are just now realizing the effects of the last three decades of nutritional misinformation.
As if the negative metabolic effects are not enough, there are other issues with fructose that disprove its safety:
More than one study has detected unsafe mercury levels in HFCS[ii].
Crystalline fructose (a super-potent form of fructose the food and beverage industry is now using) may contain arsenic, lead, chloride and heavy metals.
Nearly all corn syrup is made from genetically modified corn, which comes with its own set of risks.
The FDA isn’t going to touch sugar, so it’s up to you to be proactive about your own dietary choices.
What’s a Sugarholic to Do?
Ideally, I recommend that you avoid as much sugar as possible. This is especially important if you are overweight or have diabetes, high cholesterol, or high blood pressure.
I also realize we don’t live in a perfect world, and following rigid dietary guidelines is not always practical or even possible.
If you want to use a sweetener occasionally, this is what I recommend:
Use the herb stevia.
Use organic cane sugar in moderation.
Use organic raw honey in moderation.
Avoid ALL artificial sweeteners, which can damage your health even more quickly than fructose.
Avoid agave syrup since it is a highly processed sap that is almost all fructose. Your blood sugar will spike just as it would if you were consuming regular sugar or HFCS. Agave’s meteoric rise in popularity is due to a great marketing campaign, but any health benefits present in the original agave plant are processed out.
Avoid so-called energy drinks and sports drinks because they are loaded with sugar, sodium and chemical additives. Rehydrating with pure, fresh water is a better choice.
If you or your child is involved in athletics, I recommend you read my article Energy Rules for some great tips on how to optimize your child’s energy levels and physical performance through good nutrition.
--------------------------------------------------------------------------------
Robert H. Lustig, MD: UCSF Faculty Bio Page, and YouTube presentation “Sugar: The bitter truth” and “The fructose epidemic” The Bariatrician, 2009, Volume 24, No. 1, page 10)
[ii] “Why is the FDA unwilling to study evidence of mercury in high-fructose corn syrup?” 20 Feb 2009, Grist
Related Links:
Dramatic Example of How the Food Industry Lies to You About Corn
Guess Who Funds High Fructose Corn Syrup Studies?
Sugar is Back on Food Labels—This Time as a Selling Point
Sluggish Thyroid
Posted by: Dr. Mercola
January 02 2010 | 16,319 views
http://articles.mercola.com/sites/articles/archive/2010/01/02/Many-Symptoms-Suggest-Sluggish-Thyroid.aspx
By Dr. Mercola
Most people realize that their thyroid is important for controlling their metabolism and body weight.
But did you know that depression, heart disease, chronic fatigue, fibromyalgia, PMS (premenstrual syndrome), menopausal symptoms, muscle and joint pains, irritable bowel syndrome, or autoimmune disease could actually indicate a problem with your thyroid?
The classic signs of a sluggish thyroid gland include weight gain, lethargy, poor quality hair and nails, hair loss, dry skin, fatigue, cold hands and feet, and constipation -- and these symptoms are relatively well known.
However, some of the conditions you might not associate with your thyroid include:
High cholesterol
Irregular menstruation
Low libido
Infertility
Gum disease
Fluid retention
Skin conditions such as acne and exzema
Memory problems
Poor stamina
And there are, in fact, many more conditions that can be associated with poor thyroid function. Your thyroid plays a part in nearly every physiological process. When it is out of balance, so are you. This is why it is so important to understand how your thyroid gland works and what can cause it to run amok.
The sad fact is, half of all people with hypothyroidism are never diagnosed. And of those who are diagnosed, many are inadequately treated, resulting in partial recovery at best.
Hypothyroidism: The Hidden Epidemic
Hypothyroidism simply means you have a sluggish or underactive thyroid, which is producing less than adequate amounts of thyroid hormone.
“Subclinical” hypothyroidism means you have no obvious symptoms and only slightly abnormal lab tests. I will be discussing these tests much more as we go on since they are a source of great confusion for patients, as well as for many health practitioners.
Thyroid problems have unfortunately become quite common.
The same lifestyle factors contributing to high rates of obesity, cancer and diabetes are wreaking havoc on your thyroid… sugar, processed foods, stress, environmental toxins, and lack of exercise are heavy contributors.
More than 10 percent of the general population in the United States, and 20 percent of women over the age of 60, have subclinical hypothyroidism. But only a small percentage of these people are being treated[1].
Why is that?
Much of it has to do with misinterpretation and misunderstanding of lab tests, particularly TSH (thyroid stimulating hormone). Most physicians believe that if your TSH value is within the range of “normal,” your thyroid is fine. But more and more physicians are discovering that the TSH value is grossly unreliable for diagnosing hypothyroidism.
And the TSH range for “normal” keeps changing!
In an effort to improve diagnosis of thyroid disease, in 2003 the American Association of Clinical Endocrinologists (AACE) revised the “normal” TSH range as 0.3 to 3.04[2]. The previous range was defined as 0.5 and 5.0, which red-flagged only the most glaring hypothyroidism cases.
However, the new range is still not wholly reliable as the sole indicator of a sulky thyroid gland. You simply cannot identify one TSH value that is “normal” for every person, regardless of age, health, or other factors.
Having said that though most physicians who carefully follow this condition recognize that any TSH value greater than 1.5 could be a strong indication that an underactive thyroid is present.
Your TSH value is only part of the story, and your symptoms, physical findings, genetics, lifestyle and health history are also important considerations. Only when physicians learn to treat the patient and not the lab test will they begin to make headway against thyroid disease.
Understanding How Your Thyroid Works is Step One
The thyroid gland is in the front of your neck and is part of your endocrine, or hormonal, system. It produces the master metabolism hormones that control every function in your body[3]. Thyroid hormones interact with all your other hormones including insulin, cortisol, and sex hormones like estrogen, progesterone, and testosterone.
The fact that these hormones are all tied together and in constant communication explains why an unhappy thyroid is associated with so many widespread symptoms and diseases.
This small gland produces two major thyroid hormones: T4 and T3. About 90 percent of the hormone produced by the gland is in the form of T4, the inactive form. Your liver converts this T4 into T3, the active form, with the help of an enzyme.
Your thyroid also produces T2, yet another hormone, which currently is the least understood component of thyroid function and the subject of much ongoing study.
Thyroid hormones work in a feedback loop with your brain -- particularly your pituitary and hypothalamus -- in regulating the release of thyroid hormone. Your pituitary makes TRH (thyroid releasing hormone), and your hypothalamus makes TSH. If everything is working properly, you will make what you need and you’ll have the proper amounts of T3 and T4.
Those two hormones -- T3 and T4 -- are what control the metabolism of every cell in your body. But their delicate balance can be disrupted by nutritional imbalances, toxins, allergens, infections and stress.
If your T3 is inadequate, either by insufficient production or not converting properly from T4, your whole system suffers.
You see, T3 is critically important because it tells the nucleus of your cells to send messages to your DNA to crank up your metabolism by burning fat. That is why T3 lowers cholesterol levels, regrows hair, and helps keep you lean.
How to Know if You are Hypothyroid
Identifying hypothyroidism and its cause is tricky business. Many of the symptoms overlap with other disorders, and many are vague. Physicians often miss a thyroid problem since they rely on just a few traditional tests, so other clues to the problem go undetected.
But you can provide the missing clues!
The more vigilant you can be in assessing your own symptoms and risk factors and presenting the complete picture to your physician in an organized way, the easier it will be for your physician to help you.
Sometimes people with hypothyroidism have significant fatigue or sluggishness, especially in the morning. You may have hoarseness for no apparent reason. Often hypothyroid people are slow to warm up, even in a sauna, and don’t sweat with mild exercise. Low mood and depression are common.
Sluggish bowels and constipation are major clues, especially if you already get adequate water and fiber.
Are the upper outer third of your eyebrows thin or missing? This is sometimes an indication of low thyroid. Chronic recurrent infections are also seen because thyroid function is important for your immune system.
Another telltale sign of hypothyroidism is a low basal body temperature (BBT), less than 97.6 degrees F[4] averaged over a minimum of 3 days. It is best to obtain a BBT thermometer to assess this.
How about your family history? Do you have close relatives with thyroid issues?
Some of the family history that suggests you could have a higher risk for hypothyroidism includes:
High or low thyroid function
Goiter
Prematurely gray hair
Left-handedness
Diabetes
Autoimmune diseases (rheumatoid arthritis, lupus, sarcoidosis, Sjogren’s, etc.)
Crohn’s disease or ulcerative colitis
Multiple sclerosis (MS)
Elevated cholesterol levels
It might be useful to take an online thyroid assessment quiz, as a way to get started. Mary Shomon has a good one. Some of the classic symptoms are mentioned above, but there are many more -- too many to list here.
If you suspect you might be hypothyroid, you should see a healthcare provider who can evaluate this, including ordering the basic lab tests for thyroid function.
Laboratory Testing
Even though lab tests are not the end-all, be-all for diagnosing a thyroid problem, they are a valuable part of the overall diagnostic process. The key is to look at the whole picture.
New studies suggest a very high incidence of borderline hypothyroidism in Westerners. Many cases are subclinical, and even “sublaboratory,” not showing up at all in standard laboratory measurements.
Coexistent subclinical hypothyroidism often triggers or worsens other chronic diseases, such as the autoimmune diseases, so the thyroid should be addressed with any chronic disease.
Many physicians will order only one test -- a TSH level. This is a grossly inadequate and relatively meaningless test by itself, as well as a waste of your money. It would be like saying you know your water is pure because it tastes fine.
I recommend the following panel of laboratory tests if you want to get the best picture of what your thyroid is doing:
TSH -- the high-sensitivity version. This is the BEST test. But beware most all of the “normal” ranges are simply dead wrong. The ideal level for TSH is between 1 and 1.5 mIU/L (milli-international units per liter)
Free T4 and Free T3. The normal level of free T4 is between 0.9 and 1.8 ng/dl (nanograms per deciliter). T3 should be between 240 and 450 pg/dl (picograms per deciliter).
Thyroid antibodies, including thyroid peroxidase antibodies and anti-thyroglobulin antibodies. This measure helps determine if your body is attacking your thyroid, overreacting to its own tissues (ie, autoimmune reactions). Physicians nearly always leave this test out.
For more difficult cases TRH can be measured (thyroid releasing hormone) using the TRH stimulation test. TRH helps identify hypothyroidism that’s caused by inadequacy of the pituitary gland.
Other tests that might be indicated for more complex cases are a thyroid scan, fine-needle aspiration, and thyroid ultrasound. But these are specialized tests that your physician will use only in a small number of cases, in special situations.
Even if all your lab tests are “normal,” if you have multiple thyroid symptoms, you still could have subclinical hypothyroidism.
Keeping Your Thyroid Healthy in a Toxic World
Now that you have some understanding of the importance of your thyroid and how it works, let’s take a look at the factors that can readily cause problems with your thyroid gland.
Diet
Your lifestyle choices dictate, to a great degree, how well your thyroid will function.
If you follow my plan to eat for your nutritional type[5], and my nutritional plan your metabolism will be more efficient, and your thyroid will have an easier time keeping everything in check. Eating for your type will normalize your blood sugar and lipid levels and enhance your immune system, so that your thyroid will have fewer obstacles to overcome.
Eliminate junk food, processed food, artificial sweeteners, trans fats, and anything with chemical ingredients. Eat whole, unprocessed foods, and choose as many organics as possible.
Gluten and Other Food Sensitivities
Gluten and food sensitivities[6] are among the most common causes of thyroid dysfunction because they cause inflammation.
Gluten causes autoimmune responses in many people and can be responsible for Hashimoto’s thyroiditis, a common autoimmune thyroid condition. Approximately 30 percent of the people with Hashimoto’s thyroiditis have an autoimmune reaction to gluten, and it usually goes unrecognized.
How this works is, gluten can cause your gastrointestinal system to malfunction, so foods you eat aren’t completely digested (aka Leaky Gut Syndrome[7]). These food particles can then be absorbed into your bloodstream where your body misidentifies them as antigens -- substances that shouldn’t be there -- our body then produces antibodies against them.
These antigens are similar to molecules in your thyroid gland. So your body accidentally attacks your thyroid. This is known as an autoimmune reaction or one in which your body actually attacks itself.
Testing can be done for gluten and other food sensitivities, which involves measuring your IgG and IgA antibodies[8].
Soy
Another food that is bad for your thyroid is soy[9]. Soy is NOT the health food the agricultural and food companies would have you believe.
Soy is high in isoflavones (or goitrogens), which are damaging to your thyroid gland. Thousands of studies now link soy foods to malnutrition, digestive stress, immune system weakness, cognitive decline, reproductive disorders, infertility and a host of other problems -- in addition to damaging your thyroid[10].
Properly fermented organic soy products such as natto, miso, and tempeh are fine -- it’s the unfermented soy products that you should stay away from.
Coconut Oil
Coconut oil is one of the best foods you can eat for your thyroid[11]. Coconut oil is a saturated fat comprised of medium chain triglycerides (MCTs), which are known to increase metabolism and promote weight loss.
Coconut oil is very stable (shelf life of 3 to 5 years at room temperature), so your body is much less burdened with oxidative stress than it is from many other vegetable oils. And coconut oil does not interfere with T4 to T3 conversion the way other oils can.
Iodine
Iodine is a key component of thyroid hormone[12]. In fact, the names of the different forms of thyroid hormone reflect the number of iodine molecules attached -- T4 has four attached iodine molecules, and T3 has three -- showing what an important part iodine plays in thyroid biochemistry.
If you aren’t getting enough iodine in your diet (and most Americans don’t[13]), no matter how healthy your thyroid gland is, it won’t have the raw materials to make enough thyroid hormone.
Chlorine, fluorine and bromine are also culprits in thyroid function, and since they are halides like iodine, they compete for your iodine receptors.
If you are exposed to a lot of bromine, you will not hold on to the iodine you need. Bromine is present in many places in your everyday world -- plastics, pesticides, hot tub treatments, fire retardants, some flours and bakery goods, and even some soft drinks. I have written a special article about bromine and its influence on your thyroid gland and I encourage you to read it.
Also make sure the water you drink is filtered. Fluoride is particularly damaging to your thyroid gland[14]. Not all water filters[15] remove fluoride, so make sure the one you have does.
Stress and Adrenal Function
Stress is one of the worst thyroid offenders. Your thyroid function is intimately tied to your adrenal function, which is intimately affected by how you handle stress.
Many of us are under chronic stress, which results in increased adrenalin and cortisol levels, and elevated cortisol has a negative impact on thyroid function. Thyroid hormone levels drop during stress, while you actually need more thyroid hormones during stressful times.
When stress becomes chronic, the flood of stress chemicals (adrenalin and cortisol) produced by your adrenal glands interferes with thyroid hormones and can contribute to obesity, high blood pressure, high cholesterol, unstable blood sugar, and more.
A prolonged stress response can lead to adrenal exhaustion[16] (also known as adrenal fatigue), which is often found alongside thyroid disease.
Environmental toxins place additional stress on your body. Pollutants such as petrochemicals, organochlorines, pesticides and chemical food additives negatively affect thyroid function.
One of the best destressors is exercise, which is why it is so beneficial for your thyroid.
Exercise directly stimulates your thyroid gland to secrete more thyroid hormone. Exercise also increases the sensitivity of all your tissues to thyroid hormone. It is even thought that many of the health benefits of exercise stem directly from improved thyroid function.
Even something as simple as a 30-minute walk is a great form of exercise, and all you need is a good pair of walking shoes. Don’t forget to add strength training to your exercise routine, because increasing your muscle mass helps raise your metabolic rate.
Also make sure you are getting enough sleep. Inadequate sleep contributes to stress and prevents your body from regenerating fully.
Finally, one excellent way to reduce stress is with an energy psychology tool such as the Meridian Tapping Technique (MTT). More and more people are practicing MTT and experiencing amazing results[17].
Treatment Options for a Sluggish Thyroid
Here are some suggestions that can be used for general support of your thyroid, as well as treating an underperforming one:
Eat plenty of sea vegetables such as seaweed, which are rich in minerals and iodine (hijiki, wakame, arame, dulse, nori, and kombu). This is probably the most ideal form of iodine supplementation as it is also loaded with many other beneficial nutrients.
Eat Brazil nuts, which are rich in selenium.
Get plenty of sunlight to optimize your vitamin D levels; if you live where sunlight is limited, use vitamin D3 supplementation[18].
Eat foods rich in vitamin A, such as dandelion greens, carrots, spinach, kale, Swiss chard, collard greens, and sweet potatoes.
Make sure you are eating enough omega-3 fatty acids.
Use pure, organic coconut oil in your cooking -- it’s great for stir fries and sautéing many different meats and vegetables.
Filter your drinking water and your bathing water.
Filter your air, since it is one of the ways you take in environmental pollutants.
Use an infrared sauna to help your body combat infections and detoxify from petrochemicals, metals, PCBs, pesticides and mercury.
Taking chlorella[19] is another excellent detoxification aid.
Take active steps to minimize your stress ... relaxation, meditation, hot soaks, EFT, whatever works for you.
Exercise, exercise, exercise!
Thyroid Hormone Replacement
If you know your thyroid function is poor, despite making the supportive lifestyle changes already discussed, then it might be time to look at thyroid supplementation.
Taking thyroid hormone should be done only after you have ruled out other conditions that could be causing the thyroid dysfunction such as adrenal fatigue, gluten or other food allergies, hormonal imbalance, etc. It is always best to get your thyroid working again by treating the underlying cause, as opposed to taking an external source of thyroid hormone.
But sometimes supplementation is necessary.
Conventional pharmaceutical treatment usually consists of replacing only T4 in the form of Synthroid, Levoxyl, Levothyroid, Unithroid, and levothyroxine, leaving your body to convert this to T3.
However, research has shown that a combination of T4 and T3 is often more effective than T4 alone. The conversion to T3 can be hampered by nutritional deficiencies such as low selenium, inadequate omega-3 fatty acids, low zinc, chemicals from the environment, or by stress.
Oftentimes, taking T4 alone will result in only partial improvement.
Taking T3 alone is usually too stimulating. The drug Cytomel is a very short-acting form of T3 that can cause palpitations, anxiety, irritability and insomnia. I never recommend this drug.
By far, the better approach is combined T4 and T3 therapy.
Natural thyroid products, like ArmourThyroid[20] are a combination of T4, T3 and T2 made from desiccated, or dried, porcine thyroid. Armour Thyroid has gotten a bad rap over the years, perceived by physicians to be unstable and unreliable in terms of dosage. However, many improvements have been made in the product, making it a safe and effective option for treating hypothyroidism today.
In fact, a study done ten years ago clearly demonstrated that patients with hypothyroidsim showed greater improvements in mood and brain function if they received treatment with Armour Thyroid than if they received Synthroid[21].
The optimal dose for Armour Thyroid ranges from 15 to 180 milligrams, depending on the individual. You will need a prescription.
Once on thyroid replacement, you will not necessarily need to take it for the rest of your life, which is a common misconception. Once all the factors that have led to your thyroid dysfunction have been corrected, you may be able to reduce or discontinue the thyroid hormone replacement.
Once on thyroid hormone replacement, I recommend you monitor your progress by paying attention to how you feel, in addition to regular lab studies.
You can also routinely check your basal body temperature. If you are on the correct dose, your BBT should be about 98.6 degrees F.
If you begin to feel symptoms such as anxiety, palpitations, diarrhea, high blood pressure, or a resting pulse of more than 80 beats per minute, your dose is likely too high as these are symptoms of hyperthyroidism, and you should let your physician know immediately.
Final Thoughts
A thyroid problem is no different than any other chronic illness -- you must address the underlying issues if you hope to correct the problem. The path to wellness may involve a variety of twists and turns before you find what works for you.
But hang in there.
If you approach it from a comprehensive, wholistic perspective, you will find in time that all of the little steps you take will ultimately result in your feeling much better than you could have ever imagined.
Why is it so dramatically different if businesses require you to do something versus government requiring you to do something. Personally I think big money and big business can be trusted less than government because big money and big business in my opinion views us typically as only walking wallets and sheep to be fleeced.
Did you even read the article?
I don't buy auto insurance -- I choose not to own/drive a car. I walk, bike, and take public transit. And even those who are forced to buy auto insurance because they do own/drive a car on public roads, they are only required to have LIABILITY insurance -- insurance that will pay for injuries caused to others, not injuries caused to themselves or their own property.
I don't have homeowner's insurance -- I rent. No one is forced by the government to buy homeowner's insurance -- usually if you have a mortgage, your mortgage holder will require that you have homeowner's insurance. Once you have paid off your mortgage (or if you originally just paid cash for your house, a novel concept), you are not "required" by anyone to have homeowner's insurance.
A legal requirement that I, as a condition of living, buy a product (health insurance) from a private company is unconsitutional. If the government wanted to create some kind of "Medicare/Medicaid for all" universal insurance, and enacted a new payroll tax to pay for it, that would be constitutional under Supreme Court precendents (though some would still argue those precedents are wrong).
Gloe, I and most all others in the US are required to buy auto insurance. Home buyers with mortgages are typically required to buy home insurance.
Why the Personal Mandate to Buy Health Insurance Is Unprecedented and Unconstitutional
http://www.heritage.org/Research/LegalIssues/lm0049.cfm
by Randy Barnett, Nathaniel Stewart and Todd F. Gaziano
Legal Memorandum #49
Executive Summary
A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government.[1]
This statement from a 1994 Congressional Budget Office Memorandum remains true today. Yet, all of the leading House and Senate health-care reform bills being debated in Congress require Americans to either secure or purchase health insurance with a particular threshold of coverage, estimated by CBO to cost up to $15,000 per year for a typical family.[2] This personal mandate to enter into a contract with a private health insurance company is enforced through civil and criminal tax penalties in section 501 of the House bill[3] and with a freestanding mandate and equally questionable civil tax penalties in sections 501 and 513 of the pending Senate bill.[4]
The purpose of this compulsory contract, coupled with the arbitrary price ratios and controls, is to require many people to buy artificially high-priced policies to subsidize coverage for others as well as an industry saddled with other government costs and regulations. Congress lawfully could enact a general tax to pay for these subsidies or it could create a tax credit for those who buy health insurance, but that would require Congress to "pay for" or budget for the subsidies in a conventional manner. The sponsors of the current bills are attempting, through the personal mandate, to keep the transfers entirely off budget or--through the gimmick of unconstitutional taxes or penalties they dub "shared responsibility payments"--make these transfers appear to be revenue-enhancing.
This "personal responsibility" provision of the legislation, more accurately known as the "individual mandate" because it commands all individuals to enter into a contractual relationship with a private insurance company, takes congressional power and control to a striking new level. Its defenders have struggled to justify the mandate by analogizing it to existing federal laws and court decisions, but their efforts do not withstand serious scrutiny. An individual mandate to enter into a contract with or buy a particular product from a private party, with tax penalties to enforce it, is unprecedented-- not just in scope but in kind--and unconstitutional as a matter of first principles and under any reasonable reading of judicial precedents.
Congress has a responsibility, pursuant to the oath of all Senators and Representatives, to determine the constitutionality of its own actions independently of how the Supreme Court has previously ruled or may rule in the future. But it is very unlikely that the Court would extend current constitutional doctrines, or devise new ones, to uphold this new and unprecedented claim of federal power.
Constitutional Overview
In reaction to states that were enacting trade barriers and violating the rights of their citizens, those who drafted and ratified the U.S. Constitution were determined both to constrain the powers of states and, at the same time, limit the power of Congress. They designed an ingenious system of checks and balances that divides state and federal authority in the hope of preventing any one government from exerting too much control over a free people.[5] To that end, the Constitution creates a national government with a legislature of limited and enumerated powers. Article I allocates to Congress "[a]ll legislative powers herein granted,"[6] which means that some legislative powers remain beyond Congress's reach. The Constitution's Necessary and Proper Clause similarly grants Congress the power "[t]o make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof."[7]
The Supreme Court recognized and affirmed this fundamental principle from the earliest days of the republic, as Chief Justice Marshall famously observed: "The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the constitution is written."[8] And in his canonical opinion interpreting the Necessary and Proper Clause, Chief Justice Marshall insisted that "should Congress, under the pretext of executing its powers, pass laws for the accomplishment of objects not entrusted to the [national] government; it would become the painful duty of this tribunal, should a case requiring such a decision come before it, to say that such an act was not the law of the land."[9]
Nowhere in the Constitution is Congress given the power to mandate that an individual enter into a contract with a private party or purchase a good or service and, as this paper will explain, no decision or present doctrine of the Supreme Court justifies such a claim of power. Therefore, because this claim of power by Congress would literally be without precedent, it could only be upheld if the Supreme Court is willing to create a new constitutional doctrine. This memorandum explains why the two powers cited by supporters of this bill--the power of Congress to regulate interstate commerce and the power of Congress to tax--do not justify an individual mandate, even under the most expansive readings given these powers by the Supreme Court. In particular, this paper addresses four topics that have not yet been given adequate consideration by Congress and most, if not all, of the commentators:
First, most arguments, either favoring or opposing the individual mandate, do not discuss the Supreme Court's "class of activities" test, which it has applied in every relevant Commerce Clause case. This paper addresses this oversight and argues that, despite the broad congressional power to regulate interstate commerce, the individual mandate provision fails this test and is unlikely to survive the Court's review.
Second, this paper addresses the common, but mistaken, suggestion that a universal federal mandate to obtain health insurance is no different than a state requiring its licensed automobile drivers to have liability insurance for their injuries to others.
Third, this paper analyzes claims arising under the Taxing Clause. A preliminary review raises serious questions about the constitutionality of using the taxing power in this manner.
And finally, this paper explains why it is highly unlikely that the Supreme Court would break new constitutional ground to save this unpopular personal mandate.
The Interstate Commerce Clause
Advocates of the individual mandate, like Speaker Nancy Pelosi (D-CA) and law professor Erwin Chemerinsky, have claimed that the Supreme Court's "Commerce Clause" jurisprudence leaves "no doubt" that the insurance requirement is a constitutional exercise of that power.[10] They are wrong.
The Commerce Clause, set forth in Article I, section 8, grants Congress the authority "[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes."[11] From the Founding, both Congress and the Supreme Court have struggled to define the limits of that authority, but it has always been understood that some limit exists beyond which Congress may not go. To be sure, the Supreme Court has been deferential to congressional claims of authority to regulate commerce since 1937. Yet, even as it allowed Congress to exercise expansive powers over the national economy, the New Deal Supreme Court declared that:
The authority of the federal government may not be pushed to such an extreme as to destroy the distinction, which the commerce clause itself establishes, between commerce "among the several States" and the internal concerns of a State. That distinction between what is national and what is local in the activities of commerce is vital to the maintenance of our federal system.[12]
As the Congressional Research Service has recognized, the individual mandate could face a variety of constitutional obstacles, especially under the Commerce Clause:
Despite the breadth of powers that have been exercised under the Commerce Clause, it is unclear whether the clause would provide a solid constitutional foundation for legislation containing a requirement to have health insurance. Whether such a requirement would be constitutional under the Commerce Clause is perhaps the most challenging question posed by such a proposal, as it is a novel issue whether Congress may use this clause to require an individual to purchase a good or a service.[13]
Another word for "novel" is unprecedented, which is literally true: There is simply no legislative or judicial precedent for this claim of congressional power. In the absence of binding judicial precedent, however, the current Supreme Court is unlikely to stretch the commerce power even further than it already has.
The Supreme Court's "Class of Activities" Test
In the last seventy years, the Supreme Court has applied a relatively straightforward judicial test to determine whether a federal statute is within the commerce power of Congress. When evaluating a claim of power under the Commerce Clause, the Court proceeds with a two-pronged inquiry. First, the Court determines whether the entire class of regulated activity is within Congress's constitutional reach; and second, whether the petitioner is a member of that class.
A long line of Supreme Court cases establishes that Congress may regulate three categories of activity pursuant to the commerce power. These categories were first summarized in Perez v. United States, [14] and most recently reaffirmed in Gonzales v. Raich.[15] First, Congress may regulate the "channels of interstate or foreign commerce" such as the regulation of steamship, railroad, highway, or aircraft transportation or prevent them from being misused, as, for example, the shipment of stolen goods or of persons who have been kidnapped. Second, the commerce power extends to protecting "the instrumentalities of interstate commerce," as, for example, the destruction of an aircraft, or persons or things in commerce, as, for example, thefts from interstate shipments."[16] Third, Congress may regulate economic activities that "substantially affect interstate commerce."[17]
Under the first prong of its Commerce Clause analysis, the Court asks whether the class of activities regulated by the statute falls within one or more of these categories. Since an individual health insurance mandate is not even arguably a regulation of a channel or instrumentality of interstate commerce, it must either fit in the third category or none at all. Predictably, Congress has cited only this third basis. The Senate bill asserts (erroneously) that: "[t]he individual responsibility requirement...is commercial and economic in nature, and substantially affects interstate commerce.... The requirement regulates activity that is commercial and economic in nature: economic and financial decisions about how and when health care is paid for, and when health insurance is purchased."[18]
The second prong of the Court's Commerce Clause analysis requires a determination that the petitioner has in fact engaged in the regulated activity, making him or her a member of the regulated class. In its modern Commerce Clause cases, the Supreme Court rejects the argument that a petitioner's own conduct or participation in the activity is, by itself, either too local or too trivial to have a substantial effect on interstate commerce. Rather, the Court has made clear that, "where the class of activities is regulated and that class is within the reach of federal power, the courts have no powers 'to excise, as trivial, individual instances' of the class."[19] Thus, for example, a potential challenger of the proposed mandate could not argue that because her own decision not to purchase the required insurance would have little or no effect on the broader market, the regulation could not be constitutionally applied to her. The Court will consider the effect of the relevant "class of activity," not that of any individual member of the class.
To assess the constitutionality of a claim of power under the Commerce Clause, the primary question becomes, "what class of activity is Congress seeking to regulate?" Only when this question is answered can the Court assess whether that class of activity substantially affects interstate commerce. Significantly, the mandate imposed by the pending bills does not regulate or prohibit the economic activity of providing or administering health insurance. Nor does it regulate or prohibit the economic activity of providing health care, whether by doctors, hospitals, pharmaceutical companies, or other entities engaged in the business of providing a medical good or service. Indeed, the health care mandate does not purport to regulate or prohibit activity of any kind, whether economic or noneconomic. To the contrary, it purports to "regulate" inactivity.
Proponents of the individual mandate are contending that, under its power to "regulate commerce...among the several states," Congress may regulate the doing of nothing at all! In other words, the statute purports to convert inactivity into a class of activity. By its own plain terms, the individual mandate provision regulates the absence of action. To uphold this power under its existing doctrine, the Court must conclude that an individual's failure to enter into a contract for health insurance is an activity that is "economic" in nature-- that is, it is part of a "class of activity" that "substantially affects interstate commerce."
Never in this nation's history has the commerce power been used to require a person who does nothing to engage in economic activity. Therefore, no decision of the Supreme Court has ever upheld such a claim of power. Such a regulation of a "class of inactivity" is of a wholly different kind than any at issue in the Court's most expansive interpretations of the Commerce Clause. A mandate to enter into a contract with an insurance company would be the first use of the Commerce Clause to universally mandate an activity by all citizens of the United States.
Today, even voting is not constitutionally mandated. But, if this precedent is established, Congress would have the unlimited power to regulate, prohibit, or mandate any or all activities in the United States. Such a doctrine would abolish any limit on federal power and alter the fundamental relationship of the national government to the states and the people. For this reason it is highly doubtful that the Supreme Court will uphold this assertion of power.
The Supreme Court's Most Expansive Precedents: Wickard and Raich
To show that such a claim of power is literally without precedent, this paper will now turn to the two Supreme Court decisions that are universally acknowledged as the most expansive interpretations of the Commerce Clause to date: the 1942 case of Wickard v. Filburn[20] and the 2005 decision in Gonzales v. Raich.[21] Neither case supports the individual mandate.
Wickard v. Filburn, widely regarded as a watershed expansion of the Commerce Clause power, upheld regulations under the Agricultural Adjustment Act of 1938, which, in an effort to avoid wheat surpluses and boost prices, controlled the volume of wheat sold in interstate commerce. Under the regulation, farmer Roscoe Filburn had been allocated 11 acres for his wheat crop, but instead he planted an extra 12 acres of wheat to consume on his own farm. Filburn argued that Congress's power to regulate the interstate wheat market did not include wheat that was not commercially traded, but was to be consumed on his own farm.[22]
The Wickard Court rejected this contention because the class of activity being regulated was wheat production. As a wheat grower, farmer Filburn was a willing, participating member of that class, and could be barred from growing more wheat than his allotment, regardless of how he planned to use it. Unlike farmer Filburn, however, those who decide not to purchase health insurance have not engaged in a commercial activity. Indeed, they have chosen to abstain from engaging in economic activity.
In passing the Agricultural Adjustment Act of 1938, Congress only claimed the power to regulate commercial farmers, like Roscoe Filburn, who engage in the activity of growing wheat as part of an interstate market. The statute even exempted small farms. Congress's current effort to compel all Americans to buy health insurance, whether they want to or not, is tantamount to the Agricultural Adjustment Act requiring each American, rural and city dwellers alike, to grow a particular amount of wheat. After all, the refusal to grow any share of wheat could be said to place the burden of wheat production on others and thereby limit the country's wheat supply. Such a limitation would, in turn, substantially affect the commercial market. Therefore, using the same logic underpinning the personal health insurance mandate, Congress can compel every American to grow his or her own wheat to ensure a greater supply to meet the public's demand. Or, conversely, Congress can simply "mandate" that every American buy two loaves of wheat bread each week, thereby ensuring a higher, more consistent demand and price for farmer Filburn's wheat crop.
By boldly asserting that the authority to regulate interstate commerce includes the power to regulate not merely voluntary activity that is commercial or even ancillary thereto, but inactivity that is expressly designed to avoid entry into the relevant market, this theory effectively removes any boundaries to Congress's commerce power--Congress could mandate anything. Under this theory, given that the American auto industry is a highly regulated commercial activity in the national marketplace (in which the federal government has invested), Congress could constitutionally require every American to buy a new Chevy Impala every year, or a pay a "tax" equivalent to its blue book value.
Even in wartime, when the production of materiel is crucial to national survival, Congress has never claimed such a power. For example, during World War II, no farmer was forced to grow food for the troops; no worker was forced to build tanks. While the federal government encouraged the public to buy its bonds to finance the war effort, it never mandated they do so. While Congress levied a military draft, it did so as necessary and proper to its enumerated power in Article I, sec. 8 "to raise and support armies," not its commerce power. What Congress did not and cannot do during a wartime emergency, with national survival at stake, it cannot do in peacetime simply to avoid the political cost of raising taxes to pay for new government programs.
More recently, in Gonzales v. Raich,the Supreme Courtconsidered the power of Congress under the Commerce Clause to regulate the cultivation and possession of home-grown marijuana that is neither sold nor bought and is authorized by state law for medical use. In upholding the constitutionality of the Controlled Substances Act,the Court considered this activity to be strikingly similar to that involved in Wickard:
Like the farmer in Wickard, respondents are cultivating, for home consumption, a fungible commodity for which there is an established, albeit illegal, interstate market. Just as the Agricultural Adjustment Act was designed "to control the volume [of wheat] moving in interstate and foreign commerce in order to avoid surpluses . . ." and consequently control the market price, a primary purpose of the CSA is to control the supply and demand of controlled substances in both lawful and unlawful drug markets.[23]
As in Wickard, the regulated class of activity was the production of a "fungible commodity," and the Court refused to "excise, as trivial," the de minimis nature of Angel Raich's medicinal marijuana plants, or carve out from the class a subset of medical marijuana cultivation in states that permitted this use. Indeed, the Court rested its decision, in part, on the economic nature of the class of activities being reached by the statute:
[T]he activities regulated by the CSA are quintessentially economic. "Economics" refers to "the production, distribution, and consumption of commodities." Webster's Third New International Dictionary (1966). The CSA is a statute that regulates the production, distribution, and consumption of commodities for which there is an established, and lucrative, interstate market.[24]
Having found the activities in question to be economic, the Court then accepted the government's contention that the intrastate subset of this class of activity could not be separated from the larger class: "One need not have a degree in economics to understand why a nationwide exemption for the vast quantity of marijuana (or other drugs) locally cultivated for personal use (which presumably would include use by friends, neighbors, and family members) may have a substantial impact on the interstate market for this extraordinarily popular substance."[25] In short, because the Court in Raich found both that the production of marijuana, like the production of wheat, was an economic activity, and that Congress had power to regulate or prohibit this entire class of activities, it denied the constitutional challenge.
To uphold the constitutionality of a health care mandate under the authority of Raich, the Court would have to find that a decision not to enter into a contract to purchase a good or service was an economic activity that, in the aggregate, substantially affects interstate commerce. Before so concluding it would immediately be apparent to the Justices that, by this reasoning, every action or inaction could be characterized as "economic" thus destroying any limitation on the commerce power of Congress. It is a safe bet that any argument that leads to a conclusion that Congress has an effectively unlimited police power akin to that of states will be rejected by this Supreme Court. As the Court stated in the 1995 case of United States v. Lopez:
To uphold the Government's contentions here, we would have to pile inference upon inference in a manner that would bid fair to convert congressional authority under the Commerce Clause to a general police power of the sort retained by the States. Admittedly, some of our prior cases have taken long steps down that road, giving great deference to congressional action. The broad language in these opinions has suggested the possibility of additional expansion, but we decline here to proceed any further. To do so would require us to conclude that the Constitution's enumeration of powers does not presuppose something not enumerated, and that there never will be a distinction between what is truly national and what is truly local.... This we are unwilling to do.[26]
Nothing about the Court's current composition suggests it would now be any more receptive to an argument that eliminates all limits on the commerce power.
Moreover, the specific type of legal challenge in Raich was constitutionally distinct. The litigants in Raich did not challenge the CSA on its face as an unconstitutional exercise of congressional authority. Rather, as the Court noted, "respondents' challenge is actually quite limited; they argue that the CSA's categorical prohibition of the manufacture and possession of marijuana as applied to the intrastate manufacture and possession of marijuana for medical purposes pursuant to California law exceeds Congress' authority under the Commerce Clause."[27] Thus, Raich addressed an "as-applied" challenge to the CSA, which sought to carve out a subset "class" of state authorized cultivation and possession of marijuana for medical purposes that was insulated from the national market. Instead, the Court found that the relevant "class of activity" in Raich was the entire national market in narcotics and controlled substances--and no one disputed Congress's authority to regulate this class of economic activities. The Supreme Court refused to carve out the proposed subset of this class for separate consideration.
By contrast, a constitutional challenge to a health insurance mandate would not be "as-applied," as it was in Raich, but would challenge Congress's authority to regulate the entirety of this statutorily defined "class of (in)activity"--that is, the individual citizen's choice to refrain from engaging in an economic activity. Unlike an as-applied challenge, which requires the Court to second guess the "class of activities" defined by Congress, a facial challenge assumes the definition of the class of activities in the statute and denies that this class is within the power of Congress to reach.
While the Court has never upheld an as-applied Commerce Clause challenge, in recent years it did sustain two facial challenges--that is, challenges alleging that provisions or bills are unconstitutional under all circumstances--to statutes that attempted to regulate classes of activities that were beyond the power of Congress to enact. In 1995, in Lopez, it upheld a facial challenge to the Gun-Free School Zone's Act, which attempted to reach the activity of possessing a gun within a thousand feet of a school. And again in 2000, in United States v. Morrison,[28] it upheld a facial challenge to the Violence Against Women Act, which attempted to reach the activity of gender-motivated violence. In each case, the Court found the class of activities regulated by the statute was noneconomic and, therefore, outside the reach of the commerce power of Congress, regardless of its effect on interstate commerce.
Because the personal insurance mandate purports to reach the refusal to engage in economic activity--which is both inactivity and noneconomic--the Supreme Court could not uphold this exercise of power without admitting that the Commerce Clause has no limits, a proposition it rejected in Lopez and Morrison, and from which it did not retreat in Raich. Although Congress may possibly regulate the health care industry or the health insurance industry in light of their substantial effect on interstate commerce, the individual mandate regulates the noneconomic inactivity of not purchasing a particular service or entering into a contract.
Both Lopez and Raich acknowledged that Congress could include in the "class of activities" it seeks to regulate some purely local activity it could not otherwise reach if it is essential to a larger regulatory scheme that this intrastate activity be included in the class. The actual language in Raich noted that the CSA was a "detailed statute creating a comprehensive framework for regulating the production, distribution, and possession of five classes of 'controlled substances.'"[29] In short, the Court refused to carve out a subset from a "class of activities" when doing so might "undercut" a comprehensive regulatory scheme. Therefore, Congress may reach even small-scale wholly intrastate production and possession of a good as part of a comprehensive scheme to regulate the interstate commerce in that good. However, just because Congress can or does regulate an entire class of activity or industry "comprehensively" (including some arguably local activity), it does not follow that it can regulate and control every other type of behavior that may affect this class or industry. In the words of the Court in Morrison, this "method of reasoning" should be "rejected as unworkable if we are to maintain the Constitution's enumeration of powers."[30]
Although a refusal to engage in economic activity may ultimately have a ripple effect on the marketplace, the noneconomic activities of possessing a gun near a school or gender-based violence-- activities which occur throughout the nation--had the same secondary effects. Nevertheless, refusing to "pile inference upon inference," the Court sustained facial challenges to both statutes on the ground that the class of activities was outside the commerce power of Congress. Every decision a consumer makes undoubtedly ripples through the broader economic pool; and, in the aggregate, consumer decisions create the national marketplace. Yet this reasoning has never been used to place each individual consumer decision within the purview of federal regulation. Simply because Congress can regulate wheat production under the Agricultural Adjustment Act does not entail that Congress can require every American to buy boxes of Shredded Wheat cereal on the grounds that, by not buying wheat cereal, non-consumers were adversely affecting the regulated wheat market.
Law professor Erwin Chemerinsky has speculated that the Supreme Court's civil rights decisions in Heart of Atlanta Motel v. United States[31] and Katzenbach v. McClung[32] would permit Congress to regulate economic "inactivity": "Congress can use its commerce power to forbid hotels and restaurants from discriminating based on race," he contends, "even though their conduct was refusing to engage in commercial activity."[33] At issue in Heart of Atlanta Motel, however, was whether "racial discrimination by motels affected commerce."[34] As the Court explained in Perez:
It was the "class of activities" test which we employed in Heart of Atlanta Motel, Inc. v. United States, to sustain an Act of Congress requiring hotel or motel accommodations for Negro guests. The Act declared that "'any inn, hotel, motel, or other establishment which provides lodging to transient guests' affects commerce per se." That exercise of power under the Commerce Clause was sustained.[35]
Under the civil rights acts upheld by the Court, no person was mandated to operate a motel. But, as with any economic regulation, anyone who chose to operate a motel--a quintessential economic activity--had to play by certain rules set by Congress. Similarly, Katzenbach concerned the federal rule against racial discrimination by anyone who chose to operate a restaurant, another economic activity. The class of regulated activity upheld in these cases was the operation of motels and restaurants. According to the Court in Katzenbach, the Civil Rights Act regulated a restaurant "if...it serves or offers to serve interstate travelers or a substantial portion of the food which it serves...has moved in commerce."[36] The legislation barred racial discrimination by those who freely chose to operate a commercial enterprise. No one was mandated to open a motel or restaurant; and no one was mandated to open the doors of their homes to bed and feed strangers. Individuals, unlike motels or restaurants, are not commercial enterprises actively engaged in interstate commerce.
Individuals' decisions not to enter certain economic transactions have never before subjected them to the federal regulation of a market that they have chosen not to enter. The health bill's individual mandate provision would have the unprecedented effect of subjecting an individual's decisions to federal control by virtue of the fact that the individual merely resides within the borders of the United States. No such result was supported or even contemplated by the Supreme Court in Katzenbach or Heart of Atlanta Motel.
Personal Health Insurance v. Drivers' Auto Liability Insurance
Some have argued that a federal mandate requiring all citizens to obtain health insurance is no different than state laws that require licensed drivers to carry proof of auto insurance when driving on the public roads.[37] But there are several important constitutional differences that render the comparison decidedly inapposite.
First, there is a fundamental constitutional difference between the inherent police powers of the states and the enumerated powers of the national government. A bedrock principal of the American republic is that, whereas states enjoy plenary police powers (albeit subject to various constitutional limits), the national government is limited to the enumerated powers "herein granted" to it by the Constitution. Thus, states may craft numerous regulations for the protection of their citizens which are beyond Congress's power. In striking down the federal Gun-Free School Zones Act, the Lopez Court acknowledged that the states already enforced similar criminal laws even though Congress could not. Likewise, when it struck down the federal tort action for rape in Morrison,the Court did not question state laws allowing similar causes of action. State laws regulating the level of insurance that licensed state drivers must have to operate on state roads stem from a completely different source of constitutional authority--a state's police power--than Congress can invoke. Congress has never been thought to have such power, and the Supreme Court has always denied that such plenary federal power exists.
Second, automobile insurance requirements impose a condition on the voluntary activity of driving; a health insurance mandate imposes a condition on life itself. States do not require non-drivers, including passengers in cars with potentially bad drivers, to buy auto insurance liability policies--even though such a requirement undoubtedly would lower the auto insurance premiums for those who do drive. The auto insurance requirement is linked to driving and to the possibility that bad driving may cause injuries to others, including passengers in the driver's car, not to those who benefit from roads generally.
Third, state auto insurance requirements are limited to those who drive on public roads. The public roads are mostly constructed, owned, and maintained by the government, or in some other cases, are built on public rights of way or through the use of eminent domain. What a state (or private citizen) may require of someone using its property is wholly different than what it may do to control their purely private behavior. Driving on government roads is a privilege--one easily distinguished from merely living. For those who choose to drive on public roads, the state can establish terms and conditions reasonably related to preventing injury to others. States may issue drivers licenses, establish and enforce traffic laws, and may require that all those driving on their roads be adequately insured to compensate others for their injuries. These same rules do not extend to driving on private roads or property. Indeed, one may drive vehicles on private property without ever obtaining a state driver's license.
Finally, states require drivers to maintain auto insurance only to cover injuries to others.[38] The mandate does not require drivers to insure themselves or their property against injury or damage. Thus, the auto insurance requirement covers the dangers and liabilities posed by drivers to third parties only, even though many of those same risks apply to the driver himself. The auto insurance mandate seeks to avoid the all-too-common problem of an uninsured and insolvent motorist severely injuring a third party on a public road, leaving the injured party to cover her own medical expenses. But the driver remains free to assume the risk that she will injure herself, even if she is insolvent to pay for her own expenses. Thus, states only seek to ensure that drivers can pay the equivalent of tort judgments for their wrongful conduct to others on state roads; they do not tell drivers how to take care of themselves.
Therefore, comparisons between a federal mandate for personal health insurance and the state auto insurance requirements are specious. The dissimilarities between the two types of schemes actually illuminate how Congress's new "personal responsibility" mandate is without precedent in policy and, for this reason, lacks any precedent in constitutional law. Whether or not Congress has the power to establish a national "single payer" health care program by using its powers to tax and spend, such a program would not be supported by the Constitution's Commerce Clause. Any power to establish a national health care program simply does not entail the distinct constitutional power to compel persons to purchase a contract of insurance from a private insurance company.
An Unconstitutional Tax
Article I, section 8 of the U.S. Constitution delegates to Congress the power "To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States...." From this enumerated taxation power, the courts have derived an implied power to spend tax revenues. Whether correct or not, current precedents do not limit this so-called "spending power" to expenditures that are necessary and proper to carry into execution an enumerated power. Therefore, the courts may well allow Congress to use its taxing and spending powers to craft a general income tax sufficient to pay for health care insurance for more Americans.[39] They may also allow grants to states to encourage them to insure more Americans. Finally, they may allow Congress to create tax credits for individuals who pay for their own health insurance policies. But just because Congress may use its powers of taxation in these ways does not mean that anything it decides to call a "tax" is constitutional.
Should it adopt any of these constitutional taxing and spending measures, Congress would have to incur the political costs arising from increasing the income tax and the long-term budget implications of issuing tax credits. Precisely to avoid incurring these political costs, Congress is calling fines in the Internal Revenue Code "shared responsibility penalties" so that persons fund the cost of its new regulatory scheme by channeling money through private insurance companies in the form of "premiums." It is likely that the Supreme Court will find this effort to avoid political and fiscal accountability a pretextual assertion of Congress's taxation powers and therefore, unconstitutional.
The Supreme Court has invalidated congressional action on the ground that such action employed unconstitutional means to an end that Congress could have constitutionally accomplished in another manner. For example, in the 1997 case of Printz v United States,[40] the Court struck down a provision of the Brady Handgun Violence Prevention Act requiring that local county sheriffs conduct instant background checks on gun purchasers. Although Congress had the power to provide and pay for its own enforcement mechanism, the Court thought that "[t]he power of the Federal Government would be augmented immeasurably if it were able to impress into its service--and at no cost to itself--the police officers of the 50 States."[41] In Printz, the Court rejected what it referred to as "the last, best hope of those who defend ultra vires congressional action, the Necessary and Proper Clause." It concluded that, "[w]hen a 'La[w]...for carrying into Execution' the Commerce Clause violates the principle of state sovereignty, it is not a 'La[w]...proper for carrying into Execution the Commerce Clause,' and is thus, in the words of The Federalist, 'merely [an] ac[t] of usurpation' which 'deserve[s] to be treated as such.' The Federalist No. 33, at 204 (A. Hamilton)."[42]
Even if these bills propose a genuine tax, rather than a fine under the pretext of a "tax," such a tax raises an independent constitutional problem. The bills alternatively call the individual mandate tax a "penalty" or a "shared responsibility payment" on any person in the United States who fails to maintain "minimum essential coverage" for one month or more, and who does not fall into one of a list of exceptions.[43] Rather than operating as a tax on income, this is a tax on the person--all persons who cannot avail themselves of an exception--and is, therefore, a capitation tax.[44]
Unlike income taxes, which under the Sixteenth Amendment can be assessed disproportionately among the states based upon disparities in income, the Constitution requires that capitation taxes be apportioned among the states on the basis of census population.[45] Soon after the passage of the Sixteenth Amendment, the Supreme Court acknowledged the continued constitutional requirement of apportionment of taxes imposed directly on the person:
[T]his amendment shall not be extended by loose construction, so as to repeal or modify, except as applied to income, those provisions of the Constitution that require an apportionment according to population for direct taxes....This limitation still has an appropriate and important function, and is not to be overridden by Congress or disregarded by the courts.[46]
Accordingly, in order to be constitutional, the health care mandate tax must be assessed evenly based upon population, and not vary based upon factors such as the financial condition of the state's residents. A state with 5 percent of the population must therefore pay 5 percent of the tax, even if its residents are disproportionately wealthy or poor as compared with other states.
This requirement will be impossible to meet based upon the variety of exceptions provided for in the mandate. For example, the mandate exempts individuals who are not lawfully present in the United States.[47] But illegal aliens have been counted in the census,[48] and the Constitution requires that any capitation or direct tax be apportioned on a basis that would include that population. Failure to apportion the tax to include illegal immigrants would therefore be constitutionally fatal to the tax.
The mandate also excludes taxpayers with income under 100 percent of the poverty line,[49] individuals for whom the required contribution would exceed 8 percent of their income,[50] religious objectors,[51] incarcerated individuals,[52] and anyone determined to have suffered a hardship regarding their capability to obtain coverage, as determined in the discretion of the Secretary of Health and Human Services.[53] While it is common to carve out exceptions like these in the context of the individual income tax, the Constitution forbids these distinctions in capitation or direct taxes insofar as they would upset apportionment on the basis of census population, which they unquestionably will.
A Properly Restrained Supreme Court
Mandating that all private citizens enter into a contract with a private company to purchase a good or service, or be punished by a fine labeled a "tax," is unprecedented in American history. For this reason, there are no Supreme Court decisions authorizing this exercise of federal power. There are strong grounds to predict that the current Court will not devise any new doctrines by which to uphold an individual health insurance mandate. First and foremost, as already mentioned, to uphold this exercise of power, the Supreme Court would have to affirm for the first time in its history that Congress has a general or plenary police power--a position the Court has repeatedly refused to take.
While the Raich decision affirmed the continuing vitality of the Wickard line of Commerce Clause cases, it neither overruled nor limited Lopez and Morrison. Instead it adhered to those decisions by finding that the cultivation of marijuana was an economic activity. Unlike Raich, both Lopez and Morrison were facial challenges to an act of Congress. In evaluating an as-applied Commerce Clause challenge, the Raich Court adopted the "class of activities" defined by Congress in the Controlled Substances Act, and refused to consider the narrower class of activity proposed by the parties challenging the application of the Controlled Substances Act to them, because reaching this subset of economic activities was essential to the broader regulatory scheme. Although this made "as-applied" Commerce Clause challenges more difficult, it did nothing to undermine a "facial" challenge to a statutorily defined class of activities that are largely or entirely outside the scope of the Commerce Clause. Any more expansive reading of Raich is unfaithful to the actual reasoning of the Court and is an exercise in wishful thinking by those who support unlimited federal power.
Moreover, there is every reason to believe that five Justices of the Supreme Court will be open, and perhaps even eager, to reaffirm the principles of Lopez and Morrison in a case involving neither an as-applied challenge nor marijuana, and to dispel any impression that these cases were permanently eclipsed by Raich. There is no reason to believe, and much reason to doubt, that a majority of the current Justices will be interested in expanding federal power even farther than they did in Raich. And it is quite unlikely that a majority of Justices is open to any constitutional theory that would officially and effectively abolish the enumerated powers scheme embodied in Article I and the Tenth Amendment, as would be necessary to uphold a personal health insurance mandate.
Furthermore, the 2008 case of District of Columbia v. Heller shows that a majority of the current Court takes the text and original public meaning of the Constitution quite seriously, especially when considering issues not controlled by existing precedent. A constitutional challenge to an individual health care mandate would be considered an opportunity by the Justices who made up the Heller majority to further vindicate their commitment to text and history in evaluating claims of federal power.
This majority of Justices would know that a refusal to extend the Commerce Clause to reach the individual health insurance mandate will not invalidate any other law. These Justices will also know that Congress has other constitutional, and more politically accountable, means of accomplishing the same ends. Further, the majority will be aware that the health care mandate is not necessary to win a war or respond to a serious economic depression, areas where the Court has sometimes deferred to the political branches. To the contrary, the majority will likely understand that the individual mandate may even cut against health care cost containment.
Although it is always difficult for the Supreme Court to thwart what is perceived to be the popular will, polling consistently shows that this legislation, if enacted, will fly in the face of popular opposition. If that remains true after enactment, the majority of the Justices who are inclined to preserve the enumerated powers scheme and adhere to the original meaning of the text will have little inclination or incentive to stretch the Constitution to reach so decidedly unpopular and far-reaching a power as this one.
Conclusion
In theory, the proposed mandate for individuals to purchase health insurance could be severed from the rest of the 2,000-plus-page "reform" bill. The legislation's key sponsors, however, have made it clear that the mandate is an integral, indeed "essential," part of the bill.[54] After all, the revenues paid by conscripted citizens to the insurance companies are needed to compensate for the increased costs imposed upon these companies and the health care industry by the myriad regulations of this bill.
The very reason why an unpopular health insurance mandate has been included in these bills shows why, if it is held unconstitutional, the remainder of the scheme will prove politically and economically disastrous. Members need only recall how the Supreme Court's decision in Buckley v. Valeo--which invalidated caps on campaign spending as unconstitutional, while leaving the rest of the scheme intact--has created 30 plus years of incoherent and pernicious regulations of campaign financing and the need for repeated "reforms." Only this time, the public is aligned against a scheme that will require repeated unpopular votes, especially to raise taxes to compensate for the absence of the health insurance mandate.
These political considerations are beyond the scope of this paper, and the expertise of its authors. But Senators and Representatives need to know that, despite what they have been told, the health insurance mandate is highly vulnerable to challenge because it is, in truth, unconstitutional. And political considerations aside, each legislator owes a duty to uphold the Constitution.
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Randy Barnett is the Carmack Waterhouse Professor of Legal Theory at the Georgetown University Law Center. Nathaniel Stewart is a lawyer at the firm of White & Case, LLP. Todd Gaziano is the Director of the Center for Legal and Judicial Studies at The Heritage Foundation.
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[1]Congressional Budget Office, The Budgetary Treatment of an Individual Mandate to Buy Health Insurance,(1994) available at http://www.cbo.gov
/ftpdocs/48xx/doc4816/doc38.pdf.
[2]Letter from Douglas Elmendorf, Director, Congressional Budget Office, to Rep. Charles Rangel (Nov. 2, 2009).
[3]Affordable Health Care for America Act, H.R. 3962, 111th Cong. (2009). See Brian Walsh & Hans von Spakovsky, Criminalizing Health-Care Freedom, National Review Online, Nov. 19, 2009, http://article.nationalreview.com/
?q=MjVjY2FmYmE3MTQwNmNlYWRlMzE4YTc5NGQ4OGJkMmM= .
[4]Patient Protection and Affordable Care Act, H.R. 3590, 111th Cong. (2009). The Senate took up a different House-passed bill and then amended it with substitute language that is now being debated.
[5]The Separation of Powers was designed to function in a similar and complementary way to better protect individual liberty. SeeThe Federalist No. 51, at 323 (James Madison) (Clinton Rossiter ed., 1961).
[6]U.S. Const. art. I, § 1 (emphasis added). The executive and judicial powers delegated in Articles II and III, respectively, contain no such qualification.
[7]U.S. Const. art. I, § 8, cl. 18 (emphasis added).
[8]Marbury v. Madison, 5 U.S. (1 Cranch) 137, 176 (1803); see also Gibbons v. Ogden, 22 U.S. (9 Wheat.) 1, 187 (1824) (noting that the Constitution "contains an enumeration of powers expressly granted by the people to their government").
[9]McCulloch v. Maryland, 17 U.S. (4 Wheat.) 316 (1819) (emphasis added). See Randy E. Barnett, The Original Meaning of the Necessary and Proper Clause, 6 U. Pa. J. of Const. L. 185 (2003) for a discussion of the original meaning of the Clause.
[10]See e.g. Erwin Chemerinsky, Health Care Reform is Constitutional, Politico, Oct. 23, 2009, http://www.politico.com/news/stories/1009/28620.html. See also Ruth Marcus, An 'Illegal' Mandate? No, Wash. Post, Nov. 27, 2009 (making similar conclusory arguments).
[11]U.S. Const. art. I, § 8, cl. 3. See also Randy E. Barnett, The Original Meaning of the Commerce Clause, at 146 for discussion of the original public meaning of the Clause.
[12]N.L.R.B. v. Jones & Laughlin Steel Corp., 301 U.S. 1, 30 (1937).
[13]Jennifer Staman & Cynthia Brougher, Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis, Congressional Research Service Report for Congress, July 24, 2009 (emphasis added).
[14]See Perez v. United States, 402 U.S. 146, 150 (1971).
[15]Gonzales v. Raich, 545 U.S. 1, 16-17 (2005).
[16]Perez, 402 U.S. at 150.
[17]Raich, 545 U.S. at 16.
[18]H.R. 3590, Subtitle F--Shared Responsibility for Health Care § 1501(a)(1)-(2)(A)(emphases added). The Supreme Court makes its own judgment about such claims, as it did when it struck down part of the Violence Against Women Act, which was supported by detailed findings and a voluminous record attempting to show the economic costs of gender violence. See infra note 28 and accompanying text.
[19]Perez, 402 U.S. at 154.
[20]317 U.S. 111 (1942).
[21]Raich, 545 U.S. at 16-17.
[22]Wickard, 317 U.S. at 118.
[23]Raich, 545 U.S. at 18-19.
[24]Id. at 25 (emphasis added).
[25]Id. at 28.
[26]United States v. Lopez, 514 U.S. 549, 567 (1995).
[27]Raich, at 15 (emphasis added).
[28]United States v. Morrison, 529 U.S. 598, 617 (2000).
[29]Raich, 545 U.S. at 18-19 (emphasis added).
[30]Morrison, 529 U.S. at 615.
[31]379 U.S. 241 (1964).
[32]379 U.S. 294 (1964).
[33]Chemerinsky, supra note 10.
[34]Heart of Atlanta Motel, at 258-59 (emphasis added).
[35]Perez v. United States, 402 U.S. at 153.
[36]Katzenbach, at 298 (emphasis added).
[37]Chemerinsky, supra note 10.
[38]See, e.g., Carinsurancerates.com, State by State Insurability Requirements, http://www.carinsurancerates.com/news/136-state-by
-state-minimum-car-insurance-requirements.html (last visited December 7, 2009). The amount of liability insurance varies from a high in Alaska and Maine of $50/100/25 thousand of coverage (for bodily injury per person, bodily injury per accident, and property damage, respectively) to a low of $10/20/5 in Mississippi.
[39]But see John Eastman, Restoring the "General" to the General Welfare Clause, Chapman L. Rev. (2001), arguing that the Tax and Spending powers are limited to the ends necessary to effectuate other enumerated powers.
[40]Printz v. United States, 521 U.S. 898 (1997).
[41]Id. at 922 (emphasis added).
[42]Id. at 924.
[43]The tax applies to "applicable individual[s]" who fail to carry "minimum essential coverage" for one month or more. See Patient Protection and Affordable Care Act, H.R. 3590, 111th Cong. § 5000A(b)(1) (2009). "Applicable individuals" are defined as all individuals within the United States who do not qualify for one of the exemptions. See H.R. 3590 § 5000A(d).
[44]See Black's Law Dictionary 211 (6th ed. 1990) ("A tax or imposition upon the person.").
[45]U.S. Const. art. I, §§ 2 & 9.
[46]Eisner v. Macomber, 252 U.S. 189, 206 (1920).
[47]H.R. 3590 § 5000A(d)(3).
[48]Memorandum from Margaret Mikyung Lee, CRS legislative attorney, & Erika K. Lunder, CRS legislative attorney, to the Honorable David Vitter, regarding legal analysis of requiring census respondents to indicate citizenship status (July 28, 2009) (on file with the authors).
[49]H.R. 3590 § 5000A(e)(2).
[50]Id. § 5000A(d)(1).
[51]Id. § 5000A(d)(2).
[52]Id. § 5000A(d)(4).
[53]Id. § 5000A(e)(5).
[54]See, e.g., Donna Smith, "U.S. Health Insurance Mandate Gains Support," Reuters, March 27, 2009:
When you make peace with yourself, you make peace with the world.
~ Maha Ghosananda
Plastics:
I asked these doctors what they do in their own homes to reduce risks. They said that they avoid microwaving food in plastic or putting plastics in the dishwasher, because heat may cause chemicals to leach out. And the symposium handed out a reminder card listing “safer plastics” as those marked (usually at the bottom of a container) 1, 2, 4 or 5.
It suggests that the “plastics to avoid” are those numbered 3, 6 and 7 (unless they are also marked “BPA-free”). Yes, the evidence is uncertain, but my weekend project is to go through containers in our house and toss out 3’s, 6’s and 7’s.
http://www.nytimes.com/2009/12/06/opinion/06kristof.html?th&emc=th
Nutrition can save America:
http://www.naturalnews.com/Report_Nutrition_Health_America_10.html
(read all the sections).
Health Victory: Vit D
http://www.naturalnews.com/027637_cancer_vitamin_D.html
Cancer doctors begin prescribing vitamin D as part of cancer treatment: Resounding evidence proving the effectiveness of vitamin D in slowing the onset of breast, colon, and other cancers is convincing a growing body of doctors and physicians to utilize the sunshine vitamin in their arsenal of cancer treatment weapons.
In the last several years, numerous epidemiological studies have illustrated the correlation between vitamin D deficiency and serious disease, including cancer. Researchers are now focusing attention on elevated levels of "therapeutic" vitamin D, far above the government's daily recommended amounts, for use in disease treatment and prevention.
Oncologist Tracey O'Connor from the Roswell Park Cancer Institute in Buffalo has stated that she is now having all her patients supplement with vitamin D. Since vitamin D carries no risk unless taken at enormously high amounts above and beyond what any normal person would ingest, it can only benefit those who are already healthy by preventing disease, as well as those who are sick.
Recent studies have also shown that the general public is grossly deficient in vitamin D. Those with debilitating diseases have been found to be the most deficient, indicating a clear correlation between deficiency and the onset of disease. O'Connor pointed out that among women with breast cancer, about 80 percent of them are vitamin D-deficient.
Current research is suggesting that healthy doses of vitamin D require a several-thousand IU daily intake rather than the two- to six-hundred IU dose that has typically been recommended. While these lower levels may prevent rickets, they do little or nothing to prevent the development of many common ailments that have become prevalent in modern society.
Natural sunlight is the best way to obtain vitamin D throughout the warm months of the year. The precursor to vitamin D, ultraviolet light from the sun is absorbed into the skin where it is converted into this life-giving vitamin. The body knows when it has received enough for the day and shuts off production at the proper time, eliminating the risk of generating too much.
Vitamin D3 is the next best option as it is a natural plant form of vitamin D that is readily absorbed by the body. Advocacy groups and physicians recommend anywhere from 1,000 to 50,000 IU a day of vitamin D3 depending upon a person's condition. Healthy individuals typically do well taking between 2,000 and 10,000 IU a day while someone with cancer might be prescribed as much as 50,000 IU a day as part of a cancer treatment plan.
Sources for this story include
http://www.theglobeandmail.com/life...
More on mammograms:
http://www.naturalnews.com/027641_mammograms_brst_cancer.html
Ever since the U.S. Preventive Services Task Force took a look, finally, at the scientific evidence and announced new recommendations earlier this month for routine mammograms -- specifically that women under 50 should avoid them and women over 50 should only get them every other year -- the reactions from many women, doctors and the mainstream media have reached the point of near hysteria (http://www.naturalnews.com/027558_m...). Not getting annual mammograms, some say, means countless women will receive a virtual death sentence because their breast tumors won't be discovered. But what is rarely discussed about mammograms is this: the tests could actually be causing many cases of breast cancer.
In fact, a new study just presented at the annual meeting of the Radiological Society of North America (RSNA), concludes the low-dose radiation from annual mammography screening significantly increases breast cancer risk in women with a genetic or familial predisposition to breast cancer. This is particularly worrisome because women who are at high risk for breast cancer are regularly pushed to start mammograms at a younger age -- as early as 25 -- and that means they are exposed to more radiation from mammography earlier and for more years than women who don't have breast cancer in their family trees.
"For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30," Marijke C. Jansen-van der Weide, Ph.D., an epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands, said in a statement to the media. "Further, repeated exposure to low-dose radiation should be avoided."
Dr. Jansen-van der Weide and colleagues analyzed peer-reviewed, published medical research to investigate whether low-dose radiation exposure affects breast cancer risk among high-risk women. Out of the six studies included in this analysis, four looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers. The other two studies traced the impact of radiation on women with a family history of breast cancer. The researchers took the combined data from all these research projects and then calculated odds ratios to estimate the risk of breast cancer caused by radiation.
The results? All the high-risk women in the study who were exposed to low-dose mammography type radiation had an increased risk of breast cancer that was 1.5 times greater than that of high-risk women who had not been exposed to low-dose radiation. What's more, women at high risk for breast cancer who had been exposed to low-dose radiation before the age of 20 or who had five or more exposures to low-dose radiation were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.
Bottom line: any supposed benefit of early tumor detection using mammograms in young women with familial or genetic predisposition to breast cancer is offset by the potential risk of radiation-induced cancer. "Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted," Dr. Jansen-van der Weide said in the press statement.
The mammogram scam exposed
Incredibly, although it is rarely reported in the mainstream media, the new study follows on the heels of several others that have already sounded the warning that mammograms may cause breast cancer. For example, NaturalNews covered a Johns Hopkins study published earlier this year in the Journal of the National Cancer Institute (http://www.naturalnews.com/025560_c...) that warned radiation exposure from annual mammograms could trigger breast malignancies in women with a strong family history of breast and/or ovarian cancers who have altered genes (identified as BRCA1 or BRCA2).
And it may not be only women with a familial risk for breast cancer who are at extra risk from mammography radiation. As NaturalNews covered last year, a report published in the American Medical Association's Archives of Internal Medicine found breast cancer rates increased significantly in four Norwegian counties after women there began getting mammograms every two years. In fact, the start of screening mammography programs throughout Europe has been linked to an increased incidence of breast cancer (http://www.naturalnews.com/024901.html).
Comments by the Health Ranger, Editor of NaturalNews.com
Mammogram pushers now have nothing left to stand on. The complete and utter hoax of mammography has now been wholly discredited through a flurry of groundbreaking studies performed by conventional medicine researchers! Yes, even the industry's own former advocates now admit mammography harms far more women than it helps.
Why? Because mammography causes the very disease it claims to "detect". It's much like a clever sleight-of-hand magician's trick where they reach for your ear and suddenly produce a coin that was presumably hidden there. But as everybody knows, they put it there themselves! Mammograms offer a similar kind of sleight-of-hand trick (or sleight-of-breast, as the case may be) by actually generating the very disease they claim to find. If so many women hadn't already been harmed by mammography, the whole thing would be quite hysterical.
"Early detection saves lives," they say. Except they stupidly forget to tell women the other side of the story: "Mammograms cause cancer." And if you're gullible enough to actually irradiate your breasts every year, don't be surprised -- shocked! -- if they someday find tumors in them.
Reconsider Some Cancer Screenings . . .
http://www.naturalnews.com/027459_cancer_Prostate_cancers.html
(NaturalNews) According to the American Cancer Society (ACS), breast cancer is the most common cancer in women, affecting over 200,000 women in the U.S. each year and killing more than 40,000. For American men, cancer of the prostate is the type of malignancy that strikes with the greatest frequency.
The ACS says an estimated 192,280 men will be diagnosed with the disease in 2009 and around 27,360 men will die from it. Based on the assumption that finding breast and prostate cancers in the earliest stages will make them easier to cure and slash mortality rates, for over twenty years the U.S. medical establishment has pushed for mass screenings for these common cancers.
So after two decades, all this testing must have resulted in a huge decline in deaths from these diseases, right?
Wrong.
In an opinion piece published in the October 21st issue of the Journal of the American Medical Association (JAMA), experts from the University of California, San Francisco (UCSF) and the University of Texas (UT) Health Science Center explain that overall breast and prostate cancer rates are higher and far more men and women are being treated. However, the incidence of aggressive or late stage cancers has not been significantly reduced at all. Bottom line: the huge and highly hyped effort to screen the adult population for breast and prostate cancers has not brought about the anticipated decrease in deaths.
"Screening does provide some benefit, but the problem is that the benefit is not nearly as much as we hoped and comes at the cost of over diagnosis and over treatment," said one of the paper's authors, Laura Esserman, MD, MBA, in a statement to the media. Dr. Esserman is a professor of surgery and radiology, director of the UCSF Carol Franc Buck Breast Care Center, and co-leader of the breast oncology program at the UCSF Helen Diller Family Comprehensive Cancer Center.
"We need to focus on developing new tools to identify men and women at risk for the most aggressive cancers, to identify at the time of diagnosis those who have indolent or 'idle' tumors that are not life-threatening. If we can identify groups of patients that don't need much treatment, or don't need to be screened, wouldn't that be great?" she stated. "Screening is by no means perfect. We should want to make it better. For both breast and prostate cancer we need to invest in changing our focus from the cancers that won't kill people to the ones that do."
The JAMA article points out that screening costs an enormous amount of money -- more than $20 billion is spent annually in the U.S. to check people for prostate and breast cancer. And the sheer number of people convinced to have these tests has resulted in far more early cancers being detected than in the past. For example, because of regular prostate screening antigen (PSA) testing, now considered "necessary" for most middle-aged men, the number of American men diagnosed with prostate cancer has almost doubled since l980. The number of woman being diagnosed with breast cancer has nearly doubled over that time as well.
So why do the authors of the JAMA article write "the contribution from screening is uncertain"? Because while screening increases the detection of slow growing tumors, the JAMA authors point out, it too often misses the most aggressive cancers which grow so fast that they are not detected early enough to be cured in many cases. And the cancer experts also point out that many patients are undergoing treatment from cancers that actually pose minimal risk. That's right: despite all the fear and scary statistics loudly publicized about these diseases, having breast or prostate cancer doesn't necessarily mean you have a dangerous disease.
"Without the ability to distinguish cancers that pose minimal risk from those posing substantial risk and with highly sensitive screening tests, there is an increased risk that the population will be over-treated," the authors of the JAMA article conclude.
"The basic assumption that screening programs that find and treat early stage disease will then prevent late-stage disease, or prevent cancer from spreading, may not always be correct. If a tumor is aggressive, finding it early may not prevent death," one of the authors, Ian Thompson, MD, said in a statement to the media. Dr. Thompson is professor and chairman of the Department of Urology at the Cancer Therapy and Research Center at the UT Health Science Center at San Antonio and has authored about 400 scientific articles addressing prevention, early detection, and treatment for prostate, kidney, and bladder cancers.
The JAMA authors are not condemning all cancer screening but getting the word out that it is "most successful when pre-malignant lesions can be detected and eliminated" such as during colonoscopies. And they are calling for these specific recommendations for early detection and prevention:
• The development of tests that distinguish between cancers that are lethal and those that are low-risk.
• A reduction in treatment for low-risk disease. "Diagnosing cancers that don't kill the patient has led to treatment that may do more harm than good," they stated.
• Developing tools for doctors and patients to help them make informed decisions about prevention, screening, biopsy and treatment. This includes providing individualized treatments tailored to a person's specific tumor.
• Working to identify those who are at the highest risk for cancer and using proven prevention interventions to keep them from developing a malignancy in the first place.
"Over the years we have worked hard to find new treatments and new ways of finding disease and many of these interventions when appropriately assessed have saved lives," said Otis W. Brawley, MD, chief medical officer of the American Cancer Society, and professor of hematology, oncology and epidemiology at Emory University, in the press statement. "It is very appropriate that we occasionally step back, assess and reflect on what we in medicine are doing. In the case of some screening for some cancers, modern medicine has overpromised. Some of our successes are not as significant as first thought. Cancer is a complicated disease and too often we have tried to simplify it and simplify messages about it, to the point that we do harm to those we want to help."
NaturalNews has previously reported on serious health issues involving mass screenings for breast and prostate cancer, including a study showing that an increase in mammography screenings is associated with an increased incidence of breast cancer (http://www.naturalnews.com/024901.html). In addition, research published recently in the Journal of the National Cancer Institute concluded over a million American men who were told they had prostate cancer following the advent of PSA tests most likely had no real health problem -- until they started down the path of side-effect laden treatments and became labeled as "cancer patients" (http://www.naturalnews.com/027193_c...).
For more information:
http://news.ucsf.edu/releases/exper...
[Just like I say that I will never set foot in So. Cal., I have never had a mammogram and never intend to. And my dear doc agrees. Thanks Dr. G!]
Yes
thank you
sb
An interesting approach to eating:
http://www.10in10diet.com/
Hi gloe :o)
Was lucky this time for the Dentist said every thing was ok.
Best wishes,
sbird
***But i am not a candy or cake kind of man , but do enjoy a chip or 2 or 3 / pretzel as well.***
Ouch! Hope it went well.
g
Hi gloe
Wish me luck for I am going to the dentist soon LOL.
Best wishes,
sbird
Just interesting "other" stuff I want to keep track of.
Create in me a pure heart, O my God, and renew a tranquil conscience within me, O my Hope! Through the spirit of power confirm Thou me in Thy Cause, O my Best-Beloved, and by the light of Thy glory reveal unto me Thy path, O Thou the Goal of my desire! Through the power of Thy transcendent might lift me up unto the heaven of Thy holiness, O Source of my being, and by the breezes of Thine eternity gladden me, O Thou Who art my God! Let Thine everlasting melodies breathe tranquility on me, O my Companion, and let the riches of Thine ancient countenance deliver me from all except Thee, O my Master, and let the tidings of the revelation of Thine incorruptible Essence bring me joy, O Thou Who art the most manifest of the manifest and the most hidden of the hidden! ~ Baha'i Prayer
Healing Baha'i Prayer: Thy name is my healing, O my God, and remembrance of Thee is my remedy. Nearness to Thee is my hope, and love for Thee is my companion. Thy mercy to me is my healing and my succor in both this world and the world to come. Thou, verily, art the All-Bountiful, the All-Knowing, the All-Wise. ~ Baha’u'llah
Is it possible, I asked myself, that I'm being summoned from some deep and holy place within? Am I being asked to enter a passage in the Spiritual life - the journey from false self to true self? Am I being asked to dismantle old masks and patterns and unfold a deeper, more authentice self - the one I intended to be? Am I being compelled to disturb my inner universe in quest of the undiscovered being who clamors from within?
Sue Monk Kidd in When the Heart Waits
This disposition to admire, and almost to worship, the rich and the powerful, and to despise, or, at least, to neglect, persons of poor and mean condition, though necessary both to establish and to maintain the distinction of ranks and the order of society, is, at the same time, the great and most universal cause of the corruption of our moral sentiments.
Adam Smith, The Theory of Moral Sentiments (1759)
Amazing Photos: http://articles.mercola.com/sites/articles/archive/2007/11/13/breathtaking-photography.aspx
Some favorites:
Blogs/forums:
http://xtrends.blogspot.com/
http://worldmarket.blogspot.com/
http://woodiescciclub.com/forum/index.php?sid=04936ba0d21dd4b2640dbd1bf331b441
http://www.tradingthecharts.com/phpBB/index.php
http://tradersparadise.blogspot.com/
http://tradershaven.net/forum/php/phpBB2/index.php
http://trendythird.blogspot.com/
http://forum.themarkettraders.com/list-m/26 (MISH)
http://technitrend.blogspot.com/
http://www.kirkreport.com/
http://wallstreetexaminer.com/blogs/winter/ (RUSS WINTER)
http://www.rgemonitor.com/simple_content_frame.html (Roubini)
http://www.forum.qtusers.com/index.php (QT Users)
http://globaleconomicanalysis.blogspot.com/ (MISH Blog)
http://glorytrades.com/forum/index.php?sid=51a516b0475ec385ee511f200a3fc09c (my forum)
http://glorytrades.blogspot.com/ (my blog)
and last but not least: http://www.billcara.com/ (the best)
News:
http://premium.econoday.com/calendar/US/EN/New_York/year/2007/month/06/day/11/daily/index.html (Main source of eco releases)
http://finance.yahoo.com/marketupdate/overview?u (daily overview with intra-day updates)
http://www.dailyfx.com/ (world wide eco news - click "calendar")
Investing: SPX Dividend Yield: http://www.indexarb.com/dividendYieldSortedsp.html
Do not seek to have events happen as you want them to, but instead want them to happen as they do happen, and your life will go well. ~ Epictetus
When you recognize and understand your weaknesses that is when you can truly begin to focus on your strengths. Sol Palha
Great site for lyrics: http://www.sing365.com/index.html
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