New York's Court of Appeals Kills Bloomberg's Soda Ban Legislation

The top court in New York, the Court of Appeals, ruled against the Bloomberg era soda law that limited certain carbonated beverage sizes. The law was convoluted, hard to administer, and ignored that there were entire classes of beverages that delivered the same or greater amounts of sugar but were exempt from the size restriction.

http://www.scribd.com/doc/231420602/134opn14-Decision

The court properly ruled against the soda size ban both substantively and procedurally. Mayor Bloomberg seems to have targeted those products that he thought he could ban without a stiffer fight - rather than following the science.

“By choosing among competing policy goals, without any legislative delegation or guidance, the Board engaged in law-making and thus infringed upon the legislative jurisdiction of the City Council of New York,” Judge Eugene F. Pigott wrote for the majority in 4-2 decision.

The ruling likely strikes the final legal blow to the controversial policy enacted by Mayor Bloomberg’s administration to ban large sugary beverages over 16 ounces.

Administration officials had argued the policy was necessary to combat the growing problem of obesity.

In arguments before the court earlier this month, city attorney Richard Dearing argued the 2012 regulation was a reasonable and science-based effort to combat obesity.

The ultimate goal was a worthy one, but that doesn't trump fact that the law was poorly written, it didn't follow the science, and infringed on personal rights and choices.

The law was so poorly thought out that it would have added costs to restaurants and businesses selling drinks by the cup, but it wouldn't appear to ban refills, which is yet another way to circumvent the ban on portion size. It ignored those beverages that are sold at places like 7-11 like the Big Gulp, as well as 2-liter beverages sold in grocery stores, but targeted only those beverages sold by the cup in restaurants. That was a restriction unfairly targeting those businesses and put them at a disadvantage. A restaurant couldn't sell a 32 ounce soda beverage, but the 7-11 next door could.

The law also ignored just how many calories were present in fruit juices, coffee products, and other products that are non-carbonated. That meant that sweetened ice tea wasn't restricted, but a soda beverage with the same calorie count per ounce would be restricted. It made no sense until you realize how the law was shaped by the need to get something passed and this was the path of least resistance; it had nothing to do with science.


And, as I've noted before, the soda makers could rebut the empty calories claims by adding vitamins and minerals to the soda products (and we're already starting to see some of that). It also ignores that obesity isn't the product of drinking more soda - if anything consumption of soda has declined, but obesity rates have continued to increase. Even the shift to more sugar-free sodas hasn't reduced the obesity epidemic. It's because people substitute even more calories from other sources when they think that they're not getting calories from soda. They pile on to their plates when they think they're getting a calorie free soda.

Obesity is a product of a sedentary lifestyle and consumption choices. Bloomberg seems to think that hiking the price of soda (which is what the ban on super-sized beverages would have) will result in reduced consumption and lower obesity levels. I expect that people will simply choose other alternatives and continue consumption of all calories at existing levels. Substitution will occur - not reduction.

The problem is that obesity isn't something as simple as cutting out soda. It means reducing overall calories, changing lifestyles, and making better and healthier diet choices.

The soda ban doesn't accomplish any of that. And the Court properly struck it down.

End the Magical Balance Fairy Shutdown Myth

Let's go straight to the video tape.

Breaking News

That's from This Week With George Stephanopoulos this past weekend (10/04/2013) - starting around the 3 minute mark.

The transcript:

STEPHANOPOULOS: But Mr. Speaker, he says -- and he said it publicly on many occasions, that you came to him back in July and offered to pass a clean government funding resolution, no Obamacare amendments, that was $70 billion below what the Senate wanted. They accepted it. And now, you've reneged on that offer.

BOEHNER: No, clearly there was a conversation about doing this.

STEPHANOPOULOS: Several conversations.

BOEHNER: Several. But--

STEPHANOPOULOS: And you offered a clean resolution.

BOEHNER: But I and my members decided the threat of Obamacare and what was happening was so important that it was time for us to take a stand. And we took a stand.

STEPHANOPOULOS: Did you decide it or was it decided for you?

BOEHNER: I, working with my members, decided to do this in a unified way. George, I have 233 Republicans in the House. And you've never seen a more dedicated group of people who are thoroughly concerned about the future of our country. They believe that Obamacare, all these regulations coming out of the administration, are threatening the future for our kids and our grandkids. It is time for us to stand and fight.

STEPHANOPOULOS: But Mr. Speaker, this is clearly not what you want. I want to go back to several points you've made about this over the last few -- here you were right after the election with Diane Sawyer.

(BEGIN VIDEO CLIP)

BOEHNER: It's pretty clear that the president was re-elected. Obamacare is the law of the land.

If we were to put Obamacare into the CR and send it over to the Senate, we were risking shutting down the government. That is not our goal.

(END VIDEO CLIP)

STEPHANOPOULOS: So right there, you say that's not your goal. You don't want to put Obamacare on the CR. You did it.

BOEHNER: George, I have made it clear to my colleagues. I don't want to shut the government down. We voted to keep the government open.

Clearly, the Speaker admits that he had the opportunity to pass a budget, but refused because he and the rest of the Republicans decided to make it about defunding/delaying/destroying Obamacare. They had more than 40 attempts at repealing it, and failed on every single one, so their strategy became to tie the defund/delay/destroy to the annual appropriations cycle.

And it's time for all the media to quit playing that this is something that both sides made happen, or that the President and the Senate are responsible for this. The Speaker gave the game away and admits for all the world to see that the House GOP blew up a deal on a budget over Obamacare.

The Speaker has tied his legacy to the extremists in his party. He has become one of them by allowing them to dictate the terms of a deal that would end the shutdown. He has the power to end the shutdown by opening up the floor to a clean vote.

He refuses to do so, claiming that the votes aren't there.

If that's the case, then he has nothing to lose by letting the Democrats expend political capital in a failed effort to have a vote that wouldn't succeed. He'd gain politically by knowing that the count doesn't work in his favor, except that he, and everyone else, knows that this isn't true.

The math doesn't work in his favor. The votes are there, but the votes would undermine his ability to lead a fractured Republican caucus. So he's doing all he can to cast Democrats as the problem even though he clearly acknowledges that a deal was in hand but for the Republican insistence on destroying Obamacare as a precondition to a deal.

It's the poison pill provisions that the Republicans have offered up that have led us to this critical moment.

It's a clarifying moment - exposing the GOP extremism and extortion for what it is. It's an attempt to rewrite how government does business outside the regular legislative and electoral process.

Republicans will only agree to have these negotiations in a context where a government shutdown and the threat of default do give them that added leverage. This is an objective statement of the GOP position. Dems have offered Republicans the negotiations they want, once those conditions are lifted. Republicans have refused. Therefore, their position is that conditions which continue to threaten widespread destruction, giving them leverage, must remain for any talks to proceed.

The key tell is that Cantor and Ryan don't directly defend this position. They elide it. To be sure, both repeat the claim there have been negotiations attached to debt ceiling hikes in the past. But as Jonathan Chait explains, that isn't the same as dangling the actual threat of default and untold economic havoc as a way to extract massive one-sided concessions. Republicans cannot defend this tactic because they will not acknowledge they are actually employing it. John Boehner already allowed in March that the debt ceiling will and must be raised, because: "I'm not going to risk the full faith and credit of the federal government." But on ABC on Sunday, when Boehner was pressed on whether he'd actually allow default if Dems didn't give him what he wants, he repeatedly fudged, saying he would not allow a vote on a "clean" debt limit bill. What happens if default is the only other option? We just don't know.

Either Republicans are actually prepared to allow default and to use this frightening prospect as a weapon with which to get what they want, in which case such tactics cannot be rewarded, because they will all but ensure extensive destruction later. Or Republicans are not prepared to allow default, in which case the very notion that they have leverage here is a sham. Republicans are trying to use this ambiguity to their advantage. On the one hand, the uncertainty it creates is supposed to force Dems to give in to their demands. On the other, it is meant to obscure their actual intentions and thus shield them from politically potent charges that they are actually willing to place the country at grave risk to extract concessions they couldn't get through conventional channels.

The Democrats don't need to offer up anything other than a clean budget resolution on the terms they agreed to in July. That was already a concession on $70 billion on spending. The GOP took that offer and tossed it in favor of a political fight they cannot hope to possibly win.

The fight is already wearing down Republican polling and ratings for Congress in general. While Republicans are cheering that the President's approval ratings are at 37%, the Congress rates only 5% approval. The President doesn't face reelection and has a freer hand to use the bully pulpit to attack the Republicans for bringing about this crisis because they are trying to unite the base in opposition to health care reforms that would expand access to health insurance to millions of people.

The GOP has to engage in cognitive dissonance on a massive scale to reconcile its positions - that it wants to end the shutdown, avoid default, and recognizing the economic harms that those actions are having all while advocating for those same things and claiming that the damage is minimal. The GOP has to lie to itself and everyone else to do so, and the public is seeing through the lies.

The video clip above highlights the problems succinctly. Republicans who agree that the default will lead to widespread destruction, yet use this as leverage by refusing to deal unless the GOP demands (preconditions) are met are the worst of the worst in this ongoing saga. They're putting politics and passion over reality, economics, and national security.

Any Republican who hews to this position needs to be run out of office. And that's a list that is significant.

It includes none other than Speaker Boehner himself. He's claiming that he wouldn't let the nation default because of the harm done, and yet he's completely going along with the Tea Party wing in demanding that the Administration and Democrats accept their demands or else.

Or else what? Economic catastrophe if we don't do what the GOP says? It's extortion. And it's economic folly. The Speaker knows it, but by continuing to pander to the extortionists, he's one of them.

The GOP and the Speaker are guilty of target fixation. They've determined that destroying Obamacare is paramount, and are willing to do whatever it takes to destroy it. That might help keep the extremists in the party happy, but it is having tremendous damage to the polity and even greater damage is on the horizon if the debt ceiling is not increased.

It's all part of a larger fight by the GOP to slash and burn government spending at all levels, and it's a fight that the Tea Party relishes because they believe that they have a mandate to chop government spending, even though they are a minority within their own party. The tools that were supposed to get the parties to compromise and come to agreement have instead been used by the Tea Party to institute far harsher cuts and more destructive policies than if a compromise had been worked out.

The sequester is case in point. A refusal to work out a deal that targeted cuts and offer up even the slightest bit of tax increases or reductions in tax credits and incentives was rebuffed and refused. Instead, across the board cuts were instituted, and the GOP won the day. The Senate and the Administration are now working off the sequester figures - accepting the cuts. The GOP won that fight, and that's what's driving them here too. The GOP and Tea Party have flipped the tools and events that should force compromise into ones that bring about the very policies that they endorse - smaller government.

It's a worrying trend, and one that may lead the nation into default. With no reason or intention to compromise, the GOP will take the nation over the cliff. One can only hope that voters realize who's taking them for this dangerous ride.

The GOP.

Cross posted at LGF.

The Carnival Cruise Failure - An Indictment of the Entire Cruise Ship Industry

Late last night, the Carnival Triumph finally came into port in Mobile Alabama and began disembarking passengers after being stranded at sea aboard due to an engine room fire.

Even the towing was not without its own problems. Just within view of shore, a tow line snapped and left the ship again stranded before it could be reattached.

There were 4,200 passengers and more than 1,000 workers on board the ship when the fire killed the power to the ship.

These are floating cities that rely on their power systems to operate pretty much every system, from propulsion to water and sanitary sewer systems (the toilets, wash rooms, refrigeration and freezer systems, etc.) You would think that backup systems would be able to kick in to handle the key power systems should the main systems go down, but you'd be wrong.

The backup systems can't - and it's not because those systems don't exist. It's because they'd cost money that the cruise lines and their engineers have deemed to be unnecessary and would otherwise cut into their profit margins.

Cruise ships have gotten progressively larger, which means that when the cruise ships lose power, ever larger numbers on board are affected. The Carnival Triumph is among the largest of the current fleet of cruise ships.

Larger ships are on the drawing board, but they too will have a similar problem.

Fire is an all too common event on board cruise ships, and that's one of the reasons that cruises always start with mandatory drills at the start of their cruises - to familiarize passengers with the location and how to deal with emergencies at sea. Engine room fires happen all the time, as do the loss of power.

The Triumph is just the highest profile of these fire events in recent years, but there's very little that the IMO (the international organization that oversees safety on board shipping) can do that would improve conditions on board ships should they lose power. Their recommendations don’t come with the kind of enforcement powers we associate with the US Coast Guard (which itself is woefully undermanned and can’t conduct much more than annual surveys on board the cruise ship plus their initial certification).

The problem isn't just confined to Triumph, or even the Triumph class of cruise ships. Backup systems apparently can’t handle the kind of load necessary to run vital public health systems (plumbing, ac, etc.) That has to change, and that’s going to cost a whole lot of money to a cruise industry that thrives due to sub-par compensation to its workers, working ships to within an inch of their existence, and doing everything possible to keep the boats in service even after public health incidents (norovirus outbreaks) that could continue into the next cruise because there’s really no way to properly clean the ships thoroughly if they’re already taking on passengers for the next cruise within hours of the end of the prior cruise.

I’m waiting for the National Parks Service (or an amusement park) to hit back at Carnival’s current ad campaign showing how smooth their park experiences can be compared to the Carnival Triumph one.

Thing to remember is that when a cruise goes okay, it’s one thing, but when a cruise ship has problems, things can go wrong in a real hurry and cause huge problems.

Carnival’s hoping people have real short term memories, and that it wont affect bookings. They’re already hurting because of the Costa Concordia. This wont help them and their bottom line. I fully expect the lawsuits to come rolling in - especially now that they’re talking about $500 cash to passengers, which barely covers salary losses and other losses incurred by the extended time on board, plus the decrepit conditions.

Meanwhile, the Triumph will be out of service for the better part of this year to deal with cleaning up the huge biohazard mess left behind in the wake of this week's cruise mess.

NYC Department of Health Approves Super-Sized Soda Ban

In what should be a surprise to absolutely no one, the New York City Department of Health rubber stamped Mayor Mike Bloomberg's proposal to ban sugared beverages that exceed 16 ounces. The vote was 8-0 with one absention.

The regulation passed Thursday puts a 16-ounce size limit on cups and bottles of non-diet soda, sweetened teas and other calorie-packed beverages.

The ban will apply in fast-food joints, movie houses and Broadway theaters, workplace cafeterias and most other places selling prepared food.

It doesn't cover supermarkets or most convenience stores.

City health officials say the ban is necessary to combat a deadly obesity epidemic.

The ban would take effect in March 2013. Health experts claim that the limit would help fight the obesity epidemic, and that soda is nothing but empty calories.

Never mind that this becomes an indirect tax on those who purchase the oversized beverages rather than a multitude of smaller beverages (sharing among multiple cheaper because it's cheaper per ounce to do so).

Setting aside the nanny-state aspects of the ban, which are numerous, there are practical problems with the ban.


The ban ignores that there are other more dangerous food products that are just as likely, if not more so, to cause adverse health effects.

No one is calling for bans on sales of steaks larger than 8 ounces, even though beef products can contain more fat and calories that can pack on the pounds and lead to obesity.

Here, the focus appears to be on the "empty" calories, and nothing more.

There are carve-out exemptions for milk-based beverages, such as iced coffees, and juices, and that too ignores that those beverages contain far more calories than the now-banned products.

The restrictions would not affect fruit juices, dairy-based drinks like milkshakes, or alcoholic beverages; no-calorie diet sodas would not be affected, but establishments with self-service drink fountains, like many fast-food restaurants, would not be allowed to stock cups larger than 16 ounces.

Only establishments that receive inspection grades from the health department would have to obey the rules, a group that includes movie theaters and stadium concession stands. Convenience stores, including 7-Eleven and its king-size “Big Gulp” drinks, would be exempt, along with vending machines and some newsstands.

Mayor Michael R. Bloomberg has said the plan does not limit consumers’ choices, since customers can still purchase as many 16-ounce drinks as they would like. The soft-drink industry, which has spent more $1 million on a public-relations campaign opposing the plan, argues that the policy restricts consumers’ freedom to buy beverages as they see fit.

Six in 10 residents said they thought the plan was a bad idea in a recent poll by The New York Times. But the measure easily earned the approval of the health board, whose members were appointed by the mayor. The board voted eight to zero, with one abstention, to approve the measure just after 11 a.m. Thursday.

Mr. Bloomberg has made curbing obesity a top goal for his administration, citing higher rates of diabetes and fatalities among the city’s more overweight neighborhoods. More than half of adult New Yorkers are obese or overweight, according to the city’s health department.

Bloomberg seems to have targeted those products that he thought he could ban without a stiffer fight - rather than following the science.

This wouldn't appear to ban refills, which is yet another way to circumvent the ban on portion size.

And, as I've noted before, the soda makers could rebut the empty calories claims by adding vitamins and minerals to the soda products. It also ignores that obesity isn't the product of drinking more soda - if anything consumption of soda has declined, but obesity rates have continued to increase.

Obesity is a product of a sedentary lifestyle and consumption choices. Bloomberg seems to think that hiking the price of soda (which is what the ban on super-sized beverages would have) will result in reduced consumption and lower obesity levels. I expect that people will simply choose other alternatives and continue consumption of all calories at existing levels. Substitution will occur - not reduction.

If the New York City ban takes effect as scheduled, expect other cities to follow suit.

Nanny State In Action: Bloomberg's Boobish Plan

New York City Mayor Mike Bloomberg continues proposing health-related plan after health related plan, regardless of their constitutionality (the sugared beverage plan) or smoking bans in public spaces (and restaurants, etc.). His latest idea is to ban giving new mothers formula as part of a plan to increase the number of mothers breast feeding.

Mayor Bloomberg is pushing hospitals to hide their baby formula behind locked doors so more new mothers will breast-feed.

Starting Sept. 3, the city will keep tabs on the number of bottles that participating hospitals stock and use — the most restrictive pro-breast-milk program in the nation.
Under the city Health Department’s voluntary Latch On NYC initiative, 27 of the city’s 40 hospitals have also agreed to give up swag bags sporting formula-company logos, toss out formula-branded tchotchkes like lanyards and mugs, and document a medical reason for every bottle that a newborn receives.

While breast-feeding activists applaud the move, bottle-feeding moms are bristling at the latest lactation lecture.

“If they put pressure on me, I would get annoyed,” said Lynn Sidnam, a Staten Island mother of two formula-fed girls, ages 4 months and 9 years. “It’s for me to choose.”
Under Latch On NYC, new mothers who want formula won’t be denied it, but hospitals will keep infant formula in out-of-the-way secure storerooms or in locked boxes like those used to dispense and track medications.

With each bottle a mother requests and receives, she’ll also get a talking-to. Staffers will explain why she should offer the breast instead.

“It’s the patient’s choice,” said Allison Walsh, of Beth Israel Medical Center. “But it’s our job to educate them on the best option.”

Doctors have long known of the benefits of breast feeding but it is ultimately up to the parents to decide. Many have already talked the matter over with their physicians, and are able to make an informed decision. Lactation specialists at hospitals are more than welcome to share their information on how to prepare expectant and new mothers on how to maximize their experience and how to best nurture their newborns.

But to knowingly make it more difficult for new mothers to obtain formula? That's just nuts. Not every new mother can and would have the opportunity to breast feed once they're out of the hospital. Some could have medical conditions that make it impossible. Others could have job situations that make breast feeding (or pumping) impractical or impossible. They've already given it thought and the notion that the Bloomberg, by and through his Health Department, can limit access to formula is most certainly an infringement on the patient's right to choose a course of treatment and what's best for them and their children.

In fact, his proposal could actually worsen the health of the mother - it could lead to further post-partum depression since mothers who have made the choice not to breast feed will be continually lectured each time they seek to bottle feed. It will spur a feeling of inadequacy:

For many women, breastfeeding is HARD, that's why there are lactation consultants who charge like $175/private visit or $35 for a 15-minute phone call after you leave the hospital. And when the breastfeeding isn't going well, it really makes the mom depressed. For some moms and babies, it's easy, for others, it's harder.

It is bureaucracy at its worst, and even worse, it is a waste of limited health care resources.

Time wasted each time on giving instructions about breast feeding over bottle feedings is time that could go to improving care in other more important facets. It would mean less time devoted to infection control and making sure health care instructions are followed upon discharge - those two issues are a massive problem for hospitals since it leads to unnecessary complications and quantifiable health care costs.

Bloomberg's nanny state ways continue to irritate and show no bounds. Many New Yorkers will likely be relieved when Bloomberg's term comes to a close.

If Bloomberg were truly seeking to improve health care and the lives of New Yorkers, he would be directing the Department to seek tighter regulation on infection control and discharge instructions at City-controlled/operated hospitals. Consumer Reports recently ranked hospitals based on quality of care issues, and many of the hospitals fared poorly (both city-run and privately operated facilities including nationally known ones such as NYU Medical Center for instance), precisely because of infection control and instruction issues that lead to readmissions. Making sure that hospitals improve in these areas would have a huge impact on public health.

The focus must be there; Bloomberg is addressing a non-issue and a non-starter.

Soda Ban Proposal Gets Health Department Public Hearing Today

The New York City Department of Health will be holding a hearing today to allow comment on a proposal to ban certain kinds of sales of sugar-containing beverages.

A just released study by New York University found that the ban as proposed would cut caloric intake by 63 calories, but the results may be negligible as customers simply buy more of the beverages:

Mayor Bloomberg's proposed ban caps a maximum size of 16 ounces for sugary drinks - sold in cups or bottles - at food establishments under the New York City Department of Health and Mental Hygiene's jurisdiction. That includes restaurants, fast food chains, delis, street carts and movie theaters. Drinks sold at grocery and convenience stores - including two-liter bottles and 7-11's "Big Gulp" fountain drinks - would be exempt from the ban.

New research led by Dr. Brian Elbel, an assistant professor of population health and health policy at NYU Langone School of Medicine in New York City, analyzed what impact Mayor Bloomberg's proposal would have on a typical consumer's calorie intake.

Elbel and fellow NYU researchers pooled data from two studies that included 1,624 sales receipts listing a non-milkshake beverage (dairy products are excluded from the proposed ban), which were collected from diners at three different fast-food restaurants in New York City, Newark, N.J., Philadelphia and Baltimore from 2008 to 2010. Their research is published in a correspondence to the editor in the July 23 online issue of the New England Journal of Medicine.

Based on the receipts and corresponding survey information collected from the studies, the researchers determined that 62 percent of beverages bought at these restaurants would be over 16 ounces and subject to the mayor's new proposal. Elbel explained to HealthPop in an interview that if 100 percent of fast food consumers switched to a 16-ounce drink from their previous order, the average consumer would take in 63 fewer calories per trip to a fast-food restaurant.

However that's assuming nobody opts to purchase an additional 16-ounce beverage - people can buy as many as they like at these establishments under Bloomberg's proposal - which Elbel conceded may not be likely. His research found that if only 30 percent of consumers reduced their intake to a 16-ounce beverage, the decrease in calories would be negligible.

I've repeatedly stated my opposition to this ban on several grounds, including that it arbitrarily creates a class of banned beverages, even though there are other beverages that contain far more calories per ounce and that other lifestyle choices can have a far greater impact on public health (many a Starbucks beverage will often have more calories than a soda as would many of the iced beverages sold at McDonalds and other chains).

In other words, the class of beverages affected is arbitrary and will not have any appreciable effect on obesity, but it would pave the way for far more intrusive changes imposed by health departments around the country.

Sedentary lifestyles play a significant role in obesity and getting more exercise needs to be considered. Cutting soda portion size isn't a panacea, particularly when soda consumption has been down even as the number of obese people has increased. Something else is at play when soda consumption is down even as the percentage of obese people has increased. That something happens to include a sedentary lifestyle and oversized food portions.

Mayor Bloomberg's proposals are about what he thinks the Department of Health can get away with as far as limiting portion sizes, not based on actual science or greatest impact on public health.

It still comes down to personal choice, and a person will take in far more calories than they need, which is why so many people try and fail on diets to eat sensibly and within their caloric needs as determined by nutritionists or diet experts. The failure to exercise makes things all the worse.

After all, someone who eats a 16 ounce porterhouse or other similar steak will take in far more calories than someone drinking a 16 ounce soda, but there's no limiting the restaurant from serving even bigger portions of steak, even though a serving size is a fraction of that amount.

This is just a misguided effort by a nanny stater to impose a ban that will have a negligible effect on public health.

If He Can't Tax It, Bloomberg Hopes To Ban Big Gulp-Sized Soda Sales

Mayor Mike Bloomberg continues his nanny-state ways. His latest proposal is to ban sales of super-sized sugary beverages:

The man behind calorie counts is set to announce a new public health initiative to battle obesity, taking aim at super-sized sugary drinks.

In other words, it may soon be time to say goodbye to those Big Gulps, those Slurpees or even Venti at Starbucks, CBS 2’s Derricke Dennis reported.

“That’s okay,” one person said.

No it’s not, according to Mayor Bloomberg, who is set to propose a ban on sugary drinks over 16 ounces everywhere, all across the city.

“I disagree with it, because it’s the right to choose. If you want to drink a Slurpee, you should be allowed to drink a Slurpee,” said Jamie Sawyer, a tourist from Oklahoma.

It's one thing to require calorie counts so that people can have the knowledge to choose products that may be healthier and lower in calories.

It's quite another to ban an entire size category - anything larger than 16 ounces. Nothing stops those who are already buying those products from simply buying two of the smaller size - and increasing the costs to the purchaser (which might be part of Bloomberg's strategy).

However, soda and sugary beverages aren't the sole culprit, or even the main culprit in an obesity epidemic. Consider that most folks aren't getting enough exercise. A sedentary lifestyle plays a far greater role than soda.

Then, there's the caloric intake due to super sized meal portions or even portions at high end restaurants that blow the scales on calories. Consider that a famed restaurant like Junior's in Brooklyn is notable for their desserts, including cheesecake. Those portions aren't small. In fact, a single serving could feed two or more people in many cases. We're not talking an insubstantial calorie count either.

How about the steakhouses around the city (either sole locations or chains). They offer up huge steak portions - thousands of calories, tons of fat, protein, and other nutrients. Those aren't even being considered.

So, does this in fact turn out to be a "tax" on those who are least able to afford food cost increases? Since many vendors charge far less for the largest sizes of beverages per ounce than those with the smaller sizes, sharing among family members or friends would be out of the question with Bloomberg's ban, and it would mean that customers would incur higher charges to get the same amount of product.

Moreover, there's no reason to single out sodas and sugary beverages from other products - like juices or milk-based products (like milk shakes) if we're talking strictly calorie counts - the basis of Bloomberg's premise behind the proposed ban.

It appears that the only reason that juice and milk-based products aren't included in the ban is because they have other nutrients. Yet, juice and milk shakes can contain as much or more calories per ounce than soda - and the fact that soda doesn't have any other nutrients could be altered if the soda manufacturers add other nutrients to them - to get around a proposed ban.

If Bloomberg goes ahead with this ban, watch soda manufacturers consider lawsuits seeking to overturn the ban, as well as consider adding vitamins or minerals to show that these aren't merely empty calories (and undermining Bloomberg's premise). UPDATE: To give you an idea of how asinine Bloomberg's proposal is, consider that a T-bone steak - 8 oz worth is 448 calories. That compares to 8 ounces of Coca Cola that runs 98 calories. It would take 32 ounces of soda to equal the steak, and the steak has other issues (namely fats that contribute to obesity, although there is protein and other nutritional value to steak in moderation.

Common Sense Prevails As Doctors' Group Calls Upon Profession To Stop Over-Ordering Tests; Procedures

The MSNBC headline is misleading. Doctors aren't calling for an end to 45 procedures, including PAP tests in certain circumstances, or chemotherapy for those suffering from terminal cancer. They're calling for doctors to utilize procedures and drug regimes when the circumstances call for it - based on the science.

Nine medical societies, including the American Society of Clinical Oncology and the American College of Cardiology, representing nearly 375,000 physicians are challenging the widely held perception that more health care is better, releasing lists Wednesday of tests and treatments their members should no longer automatically order.
The 45 tests and procedures considered to be overused include:

• Repeat colonoscopies within 10 years of a first test
• Early imaging for most back pain
• Brain scans for patients who fainted but didn't have seizures
• Antibiotics for mild- to-moderate sinusitis unless symptoms last for seven or more days or worsen
• Stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present
• PAP smears on women younger than 21 or who have had a hysterectomy for a non-cancer disease
• Advanced imaging or bone scans in patients with early-stage breast or low-grade prostate cancer
• Bone scan screening for osteoporosis in women younger than 65 or men younger than 70 with no risk factors
• Routine cancer screening on dialysis patients with limited life expectancies
• Chemotherapy for sickest cancer patients

Dr. Christine Cassel, president of the American Board of Internal Medicine, said the goal is to reduce wasteful spending without harming patients. She suggested some may benefit by avoiding known risks associated with medical tests, such as exposure to radiation.

Doctors may be prescribing these procedures or ordering tests because they're practicing defensive medicine - ordering tests so that if they miss something they can point to the test (and the ordered test) to show that they didn't commit medical malpractice. That's something that the article doesn't address.

The article does tangentially address the fact that some doctors and medical groups may benefit economically from ordering tests and procedures, such as EKGs, even though they aren't always necessary. It notes that insurance companies would have a hard time filtering out unnecessary tests from those that are prudent and necessary:

Insurers will certainly take a close look at the recommendations, but what they do may be limited. That's because most of the questionable tests and treatments in the lists don't particularly stand out in the avalanche of bills processed daily by insurance companies.

Take a recommendation for no annual EKGs for low-risk patients with no heart symptoms. Dr. John Santa, director of the Consumer Reports Health Ratings Center, said he used to routinely order EKG's when he was a general adult medicine practitioner. EKGs cost $50 to $60. A medical assistant would do the tests, and it would take Santa just a couple of minutes to read them. Yet 2 percent to 3 percent of his income came from EKGs, enough to make a difference in a tight year.

"It's very difficult for an insurance company to tell the difference when an EKG is being used as a diagnostic tool and when it is being used as a screening test," said Santa. "It would probably cause more trouble for insurance companies."

However, doctors and patients need to understand that not everyone benefits from a one-size fits all approach.

New Jersey Should Finally Pass Fluoride Bill

New Jersey has long lagged the rest of the region in municipalities that fluoridate the water supplies. Misinformation is one of the reasons - the fact that junk science is driving the opposition is costing New Jersey residents' public health.

The costs for fluoridation are a fraction of the dental health costs. It's far cheaper to fluoridate the water than to deal with the costs of cavities and poor dental health.

The Legislature is considering a new bill, and the usual suspects are lined up against it - citing costs and claims that fluoridation can lead to other diseases.

In New Jersey, water providers typically serve several towns, meaning that all must agree to fluoridate their water — and typically they do not.

Opponents and supporters of the fluoride legislation believe it has a higher chance of passing this year, in part because it has bipartisan sponsorship. Gov. Chris Christie has not said whether he would sign the bill if it passed.

The state’s League of Municipalities has opposed the bill, concerned about the cost of what it calls an unfunded mandate. The New Jersey Utilities Association testified against it, arguing that it “is known to have adverse health effects in certain quantities” and that it would cost water companies anywhere from $400,000 to $64 million.

“We think the cost benefit is not there,” said Karen Alexander, the president of the association.

Many opponents say their information has come online, from national groups like the Fluoride Action Network and Citizens for Safe Drinking Water, which argue that fluoridation would cost $5 billion statewide. On their Web sites, the groups argue that fluoridation would lead to fluorosis, a rare staining of the teeth. They say fluoride has many adverse health effects, including bone cancer, and no proven benefit.

But public health officials say that the National Academy of Sciences examined the studies linking fluoride to lowered I.Q. and could not substantiate them. Similarly, two large and recent studies, one from Harvard and the National Cancer Institute, the other in California, found no link between fluoride and bone cancer. Fluorosis in the United States, they say, tends to be barely visible.

While some communities have stopped fluoridation nationally - it was because of costs, not because the science didn't support fluoridation.

Health Panel Indicates Intention To Cover First Responders' Cancer Under Zadroga Act

This is a big deal to many emergency personnel and construction crews who worked in and around Ground Zero following the 9/11 attacks and have since been diagnosed with cancer. The health care panel created by Congress to determine whether ailments should or shouldn't be covered under the James Zadroga Act voted to cover cancer under the Act's compensation provisions:

Hundreds of 9/11 first responders could receive compensation for their cancer treatment after an advisory panel voted Thursday that the disease should be covered under the Zadroga Act.

The 15-member panel, appointed by Congress to review research and decide which health conditions are linked to toxins at Ground Zero following the Sept. 11 attacks, believes research clearly shows a link between 9/11 exposure and cancer, said panel member Catherine McVay Hughes.
"The committee agreed that cancer should be included [in the Zadroga Act]," said Hughes, who is also vice chairwoman of Community Board 1. "This is a major step in the right direction."

The panel will now draft a list of all the specific cancers they believe ought to be covered. Based on the existing research, the preliminary list discussed at Thursday's meeting would include blood cancers, lymphoma, leukemia, lung cancer, mesothelioma, multiple myeloma and others, Hughes said.

The panel, called the World Trade Center Scientific and Technical Advisory Committee, will submit a final recommendation on cancer to the federal government within the next couple of weeks.

Dr. John Howard, the World Trade Center health program administrator for the federal government, will make the final decision by early April on which cancers, if any, should be covered, Hughes said.

If cancer is officially included in the James Zadroga 9/11 Health and Compensation Act, those who are sick with cancer and the families of those who have died from the disease will be able to apply to the $2.8 billion 9/11 Victim Compensation Fund to cover their medical expenses, as well as pain and suffering.

The Unintended Consequences Of Personhood Legislation

The GOP is pursuing personhood legislation in states around the country as a way to make abortions illegal. Since the pro-life movement hasn't been able to overturn Roe v. Wade, they're using this as an alternative attack on the legal right to abortion in the country. Colorado has twice tried to bring a personhood amendment, and Missouri has also failed to approve a personhood bill.

It's a move that is destined to have unintended consequences that its proponents are wary to even discuss. Virginia is the latest to attempt to legislate away the right of abortion by redefining the term person. The GOP is pushing a personhood bill there, and yet the word "person" appears in the Virginia statutes 25,000 times. Any chance that something important might be affected by changing the definition?

Absolutely.

Unfortunately, not only would this bill lay the foundation to ban abortion and contraception, it could also wreak havoc on other areas of the law. The word “person” appears over 25,000 times in the laws of Virginia. No one knows the exact consequences of changing such an ordinary word, but the proponents of H.B. 1 refused to discuss or address these concerns in committee or on the floor of the House. Granting fertilized eggs all of the rights, privileges, and immunities the people of the Commonwealth currently hold could impact inheritance laws, election laws, tax laws, and even criminal laws. The bill has the potential to allow individuals to claim embryos in petri dishes as dependents, to challenge population numbers and election districts based on where IVF clinics are located. We fear this bill could even allow a non-family member to bring charges against a woman who has had a miscarriage.

The more legislatures attempt to push these kinds of laws, the greater the chances that the unintended consequences will be more severe.

Granting personhood to an embryo could potentially result in questioning census results, tax levies, inheritance law, and domestic relations laws, employer benefits laws, etc.

The GOP is opening a Pandora's box of trouble with this - and it's all with an eye towards eliminating the legal right to abortion. It's a roundabout attempt to make abortions illegal - and by making a claim that is unsupported by the science at that.

On the Destruction of the Susan G. Komen Brand Over Pulling Planned Parenthood Funding

There was no reason that the Susan G. Komen charitable foundation should ever have waded into the mess that it is now in. I'm heartened by the fact that some of the Komen affiliates are rebelling against the central organization's directives:

Komen has said the decision stemmed from newly adopted criteria barring grants to organizations under investigation — affecting Planned Parenthood because of an inquiry by a Republican congressman acting with encouragement from anti-abortion activists.

A source with direct knowledge of decision-making at Komen's headquarters gave a different account, saying the grant-making criteria were adopted with the deliberate intention of targeting Planned Parenthood. The criteria's impact on Planned Parenthood and its status as the focus of government investigations were highlighted in a memo distributed to Komen affiliates in December.

According to the source, who spoke on condition of anonymity for fear of repercussions, a driving force behind the move was Karen Handel, who was hired by Komen last year as vice president for public policy after losing a campaign for governor in Georgia in which she stressed her anti-abortion views and frequently denounced Planned Parenthood.

Karen Handel is said to be a driving force behind Komen's decision this week to cut breast-screening grants to Planned Parenthood.

Brinker, in an interview with MSNBC, said Handel didn't have a significant role in the policy change.

Among Komen's affiliates, there were clear signs of discomfort with the decision. All seven Komen affiliates in California, in a joint letter to their congressional delegation, said they were "strongly opposed" to the policy change and were working to overturn it.

"Our commitment to our mission is unwavering," the letter said. "This is a misstep in that journey and ... we will do whatever it takes to do what is right for the health of women and men in California."

Philanthropy experts said it will be difficult for Komen to convince people it wasn't playing politics.

The charity has destroyed its brand all over an attempt by anti-abortion advocates to politicize where funding goes.

A Connecticut chapter has also said that it wont pull funding from Planned Parenthood in that state.

They've alienated half (or more) of the country that supports abortion rights and Planned Parenthood all to cater to the vocal anti-abortion advocates who have joined the ranks of the Komen leadership.

The timeline bears out the politicization of the process within the organization.

Komen changes its policy, claiming that it will no longer fund entities that are under investigation.

That change came after a known anti-abortion activist, Karen Handel, joined Komen in a key leadership role.

Komen announces end of funding to Planned Parenthood affiliates over an ongoing Congressional investigation.

That Congressional investigation is being conducted by a member of Congress whose anti-abortion views are known, and who was doing the investigation at the behest, and on behalf, of other anti-abortion groups.

As a result of the change in policy, Komen will withhold $600k+ in funding from Planned Parenthood. Planned Parenthood cries foul and a massive fundraising effort ensues to make up shortfall. More than $400,000 is raised within 24 hours, and that doesn't include up to $250,000 in matching donations by New York City Mayor Mike Bloomberg.

Komen plays defensive (late at that) claiming that the decision wasn't politically motivated or motivated by anti-abortion views, but insiders claim a different story - that this was motivated by the new hire (Handel).

That you're now seeing other Komen affiliates rebelling against the directive suggests that they see politics in the matter and it undermines their ability to raise funds to ... you know... fight breast cancer.

No matter how you look at this, this whole mess undermines that core mission. Komen has made such a mess of this situation that they can't be trusted on their statements and they will be sure to alienate a significant portion of potential donors no matter what decision they take now (keep the PP funding frozen out, restore it, or some combination of the above). It's a permanent blight on their ability to remain credible.

The charity has taken a word, "investigation", and applied it to political witch-hunts in Congress, and not law enforcement investigations, which is really what Komen ought to be worried about if they're dealing with integrity issues. Congressional investigations are as much about political witch hunts and campaigning as they are about legitimately looking at issues requiring Congressional attention. Planned Parenthood is among the most scrutinized charities in the nation because of the kinds of services they provide, and this is just another excuse to stick it to them.

What really strikes me as particularly galling is that Komen is ignoring actual criminal investigations ongoing at Penn State University, but they continue funding operations there. If this were really about curtailing financing to those entities under investigation, the Penn State funding would have been first up on the chopping block. To me, that says that this was politically motivated, and not merely an attempt to improve Komen's integrity.

Moreover, I have to wonder what would happen if Komen itself came under investigation by Congress for how it spends its money. Would that mean that it would have to divest itself from its monies in the same way that they're acting towards Planned Parenthood?

UPDATE:
In a surprising turn of events, Komen has announced that they will reverse course and will amend their policy to exclude political investigations, which is good news for Planned Parenthood. The whole reason that they sought to exclude Planned Parenthood was precisely because it was the target of a political investigation. Yet, it doesn't mean the end of the mess for Komen though. The fallout will continue for some time to come.

Health Care Reform Law To Go Before US Supreme Court Next Year

The US Supreme Court will take up portions of the health care reform act (Affordable Care Act of 2009) in oral arguments scheduled for March 2012. Its timing will also impact the 2012 elections, as the health care reform is one of President Barack Obama's signature accomplishments. Briefs for both sides, including amicus briefs, are posted on the Supreme Court site.

The oral arguments will focus on the limits of federal power and what the federal government can or cannot prescribe.

On Tuesday, on the other hand, a three-judge panel of the District of Columbia Circuit upheld the law. Judge Silberman, who had grilled Ms. Brinkmann so aggressively, wrote the majority opinion, and his discussion of the limits of Congressional power may have handed the administration a bigger victory than it wanted, because it presumably did not want to win on the grounds that Congress could do anything at all.

Judge Silberman said he remained troubled by what he called “the government’s failure to advance any clear doctrinal principles limiting Congressional mandates that any American purchase any product or service in interstate commerce.”

Then he adopted a version of Mr. Dellinger’s argument.

“That a direct requirement for most Americans to purchase any product or services seems an intrusive exercise of legislative power,” Judge Silberman wrote, “surely explains why Congress has not used this authority before — but that seems to us a political judgment rather than a recognition of constitutional limitations.”

Judge Silberman said there were Supreme Court decisions on issues like regulating the use of medical marijuana that had endorsed broad Congressional power to legislate in the name of commerce.

“It certainly is an encroachment on individual liberty,” he wrote of the health care law, “but it is no more so than a command that restaurants or hotels are obliged to serve all customers regardless of race, that gravely ill individuals cannot use a substance their doctors described as the only effective palliative for excruciating pain, or that a farmer cannot grow enough wheat to support his own family.”

In dissent, Judge Kavanaugh praised the majority for its honesty in describing what followed from its ruling.

“The majority opinion here is quite candid — and accurate,” he wrote, adding: “The majority opinion’s holding means, for example, that a law replacing Social Security with a system of mandatory private retirement accounts would be constitutional. So would a law mandating that parents purchase private college savings accounts.”

My own beef with the mandatory insurance requirement is that the penalty provision is essentially a tax, and the enforcement provisions are carried out through the tax code. The penalties are imposed for people who refuse to sign up for health insurance plans if they are capable of doing so (have income above a certain level).

As written, the mandate requires almost everyone to get insurance or face a fine - $95 in 2014, $325 in 2015 and $695 in 2016 (with a maximum of $2,250 for a family). There is an exemption for low-income people.

This portion could be struck down but the lost revenue generated from the mandate would affect other provisions, including the preexisting conditions clause.

The individual mandate takes effect 2014. The preexisting condition requirement went into effect for children under 19 who are to be on their parents insurance. Adults will have the preexisting condition requirement starting in 2014. You would expect to see a fiscal effect based on the changes already enacted from which one can objectively judge the financial scoring on the health care package.

The health care reform doesn't hit at the core problem with health care delivery in the country - cost. The requirement to force people into obtaining health insurance doesn't reduce the cost of health care to these people. It increases those costs - significantly. The notion that having a greater pool of people paying into health care insurance will lead to overall lower premiums may work, but the costs for health care aren't being contained by any stretch. That will only come through changes not included in the health care reform package.

There's a difference between access to health care and affordability - and the health care reform package obfuscated the two.

So, the Supreme Court will take this matter and issue an opinion within months of the 2012 election, which makes the decision as much a political document as it is a legal one.

Computerized Pathology May Lead To Cancer Diagnosis/Treatment Breakthroughs

Scientists have been working to create computer programs that can help identify and catalog cancers, which involve abnormalities in various kinds of cells in the human body. After researchers taught the program how to identify cancer cells among the slides, they found that the program not only correctly identified cancer cells, but that characteristics of the cancer cells and those of surrounding cells were important to identifying prognosis for recovery.

Once it was trained, Beck et al. used C-Path to evaluate tissues of cancer patients it had not examined before. Again, the researchers already knew the outcome, so they were able to check C-Path’s success rate. Its results were a statistically significant improvement over human-based examination, the authors say.

C-Path even figured out something pathologists haven’t — that the characteristics of the cancer cells and the surrounding cells were both important in determining a patient’s outcome. “Through machine learning, we are coming to think of cancer more holistically, as a complex system rather than as a bunch of bad cells in a tumor,” said Dr. Matt van de Rijn, a professor of pathology and co-author of the study, in a statement. “The computers are pointing us to what is significant, not the other way around.”

This is an impressive result, as Rimm explains it, because existing pathological analysis is a very subjective science. Experts make judgments about tissue metastasis and a patient’s overall chances of survival by simply looking at tissue, and their own diagnoses can vary widely, as a 2008 study showed. But a computer model using thousands of times more criteria could be much more consistent.

Despite this success, C-Path is still a long way from clinical use, the authors say.

Faster please.

Guru of Sports Medicine Finds MRIs Vastly Overused

If you want to find a reason for the high costs for health care, look no further than the overuse of MRIs, says Dr. James Andrews, the doctor who revolutionized sports medicine.

He did a study where he looked at MRI scans of healthy athletes, and found that the scans picked up abnormalities nearly all the time.

“An M.R.I. is unlike any other imaging tool we use,” Dr. Sangeorzan said. “It is a very sensitive tool, but it is not very specific. That’s the problem.” And scans almost always find something abnormal, although most abnormalities are of no consequence.

“It is very rare for an M.R.I. to come back with the words ‘normal study,’ “ said Dr. Christopher DiGiovanni, a professor of orthopedics and a sports medicine specialist at Brown University. “I can’t tell you the last time I’ve seen it.”

In sports medicine, where injuries are typically torn muscles or tendons or narrow cracks in bones, specialists like Dr. Andrews and Dr. DiGiovanni say M.R.I.’s often are not needed — they usually can figure out what is wrong with just a careful medical history, a physical exam and, sometimes, a simple X-ray.

M.R.I.’s are not the only scans that are overused in medicine but, in sports medicine, where many injuries involve soft tissues like muscles and tendons, they rise to the fore.

In fact, one prominent orthopedist, Dr. Sigvard T. Hansen, Jr., a professor of orthopedics and sports medicine at the University of Washington, says he pretty much spurns such scans altogether because they so rarely provide useful information about the patients he sees — those with injuries to the foot and ankle.

“I see 300 or 400 new patients a year,” Dr. Hansen says. “Out of them, there might be one that has something confusing and might need a scan.”

The price, which medical facilities are reluctant to reveal, depends on where the scan is done and what is being scanned. One academic medical center charges $1,721 for an M.R.I. of the knee to look for a torn ligament. The doctor who interprets the scan gets $244. Doctors who own their own M.R.I. machines — and many do — can pocket both fees. Insurers pay less than the charges — an average of $150 to the doctor and $960 to the facility.

MRI machines are a profit center for doctors and those operating the scanners. The machines, which can cost upwards of $250,000 a piece, have utility for certain kinds of illnesses and injuries, but are being overused. When an individual scan can cost $1,000 or more - these costs add up over time.

Indeed, the news report highlights the need for doctors to take a careful and detailed personal history and physical examination rather than relying on scans alone. In one instance, several doctors claimed that a patient had a torn ACL, but if they took a detailed history, they would have known that the patient continued skiing after the apparent injury, which is something that would not have been possible had the ACL truly been torn. It turns out that the patient had a broken bone in his leg.

And patients and defensive medicine plays a significant role in why these MRI scans are being ordered:

Dr. DiGiovanni did a similar study with foot and ankle patients, looking back at 221 consecutive patients over a three-month period, 201 of whom did not have fractures. More than 15 percent arrived with M.R.I.’s obtained by doctors they had seen before coming to Dr. DiGiovanni. Nearly 90 percent of those scans were unnecessary and half had interpretations that either made no difference to the patient’s diagnosis or were at odds with the diagnosis.

“Patients often feel like they are getting better care if people are ordering fancy tests, and there are some patients who come in demanding an M.R.I. — that’s part of the problem,” he said.

Some doctors might also feel they are providing better care if they order the scans, Dr. DiGiovanni said, and doctors often feel that they risk malpractice charges if they fail to scan a patient and then miss a diagnosis.

This is exhibit A as to why health costs are soaring.

NYC Health Department Continues Assault on Soda

Once again, the New York City Health Department is focusing on sodas as the cause of obesity and other health-issues in New York City. It claims that drinking a soda a day would cause someone to consume 50 pounds of sugar over the course of a year.

The health department says drinking one soda a day equals 50 pounds of sugar a year, which can lead to problems like obesity, diabetes and heart disease.

“Sugary drinks are the largest single source of added sugar in the diet, and a child’s risk of obesity increases with every additional daily serving of a sugary drink,” said New York City Health Commissioner Dr. Thomas Farley in a statement.

Cathy Nonas, director of the city’s physical activity and nutrition program, says that 50 pounds of extra sugar can be harmful to the body.

“When we’re looking at a city where there is an epidemic of overweight and obesity and we look at the diseases that are associated with obesity, even in young kids, 50 pounds of sugar a year, of added sugar to rest of the diet, is way too much,” Nonas told 1010 WINS.

That’s why the health department is launching a 30-second TV spot to talk about health issues associated with sugary drinks and to offer healthy alternatives.

A 12-ounce can of Coca Cola contains 39 grams of sugar and 140 calories.

That means 14,235 grams over the course of the year. Converting to pounds, that isn't 50 pounds. It's 31.382803 pounds. Just a wee bit of a difference. It's a huge difference and one that sorely undermines the argument being made against soda consumption.

However, if you're drinking a 20 ounce bottle of Cherry Coke, you would be consuming 70 grams of sugar per bottle, which results in 25,550 grams of sugar over the course of a year; that translates to 56+ pounds of sugar a year.

That discrepancy further shows the necessity of portion control and how size matters when you're talking about food.

But the problem still comes down to too little exercise and too much of a sedentary lifestyle. So the Health Department is fixated on soda when there is little else it can do. It isn't likely to go after steakhouses that offer up monster sized portions. At a time when nutrition experts suggest 4 ounce portions, restaurants frequently serve up portions several times that size. Heck, it's considered a value.

Ultimately, it's up to the individual to decide that it's better to pick a smaller sized food option - portion control and balanced meals are far better than the incessant drumbeat of soda being bad.

Obama Administration To Scrap Portion of Health Care Reform As Too Costly

In response to the realization that a portion of the health care reform package was not going to ever work as hoped, the Obama Administration is scrapping a portion of the package dealing with long-term care programs.

Kathleen Sebelius, the secretary of health and human services, said she had concluded that premiums would be so high that few healthy people would sign up. The program, which was intended for people with chronic illnesses or severe disabilities, was known as Community Living Assistance Services and Supports, or Class.

“We have not identified a way to make Class work at this time,” Ms. Sebelius said. She said the program, which had been championed by Senator Edward M. Kennedy, Democrat of Massachusetts, was financially unsustainable.

Kathy J. Greenlee, the assistant secretary of health and human services in charge of the program, said: “We do not have a viable path forward. We will not be working further to implement the Class Act.”

This is a huge setback on the supposed cost savings anticipated from the overall health care reform package. Of the $210 billion in deficit reduction due to health care reform, $86 billion was attributed to the CLASS program. It's only going to add fuel to the fire that Congressional Republicans have been grousing about with the workability of the entire program.

The reason that the program is being shelved is that the premiums would have been too high and too few healthy people would have signed up to make the program work as intended.

That's a problem with all too many portions of the health care reform package - including the portions of the package that imposes penalties on people or businesses who refuse to sign up for health care insurance if they don't already have it.

Light The Night Kickoff

This weekend, I had the honor to attend the 2011 Light The Night Walk kickoff event for Red Bank, New Jersey. The Red Bank walk in the newest location in New Jersey to host a Light the Night Walk -- this is the third year for this location. As I explained in an earlier post, Light the Night is the oldest walk to raise money for cancer research.

At the kickoff event, we heard some additional information regarding the new treatment breakthrough for chronic lymphocytic leukemia, or CLL. Lawhawk posted about this last week. This new therapy essentially takes cancer T-Cells, infuses them with a new protein and reintroduces them into the body. The new infused cells begin to attack the cancer cells, and most excitedly, get the bodies existing cells to fight the cancer as well. Currently, two patients are more than 1 year cancer free, with a third approaching 1 year. When they get 12 patients cancer free for 1 year, the procedure will be considered for approval.

The reason for the discussion at the kickoff was that the Leukemia and Lymphoma Society has donated more than $50 million to this research over the years. Over that past several years, the FDA has approved 19 new drugs and therapies for blood cancer -- all with the assistance of the LLS. Of the 19, 12 have been approved or are being studied for the treatment of other forms of cancer as well. That is remarkable.

I was watching a baseball game the other day and a commercial for the MLB's involvement with Stand Up 2 Cancer came on (anyone who saw the All Star Game, the Stand up 2 cancer half inning display was chilling.) They splashed two stats on the screen that shook me. 1 in 3 women and 1 in 2 men will get cancer. The numbers are staggering. With respect to blood cancer:
• Every 5 Minutes: Someone in the United States learns that he or she has leukemia, lymphoma, Hodgkin’s disease or myeloma.
• Every 10 Minutes: Another child or adult is expected to die from a blood cancer.

This is why I renew my plea to all our readers and donations to the Light the Night Walk can be made through the link on the top left of the page, or by going to my team page . Any amount of support is greatly appreciated. By donating, you are not only helping to cure blood cancers, support caregivers, assist patients with purchasing drugs they could not otherwise afford, but you are indirectly supporting research that is going to treat and cure other cancers as well.

The 2011 Leukemia & Lymphoma Society’s Light the Night Walk

A few weeks ago I asked Lawhawk to place a widget on this page to donate to the Leukemia & Lymphoma Society’s Light the Night Walk. The Light the Night Walk is the oldest walk to raise money for cancer research and patient care. For those who have not attended one, the Light the Night Walk is an inspirational event, where thousands of people walk holding colored balloons with lights (red to honor someone, white for survivors and gold in memory of a loved one.)

Last year, I became personally involved with the LLS when my wife, while 29 weeks pregnant with our second child, was diagnosed with a rare form of Non-Hodgkin’s disease called Primary Mediastinum B-Cell Lymphoma. Essentially, a 10-centimeter mass had grown in her chest, above the lung, next to the heart and was effecting her breathing and blood flow. Because of the size of the mass, she required immediate treatment. She received two rounds of chemotherapy while pregnant, gave birth to our son at just shy of 36 weeks, and then continued for 4 additional rounds of chemo, followed by 17 rounds of radiation.

Since her diagnosis, both of us have become involved with the LLS. The LLS provides funding for research, support for patients who cannot afford medication, as well as patient and care-giver counseling and information. LLS is proud that over 72% of every dollar received goes directly toward the mission: To cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of life of patients and their families. However, the statistics are startling:

• Every 5 Minutes: Someone in the United States learns that he or she has leukemia, lymphoma, Hodgkin’s disease or myeloma.
• Every 10 Minutes: Another child or adult is expected to die from a blood cancer.

Without support from the LLS, drugs like Rituxan (one of the main drugs in my wife’s regiment) and Gleevec (dubbed the “miracle drug” for Chronic Myeloid Leukemia) may never have hit the market. Thanks to the LLS, and support from its donors, people who cannot afford these drugs receive financial support. Patients, families and care-givers, have a place to turn for information, support or just someone to talk to.

Thankfully, for us the treatments worked. My wife is now in remission and our son, who just turned one, suffered no ill-effects from the chemo. She has also been honored by being selected as one of the 2011 Honored Heroes (http://www.lightthenight.org/nj/localchapter/patients). From what I was told by members of the selection committee, she was a unanimous, and virtually instantaneous, selection.

If any of you are so inclined, donations to the Light the Night Walk can be made through the link on the top left of the page, or by going to http://tinyurl.com/3v9w22m. Any amount of support is greatly appreciated.

For more information on the Leukemia & Lymphoma Society please go to www.LLS.org.

For more information on the Light the Night Walk, to join a walk in your area or to see a message from this year’s Ambassador, Michael C. Hall (himself a Hodgkin’s Lymphoma survivor), please go to http://www.lightthenight.org/.

Thank you for your support.

Will Zadroga Act Cover Cancer?

That's the multibillion dollar question being asked after a report released by Dr. John Howard, the director of the National Institute for Occupational Safety and Health, found no connection between exposures at Ground Zero and any multitude of cancers that Ground Zero responders believe to be caused by that exposure.

But the report, released by Dr. John Howard, the director of the National Institute for Occupational Safety and Health, said that there was very little evidence to go on, as there have only been 18 published research studies on the attack that even mentioned cancer, and only five of those were peer-reviewed. The results of the peer-reviewed studies were mixed.

Even if it appeared that the events of 9/11 caused cancer in certain people, it would be hard to prove because cancer is widespread in the general population. In the United States, the probability that a person will develop cancer over a lifetime is one in two for men and one in three for women, the report said.

“Drawing causal inferences about exposures resulting from the Sept. 11, 2001, terrorist attacks and the observation of cancer cases in responders and survivors is especially challenging since cancer is not a rare disease,” the report said.

The report was required by the James Zadroga 9/11 Health and Compensation Act, which took effect on Jan. 2; it provides $4.3 billion over the next five years to monitor, treat and compensate people who were exposed to the fumes and dust.

The act provides treatment and compensation for a specific list of illnesses, mainly asthma and other respiratory diseases. As part of a political compromise needed to pass the bill, cancer was not included. A provision of the law, however, specified that the administrator of the National Institute for Occupational Safety and Health would periodically review the evidence to determine whether cancer, which could be one of the most expensive illnesses to treat and compensate for, should be added to the list.

This goes to basic epidemiology. Scientists have to look at the specific incidence of a given disease and determine whether there is an increased rate. Then, they have to see whether there's more than a casual connection with exposure at Ground Zero.

The NIOSH will periodically review the findings, but it will take further studies to show that there's an actual cancer link between 9/11 and the responders' incidence of cancer. So, while a link hasn't been shown to date, this doesn't mean that within the next several years that the link wont be proven.

All this is cold comfort to those who are suffering from cancers they believe were the result of service at Ground Zero following the 9/11 attacks, and who believed that they would be covered by the Zadroga Act.

Dr. Howard may be the official responsible for not including cancers among the compensated illnesses, but that doesn't mean that other doctors treating Ground Zero responders aren't finding a connection.

Dr. Philip J. Landrigan, head of a 9/11 treatment, monitoring and research program at Mount Sinai Medical Center, said Tuesday that the possibility of cancer in the responders increases as time goes by. Mount Sinai, he said, is tracking the rates of 60 different cancers, and will be feeding that information to the federal government.

Dr. Landrigan said his researchers were looking especially hard at multiple myeloma, because they had already found eight cases — an unusually high number — in responders younger than 45. Usually, he said, myeloma is found in people who are older.

Landrigan and his fellow doctors have to publish their findings and get others to confirm those findings, before it can be added.