Maryland how I love thee

I’m so proud of my home state for affirming equality for all in the ballot box rather than in the courts. I was born and raised in Maryland, although I’ve spent more of my adult life in Virginia, one of the big things I’ve noticed in the divide between the two states (and I love both of them) is that Marylanders do a better job at taking care of each other, and running an effective state with high quality services. Marylanders believe government can work, and generally (outside of Baltimore) it does. Marylanders also reject bigotry, and with question 4 (the Maryland Dream act) and question 6 affirming the rights of LGBT to marry, I’m so proud of my state for rejecting bigotry and electing to give everyone a chance at the dream.

Another lesson learned from this election is to follow Lincoln’s advice, “it’s better to be quiet and be thought of a fool than to open your mouth and remove all doubt.” Moron fundamentalists’ ideas of how lady parts work and divine rape plans have been extraordinarily costly for the Republicans, and provide hope for the future that voters will reject some of the truly contemptible unscientific beliefs of these bigoted old men running our government. I’m pleased to see there might be an actual limit on the incredibly stupid things one may say, and still expect election to congress. So remember Republicans, you can’t piss off the ladies and expect to keep winning elections. They need to shape up, or at least keep their incredibly stupid ideas to themselves. As women represent more and more of our delegations to congress, hopefully statements like Akin’s and Mourdock’s will just be embarrassing historical footnotes. Although, the continued presence of Michelle Bachmann is reminder that being female is, of course, no protection from believing incredibly stupid things.

Did anyone else snort when Romney mention the “enduring principles on which our society is built” and the first he listed was honesty?

Finally, I’m very curious to see the effect of the decision by Coloradoans and Washingtonians to openly defy Federal law and legalize, not just decriminalize, marijuana use. In this second term of a moderate Democratic president, will this showdown over drug laws finally result in a pull-back in the drug war? The amount of money, time, and jail-space devoted to criminalizing marijuana use is a national disgrace. Maybe these state reversals of marijuana prohibition will result in a more mature national conversation on drug policy?

This election has left me optimistic we will take the right steps to shore up our economy, make the right policy on healthcare, and increase the investment in science and research, which are my priorities. It’s been a good day.

Holy cow, yet another conspiracy theory!

This has been a year of some wonderfully crazy new conspiracies. Birtherism is actually looking pretty banal next to the “Obama is gay-married to a Pakistani” conspiracy, the “Obama is a Jihadist sleeper agent conspiracy, the Aurora conspiracies, job numbers conspiracies, polling conspiracy theories from America’s least-accurate pollster Dick Morris, and, my former favorite, the Obama is buying bullets for the Social Security Administration to kill all Americans conspiracy theory.

Now the American Spectator is publishing a new crackpot conspiracy theory that I think rivals my former favorite. It’s “the media has a secret backchannel where they discuss their plans to get Obama re-elected conspiracy”. And who is the proof this conspiracy theory is at work? Candy Crowley!

Shortly after Obamacare was passed and signed by the President, Michael Tanner of the Cato Institute noted a sudden plethora of articles that had begun to appear in a wide variety of MSM outlets about the probable ill-effects of “reform.” This prompted him to ask, “Where were these reporters before the passage of the health care bill?” The answer to this question is now pretty obvious. They were colluding, via JournoList and other such forums that we don’t know about, to make sure that no one screwed up and told the truth before that morass of taxes and regulations became the law of the land. To the nation’s cost, their self-censorship succeeded.

Today, we face a similar but much more dangerous situation. The “reporters” of the establishment news media are engaged in a concerted campaign of misinformation to get Barack Obama re-elected. This has been evident for some time, but the breathtaking mendacity of this effort was writ large by Candy Crowley during last Tuesday’s presidential debate. Everyone has by now seen the video clip: the President made the preposterous claim that he had identified the attack on our Benghazi consulate as an act of terrorism as early as September 12. Then, when Romney called him on this egregious whopper, Crowley repeated the lie.

Wowzers. It’s hard to continue to debate with a conspiracy theory that is dependent on questioning such an easily verifiable fact. For the record, the transcript from Obama’s speech on the 12 reads:

No acts of terror will ever shake the resolve of this great nation, alter that character, or eclipse the light of the values that we stand for. Today we mourn four more Americans who represent the very best of the United States of America. We will not waver in our commitment to see that justice is done for this terrible act. And make no mistake, justice will be done.

or you can watch the video:

To believe that Obama was talking about some other act of terror other than Benghazi is highly disingenuous as the very next sentence refers to “four more Americans” that died as a result of this “terrible act”. But I suppose it’s possible, if you are reading at a fifth grade level or something, you could think he was still referring to 9/11. That might make sense, and Romney then might have a valid claim about “14 days” until the relatively meaningless distinction is made, except the very next day Obama says it’s an act of terror again.

Let me say at the outset that obviously our hearts are heavy this week — we had a tough day a couple of days ago, for four Americans were killed in an attack on our diplomatic post in Libya. Yesterday I had a chance to go over to the State Department to talk to friends and colleagues of those who were killed. And these were Americans who, like so many others, both in uniform and civilians, who serve in difficult and dangerous places all around the world to advance the interests and the values that we hold dear as Americans.

And a lot of times their work goes unheralded, doesn’t get a lot of attention, but it is vitally important. We enjoy our security and our liberty because of the sacrifices that they make. And they do an outstanding job every single day without a lot of fanfare. (Applause.)

So what I want all of you to know is that we are going to bring those who killed our fellow Americans to justice. (Applause.) I want people around the world to hear me: To all those who would do us harm, no act of terror will go unpunished. It will not dim the light of the values that we proudly present to the rest of the world. No act of violence shakes the resolve of the United States of America.

Talking about these deaths he again describes it as an act of terror, unless of course, you think he just threw that in there as a red herring. He just randomly inserts “act of terror” into speeches about healthcare I’m sure. But why this is my favorite new conspiracy theory is because there actually are people who think a defunct online Google forum is evidence of left wing journalists’ attempts to rule the world.

For those that are interested, the reference to “journolist” is this now defunct chat group of which many prominent left-leaning journalists shared often impolitic statements about people in the news. Ezra Klein even tried to bring in Tucker Carlson just to allay the crank conspiracy fears about journalists *gasp* socializing online. We even used to have one here at scienceblogs where we would, yes, even coordinate posts, but mostly it was a forum for invective, like most online forums. Snore. Anyway, for the conspiratorial mind the existence of such a group combined with a few cherry-picked offensive statements is proof enough for an illuminati-style conspiracy of the MSM to rule the world. At worst, it seemed to include what I thought were appropriate reactions to the Jeremiah Wright story, which could be summed up by, “this is crap, we shouldn’t even cover it, it makes us all stupider.” The most obvious question raised by such a non-parsimonious conspiracy theory is do you really think that if journalists were engaged in a conspiracy to control the MSM, would the gateway to this super-secret and all powerful Google group be a mouse-click by Ezra Klein? And would Ezra Klein, being the mastermind of this great conspiracy, be exercising good judgment by inviting Tucker Carlson to join and telling him all about it?

I have something for people who think this is proof of a conspiracy:

The tinfoil hat!

Conspiracy-targeted Campaigning from Romney

Slate has an interesting article about Romney campaign mailings that appear to contain buzzwords for chronic Lyme disease advocates in Virginia. Romney’s plan for Lyme disease includes these two points:

Ensure that government agencies have an open line of communication and work with patients, researchers, doctors, and businesses in an objective, comprehensive manner.

Encourage increased options for the treatment of Lyme Disease and provide local physicians with protection from lawsuits to ensure they can treat the disease with the aggressive antibiotics that are required.

Note the “aggressive antibiotics” line. This refers to a bogus medical practice of prescribing long courses of antibiotics, often in IV form, for “chronic Lyme” syndrome. While people can have chronic complications of actual Lyme disease, another, crankier disease entity has been promoted by irresponsible doctors who treat a syndrome similar to fibromyalgia, or chronic fatigue, or maybe even depression, with long-term IV antibiotics. These treatments are administered at their own clinics, usually without insurance paying for it (insurance companies can smell this BS and won’t cover it), at great expense because IV antibiotics cost a lot more to administer, and often without evidence of Lyme infection by tests or history.

This has been a season of bizarre political conspiracy mongering with everything from birtherism from Mitt Romney, Sheriff Joe’s craziness, magic Kenyan Telegrams, Aurora conspiracies, job numbers conspiracies, polling conspiracy theories from America’s least-accurate pollster Dick Morris, and my favorite Obama is buying bullets for the Social Security Administration to kill all Americans conspiracy theory. Now, rather than coming up with Obama conspiracies it looks like they’re trying to solicit vocal conspiracy theorists who think the pharma/CDC/infectious disease society illuminati are trying to suppress a bogus diagnosis their doctor has successfully treated by emptying out their wallets.

It’s very sad, really. People with a legitimate medical disorder, likely along a similar spectrum with fibromyalgia and chronic fatigue that have a disordered sense of pain perception, are being exploited by quack physicians who directly profit from a dangerous course of powerful antibiotics. Antibiotics are not benign drugs, and should not be used carelessly, as they too often are. And the non-evidence based used of megadoses of these drugs, often without any actual evidence of infection should result in a campaign to revoke these physicians’ licenses, not to solicit their votes by hinting at support of quack medical theories and protection of irresponsible physicians from liability. Is this a new all time low for a political campaign?

Welcome Back to Denialism Blog

Despite rumors to the contrary, I am not dead. Instead I’ve been working hard as a new surgical intern and sadly not finding the time to write for the denialism blog. However, now more than ever, it seems that we need to talk about the problem of denialism.

Two major new issues for denialism have cropped up, and both are major new forms of political denialism. The first, I’ll broadly describe as Obama-denialism. Obama is a muslim, Obama was not born in the US, there is a giant conspiracy involving the Hawaii Secretary of State, the Democratic Party and muslims worldwide to take over the US government with a madrassa-trained presidential double agent etc. These are of course nonsense. FighttheSmears a website created by Obama supporters has most of the more ridiculous rumors debunked, including the absurd birth certificate/birther conspiracy theory. appropriately mocking LA Times blog entry. Whatever. As readers of denialism blog, it should have been clear from the get-go that this is just the usual conspiracist-drivel propagated by people who are upset at having a black president, and, just like the truthers, holocaust deniers, AIDS denialists, or any other group driven by racism, paranoia or just plain stupidity they won’t be satisfied by any evidence that contradicts their illogical conclusions. The format of the arguments is prima-facie absurd. The conspiracies are non-parsimonious, and lead immediately to more questions that just don’t make any sense. Despite this, bigots and crackpots like Fox News and Lou Dobbs “cover the controversy” to keep it stirred up. We must address it for what it is, closet racism and sour grapes over losing an election.

The second major issue, even more distressing to me now that I’m fully immersed in our health-care system, is that of universal health care denialism. Most upsetting to me was pronouncements like that of Sarah Palin that health care reform will lead to “death panels”. This is where the political opponents of progressive governance have crossed the line from the usual political ignorance and lies to truly despicable tactics designed to sink health care reform at any cost. The reality of the language originally in the bill was that it was designed to encourage physicians to have end-of-life discussions with their patients by paying them for such consultations. This is an area in which our health system currently fails miserably to the detriment of our patients. We truly need to have all patients interacting with our health system to have frank discussions about their wishes at the end of their lives, to have living wills, and make their desires for their level of intervention clear before they end up in the ICU, on a ventilator, and having invasive treatments performed ad nauseum that they may or may not approve of if they were able to communicate their wishes. But no, the political opponents of health care reform have instigated a scorched-earth policy, and even something as noncontroversial as asking people what they want their physicians to do when they’re sick has been thrown under the bus by the denialists. Other lies? Universal health care reform will turn us into communist Russia! A belief inconsistent with the fact that every other country in the industrialized world has survived the conversion to universal systems without requiring Stalinist dictatorships to enforce the dastardly public option. These arguments transcend mere denialism and can only be described as ideological insanity.

There is a legitimate debate to be had over health care, but we clearly are not having it. One legitimate question is how do we pay for it? I’m confident that reform will pay for itself and it is more expensive not to have universal access. As we discussed in our health care series, every other country in the world has accomplished this feat, provide equivalent or measurably better care in terms of access, health of populations, and life expectancy. Despite their universal coverage they all spend less than half as much per capita than the US on health coverage. Having people access the system in our ERs, lacking preventative care, and failing to provide the universal inexpensive interventions costs more than just providing care to people. After all, we already pay for the uninsured, hospitals and doctors are ethically obligated to provide care for everyone who walks in the door, insured or not. The costs of covering the uninsured are already built into our excess costs. Worse, having a administrative system designed to deny care is costly and unnecessary. The “privatization” or “subcontracting’ of medicare administration under Bush increased the cost of healthcare administration by 30% in three years despite the number of patients covered increasing by only about 4%. Paying for things in a planned, thoughtful and systematic way is cheaper than allowing problems to stew and boil over. I’ve already had way too many patients showing up in the ER with disastrous and expensive health problems requiring a huge expenditure of resources that if they had been addressed early would have cost next to nothing. And yes, they always tell me they didn’t get it addressed before it was critical because they lacked insurance. This is stupid and not the kind of care I want to be providing. Another legitimate question is will universality damage our technological and research prowess? Again I believe the answer is no. The US has excellent technology and research because we pay for it through government agencies like the NIH. The technology won’t go away because that has more to do with the culture of our healthcare system than the fact that we have oodles of money to pay for it (because we don’t really). It’s also not a fact that our technology necessarily makes our care better. CT scans, and MRIs are not as important to provision of health care as having ready access to services and adequate access to primary care physicians and preventative care. Another good question, is a public option necessary? Again I believe not. While I believe countries that provide a public option like Australia are ones on which we may model our system, other countries such as the Netherlands or Germany have developed excellent healthcare systems through insurers by tightly regulating them and not letting them screw their citizens. Here’s a great question, would anyone under these systems choose the US one? As evinced by the commentary from our health system, the critics of universal healthcare are speaking from ignorance when they claim citizens of other countries are suffering in their systems. The data we presented, and reinforced by commentary from all over the world, was that these systems have problems, but no one in their right mind would trade them for the US system.

Let’s get back to having a public debate that is not overwhelmed by the ideological fanatics and deniers and instead focus on the very real and critical problems that this president was elected to address. The denialists and their scorched earth tactics have done a great deal of harm to our debate on reform. Now more than ever, we need to talk about the difference between denialism and debate.

Lifting the stem cell ban – was there any point?

President Obama has lifted the ban on embryonic stem cell research enacted by Bush, but I’m left feeling that this intervention came many years too late.

Pledging that his administration will “make scientific decisions based on facts, not ideology,” President Obama on Monday lifted the Bush administration’s strict limits on human embryonic stem cell research.

But Mr. Obama went on to say that the majority of Americans “have come to a consensus that we should pursue this research; that the potential it offers is great, and with proper guidelines and strict oversight the perils can be avoided.”

In making his announcement, Mr. Obama drew a strict line against human cloning, an issue that over the years has become entangled with the debate over human embryonic stem cell research.

As someone who works with stem cells I find this largely an empty, symbolic act, but one that needed to be done anyway. The reality is the damage was done by Bush already, and we’re fortunate that it was only a temporary delay in some of the most important research humans have developed to date.

What a lot of people don’t realize is that in 2006 a revolutionary result was discovered by Japanese scientists led by Shinya Yamanaka at Kyoto University. What they found was the reset button for mammalian cells, the genes that need to be expressed for a cell to revert to a pluripotent state. We wrote extensively about what results in these cells – induced Pluripotent Stem Cells or iPSC – mean for stem cell research and regenerative medicine overall. Basically, the ability to reprogram the cells of any individual to a totipotent state – one in which the cells may make any cell-type or tissue in the human body. Before some fool suggests this was due to Bush remember it was a Japanese group, the research started long before Bush, and it never would have been possible without ES cells from which they culled the critical genes for the transformation.

So why does it matter that Obama has reversed this policy? Not only are ES cells inferior compared to iPSC for human therapies, but wouldn’t it be easier not to upset the fundamentalists that would equate the value of our lives to that of a ball of undifferentiated cells?

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