People have different perceptions of what is or is not constitutional. Some people believe that the Constitution explicitly lists everything the federal government is authorized to do, and thus if it is not listed (health insurance legislation, a census that asks for more than a count of people living at an address) then it is not constitutional. Others embrace a broader interpretation, using things like the “promote the general welfare” text from the preamble as justification for federal government involvement in these areas.

In my opinion, the best claims of unconstitutionality are related to the absence of any explicit reference to health insurance in the Constitution (or subsequent amendments) and the ninth and tenth amendments.

Ninth amendment: “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” Thus a right to choose for yourself or your family health insurance would seem to me to belong to the people, not the government. In fact, if the Massachusetts plan requires all to have insurance as I’ve heard recently, I don’t know why this amendment couldn’t be used to rule it unconstitutional. There is quite a big step from regulating business for the common good and requiring private citizens to purchase a product (even one as intangible as insurance).

Tenth amendment: “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” The history of health insurance in this country is that it is regulated by state governments, not the federal government. I believe that provides at least a de facto basis for a claim that health insurance regulation is not a power of the federal government. Note: The Supreme Court rarely if ever uses this amendment to rule anything unconstitutional, so I’m not holding my breath.

Regarding the preamble text: two phrases appear immediately next to each other. One is “provide for the common defence”, and the other is “promote the general welfare”. I have always found it interesting (in the context of those who would use the “promote the general welfare” phrase to justify something like health insurance reform by the federal government) that the Constitution says to *provide* *for* defense but to *promote* *general* welfare. The most appropriate definition I found for “provide” would be “take measures in preparation for”. “Promote” is most appropriately defined as “to advocate or urge on behalf of something or someone”. If the federal government was meant to provide things necessary for the general welfare of the people of the United States, why wouldn’t the Constitution say so? It had no problem using the word “provide” in the context of defense. Thus I believe the choice of “promote” in the context of welfare to be a deliberate effort to differentiate the concepts.

Finally, requiring all people to buy health insurance doesn’t seem to be an effective way to secure the blessings of liberty to ourselves or our posterity. Though I guess an argument could be made that it liberates us from crushing expense due to health care costs, but that just doesn’t feel to me to be the type of liberty they were aiming for.

Ultimately, there are exactly nine people that will have a say into whether or not this legislation is constitutional. In the meantime we all get to rant about how evil it is or how much of a blessing it is or sit back and watch all the wacky people on both sides. :)

Many people are critical of the government response because the swine flu vaccine is believed to have killed 25 people, whereas the swine flu (if that’s what it really was!) only killed 1 person. That’s 2400% more people who died from the vaccine than the disease! How can any rational person possibly think it wasn’t a deliberate conspiracy on the part of the government and the pharmaceutical companies? This (or variations thereof) appeals to the intuition of a lot of people.

Unfortunately, intuition is not logic. Think about it this way: 40 million people got the vaccine. The death rate in 1976 was 8.8 people per 1000. So, (if I’m thinking this through correctly) assuming a random distribution (which is probably not a good assumption, but let’s go with it for the moment), approximately 352,000 people out of that 40 million died in 1976. The 25 who died from the vaccine were less than 0.008% of the people who died, and less than 0.0000625% of the total people vaccinated … those numbers are both less than the margin of error of any statistical analysis I’ve ever seen.

Plus, not all 25 people died within a year of that. At least one woman died in 1982, five or six years after the fact. So the real annual increase is somewhat less.

Plus plus, from what I’ve read, a disproportionate number of elderly people got the vaccinations, a group of people at much higher risk to the disease as well as complications from the vaccine.

Do any of these numbers make the deaths any less tragic? Of course not. However, it is possible that the 40 million who were vaccinated (over 18% of the country at the time) eliminated many potential infection vectors. It’s also possible that it made no difference. We’ll never know.

Me? I think the government probably overreacted. I also think they were damned if they did go ahead with vaccinations and no one died of swine flu (even though that is the intent of the vaccine!) and damned if they didn’t go ahead and there was a massive outbreak.

Many people (the well intentioned as well as those who just want to make a name for themselves) fail to take into account (unintentionally or otherwise) that there is a mortality rate associated with everything. Vaccinations have a mortality rate, which is generally quite a bit lower than the mortality rate of the disease it is designed to prevent.

That being said, I know there are a lot of kooks out there (many of which listened to the radio station I once worked at) who have never seen a single person suffering negative effects from an artificial sweetener. These same people will insist everyone who touches the stuff is going to die Die DIE! Or even better, that artificial sweeteners were deliberately engineered to make the populace docile and easily controlled! Note that it doesn’t matter which artificial sweetener is referenced. There is a group out there actively trying to smear it.

Anyway, the topic came up with my sister specifically in regard to sucralose. There is a group of people out there that think it is the worst thing you can put in your body. My sister didn’t say that, I’ve just read some of their crap online.

The biggest argument I’ve seen against sucralose is that it contains chlorine, and chlorine is a poison! Never mind the fact that it is one half of sodium chloride, which is essential. The process of replacing one part of the sugar with chlorine in the sucralose process changes it, making it a stable, safe-for-consumption product.

Note: I will add the disclaimer “safe-for-consumption as far as we know”. Times change, new research can come forward and change what we know. Kind of like how eggs are healthy one day, unhealthy the next, and ok the third. :) On the other hand, I certainly don’t think it is harmful to avoid artificial sweeteners, so more power to you!

My sister has been told that, because she does other things that aren’t good for you, she shouldn’t sweat the artificial sweeteners. That’s like saying because diabetics can’t avoid 100% of sugar, they shouldn’t bother reducing their sugar intake!

That being said, here is a funny story: My first job in high school was as a telemarketer for a fund raising operation. One day I was going to a vending machine to get something to drink and offered to pick up something for anyone else. A girl working in the office, who smoked, said she would like something, but was adamant that it not contain saccharin, as saccharin causes cancer. I couldn’t keep from laughing, which caused her to blush and stammer some rationalization.

Frankly, I agree with her that saccharin should not be consumed, but it has nothing to do with the cancer causing potential (which they’ve backed off on in recent years). I just think saccharin tastes like crap and doesn’t belong anywhere near my taste buds.

I’d like to meet the person who tasted saccharin and thought “this is like sugar” and give them a swift kick in a painful anatomical location. I think salt is a better sugar substitute!

Fast forward about 9 years. I developed a really bad case of strep throat. My dad took me to the ER, the doctor identified it as strep, and asked if I’d had my tonsils out. I thought “Isn’t it obvious?” but answered “Yes, why?” He said there had been some regrowth of the tonsil tissue, but that it wasn’t anything like normal healthy tonsil size. Interesting.

Over the next 16 or so years, my rate of strep infection gradually went up. From once a year, to twice, to thrice, and so on. Finally as I was approaching 30, I had an 8 week window where I came down with 4 separate infections. I’d take the antibiotics as prescribed, but in less than a week after getting “better” I’d be right back to the doctors office. I got really good at self diagnosis of strep vs a regular sore throat.

Several times over the years I had asked doctors if having another tonsillectomy might help, and the idea was always dismissed out of hand. I finally asked the latest doctor, who also dismissed it. I then recounted the above to him, he looked at my throat again, said “You’ve really had these out before?” and gave me a referral to an ear/nose/throat specialist after I said yes.

That specialist took one look at my tonsils, horribly scarred from previous surgery & years of repeated infection, said “you poor guy”, scheduled a surgery, and wrote me a refillable prescription for antibiotics so I wouldn’t have to come in every time I had a recurrence. I think I had to use it twice before surgery (a few months out).

I’ve had maybe two infections in the 10+ years since that second surgery, and they’ve never been as bad as before.

Anyway, the point I had originally intended to make. While at BYU, I had one of those infections and went to the health center for treatment. I just *knew* I had strep. A quick strep test came back negative. I told the doctor I was pretty sure I had strep, and he was kinda rude about telling me he was the doctor and knew what strep was, but it successfully bullied me into second guessing myself. I waited through two more weeks of continual and building pain before I finally went to UVRMC’s ER. The ER doctor took a culture (rather than the quick test) but gave me antibiotics on the spot and said my self diagnosis was pretty good. He also indicated that there are things that can interfere with the quick test that I may have done in trying to self treat before going to the doctor originally (throat spray or some such, it’s been a long time). From this I learned doctors are not perfect and the value of a second opinion.

Sometime later (but before the second tonsillectomy) I had to go in for yet another infection. They did the quick test and it came back negative. The ER doctor prescribed antibiotics anyway because:

1. A visual inspection showed it obviously to be an infection.
2. There are bacteria that are just as bad or worse than strep that wouldn’t show in a quick strep test.
3. Even if it was viral, that often creates an opportunity for bacteria to take hold that they wouldn’t normally have in an otherwise healthy person, and antibiotics can help stave that off.

In conclusion, I understand that antibiotics are not a universal cure all and can’t help a range of problems. However, you live with your body 24/7, and the doctor doesn’t (especially not a health center or ER doctor you don’t see regularly). You may not have a medical degree, but you know what is normal and abnormal to a large extent with yourself. If you go to a doctor and think the diagnosis is off, don’t be afraid to push back (politely, of course) and/or seek a second opinion. You might be wrong ultimately, but you might inspire the busy doctor to look a little deeper than he otherwise would have and come to a different conclusion with additional facts.

The media is now reporting that she is well on the road to recovery, and have shown pictures of her in her current state:

Isabelle Dinoire at a press conference regarding her partial face transplant. (Photo: EPA)

As you can see, she’s not 100% better yet, but it is truly remarkable. Some facts I found interesting:

• The attack was by her own dog after what may have been a suicide attempt (or at least an overdose of sleeping pills).
• She felt no pain when she woke up and didn’t realize exactly what had happened until she looked in the mirror.
• She’s resumed chain smoking, a habit she’d been forced to kick for about six months prior to the surgery.
• She was able to eat normally again just a week after the surgery (before the surgery she could only open her mouth about a tenth of an inch).
• Her body tried to reject the transplant during December, but the rejection was successfully countered with immunosuppression medications.

As I was looking up information on this story to post this followup, one head line from Google News jumped out at me:

Face transplant woman improving by the fag.

She remains in hospital in Amiens, where Devauchelle said she spends her time knitting, exercising on a bicycle and smoking. “She smokes fag after fag. It’s not perhaps the best thing she could be doing – but it’s her choice,” the doctor said.

Ah, blessed double meanings… Can you say “C’est la vie?” I knew you could.

ABC News is reporting that a French woman has received a partial face transplant (the first of its kind, apparently.) While the article goes into some discussion of the ethics and the science (very shallow discussions, but discussions nonetheless), that’s not what I found really interesting…

When I clicked that very same link to view the article, there was an advertisement on the page. No big deal, that’s the way the web works. Except when I clicked on it, the ad shown was for Microsoft Office and included this picture (it’s the first thing I saw):

Screen capture of ABC News face transplant article scaled to 400 x 300 and lossily compressed with JPEG.

For ABC News, an unfortunate choice of ad placement. For me, a hilarious choice of ad placement.

Note: I captured the screen, cropped it to 800×600, scaled it to 400×300, and saved it as a jpeg; no other editing took place. If you’d like to see the losslessly compressed version (a png file), click here.