Pharyngula

Posted by: The Science Pundit | October 11, 2009 2:52 PM

Linda Bergthold went off on Maher over this at--of all places--The Huffington Post!

Posted by: rock-biologist | October 11, 2009 2:59 PM

A rule of thumb is when people on opposite poles of the political spectrum agree on something (see Glenn Beck and Bill Maher agreeing that the 9/11 Truthers are nuts), there's a good chance it's correct. Good to hear this, although it was disappointing that Frist ducked talking about evolution, right after citing the New England Journal of Medicine.

Posted by: idle.pip.verisignlabs.com | October 11, 2009 3:04 PM

American medicine is pretty good... As a canadian, I wish we had the same type of doctors and hospitals that you yankees have. I wouldn't, however, like the health care system, with the ridiculous insurance schemes. I agree with Frist on this entirely. I don't think he is crazy to assert that.

Posted by: marcusau2 | October 11, 2009 3:15 PM

I too was shocked to see that Bill Maher made Frist look sensible when I watched this as it aired. I listened to PZ's podcast with the Nonprophets where they discussed Bill Maher's nutty views on medicine and germ theory. I agree that he needs to be confronted and doesn't need to be allowed to represent the thinking of members of mainstream atheist/secular organizations that advocate skepticism and critical thinking.

I love Maher's willingness to speak out against the power structure when no one else has the courage, but he has gone too far. I think the flaw in thinking that many of we liberals have is in some of our critiques of power. Instead of attacking elements of corruption in the Health Care/Pharmaceutical industry, Maher views the entire industry as a sham that not only is corrupt but is manipulating people and making them sick. 9/11 truthers do this as well but it's perplexing that Bill Maher becomes so outraged at 9/11 truthers to the point of throwing them out of his audience but can be taken in by a no less nutty conspiracy theory. We secularists should be very cautious in our associations with this man.

Posted by: Knockgoats | October 11, 2009 3:26 PM

What a dangerous, irresponsible idiot Maher is. After seeing this, I agree with Orac that whatever the fallout, Dawkins should have refused to give him the AAI award.

Frist is probably right that the health care system is not the main factor in poor US health outcomes (as opposed to excessive costs, where it certainly is). The main factor is income inequality: The Evidence: Health.

Posted by: SC OM | October 11, 2009 3:32 PM

After seeing this, I agree with Orac that whatever the fallout, Dawkins should have refused to give him the AAI award.

I was just thinking the same thing. I don't think the people who selected him - who didn't do their research and made a huge error - could then take it back, but Dawkins personally should have refused to present the award or attend the ceremony, publicly stating why he was doing so.

Posted by: Susan | October 11, 2009 3:39 PM

You could have left off the "on medicine".

Posted by: 386sx | October 11, 2009 3:59 PM

He's a polio vaccine denier too...

http://transcripts.cnn.com/TRANSCRIPTS/0512/15/lkl.01.html

Posted by: Ichthyic | October 11, 2009 4:08 PM

KING: How do you treat illness?

MAHER: I promise you that if you get a headache the reason for that headache is not aspirin deficiency. The reason...

KING: No, of course not.

MAHER: Right, so you're taking -- so it's not...

KING: Something to take the pain away. Why is that bad?

MAHER: But why don't you find out the real root of that pain?

KING: Well, while you're finding take the aspirin.

MAHER: But that's what we do. We have immediate cures that address the symptom and not the root cause of anything. I have no worries about bird flu whatsoever. First of all, it's not going to happen. Second of all, the fact that it is mutating shows that if you did come up with a vaccine tomorrow, it wouldn't be effective against the disease when the disease comes because the disease is always morphing and mutating. It's just a way to funnel money into the pharmaceutical companies. Follow the money. You'll find out where the bird flu is.

KING: You wouldn't say the Salk vaccine was a bad idea.

MAHER: That's somewhat of a different case, yes.

KING: Polio was eliminated. MAHER: Yes but, you know, there are many books out that will -- that will -- and I'm not well enough versed on it to talk about it that will indicate that there are other reasons why it was.

And a lot of diseases that have been they say, whoa, this was eliminated because of a vaccine, they find out well no actually the country got toilets and that's what happened.

KING: You're a Christian Scientist?

heh. Interesting conclusion from Larry.

Posted by: howdy-lentils | October 11, 2009 4:20 PM

Bill Maher is a good example of the concept that atheists and agnostics are not immune to irrational thinking. He rails against intelligent design supporters for discounting evolution despite the evidence, yet he will spout the most ridiculous garbage about vaccines e.g. that polio was eradicated by cleaner living conditions, not the vaccine.

Posted by: Oregonian | October 11, 2009 4:22 PM

I know Bill is very controversial, but I'm looking forward to seeing him when he comes to Oregon in November.

Posted by: flyonthewall | October 11, 2009 4:35 PM

on a side note, that bit about the pope and selling the vatican was priceless.

Anyone see the Ricky Gervais movie, The Invention of Lying?
It was pretty good at blasting religion. A lot of stodgy old people were not happy at the end of the movie.

After coming out of the movie i was surprised that it wasn't picketed or causing more fuss.

Posted by: Aaron Baker | October 11, 2009 5:15 PM

Of no importance whatsoever; but . . .

I saw the title "Maher really is a moron on medicine," and I thought for way too many minutes that it meant "a moron WHILE on medicine."

That's all.

Posted by: Jeff Eyges | October 11, 2009 6:06 PM

But, wait - Maher is on our side... and Frist is on their side...

When the business of giving him the award was being argued here, I dismissed it as irrelevant infighting. I recant. I didn't realize he was so adamant and so wrong.

And now I really need to lie down.

Posted by: 'Tis Himself, OM | October 11, 2009 6:12 PM

Frist graduated from Havard Medical School and was a cardiac surgeon for several years before he became first a medical bureaucrat and then a politician. Unlike Maher, he does know what he's talking about when discussing medicine.

Posted by: 386sx | October 11, 2009 6:52 PM

I always thought the "New Rule" shtick was embarrassingly lame. "New rule, blah blah blah bhlal blalh." Everybody else seemed to like it though, so I kinda just went along with the crowd.

CROWD: "Hey, Bill Maher new rule the other day youtube!! Haha hahaha ha haha ha!!"

ME: "Yeah, haha haha ah ha!! That's not lame at all! Haha ha aha. Yeah, a good one, haha ha ha ah haa!!"

I suspect he fails to realize this. I wondered what his "base" was. Anti-corporation looks like it. Thanks. I was wondering.

But Maher himself is a corporation, and "New Rule" is a product.

Posted by: maggotpunk | October 11, 2009 7:19 PM

Yeah, the government really screwed up on smallpox and polio. How many Americans die from that every year Maher? Oh yeah, none. What a dumbass.

Posted by: Rorschach | October 11, 2009 7:24 PM

Talk about rehashing of old arguments.....

And a wee bit hypocritical, too.So we ditch Maher as a public voice for atheism because of his vaccination woo, do we also ditch Hitchens for good now because of his views on the Iraq war ? Some people do, some don't.So what's the difference?
And let's hope we don't find out Dawkins is a libertarian some day, or holds some other weird fringe idea.Then we're really in trouble.

Posted by: Ichthyic | October 11, 2009 7:28 PM

And let's hope we don't find out Dawkins is a libertarian some day, or holds some other weird fringe idea.Then we're really in trouble.

sorry, but this is false equivalence.

It's also the very same misleading argument that is at the root of Mooney's complaint against the "antiaccomodationists".

True skeptics take arguments one step at a time, and frankly Maher shows basic failures in reasoning both in his support and his rejection of various concepts and realities.

Maher can be a spokesman for atheism if he wishes, but I'll be damned if I would want him as a spokesman for rationality or skepticism in general.

Posted by: Walton | October 11, 2009 7:48 PM

Wow, Ichthyic and I actually agree on something for a change.

Maher is a blithering idiot. I don't care what stance he takes on religion; he is not a rationalist or a sceptic.

Rather than "promoting atheism", we should be promoting a generally rational and evidence-based worldview. The most dangerous forms of woo are those which masquerade as real science: this includes religious creationism, but it also includes "alternative medicine" and the anti-vax movement. We should not give any kind of support, recognition or credibility to anyone who supports these things, whatever their stances on other issues.

Posted by: DLC | October 11, 2009 7:57 PM

But we do have the best health care in the world.
We do lifesaving surgeries daily, using technology and procedures not even thought of elsewhere. We develop new drugs and new therapies all the time which save the lives patients who would have died just a few years previously.
Just so long as you can afford it.
Oh, you mean you haven't got a quarter of a mil to throw away on that new liver? Too bad. Your insurance company will deny you, and then flip you the finger when you come to protest.

Posted by: SC OM | October 11, 2009 8:02 PM

True skeptics take arguments one step at a time, and frankly Maher shows basic failures in reasoning both in his support and his rejection of various concepts and realities.

The charge of hypocrisy is also laughable. Neither Knockgoats nor I held back in our statements about Hitchens on a recent thread; we also argued with and criticized Dawkins to his virtual face. Rorschach, IIRC, was among those calling for more deference to be shown to "leading voices of atheism" or some such blather.

But then Rorschach doesn't make rational arguments about specific questions. He goes on emotion: attachment to heroes - Maher, nothing's sacred,... - and rejection of those he doesn't like - strange gods, Orac,....

I wonder if Rorschach will change his tune about Maher if he starts to see people dying in his hospital because they listened to him. Let's hope we don't have to find out.

Posted by: Gregory Greenwood | October 11, 2009 8:04 PM

Roll up, roll up ladies and gentlemen to see the amazing Bill Maher. The living, breathing embarrasment to atheism.

*facepalm*

Posted by: Brian Atwood | October 11, 2009 8:17 PM

"we have the best health care system in the world" (baloney)"

This statement was not once made in the video. Frist very clearly stated: "We have the best health care in the world. NOT the best health care SYSTEM in the world."

Please, if you are going to accuse Maher of hypocrisy, don't fall prey to the practice yourselves. If taken to mean "at its best, we have the best health care in the world" (a reasonable assumption, I think), Frist's statement is much less grand and controversial than you've made it out to be, and is most probably correct.

Posted by: Ichthyic | October 11, 2009 8:31 PM

we also argued with and criticized Dawkins to his virtual face. Rorschach, IIRC, was among those calling for more deference to be shown to "leading voices of atheism" or some such blather.

remembering that thread now, and you're absolutely dead on right. Without detailing who was where on that issue, it was hardly the case that there was much deference to authority going on.

Rorschach is projecting his own hypocrisy.

I guess there's not much reason to cut any slack there.

That said, I'd like to point out the difference between Dawkins and Maher, using the very thread you mention.

Dawkins stated his opinions based on actually having read the piece in question, and it was pretty obviously a case of a different interpretation of what the author wrote.

he made a logical, rational case that several posters disagreed with while presenting their own interpretations.

there were no claims of gov't conspiracy's, no woo peddling.

The two people think about the world entirely differently.

It's why I'm happy to have Richard as a spokesman for rationalism, regardless of whether I agree or disagree with any specific argument he makes, while Maher's continual lack of rational argumentation makes him at best a public symbol for atheism, but a horrible choice to represent rational skepticism.

In a long-winded way, I guess I'm just repeating my claim that comparing the two is a case of false equivalence.

Posted by: jimspice.myopenid.com | October 11, 2009 8:37 PM

Maher initially (and rightfully, I'd suggest) discounts the tale of the 30-year-old healthy dead man as anecdotal, but eventually plays along. Perhaps he might change his tune if presented with a dead body with his name on it. Headline: "Ann E. Person, unborn infant, die of Swine Flu after taking Maher's advice."

His position is wrong, but I don't see him above changing his mind. A public mea culpa from him could really shine some light on the issue.

Posted by: gregc | October 11, 2009 8:48 PM

Brian Atwood (#48) is right -- PZ didn't listen to Frist closely enough. Frist clearly makes a distinction between health care (doctors, facilities) and the health care system.

Maher's right in suspecting the motivations of pharmaceutical companies as they advise the use of countless drugs. As Maher says, exercise is in many cases a better way of dealing with something like depression than popping pills. Where Maher's wrong is that he 'throws the baby out with the bathwater' when it comes to modern medicine, particularly on the subject of vaccines. Frist sorts him out quite well with examples of what vaccines have done for polio.

Posted by: Jeremy O'Wheel | October 11, 2009 9:13 PM

I just wanted to say regarding PZ's last point, there really is fairly strong scientific evidence that the US' low health is due to lifestyle differences rather than medicine. It's relatively easy to compare people who do have the same levels of medical care. When you look at the top killers in most Western countries, they are essentially smoking, heart disease and stroke. The cause of these three killers are (obviously) choosing to smoke, poor diets and lack of enough exercise. They are all lifestyle deaths. The countries in the world with higher life expectancies also have lower instances of these occurring - regardless of their health care system.

Of course the US system is very inefficient and unjust, so obviously it should be fixed so that everybody has access to health care and you're not needlessly spending money you don't need to - but you really won't see massive changes in your life expectancies or health.

Posted by: tmaxPA | October 11, 2009 10:02 PM

Bill Maher is entertaining if you can keep him off his "food kills" bullshit. I call them "Whole Foods Liberals", mostly Californian, all of them rich and pampered and just as sure that poor people are unhealthy because they make stupid choices (like not buying fresh organic produce from local farms...) as Rush Limbaugh is.

Bill Maher is just a Glenn Beck who smokes pot. Which is why he is usually slightly funnier.

Posted by: Benjamin Geiger | October 11, 2009 10:34 PM

The American health care system is the best in the world.

The American health insurance system is quite possibly among the worst.

Which is why we need to reform the health insurance system. To borrow a concept from Mooney, frame it this way: Keep the health care system, replace the health insurance system. I haven't watched the video yet (my blood pressure is too high as it is) but from other comments it appears that Frist made the same point, but oddly enough, as an excuse to *not* reform.

And the Maher/Frist matchup only proves one thing: the dumbest of us is dumber than the smartest of them.

Posted by: RamziD | October 11, 2009 11:39 PM

Bill Maher is completely ignorant when it comes to modern medicine. As an MD, I find his take on vaccines revolting and I thank goodness that he is not a doctor. However, on the point of obesity causing much of our health care costs, he does have a point. Chronic diseases like cardiovascular disease and diabetes eat up a huge part of our health care costs, and obesity is a large contributing factor (although, not the only one). I imagine that a pretty significant chunk of our health care costs could be eliminated if people would eat more healthy and exercise.

Posted by: Zetetic | October 12, 2009 12:22 AM

For Bill Maher, "Alternate Medicine" is his Fundamentalism.

He not only uses the same illogical arguments that they use for denying an old Earth and evolution, he even wraps himself up in the same sort of persecution/martyr complex that the fundies are so enamored of.

Orac posted this before, but listen at about 1:10 into the video where Maher whinges about how persecuted the alt-med community is. He refers to people... "going to jail for even suggesting any alternative treatment for cancer", a complete barefaced lie for the USA.
Bill Maher Overtime Sep 18 2009 with David Cross

Now compare Maher's lamentations about how persecuted alt-med is to Kirk Cameron whinging about the plight of the poor persecuted religious community in the USA.
Origin Into Schools

---------------------------------------------------------------------------------------------------------------------------------------------------

While I half expected fundie Cameron to say something despicable like.... "Can you believe that there are states in this country where you can go to jail for beating up a gay?"

I wouldn't have been surprised to hear Maher say something like.... "Can you believe that you can go to jail for killing someone an utterly unscientific and unproven medical treatment, or for practicing medicine without graduating medical school?"

Posted by: vogonpoet | October 12, 2009 12:59 AM

The sad fact that a fucking Republican has to edumacate a famous liberal shows how low this nation's discourse has sunk, where a known fascist is ahead of the "liberal" in debate. This emphasizes the degree to which the left has fallen.

Posted by: Woof | October 12, 2009 1:45 AM

jimspice@52:

Maher initially (and rightfully, I'd suggest) discounts the tale of the 30-year-old healthy dead man as anecdotal, but eventually plays along. Perhaps he might change his tune if presented with a dead body with his name on it. Headline: "Ann E. Person, unborn infant, die of Swine Flu after taking Maher's advice."

billmaherbodycount.com is available...

Posted by: Rorschach | October 12, 2009 2:16 AM

First of all, I marvel at SC's capability to produce year-old quotes from people from threads long forgotten...:-)

As to the criticism of what I said upthread, let me try and answer :

Maher can be a spokesman for atheism if he wishes, but I'll be damned if I would want him as a spokesman for rationality or skepticism in general.

That was not my point was it Ichty? I have been saying all along that the guy is an important voice for atheism, Im not talking about him being a skeptic, or him being made a "spokesman for rationality".Strawman argument.
What I have been saying is, see the guy's usefulness to further the cause of atheism, and that alone, and leave it at that.Same with Hitchens, I dont care what he says about Iraq, he wipes the floor with religionists, and thats good enough for me, in the context of me being for the advancement of atheism in society.

This whole notion of atheists being rational, likeable and wholesomely good people by definition is completely bollocks in the first place.Why would I like someone who is obviously a dickhead just because he/she doesnt believe in gods? But better an atheist that a faithhead.

But then Rorschach doesn't make rational arguments about specific questions. He goes on emotion: attachment to heroes - Maher, nothing's sacred,... - and rejection of those he doesn't like - strange gods, Orac,....

As opposed to SC, who does nothing based on emotion. Oh, wait !!
And the "attachment to heroes" crap, ah well.....not worth answering, really.Especially if one of those you call my hero is someone you know much better than me.But that couldnt have anything to do with the fact that you keep bringing this up, could it?

As to SC pulling some random quote from a year ago out of the hat, to show what exactly? I'm not sure.And Orac didnt "prove me wrong" in the context, he talked about the success of vaccination programs by the WHO, when I spoke with David M about measles parties in the 70s.

You know SC, things change, people change their views, I probably thought Maher to be more rational a year ago then I do today when I've seen and heard more from him, but I still disagree with those who maintain we have to diss him as a voice for atheism because of him being a general wooist.

Posted by: Knockgoats | October 12, 2009 8:20 AM

keglined,
As a Brit, I know very little about Maher except for his stupid and dangerous antivax views, and his recent AAI award.

But any family who chooses to forgo vaccinating their child will do so with or without Maher's endorsement

How do you think you know that?

Posted by: Sastra | October 12, 2009 9:08 AM

Maher shouldn't have gotten this specific award, agree, and he's certainly not a spokesperson for science, reason, and/or skepticism. When it comes to alt med, his views aren't only anti-science, they're dangerous.

His value to the so-called atheist movement is I think due to his role as a major, public figure embodying the spirit of Dawkin's OUT Campaign. Do not be afraid to criticize religion in public. Mock it, it's okay. Faith isn't a beautiful, untouchable virtue. Atheism is a perfectly legitimate viewpoint, and nobody should think that it's only on the narrow fringe, or that it ought to be stifled, ignored, or flagged with the word "avowed" -- as if being an atheist is so startling or insulting that it needs to be emphasized that yes indeed, someone really admitted that themselves.

Much as certain elements of the culture might want, we are not going to speak in embarrassed whispers behind closed doors, and stay off the mainstream media where anybody might hear, by accident even. Maher reaches a much wider audience than most atheists -- including the "spiritual" liberals who aren't sure about atheists because they tell people they're wrong on religion, and you're not supposed to do that. Maher does that, and he's funny. Satire and humor are important weapons in breaking the spell against openly criticizing faith. Until this spell is broken, skepticism is muffled for, like atheism, it tells people what they don't want to hear, and it laughs, and that's not nice.

True, it's not a compelling or winning case for Maher getting the award (he really shouldn't have), but it's not a completely unreasonable one given this focus.

Posted by: Steven Dunlap | October 12, 2009 10:11 AM

Quick work on medical care vs. lifestyle:

One of my doctor's complaints is that he would like to spend more time on patient education but can not because of the time constraints imposed on him. Introducing more education through media or schools may help but nothing works as well as doctors performing their jobs one-on-one with their patients. A friend of mine who was an ex-pat in France reported that her doctor spent at least a half an hour or more with her during a typical visit. The doctor learns far more about the patient than the quick 5-10 minutes typical in a private-insurance driven system.

Medical care and lifestyle: they're related.

Posted by: lordshipmayhem | October 12, 2009 11:38 AM

Unfortunately toilets have also been responsible for the acute rise in toilet-disseminated venereal disease.

Male patient: "I must have got it from a toilet seat!"
Doctor: "That's a funny place to make love to your girl!"
- from the book, Emergency Room Diary by Theodore Isaac Rubin, MD, 1973
(much as I'd like to take credit for that myself)

xxx

Regarding Vaccination (specifically, polio):
I have to express deep astonishment that Bill Maher considers the United States to have been, up until the [sarcasm] completely co-incidental [/sarcasm] introduction of Dr. Salk's polio vaccine, a third-world country, and even had a President who, despite coming from an incredibly wealthy and deeply politically-connected family, didn't have clean toilets using indoor plumbing.

And I'm insulted that he considers Canada to have been a third-world country during the 1940's and 50's.

Posted by: Natalie | October 12, 2009 12:08 PM

Tom Riddly @ 69:

Whereas I'm happy to forego some disposable income to provide healthcare to those that need it, I loathe the idea of giving up those same dollars to people who choose to live an unhealthy lifestyle. Let them pay a monster premium if they want to smoke or neglect their weight.

Where does it stop? There are far more behaviors that affect health than smoking or being overweight. Should I be charged more for being sexually active, which increases my risk of both contracting an STD or getting pregnant? After all, having sex is a choice just as much as smoking and fatness are. It seems to me that picking out every single behavior that increases (or decreases) one's chances of using the health care system and then assigning a premium to it would be a logistical nightmare.

Aside from that, just because a specific behavior chances the probability of a certain outcome doesn't mean we can predict who will actually use more healthcare. Not every smoker gets lung cancer; not every fat person has a heart attack. We would be in the position of punishing people for behaviors we deem irresponsible.

Posted by: crystalsystem | October 12, 2009 12:56 PM

Mr. Myers, despite the importance that you you feel Mr. Maher is a moron on medicine, I am wondering if you feel the swine flu vaccine is safe for human consumption.

Here is a partial list of possible side-effects from the swine flu vaccine for healthy children which our good government intends to hoist on the rest of the population if necessary:

Arthritis, hot flashes, chills, dizziness, generalized weakness, fainting, vomiting, nausea, diarrhea, loss off appetite, abdominal pain, back pain, lymph node enlargement, bleeding, decrease in red blood cells, decrease in red blood cells, high blood pressure, shortness of breath, wheezing, chest tightness, chest pain, cough, sore throat, runny nose, “pins and needles” in the skin, sweating, skins disorders related to allergic reaction (which can lead to rash and skin loss, inflammation of blood vessels (may cause short-term effect on kidneys),confusion, headaches similar to those described as migraine, seizures associated with fever, spinal chord or brain inflammation, paralysis, muscle weakness, infection, life-threatening disorders of the nervous system, autoimmune disorders in which the body’s tissues are attacked by its own autoimmune system.

source:
http://www.scribd.com/doc/19638768/Vaccine-Trial-Paperwork

Posted by: titmouse | October 12, 2009 1:32 PM

Oh I said the opposite of what I wanted. I meant, "that religious irrationality is worse than other sorts of irrationality."

Posted by: SC OM | October 12, 2009 2:08 PM

Don't get me wrong. SC's political views are completely insane, and I have said so on many occasions.

BWAHAHAHAHAHAHAHA!

Posted by: Hyperon | October 12, 2009 2:22 PM

My respect for Bill Maher plummeted after watching the above video. Until now I'd always assumed his kooky views on medicine were just a sort of isolated "blind spot". He does have some good points -- for instance, people are being systematically ripped off by the pharmaceutical industry. Eating crap and doing no exercise is one of the leading causes of health problems. Surely, I thought, he is just getting carried away with these eminently reasonable points, and is simply extrapolating too far. Kind of like PZ Myers, who is a reasonable guy most of the time, but occasionally becomes disingenuous and misrepresentative due to his passionate solidarity with left-wing politics.

It seems, though, that Maher is incorrigible. Surely by now the kookiness of his stance should have been brought to his attention, especially after all the brouhaha about his winning an award at AAI. He's putting people's lives in danger here.

Posted by: Celtic_Evolution | October 12, 2009 2:34 PM

Kind of like PZ Myers, who is a reasonable guy most of the time, but occasionally becomes disingenuous and misrepresentative due to his passionate solidarity with left-wing politics.

Sigh.

This added to your argument how? Stop being so damned Kwok-ian, would you? Just make a point and stick to it... the needless PZ histrionics just detract from any point you might have had.

Posted by: crystalsystem | October 12, 2009 3:16 PM

Posted by: Rev. BigDumbChimp post #87

"Do you take any medicine at all?"

No.

"Every single medicine, vaccine, and medical procedure has some possible side effects."

no kidding.

"Stop buying into the scare tactic nonsense being spewed by the anti-science crowd and grow up."

"Grow up"? What scare tactic and anti-science nonsense did I quote? Like the source of my information? Did you bother to read it or understand its context?

Basically you are saying, I should believe everything I am told and take the vaccine like a good little citizen.

Your link to a "nice post on why the flu vaccine is not only safe ... blah, blah" is interesting but worthless because I already know how vaccines are created and that they are generally safe. Do you know anything about Baxter International? I worked for Baxter, they had a serious security breach recently resulting in contaminated flu vaccination product scheduled to be distributed to tens of millions of people but luckily another company spotted the problem.

Posted by: Rev. BigDumbChimp | October 12, 2009 3:26 PM

Do you know anything about Baxter International? I worked for Baxter,

Why yes I do.

they had a serious security breach recently resulting in contaminated flu vaccination product scheduled to be distributed to tens of millions of people but luckily another company spotted the problem.

Which is why you listed the possible side effects right?

Your zealotry is showing.

Posted by: Ichthyic | October 12, 2009 3:29 PM

I worked for Baxter

Smells fishy to me.

Posted by: Zetetic | October 12, 2009 3:32 PM

@ crystalsystem:
Did you even read the rest of the paper that you linked to?

First of all the form makes it clear that the paper was consent for for a field test to determine in effectiveness and potential side-effects of the vaccine.

Secondly it's listing such a broad range of potential side effects because they are rare, but still possible side effects for all most all vaccines.

Surely you must realize that they have to test it on people at some point, and they it's actual effectiveness and side-effects will not be known (only estimated) until after it's tried?

The H1N1 vaccine has been show to be just as safe and effective (with the same risks as the regular seasonal flu vaccine). In other words unless you are allergic to some of the ingredients, and the warning about potential allergic reactions is quite clearly spelled out, the only risks are the same minor risks as any other flu vaccine.

Clearly there is such a conspiracy to hide the dangers of the H1N1 vaccine from the public, that the CDC is trying to hide the same information (as your form) on their public internet site. [/sarc]
Key Facts About 2009 H1N1 Flu Vaccine

Loose the fear mongering crystalsystems, vaccination (when done properly) works.

Posted by: Celtic_Evolution | October 12, 2009 3:38 PM

crystalsystem

here are just a few of the possible side-effects of the Polio vaccine:

Trouble breathing, Hoarseness, Wheezing, Hives, Pale skin, Weakness, Fast heartbeat, Dizziness, High fever, Behavior changes.

potential side-effects of the MMR vaccine:

Fever, Mild rash, Swelling of glands in the cheeks or neck (rare), Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses), Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4), Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses), Serious allergic reaction (less than 1 out of a million doses).

However, in both of these cases, getting the disease is far worse than the possible side effects... and in both cases, the diseases have been all but eradicated due to the vaccines.

You listed the possible side effects of getting the Swine Flu vaccine... do you know what the possible side effects are of not getting as much herd immunity as possible against the Swine Flu? I think I can weigh those two things and pretty easily come up with what I feel is the more responsible course of action.

Posted by: Zetetic | October 12, 2009 3:44 PM

crystasystem @ #92

What scare tactic and anti-science nonsense did I quote? Like the source of my information?

Here's what you just stated at post #82

I am wondering if you feel the swine flu vaccine is safe for human consumption.

Here is a partial list of possible side-effects from the swine flu vaccine for healthy children which our good government intends to hoist on the rest of the population if necessary

Never mind that it' s the same

potential

----------------------------------------------------------------------------------------------------------------------------------------------------
Well, off to work for me....

Posted by: SC OM | October 12, 2009 3:46 PM

Selecting Maher was still a mistake, but at least he couldn't think it was for his being such a scientific thinker.

For outstanding contribution to freethought

http://en.wikipedia.org/wiki/Freethought

I don't think someone so publicly and influentially opposed to the basic principles of freethought in a life-and-death matter should be receiving an award for his "outstanding contribution" to it (not to mention the actual description of the award, regardless of what's written on the object).

The more acclimated people become with skepticism in that area, the more they will be reconciled, I hope, to skepticism in pseudoscience.

Or vice versa. But there's no reason not to call out antiscience across the board, all at once, if we're really about promoting freethought. If we don't draw a line at people whose antiscience is likely to directly contribute to people's deaths, I don't know where we could draw it.

Posted by: SC OM | October 12, 2009 3:57 PM

Sastra,

Ignore the second part of my response. I see the point you were making to the little dipshit.

I also know you think he shouldn't have been selected for the award, but I don't agree with what you appear to be saying - that it was properly handled by Dawkins.

Posted by: SC OM | October 12, 2009 4:17 PM

Well, the award was named after him, but it's not given out by him. Apparently he felt a bit stuck, and did what he felt he honorably could by calling Maher out on alt med during the actual ceremony.

I think what I suggested @ #12 would have been equally honorable and sent a clearer and more powerful message.

I blame the committee (ahem) more than Dawkins -- a carnival of little errors and misunderstandings adding up to a large one.

It appears they need a better selection process (one which involves Dawkins, if he's going to be expected to participate in the ceremony).

Posted by: TomRiddle | October 12, 2009 4:39 PM

Where does it stop? There are far more behaviors that affect health than smoking or being overweight.

True, but you would be hard pressed to come up with another behavior that has a greater influence on both total and unnecessary health costs compared to smoking or obesity. It stops where reason meets reality.

[J]ust because a specific behavior chan[g]es the probability of a certain outcome doesn't mean we can predict who will actually use more healthcare.

Again true, but insurance does not ask a person to pay for their actual use, it asks them to pay for the probability of use. A smoker/overweight person can expect to pay substantially more than a non-smoker/fit person for life insurance, because over the broad spectrum of individuals purchasing life insurance, the smoker/overweight population will utilize the benefits to a much greater extent. The fact that they still buy life insurance lets you know that they perceive value in the transaction even at the elevated rates. Why should health insurance (particularly, publically funded) be any different?

It seems to me that picking out every single behavior that increases (or decreases) one's chances of using the health care system and then assigning a premium to it would be a logistical nightmare.

And it would be counterproductive, unnecessary, and downright stupid. If you are trying to curtail healthcare costs in order to cover more individuals, you go after the factors with the greatest returns. Even if avid skydivers use more healthcare than smokers, the administrative expenses of separating that group would greatly outweigh the benefit of higher premiums from that group. If there are other large-impact, choice-based, factors that can be easily distinguished (like illegal drug use), go ahead and separate those out too. You don’t need to go any further than the latest life insurance application to see how short that list is.

Aside from that, […w]e would be in the position of punishing people for behaviors we deem irresponsible.

How is it a punishment to allow someone to live their life as they deem fit, but ask them to cover their fair share of expenses? We are offering coverage, not taking it away.

In general, I would like to see healthcare offered to the twelve year old girl whose parents have no reasonable current access to it, or to the farmers that provide us with the most stable food source in the world for less than $20K per year. I don’t particularly care if I offend Jane Smoker and Joe Couchpotato in calling out that they are the ones making it impossible to make any real progress on that front.

Posted by: Carlie | October 12, 2009 5:33 PM

Tom Riddle:

Obesity isn't a behavior, dumbass.

And obese people aren't less healthy by being overweight, ignoramus.

And obesity is badly defined anyway, stupid git.

And never mind that fat people tend to avoid getting health care at all, since they get treated like shit when they try, you dolt.

Posted by: Carlie | October 12, 2009 6:24 PM

Marc - the first link indicates that there are several other causes for obesity besides sitting on the couch eating donuts, and examines one potential reason in great detail.

The second links to the news that the CDC renounced its study that indicated that obesity was a leading cause of death, and the story itself linked to several other pieces of information on obesity not being as much of a health risk as previously thought (particularly those linking to Paul Campos).

Posted by: Carlie | October 12, 2009 6:31 PM

proper link

Posted by: Sven DiMilo | October 12, 2009 7:13 PM

there are several other causes for obesity besides sitting on the couch eating donuts

Straw fatman. There is only one way to become overweight, and that is to take in, over a long period, more energy than you spend. Both intake and expenditure are clearly linked to behavior. There are complex internal and external factors that contribute to regulation of those behaviors, but even someone with a ridiculously low metabolic rate gets fatter from 1) eating more than needed and/or 2) not exercising enough to raise the longterm metabolic rate to match intake.

the CDC renounced its study that indicated that obesity was a leading cause of death, and the story itself linked to several other pieces of information on obesity not being as much of a health risk as previously thought

Wow, that's a really misleading summary of that article! They did not renounce an earlier study, they did a new study with more and newer data and reached a somewhat different conclusion. A number of actual and potential problems and complicating factors with the data are discussed. At the time that article was written (2005), in fact, it was not at all clear which of the two studies was "better" or more accurate. In the newer study, obesity was "downgraded" from the second to the seventh largest cause of preventable mortality. However, the health risks associated with obesity are well known, even if with modern medications and other treatments they don't lead as often as they used to to death.

Point being that "the mortality rate isn't as high as previously estimated" is a much different statement than "obesity not being as much of a health risk as previously thought," which is in turn a lot different from your earlier claim that "obese people aren't less healthy by being overweight"!

And you followed your approving link to that article--discussing a study in which BMI was the independent variable--with a link to the suggestion that BMI is a horribly flawed metric. Want it both ways?

Posted by: TomRiddle | October 12, 2009 7:55 PM

Obesity isn't a behavior, dumbass.

You are correct. It is the normal conclusion of a series of behaviors. Whereas it can be caused by a genetic disorder or bacterial infections, it is most commonly caused by excessive calorie consumption in the face of inadequate physical activity. As such, it is also normally reversible by decreased caloric consumption and moderate physical activity.

And obese people aren't less healthy by being overweight, ignoramus.

It doesn’t matter, and bullshit. So long as there is a heavy correlation between obesity and healthcare costs, it doesn’t matter whether or not the relationship is truly causal. Yes it is possible to be overweight and healthy, but it is the exception, not the norm. I’ll stand by the correlation to increased healthcare costs as evidence. Feel free to Google the term and find a litany of articles to go along with that view. You won’t even have to rely on personal interpretation of an obscure article from 2005 to draw your conclusion.

And obesity is badly defined anyway, stupid git.

See Sven's brilliant response in #118

4-month old infant denied health insurance

No, this is not where thinking like mine leads. This is where out-of-control healthcare costs lead, particularly when your only option for insurance is subject to profitability standards of a public company. Curb the costs where you can and open up insurance for the rest of America.

By the way Carlie, I’m assuming you didn’t have time to post articles stating that second-hand smoke isn’t really dangerous, and that big-tobacco is to be blamed for addiction rather than individual users. Even if you don’t like it, there are items in our control that we have to take responsibility for if we are ever going to get out this mess.

And, by the way, the derogatory tantrums do little to further your cause.

Posted by: titmouse | October 12, 2009 8:04 PM

Yeah Sastra, I can see the AAI were trying. But a distinct award needs a distinct name. A fine print re-write will be invisible to all but the most intimately involved.

I see nothing wrong with the AAI handing out an award to anyone --including someone with a thought disorder or other major mental illness-- for some useful contribution. Call it the "OUT!" award, whatever. But don't call it the "Richard Dawkins Award," unless you care little for Richard's efforts to emphasize the basis of belief.

Posted by: Carlie | October 12, 2009 8:32 PM

So long as there is a heavy correlation between obesity and healthcare costs, it doesn’t matter whether or not the relationship is truly causal.

Really? I would think that if your goal is to drive down health care costs, you'd better be damned sure that you get at the cause of it, not just the correlation. Otherwise you'll never get the costs down, because you've never addressed the actual problems.

Since you won't accept CDC data or medical studies as support that fat might not be the worst health problem in the world, I'll go for an economic justification instead. (If you are at all interested in looking at the growing medial data that are out there, Gina Kolata and Paul Campos are good people to start with.)

I'm not saying "OMG ALL FAT PEOPLE ARE TOTALLY HEALTHY" (although they're more healthy on average than you think they are). I'm saying that the opposite, "OMG ALL FAT PEOPLE ARE UNHEALTHY" is also inaccurate, and more than that, it's dangerous for overall health AND for the costs of health care. It punishes the fat people who are healthy by making them pay for the perception that fat is bad; not just by making them pay more for insurance and care, but in more and more cases by denying them coverage entirely. That plays out in reality in some pretty nasty ways. Take a thin person and a fat person, both with glaucoma. The thin person gets to have it treated under their insurance plan, because they're a virtuous thin person. The fat person? Gets to go blind if they can't afford the out-of-pocket cost themselves, because they've committed the sin of being fat. They might at some point end up in the ER with it, and if they can't pay that puts a strain on the system of a thousand dollars or so of unpaid hospital care, rather than a couple of doctor's visits partly covered by a regular affordable policy they'd be happy to pay for if only the company would accept them.

But besides the straight effects of direct health care money, the attitude of "all fat people are unhealthy because they eat too much and can't control their own behavior" cuts off any other avenues of research and potential policy changes at the knees. Let's say you're right that fat is bad. How to change all the fat people? It would be fabulous if nutritious food were subsidized instead of corn syrup. It would be great if school districts were properly funded so that every extracurricular group didn't have to make money by selling candy bars, and if they were rewarded for locally sourcing good food for the cafeteria instead of having to go with the cheapest slop available. If it turns out that there is incredible variance between individuals' metabolic rates, it would be peachy if there could be medication developed to regulate it the way we do with blood pressure and cholesterol. But none of that will even be explored if the entire thing gets stopped at "Stop eating so much, fatty". That kind of societal vilification and fat-shaming hasn't worked so well to remove the fat from society, unless you count the ones who end up dying from eating disorders, so it really doesn't seem like a good platform for dealing with health care.

Posted by: VinzKlortho | October 12, 2009 9:23 PM

@Carlie

There is a treatment for low a metabolism. It's called exercise. I was fat through most of my childhood. I had low self esteem and a victim mentality because of it. I always thought that it was unfair and I hated everybody around me and how they looked at me and treated me. Now I still eat whatever I want, but I work out 5 days a week. I don't have a six pack but I'm thin enough to squeeze into places that a lot of Americans can't. I'm not saying I'm a vision of health. I'm not saying that I'll never get cancer or have a stroke because of my new, healthier life style, but I am saying that if fat people want to loose weight then they have to get off their asses. They can't sit around and wait for a pill to do it for them. That kind of thinking is lazy and defeatist.

Posted by: Carlie | October 12, 2009 9:48 PM

Vinz, that was so not my point. But I'm very happy for you that you happen to have the kind of lifestyle that affords you the time and energy to work out most days, rather than the kind where your normal job (or jobs) involves labor that leaves you too exhausted at the end of the day or with too little time left over after caring for your family to even think of taking an hour or so for exercise for its own sake. Not everyone in this country has that luxury.

Posted by: TomRiddle | October 12, 2009 10:06 PM

You are all over the boards Carlie. Your original argument was than obesity is not unhealthy and that it was ignorant to suggest otherwise. I'm not going to put words into your mouth, but you have been conspicuously silent on that topic after a few rebuttals. Would you care to further that discussion, or will you concede the point that it is a legitimate health concern as well as a legitimate driver of medical costs?

Your latest diatribe relates to the plights of overweight people trying to cope with the prospects of shedding unwanted pounds. I've never said it was easy nor have I've ever demonized the condition. I agree with some of your points, and not at all with others. Regardless, it is all off topic.

I am not on some sort of mission to rid the world of the overweight. In fact, I am strongly against any legislative intervention on the personal choice on how much you exercise, what you eat, or what you smoke. However, as those are all undeniably personal choices that lead to undeniably higher healthcare costs, I still have yet to hear a salient argument as to why those individuals should not be expected to pick up a larger portion of the healthcare tab.

As for your argument about the "fat but fit" individual paying more for glaucoma treatment, I am willing to admit that any system will have inherent flaws where some individuals will benefit at the unfair cost to others. I will go out on a rather strong limb and predict that there are many fewer "fat but fit" individuals than there are I unhealthy overweight individuals. As such, I am brave enough to pick the lesser of two evils in favor of furthering an important cause.

Posted by: Stu | October 13, 2009 1:45 AM

Oh, by the way:

As such, I am brave enough

Fuck you very much. If selfishness is bravery, you win. Here in the real world, it makes you an insecure cunt.

Posted by: Rorschach | October 13, 2009 4:07 AM

And to add to that, running and working out will be cardioprotective, as opposed to detrimental to your health.

Posted by: Carlie | October 13, 2009 5:42 AM

Tom, I realized I was being scattershot, and tried to explain specifically why in #127. There are a lot of angles to approach it with because there are a lot of disparate reasons why "blame the fatties for our health care problems" is wrong. The reason I didn't go back to the fat isn't always unhealthy issue is that I think I did give some good links that show it isn't; however, if that isn't convincing as a reason why not to penalize fat people, then there are other reasons not to to go with "blame the fat people" which I then switched to.
If you want to stay on the fat/health issue more, though, how much research have you done on the links between obesity and health? Is it anything beyond hearing about it on the news once in awhile? Do you have the original CDC 400,000 deaths/year due to obesity number that is still trotted out hither and yon stuck in your head, instead of the revised numbers since then, and do you have a framework for evaluating whether that is high or low compared to other risks? If you think that research showing that it isn't so bad is flawed, what about those studies is bad? There are some pretty decent books that catalog studies indicating that fat isn't as unhealthy as it's made out to be, and that focusing on health irrespective of weight makes people more healthy, but not less fat.

You just can not compare the short term risk of a -mostly harmless and easily fixable- sports injury with the long term metabolical and vascular changes that happen over accumulated time with eating fatty and processed foods,

Mostly harmless and easily fixable don't describe all sports injuries, and it's disingenuous of you to put it that way. Besides that, they usually involve trips to the emergency room and often surgery, which can eat up more health care dollars in one incident than 20 years' worth of a chronic condition. Heck, trampolines cause close to 100,000 ER visits a year - refusing to cover people who are stupid enough to use them would save a lot of money, just to pull out one example. Check out this report, funded by the National Center for Health Statistics wing of the CDC, on the top 5 conditions for medical spending. Trauma-related disorders have had one of the highest increases over the last 10 years. The others were heart disease, cancer, mental disorders, and asthma. Of those, the only one with any link to weight is heart disease, and again that's not an easy direct fat=heart disease causality. Regardless of whether you accept any of the studies showing that obesity isn't a death knell, looking where actual health care dollars go indicates that focusing on it isn't the most efficient way to decrease costs.

And I can't believe I'm saying this, but yeah, what Walton said. Some of it, anyway.

Posted by: Bernard Bumner | October 13, 2009 6:29 AM

The others were heart disease, cancer, mental disorders, and asthma. Of those, the only one with any link to weight is heart disease, and again that's not an easy direct fat=heart disease causality.

Mmm. Not true?

Body weight and cancer.

Obesity may exacerbate asthma symptoms.

Obesity may also affect mental health.

Posted by: Rorschach | October 13, 2009 6:58 AM

but then again you're going into the realm of "if you're sick it's your fault"

Shades of grey here, not black and white.
The paraplegic that cant move his legs but does weights with his arms and keeps his BMI down that way, admirable.
The busy business woman that goes to the gym at 6am before work to sweat on the treadmill, good on her.

Are there genetic conditions leading to being overweight? Yes, but they are rather rare, and most overweight people are overweight because of lack of exercise and eating more than they burn, calorywise.Unfortunately it is that simple.

Our society encourages people to eat crap food, and that's what we have to change.

Posted by: Carlie | October 13, 2009 7:21 AM

The paraplegic that cant move his legs but does weights with his arms and keeps his BMI down that way, admirable.

Wow. So he's a good paraplegic, and therefore worthy of health care? Does that mean a paraplegic who doesn't feel like exercising (like an awful lot of sedentary skinny people) is bad and shouldn't get it? What about a paraplegic who also has chronic fatigue syndrome and can't exercise? Shades of gray is one of the big underlying issues here. I'm not prepared to sit in judgment over whether a person has been "good" enough with his or her behavior to determine whether their health problems are their fault or not, and I don't think that anyone else has enough information to make that judgment, either. Even if you think you do, how do you weigh mitigating factors? That businesswoman of yours who goes to the gym at 6am has an awful lot of perks to her life that an assembly line worker doesn't have. The line worker has to be at work at 6am, and has to stand all day. Not a lot of exercise involved, but it's damned tiring. I worked an assembly line when I was young and in peak health, and it was exhausting. Then she has to go home at 3 and deal with her kids coming home from school, and cooking dinner, and helping with homework, and if she's lucky she doesn't have to go work a second job in the evening, and hey, she might just want to sit and rest a bit before going to bed instead of walking around the block a few times (especially if there's a lot of violence on her block to begin with). If she's fat, do you want to call her a bad person with behavioral problems who doesn't deserve health care?

And on this: "Our society encourages people to eat crap food, and that's what we have to change." I agree with you. I said as much at #124. But the way to change it isn't to just to tell people to eat differently. It's to change the system that keeps crap food cheap and good food expensive and forces people to work so much they don't have time to cook and at such low wages that they can't afford to have freezers/refrigerators/ovens at their disposal to do it with.

Posted by: windy | October 13, 2009 11:09 AM

TomRiddle:

...over the broad spectrum of individuals purchasing life insurance, the smoker/overweight population will utilize the benefits to a much greater extent. The fact that they still buy life insurance lets you know that they perceive value in the transaction even at the elevated rates. Why should health insurance (particularly, publically funded) be any different?

I don't think countries with public health insurance generally require smokers et al to pay more. They may tax cigarettes and alcohol out the wazoo, though.

Carlie:

obese people aren't less healthy by being overweight

If you go by that study, somewhat overweight people are not less healthy by being overweight, but obese people are less healthy by being obese. Like Sven said in #118, if you don't trust them to define overweight and obese, it's inconsistent to quote the conclusions.

the revised estimates concluded that being underweight was the cause of more deaths than being overweight, and that being slightly overweight was healthier than being "normal" weight. I fail to see how that means that all of our health care energy should be directed at targeting obesity specifically as a terrible behavior

It doesn't mean that it shouldn't be targeted, either. Drinking small amounts of alcohol may be healthy, but it's not in any way inconsistent with saying that alcohol use is a problem that increases health care costs (which is not the same as saying that it's just a problem of personal responsibility)

Posted by: Ichthyic | October 13, 2009 12:20 PM

Which one are you going to choose? They are not even remotely equivalent.

strangely enough, I'd expect the triatheletes (the serious ones) to require the most healthcare over time.

they're the ones actually pushing their bodies the hardest.

My brother is an extreme athlete, and that guy has spent more time in hospitals than anyone I know.

Posted by: Carlie | October 13, 2009 1:12 PM

Tom, I've given my points; doing it again would just be repetitive for the sake of watching myself write. I did reply to Rorschach and Bernard and added more information.

You are consistently missing the difference between a factor that is in your control, and one that is not. Overweight individuals and smokers have the ability to decrease the total required healthcare, IVF preemies do not.

In fact, that's one that is under much more control. IVF babies have a well-known higher risk of being born premature and with physical problems, prospective parents know this full well going in, yet they decide that their drive to have a child with their own DNA should win out over those risks. If IVF weren't so readily available and in such badly-regulated ways (as is outlined in the article I linked to), it would be a much lower drain on the system. What you're doing, again, is going down the path of "I don't want to pay for those people's care, because they don't deserve it because they brought it on themselves." That line of thinking would lead to total dissolution of health care, because I don't want to pay for some self-centered parents to spend $15k on IVF and $9k on prenatal treatment/birth and $400k on ICU care for the baby they decided they absolutely had to have look like them to make their lives more meaningful. I also don't want to pay the $25k for the surgery for the stupid weekend warrior who didn't want to admit he isn't 20 any more and tore his ACL trying to impress his girlfriend by playing football in the yard with her younger cousins. See where it goes when you decide that personal decisions and moral judgments ought to influence who gets health care?

We draw the line at the items that have the most meaningful impact on reducing overall healthcare costs.

And you still haven't addressed the information I provided that showed that obesity itself isn't actually one of those.

Your harping about overweight being entirely under an individual's control has also sidestepped environmental factors. Please let me know whether you will penalize a fat assembly line head of household, a fat upper-class stay at home wife, and a fat disabled taxi driver the same way.

Posted by: Marc Abian | October 13, 2009 5:46 PM

If we're talking about contributions to health-care costs, then you would need to present evidence that this contributes to the disproportionately high US costs relative to other countries. As the report I linked to above shows, however, to begin with the US doesn't have high smoking rates relative to other countries with lower health-care costs and better outcomes, so it doesn't sound exactly plausible.

Wait, are you saying that to prove smoking is a drain on health care one needs to prove it's causing the disproportionately high health costs in the US relative to other countries?

Posted by: TomRiddle | October 13, 2009 9:59 PM

you still haven't addressed the information I provided that showed that obesity itself isn't actually one of those.

I've referred to several other posts that have clearly addressed this matter. You have one CDC study refuting the relationship between obesity and healthcare costs vs a mountain of other studies establishing the relationship. Some have already been cited, here are more. At best, you are arguing a minority position.

"I don't want to pay for those people's care, because they don't deserve it because they brought it on themselves."

No, I am definitely not saying this, and I am not certain why you feel the need to keep misrepresenting my position with your "summary quotations". Everyone should be covered, I have never stated otherwise. I am taking the position that people who are in a higher risk class due to factors under their control should simply be paying more than everyone else.

In fact, that's one that is under much more control.

No it is not. Once the babies are born, they have no control over their condition. Whether or not parents should have to pay an insurance surcharge along with an IVF procedure is another matter entirely, and like other groups IVF babies are not a substantial enough population to focus on them.

Please let me know whether you will penalize a fat assembly line head of household, a fat upper-class stay at home wife, and a fat disabled taxi driver the same way.

Again, I fail to see how offering affordable healthcare to anyone qualifies as a penalty. If distinctions need to be made in the system to compensate for economic status, so be it - I have never proposed otherwise.

You can argue all day long about the difficulties and reasons for being overweight - I have already conceded that I agree with some of your points. Nonetheless, I find your overall view of personal accountability both patronizing and lacking substance. If we can't be held accountable for the very food we put in our mouths there is very little anyone can do to improve our society.

Posted by: Carlie | October 13, 2009 10:38 PM

. You have one CDC study refuting the relationship between obesity and healthcare costs vs a mountain of other studies establishing the relationship.

And I also provided links to three books, each containing numerous studies. Not everything is right there on the internet, you know. Those "book" things contain lots of information.

I am taking the position that people who are in a higher risk class due to factors under their control should simply be paying more than everyone else.

And I'm saying that all kinds of risk factors are under a person's control; if you want to go there, you have to go all the way. If you take the risk of playing contact sports, you should pay more than people who don't. If you take the risk of IVF, you should pay a hell of a lot more than people who don't. Etc. and so forth. At some point not far in, it becomes economically unfeasible to spend so much effort assessing individual risk rather than simply spreading out the costs.

If distinctions need to be made in the system to compensate for economic status, so be it

Those examples weren't there simply to say that economic status has to be considered when discussing costs. They were there to illustrate that "risk factors under your own control" are under different amounts of control for different kinds of people.

If we can't be held accountable for the very food we put in our mouths there is very little anyone can do to improve our society.

So you're saying that you want a system in which you have to account for every bite you put in your mouth, and are assessed rewards and penalties on that basis. That sounds awfully...totalitarian and invasive. Kind of counter to the whole notion of individual liberties, really.

Posted by: Carlie | October 14, 2009 6:46 AM

Shockingly, I chose not to buy and read those books in the last 24 hours. You can also find books on homeopathy, Wiccan potions, and autourinology - that doesn't make their contents worth considering. And while we are on the topic, citing a book is not the same as reading it.

I didn't say you ought to have, I was countering your claim that I had only cited one study. You know, I had felt bad that I started calling you names right out of the gate, but now I'm reconsidering given your propensity for mischaracterization. And yes, I have read them, and believe it or not, even looked up (gasp!) primary literature on it, and even (another gasp!) know how to distinguish decent studies from crap.

How can you even pretend those are equivalent or easily mistakable concepts?

Because that is exactly where it leads. How could it not, given the guidelines you've laid out? And controlling what people eat isn't a foreign concept. I doubt you've ever noticed, but there are laws on the books and in the works that make it criminal for certain women to drink alcohol. It's not a far stretch to expand that to other people and other substances.

Posted by: Walton | October 14, 2009 7:13 AM

There are really several different issues being discussed here, which need to be separated from one another and clearly delineated.

As far as I can tell, one of the questions being argued is "to what extent is obesity a major cause of poor health outcomes in America?" This is an empirical scientific question, and one on which I am not especially qualified to offer an opinion; but in my (layman's) understanding, the mainstream medical consensus is unequivocal in saying that obesity is a serious threat to health, and is one of the largest public health problems facing the developed world today. I can't see how there can be much debate about this.

Another, completely separate, question is "should a health care system disadvantage those people who knowingly make unhealthy/risky lifestyle choices?" This is a normative, not an empirical, question, and depends really on your personal moral philosophy. But as I said earlier, I don't see that it would be practical to try and separate out the "deserving" from the "undeserving" and penalise those who make certain lifestyle choices. Doing so would be a serious threat to individual liberty. As a classical liberal, I certainly don't believe that government should be stopping people from smoking or overeating; a person has the right to abuse his or her own body as much as he or she wishes. Unfortunately, having a government-run healthcare system makes people's lifestyle choices into a problem for government.

In countries with a largely government-run healthcare system - such as my own country, the UK - there are some measures which help to compensate for the disproportionate cost of treating those who make unhealthy life choices. For instance, we charge very high Pigovian sales taxes on cigarettes and alcohol. Unfortunately, I can't see any means of implementing a similar Pigovian disincentive in the context of obesity; taxing "unhealthy foods" would involve complicated and controversial nutritional judgments, and would expand the reach of nanny-state government further into every aspects of consumer choice. So I'm not keen on that idea.

There are a few things which I think we can change, however. For instance, I am bemused and appalled by the fact that, in the UK, the NHS funds IVF treatment for infertile couples. Why should I be subsidising other people's desire to have children? If they want IVF, they are welcome to pay for it themselves. (If they don't have the financial resources to do so, then, in any case, they really ought to be reconsidering whether they are in a sufficiently secure financial position to give a child the care and attention he or she needs.) I cannot see any good reason for taxpayer funding of fertility treatments. In an overpopulated world, encouraging people to have more children - especially when they can't support those children financially - cannot be a desirable social goal. If you ask me, we should abolish public funding for IVF, and instead spend the money on providing free contraception and advice on how to avoid having children.

Posted by: Bernard Bumner | October 14, 2009 8:19 AM

For instance, I am bemused and appalled by the fact that, in the UK, the NHS funds IVF treatment for infertile couples. Why should I be subsidising other people's desire to have children?

We already do so, by providing child benefits and tax-credits.

(If they don't have the financial resources to do so, then, in any case, they really ought to be reconsidering whether they are in a sufficiently secure financial position to give a child the care and attention he or she needs.)

It does not follow; there is a difference between paying a lump sum for the cost of IVF, and making a long-term investment in raising a child.

Also, since when was it the job of the state to judge a person's suitability for parenthood on the basis of financial means?

I cannot see any good reason for taxpayer funding of fertility treatments.

Fertility treatment does not necessarily equal IVF. At what point do you draw the line on which treatments are allowed? Do you say that even trivial procedures will not be provided? If they are, then why not the more expensive ones?

It sounds a lot like putting financial concerns above compassion in the decision-making process.

In an overpopulated world, encouraging people to have more children - especially when they can't support those children financially - cannot be a desirable social goal.

People who go through the process and all that it involves, are likely to be highly motivated parents.

If you ask me, we should abolish public funding for IVF, and instead spend the money on providing free contraception and advice on how to avoid having children.

False dichotomy. We can provide education and resources to help avoid unplanned and unwanted pregnancies, without having to stop providing fertility treatment.

I think that you underestimate the impact of infertility on people's wellbeing, and you are trivialising the desire to have children.

Posted by: Knockgoats | October 14, 2009 9:00 AM

As per usual, Walton can't be bothered to actually find out anything about a subject before shooting his glibertarian mouth off.

As Bernard Bumner notes, IVF is only a small part of infertility medicine. The largest part would be advice on diet, exercise, cutting down on alcohol, stopping smoking, when (and believe it or not, even how!) to have sex.

In an overpopulated world, encouraging people to have more children - especially when they can't support those children financially - cannot be a desirable social goal. - Walton

About 30,000 children have been born as a result of IVF in the UK in the past 21 years. Even you should be able to see that this is a trivial number. IVF, incidentally, is a gruelling and medically risky procedure: no-one is going to go through it on a whim.

If you ask me - Walton

I haven't caught up with the whole thread, but I'm nonetheless confident in stating that no-one did.

Posted by: Rorschach | October 14, 2009 9:42 AM

This whole issue of who to charge how much and how much, and for what has been around for a long time, and is extremely complicated, where to start, where to stop?
How to compare the non-exercising fatty food eating low socioeconomic status factory worker or truck driver with the businessman who goes skiing 10 times a year, or the extreme sports fanatic?

Even in places like Germany, where you have, compared to american standards, "socialised health care" , this gets tossed around every now and then.
The reality is, if you have a system where people contribute in solidarity and finance the health costs of the community that way, there is no easy way to "punish" anyone for eating bad, not exercising or taking health risks via risky sports etc.

It might be a different thing in places like the US.

Posted by: Tor Hershman | October 14, 2009 10:23 AM

The last two postings, at moi’s blog, have featured Bill Maher’s flick (Once, straight – the other as parody) which I enjoyed, with some VAST reservations, greatly.

I mean, he REALLY sucks-up to the prevailing mythologies but one must remember this, if Mr. Maher was NOT serving the Master’s mental illnesses he would NOT have a show makin’ BIG BUCKS.
In his position I may’ve kissed Hay Zeus’s arse just as royally as he did/does.
He did make several HUGE mistakes, possibly inadvertently.

Ain't that something the loopy Master's would give a worldwide platform to?

YEP!

Stay on groovin’ safari,
Tor Hershman

Posted by: Rev. BigDumbChimp | October 14, 2009 10:51 AM

This comment is as confused as the ones on your blog.

BUT they looked REALLY COOL because HE used some CAPS!

Posted by: Walton | October 14, 2009 3:08 PM

Bernard Bumner,

We already do so, by providing child benefits and tax-credits.

Yes, but those can be justified on the basis that, when a child has been born, he or she should not have to suffer a deprived childhood merely because of having been born into a lower-income family. The child is not to blame for his or her parents' irresponsibility, and shouldn't have to suffer for it. That consideration does not apply in the case of fertility treatments.

Also, since when was it the job of the state to judge a person's suitability for parenthood on the basis of financial means?

In general, it isn't; in a free society, the State has no right to interfere with individuals' sex lives. However, when we're talking about spending taxpayers' money, the State has a duty to be as prudent and frugal as possible in its expenditure of such money. The onus is therefore on you to show that fertility treatments are a worthwhile expenditure of public funds.

Fertility treatment does not necessarily equal IVF. At what point do you draw the line on which treatments are allowed? Do you say that even trivial procedures will not be provided? If they are, then why not the more expensive ones?

Easy. No fertility treatments should be provided at taxpayer expense, ever, under any circumstances. If you think otherwise, you need to demonstrate that it is in the public interest to fund such treatments.

It sounds a lot like putting financial concerns above compassion in the decision-making process.

"Compassion" does not entitle a person to be given whatever he or she wants, at the expense of his or her fellow citizens. I recognise that many couples desperately want to have children. But it does not follow from this that the taxpayer must pick up the bill for their doing so. I, for my part, desperately want to drive a Toyota Hilux; but I don't expect the taxpayer to buy me one.

False dichotomy. We can provide education and resources to help avoid unplanned and unwanted pregnancies, without having to stop providing fertility treatment.

Except that financial resources are inevitably limited. In the UK, all areas of government spending are currently suffering drastic cutbacks (including the MoD, at a time when our military resources are already seriously over-stretched). Public money does not grow on trees; it comes out of taxpayers' pockets, or out of the budgets for other vital areas of spending.

I think that you underestimate the impact of infertility on people's wellbeing, and you are trivialising the desire to have children.

I don't doubt that many people have such a desire. But this does not illustrate that they should be entitled to indulge it at taxpayer expense. Bear in mind that, in the UK and around the world, there are many neglected children in local authority foster-care. Would it not be both more moral and more rational for infertile couples to adopt children, rather than expecting the taxpayer to fund them in producing their own?

Knockgoats,

As Bernard Bumner notes, IVF is only a small part of infertility medicine. The largest part would be advice on diet, exercise, cutting down on alcohol, stopping smoking, when (and believe it or not, even how!) to have sex.

That's irrelevant. Any fertility treatment, for which the cost is more than de minimis, should not be funded by the public purse. If you think otherwise, you need to explain why the provision of fertility treatments serves a compelling public interest.

Posted by: Walton | October 14, 2009 4:31 PM

Jadehawk,

instead, we should be designing a society/infrastructure that nudges people into being healthier rather than unhealthy, for example by providing biking and walking infrastructure, making non-processed food cheaper and more easily obtainable than processed food, giving people enough free time to exercise (i.e. cheap daycare, sufficient income to make do with 40 or less hrs a week of work, etc.), and cultural promotion of a slower lifestyle (for example "slow food" rather than "food to go").

That's nice in theory, but how do you propose we fund all these expensive reforms? And do you really believe that it's possible, or desirable, to "design" a society to meet some kind of blueprint?

Posted by: crystalsystem | October 14, 2009 4:47 PM

REFERENCE #101
Posted by: Rev. BigDumbChimp | October 12, 2009 3:40 PM

I said: I worked for Baxter.

You said: Very fishy ... on the other hand a good friend of my wife's from College works for Baxter in L.A., maybe I'll give him a call.

Smell fish all you want dumb chimp. Please call Westlake Village facilities in L.A.. Ask them about the offices in Vienna, Austria (where I was employed). I am amazed at the narrow outlook on this subject here. This has nothing to do with fear-mongering or conspiracy as you or other commentators think. I implied incompetence. I have not had the pleasure of reading what you write on your website dumb chimp but your responses here appear similar to those apologists for the big pharmaceuticals and sometimes imperfect governments. If I have not made myself clear it is because English is not my first language and hopefully I will improve, express my point more clearly in the future.

... this can be googled

“2009 avian flu contamination

"In early 2009 supplies of contaminated vaccine material with Avian flu virus (Influenza A virus subtype H5N1) provided by Baxter International were sent to a series of European laboratories. The deadly H5N1 strain was mixed with the less harmful H3N2 subtype of the seasonal flu virus, and was detected after it killed test animals in a lab in the Czech Republic. Though the serious consequences were avoided by the lab in the Czech Republic, Baxter claimed the failed controls over the distribution of the virus were 'stringent' and there was 'little chance' of the lethal virus harming humans, apart from its deadly effect.”

"little chance" of harming humans? They white-wash the seriousness of the contamination.

Posted by: Rorschach | October 14, 2009 7:21 PM

There is really no sense in punishing people for living in a society that does its best to promote being unhealthy

Completely agree !

Posted by: Hyperon | October 14, 2009 10:14 PM

...instead, we should be designing a society/infrastructure that nudges people into being healthier rather than unhealthy, for example by providing biking and walking infrastructure, making non-processed food cheaper and more easily obtainable than processed food, giving people enough free time to exercise (i.e. cheap daycare, sufficient income to make do with 40 or less hrs a week of work, etc.), and cultural promotion of a slower lifestyle (for example "slow food" rather than "food to go").

Speaking for the UK (which is one of the fattest countries on the planet), we already have plenty of bike routes. Non-processed food is already cheap (for instance, rice is one of the cheapest options available). Work is already generally 40 hours or less. Slow food is already promoted over fast food (for instance, McDonalds gets undeservedly bad press). In fact I think America shares all of these traits, apart from the bike routes.

As for "walking infrastructures" -- do you live inside a volcano or something? Last I knew, the term in colloquial English for "walking infrastructure" was "ground".

Posted by: Jadehawk, OM | October 14, 2009 10:36 PM

I seem to recall hearing of a place like that. I think it's called "Europe", or something along those lines.

In fact I think America shares all of these traits, apart from the bike routes.

As for "walking infrastructures" -- do you live inside a volcano or something? Last I knew, the term in colloquial English for "walking infrastructure" was "ground".

Posted by: TomRiddle | October 15, 2009 2:03 AM

More importantly, you keep avoiding the other "personal choice" examples that have been brought up. Is eating the only personal choice you think ought to be penalized? Traumatic injuries cost more and are the result of decisions, too - accidents don't just happen, they happen when people make bad judgments and bad decisions and don't pay enough attention to what they're doing. Yet you haven't said a word about those... Why is it that fatness is the only thing you advocate people be punished for?

See posts 110, 133, 134, 137, 145, & 155 (most of which are mine) as well as my constant reference to smoking. If you are trying to cut costs, you go after the highest controllable impacts. For the record, if it is indeed the case that the net cost of a weekend warrior drives meaningful costs into healthcare (which I do not believe is the case) and you can separate and charge that population a premium to offset their costs in a manner that is cost effective (which I don't think you can), do it. Meanwhile, I would still like to see you take a position on the smoking side of this issue. Is it controllable and should they be held financially accountable for their decision to smoke? Should you choose to go into depth (which I am not requesting), please answer the question directly first to avoid any misinterpretation. I also would like to know how offering coverage to an overweight person that currently has no access to any (albeit at a marginally higher rate that a fit person) constitutes a punishment.

However, given that you posted the abstract of a fictional business case study to support your thesis in post #157, I believe some skepticism is justified. Which is why I said "even think of taking it that far". Reading is fundamental.

I did read, and I hope you'll agree that "even think of taking it that far" in is not exactly a direct translation of "here is a far reaching and entirely hypothetical situation to consider." Giving you the benefit of the doubt, this is a rather frustrating red herring.

it is a valid conclusion based on the statements you have made about your opinion of fat people, their own behaviors and priorities, and how you think they ought to be treated.

Other than my position on healthcare premiums, can you give me an example of a statement I have made regarding overweight individuals that supports your earlier claim that "I don't like fat people and they're easy to pick out and blame," or that I have a poor opinion about them?

So you think that it would be a kind, unprejudiced, and rational thing to have presented your friend with a whopping big hospital bill, larger than other people who were there for other problems, because he was fat and hadn't managed to lose weight.

No to the whopping part (that defeats the purpose of universal insurance), yes to the larger than other people part. Any system with limited resources must make allocation decisions, it is the underlying principle of economics. If it was possible to offer universal unlimited medical benefits with no societal consequences we would already have it.

do you honestly think he looked at the entire situation and said "Nope, twinkies are too important to me, don't care if I die a horrible death for it"? I highly doubt it.

He made no qualms that his love in life was eating with his friends. If you spoke to him about cutting back, he would sometimes jovially and sometimes seriously explain that so long as he had to die, at least he was doing what he loved. I respect the choice he made, even if I didn't agree with him. He lived 65 wonderful years and he would have been happy to explain to you the difference between the choices he made and his son's congenital heart defect.

And quite sincerely, thank you for leaving the personal attacks out of your last post.

Posted by: Carlie | October 15, 2009 8:56 AM

Oh lord, look who showed up. TomRiddle, you are interesting to argue with. For all that your conclusions and interpretations frustrate me (and that I disagree with), you're at least addressing the points head-on, not veering into irrelevant comments, and owning what you say. Hyperon is just a clueless mess who has no idea what he's saying, how it comes off, or how wrong he is.

It's already been addressed, but Hyperon, there is a huge difference between "ground" as in nice open land to walk across, and "ground" as in 4-lane highway. For instance, there is a shopping mall across the street from where I work. I would love to pop over there during lunch and get a nice little walk in the bargain. However, between it and me? 4-lane highway, speed limit 65 mph. I could take a circuitous route that takes me only a mile around to get over there, and that's not too much added distance, but that route is also on roads with no sidewalks and not even a shoulder to speak of, and includes exit ramps.

Suburban America was not built for walking. Not even for biking; the rate of bicycle accidents in this country is frightening.(Tom: 540,000 bicycle ER visits per year, 27,000 of whom end up hospitalized, direct and indirect health care costs estimated at $2.3 billion dollars per year, for keeping track of those health care costs. (source)

No time to go into more detail now on your questions, Tom, but I will try later.

Quick one, though - no, I actually don't think that smokers should have to pay higher health care premiums. The people in this country as a whole have decided that smoking should be a legally permitted activity, so I don't think they should be able to then turn around and punish people for engaging in it.

Posted by: Carlie | October 15, 2009 6:50 PM

I also would like to know how offering coverage to an overweight person that currently has no access to any (albeit at a marginally higher rate that a fit person) constitutes a punishment.

I'm not talking about people who have no coverage; I'm saying that someone shouldn't get a financial penalty from their insurance company based on nothing but their weight. I've already said that I don't agree with differential prices in the first place, but given that model, I think it's vastly unfair given that it would result in some healthy people being charged more than some unhealthy people just on the basis of their size, no matter how many instances of it that would cause. Even one is unfair and therefore not a proper setup.

Other than my position on healthcare premiums, can you give me an example of a statement I have made regarding overweight individuals that supports your earlier claim that "I don't like fat people and they're easy to pick out and blame," or that I have a poor opinion about them?

Your very first comment here:
"I loathe the idea of giving up those same dollars to people who choose to live an unhealthy lifestyle."

You equate being fat with choosing to live an unhealthy lifestyle. I've spent several comments trying to unpack why those are unfair conclusions to draw. You've just stereotyped all fat people as lazy and unhealthy by choice.

"So long as there is a heavy correlation between obesity and healthcare costs, it doesn’t matter whether or not the relationship is truly causal."

That is saying that it's easy to pick on the obese because there's a correlation there, and you don't care whether or not there's any causality to it. If the correlation fits, charge them for it.

Bravery is standing by an unpopular but necessary principle.

This seems to indicate that you think it's brave to punish fat people? As if that's not the standard operating procedure, oh, everywhere? You seem here to be thinking of yourself as the valiant knight, standing up against the wall of adipose that is threatening the very fabric of society.

You might not think that you have a poor opinion of fat people and are bigoted against them, but everything you've written here points to that as an underlying theme to your opinions. Perhaps it's so deep that you haven't noticed it (in a similar way to Hyperon's inability to see that he's a racist). You keep trying to stick to the economics argument, but as soon as you scratch the surface it all comes down to "fat people brought it all on themselves and therefore must pay for it, because I'm sure as hell not going to lift a finger for them". Look at all of your comments together - that's a pretty strong theme. It might not be a theme that you're comfortable with having, but that's what you've expressed here, and all I can go on is what you're writing.

Posted by: Jadehawk, OM | October 15, 2009 7:00 PM

Sorry if my statement was ignorant, but there is no need to jump down my throat.

Posted by: Carlie | October 15, 2009 8:26 PM

That was a great interview, SC.

It's even worse than anyone thought - fat people are going to kill the mitten industry! We can blame fat for everything now!

Posted by: Carlie | October 15, 2009 9:35 PM

It is owning to your flaws, not mine, that you unremittingly fail to appreciate the intellectual inconsistency of your subjecting one person to special tailor-made standards of rigour.

Ok, then, who do you see me letting off the hook? Burden of proof is on you to substantiate your claim.

Posted by: TomRiddle | October 15, 2009 11:37 PM

"I loathe the idea of giving up those same dollars to people who choose to live an unhealthy lifestyle." You equate being fat with choosing to live an unhealthy lifestyle... You've just stereotyped all fat people as lazy and unhealthy by choice.

You'll notice you are the one who inserts the word "lazy", which is a very common and negative stereotype for overweight individuals. It is not one I support, nor do I believe it is an accurate representation of the statement you quoted. If you go back, you will see the particular statement you quoted refers to both overweight individuals and smokers. Is it your opinion that I have simultaneously characterized smokers as "lazy" as well? I think you'll have to do better than that to keep defending this point.

Similarly, my statement regarding correlation is in the context of a discussion about the ability to use a correlated attribute to effectively target costs, and it is stretch to transfer that over to my views on individuals.

As for your argument that I am on some anti-adipose crusade, please note that I have initially and consistely targeted two groups, smokers and overweight individuals. You have consistently ignored that fact.

My whole point in this exercise (thank you for participating) is that you have spent a lot of effort in an attempt to frame me as some overtly bigoted Neanderthal so you can dismiss my arguments by virtue of association. You have built a false dichotomy of either viewing overweight individuals as either victims or slobs. I might suggest you are paying more attention to your "Summary of Tom's views" statements than you are to my actual statements in forming your opinion (even the one regarding the nether regions of my psyche).

You keep trying to stick to the economics argument

In all fairness, it is my field of expertise. Universal healthcare begins as a strong moral argument, but the economics of the plan will determine its success or failure. Right now the costs are so staggering we can't even get it out of committee. We are facing massive deficits for many years to come and any fix to the healthcare system is just going to make the near term deficit worse (don't bother posting the contrarian studies, I'm aware of them and they are clearly in the minority). Bad economies have real and far reaching effects on citizens. Like I said, choose you evil, because you are not going to avoid it altogether.

Posted by: Carlie | October 16, 2009 12:46 PM

I'm worn out - I don't think we'll get anywhere further, and I'm trying to mop up a flooded house now thanks to an overnight water valve break. But I'll do one more comment, just to make sure my position is clear.

We should not be able to punish them, but charging them for its effects on society is fair game.

What is a punishment to you? Taking more money from one person than another for the same level of care is punishment to me.

So, unless you can show that paying your fair share constitutes a punishment,

I've spent an awful lot of effort on the idea that "your fair share" is something that is arbitrarily assigned, possibly without much basis in reality, and often wrong. I wouldn't even begin to accept the idea of paying one's fair share unless that share were properly and accurately defined for each individual. If you're interested, I'd urge you to check out some of the links, some of the books, even watch the video clip SC linked to, just to see if any of it might convince you to modify your stance a little.

Is it your opinion that I have simultaneously characterized smokers as "lazy" as well?

That was my characterization of your continued assertion that people who are overweight (and smokers, fine) don't want to change, that their problem is that they won't take the effort to make the changes you think they should make. Generally refusal to do something is described as "lazy", but I'll take your point that you didn't specifically mean that. I guess you could have been thinking "obstinate". That's a larger issue - do you honestly think that people who smoke and who are fat enjoy being that way? That they don't try to change? Then whence the $40 billion dollars to the diet industry, and the desperate attempts at gastric bypass, etc? The thing is, they try and it doesn't work. They try over, and over, and over, and it doesn't work. That's one of the other reasons I think adding a financial penalty is unfair. Yes, there are people who overeat and don't change that. Some of them are fat, some of them aren't. Some of the fat people are healthy, some aren't. There's enough variation that applying one penalty to all of them is NOT a "fair share" distribution.

Posted by: Rev. BigDumbChimp | October 17, 2009 9:40 AM

My take is that Bill Maher is more courageous than most when it comes to refusing to bow his head when commanded, regardless the source of the pressure.

Yes it's very noble to not bow to the pressure when you are 100% wrong about a subject.

Oh wait, not its not. That's just stupidity defined.

There's something stupid, cruel and cannibalistic about blindly ripping this guy to shreds.

There's also something stupid about calling pointed criticism about Maher's incorrect and dangerous viewpoints on medicine and vaccines "Blindly ripping".