Decline in heart attacks

Researchers almost had a heart attack recently when a study purported to show that anti-smoking bans caused a huge reduction in heart attack admissions to hospitals. As Michael Siegel explains:

In October, Dr. David Meyers and colleagues published a paper in the Journal of the American College of Cardiology in which they reported the results of a meta-analysis of published studies on the effect of smoking bans on heart attack admissions. The paper concluded that smoking bans were associated with a 17% decline in heart attack admissions in the 11 studies that were reviewed.

These results were disseminated widely in the media and heavily touted by anti-smoking groups as supporting the conclusion that smoking bans immediately and dramatically reduce heart attacks and that brief exposure to secondhand smoke in bars and restaurants causes a large number of heart attacks.

But then, like so many of these anti-smoking pronouncements, it went bust:

As it turns out, the study findings were due to a careless error. In the original study, the authors had inadvertently reported the Pueblo study has having reported a 70% reduction in heart attacks (a result that is completely implausible and clearly should have been noticed as having been in error). Instead, that study actually reported a 34% reduction in heart attacks. The meta-analysis authors published a correction in which they re-analyzed the correct data.

It turns out that the 11 studies did not find a 17% reduction in heart attacks, but only found an 8% reduction in heart attacks.

In other words, the increase was overstated by over half. That would seem to suggest that these bans might still be effective, even if not as pronounced as before. The study, however, like so many politically motivated studies, apparently did not contain a control. But you can get the rough equivalent by going outside the study to see what the total national decline is:

This level of decline in admissions for heart attacks is obviously not significantly different from the levels of decline in heart attacks that are being observed in the absence of smoking bans, which have varied between 5% and 10% per year in many communities.

For example, in the United States as a whole, heart attack admissions declined by 8.2% in 2004. The decline of 8% in communities/nations with a smoking ban is comparable to this. Therefore, the meta-analysis result fails to provide any evidence that the smoking bans resulted in a decline in heart attacks.

That's what you call the research equivalent of an exploding cigar. You would think the Science Integrity Patrol would be all over this kind of thing. But when it comes to the War on Tobacco, just one front in the Politically Correct Health Crusade, we must are all instructed to just go on as if nothing unusual had happened.

Funny how that works.

The University of Kentucky Health Police given new powers

The University of Kentucky has now implemented their total ban on tobacco use on campus:

The tobacco ban at the University of Kentucky includes outdoor areas and applies to chew, pipes, cigars and snuff as well as cigarettes. Kentucky leads the nation in the production of burley tobacco, and has some of the nation's highest smoking rates.

So far no word from the UK Health Police about junk food and soft drinks, which are even less healthy.

Louisville's Food Police: People free to comment on whether their freedoms should be taken away, says Courier-Journal

This has to be the year's most ironic headline: "Public to get say on trans fats ban." Oh, you mean we actually have a voice in the process by which our freedoms get taken away? How considerate of them.

"Them," in this case, is the Food Police, otherwise known as the Louisville Department of Health and Wellness. I know, it's a scary title, but there it is. They are taking public comment on whether trans fats should be banned in Louisville and will make a recommendation to the Louisville Metro Politbur... er, I mean Council. This is the same bunch that passed a ban on cigarette smoking at all public facilities except the politically powerful Churchill Downs, who got an exemption.

When Kathy Stein and I appeared on KET's "Kentucky Tonight" several years ago on the issue of whether middle school girls should undergo forced vaccinations of the controversial Gardasil vaccine for HPV, I wondered what would be next, joking that the next thing down the pike was a trans fats ban.

"They'll be coming for your french fries," I said. I was joking of course. But (and I should have known this, my predictions have been so dead on in the past) now they're actually thinking of doing it. I would joke again about what they're coming for next, but I'm afraid now it might actually happen.

And just in case you think this is alarmism, check out the discussion on whether hamburgers should be banned, or Obama's soda tax.

As for me, I am taking special precautions, mostly consisting of stockpiling large quantities of Crisco, margarine, Bisquick, Ramen noodles, and frozen chicken pot pies. These people may be determined, but they'll have to pry the tater tots out of my cold, dead fingers.

Banning smoking: The permissivist people who run our educational institutions are still puritanical about some things

The University of Kentucky is set to ban smoking outdoors, another piece of evidence indicating that the anti-smoking movement is really not a matter of concern for health, but instead a moral crusade. "I think there clearly are indications that second hand smoke is an issue," says UK Hollow Man-in-Chief Lee Todd declares. "And I do think smoking is a health hazard."

I'd love to see the research evidence that shows second hand smoke outdoors is a health hazard. No, this has nothing to do with health. It has to do with the university telling students how they should lead their lives, a practice it scrupulously avoids on less politically correct issues.

In a world of coed dorms, condoms in the dormitory vending machines, and taxpayer subsidies of the live-in partners of university staff, you would think the days of moral crusades were over. But, in fact, they just take another form. It all goes back to my theory that once people give up religion they create their own secular forms of it.

A paddle or a pill? Which is the better form of behavioral discipline?

Human Rights Watch and the ACLU are concerned about the paddling that is still going on in some schools. The use of this cruel and inhumane punishment is apparently most prevalent way down South in the land of cotton, wouldn't you know. And what's worse, it is practiced more often with minority children.

You've got to envy all those white Yankee children, whose disciplinary problems are dealt with using the much more humane, civilized, and modern method of behavior management which consists of the administration of psychotropic drugs.

No word from Human Rights Watch and the ACLU on which will have the worse long term effect.

Maybe the poor should eat the rich

Today's story in the Louisville Courier-Journal on obesity in Kentucky prompted me to do a Google search. Here are my findings:

#1: There is a hunger crisis.

#2: There is an obesity crisis.

Only in America.

Keep circumcision safe and legal

A prominent gay blogger is calling for circumcision to be universally banned.

D. Stephen Heersink, who runs "The Gay Species" blog, argues that circumcision is against the Geneva Convention, which calls it "barbaric" and "inhumane". Hmmm. Circumcision is against the Geneva Convention, but abortion isn't? Boy, that certainly tells us something, doesn't it?

Heersink also argues that it "desensitizes" men. And we know how bad the problem of desensitized men is today, don't we?

Here in Kentucky we have people wanting to mandate a vaccine that prevents HPV for all middle-school girls because it would save lives. But recent studies show that circumcision dramatically reduces HIV transmission, so, by the same logic, we should mandate circumcision middle school boys, an idea I have advocated, tongue firmly implanted in cheek.

What I wouldn't give to see Heersink and Rep. Kathy Stein together discussing their views on circumcision.

Keep circumcision safe and legal.

Smoking up in smoke at Disney

Just in case we needed any more object lessons in how morality is being turned upside down, D. Andrew Kern over at Besidethequeue reports that Disney has banned all smoking from its movies. We assume that sex and violence are still acceptable to the folks who are busy about squandering Walt's legacy.

This is also, by the way, further proof of my theory that health is the new religion for people who have abandoned their old one.

Gay rights group compares Frankfort demonstrators to Ku Klux Klan

Herald-Leader? Courier-Journal? Are you there? Are your hypocrisy meters turned on? Once again gay rights advocates, who make a big show of opposing hate, are spewing hateful rhetoric.

Here is the Kentucky Equality Federation on today's rally at the Capitol against taxpayer-funded health benefits for live-in sexual partners of state university staff:

The Family Foundation of Kentucky, our 'KKK members with church clothes on' are holding signs deliberately bringing religion into government even though it is prohibited by the Commonwealth's Constitution.

Is there a better example of hate than comparing someone to the Ku Klux Klan? What exactly did the demonstrators--who are supposed to be so hateful, according the "Equality Federation"--say that even compares to it?

Of course the state media will completely ignore this most recent example of hate speech by gay rights groups. They get a free pass on this behavior by a media that thinks they can do no wrong.

Then there is this little gem from the "Ditch Mitch" blog:

What makes the rally so disgusting is that their protest runs much deeper than even homophobia – it’s simply a pro-hate rally.

Now the Ditch Mitch people know hate when they see it. What constitutes hate for these people? Hate, they argue, is when anyone would not be willing to force taxpayers to pay for anyone and everyone's health care:

Right here in America, nearly 18,000 people die every year simply because of a lack of healthcare coverage. With nearly 1 in 6 people in the country living without access to healthcare, we should all be rallying in favor of anything that helps cover more Americans. Anything less is simply unconscionable.

In other words, anyone who opposes universal health coverage is guilty of hate.

Well, if anyone ever wondered why civil discourse has gone down the tubes, they need look no further than groups like the Kentucky Equality Federation and "Ditch Mitch," which can't acknowledge that anyone who disagrees with them is anything but evil.

It must be hard to live in a world where you think that anyone who disagrees with you hates you too. Maybe we shouldn't be indignant about them after all. Maybe pity is more appropriate.

Holsinger's testimony proof he's perfect for Washington

Kentuckian James Holsinger is looking more and more qualified for life in Washington should he be approved by a Senate Committee that is now conducting a show trial on his nomination as U. S. Surgeon General. He announced, as everyone expected, that he disavowed the now controversial report he wrote as a member of a United Methodist task force in 1991 that found certain homosexual sexual practices were unhealthy.

This shows that he is willing to bow to political pressure to secure his position. This is an essential skill one must master in the nation's capitol in order to survive politically.

Furthermore, after bowing to political pressure, Holsinger announced that, if approved as U. S. Surgeon General, he would never bow to political pressure. This is also a promising sign. This shows his willingness to engage in hypocrisy with a straight face. Even some seasoned political operators have not completely mastered this skill. To be able to look straight into a camera and claim that you are not going to do what you are, in fact, even at that very moment, doing will come in handy in Washington.

Surely Ted Kennedy, of all people, should appreciate this quality in Holsinger.

The other members too should see in Holsinger a characteristic they all ought to admire, since they possess it to such a large degree themselves. After all, none of the medicine has changed since the report was written, but the politics certainly has. And these senators, who at the time would undoubtedly themselves have agreed with the report's findings (remember, this was 1991, when almost everyone agreed with what Holsinger wrote in his report), are indignant that anyone would have believed then what they themselves surely believed at the time.

But for some reason, many of the members of the committee, who want to ensure that the U. S. Surgeon General's office remains above politics by forcing nominees to bow to politics, remain unimpressed.

Here is a committee of politicians who want to sacrifice science to politics while it is saying that it doesn't want science sacrificed to politics, and it has a nominee in front of it who is willing to sacrifice science to politics and bold enough to tell the committee that he would never do such a thing, and they're going to let the opportunity go by?

If they do that, someone is just going to have to start questioning their integrity.

Holsinger op ed in today's Herald-Leader

My editorial "Do we need a Surgeon General who takes medicine this seriously?" (see below) was the lead opinion piece in today's Lexington Herald-Leader. The new title: "He's just a doctor. What does he know?"

Kentucky Equality Federation opposes Holsinger for "U. S. Attorney General" just in case.

Gay rights zealotry has its privileges, which apparently include the ability to oppose a nominee for a position for which he has not even been considered. The Kentucky Equality Federation is so opposed to Dr. James Holsinger that they are not merely opposing him for the position for which he has been nominated, but also for positions for which he has not been nominated.

Bible Belt Blogger Frank Lockwood (who, by the way, kindly posted a link to a previous post despite the fact that I took a pop at him in the piece--what a guy) spotted this comment in The Kentucky Equality Federation's newest press release:

Kentucky Equality Federation will be sending its certified condemnation of Dr. James Holsinger as U.S. Attorney General to U.S. Senator Ted Kennedy, the chairman of the U.S. Senate Committee on Health, Education, Labor, and Pensions. [emphasis added]

I'm sure Ted Kennedy will appreciate the sentiment.

While they're at it, why don't they go ahead and oppose him for Labor Secretary, Chairman of the Joint Chiefs of Staff, and Secretary of State? They could, on the other hand, take a completely different tack and actually support him for some other position. I'm thinking, for instance, of something like Ambassador to the Sudan.

The wording of the Equality Federation's press release is interesting for another reason. Note that they are not simply opposing Holsinger's nomination, but condemning him. This is not atypical behavior for the Tolerance Police, who, while they lecture everyone else about the evils of hate, are in fact the most inveterate practitioners of it.

Oh, and this condemnation is not just a condemnation, but a "certified condemnation." Ooooh. Exactly where does one go to get a condemnation certified? Can I do it at my local bank? At the post office? One begins to think that it is only a matter of time before the Equality Federation begins issuing official anathemas against those who have the temerity to question their gay rights dogmas.

The press release contends that Holsinger's medical opinions have been influenced by his religious beliefs. That, of course, is against the Equality Federation's long-standing position that medical opinions should not be influenced by religion, but should instead be influenced by politics.

Do we need a Surgeon General who takes medicine this seriously?

The President's nominee for Surgeon General, Dr. James Holsinger, seems to have run into some difficulty on this way to appointment as the "America's doctor." It seems Holsinger, who is professor of preventive medicine at the University of Kentucky College of Public Health, has kept a scandalous secret these many years, one which could torpedo his nomination altogether.

The secret involves homosexuality.

Isn't it strange? You think you know someone one moment, and the next you find that he's a completely different person from the one you thought you knew. Holsinger, who holds the Wethington Chair in Health Sciences at UK, had all the appearance of a morally upright, model citizen. He was active in his church, and he seemed for all intents and purposes to be just like you and me.

Then, the awful truth finally came out: Holsinger, whose career includes several stints as chief of staff for several VA hospitals, thinks that homosexuality has bad health consequences.

Yes, it sounds preposterous, but there it is. A religious believer who thinks that there's something wrong with men having sex with other men. A doctor who thinks that anal sex isn't healthy.

Just what turnip truck did this guy fall off of anyway? Where has he been the last few years? Studying AIDS data or something? Reading his Bible? Okay, I know people used to take medicine seriously, and that once upon a time all you needed to have to say something negative about a certain behavior was actual evidence. But aren't we past all that? Haven't we come to the realization that there are certain things more important than medical facts?

Things like the political agenda of gay rights groups?

And since when were people like Holsinger, former Secretary of the Kentucky Cabinet for Health and Family Services, allowed to take their religious beliefs seriously and use them as some kind of basis for what they think--or how they act? You would think religious fanatics like Holsinger, who was chancellor of the University of Kentucky Chandler Medical Center for nine years, would have at least a passing familiarity with the Constitution, where it talks about a "Wall of Separation" between church and state.

It's right there in the First Amendment. Well, okay, it's not really there, but it ought to be, and what it means is you can't be religious and be in government. Or something like that.

We could lay all this at the feet of Holsinger himself, who earned his MD as well as a doctorate in anatomy and physiology at Duke University, but there is a larger question that needs to be answered: Where have the Tolerance Police been all this time? Why weren't groups like the Fairness Alliance warning us all along that this guy was on the loose? What if his beliefs had never been discovered? Would Holsinger, who holds a master’s degree in hospital financial management from the University of South Carolina, still be walking the streets?

Yes, Holsinger has tried to cover his tracks by going out of his way to personally give medical attention to gays and lesbians with diseases which no one knows how they got, but all this shows is just how cunning this man is.

And who are we supposed to believe about the health effects of homosexuality anyway: some guy with a list of medical credentials a mile long? Or the medical geniuses over at places like the Fairness Alliance, Soulforce, and the Human Rights Campaign?

Holsinger's scandalous background was only made public when religious blogger Frank Lockwood ("Bible Belt Blogger") began publishing past statements Holsinger, one of the nation's most respected physicians, had made about homosexuality. Lockwood's impeccable religious credentials include the fact that he was the religion reporter for the Lexington Herald-Leader.

Lockwood, who underscores his objectivity (which he undoubtedly learned at the Herald-Leader) by always prefacing Holsinger's name with the term "anti-gay," uncovered the fact that Holsinger wrote a report for the Committee to Study Homosexuality of The United Methodist Church in 1991. The discovery has caused an uproar--among people who get in an uproar when other people disagree with them--for its bizarre conclusions.

Check this out: the report claims that scientific disciplines like anatomy and physiology have some bearing on the health of sexual behavior. Right. He probably believes that eating right and getting exercise can reduce heart disease too.

And if that doesn't make you wonder what planet this guy beamed down from, listen to this: the human digestive system, he says, shouldn't be used like the human reproductive system!

Sheez. Some people really know how to spoil a party.

And then there's the statement in the report that men having sex with men isn't a good idea from a health standpoint. The reason? Because it leads naturally to "gonorrhea, infections with chlamydia trachomatis, syphilis, herpes simplex infections, genital warts, pubic lice, scabies); enteric diseases (infections with hig gel la species, Campylobacter jejuni, Entamoeba histolytica, Giardia lamblia, hepatitis A, hepatitis B, hepatitis non-A, non-B, and cytomegalovirus); trauma (fecal incontinence, hemorrhoids, anal fissure, foreign bodies, rectosigmoid tears, allergic proctitis, penile edema, chemical sinusitis, inhaled nitrite burns, and ... AIDS."

I mean, does the guy really have to be such a killjoy? Chill out with the medical jargon, dude. Can't people have a little fun without doctors throwing medical statistics in their face?

And after all, isn't that the worst aspect of this whole episode? Here we have a nominee to be United States State Surgeon General who takes this medical stuff just a little too seriously.

What's the world coming to?

Did James Ramsey tell the truth?

U of L Pres. James Ramsey told a House committee his university does not subsidize domestic partner benefits. Why is he telling state lawmakers one thing, and his employees something completely different?

In the debate over domestic partner benefits at Kentucky’s public universities, one alleged fact has been hammered home by proponents again and again: that no taxpayer money was being used by the University of Louisville to subsidize the benefits. Legislators have relied on this fact in arguing for it, and U of L’s own Board of Trustees relied on it in making their decision to approve the university’s plan. But new information is calling into question whether the university is being truthful in its statements to state lawmakers and the public.

During House Health and Welfare Committee testimony on March 6, University of Louisville President James Ramsey testified that his university did not subsidize its employee health insurance plans of domestic partners. U of L officials have maintained since last year, when it instituted its domestic partner benefit plan, that no taxpayer or tuition money was involved in their decision, since the cost of their health benefits was borne solely by employees.

That testimony was the chief point of controversy for many of the committee members. Representative Bob Damron (D-Nicholasville) tried to clarify the matter during Ramsey’s testimony:

Damron: You mentioned that there is no cost to the university. Is your health insurance plan structured such that the dependents, spouses, children and so on that are added to your plan are purely a pay as you go basis or is there any subsidy? Most state plans have a subsidy that helps to pay part of the family plan or at least a piece of it or buys the cost of participating in a family plan. Are you stating that the University of Louisville pays for the single policy but they don't subsidize in any shape form or fashion adding additional people to the plan?

Ramsey: As I indicated to you I pay for my dependents health insurance

Damron: That's not the question. The question is are you partially subsidizing the cost of a family plan? The state of Kentucky partially subsidized the cost of the family plan. Is the University of Louisville not partially subsidizing the cost of their family plan?

Ramsey: No. Are you talking about on an actuarial basis?

Damron: On an actuarial basis.

Ramsey: The actuaries told us no we are not.

Damron continued to press the issue, and pointed out that he didn’t think the numbers added up. Again Ramsey affirmed that U of L did not subsidize their plan:

Damron: I guess in my own mind, I’m having a hard time figuring out how you could do that at half the cost of what the state employee’s were paying for their family plan.

Ramsey: Do you want us to follow the state plan? [laughing]

Damron: No, I want to make sure that before you make a statement, before a committee of the General Assembly, that you are accurate in what you say.

Ramsey: Bob, you’ve known me for a long time, and I’ve always been honest with the General Assembly.

Damron: I’m not saying you’re not honest. I’m just saying I think you need to look at that issue before you make statements like that.

Ramsey: What I’m telling you is what I’m telling you.

A few minutes later, Rep. Darryl Owens (D-Louisville) brought up the matter again, just to make sure:

Owens: That does not change the fact of your testimony which is that the university does not subsidize. Is that correct?

Ramsey: Correct.

Maybe I'm mistaken, but I think Ramsey is saying that Uof L doesn't subsidize its benefits. But there's one little problem: the health care section of U of L’s own website indicates exactly the opposite.

Not only does it say they are subsidizing family benefits, but the new part of the site dealing with domestic partner benefits says quite clearly that the university is subsidizing benefits for domestic partners. According to the website page dealing with domestic partners:

Whether or not your domestic partner qualifies as a tax dependent,” says the site, “makes a difference in how taxes will be deducted from your paycheck for benefits. IRS does not allow pre-tax treatment for any dependents that don't qualify as your tax dependent. Therefore, if that's the case, you will be taxed on the money you spend through payroll deduction as well as the money U of L spends for your domestic partner and his/her children.” [Italics added]

In the same section, it goes on to say that the university pays the same amount for an employee and domestic partner as with an employee and spouse.

You will see that the university contributes the same amount in both situations, but the differences in the tax treatment will make a difference in your net take-home pay.” [Italics added]

Now I could be mistaken again, but this seems to say that the University of Louisville is subsidizing the benefits.

The site goes on to show an example of the employee’s paycheck with the benefit for the domestic partner under the label “Employer Paid Benefit.”

In other words, the university’s own website would appear to directly contradict President Ramsey’s unequivocal testimony before the committee. If U of L is not subsidizing the benefit, then how can employees report to the IRS that it is?

It is beginning to look like President Ramsey owes state lawmakers—and his own Board of Trustees—an explanation of why he is telling them one thing while his university is telling its employees something completely different.

Erratum Meum Oopsum

We take refuge in Latin when we make a mistake, and State Rep. Kathy Stein points out an inaccuracy in my piece the other day about Merck contributions to legislators, one which is fairly minor, but we do want to keep things as accurate as possible here.

It was not "Front Page with Sue Wiley," on which State Sen. Dan Kelly appeared (and into which Rep. Stein called in), but the "Kruser Show." She also says that she has a recording of the program in which Sen. Kelly was talking about "payoffs from drug companies" (or something similar to that--Rep. has the recording), to which, of course, she takes exception.

Well, I'll take her word for it. And I wouldn't use those words myself (and didn't the other day), but the problem is that when you take money from a company who developed a drug, and the drug company stands to make literally billions of dollars from a piece of legislation mandating that drug, and then you vote for the bill, you open yourself up to such charges, and its hard to sort out whether there was a relationship between the campaign donation and the vote in favor of the bill or not.

That's why I stressed the importance of the appearance of impropriety in my post--precisely because it looks to some people like this is exactly what is happening.

Today's reading for Rep. Kathy Stein

While the media snores, here are the facts about contributions to state lawmakers from the developers of the HPV vaccine.

I don't remember who it was who told me a few years back about a reporter who came to a major Kentucky newspaper from New York, and who was appalled at the laziness of his newly acquired colleagues. The concept of investigative reporting, he observed, was almost unknown to members of the media in this state, whom, he thought, spent entirely too much time in their office cubicles, and not nearly enough time snooping out the facts behind the obvious.

The story was related to me in the context of the Kentucky Education Reform Act of 1990 (KERA), the propaganda for which was swallowed hook, line, and sinker by the major Kentucky media, until a few of us pointed out the very obvious problems with it, at which point a small handful of them were energetic enough to actually look at KERA for what it was. But the debate over mandatory HPV vaccinations has revealed once again the lack of interest of the state media in doing any journalistic heavy lifting.

A case in point is the controversy over donations by the developer of Gardasil, the HPV vaccination, to state legislators who have been considering a mandate for the drug, an issue which finally hit the media yesterday in a Lexington Herald-Leader story about State Rep. Kathy Stein's demand that Senate Majority Floor leader Dan Kelly issue an apology to her and other lawmakers for erroneously accusing them of taking money from the drug company.

Come again?

First of all, Kelly, who made the comments on "Front Page with Sue Wiley," was talking about the issue in other states (whose reporters apparently dig a little deeper than those here) where this has been the case.

Secondly, is Stein denying that Kentucky lawmakers have received money from Merck? If she is, she--not Dan Kelly--has some apologizing to do.

Here is what The Institute on Money in State Politics says about Merck contributions in Kentucky in its report, "Names in the News: Merck & Company." This report was laboriously obtained by first sitting down at the chair in front of my laptop (a complicated procedure), then pressing the "on" button, an effort which necessitated the expenditure of who knows how many of the calories I had gained from the Snickers bar I had just consumed, and then entering "www.followthemoney.org," which required--count 'em--22 whole keystrokes:

• Total Merck contributions to state lawmakers across the country, 2000-2006: $2,450,352.
• Total Merck contributions to Kentucky state lawmakers, 2000-2006: $40,225.

Who did they go to? A wide variety of lawmakers, some for the HPV mandate, and some against. Is this a surprise? No. Drug companies--and every other business interest--give money to candidates all the time. So what is the problem?

Here's the problem:

First, if you have taken money from the developer of the drug, and you do vote for the mandate--particularly if you have some influential role in its passage--you create the appearance of impropriety. Does it mean you voted for the mandate because you received money? No. But everyone seems pretty much agreed these days that when it comes to being a public official, the standard is not just actual impropriety, but even the appearance of it. That's why we have things like legislative ethics commissions. They deal in almost nothing but the appearance, rather than the actual incidence of influence peddling.

Second, when people like Kathy Stein publicly challenge someone who states that Merck has been giving money to public officials and questions this, the issue then becomes who is telling the truth.

Here's the truth (as revealed by the toilsome process of a few more keystrokes, and--pant, pant--a site search):

• A number of Kentucky state lawmakers took money from Merck & Co. from 2000-2006.
• The money from Merck was given to lawmakers from both parties.
• The people who took money from Merck fall out on both sides of the issue.
• People who are criticizing Merck contributions to supporters of the HPV mandate and who are not supporters of the mandate took money from Merck.
• Some of of the people who sat in key positions contributing to the passage of the HPV mandate are among the people who received contributions from Merck.
  

None of these is a problem, except for the last one, because of that little matter of the appearance of impropriety.

Who are we talking about? Tom Burch, he the chairman of the House Health & Welfare Committee that approved HB 345, the HPV mandate, in the House.

According to followthemoney.org, State Rep. Tom Burch received $500 on 2002, $800 in 2004, and $500 in 2006. There were other lawmakers on the committee who voted for the bill who received money from Merck, and a few others who voted for the bill on the House floor. This doesn't mean it is the reason they voted for the bill, but at minimum--the rock bottom expectation on these kinds of issues--is that they should have disclosed that fact when they voted.

Should they go to jail? No. Not even close. Should they have made a point to mention the contributions in the process of passage of the bill? Yes.

Oh, and one final question: Should I be the one having to point this out because the media is either too lazy or refuses to do it?

Mandating circumcision for middle school boys

New data on circumcision's role in reducing HIV transmission cries out for a mandate. Well, not a mandate, but something exactly like it. Sort of.

According to the new issue of Time Magazine, a new National Institutes of Health study shows that circumcision reduces the risk of contracting HIV by 60 percent. A report of the study appears in the most recent issue of The Lancet, a widely regarded British medical journal.

Now obviously this means that the more boys who are circumcised, the better off we will be. The more circumcisions, the less HIV. And the less HIV, the fewer deaths that will result from it. And how best to ensure that more boys are circumcised? Surely the answer to that question is obvious:

Mandate the circumcision of middle school boys.

Just look at the HIV statistics. How many people die of HIV every year? Imagine the lives that might be saved if we ensured that every young boy was circumcised before entering middle school.

And that's why we need to mandate circumcision in Kentucky: because it will save lives.

Now undoubtedly there will be those detractors who will oppose this idea. But these are the same people who opposed mandating the HPV vaccine: religious people. And we know about them, don't we?

These people say that the decision to circumcise their children should be left up to parents. And that would be a fine idea—if all parents were good parents. But we all know that is not the case. All parents are not good parents. There are some parents who will not do what is best for their own children (according to us), and so we must make these decisions for them.

According to most statistics, only 76 percent of boys are circumcised. But among some groups of people—and these are the people who we are really concerned about, even though we don’t like to admit it because we want them to continue to vote for us—the rate is as low as 45 percent.

The government has the responsibility to step into the relationship between families and their physicians for their own good. Of course, this principle does not extend to the abortion issue, where we take the complete opposite position. There, the government has no business in the health care decisions of individuals, as we have said repeatedly until we are blue in the face, and then decide to say something completely different.

But that is another issue altogether that we really don't want to talk about right now.

Back to these religious people who think that parents have rights. Even though these people will argue that mandating circumcision violates parental rights, they really have an ulterior motive. What really bothers them about mandating the circumcision of middle school boys is that it has to do with sex. In fact, as State Rep. Tom Burch points out, they wouldn't even be involved in debates like this if it weren't for sex.

Come to think of it, nobody would be involved in any debate if it weren't for sex. In fact, nobody would be here at all. But regardless, we need a mandate.

Mandate?

What mandate? Who said mandate? When did we ever say we should mandate circumcision? We're not talking about a mandate, and anyone who says that we ever proposed a mandate is misrepresenting us.

Now of course one of the reasons we need to mandate circumcision is that if we don't mandate it, insurance plans won't have to cover it. But, of course, like we just said, this isn't really a mandate. It's only a mandate in this paragraph so that we can make this argument. In the next paragraph, it isn't a mandate anymore.

You've got to follow along closely here and pay attention.

Never mind that most insurance plans already cover circumcision (just like they cover Gardasil, the HPV vaccine). Theoretically, under different circumstances, maybe in a different dimension (possibly in the one inhabited by the Lexington Herald-Leader), they could conceivably not cover circumcision. And what would happen then? Why, we would have uncovered circumcisions, that's what. And we know how embarrassing that would be.

That's why we need a mandate—even though that's not what this is.

One of the reasons this isn't a mandate is because we are going to allow the families of these boys to opt out. Now there are some people (those religious people) who ask why, if it is not a mandate, we need an opt out in the first place. They point out that there is no reason for an opt out unless it is a mandate. If it's not a mandate, there would be nothing to opt out from. They say we are talking out of both sides of our mouth. But remember, these are just crazy religious people.

And we say that out of both sides of our mouth.

Besides, if these people don't stop misrepresenting us, we're going to mandate this for them too—whether they need it or not. No anesthesia, no opt outs, no nothin'.

Remember, this non-mandate mandate could save thousands of lives nationally and worldwide. Now you may be wondering how a Kentucky law could save all of these lives across the nation and around the world. Well, we wonder about that also, but this same argument worked for the bill to mandate the HPV vaccination (SB 345, the mandate that wasn't a mandate), so we figure it will work on this issue too.

And let's deal right here with the nasty rumor going around that our support for mandatory circumcision of middle school boys has anything to do with campaign contributions to key Kentucky legislators by the National Association of Rabbinical and Non-Rabbinical Mohels (NARNRM). We can't deny this, of course, any more than we can deny that there were campaign contributions in 2004 and 2006 from Merck & Co., the developer of Gardasil, the HPV vaccine, to legislators in whose committees HB 345 was considered. But so what?

Have you seen anything in the news media about these contributions? No. Just like there was nothing ever said about Merck's contributions. Now wouldn't you think that if there had been something amiss, the intrepid investigative reporters at newspapers like the Lexington Herald-Leader and the Louisville Courier-Journal would have said something about it?

Huh?

But all this is just a distraction from the main point that anyone who opposes the idea of mandating circumcision is opposed to saving lives. If they were really concerned about lives, they would ignore the inherent contradictions and illogical arguments offered for this mandate that really isn't a mandate even though we keep saying so and then denying it.

But what do they do instead? They just keep confusing the issue with logic and facts that have nothing to do with whether it's a mandate—or isn't. Maybe.

In fact, speaking of the HPV vaccination for girls: in comparison to that idea, circumcision for boys is simple. Girls have to endure the ordeal of going in for three different shots. But circumcision for boys? It's quick and easy. Whack! and it's over.

Come to think of it, if we could get the doctor to slice just a few more inches closer to the body, we could probably prevent a lot of other societal havoc. But that's a discussion for another day. Or maybe next week, when we decide to mandate something else we think is good for everybody and then pretend that it's not a mandate, except on Tuesdays.

But for right now we need to think about HIV, and all the other diseases that have nothing to do with HIV but that kill people too because they all make us sad. And sadness is a bad thing—except when it gets people so emotional they forget that these other diseases have absolutely nothing to do with HIV and whether a mandate will actually reduce it, and whether this is really a mandate or not.

And that is why we need this new policy. Because it isn't a mandate.

Except when it is.

The above cartoon comes by way of On the Right, Steve Manning's blog.

Legislative debate over HPV vaccinations, by Lewis Carroll

Yesterday's House floor discussion over HB 345 seemed like something Alice might have encountered after falling down the rabbit hole.

Okay. So state lawmakers are not professional logicians. Premise granted. But really, how do the proponents of mandatory HPV vaccinations show their faces in public again after yesterday's surreal debate?

Kathy Stein got up on the floor and argued that HB 345 was NOT a mandate, and that was one of the reasons House members should vote for it. Then another legislator got up and said that the reason to vote for it was because the only way insurance companies would be forced to cover the cost of the vaccine was if it was a mandate. In other words, the reason they should vote for it was because it WAS a mandate.

In other words, the reasons to vote for it canceled each other out.

Lawmakers must have had the same feeling you get after the Teacup ride at Disneyland as they left the chambers.

Then, even though (claimed Stein) it was not a mandate, an attempt to replace the word "require" was not only opposed by bill supporters, but ruled not germane by Speaker Jody Richards, even though it clearly was germane.

Next week's featured House debate: Whether the knave of hearts really stole those tarts.

HPV mandate for middle school girls will not cure most cases of cervical cancer

An article in today's Washington Times points out that administering Gardasil to pre-teen girls would be ineffective against most cases of cervical cancer.

Why?

Because the drug is only proven to last 5 years, by the time they are 16-18 years old, the drug is probably ineffective. But the average cervical cancer patient is 47 years old. In fact, more than 70 percent of cervical cancer patients were older than 40. According to infectious disease specialists and cancer pathologists, the incubation period of the virus is 10-15 years, meaning that the average cervical cancer patient contracted the HPV that caused the cancer in her 30's--long after Gardasil would have worn off from middle school vaccinations.

So since such vaccinations are said to be effective against 70 percent of cervical cancers, administering it before middle school would miss the vast majority of these. Cervical cancer is on the National Institute for Health's list of rare diseases. Now we have a drug that will apparently only prevent a few of these rare cases.

So what was the reason for mandating it again?

CJ poll shows opposition to HPV vaccination

According to this morning's Louisville Courier-Journal, the Bluegrass Poll found a majority of Kentuckians opposed to mandatory HPV vaccinations. About 47 percent of Kentuckians opposed making it mandatory while only 38 percent supported it.

Of course, that's not what the CJ's headline said. The headline said, "Kentuckians split on cervical cancer vaccine." Well, well.

Of course, in its results on casino gambling, were somewhat similar (52-38) if you take the margin of error into account (3.5 percent). But that result, interestingly, was billed as support for casino gambling.

Funny how that works.