Jonathan Gruber, MIT Economist

Vik Khanna:

My thoughts on the Jonathan Gruber, foot-in-mouth, events.

Originally posted on Your Personal Affordable Care Act:

By now, the insulting comments by Obamacare advisor and Affordable Care Act designer, Jonathan Gruber, are well known. If you need a primer, read these twoarticles, or Google it; there’s no shortage of data.

My friend Saurabh Jha, a radiologist of powerful intelligence and wit, thinks Gruber is to be applauded for his intellectual honesty. Not quite. Jonathan Gruber’s odious dismissal of his fellow citizens lays bare the poisoned apparatus for making health policy in our country. His smug, “we showed them,” attitude reflects that healthcare policy generation in the U.S. is driven by a cabal of crony capitalists, a small army of disdainful, contemptuous, ideologues who have played footsie with each other, the government, and the healthcare industry for years, decades even.

They are a treacherous clique that cultivates personal riches and power at the expense of Americans who have been struggling with a hyper-expensive and equally inefficient healthcare…

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Your Personal Affordable Care Act | How To Avoid Obamacare

ebook_6x9_v4 with blue stripe after pixel check (1) The most creative, assertive, and unyielding take down of Obamacare is available now as an e-book in the Amazon.com Kindle marketplace and at Smashwords.com. Read and enjoy! (Watch the video here.)

 From John Irvine, Executive Editor of The Health Care Blog: “If you haven’t met Vik Khanna, you need to. Your health may depend on it. Packed with invaluable advice that will arm you with the tools and the strategies you’ll need to stay as far away from the healthcare industry as humanly possible, you’ll find yourself turning to Vik’s book again and again. Both thumbs up!!

 From Health Economist Al Lewis: “As Vik writes, the only hope we have of fixing the healthcare industry is to fix ourselves, and that is something hospitals, doctors, and health plans cannot do for us. For both the healthcare industry’s long-term sustainability and our individual successes and sanity, we must reacquaint ourselves with the importance of executing the fundamentals well – regular exercise, healthy (or at least healthier) eating, not smoking, and managing our stresses – and doing so repeatedly. Just because you are not paranoid does not mean the healthcare industry is not out to get you.”

Your Personal Affordable Care Act | How To Avoid Obamacare.

Workplace Wellness Produces No Savings – Health Affairs Blog

Al Lewis, Shana Montrose, and I take it to the wellness industry in our new paper, just published on the Health Affairs Blog.

Workplace Wellness Produces No Savings – Health Affairs Blog.

USPSTF: Routine Vitamin D Screening Unsupported

To paraphrase Freddie Mercury and Queen: another one bites the dust, hey, hey, another one bites the dust.

More screening bullshit down the drain. Well, except for the fact Obamacare wants people to get more screenings, and just becuase the law compels health plans to pay for only screenings graded A or B doesn’t mean that providers can’t seduce people into getting useless, lower-graded screenings and either paying out of pocket or finagling a reimbursement agreement with insurers.

USPSTF: Routine Vitamin D Screening Unsupported.

I fought My Fitness Pal, and I won

On November 13, 2014, I slammed My Fitness Pal, a very popular health app, in a column I wrote for The Health Care Blog, which you can read here. I win.

My Fitness Pal, unlike your common, garden-variety wellness vendor has changed its homepage and removed the questionable claim that 65 million of its users had lost weight. The top screenshot below is the before; the lower one is the after.

Before my column

Before my column

After my column

After my column

They also no longer say on the homepage that you can “Eat whatever you want.”

The win was not complete, however. When I logged into my free My Fitness Pal account, I learned that, unfortunately, an ad for The Cruise Control Diet ($39.95), has been replaced by ads for Motts juices, Zone diet bars, and Real Dose Nutrition, a physician-promoted diet formula that’s $180 for six-months. My Fitness Pal has not responded to my criticism that they expose their users to costly diet schemes, other than the fact that they need the ads.

My Fitness Pal’s claim revision is a good first step, but that’s all it is. In a blog post on November 17, 2014 (http://blog.myfitnesspal.com/2014/11/myfitnesspal-works-if-you-use-it/), co-founder Mike Lee made a different claim that deserves scrutiny: that users have lost 180 million pounds collectively. If you use their previous claim of 65 million as a denominator, you get average weight loss of 2.7 pounds. Not exactly earth shattering. And, all of the other questions I raised in my column are completely ignored. Because Mr. Lee and his colleagues likely don’t want to admit that they have no idea about any of them.

Voltaire said that to have a pen is to be at war. My colleague, Al Lewis, and I are at war with the wellness industry: an industry built on lies, exaggeration, false success claims and “ooh, we didn’t notice that” excuses. Chalk one up for the good — and right — guys.

Think Twice Before Choosing Knee Replacement – NYTimes.com

If you are thinking about a knee replacement, and especially if you do not have severe functional limitations and are in your 40s or 50s, think again.

This is a very active racket in suburban neighborhoods, such as mine, which are chock full of well-insured baby boomers, who run to the doctor for every little ache and pain, and the doctors are only too happy to take as much of their money as possible.

Think Twice Before Choosing Knee Replacement – NYTimes.com.

PLOS ONE: Running for Exercise Mitigates Age-Related Deterioration of Walking Economy

Cool study that looks at whether older adults who run walk more efficiently. And, the answer is yes. Older adults who run (you don’t have to sprint, just jog), walk as efficiently as young adults 40 years their junior.

Just another indicator of how the government, and its private sector enforcers such as the American Heart Association and the American College of Sports Medicine, are all wrong with their insipid and incessant advice that everyone should just take a walk. Get off your ass. Walking, unless it is really fast walking, at around 4 mph, isn’t going to do much for you unless you do an awful lot of it, like about an hour a day. If you have other useful things to do with your time, you might throw in a little jogging which will, surprise, surprise, deliver much more bang for the buck.

PLOS ONE: Running for Exercise Mitigates Age-Related Deterioration of Walking Economy.

Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials

Updated review of the benefits of soluble oat fiber for lowering cholesterol. It appears to continue to be a valid claim. A dose of 3 gm per day produces a lowering of cholesterol by about 5.5 mg/dl. Appears to have greater impact in people with higher baseline cholesterol levels and perhaps in people with diabetes.

I eat nearly a cup of rolled oats almost every day. An easy way to get fiber, protein, and benefits of a whole grain.

Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials.

65 Million People Lost Weight With MyFitnessPal? | The Health Care Blog

Who believes the claim that graces the home page of My Fitness Pal? Go ahead, raise your hands and be counted.

65 Million People Lost Weight With MyFitnessPal? | The Health Care Blog.

MIT Economics : Jonathan Gruber

Vik Khanna:

You simply could not make up the intellectual dishonesty of this administration when it comes to its signature healthcare law.

Originally posted on Your Personal Affordable Care Act:

Smarmy, academic hack and Obamacare designer, Jonathan Gruber, thinks you are STUPID. Why don’t you call or email him and let him know…politely and without the condescenion he showed you…what you think of his commentary. More to come on this.

Oh, in case they take his page down, here is a screenshot:

via MIT Economics : Jonathan Gruber.

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Cardiorespiratory Fitness, Exercise, and Blood Pressure

An excellent, brief, and easy to understand review article on the impact of fitness and exercise (you do the second to achieve the first) on blood pressure. The three most important sentences are at the end: “The dose–response association between increased cardiorespiratory fitness, BP, and mortality risk reduction supports the existence of a causal mechanism(s). However, the mechanism or mechanisms are not well understood. It is likely that the favorable effects cardiorespiratory fitness, exercise, and physical activity have on several biological systems traditional risk factors are likely to share the credit.”

The medical profession’s abject ignorance about the effects of exercise on non-traditional risk factors is a huge barrier that has yet to be overcome. It is heartening to see leading physicians writing about it in leading journals.

Cardiorespiratory Fitness, Exercise, and Blood Pressure.

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