Chris Christie’s Big Problem
Whether or not he lets himself be persuaded to run for president, Chris Christie needs to find some way to lose weight. Like everyone else, elected officials perform best when they are in optimal health. Christie obviously is not.
You could argue that this is none of my business, but I disagree. Christie’s problem with weight ceased being a private matter when he stepped into the public arena — and it’s not something you can fail to notice. Obesity is a national epidemic whose costs are measured not just in dollars and cents but also in lives. Christie’s weight is as legitimate an issue as the smoking habit that President Obama says he has finally kicked.
On rare occasions, Christie speaks candidly about his weight. “I’m really struggling, been struggling for a long time with it,” he told CNN’s Piers Morgan in June. “And I know that it would be better for my kids if I got it more under control, and so I do feel a sense of guilt at times about that.”
Six weeks later, the New Jersey governor was briefly hospitalized for asthma — a condition that he has had for most of his life. Researchers say that many respiratory problems, including asthma, are worsened by obesity.
As he left the hospital, Christie acknowledged the connection. He described himself as “relatively healthy by all objective indicators,” but added that “if I weighed less, I’d be healthier.”
“The weight exacerbates everything,” he said.
And it does. According to the National Institutes of Health, obesity puts people at greater risk for Type 2 diabetes, coronary heart disease and stroke, certain types of cancer, sleep apnea, osteoarthritis, and gallbladder and liver disease.
The NIH estimates that nearly 34 percent of U.S. adults can be classified as “obese,” meaning they have a body mass index of more than 30. By this standard, a man who stands 5-foot-11 — Christie’s reported height — would be obese if his weight reached 215 pounds. While Christie does not disclose his weight, it appears to exceed the 286 pounds that would place him among the 5.7 percent of American adults whom NIH classifies as “extremely obese.”
I refer to obesity as an epidemic because the percentage of obese adults has doubled in the past 40 years — and childhood obesity is increasing even more rapidly. Again according to the NIH, “obesity is associated with over 112,000 excess deaths due to cardiovascular disease, over 15,000 excess deaths due to cancer, and over 35,000 excess deaths due to non-cancer, non-cardiovascular disease causes per year.”
On average, health-care costs for obese persons are 42 percent higher than costs for individuals whose weight falls into the “normal” range. It costs Medicare $1,723 more a year for an obese beneficiary than a non-obese one. For Medicaid the differential is $1,021, and for private insurers it’s $1,140. In other words, obesity is helping propel the rise in health-care costs, which are fueling the long-term rise in the national debt.
My intention is not to blame Christie for the federal government’s deficit spending — or, in fact, to blame him for his own obesity. Blame is not the point. Christie is just 49 and has four young children; politics aside, I’m sure he wants to be around to share the milestones in their lives. He prides himself on bullheaded determination and speaks often about the need for officials to display leadership. Well, Gov. Christie, lead thyself.
“I weigh too much because I eat too much,” he said after his hospitalization this summer, “and I eat some bad things, too.”
If only it were that simple. Yes, the basic arithmetic of calories ingested vs. calories expended is inescapable. But the science of weight control now takes into account the role that genetics might play, along with psychological factors that lie outside our conscious control. There are new options, including gastric surgery, beyond the dieting roller coaster — lose 40 pounds, gain it all back — that Christie says he has been riding for years.
Those who have lost weight and kept it off for extended periods, including former Arkansas governor Mike Huckabee, say they have succeeded by making proper diet and exercise part of their lives — not just unpleasant chores that have to be endured.
Politically, I disagree with Christie on almost everything. I’ll have plenty of opportunities to tell him why. Today, I’d just like to offer him a bit of unsolicited, nonpartisan, sincere advice: Eat a salad and take a walk.
By: Eugene Robinson, Opinion Writer, The Washington Post, September 29, 2011
Michele Bachmann: ‘Anti-Vaccine Wingnut’?
Rep. Michele Bachmann (R-Minn.) earned glowing reviews for her performance in Monday’s CNN/Tea Party presidential debate. Her perceived finest moment: Hammering Texas Gov. Rick Perry over his (quickly overruled) 2007 executive order mandating that “innocent little 12-year-old girls” in Texas get vaccinated against the sexually transmitted infection HPV. Bachmann didn’t fare as well, however, in her post-debate media blitz, ill-advisedly repeating the cautionary tale of a mother who claimed her daughter “suffered from mental retardation” because of the HPV vaccine. Has Bachmann “jumped the shark” (as Rush Limbaugh suggests) by attacking vaccines instead of just Perry?
Bachmann is sabotaging herself: Bachmann’s odd assertion sounds a lot like the “thoroughly debunked” claim that childhood vaccines cause autism, says Doug Mataconis at Outside the Beltway. And as with the autism “nonsense,” there is no evidence that the HPV vaccine has ever caused anything like “mental retardation.” Bachmann really blew it here, quickly fleeing the debate’s winner’s circle for the fringe camp of “anti-vaccine wingnuts like Jenny McCarthy.”
This is just Bachmann being Bachmann: “News flash: Vaccine luddism is rather widespread,” says Dave Weigel at Slate. And the fact that it’s Bachmann who’s tapped into it is “totally unsurprising,” given her penchant for “endorsing or ‘just asking questions’ about dark theories that she’s overheard.” Really, such claims are just par for the course with Bachmann.
Whatever her reasons, this will cost Bachmann: “I liked Michele Bachmann. A lot,” says Lori Ziganto at RedState. That ends now. I don’t care if she’s “actually cuckoo pants or if she’s just lying and using children and the fears of their parents to score political points,” but this “tall tale” about a 12-year-old absurdly “catching” mental retardation — something you’re born with — tells me all I need to know: Bachmann’s “not very bright” and she’s a “Jenny McCarthyist.” Let’s not forget: “Vaccinations save lives.”
By: The Week, Opinion Brief, September 14, 2011
Texas-Style Tort Reform: Rick Perry’s Texas Health Care Hoax
In his quest to win the Republican presidential nomination, Texas Gov. Rick Perry is perpetuating a convincing hoax: that implementing Texas-style tort reformwould go a long way toward curing what ails the U.S. health care system.
Like his fellow GOP contenders, Perry consistently denounces “Obamacare” as “a budget-busting, government takeover of healthcare” and “the greatest intrusion on individual freedom in a generation.” He promises to repeal the law if elected.
Unlike those in the “repeal-and-replace” wing of the Republican Party, however, Perry has emerged as leader of the “repeal-and-let-the-states-figure-it-out” wing that believes the federal government has no legitimate role in fixing America’s health care system.
“To hear federal officials tell it, they’ve got all the answers on health care and it’s up to the rest of us to sit, wait and embrace whatever solution — if any — they may eventually provide,” Perry wrote in a newspaper commentary in 2009. “I find this troubling, since states have shown they know a thing or two about solving problems that affect their citizens.”
Even as he points with pride to the alleged benefits of malpractice and other tort reforms that have been enacted during his tenure as governor of Texas, Perry says he is opposed to tort reform at the federal level. He cites the 10th Amendment to the Constitution, which states-rights advocates say limits the role of the federal government.
But if Perry had his way, all the states would do as Texas did in 2003 when lawmakers enacted legislation, which he championed, limiting the amount of money juries can award patients who win malpractice lawsuits against doctors and hospitals. The legislation capped non-economic (pain and suffering) damages at $250,000 in lawsuits against doctors and $750,000 against hospitals. A few months after he signed the bill into law, the state’s voters narrowly passed a constitutional amendment, also endorsed by Perry, which had the same effect. Proponents of the amendment wanted to be sure the new law would be constitutional.
Texas, he wrote in that 2009 commentary “stands as a good example of how smart, responsible policy can help us take major steps toward fixing a damaged medical system, starting with legal reforms.”
As a result of the 2003 tort reform law, malpractice liability insurers reduced their rates in Texas and, according to Perry, the number of doctors applying to practice medicine in the state “skyrocketed.”
He says that in the first five years after tort reform was enacted, 14,498 doctors either returned to practice in Texas or began practicing there for the first time.
Tort Reform Backfires in Texas
That certainly sounds impressive — so long as you look at that number in isolation. But when you look at how Texas stacks up with the rest of the country in terms of physician growth in direct patient care, tort reform appears to have given Texas no leg up in competition with others states for doctors. In fact, according to statistics compiled by the American Medical Association and other physician organizations, Texas has actually lost ground when it comes to the number of doctors practicing in the state since tort reform was enacted. Big time.
In 2008, the number of physicians in patient care per 10,000 civilian population in the United States was 25.7. At just 20.2 doctors per 10,000 people, Texas ranked near the bottom of the 50 states. In fact, only nine states fared worse. In 2000, three years before tort reform, Texas was still bringing up the rear, but not as badly. Back then, 11 states fared worse than the Lone Star state.
Even more revealing, the number of doctors in patient care increased 13.2 percent nationwide from 2000 to 2008. It increased only 12.8 percent in Texas. The rate of growth was actually greater in 41 other states and in Washington, D.C. than it was in the Lone Star state.
It is true that malpractice insurance rates dropped in Texas after tort reform was enacted, but Texans would be hard pressed to claim any direct benefit from that drop — except, that is, Texans who are doctors.
The Dallas Morning News published a chart earlier this year showing that the average malpractice rate charged ob/gyns in Texas by the state’s largest domestic insurer of physicians fell from $53,752 in 2003 to $33,881 in 2011. The paper reported drops of similar percentages for doctors in family practice and general surgery.
Advocates of tort reform have long claimed that one of the reasons for escalating health care costs is the “defensive medicine” doctors practice, such as over-treating and prescribing more medications and diagnostic tests than necessary, out of fear of being sued. Well, if Texans believed their own health insurance rates would go down once tort reform made defensive medicine less prevalent, they have by now been disabused of that notion. The chances of a Texas family saving a few bucks on premiums would actually be greater if they moved to another state.
In 2010, the average premium for family coverage in Texas was $14,526. That’s $655 higher than the U.S. average. Those numbers seem to indicate that doctors have not passed on their own insurance savings to their patients and that they are not practicing medicine any less defensively than before tort reform was enacted.
Not only are Texans paying more for their own insurance while doctors are paying less for theirs, their chances of getting employer-subsidized coverage is less than it would be if they lived in another state. The Dallas Morning News, citing statistics from the Agency for Healthcare Research and Quality and other sources, reported that a smaller percentage of employers in Texas offered coverage to their workers last year than in the U.S. as a whole (51 percent and 53.8 percent, respectively). And the Texans who do have coverage through the workplace are contributing far more out of their own pockets for that coverage than people who live in most other states. In Texas last year, the average employee contribution toward company-sponsored coverage was $4,500. The U.S. average was much lower: $3,721.
Another statistic Perry is not likely to mention when he talks about the benefits of tort reform is the number of Texans who are uninsured. The U.S. Census Bureau reports that Texas continues to be the state with the highest percentage of its residents without coverage, a whopping 25 percent last year, compared to about 16 percent nationwide. It was dead last in 2003 and it is dead last now.
All this should leave us wondering what “thing or two” states have come up with to solve the problems that affect their citizens. Considering the dismal state of health care in Texas, perhaps Perry had Massachusetts in mind.
By: Wendell Potter, Center for Media and Democracy, September 1, 2011
Austerity Versus Salvation: What Price Life?
So the big, bad storm huffed and puffed and didn’t blow all the houses in.
Reversing Katrina, on the sixth anniversary of that shameful episode in American history, the response to Irene was more powerful than Irene.
And that made some solipsistic Gothamites who missed their subways and restaurants grouchy. There is no greater abuse to New Yorkers than inconvenience.
Once the storm became “Apocalypse Not,” as The New York Post called it, there were those who accused Mayor Michael Bloomberg and Gov. Chris Christie of New Jersey of overreacting to make up for their infamous underreactions to last year’s Christmas blizzard, when Hizzoner was baking in Bermuda and the Guv was playing at Disney World in Florida with his family.
In a Wall Street Journal column, Bret Stephens suggested “a new edition of the Three Little Pigs, this one for the CYA age.”
Ordered to evacuate from his Manhattan home near the Hudson River, Stephens took his family to his parents’ wood-framed house in Connecticut, where a 50-foot elm crashed in the yard. So he went hard on the Chicken Little mayor. “What’s the wisdom of the ages,” Stephens asked, “when a mayor wants to erase the stain of mishandling last winter’s snowstorms by forcibly relocating people from his zone of responsibility to places that are somebody else’s zone of responsibility?”
Should those whose job it is to prepare for the worst be punished because the worst didn’t happen?
What determines your judgment of politicians’ reaction is what happens to you. Those washed out from North Carolina to New Jersey to Vermont don’t think government overreacted. As Mel Brooks once said, “Tragedy is when I cut my finger. Comedy is when you walk into an open sewer and die.”
Asked at a Saturday hurricane briefing about the response in relation to the debate about the role of government, Christie made it clear that saving lives was the most important thing. The Republican said he didn’t think that Democrats and Republicans were debating this: “Protecting the safety of our citizens is one of the bedrock roles of government.”
Not so bedrock for some of the Flintstones types in Washington who are now hotly debating austerity versus salvation. The impressively hands-on performances of Christie, Bloomberg and Gov. Andrew Cuomo of New York were not enough to make Tea Partiers, Republican presidential candidate Ron Paul and Republican House Majority Leader Eric Cantor root for big government against rampaging nature.
Paul, a libertarian whose scorn of government is so great that he doesn’t even want it to coordinate in natural disasters, insisted that FEMA, which he calls “a giant contributor to deficit financing,” should be shut down.
Though his state of Virginia was the epicenter of an earthquake before being hit by Irene, Cantor has insisted that additional money for cash-strapped FEMA must be offset by spending cuts, echoing his remarks in May that money sent to traumatized tornado victims in Joplin, Mo., would mean cuts somewhere else.
The callous comments about disaster relief in recent days by Cantor, Paul and, believe it or not, the disgraced former FEMA Chief Michael “Heck of a job, Brownie” Brown infuriated Bernie Sanders, the independent Vermont senator touring his inundated state. He told Carl Hulse of The Times that coming together to help on disasters “is what being a nation is about.”
In a briefing at the White House Monday, FEMA Director Craig Fugate said that the lesson of Katrina is for the federal government to “get things going earlier” and not wait until an overwhelmed state “says we’re going to need help.”
Too bad that didn’t occur to W. in 2005. He met with Gov. Kathleen Blanco of Louisiana and New Orleans Mayor Ray Nagin on Air Force One and correctly assessed that they were not up to the job but then retreated behind clinical states’ rights arguments as a great American city drowned.
In his new memoir, Dick Cheney faults Blanco for dithering and not requesting that the president federalize the response to Katrina. It’s a variation on Rummy shrugging that “You go to war with the army you have.”
Always the hard-liner, Cheney notes: “President Bush has written that he should have sent in U.S. troops earlier, which may be true, but which to my mind lets state authorities off the hook too easily.” Why save lives if you can slap bumbling Democrats around? Proving once more that he is truly delusional, Vice praised President Bush in the wake of Katrina for “reaching out to people who needed to know that their government cared about them.”
The awful hypocrisy is this: As we saw when they spent trillions trying to impose democracy on Iraq and Afghanistan, W. and Cheney believe in big government, in a strong, centralized executive power. But with Katrina, they chose not to use it.
By: Maureen Dowd, Op-Ed Columnist, The New York Times, August 30, 2011
Hurricane Irene And The Benefits Of Big Government
Don’t expect anybody to throw a tea party, but Big Government finally got one right.
On Monday, six years to the day after Hurricane Katrina destroyed New Orleans and obliterated the notion of a competent federal government, Federal Emergency Management Agency (FEMA) Administrator Craig Fugate offered an anecdote that showed just how different things were with Hurricane Irene.
On the podium in the White House briefing room, he recalled the satellite images of Irene’s path. “Do you remember seeing the satellite, how big that storm was and how close it was to the state of Florida?” he asked. Fugate, the former emergency management chief in Florida, said that a decade or so ago, “Florida would have had to evacuate based upon this track.”
Instead, the National Oceanic and Atmospheric Administration’s improved models predicted landfall in North Carolina, and, in fact, “the track was only about 10 miles off of where they actually thought it was going to come ashore.”
This was just one piece of the overall anticipation of Irene and response to the storm that has earned high marks for FEMA and NOAA. Like the killing of Osama bin Laden, it was a rare reminder that the federal government can still do great things, after all other possibilities have been exhausted.
Such successes might provide an antidote to the souring of the public’s confidence in government. By coincidence, a Gallup poll released Monday showed that only 17 percent of Americans have a favorable view of the federal government, a new low.
More likely, however, Americans won’t have long to savor this new competence in government. NOAA has already been hit with budget cuts that will diminish its ability to track storms, and FEMA, like much of the federal government, will lose about a third of its funding over the next decade if Tea Party Republicans have their way.
In the spending compromise for this year worked out between congressional Republicans and the White House, NOAA’s budget was cut by about $140 million (House Republicans had sought much larger cuts) and money for new satellites was cut by more than $500 million from President Obama’s request. NOAA Administrator Jane Lubchenco warned in May, “we are likely looking at a period of time a few years down the road where we will not be able to do the severe storm warnings . . . that people have come to expect today.”
Congressional Democrats and the White House were somewhat more successful this year in resisting cuts to FEMA that Republicans had proposed. But under the House Republicans’ plan to freeze discretionary spending at 2008 levels over a decade, FEMA cuts are inevitable. According to an analysis by the Center for American Progress’s Scott Lilly that takes into account inflation and population, this amounts to a 31 percent cut in real per capita spending on discretionary functions such as FEMA.
Tea Partyers who denounce Big Government seem to have an abstract notion that government spending means welfare programs and bloated bureaucracies. Almost certainly they aren’t thinking about hurricane tracking and pre-positioning of FEMA supplies. But if they succeed in paring the government, some of these Tea Partyers (particularly those on the coasts or on the tornadic plains) may be surprised to discover that they have turned a Hurricane Irene government back into a Katrina government.
The Irene government would seem to have its benefits. Before the storm struck, 18 FEMA teams deployed from Florida to Maine, repositioning as the emphasis moved to New England. Food, water, generators and tarps were in place along the storm’s path. In Vermont, when the storm forced evacuation of the state emergency operations center, the workers relocated to a FEMA facility. In North Carolina, FEMA provided in-the-dark local authorities with generator power. And everywhere, FEMA, given new authority by Congress after Katrina, didn’t have to wait for states to request help.
“We have to go fast; we have to base it upon the potential impacts,” Fugate said Monday, describing the Irene response. “That’s why we look at these forecasts we get from the hurricane center, and we make the decisions based upon what the potential impacts could be. If you wait till you know how bad it is, it becomes harder to change the outcome.”
That’s one model. The other model is to have a weak federal government, without the funds to forecast storms or to launch a robust emergency response in time to do any good.
You might call that the Tea Party model.
By: Dana Milbank, Opinion Writer, The Washington Post, August 29, 2011
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