QuoteOriginally posted by: exotiqVaccines are a common-sense solution to me, and I don't mind federal regulation of it in some very limited form, but I do believe in this case, like many others, that local solutions would work better. I don't believe in gassing an entire building to kill one cockroach we know is on the 13th floor, just like I don't believe rural Oregon needs to be vaccinated as urgently as Jacksonville if the bird flu breaks out there. The massive deaths by lack of vaccinations are probably not as much a fault of the states as it is of no organization being effective about these vaccines, simply because politics prefers to think of the cure rather than prevention, which does not seem to differ between federal or state.______________________________A national approach to any bird flu outbreak would be far preferable than a state by state hodgepodge approach due to the extra-territorial and explosive nature of the problem of viruses spreading across state (and indeed national) boundaries.First, and most critically, we need a nationwide surveillance system which tracks emerging outbreaks and puts them in a databank like what we currently have at the CDC. We need standardized criteria to address the problem of unreported illnesses which turn out to be bird flu. This was a huge problem with SARS last year, with remote Chinese provinces underreporting which had extreme consequences much later and caused quite a few excess deaths due to China's decentralized approach. Contrast this with the outstanding performance of Vietnam combatting SARS, whose top-down get tough approach won worldwide accolades and admiration.For example, a national H5 avian flu reporting standard might say, "You need to tell us EVERY hospital admission with a rapid onset fever over 102 degrees accompanied by a persistent cough" instead of one state deciding that only fevers over 102.6 should be reported that have lasted longer than 4 days and another stating that fevers over 100.8 will be reported except in those cases where the patient is over 65 and has had a pneumonia shot within the last 2 years. The data points are far less helpful when 50 different metrics are used.Because the best epidemiologists are very few and far between, we need to concentrate and leverage their expertise in a crisis and not let some clowns in Alabama set standards allowing an impoverished family with one member having an unreported case of bird flu boarding an airplane to Tallahassee Florida, starting a new outbreak there which may not be properly reported, and having it then spread to New York City and lose 15,000 innocent people in NYC because of that initial ideological meta-mistake which prefers a bottoms up approach to public health no matter what.There's no point in that. That's the thumbnail sketch of why we need national (and indeed international) standards for surveillance and reporting for these dangerous outbreaks that will be coming. These issues just aren't in dispute among epidemiologists in the world; we learned all these lessons with polio and typhoid and tuberculosis and they are well settled.Then there's the issue of vaccine production and distribution and quarantines. We need national (not state) managment of exactly how much vaccine to produce and how to ship how much how rapidly where. It's very much of a war room scenario and just like generals in Miami's Southern Command need total battlefield information to the extent possible in Iraq and Afghanistan, this same methodology holds true for what is needed in Atlanta to manage an emerging pandemic with multiple outbreaks.Additionally, we need the national authority to shut down airline travel to and from cities and in the worst cases to manage road access to affected areas if, heaven forbid, something historically virulent comes along.We can't fight wars without a centralized command and we can't manage pandemics without a global, national and regional approach seamlessly woven together. A complete solution must necessarily include an entire problem within its scope, and global pandemics require a global approach.Surely operational decisions need to be made on the local level, but just as surely every war needs generals and centralized decision making and command and control to ultimately prevail.Matthew

QuoteOriginally posted by: mdubuqueQuoteOriginally posted by: exotiqThe reason I oppose a health care tax on smoking is that I believe the statistic I see about smoking being a net benefit to taxpayers.Exotiq, do you have a citation to this study? I do know it was funded by the tobacco companies, which is a bit of a yellow flag.For example, smoking is a leading cause of impotence. I'd be willing to bet they did not factor in the cost of supplying expensive drugs like Viagra to a disproportionately high amount of smokers on Medicaid in that study.MatthewOne reference I remember off the top of my head are the economics lectures by Timothy Taylor, published on Audio by the teaching company, but I've seen others as well, and I doubt all of them were funded by tobacco companies. Tim's an excellent lecturer who presents a very common sense way of looking at both sides of many contraversial issues, and his sources are cited in the accompanying pamphlets. Personally, I can also cite cases in my own family where the smokers have died younger used up far less government money over their lifetimes than my non-smoking great aunts who lived well into their 90s. I recently heard Viagra was going to be covered by Medicare, which nearly made me fall out of my seat with rage, but I did not think Medicade also covered it, but perhaps I shouldn't be surprised if such an enormous government program decided that ED was a bigger problem than prenatal care. Even them, I'm not sure that one single windfall to Pfizer would be enough to offset the costs of non-smokers living longer.

To answer the original question I think in today's society there is no reason to be obese and if the original article was enforced in the USA it would be a healthier place.

Going back to the original question, I think it kicks off the discussion in the wrong direction. Prader Willi sufferers are literally starving except when they are eating and cannot take rational decisions over food. The tradeoff made by the individual and carers (who are nearly always needed) is how much freedom to feed their starvation can they be given at the cost of the resulting large reduction in their quality of life. Freedom of the individual is a bit of a red herring because these individuals do not have any as far as their lifestyle is concerned - it is largely a matter of trading one set of strict constraints for another.

QuoteOriginally posted by: PricerTo answer the original question I think in today's society there is no reason to be obese and if the original article was enforced in the USA it would be a healthier place.It appears that you think being obese is always a choice. It's like saying one always has a choice in one's sexual preferences, or one always has a choice in how tall they are ......... (rather limited thinking, I'd say). I still haven't had a response to my question : Does one have a right to be skinny?

QuoteOriginally posted by: AlanBQuoteOriginally posted by: PricerI still haven't had a response to my question : Does one have a right to be skinny?Some would argue that both extremes of the weight spectrum (i.e. anorexia and clinical obesity) represent two sides of the same condition, that condition being an inability to correlate calorie intake with basal metabolic requirements.This line of reasoning then states that since these two conditions have a very similar etiology, rights and obligations accorded their classes should be substantially similar.That's one school of thought.Matthew

QuoteOriginally posted by: AlanBQuoteOriginally posted by: PricerTo answer the original question I think in today's society there is no reason to be obese and if the original article was enforced in the USA it would be a healthier place.It appears that you think being obese is always a choice. It's like saying one always has a choice in one's sexual preferences, or one always has a choice in how tall they are ......... (rather limited thinking, I'd say). I still haven't had a response to my question : Does one have a right to be skinny?I would certainly say there is more choice in how fat or skinny someone is than how tall they are (I've hear childhood nutrition can affect how tall one grows within the range their genes allow them to), but you're right that it's not all within someone's control to go the way other people think he should.By a "right" to be fat/skinny, my answer is: you have a right to be either one in the sense that no government should be able to lock you up and deny you life, liberty, or property soley on basis of your weight. I would not mean by "right" that if someone has the "right" to be skinny, that the government should not deny that person assistance to become skinny, nor should they interfere in a way that hinders that person from becoming skinny. Now if one is sick in a way that is hazardous to someone else's, and perhaps even their own well-being, then those close to that person and concerned with that person's well-being often do what will help that person get better, which sometimes means confinement to a hospital or the like. If there's no one around that cares for that person, then there is no longer a question of rights but whether anyone else has the responsibility to intervene.I agree with Matthew that overeating and anorexia are symmetric disorders that really do not deserve much different legal treatment...

It appears that you think being obese is always a choice. It's like saying one always has a choice in one's sexual preferences, or one always has a choice in how tall they are .Of course you have input into all these things, assuming that one has free will.Diet can affect height enormously, and I've noticed that the evolution of a number of people's sexuality is not a simple function of a predermined fact.The question is whay is this person this shape ? Being very light or heavy is evidence that something is wrong with them, but it's the symptom, not the disease.

QuoteOriginally posted by: DCFCIt appears that you think being obese is always a choice. It's like saying one always has a choice in one's sexual preferences, or one always has a choice in how tall they are .Of course you have input into all these things, assuming that one has free will.Diet can affect height enormously, and I've noticed that the evolution of a number of people's sexuality is not a simple function of a predermined fact.The question is whay is this person this shape ? Being very light or heavy is evidence that something is wrong with them, but it's the symptom, not the disease.But ....Does one have a right to be skinny?

But ....Does one have a right to be skinny?I suepct the answer to that is no.No society of which I am aware allows people the unbounded choice of sub-optimal health choices.Their response varies in competence and humanity, but if you do dumb shit to yourself, the state acquires the right to stop you.Lots of people bleat about rights, but fight shy of process and efficient decision making, preferring instead empty rehetoric of the form "we all have the right to eat strawberry pizza".Is there anyone here who really believes mentally ill people should be allowed to do whatever it occurs to them to do to themselves ?Thus we are in the tricky world of drawing lines for where an individual is competent. This is a growing problem, and we have to face the fact of millions of people who are rational by any standard >95% of the time. Indeed, most "mentally ill" people aren't all that dysfunctional, nearly are capable of doing a wide variety of things reasonably well, and make sensible choices. Thus we are in fact dealing with random events.By reducing it to slogans and tabloid headlines we lose sight of the fact that the processes are deeply defective in most countries, and could be fixed with realtively models allocation of resources and changing the staff making decisions beyond their competence.We have few ethical dilemmas but don't carry out our ethics efficiently.But that's not a slogan any politcal party will gain any support from, even when addressing people like Wilmotters who are on average vastly better educated than the mean.The process if bogged down by vested interests from social workers through to people who harm others like vegans and Christian scientists.The evidence that kids need drugs and meat is overwhelming, but parents who deprive their kids of painmkillers and protein are seen as exercising "parental choice".As a parent I see a lot of this crap. What actually makes me really quite angry is where parents say "we don't believe in giving painkillers to kids". They genuinely see this as a virtue, and their "reasons" for believing this make the assertions of a paranoid schizohprenic look reasonable. Strangely enough, they partake of ibuforen iet al with gay abandon. Listen to such a parent explain how homeopathy "works" and the physics of Star Trek like quite plausible.

QuoteOriginally posted by: DCFCBut ....Does one have a right to be skinny?I suepct the answer to that is no..I guess we'll have to agree to disagree.

To me, this is like asking: Does one have a right to color one's hair, does one have a right to have a particular hairstyle.There is no law against your personal style or lifestyle.

There is no law against your personal style or lifestyle.Actually that's false in pretty much every country I can think of.

QuoteOriginally posted by: fars1d3sTo me, this is like asking: Does one have a right to color one's hair, does one have a right to have a particular hairstyle.There is no law against your personal style or lifestyle.There is no JUSTIFIABLE law against your personal style or lifestyle

There is no JUSTIFIABLE law against your personal style or lifestyle The fat thing was of course evidence that a person was mentally ill, are you saying that people who are damaging themselves should never be prevented from doing so ?In Europe, unlike Britain or America, there is a prohibition against Nazi insignia, and although the French & Germans are generally more liberal, they lose it over this. However it is an ancient good luck symbol for many Indians.There is a deep & hard point here, that is beyond my ability to solve.Very few, if any people accept the idea of unbounded expression of ideas, even if it is just a badge. I don't know if you're old enough to remember socialism at universities ?Their line was basically "silence the enemies of free speech"."Free speech" in their context of course was permitting those sentiments they approved of.This idea still exists at American universities where an academic may not even question ideas like equality of the sexes without risking his job.Is there no symbol you would ban peple from wearing ? No slogan on a T shirt, no matter how offensive to some group ?