Friday, June 29, 2012

Obesity and sedentary lifestyles: risk for cardiovascular disease in women

http://www.ncbi.nlm.nih.gov/pubmed/22740737


 2012;39(2):224-7.

Obesity and sedentary lifestyles: risk for cardiovascular disease in women.

Source

Department of Medicine, Baylor College of Medicine, Houston, Texas 77030.




No abstract, but the title says it all.

Principles for high-quality, high-value laboratory testing

http://www.ncbi.nlm.nih.gov/pubmed/22740357


 2012 Jun 27. [Epub ahead of print]

Principles for high-quality, high-value testing.

Source

Pharmacy Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Abstract

A survey of doctors working in two large NHS hospitals identified over 120 laboratory tests, imaging investigations and investigational procedures that they considered not to be overused. A common suggestion in this survey was that more training was required. And, this prompted the development of a list of core principles for high-quality, high-value testing. The list can be used as a framework for training and as a reference source. The core principles are: (1) Base testing practices on the best available evidence. (2) Apply the evidence on test performance with careful judgement. (3) Test efficiently. (4) Consider the value (and affordability) of a test before requesting it. (5) Be aware of the downsides and drivers of overdiagnosis. (6) Confront uncertainties. (7) Be patient-centred in your approach. (8) Consider ethical issues. (9) Be aware of normal cognitive limitations and biases when testing. (10) Follow the 'knowledge journey' when teaching and learning these core principles.

The surgeon's role in molecular biology

http://www.ncbi.nlm.nih.gov/pubmed/22739075


 2012 Jun 25. [Epub ahead of print]

The surgeon's role in molecular biology.

Source

Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, National Cancer Institute, Pascale Foundation, Naples, Italy.

Abstract

The biomolecular era is rapidly becoming shaped around the supreme interest in targeted therapy for patients with non-small cell lung cancer. Tissue analysis has become crucial in the definition of biomarkers and genomic signatures able to predict the response to treatment or even survival. Lungscreening programs and minimally invasive thoracic surgery are jointly aimed at increasing the quantity and quality of specimens of non-small celllung cancer caught at the earliest stages with the attendant, significant, effect on patient survival. In addition, biomolecular researchers are disclosing an ever-increasing cohort of patients with specific genetic mutations that make their cancer susceptible to individualized treatment. When needed for immunohistochemical characterization, investigators are ready to request "research biopsies" to consolidate tissue availability for clinical trials, translational research, and in biobanks. With unique and diverse tools in the surgical armamentarium, the thoracic surgeon plays a central role in this new multidisciplinary professional environment, actively participating in creating the foundations of the biomolecular era.

Mark Levin: “This decision I would go as far to say is lawless. Absolutely lawless!”

http://marklevinshow.com/Article.asp?id=2484259&spid=32364


Mark Levin Eviscerates the Obamacare Ruling



“This decision I would go as far to say is lawless. Absolutely lawless!”  Listen to his First Segment from June 28’s Show

From the WSJ: Was Scalia's Dissent Originally a Majority Opinion?

http://online.wsj.com/article/SB10001424052702304058404577495202841829394.html?mod=googlenews_wsj


Was Scalia's Dissent Originally a Majority Opinion?



"Scalia's dissent, at least on first quick perusal, reads like it was originally written as amajority opinion (in particular, he consistently refers to Justice Ginsburg's opinion as "The Dissent"). Back in May, there were rumors floating around relevant legal circles that a key vote was taking place, and that Roberts was feeling tremendous pressure from unidentified circles to vote to uphold the mandate. Did Roberts originally vote to invalidate the mandate on commerce clause grounds, and to invalidate the Medicaid expansion, and then decide later to accept the tax argument and essentially rewrite the Medicaid expansion (which, as I noted, citing Jonathan Cohn, was the sleeper issue in this case) to preserve it? If so, was he responding to the heat from President Obama and others, preemptively threatening to delegitimize the Court if it invalidated the ACA? The dissent, along with the surprising way that Roberts chose to uphold both the mandate and the Medicaid expansion, will inevitably feed the rumor mill."



From the NY Times: Richard Epstein: A Confused Opinion (HT: SD)

http://www.nytimes.com/2012/06/29/opinion/a-confused-opinion.html


A Confused Opinion



From the WSJ: The Roberts Rules (HT: SD)


The Roberts Rules

The Chief Justice rewrites ObamaCare in order to save it.


"The problem is that this also involved rewriting the law. The majority merely created an opt-out that Governors and states could elect to preserve some measure of independent control, instead of telling Congress to start over. Still, this is the first time the Court has found a law enacted under Congress's spending power to be unconstitutionally coercive.
But this and even the five votes limiting Congress under the Commerce Clause pale against the Chief Justice's infinitely elastic and dangerous interpretation of the taxing power. Nancy Pelosi famously said we need to pass ObamaCare to find out what's in it. It turns out we also needed John Roberts to write his appendix."

From Scalia's dissent: "The constitutional protections that this case involves are protections of structure."

From Scalia's dissent:

"The Constitution, though it dates from the founding of the Republic, has powerful meaning and vital relevance to our own times. The constitutional protections that this case involves are protections of structure. Structural protections—notably, the restraints imposed by federalism and separation of powers—are less romantic and have less obvious a connection to personal freedom than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach otherwise, to remind our people that the Framers considered structural protections of freedom the most im- portant ones, for which reason they alone were embod- ied in the original Constitution and not left to later amendment. The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s decision should have vindicated, should have taught, this truth; instead, our judgment today has disregarded it."

From the Denver Post: Supreme Court's ruling on health care fires up Tea Party

http://www.denverpost.com/breakingnews/ci_20968309/supreme-courts-ruling-health-care-fires-up-tea


Supreme Court's ruling on health care fires up Tea Party

POSTED:   06/29/2012 01:00:00 AM MDT
UPDATED:   06/29/2012 03:36:56 AM MDT
By Allison Sherry
The Denver Post

"GOP presidential hopeful Mitt Romney on Thursday said, if elected to the White House, he will work to repeal and replace the law. In the five hours immediately following the Supreme Court's annoucement of its decision, he raised $2 million from 20,000 contributors — a high-water mark his campaign is brandishing as proof that the base is energized."

Read more:Supreme Court's ruling on health care fires up Tea Party - The Denver Posthttp://www.denverpost.com/breakingnews/ci_20968309/supreme-courts-ruling-health-care-fires-up-tea#ixzz1zHRpgCWc
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Year Of Law School Now Mandatory For Nation's 25-Year-Olds, Or Must Pay "Tax" (HT:KL)

http://www.theonion.com/articles/year-of-law-school-now-mandatory-for-nations-25yea,6616/


Year Of Law School Now Mandatory For Nation's 25-Year-Olds

MARCH 11, 2009 | ISSUE 48•26 ISSUE 45•11

"WASHINGTON—Under the provisions of a bill approved by Congress and signed into law Tuesday, every 25-year-old American, regardless of prior life commitments, is now legally obligated to enroll in a full year of study at one of the nation's accredited law schools. "This new measure gives us the means to compel 25-year-olds to simultaneously placate their parents, impress their friends with complex-sounding legal jargon, and effectively avoid any real-world responsibilities for another full year," said Rep. Steve Buyer (R-IN). "We can think of no better way for our young people to squander their postcollegiate aimlessness." Congress is reportedly seeking further legislation that would provide for an additional nine months of grumbling over LSAT prep, and up to five years of whining about paying off student loan debt."

Thursday, June 28, 2012

We're all Europeans now (HT:KS)

http://www.scotusblog.com/2012/06/the-mandate-is-constitutional-in-plain-english/


The mandate is constitutional: In Plain English


Amy Howe Editor

Posted Thu, June 28th, 2012 12:14 pm



In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.

From SCOTUSblog: AMA president cheers SCOTUS' healthcare holding

http://www.scotusblog.com/cover-it-live/

Jeremy A. Lazarus, MD President, American Medical Association: “This decision protects important improvements, such as ending coverage denials due to pre-existing conditions and lifetime caps on insurance, and allowing the 2.5 million young adults up to age 26 who gained coverage under the law to stay on their parents' health insurance policies. The expanded health care coverage upheld by the Supreme Court will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive."http://www.ama-assn.org/ama/pub/news/news/2012-06-28-supreme-court-health-care-reform-decision.page

From the Washington Post: George Will: Conservatives’ consolation prize

http://www.washingtonpost.com/opinions/george-will-supreme-court-gives-conservatives-a-consolation-prize/2012/06/28/gJQAWyhY9V_story.html


Conservatives’ consolation prize



George F. Will

George F. Will
"By sharpening many Americans’ constitutional consciousness, the debate has resuscitated the salutary practice of asking what was, until the mid-1960s, the threshold question regarding legislation. It concerned what James Q. Wilson called the “legitimacy barrier”: Is it proper for the federal government to do this? Conservatives can rekindle the public’s interest in this barrier by building upon the victory Roberts gave them in positioning the court for stricter scrutiny of congressional actions under the Commerce Clause. Any democracy, even one with a written and revered constitution, ultimately rests on public opinion, which is shiftable sand. Conservatives understand the patience requisite for the politics of democracy — the politics of persuasion. Elections matter most; only they can end Obamacare. But in Roberts’s decision, conservatives can see that the court has been persuaded to think more as they do about the constitutional language that has most enabled the promiscuous expansion of government."

From NPR: 'Many People Were Stunned'

http://www.npr.org/blogs/itsallpolitics/2012/06/28/155919089/legal-scholars-react-many-people-were-stunned


Legal Scholars React: 'Many People Were Stunned'


"Since 1937, not one federal taxing or spending program has been declared unconstitutional. Today's decision follows from that."

The Health Care Compact

http://www.healthcarecompact.org/

From SCOTUSblog: California Medical Association reaction to SCOTUS' health care holding

http://www.scotusblog.com/cover-it-live/

California Medical Assn: “While the ACA provides insurance coverage for millions of previously uninsured Californians, it does not guarantee that these newly insured patients will have access to doctors because the Medicare and Medicaid programs were left grossly underfunded. CMA was also strongly opposed to the ACA’s creation of an unaccountable Independent Medicare Payment Advisory Board (IPAB), which will mandate arbitrary spending cuts, force more physicians out of the program, and limit seniors’ treatment options.”

Federalism and Scalia's dissent (HT:SD)

From Scalia's dissent:


"The values that should have determined our course today are caution, minimalism, and the understanding that the Federal Government is one of limited powers. But the Court’s ruling undermines those values at every turn. In the name of restraint, it overreaches. In the name of constitutional avoidance, it creates new constitutional questions. In the name of cooperative federalism, it undermines state sovereignty.

The Constitution, though it dates from the founding of the Republic, has powerful meaning and vital relevance to our own times. The constitutional protections that this case involves are protections of structure. Structural protections—notably, the restraints imposed by federalism and separation of powers—are less romantic and have less obvious a connection to personal freedom than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach otherwise, to remind our people that the Framers considered structural protections of freedom the most im- portant ones, for which reason they alone were embod- ied in the original Constitution and not left to later amendment. The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s decision should have vindicated, should have taught, this truth; instead, our judgment today has disregarded it."

From SCOTUSblog: "Justice John Roberts -- said to be a relentless conservative activist -- joined the court's "liberal wing" in saving the law"

http://www.scotusblog.com/cover-it-live/


Howard Fineman at Huffington Post: “Defying the expectations, Justice John Roberts -- said to be a relentless conservative activist -- joined the court's "liberal wing" in saving the law by grounding the "individual mandate" not in the power of Congress to regulate commerce, but in its taxing power.” http://www.huffingtonpost.com/howard-fineman/health-care-law-supreme-court-decision_b_1633709.html

From SCOTUSblog: Rand Paul: "Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so"

http://www.scotusblog.com/cover-it-live/

Senator Rand Paul (R-Ky): “Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so. The whole thing remains unconstitutional,” the freshman lawmaker said in a statement. “While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right.”http://www.politico.com/blogs/on-congress/2012/06/rand-paul-obamacare-is-still-unconstitutional-127574.html

From Adam B at Daily Kos: The two chief justices

http://www.dailykos.com/story/2012/06/28/1103964/-The-Two-Chief-Justices

"Today is not the first time that the chief justice has disappointed conservatives in key cases." 

From CBS News: Despite today's Supreme Court ruling, polling has shown that the law is not especially popular with Americans

Public opinion of the health care law


"Since it was enacted over two years ago, the Patient Protection and Affordable Care Act, President Obama's signature piece of legislation, has never been especially popular with the American public. Just 34 percent approve of the health care law, according to a CBS News/New York Times Poll released earlier this month, while 48 percent disapprove. Other recent polls also show more oppose the law than support it."

From SCOTUSblog: "Roberts was red-eyed and unhappy as he read.”

http://www.scotusblog.com/cover-it-live/

Also discussing the courtroom as the decision was handed down: Jeff Toobin tweets, "Roberts was red-eyed and unhappy as he read.”https://twitter.com/JeffreyToobin 

Then-Sen. Barack Obama's floor statement explaining why he would vote against confirming Supreme Court Chief Justice John Roberts (Sept 2005) (HT:AP)

http://professional.wsj.com/article/SB124390047073474499.html?mg=reno-wsj

"Dark Day for American Liberty"

http://www.nbcwashington.com/blogs/first-read-dmv/Cuccinelli-To-Weigh-in-on-Health-Care-Ruling-160678915.html?dr



Cuccinelli: "Dark Day for American Liberty"

By Jim Iovino And Associated Press
|  Thursday, Jun 28, 2012  |  Updated 11:21 AM 








"Virginia Attorney General Ken Cuccinelli's reaction to the U.S. Supreme Court's rulingupholding the key provision of President Barack Obama's health care overhaul:  "This is a dark day for the American people, the Constitution, and the rule of law. This is a dark day for American liberty.""


No reason to do the wrong thing

http://www.scotusblog.com/cover-it-live/

"With this deft ruling, Roberts avoided what was certain to be a cascade of criticism of the high court. No Supreme Court has struck down a president’s signature piece of legislation in over 75 years. Had Obamacare been voided, it would have inevitably led to charges of aggressive judicial activism. Roberts peered over the abyss and decided he didn’t want to go there."

From CNBC: Stocks Lower After Health Ruling; Banks Drag

http://www.cnbc.com/id/47994090

Circus

http://www.washingtonpost.com/politics/supreme-court-upholds-health-care-law-individual-mandate/2012/06/28/gJQAykD88V_gallery.html#photo=9

The Tax Clause: 21st Century's Commerce Clause? "the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t"

In the blink of an eye: "This Election Just Became About Obamacare"

http://www.weeklystandard.com/blogs/election-just-became-about-obamacare_647928.html


This Election Just Became About Obamacare

11:06 AM, JUN 28, 2012 • BY JEFFREY H. ANDERSON

Classy

http://www.politico.com/blogs/burns-haberman/2012/06/how-the-dnc-is-celebrating-127543.html


How the DNC is celebrating (Updated)

From SCOTUSblog: Opinion: http://www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/

From SCOTUSblog: Opinion: http://www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/

From SCOTUSblog: Opinion: http://www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/

Distinction without a difference: "the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t"

http://www.scotusblog.com/cover-it-live/

"Salvaging the idea that Congress did have the power to try to expand health care to virtually all Americans, the Supreme Court on Monday upheld the constitutionality of the crucial – and most controversial — feature of the Affordable Care Act. By a vote of 5-4, however, the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t. That is the way Chief Justice John G. Roberts, Jr., was willing to vote for it, and his view prevailed. The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form."

Buy or be taxed! "We ask only whether Congress has the power under the Constitution to enact the challenged provisions"

Drudge Report: "Take your medicine!"

http://www.drudgereport.com/



SCOTUSblog: Amy, Tom,and Lyle are probably the three most listened to people on the planet right now

Like the ACA itself: "the opinions collectively are a monster"

http://www.scotusblog.com/cover-it-live/

"By the way, the opinions collectively are a monster. The Chief's opinion is 59 pages, Justice Ginsburg's opinion is 61 pages, the four dissenters are 65 pages, followed by a short two-pager from Justice Thomas. You do the math."

Rejection of Commerce Clause "a major blow to Congress's authority to pass social welfare laws"?

http://www.scotusblog.com/cover-it-live/

From SCOTUSblog:


"The rejection of the Commerce Clause and Nec. and Proper Clause should be understood as a major blow to Congress's authority to pass social welfare laws. Using the tax code -- especially in the current political environment -- to promote social welfare is going to be a very chancy proposition."

The opinion in the health care cases is here. http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Next: The Broccoli Mandate! "the penalty that someone must pay if he refuses to buy insurance is a kind of tax"

http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Holy mackerel: "the penalty that someone must pay if he refuses to buy insurance is a kind of tax"

http://www.scotusblog.com/cover-it-live/

"In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding."

From SCOTUSblog: "In opening his statement in dissent, Kennedy says: "In our view, the entire Act before us is invalid in its entirety."" Amen

Federalism may still have a breath of life left in it: "The Court holds that the mandate violates the Commerce Clause"

http://www.scotusblog.com/cover-it-live/

From SCOTUSblog: "The Court holds that the mandate violates the Commerce Clause, but that doesn't matter b/c there are five votes for the mandate to be constitutional under the taxing power."

Twitterfeed: Shock. Is federalism dead?

From SCOTUblog: "The critical detail is that you cannot take away the existing Medicaid funds"

http://www.scotusblog.com/cover-it-live/

"Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding." (p. 55)

From SCOTUSblog: "The court reinforces that individuals can simply refuse to pay the tax and not comply with the mandate"

Wow. From SCOTUSblog: "Section 5000A need not be read to do more than impose a tax"

http://www.scotusblog.com/cover-it-live/

"The money quote from the section on the mandate: Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it."

From SCOTUSblog: "Chief Justice Roberts' vote saved the ACA."