Something Not Safe for Ghost · 9:55pm Oct 22nd, 2014
Some time ago I wrote a Fallout: Equestria story, Twenty Minutes, that upset GhostOfHeraclitus a lot.
It upset him so much that he will almost certainly not read any post about it.
... are we alone now? Good.
obabscribbler does some most of the best audio readings of ponyfics (find them here). Her dog Suki
Suki.
had emergency surgery, and now her family is stuck with a $16,000 medical bill that they can't pay. Details here.
But I know that you, like me, are evil, and probably even capitalist, and wouldn't pay $16K to save your own dog if you had one. For that money, you could buy a
like a proper supervillain.
But those of you unfortunate enough to be plagued with a conscience are faced with a dilemma: On one hand, $16K could dig wells for several African villages instead. But on the other hand, you just paid $12 to see Rainbow Rocks.
(Oh, you could have cured 18 African children of schistosomiasis for $12. But, hey, that battle of the bands was bitchin', wasn't it?)
The only rational answer to this moral dilemma, of course, is to save your money and buy a
BUT.
- Scribbler wants money.
- I want Scribbler to do an audio version of GhostOfHeraclitus' story "Whom the Princesses Would Destroy".
- If I pay Scribbler to do an audio version of "Whom the Princesses Would Destroy", then I get my audio story, Scribbler gets to keep both her kidneys, and I don't have to suffer any guilt from engaging in market-corrupting, non-profitable financial transactions.
- If I get you to pay for it instead of me, bonus!
SO.
I told Scribbler I thought fans of Ghost could probably raise $300 for her to record the story. I set that figure to encourage other people to hire her for readings. I imagine many writers might pay her $30 to narrate one 2,000-word short story, and "Princesses" is 20,000 words. The audio should run about 3 hours. It seems I under-estimated how much work it takes her to do a recording, because she's lined up a cast of 25 people and says it could be finished by January.
I sent Scribbler $26 thru paypal as retroactive payment for her earlier doing an unexpected audio recording of "Trust". I'm going to send her another $30 towards "Princesses". This is legitimate payment for services rendered, and not a sign of weakness or soft-heartedness. 
(And I just remembered Scribbler also did a reading of "The Corpse Bride".)
To help pay for an audio recording of "Whom the Princesses Would Destroy", you can send money to her Paypal address: electric_hairdo@hotmail.com . Add a note saying that it's for Whom the Princesses Would Destroy. You'd also have to mention your fimfiction username for us to know it was you. You can donate through gofundme instead, but gofundme takes a big slice of the money, something like 10% (depending on how much you give). Paypal is easier and more secure than credit cards. Plus, if you use Paypal, you get to find out Scribbler's real name, which is strange and exotic, and will make hearing her narrations even more exciting.
But these are the terms needed to prevent this from being a burden to her, either from not getting paid, or from having to send back a bunch of money: If we don't reach $300, she doesn't have to do the recording, and you might not get your money back. (I made those terms up, not her. I imagine she'd give it back if it's a sizable amount, but I haven't discussed that with her.)
Or, if you want her to do a reading of one of your stories, offer her 1.5 cents a word or more for it.
And post something saying you did something. I'm reading the comments below and getting discouraged that this is generating more talk than action.
(Please don't tell Ghost about this. He'd sputter and turn red and then travel around Europe selling his blood to try to pay it all himself. That would be a devious plan to destroy him, but it lacks flair.)
I prefer this...
o.aolcdn.com/hss/storage/midas/299b849c02ea5e301c4088b5f7e2528e/200308646/01-2012-tesla-model-s-fd-1347336745.jpg
Wow. You're devious even to your bestest friend on this whole site, Bad. The look on his face will be most shocked and possibly horrified, followed by eternally gratified when he sees the recording posted.
Aren't you damn lucky I'm a rich fucker[1], eh?
And here I was, wanting to talk about 20 Minutes. Eheh... I think I scared Gabriel LaVadier by showing that fic to him. Actually, he's kinda Fluttershy like Ghost in that way, too.
Oh. And Scribbler... yeah, it's good I'll be helping her, too. Poor dog. Yeah yeah...
[1]Not entirely true. But I make a lot of money. So bleh :P
Would if I could, but living on water and stale bread donated from the local bakery at the end of the week. Pretty much just got bills...
I shall, however, send my condolences for the situation. They are very valuable to the right (no one) people. Do hope everything turns out for the best!
(Also, seriously. There's no reason why almost any medical procedure should cost 16,000 dollars - especially veterinary. Stupid artificially high prices... the medical industry is evil, I tells ya!)
Knowing you, I bet it's something like Jane Janeson.
I don't have the full amount, but I'll be sending in what I can. It's two good cuases in one!
2550005
Well, as someone who studied biomedical engineering, I can shed a little bit of light on this.
The problem with the medical industry is a fewfold. The first, largest issue is that in some cases, the choices are to pay for medical treatment, or die, and in a rather immediate manner in some cases. This removes some of the free market mechanisms ordinarily in place to keep prices low. Emergency surgery is one of those cases.
Secondly, frequently you can negotiate down medical bills - this is, in fact, what insurance companies do, and you're actually expected to do so on big ticket items. Hospitals will never, ever tell you this, because most people don't know this, and therefore don't do so, and therefore pay the full amount. I would rather strongly recommend negotiation in this case.
Third, there is the issue of training. What do you call someone who isn't good enough to go to veterinary school?
A doctor.
Yes, that's right, veterinarians actually have to live up to higher standards than human medical doctors to get into med school; it is more difficult to get in and becoming a vet is actually harder than becoming a doctor in many ways, because you have to get more training because you're expected to have better general knowledge as it is very necessary, and you have to be able to treat a wider variety of patients (relatively few vets have the luxury of specializing in only one specific kind of animal ahead of time).
Given the high level of talent required, you're paying for a top-tier professional, and possibly several in the case of surgery.
I will note that I first heard that joke from a doctor who didn't get into vet school. But it's alright; he's more than qualified to treat human beings.
Fourth, medical stuff is just generally expensive. Medical equipment is very costly, in part because of what it is, in part because of just how expensive it is to get your medical equipment approved, in part because of who ends up designing the stuff (MD PhDs and engineering PhDs don't come cheap), and in part because there generally isn't a huge market for them - you only need to (and can afford to) replace equipment every so often, and they need to use it for quite some time to pay off its capital costs. And unfortunately because it is such a small market, there isn't that much space for competition - there are only really five companies which make MRI machines, for instance, and the top-end ones are not even made by all of them. Add to the fact that you absolutely need many of these machines, and the doctors themselves are caught in the same squeeze patients are. Some medical equipment also requires special housing (many of the higher-end medical imaging machines require specialized rooms so that they don't slowly kill everyone on staff) which further adds to the cost.
That being said, $16k is still insanely exorbitant and, frankly, vastly more money than a dog is worth.
After all...
cdn.someecards.com/tldrs/pets.png
>tfw when goatsofherculitis
I have reflected that, financially, it was a mercy that our cat Ron passed before we could get him to the vet school for a CT scan. I don't know at what point I could have stopped spending money to save him, but it only ended up costing about $1100 for the first visit and the overnight intensive care. Chump change, by comparison.
I'll have to check all these links out when I'm at home and can listen to audio.
Consider it done, BH.
2550086
Are you saying that if I want an operation, I can haggle the price? Even if it's incredibly unnecessary?
Like if I want a bigger p
s?
2550126
Ghost is really the goddess of goats. Therefore, he is Shub-Niggorath.
Is it weird that this blog has motivated me to write out a list of all of my friends' triggers, so that I could use the same trick in my future blogposts? Bad Horse, as always, you are an indomitable force of evil.
Let's hope Ghost doesn't think you're trying reverse psychology.
I'll see if I can contribute some.
2550086 Thanks for the explanation. Has healthcare reform made the situation any better?
2550086
1) you are dealing with more than one species
2) your patients can't speak to you about what's bothering them (this is also the problem pediatricians face).
2550086
It's also worth noting that most medical devices and drugs are funded through the patent system, resulting in monopoly profits that are functionally equivalent to sales taxes of multiple thousand percent in extreme cases.
2550086 Also the vet industry tends to be less warped and distorted than the people industry (at least in the US) because of straight cash AND the approval process for procedures and drugs. Experimental medicines can and often do show up at the vet far earlier than the doctor, to the point where some drug companies will intentionally price and release medication that way just to get an edge on their ongoing human trials. At one time (going off memory here) a MRI for a pet in europe could be had for a few hundred dollars on the same day in the evening on the same equipment that was used for humans during the day and was backlogged for several months. (The pet owners paid cash, the humans through government. Guess which one was more profitable.)
I have a first aid kit in my GTH bag that has a couple rolls of vet wrap in it, bought of course at the vet store for about a quarter of what the exact same stuff would cost at a drug store for people.
Oh hey, you wrote a Fallout: Equestria side-story? Never knew that. Don't like that universe too much, but hell, I'll go give it a read.
You evil, evil man. I was going to ignore this, essentially on the grounds that I'd support lifesaving human medical treatment, but wouldn't bother for pets. Humans are important, but pets are, well, pets.
But I'd put money up for a Whom the Princesses audiobook, just for it to exist.
I'll attack this tomorrow. I needed to whack at paypal anyways.
I was going to read this and then use the tab for something else, too...
I can't decide whether to send $30 for Princesses, or to dig deep and get made that Writing on the Wall audiobook I've always wanted. Will sleep on it and decide tomorrow.
I'll see how much change I can dig out of the couch
2550296
The reality is that development of new drugs and equipment costs hundreds of millions to billions of dollars. According to Matthew Herper of Forbes:
Mind you, the true cost is somewhat difficult to determine in absolute terms, but by all accounts it is a gigantic pile of money, and in all probability contains nine zeros - other studies estimate a much more modest cost of $1.8 billion. And if you're ignoring capitalized costs, you might even get all the way down to just about a billion USD.
There is an added wrinkle as well: companies which produce only one drug do so more cheaply than companies which produce many drugs and services, with single-drug companies only costing about $350 million per drug. Why?
The answer, as it turns out, is failure. Small companies which only produce one drug either succeed (and thus, rake in a bunch of money) or fail (and go bankrupt as they have nothing). Large companies can eat the cost of failed drug research, and indeed, are frequently forced to do so; consequently, each drug produced by a larger company appears to be more expensive than those produced by small ones, when in fact this is because the big companies have failed drugs while the small ones don't - they just can't survive if their product fails.
The costs, as Forbes notes, are ultimately unsustainable; the insane amount of money that new medications cost is clearly unreasonable, as at some point you're going to be producing drugs which have to be so expensive to make money off of them that no one can afford them anyway, and thus you can't produce them.
It is also worth noting that there is a very high failure rate; only about 20% of drugs which start phase 1 trials end up being approved.
Patents are the only reason people develop drugs, frankly; without them, you'd have to rely 100% on government funding. Patents are pretty awesome things, really, and the reason that we give people temporary monopolies is because it encourages them to invest in R&D.
And the fact of the matter is that drugs are long-term ventures; when you are investing in drugs, you're putting in money now to make it back in ten years, assuming the drug is approved. This means, in other words, that you need higher ROI on the drugs to make them a worthwhile venture, both because they're riskier than other investments and because you have to wait so long for your money to come back to you with profits.
Drugs are very capital-cost heavy; you have to go through the whole R&D process, then build your production line and scale up the production of the drug... but once you've done all that, the cost per unit produced of most drugs is pretty low. The cost is all up front (and in advertising).
All of this combines to lead to a very ugly situation where we end up with drugs which cost really obscene amounts of money.
Now, that's not to say that drug companies don't frequently gouge - they do - but that the true costs of producing new medicines really is high, and even if you were to cut the costs of all those drugs by 30% (the profit margins of the more successful large companies), you'd be cutting the cost of a $300,000/year drug to a bit over $200,000/year - which is still obscenely high.
2550343
Yeah, if you're clever about buying stuff you can get it much more cheaply.
Hmm... I need to go over my finances a bit (I just got hit with several large and unexpected bills) but I should be able to swing something for this.
2549999
You bastard. That probably added fuel to his anti-Grimdark kick, which is driving me slightly insane.
2550681
I have no illusions that drug development is inexpensive. I was making the point that the financing is done on the back end, driving the price (far, far) above marginal cost. (Think the $80k course of treatment with the new hep-C drug that can be profitably produced for $1000 in India.) With alternative financing methods--as you note, government funding, with one example being the government retaining ownership of the patent and licensing it to manufacturers--that market inefficiency is avoidable. And it can also avoid other issues, such as the incentive to distort trials, cover up side effects reported post release, or aggressively market marginally more effective (but far more expensive) products to providers.
Add to that the fact that medical research (under free markets, anyway) is (often, depending on the difficulty of reproducing the process) a public good; a large portion of the research will be funded by the government on the back end anyway through Medicare and Medicaid (or insert country's provision or payment system here); and the fact that the risk bearing capacity of society is in general far greater than that of private enterprise (right now, the US government breaks even on 3%/year, ignoring other effects, 1% real--and it was lower before indications of premature tightening were made last year), and there are good arguments in favor of shifting to a largely or wholly government-funded system of financing medical research. Conclusive? Perhaps not.
2550681 2550296 The cost of drug development isn't that high. Most of that is the cost of drug approval. From a paper by the Manhattan Inst. for Policy Research:
This is one of the few cases where a complex-appearing problem has a simple answer: Our drugs are crazy expensive because we have a crazy high bar for a drug to get approved as "safe and effective". Which doesn't really make our drugs safe. Big companies can use political clout and fund of biased experiments to get things approved, as Donald Rumsfeld did for Aspartame.
Not to mention that your house is full of stuff far more deadly than anything the FDA would allow. Aspirin. Tylenol. Sugar. Beer. Cigarettes. Hamburger.
IMHO, the quality of statistical tests in medical studies is so low that it's ridiculous for us to demand huge safety studies in an attempt to study safety out to five decimal places, when there's probably a one in four chance the whole study is so badly-designed from the start that its conclusions are meaningless.
2550578 Click here.
2550086
I know about training and all, though I honestly still feel they get paid more than their equivalent work based on the -nature- of their work. Even if they can turn away people who can't pay so they can't receive aid and live a crippled life that devolves into an early death (like me!). Personal issue there, though.
My main issue was on your fourth point. Here...
It's stuff like this. Regardless of the reason why, especially since when dealing with things like this you first DO what you want that benefits you, THEN you find reasons to make it sound legit. It's not nearly limited to saline, but it's a good example since every country with half-decent medical practice uses saline, we can see liters of saline going for 5-12 dollars in other countries for great profit and relatively low cost for the patient, but far beyond that here in America. That is artificial, even if they have reasons supporting it.
Anyway, enough of my ranting about being poor and the system that forgets me. I hope the dog is doing alright and that the family gets through this ridiculous highway robbery.
2550761
The reason that we use the free market instead of the government is that the government is unlikely to make optimal decisions in many cases and is very intolerant of very large ($350 million) projects failing. And drug R&D fails. A lot.
Look at Solyndra. The government invested in them, and then the company failed because the price of silicon fell. People freaked out. It would be ten times worse with drugs that fail, and special interest groups would whine and moan and groan when drugs which were for their special interest didn't work, whining about why they were being cut when the reason that they were cut is that they didn't work. You know people are stupid.
And that's ignoring prioritization. Take the Ebola thing for instance. They're pulling funding from a universal influenza shot program to fund this ebola garbage. This is a mistake; influenza is much more important than eboal is, and the extra funding isn't going to make a difference in the current crisis.
The government is highly susceptible to pressure from special interest groups, whereas things which are generally useful are much less likely to have a group really concertedly pushing for it. If you're going to spend government money on something, something which helps a lot of people is better than something which only helps a small number of people.
Moreover, you seem to misunderstand why it is that the drug costs vastly different amounts in different countries. The problem is that people in India are ridiculously poor and cannot afford the drug at $80k. Frankly, a lot of them probably can't afford it at $1k, but a lot of folks can. Because producing the drug is a sunk cost, it makes sense for them to sell it for $1k in India because if they sold it for $80k in India they would get far, far less money because very, very few people would be able to buy it there. It makes perfect sense for them to sell it at a lower price there because that way they actually make more money.
And even that is ignoring the fact that there actually already are hepatitis C drugs which have been in production for quite some time, and which have been genericized by this point, and which are about 50% effective at clearing the infection. The new drug only offers 70%, though combined with the old ones (and thus, having its cost added on top of them) will clear it about 90% of the time.
The problem here is not that the drug isn't useful, but that the cost of developing the drug was insane for a drug that is going to have to compete with generics. It is better than the generics alone, but... well, think about it. You could pay less for the old treatment and still have a good chance of success. That $80k price tag is "worth it" in terms of avoiding problems in the long term, but in the short term, if you're trying to treat the largest number of people possible, is it worthwhile when you have lots of other things you could spend that money on?
And they have to make back all of the money they spent on it before it becomes generic. AND there's ANOTHER new drug coming out which competes with it, which means that they're going to have to make back their money without a monopoly on the market not only from the generics, but also from another high quality new treatment which costs about as much and works without the combination drug therapy.
That's not to say that they aren't being abusive - I'd bet money that they are, honestly. But they're going to claim that the price is reasonable because even at that stupidly exorbitant price, it is still cheaper in the long run to treat everyone with their $80k medication, and they're going to be right, because there has been a study which demonstrated exactly that.
The question, though, is whether or not that really justifies the cost, and whether or not they're, in fact, ripping people off.
There's nothing wrong with having governments funding drug research, but the issue is that if the government is in charge of it, then you end up with centralized decision making which is very easily influenced by political motivations which are not necessarily going to produce the best drugs or result in funding going where it needs to go. A lot of people think science is magic, except scientists do it. A disturbing number of those people are in Congress.
There really isn't any such thing as a free market, and the government has to step in and smack down people who are being abusive. But there usually is more than one side to an issue. It is very easy to complain about escalating drug costs, but on the other hand, the cost of developing new drugs doubles every nine years, and has been for quite some time. Putting a hard cap on these drugs and smacking down companies is good in some cases, but bad in others - hepatitis C is, at least, a common condition, so it SHOULD be possible to sell the drug in bulk. For some rare conditions, though, I'm not sure that there is any solution other than charging a bunch of money for it.
2550835
About 50% of drugs fail Phase III testing these days, which is pretty discouraging given that means you're looking at basically paying for two whole drugs on account of Phase III testing alone. The Phase II success rate is, apparently, a whopping 18%, by which point you're at 10% of the cost of a drug (rather than 100% as in phase III). So adding those two things together alone you're looking at any new drug costing at least 250% of the true cost of producing a drug, plus the cost of whatever drugs fail earlier still. Worse, 2/3rds of the drugs which fail in phase III fail because they don't work, rather than because they're dangerous - something which is dangerous, but works, is potentially useful, but something which doesn't work at all is a gigantic waste of money. 80% of the drugs which fail in phase II fail either due to lack of efficacy or because another drug already accomplishes the same function. This suggests that these studies are, in fact, doing their job - and that drug companies are producing a lot of worthless drugs.
So while it may be true that some of these studies are garbage, they do seem to be disqualifying a large number of drugs which don't work (or which don't work better than existing treatments), which is the purpose of these trials - safety concerns are eliminating only a minority of drugs.
There's not really a practical difference between development and approval; approval is about proving that the drug works, which is part of the development process. Research is coming up with the drug in the first place, development is refining and testing the drug to make sure that it works.
Aspartame is safe unless you suffer from phenylketonuria; its safety is quite well-documented by this point, and while some of the early studies were, indeed, not done very well, even after accounting for the issues with the studies the studies still indicated that the product was safe - and many, many, many years of use of the product have borne that out.
That being said, even big drug companies fairly regularly have their products fail, which suggests to me that whatever clout they may wield, the process seems to generally work; any process can be subverted, but if there is a 50% failure rate in phase III, and a 82% failure rate in phase II, the process is likely not being subverted very often. Of course, it could be that the presently high failure rates are precisely because the process isn't being subverted anymore, if one were particularly cynical, but the actual cited reason is simply that we have so many good treatments for a lot of things right now that coming up with new drugs to treat the same conditions is largely a waste of money - those drugs fail all the time. And that is a perfectly reasonable rationale to me.
The main thing which really needs to happen is that phase III and phase II failures need to be earlier in the process; failing in phase II is bad enough, but having a 50% failure rate in phase III is nuts. That is not only horrifically expensive, but it indicates a failure to properly validate the drug in earlier trials much more cheaply. Failing is good, as it meas that we're actually doing a good job of winnowing out failed drugs with our stidies; failing as expensively as possible, however, is bad, and that is what a phase III failure is.
So why are these companies failing so late? I think the real problem is probably managerial; these companies are developing products which are more likely to fail. It may be that these companies are suffering from the sunk cost fallacy and refusing to kill drug development on drugs which aren't working; the fact that a third of all drugs which make it to phase III aren't effective can only be the result of excessive optimism on the part of the drug developers. It may also be that they keep trying to make successful, say, heart medication, because that worked for them (or their competitors) last time, and they think "Oh, yeah, this is a business, we just follow the leader" when in reality a drug which doesn't work better than what is already out there is entirely worthless and an enormous waste of money.
Of course, one could argue that the proper solution to this is to clamp down very hard on drug costs and prevent these companies from charging so much money for these treatments, and thereby force them to either start making good business decisions and not wasting large amounts of money and fobbing off the waste on customers or drive them out of business if they can't do it right. I could see that as being a valid argument, and a valid solution; if companies can't be efficient, they shouldn't exist at all, and someone else will come along to serve the market if some of the present players fail (or the remaining, more efficient companies will take over the market and everything will be better - it is worth noting that the most efficient large companies are about four times more efficient than the least efficient such companies).
The fear, I think, is that these companies won't make good decisions and will go out of business rather than adapt.
2550909
Ah yes, medical billing fraud.
This is why you always, always, always ask for a fully itemized bill and challenge bullshit. Because some places will rip you off.
That's not a drug company issue, though; that's a hospital issue, where they charge you $5 for a single aspirin.
2550988
Ah, but I have read the Aspartame literature. There are over 200 studies of its safety, many of which I've read. You can divide them in half; half paid for by people who sold aspartame, and half independent. Almost all of the ones paid for by industry concluded it was safe. Most of those done independently concluded it was not. The ones that concluded it was safe were mostly very small (eg n = 6) and very short (eg, 1 day) studies. All of the largest and best mouse studies concluded it caused cancer.
The FDA approved aspartame (the second time) as part of one meeting on one day that covered about 6 different additives. So they spent about an hour on it. All they did (judging from the citations they made) was look at one review, which concluded it was safe. That review article didn't say so, but all of the people who wrote it worked for companies that sold Aspartame.
The FDA gave 2 main reasons for ignoring the large safety studies that concluded aspartame caused cancer:
1. The dose-response curve was not always linear. But this is stupid; anyone who knows anything about physiology knows dose-response curves are not linear.
2. The different studies found different types of cancer. But this is stupid; anyone who knows anything about cancer knows that a carcinogenic agent can cause different types of cancer.
As is common in medical science, there is a large, contentious literature, which was cherry-picked to reach someone's desired conclusion.
Also, I personally get severe headaches from aspartame, reliably and repeatably.
The methodology used by FDA studies is incapable of detecting effects that are different for different people, or effects with U-shaped response curves, which are each a very large portion of effects. That's why they can't establish safety and can't disprove efficacy.
2550845
I stand corrected. I sent scribbler a PM inquiring about paying for a reading
I sent a contribution for Princesses, and whaddaya know--Scribbler really does have a strange and exotic name!
It's What, you thought I was gonna blab?
2551138
I can hardly claim to have read all the studies, but I have read some, as well as some back and forthing about them. I looked into it a little bit years ago when some folks claimed a new study showed that aspartame caused cancer, and paid attention to some of the back and forthing. The Ramazzini Institute, which had performed the studies, refused to share their materials with the FDA and EFSA when they were analyzing their study, which suggests either fraud, knowledge that their experimental techniques were terrible and that they would get nailed for being sloppy, or that they lost the material and therefore had no evidence backing them up. Given what material they did present indicated that they had a number of large methodological flaws in their study, ranging from respiratory infections (which is, apparently, a problem which even goes beyond this study), letting the rats die of old age before examining them (problematic because dying of old age means you die of SOMETHING, and older rats are obviously going to have more health issues than younger ones), comparing older rats (experimental group) to younger rats (control group), and misidentifying tumors. They were admonished for holding press conferences prior to peer review, and have been admonished for doing so several times on controversial studies.
The National Cancer Institute did an observational study on humans subsequent to the Ramazzini studies and failed to find any correlation between aspartame consumption and cancer. Another study the Ramazzini Institute did on aspartame in 2010 also had large methodological issues according to the EFSA; apparently they did not learn their lesson.
It isn't even just about aspartame; they also did a study about methanol for the EPA, in which it was found that they still couldn't correctly identify cancer; in a randomized, double-blind study where they took samples from the Ramazzini Institute which the Institute identified as containing cancer and mixed them in with slides from elsewhere, only one of the twenty three slides from the Insitute was found to correctly identify cancer. Funding for the experiment was subsequently pulled, while the Ramazzini Institute has just gone straight on yelling about stuff, most recently sucralose, and holding press conferences prior to peer review.
That's not to say that they're always going to be wrong, mind you, but given these issues, I don't consider them to be a terribly reliable source about this sort of thing. And unfortunately, a lot of the random outside groups which are going to conduct "studies" on stuff like this oftentimes have motivations of their own. I'm sure you remember the whole vaccine-autism scare thing which was actively fraudulent, the study being a pretext for a lawsuit. I do wonder how many people believe aspartame causes cancer; if it is less than believe that vaccines cause autism, maybe we need to learn some lessons from the artificial sweetener industry.
Unfortunately, studies are almost always done by an interested party or by the government, which opponents of whatever the study shows will claim was obviously biased in favor of the other party, simply because if you're not interested and you're not the government, why, exactly, are you conducting the study?
Incidentally, I actually looked up the headaches thing; apparently some people do claim to have headaches from aspartame, but no one knows whether it is real or caused by the nocebo effect (as one of the most common symptoms of such is headaches). There has only been one blinded study on it, conducted back in the mid-90s, and it suggested that a certain subset of people might get headaches from it, maybe, but unfortunately the study was tiny (the total number of people in the study was only 32, of which nearly half dropped out of the study) and of those, only one subset of people who believed that aspartame caused headaches (the group which self-identified as being "very sure" that aspartame caused headaches) got them. Unfortunately, a subset of a very small group is small indeed, and there were three responses in Neurology magazine criticizing the study and pointing out issues with it. I'm not actually sure how you blind aspartame anyway, as it tastes different from sugar and other artificial sweeteners, so if you are familiar with it, you can probably identify it by taste. No one else seems to have bothered to do a proper trial on the issue, which is kind of sad, but maybe unsurprising; people try to avoid advertising possible nocebo effects because it can cause other people to start experiencing the effects, which probably makes it hard to recruit people who believe that aspartame causes headaches because it spreads the idea that it, well, does, and might cause people to start experiencing them even though it doesn't cause them at all, or doesn't cause them in them for any physiological reason. Of course, that's not to say that aspartame does not, in fact, cause headaches; there aren't any studies which indicate that, either, as there is basically the one study.
It would be interesting, if it did cause headaches, to type the people and find out if they were heterozygous for the mutation which causes PKU.
I dunno if you're familiar with CGP Gray, but he had a pretty good video on the issues surrounding nocebos a while back. Then again, maybe I'm just a sucker for his trolling.
I put some pennies in the hat. No a fan of readings, to be honest, but debt is a terrible thing. That, and I feel I owe something for your usual posts, which are enlightening.
2551667 I don't know what the real quality of the Ramizzi Institute's work is, but remember there is an entire industry of scientists hired to attack and ridicule anyone who produces results unprofitable for their clients. Magnuson, whose fingerprints are all over the aspartame debate, is one of these. The reports produced by both the FDA and the EFSA on aspartame are largely copied from her publications.
It isn't fair to consider the "methodological flaws" in the Saffriti studies, because only studies that find aspartame harmful receive critical review. If Magnuson comes out with a study claiming aspartame is safe, most likely nobody will comment on it immediately, and certainly nobody goes to her lab and demands to go over her lab books. Look at Magnuson's 2007 review of safety data to see this in action. Studies that indicate safety are described but not criticized; studies that indicate it isn't safe are gone over with a fine-toothed comb. The bias is most blatant in section 6.9.3.2, where they admit that aspartame breaks down into formaldehyde, and that formaldehyde is considered a carcinogen--but then they digress into an analysis of the literature on formaldehyde toxicity to argue that it is flawed and formaldehyde probably isn't a carcinogen at all!
But when anybody publishes a study showing aspartame is harmful, groups of mercenary scientists like Magnuson jump into action the very next day, and a long and detailed criticism is in press within two months, and then the EFSA demands all their data and treats their lab like a crime scene. I mean, read what you wrote:
Since when does a government agency scrutinize an experiment so closely that they confiscate their samples? Pretty much never.
The "methodological flaws" in the second Soffriti study were invented by Magnuson, again without disclosure of her financial interest. No evidence was presented of the claims being made, such as the claimed infection with mycoplasma, or that incidence of lung infections were higher than in any other study of equally old animals. EFSA was complaining that Soffriti's animals had more infections than young mice. And that was without ever verifying the presence of infections; they were just looking at inflammation rates. And these inflammation rates were elevated only in females, not in males, in a large sample size, so evidently EFSA thinks Soffriti discovered a new kind of infectious agent that infects only old females.
For the 2010 study they recycled the same unfounded claims. The RI didn't "learn their lesson" because there was no lesson to learn; no evidence given to them of mistakes.
Finally,
is simply not true, and you can find statements in EFSA publications about what they did with data given them by the RI, like this one:
How do you think they did the study of samples from the RI? The RI actually gave them their samples, which I've never heard of a lab doing before.
Maybe the RI is just as biased as Magnuson and EFSA, but you can't believe a word published by either Magnuson or EFSA on this issue. You have to read the studies, search the literature and find the rebuttals, and read enough of the literature to see the pattern of what articles get responded to, by whom, how quickly, and which articles government agencies use in their reports, and which articles they dismiss. Then interpret everything in light of that. Industry bought the aspartame safety approval by an aggressive, long-term campaign of attacking anyone who produced any unfavorable results, and getting their studies in front of every government worker involved.
(There are more studies of the headache issue, but no really good studies. Of course it might be individual genetic differences, but anecdotally, the few people I've spoken to who have aspartame reactions didn't have them at first; they developed after years. I have a theory that it may be caused by gut microbes that evolve to digest aspartame differently. I have calculated that studies with rodents are theoretically incapable of detecting this, due to the larger gut size and longer duration exposure of humans. You'd need, if I recall correctly, billions of mice to detect an effect large enough to impact humans.)
So what kind of harm does Aspartame cause, and are we seeing more of it since it was introduced?
Talk to me like I'm stupid, because compared to you I am.
2551848
A number of studies done in the 1970s about aspartame done by the industry were roundly criticized for sloppy work as well. The FDA did a review of all the material when they approved the stuff in 1981, and did, in fact, criticize a number of studies. I think it is fair to say that studies about the safety of aspartame were criticized early on, when they were sloppy and no one knew if it was safe or not; over time, more and more studies were done, the safety of the material was established, and now the shoe is on the other food, with the onus being to contradict the extant data.
Three different US government agencies - the FDA, the NTP, and the EPA have been critical of the RI institute; the EPA ended up doing a survey of all their data, and they found that across their data sets, the RI consistently had issues with cranial cancer, ear cancer, and lung cancer, and had issues with rats getting respiratory infections which caused lung lesions (they did not have trouble identifying solid body cancers, such as liver cancer). They were not the only agencies which have been critical of them; the EFSA; the UK's Department of Health Committee on the Caricinogenicity of Chemicals in Food, Consumer Products and the Environment; the French Food Safety Agency; and the New Zealand Food Safety Authority all also complained about their studies. This wasn't an isolated hatchet job; either multiple government agencies from multiple continents, under multiple administrations, were conspiring against a group of people whose results did not match with other experimental results, or the RI's studies sucked. I think the latter is much more likely, especially given that they seem to conduct science by press conference, something which is very much disliked by many scientists.
The samples in question were part of a cooperative thing between the EPA and the lab, because the EPA was reviewing whether or not to use their data (and thus whether or not to, you know, continue paying them money to do experiments for them - kind of a bit of an incentive there). It had been started because the NTP found methodological issues in the studies done for them, and then notifying the EPA about them. The whole thing took two years to resolve. It is true that at the end, Republicans in Congress were yelling at the EPA to release their report on the analysis of the lab's work, and in the end, the EPA ended up discarding their data and starting a new set of experiments on the carcinogenicity of certain fuel additives with a different group (why they had even used the RI for it, instead of doing it in the US, still seems to be something of a mystery). That being said, the decision appears to be entirely justified, and given that they aren't the only ones who complained about this stuff, and that various folks have expressed the desire for RI to improve its work, and that it wasn't just one chemical... frankly, I think it is fair to say that there really were issues with the studies.
Frankly, if you go and claim that something common in food causes cancer, you need to be prepared for the highest level of scrutiny; if your study is sloppy, you should expect to have it picked apart. Having people go and attack experiments like that isn't a bad thing; it is too bad it is expensive, because a lot of studies suck and it would be nice if people could do that to every poorly performed food study. A lot of the studies I see about the benefits or dangers of various things are just really shoddy studies which don't show causation, and in some cases don't even really convincingly show correlation.
Incidentally, I'm not sure why you felt that she didn't disclose her financial interest. The paper notes:
Doing some research, she had previously done work for the Cantox Group as a "Senior Scientific and Regulatory Consultant", which makes sense - she's a toxicologist, and they hired her to, well, consult about toxicology, both in a scientific and a regulatory fashion. That she got paid to do an expert review on this is not surprising given her background; her background with Cantox is probably why Burdock tapped her to do the study. She has been asked to do a bunch of aspartame related stuff by various companies, including Coca-Cola, which makes sense - if someone is an expert on something (and she does a bunch of food safety related stuff - right now she appears to be working on the safety of nanomaterials in foods/the use of nanotechnology for food safety) then it makes sense to use them (and it makes it easier to find them), especially if they're a fairly well-respected scientist. She has also worked for the Joint FAO/WHO Expert Committee on Food Additives (JECFA) due to her expertise on food safety regulations. I'm not sure that your characterization of her is very fair; every PhD toxicologist I have ever known (which, admittedly, is a very small reference pool) has done consulting work for chemical companies at some point. She seems to do a lot of analysis of the reliability of studies, and has written several things about identifying good and bad studies.
Looking at some of the stuff she has done for Cantox, like this, about the risks and benefits of nanomaterials in foods, as well as how to test for them, what you should look for in studies, some of the potential hazards which have been found, ect. seems very standard to me. She does work with the FDA (I've found several presentations which noted involvement with the Center for Food Safety and Applied Nutrition) and honestly I'm not really seeing anything super sinister here. She's an expert on food regulations, she has been consulted on food additives, she did some stuff as regards aspartame, and she seems to be heavily involved with the use of nanomaterials in food. She has consulted for various industry groups which do work in that field, as well as done work for other random folks as well. It seems like pretty much exactly the sort of thing I'd expect a toxicologist who specializes in this stuff to do, especially one who seems to have an interest in analysis of studies.
As for the ESFA thing: they did share some things, but not all the things which were requested.
It's looking like I'm not going to whack on paypal today. I know it won't happen Friday. Could you remind me Saturday? I have a tendency to forget these things, and while I doubt that I could care less about the dog, I do want to see the Princess audiobook happen.
When this gets published (-> asserting that we will raise all that money and it will), I'm telling Ghost he spawned a discussion about the inner workings of the drug market.
2551985 You know what? I don't remember. A lot of the debate was over cancer, and you'd never notice aspartame's impact on the cancer rate if it had one. It's tough to even tell if risk of cancer is increasing or decreasing, because cancer rises whenever any effective treatment is developed for any other terminal disease of the old.
I think aspartame is relatively safe; I sometimes drink things with it. I eat other foods that are a lot more dangerous, like hamburger or ice cream.
But I am angry about the literature and the government agency proclamations, because the bias is so strong, and some of the FDA and EFSA's statements can only be called blatant lies. I was outraged at how thoroughly and successfully the scientific process had been hijacked. And I was shocked that after all the studies, the latest FDA committee reviewing its safety (at the time I looked into it) spent an just hour or two on it, and didn't do much except quote Magnuson's latest review.
You can get a list of adverse effects found in early studies from this review by Walton from about 1999. It says,
You can get a list of effects studied in the decade after from Magnuson's very biased review, but you need a library e-journal subscription or some cash to see it. Table of contents includes:
6.3. Chronic and Carcinogenesis Studies
6.4. Neurotoxicity Studies
6.5. Teratogenesis and Reproductive Studies
6.6. Genotoxicity
6.7. Additional Studies
6.7.1. Immunological Effects
6.7.2. Effect on Body Weight
6.7.3. Cytotoxicity
6.9.1. Human Case Studies
6.9.1.1. Allergic Reactions
6.9.1.2. Neurotoxic Reactions
6.9.1.3. Other Adverse Effect Reports
6.9.2. Human Clinical Studies
6.9.2.1. Effect of Aspartame on Methanol, Formaldehyde, and Formic Acid
6.9.2.2. Effect of Aspartame on Headaches
6.9.2.3. Effect of Aspartame on Behavior and Cognitive Function
6.9.2.4. Effect of Aspartame on Seizures
6.9.2.5. Effects of Aspartame in Diabetic Individuals
6.9.2.6. Effect of Aspartame on Hunger and Weight Gain
2552039
I see it's in the PDF, which was what was printed in the paper. It isn't in the HTML version. But her 2007 review was paid for by an aspartame producer, and that wasn't revealed in the paper, nor were the affiliations with industry of the 9 other authors, which I discovered at the time only by using Google on them.
I do not think that my characterization of Magnuson as a mercenary is unfair. She has attacked results indicating aspartame was unsafe despite having no evident motivation for doing so; she has done biased and shoddy work; she has done work for hire without disclosure; and her work somehow repeatedly managed to be the primary source for FDA and EFSA conclusions.
I'd like to get back to the topic of Scribbler and Ghost at some point. Feel free to reply, but I will try to resist the urge to reply back bcoz too much time spent on aspartame today.
2552051
Oh. Okay. You're just angry over a difference that makes no difference except to those...to whom it makes a difference. I do that all the time. It's fun!
( "You say homoiousios , I say homoousios, let's call the whole thing off--" Didja know that's the origin of the phrase "not one iota of difference?" True!
)
2550845
Top eight results all round to 17k.
2551589
That is a strange name.
You know, I think I see that tag get used more for what, no, it's not a spoiler than I do for honest-to-god actual spoilers.
2550681
I'm almost surprised noone has jumped on you about inappropriate patents. Almost. Maybe that's a different part of the internet.
2552085
That's because they're sorted by decreasing price, and I searched up to 17k. I paid 15k for mine.
2552093
Okay, that's fair I suppose. Only the top eleven cost more than 16k. (I only looked at the top eight before.)
A search up to 16k may have reinforced your case better. (My instinct was to say "helped you case", but that's not a correct phrase here.) I only found one result at your link that was less than 16.5k and wasn't also less than 16k.
2552085
Who is "noone?" Sounds like an Eskimo. Does he ride an alot? 'Cause my spirit animal is an alot!
fc03.deviantart.net/fs71/f/2011/059/d/a/sir_mix_alot_by_succubus1982-d3ampve.jpg
2552081
A dirty little secret of toxicology is that almost everything in the world has never been tested for toxicity; we generate thousands of new chemical compounds every year, of which only a very small fraction are ever tested for safety. Almost no foods have ever been tested for safety; even amongst those which have been, the toxicity is not always known absolutely. Tomatoes could cause a 3% increase in cancer rates and we'd likely never know. Most plants contain natural pesticides, some of which are toxic to humans in sufficient quantities, but we don't think that they are harmful to us in the levels that we are exposed to them - and indeed, one of them (caffeine) is rather popular, or so I hear. We constantly consume trace amounts of pesticide and soap with no demonstrably ill effect, but that doesn't necessarily mean that it isn't bad for us - it just means that we can't detect the effect over the random noise in our environment of eating burned food, lying out in the sun all day, getting x-rays, standing on very slightly radioactive rocks, and otherwise enjoying our lives.
No one without a rare genetic disorder has ever demonstrably died from consumption of aspartame (as far as I know), but that doesn't necessarily mean that it hasn't killed anyone from long-term use. It just means we can't prove it.
Really, we never truly prove that something is safe in toxicology; we just fail to prove that it is dangerous at whatever threshold of detection we are capable of.
2552307
So why all this? Why all this wise and ominous talk of things that are, in the end, trivial and plain? Why all this anger and search for conspirators?
Is it just the omega-male prerogative of indulging at once in both outraged innocence and bitter cynicism?
Oh, it is? Well let me join you then--here, I brought my own wormwood...
2552358
Because we agree about almost everything, and therefore must find some source of disagreement, else we might... I dunno, actually do something more productive with our time than look up stuff about aspartame on the internet.
2552267
It's me leaving out the hyphen. I'm pretty sure I did it on purpose. I might start doing it all the time.
(I may be undercutting you here. I'm sorry.)
2552358 2552368
In this case, it wasn't a search for a conspiracy, but a conspiracy in plain view. The thing that upsets me is not that people are eating aspartame; it's that the scientific process was so successfully perverted, and that the scientific community's decisions can be bought (not by paying people off, but just by what amounts to a clever marketing campaign).
It is a rare thing. I looked some at the Sucralose literature, and I probably looked some at saccharine tho I don't remember, and I looked into acesulfame potassium. Sucralose is odd, but none of them had the obvious, heavy-handed corporate purchase of truth.