Grumpy opinions about everything.

Category: Commentary Page 1 of 8

This is the home of grumpy opinions.

Project 2025

A Blueprint for Better Government or a Road Map to Authoritarian Rule?

Introduction

During the recently concluded presidential campaign, we heard much about the Heritage Foundation’s Project 2025. It was generally discussed as a plan for a conservative restructuring of the government. Donald Trump has repeatedly stated that he knows nothing about the plan or its contents. Given his general lack of interest in policy details during his previous administration, I believe him.

I didn’t know much about it either. In what I now recognize as magical thinking on my part, I assumed there was no way the American people would return him to office, so I didn’t bother learning about it.

The day after the election, I went online to find a copy of the Project 2025 report. I started with the Heritage Foundation’s website, where they described different elements of the plan, but there was no way to order a copy. I checked other online sources, including Amazon, but still could not find the full report. I did discover that it is nearly 900 pages long, so even if I had obtained a copy, I doubt I would have read more than a small portion of it. Ultimately, I decided to purchase two summaries of the project, both claiming to be bipartisan. I believe they are generally balanced, as they present both positive and negative aspects of the program.

What is Project 2025?

The Heritage Foundation describes Project 2025 as a comprehensive initiative aimed at preparing for a conservative presidential administration beginning in January 2025. It is notable that the plan does not explicitly reference a Trump administration, but rather a generic “conservative” one. My interpretation is that this allows the Heritage Foundation to appear supportive of conservatism without explicitly endorsing Donald Trump, protecting their nonprofit status.

The project is structured around four key pillars:

  1. Policy Agenda: Developing a detailed conservative policy guide, titled Mandate for Leadership: The Conservative Promise, which outlines strategies for governing major federal agencies.
  2. Personnel Recruitment: Establishing a database to identify and recommend qualified individuals for presidential appointments, ensuring alignment with conservative principles.
  3. Training: Launching the Presidential Administration Academy, an online educational platform designed to equip prospective appointees with the necessary skills and knowledge for effective governance.
  4. 180-Day Playbook: Crafting a strategic plan to guide the initial actions of the administration during its first 180 days, focusing on implementing conservative policies and reforms.

At first glance, this seems straightforward and unalarming. However, delving into the details reveals a much broader scope. The plan includes discussions about eliminating certain government agencies, overhauling civil service, extending presidential control over independent agencies, and substantially revising (though not eliminating) the Affordable Care Act.

I believe that the ultimate intent of the plan is to fully implement the Unitary Executive Theory. Therefore, understanding Project 2025 requires a basic understanding of this theory.

Unitary Executive Theory

The Unitary Executive Theory is a legal and constitutional doctrine asserting that the President of the United States holds absolute control over the executive branch. Proponents argue that Article II of the Constitution, which vests “the executive power” solely in the President, provides a constitutional basis for this authority. Critics contend it undermines checks and balances and concentrates too much power in the executive.

Key Points of the Theory:

  1. Presidential Control: Advocates claim the President should have direct control over all executive functions, including hiring, firing, and directing agency heads and officials.
  2. Limits on Congressional Power: The theory asserts that Congress cannot infringe on the President’s control over executive agencies by creating independent regulatory bodies or restricting the President’s ability to remove officials.
  3. Judicial Interpretation: The Supreme Court has addressed the concept in cases such as Myers v. United States (1926), Humphrey’s Executor v. United States (1935), and Seila Law LLC v. Consumer Financial Protection Bureau (2020). These cases reflect an ongoing debate about the extent of presidential control over the executive branch.

While proponents emphasize the need for a strong, centralized executive, critics warn it could erode the system of checks and balances envisioned by the framers of the Constitution.

Historical Perspective

The roots of the Unitary Executive Theory trace back to debates about the Constitution’s structure of executive power, particularly interpretations of Article II. Key historical examples include:

  1. Alexander Hamilton’s Federalist No. 70: Hamilton argued for a single, vigorous executive, emphasizing unity as essential for accountability and effective governance.
  2. Abraham Lincoln: During the Civil War, Lincoln exercised expansive executive power by suspending habeas corpus and issuing the Emancipation Proclamation.
  3. Franklin D. Roosevelt: FDR used executive orders extensively to implement New Deal programs and manage the war effort during WWII.

The term Unitary Executive Theory gained prominence in the late 20th century, championed by conservative legal scholars and the Federalist Society.

Application to Project 2025

Project 2025 seeks to leverage the Unitary Executive Theory to expand presidential power through the following measures:

  1. Consolidating Control: Bringing the entire federal bureaucracy, including traditionally independent agencies like the Department of Justice, under direct presidential control.
  2. Streamlining Decision-Making: Allowing the President to directly implement policies without interference from career officials or Congress.
  3. Personnel Changes: Proposing the removal of job protections for thousands of federal employees, enabling their replacement with political appointees loyal to the President.
  4. Agency Overhauls: Restructuring agencies such as the FBI, which the plan criticizes as “bloated” and “lawless.”
  5. Eliminating Departments: Proposing the elimination of the Department of Education and restructuring others like the Department of Justice and Homeland Security to increase presidential control.

Concerns Raised by Critics:

  1. Concentration of Power: Critics warn of an unprecedented consolidation of power in the executive branch.
  2. Politicization of Agencies: Traditionally nonpartisan agencies may become tools for advancing political agendas.
  3. Erosion of Checks and Balances: The system designed to prevent excessive power in any one branch could be undermined.
  4. Civil Service Protections: Removing job protections for career civil servants risks creating an unstable and politically driven workforce.

Supporters argue these changes are necessary to combat entrenched bureaucracy and improve efficiency. Critics, however, warn that this could push the U.S. toward authoritarian governance.

Conclusion

I have only touched on a few elements of Project 2025. Other aspects, such as policies on immigration, reproductive rights, and protections for minorities, are also deeply concerning but beyond the scope of this discussion.

Even just within the framework of the Unitary Executive Theory, I see significant risks. Will this plan lead to better government or pave the way to authoritarianism?

While everyone will reach their own conclusions, I find myself deeply distressed by the implications. I am concerned that the restructuring of DOJ, DHS and the FBI may lead to creation of a “Department of Political Vengeance”.

If you share these concerns, I recommend reading my post from September 8th, which reviews On Tyranny: Twenty Lessons from the Twentieth Century by Timothy Snyder.

Ten Essential Health Tips for Senior Citizens

As we age, maintaining good health becomes increasingly important to ensure a high quality of life. While everyone’s health needs are unique, there are universal strategies that can help seniors stay fit, independent, and active. Below are ten key health tips tailored for senior citizens, designed to promote both physical and mental well-being.

1. Stay Physically Active

Regular physical activity is one of the most important ways to maintain overall health as you age. Exercise helps improve cardiovascular health, keeps muscles and bones strong, and enhances flexibility. Engaging in activities like walking, swimming, or gentle strength training can also help reduce the risk of falls. Most health experts recommend about 150 minutes of moderate exercise per week.  Be sure to consult with your physician prior to starting a new exercise program to get a check-up and discuss any concerns or limitations, particularly if you have not had a regular exercise program for a while.

Begin with low-impact activities to avoid injury. Gradually increase intensity and duration.  Consider joining an organized exercise group. It will make your time more enjoyable and give you a ready source of motivation.  Additionally, the group will increase your safety should you fall or become injured.

If you have mobility issues, start with low-impact activities like chair exercises, tai chi, or yoga, which are great for improving balance and joint mobility.  Stretching is also important for maintaining flexibility.  Don’t forget to hydrate before, during, and after exercise.  Our thirst cues decrease as we get older, making us more susceptible to dehydration.

2. Maintain a Balanced Diet

Nutrition plays a critical role in maintaining health and vitality. As we age, our metabolism slows down, making it important to eat nutrient-dense foods that provide essential vitamins and minerals without excess calories. Focus on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.

Incorporate foods that are high in fiber to support digestion, and make sure you’re getting enough calcium and vitamin D to protect your bones. Stay hydrated, as seniors may sometimes feel less thirsty but still require plenty of fluids.

3. Get Regular Health Screenings and Checkups

Preventive healthcare becomes increasingly important with age. Regular checkups and screenings allow doctors to catch potential health issues early, when they are more easily treatable. Seniors should monitor blood pressure, cholesterol levels, and blood sugar to detect conditions like hypertension, diabetes, and heart disease. Managing chronic conditions is important not just for physical health but for mental well-being too.

Annual vision, dental, and hearing checkups are equally important. Additionally, keep up with vaccinations, including the flu shot, pneumonia vaccine, and shingles vaccine, to prevent serious illnesses.  Take advantage of any home health services that are available.

4. Prioritize Mental Health

Mental health is just as important as physical health. Seniors are sometimes at higher risk for depression, anxiety, and loneliness, especially after the loss of a spouse or friends. It’s important to stay connected with family and friends and to stay purposeful whether through social activities, religious activities, community centers, or volunteering. If seniors are struggling with anxiety, depression, or loneliness, it’s important to seek professional help. Many people benefit from counseling, cognitive-behavioral therapy (CBT), or support groups. There’s also growing evidence for the effectiveness of telehealth mental health services, making access to care easier.

5. Get Enough Sleep

Sleep patterns often change with age, but seniors still need about 6-9 hours of sleep per night for optimal health. Poor sleep can lead to increased stress, weakened immunity, and a higher risk of falls.

Create a restful environment and stick to a consistent sleep schedule. Avoid excessive napping during the day and limit caffeine intake in the evening. If you’re struggling with insomnia or sleep disorders, consult your doctor to address underlying causes.

6. Manage Medications Wisely

Many seniors take multiple medications for chronic conditions, which can increase the risk of drug interactions or side effects. Keep a current list of all medications, including over-the-counter drugs and supplements, and review it regularly with your healthcare provider.

Take medications exactly as prescribed, and don’t hesitate to ask your doctor or pharmacist about any concerns regarding when or how to take your medications.

7. Stay Socially Connected

Staying socially engaged is vital for mental health and emotional well-being. Isolation can lead to depression, cognitive decline, and a lower quality of life. Make an effort to nurture relationships, whether with family, friends, or through community groups.

Consider joining clubs, classes, or volunteer groups where you can meet people with similar interests. Regular social interaction has been shown to improve mood, reduce stress, and even boost immune function.

8. Focus on Fall Prevention

Falls are a leading cause of injury among seniors, often leading to serious complications such as fractures and other joint injuries. To minimize the risk of falling, make sure your home is safe by eliminating tripping hazards like loose rugs or clutter, installing grab bars in the bathroom, and ensuring adequate lighting.

Regular exercise can improve balance and strength, reducing fall risk. Additionally, vision checks and proper footwear can further lower the likelihood of accidents.

9. Keep Your Mind Active

Cognitive decline is a common concern for aging individuals, but staying mentally active can help delay or even prevent this process. Regularly challenging your brain with new and stimulating activities can improve memory, attention, and problem-solving skills.

Try hobbies that require mental effort, like learning a new language, playing a musical instrument, or tackling crossword puzzles. Engaging in lifelong learning through online courses or local adult education programs can also provide mental stimulation while keeping you socially connected.

    10. Practice Stress Management

    Chronic stress can take a toll on both physical and mental health, leading to issues such as high blood pressure, sleep disturbances, and weakened immunity. Seniors may face unique stressors, including health concerns or loss of independence, but there are effective strategies to manage stress.

    Mindfulness, meditation, deep breathing exercises, and spending time in nature can all help reduce stress levels. Engage in hobbies that you find enjoyable and relaxing, whether it’s gardening, painting, or simply spending time with loved ones.

    Conclusion: Embracing Healthy Aging

    Aging is a natural part of life, and by adopting healthy habits, seniors can enjoy a fulfilling and active lifestyle well into their golden years. Staying physically active, maintaining social connections, and prioritizing mental health are key to aging gracefully. By following these ten essential health tips, seniors can significantly improve their quality of life and continue to thrive.

    While it’s important to tailor these suggestions to your personal needs and health conditions, small changes in daily routines can lead to big benefits over time. Remember that your healthcare provider is a valuable partner in supporting your health, so maintain open communication with them about any concerns or changes in your health status.

    A Path to Recovery

    How Democrats Can Regain Momentum After the Election: Part 1

    Following a disappointing election, the Democratic Party faces a familiar yet challenging task: rebuilding and re-energizing its coalition. Electoral setbacks, though disheartening, provide valuable opportunities for self-reflection and strategic recalibration. Drawing lessons from recent elections and historical precedents, I’ll be exploring how I believe Democrats might regain their footing and prepare for future success.

    But first, in the spirit of full disclosure, I am not and have never been (except perhaps briefly in college) a registered Democrat. I was a Reagan Republican who progressively became disillusioned with the Republican Party beginning in the 1990s and finally in 2016 I reached the point where I switched to “no party affiliation.” While I can’t fully embrace the Democratic Party and some of its fringe elements, it more closely aligns with my beliefs than the current Republican Party.  It may seem inappropriate for a non-Democrat to offer advice to the Party, but sometimes it takes an outsider to bring clarity. 

    There are several areas where I think the Democrats need to reassess and refine their programs. In subsequent posts I’ll mention ideas about a number of them. But first things first.  If you want to win at the national level you’ve got to be organized and ready at the local and state level.

    There needs to be an honest assessment of what went wrong. Ignoring electoral losses or solely blaming external factors without self-reflection won’t give insight into a winning program.

    After their 2012 election loss, the Republican Party conducted a comprehensive analysis, resulting in the “Growth and Opportunity Project” report. This internal review highlighted areas for improvement, including outreach to minority communities and the need for a clearer economic message.

    For Democrats, a similar post-mortem analysis will prove invaluable. By examining voter data, exit polls, and demographic shifts, the party can identify why key groups, such as working-class voters or suburbanites, have turned away. Addressing these issues directly and transparently can rebuild trust and demonstrate the party’s seriousness about listening to voters’ concerns.

    State and local elections are critical in shaping a national party resurgence. The Republican Party’s “Red Map” project in 2010 targeted state legislatures to influence redistricting, giving them significant advantages in subsequent elections.

    Democrats should adopt a similar strategy, investing in local and state races to build a pipeline of strong candidates for future national campaigns.  By organizing at the local and state level and supporting local and state candidates, the National Party can develop a better understanding of what is necessary to develop a winning national campaign. 

    A winning national platform has to come from the bottom up reflecting the desires of the average voters. It cannot be imposed from the top down. The Democratic Party has unfortunately begun to develop a reputation as a party of intellectual elites trying to force their opinion on the common people. While it may be a misconception, failure to counter that misconception with a viable local and state presence allows the Republicans to frame the narrative. That is an approach that is bound to fail.

    By focusing on local and state elections, the party will have a better understanding of the “bread and butter” issues that have driven voter turnout in recent elections.  You can’t win local elections unless the local people know you and trust you and believe that you will work for them. That knowledge and trust has to be carried all the way from the local and state level to the national level.

    Significantly, in 2024 the National Democratic Party failed to provide any meaningful support to state and local candidates in states they deemed to be “too red”, thus ensuring continued Republican dominance. There was a time, not that long ago, when many of these “too red” districts might have been considered “too blue”, but that didn’t stop the Republicans from doing a grassroots program designed to appeal to the concerns of the average voter.

    Whether the Republicans accomplish anything for the average voter remains to be seen. But the important point is they convinced the voters that they were listening to them and cared about them. That’s a lesson that the Democrats should take to heart.

    Next time, we’ll look at what else I believe can be done to rebuild support for the Democratic Party.

    Key References:

    NBC News: Five Democratic Assumptions Shattered by the 2024 Election.

    Republican National Committee’s Growth and Opportunity Project (2013).

    Pew Research Center: Voter Turnout Trends and Demographics.

    New York Times: Bill Clinton’s 1992 Campaign Strategy.

    The Atlantic: The Red Map Project.

    The Nation: Democrats Need to Fundamentally Rethink Everything.

    Government Efficiency or Personal Profit?

    I have been giving a lot of thought to the proposed Department of Government Efficiency (DOGE), to be led by Elon Musk and Vivek Ramaswamy.  The stated objective is to streamline federal operations by cutting wasteful spending and reducing bureaucracy. Am I the only one who finds it incongruous that they’re going to create an entire bureaucracy to improve government efficiency?  How anyone thinks that an entire new government department with all of its attendant rules, regulations, forms, reports and meetings can make things more efficient is beyond me.  This reminds me of a project put in place in the late 1970s when I was still in the Marine Corps. Congress passed a law called the Paperwork Reduction Act. As part of that act, were required to submit monthly reports, you guessed it, on paper documenting our reduction in paperwork.  I was an administrative plans officer for the Fleet Marine Force Pacific at the time, and the Paperwork Reduction Act generated more paper than any other project that crossed my desk.

    One of the things that interests me most about this is the current “bromance” between Donald Trump and Elon Musk.  Their personal relationship has had a series of ups and downs over the years.  One must wonder how long the King of Trump World and the Center of the Musk Universe will continue to get along.

    In 2016, Trump appointed Musk to his Manufacturing Jobs Initiative  and Strategic and Policy Forum but within six months Musk resigned from these advisory roles in protest of Trump’s decision to withdraw the U.S. from the Paris Climate Agreement.  By 2022, animosity increased when Trump labeled Musk a “bullshit artist,” alleging that Musk had falsely claimed to have voted for him in 2016. Musk responded by suggesting it was time for Trump to “hang up his hat & sail into the sunset.” 

    Despite past disagreements, their relationship improved significantly by 2024. Musk endorsed Trump’s presidential campaign and contributed tens of millions of dollars through America PAC. Leveraging his ownership of X (formerly Twitter), Musk used the platform to promote Trump’s candidacy and engage with supporters, enhancing the campaign’s digital presence.  Following Trump’s election victory, he praised Musk, stating, “We have a new star, a star is born.”

    Musk’s leadership of DOGE raises concerns about potential conflicts of interest, given his companies’ extensive dealings with the federal government.

    Musk’s ventures, such as SpaceX and Tesla, have historically benefited from substantial government contracts and subsidies. For instance, SpaceX has secured numerous contracts with NASA and the Department of Defense, including a significant agreement with the National Reconnaissance Office to build a network of spy satellites. Additionally, SpaceX’s Starshield program, designed for government use, received its first contract from the U.S. Space Force in September 2023.

    Musk has frequently criticized regulators for what he views as unnecessary investigations hindering his companies.  His role in DOGE could help protect these contracts from potential budget cuts, ensuring they remain exempt from the initiative’s cost-cutting mission.  DOGE’s focus on slashing “excess regulations” could lead to reduced oversight of Musk’s businesses, particularly in areas like Tesla’s self-driving technology safety, labor practices at his companies, and SpaceX’s rocket launch regulations

    The very name “DOGE” is, perhaps, a nod to Dogecoin, a cryptocurrency Musk frequently promotes. Attention from this initiative has already caused Dogecoin’s price to increase, potentially benefiting Musk if he holds significant amounts of the currency.

    Elon Musk has never been known for his philanthropic endeavors.  Even his charitable giving is significantly directed towards his own business or personal enterprises through the Musk Foundation.

    Given these existing relationships, Musk’s role in DOGE could potentially influence decisions that benefit his businesses, such as deregulation in sectors where his companies operate or the redirection of government funds toward projects aligned with his interests. However, it’s important to note that DOGE is proposed as an advisory body without direct authority to implement policies.  Any recommendations from DOGE should require legislative approval, but that may be bypassed as Trump has indicated his willingness to govern by executive order.

    In summary, while DOGE’s mission is to improve government efficiency, Musk’s involvement introduces the possibility of decisions that could favor his enterprises.  Perhaps a better name for this organization would be the Department of More Money for Musk.

    The Unprecedented Reach of Social Media

    A Vast Reach

    Social media has proven to be a more effective platform for spreading propaganda than traditional media due to its vast reach, the ability to target specific users, emotional manipulation, algorithm-driven amplification, and the speed at which information spreads. While print, broadcast, and other forms of media still play roles in shaping public opinion, they simply cannot compete with the scale, focus, and speed offered by social media platforms.

    This shift represents a fundamental change in the dynamics of information spread. The power to shape beliefs and influence behavior is no longer concentrated in the hands of a few gatekeepers but is now accessible to anyone who understands how to leverage the tools of technology. As a result, the modern information landscape is more fragmented and volatile, making it increasingly difficult to distinguish between genuine information and propaganda.

    Understanding these dynamics is essential for navigating the digital world, particularly as social media plays an ever-larger role in public discourse. Whether we can develop better strategies for recognizing and mitigating propaganda in this new environment remains to be seen, but it must be addressed if we are to preserve the integrity of public information.

    Sheer Scale

    One of the primary reasons social media is more effective at spreading propaganda than traditional media is its sheer scale. Platforms like Facebook, X (formerly Twitter), Instagram, and TikTok have billions of users globally. Information shared on these platforms can be instantly viewed, and reshared by a wide audience, allowing propaganda to spread virally within hours or even minutes. Unlike print or broadcast media, which require significant resources and distribution channels, social media allows anyone with an internet connection to produce and share content.

    Targeting

    Another critical advantage social media has over traditional media lies in its ability to micro-target specific individuals or groups. Social media platforms utilize algorithms that gather massive amounts of data on users’ behaviors, interests, and demographics. This data is then used to curate content with which users are most likely to engage, creating a personalized experience. While this system may enhance user satisfaction and increase time spent on the platform, it also can create filter bubbles producing highly effective propaganda.

    Propaganda creators can design content that speaks directly to the fears, values, or biases of particular segments of the population. By targeting users who are already inclined to believe certain narratives, propagandists can reinforce pre-existing biases, creating echo chambers in which users themselves specifically choose content that reflects their preexisting ideas without encountering opposing viewpoints.

    Emotional Manipulation

    Social media platforms are designed to maximize engagement, and the most engaging content is often that which provokes strong emotional responses. Whether it’s outrage, anger, fear, joy, or sadness, emotionally charged content is more likely to be shared and spread than neutral or purely informative posts. This creates an environment in which sensationalism and emotional manipulation thrive, making social media fertile ground for propaganda.  The old newspaper dictum, “If it bleeds it leads” has been carried to levels never imagined by previous generations of editors.

    The Role of Algorithms

    One of the most insidious aspects of propaganda on social media is the role of algorithms in determining what content users see. These algorithms are designed to prioritize content that keeps users engaged, often by promoting material that aligns with their existing beliefs or that provokes strong emotional reactions. In doing so, algorithms contribute to the spread of propaganda by ensuring that polarizing or misleading content reaches more people.

    The Speed and Scale of Misinformation

    Unlike print or broadcast media, where editorial processes and production timelines can act as natural checks on the spread of misinformation, social media operates in real-time. Users can share content instantly, without fact-checking or verifying sources. This speed makes it much easier for propaganda to spread before it can be debunked. By the time fact-checkers have corrected misinformation, it has already reached millions of people, many of whom may never see the correction.

    The decentralized nature of social media makes it difficult to trace the origins of propaganda. Fake accounts, bots, and coordinated campaigns can obscure the sources of misleading content, making it harder for users to assess the credibility of the information they encounter. In traditional media, the source of information is typically clear, whether it’s a newspaper, a television network, or a radio station. On social media, the source of propaganda can be either disguised or entirely anonymous, or perhaps even fabricated by artificial intelligence, adding layers of complexity to the problem.

    Hopefully this Brave New World of social media does not overwhelm the values that guide our country.  

    The Harmful Grip of Cigarette Smoking

    Addiction, Health Risks, and the Benefits of Quitting

    Cigarette smoking remains one of the leading causes of preventable death worldwide.  In the more than 65 years since the US Surgeon General first required health warnings to be placed on cigarette packs, significant progress has been made in reducing the rates of smoking. In 1965 about 45% of US adults were smokers and today fewer than 12% smoke on a regular basis. Youth smoking rates have also declined dramatically. In recent years fewer than 5% of high school students report smoking on a regular basis. In my high school class (1966) the smoking rate was probably closer to 30%. As encouraging as these numbers are, there is no acceptable rate of smoking, and I hope those of you who don’t smoke will pass this article on to family or friends who do. 

    The Power of Nicotine Addiction

    Nicotine, the primary addictive substance in cigarettes, is remarkably potent. When inhaled, it travels to the brain within seconds, where it stimulates the release of dopamine, a neurotransmitter that creates a feeling of pleasure and relaxation. Over time, the brain rewires itself, craving nicotine to maintain these pleasurable effects, leading to dependency.

    The addictive nature of nicotine makes quitting extremely difficult, as withdrawal symptoms, including irritability, anxiety, difficulty concentrating, and intense cravings, can deter many smokers from quitting. Nicotine also increases heart rate and blood pressure, contributing to the stress-relief paradox: although many smokers feel cigarettes help them relax, the substance actually exacerbates stress on the cardiovascular system.

    Smoking can be tied to our daily routines. Some people have commonly have a cigarette with morning coffee or after meals. Other people reach for a cigarette when they’re on the telephone. Social settings and peer influence can make quitting difficult. Attending social gatherings where smoking is common can reignite cravings. A smoker who decides to quit can feel surrounded by the temptations to resume smoking.

    There are a number of other factors also that make it difficult to quit smoking. There’s a lack of immediate health benefits noted.  Improvements like better lung function, reduced cancer risk or long terms outcomes are not noted right away. Some smokers fear weight gain more than they fear the effects of smoking and will delay any attempts at cessation because of that. Some smokers also feel frustration because after a few days without a cigarette they think “I don’t feel any better, what’s the point?”

    Health Risks: Nicotine and Smoke by-products

    Cigarette smoke contains over 7,000 chemicals, many of which are toxic. Among these are tar, carbon monoxide, formaldehyde, and heavy metals like cadmium and lead. Some chemicals are carcinogens, contributing to the development of cancer, while others damage tissues and organs in less visible but no less harmful ways.

    • Cardiovascular disease: Smoking increases the risk of heart attacks, strokes, and peripheral artery disease. It contributes to the buildup of plaque in arteries, restricting blood flow and forcing the heart to work harder. Among smokers greater than age 40, more than 50% develop cardiovascular disease and they’re more than twice as likely to die from cardiovascular events compared to non-smokers.
    • Congestive heart failure: Nicotine triggers release of adrenaline which increases both heart rate and blood pressure, putting more strain on the heart. Carbon monoxide from cigarettes binds to hemoglobin reducing the oxygen carrying capacity of the blood. Plaque buildup from coronary artery disease as well as myocardial fibrosis, scarring in the heart tissue, both lead to impaired cardiac function. Quitting smoking can significantly lower the risk of death from heart failure related complications.
    • Chronic obstructive pulmonary disease (COPD): Smoking damages the lungs, leading to chronic conditions such as emphysema and chronic bronchitis. Over time, lung capacity declines, making breathing progressively more difficult.  Even with smoking cessation, lost lung function cannot be fully recovered. It is vitally important that anyone with pulmonary disease quit smoking as soon as possible.
    • Cancer: Tobacco use is responsible for roughly 80% of lung cancer cases. It is also linked to cancers of the mouth, throat, esophagus, pancreas, bladder, and cervix, among others.
    • Diabetes: Smoking increases the risk of type 2 diabetes by around 30 to 40%. Smokers with diabetes are much more likely to experience complications such as heart disease and kidney failure.
    • Reproductive health issues: Smoking affects fertility in both men and women. Pregnant smokers are at higher risk for miscarriage, preterm delivery, and having low-birth-weight infants.

    The Benefits of Quitting Smoking

    It’s never too late to quit smoking, and the benefits begin almost immediately after quitting.

    • Within 20 minutes: Blood pressure and heart rate start to normalize.
    • Within 12 hours: Carbon monoxide levels in the blood drop to normal, improving oxygen flow.
    • Within weeks: Lung function improves, and circulation begins to return to normal.
    • Within months to a year: Coughing and shortness of breath decrease, and the risk of heart disease drops significantly.
    • Within five years: Stroke risk drops to that of a non-smoker, and the risk of certain cancers is cut in half.
    • After ten years or more: The risk of lung cancer is about half of what it would have been had the person continued to smoke.

    The Deceptive Appeal of Vaping

    Unfortunately, the rise of e-cigarettes, also known as vaping, has emerged as an alternative to smoking among many people. E-cigarettes deliver nicotine through vapor rather than smoke. While they eliminate some of the harmful byproducts like tar and carbon monoxide, vaping is not without risks. Some vaping products contain toxic materials not contained in tobacco. Especially custom or self-blended cartridges for vape pens that may have carcinogenic or otherwise harmful additives not readily obvious to the user. Unfortunately, many adolescents and young adults who have never smoked cigarettes have developed a nicotine addiction through e-cigarette use.

    Conclusion

    There is no safe level of use of tobacco or other forms of nicotine.  Quitting smoking improves quality of life, reducing the frequency of respiratory infections and improving overall energy levels. For long-time smokers, the prospect of reversing years of damage may seem daunting, but research consistently shows that health outcomes improve at any point, even decades after quitting.  If I could give my smoking patients only one piece of medical advice it would be: “Quit smoking and quit now”.  And I know how hard it is. I quit smoking 53 years ago and for many years afterwards it remained a daily struggle. But eventually, with the help and support of my family I was able to get past my tobacco cravings.

    What Would Ronnie Think?

    Thoughts on Ronald Reagan and the Current State of the Republican Party

    I think Ronald Reagan may have been the best president of the modern era. I know that will make my liberal friends cringe. Additionally, I have recently gained new respect for Clinton and Obama, and I know that will likewise make my conservative friends cringe. I’ve always considered myself to be more conservative than liberal. But I just cannot support the current direction of the Republican Party and now consider myself to be a “Recovering Republican”.  I didn’t leave the Republican Party. The Republican Party left me. And I wonder “What would Ronnie think?”

    Speculating on what Ronald Reagan might think of the modern Republican Party is risky and involves consideration of his political philosophy, policies, and the values he championed during his presidency from 1981 to 1989.

    Key Points of Reagan’s Ideology:

    1. Conservatism: Reagan was a proponent of traditional conservative values, emphasizing limited government, individual liberties, free markets, and a strong national defense.  He likely would have been concerned about the confrontational form of conservativism espoused by many contemporary Republicans.
    2. Optimism: He often conveyed a sense of optimism about America’s future, believing in the ability of the American people to solve their problems.  He would have been concerned about current rhetoric designed to pit Americans against one another.
    3. Bipartisanship: Reagan worked with Democrats on significant legislation, showcasing a willingness to compromise for the greater good.  President Reagan and Tip O’Neill, Speaker of the House, believed that partisanship ended after 6:00 PM and should never be a barrier to friendship.
    4. Focus on Issues: His presidency was marked by a focus on economic issues, such as tax cuts, deregulation, and a strong anti-communist foreign policy.  He likely would have been concerned by the Republican Party’s current often favorable response to the totalitarian governments in both Russia and China.

    Speculation on His Views of Today’s GOP:

    1. Populism vs. Traditional Conservatism: Reagan might be concerned about the rise of populism within the party, which sometimes shifts focus away from traditional conservative principles. He valued ideological coherence over personality-driven politics.
    2. Divisive Rhetoric: The modern Republican Party has seen an increase in divisive and confrontational rhetoric. Reagan was known for his ability to unite people and might disapprove of the factionalism that can alienate moderate Republicans and independents.
    3. Economic Policies: Reagan’s foundational economic principles might resonate with today’s emphasis on tax cuts and deregulation. However, he also expressed concern over increasing national debt and the impact of tax cuts without corresponding spending reductions.  He was a strong proponent of free trade and believed that it had benefitted the US economy by opening markets and encouraging competition and he played a significant role in establishing trade agreements that laid the basis for the North American Free Trade Act. In contrast, today’s Republican Party is more concerned with protectionist policies and tariffs and creating trade barriers which they believe will somehow benefit the country as a whole.
    4. Social Issues: Reagan had a more moderate stance on certain social issues than some factions of today’s GOP. He might find the current approach to issues like immigration and LGBTQ+ rights more contentious than his more inclusive positions.  He was slow to respond to the AIDS crisis but was not as overtly hostile to the issues as the current GOP.  Reagan advocated a restriction of federal funding for abortions but did not back a total ban on abortions.
    5. Foreign Policy: Given his strong anti-communist stance and emphasis on diplomacy, Reagan may critique some of the modern party’s more isolationist tendencies.  He might also be concerned about the current positive approach towards totalitarian regimes.  
    6. Immigration: Reagan had a different approach to immigration than the current GOP. He backed the Immigration Reform and Control Act of 1986 which provided emergency amnesty for approximately 3,000,000 undocumented immigrants. Many of today’s Republicans would label Reagan’s amnesty program as a failure and certainly not one that they would be willing to repeat. Reagan’s policies were aimed at addressing the historic realities of immigration and included provisions for legalization which is currently opposed by most Republicans.

    In summary, while Reagan might appreciate certain aspects of the modern Republican Party, such as a commitment to conservative economic principles, he would likely be critical of the divisive politics, populism, and the lack of bipartisan cooperation that he valued.  Reagan’s views might resonate with traditional conservatives who still value free market principles. Likely though, they would face pushback from factions within the party that prioritize the nationalist policies. Many Republicans today see Reagan’s approach as outdated or incompatible with their current priorities which emphasize immediate economic protection over long term global engagement. This assessment is speculative, of course, and based on my interpretation of his beliefs and leadership style.

    For a deeper dive into Reagan’s legacy, consider reading more from the Ronald Reagan Presidential Foundation (www.reaganfoundation.org)

    /

    What Would George Washington and Thomas Jefferson Think About Our Current Political Climate?

    In considering what George Washington and Thomas Jefferson might think of today’s political situation, it’s tempting to view their perspectives through the lens of nostalgia, believing that the founders had an idealistic vision that, if followed, would have prevented many modern problems. It’s impossible of course to know what they may have thought about our current environment. Certainly, such things as a 24-hour news cycle on cable television and social media would have been beyond their comprehension.  While both men lived in a vastly different era, their writings and philosophies give us a sense of how they might respond to the polarization and tensions we witness today.

    George Washington: A Warning Against Partisanship

    George Washington was deeply concerned about the rise of factions in the United States. (Political parties as such were unknown at the beginning of our republic.) In his famous Farewell Address in 1796, he warned that factions could lead to division and weaken the unity of the country. Washington was worried that faction (party) loyalty would surpass loyalty to the nation, creating conflict between groups and impairing the ability of government to function for the common good. He feared that excessive partisanship would “distract the public councils and enfeeble the public administration,” leaving the nation vulnerable to foreign influence and internal discord.

    If Washington could observe today’s political environment, he likely would be saddened by the partisanship which dominates political discourse. The gridlock, belligerent rhetoric, and divisiveness we experience today demonstrate the appropriateness of his concern. Washington would likely advocate for a return to greater civility, urging Americans to focus on the common good and to set aside factionalism for the sake of national unity. While political parties have become integral to our system, Washington would likely still press for cooperation, mutual respect, and compromise among all groups.

    Thomas Jefferson: Liberty, Democracy, and the People’s Role

    Thomas Jefferson, while more supportive of political parties than Washington, had his own complex views about governance. Jefferson believed in the power of the people to govern themselves and was a passionate advocate for liberty, democracy, and decentralization. He distrusted concentrated power, whether in government, or economic institutions, and feared that it could lead to tyranny. Jefferson was famously a champion of agrarianism and believed that widespread participation in the democratic process was the best defense against corruption and the loss of liberty.

    Jefferson, while a proponent of states’ rights and individual liberties, might view polarization as a threat to democratic ideals if it stifles dialogue and compromise. He believed in the potential for free men to govern wisely, but would caution against the erosion of civil discourse that might follow the rise of extreme factionalism

    Faced with the highly charged political debates of today, Jefferson would likely express concern over the increasing centralization of power in government, banks, and large corporations. He would, without doubt, be troubled by the outsized influence of money in politics.

    Jefferson was also a firm believer in education as a cornerstone of democracy; he would stress the importance of an informed electorate, particularly in an age where misinformation can spread rapidly.

    However, Jefferson was no stranger to political conflict, having played a central role in the fiercely partisan battles of his time. He understood the value of vigorous debate but would probably urge that such debate remain focused on the core democratic principles of liberty, justice, and equality rather than devolving into personal attacks.

    Media and Civil Discourse

    Of course, it is impossible to know what Washington and Jefferson would think about the current role of media, particularly social media which would be beyond anything in their experience. Washington felt strongly aggrieved by the attacks upon him in the newspapers of the time.  He felt unfair attacks would undermine national unity. Jefferson, on the other hand, was a strong proponent of freedom of the press. He was also very adept at the use of newspapers to accomplish political means.

    However, it is likely that both would caution against the dangers of misinformation and partisan bias to distort public perception.  Most likely both would emphasize the need for a responsible press that distinguishes between fact and opinion and supports a healthy democracy. Both would be opposed to using false or misleading statements to influence the public.

    Unity and Civic Responsibility

    Despite their differences, both Washington and Jefferson would likely agree on one thing: the importance of unity and civic responsibility. They envisioned a country where citizens were deeply involved in a participatory government, contributing not just with votes but with informed, constructive dialogue. Washington would call for a spirit of national unity above party lines, while Jefferson would insist that the preservation of liberty relies on active and informed participation from the public.

    Both founders would encourage a healthier, more cooperative political environment, one where differences are respected and not allowed to fracture the country. They would likely see today’s polarization as a threat to the very ideals they fought to establish, and both would urge Americans to remember their shared values.

    Conclusion

    In short, George Washington and Thomas Jefferson, while men of their own time, had insights that are still relevant today. Neither man could have predicted the exact nature of modern politics, but their wisdom offers enduring guidance: political disagreements must not undermine the unity, liberty, and civic responsibility that are the foundation of the American experiment.  We owe it to them not to lose the promise of the American Revolution.

    Understanding Vitamins, Supplements, Herbal Preparations, Patent Medicines, and Homeopathic Medications

    What you should know.

    The cost of prescription medications is almost constantly in the news. It has even become a topic of debate in the current presidential elections. Americans spend over $500 billion annually on prescription medications. This includes drugs covered by insurance, and out of pocket costs and specialty drugs for chronic conditions.

    But this is not the only expense Americans have for drug related health care items. Almost $90 billion a year is spent on nonprescription preparations.

    The shelves of pharmacies, health food stores and convenience stores are lined with a vast array of vitamins, supplements, patent medicines, herbal preparations, and homeopathic medications. They are also available from hundreds of online sources, both reputable and of questionable origin.

     Many people turn to these products in the hope of improving their health, boosting their immune systems, or addressing specific ailments. However, the development, testing, approval processes, and regulation of these products can be confusing, even for the most educated consumer. We will delve into each of these classes of health products, exploring how they are developed, tested, and regulated, and highlighting some potential drawbacks of which you should be aware.

    Vitamins and Dietary Supplements

    Development and Testing

    Vitamins and dietary supplements include a broad range of products such as vitamins, minerals, amino acids, and other nutritional components. These products are typically developed through a combination of scientific research and commercial interest. Manufacturers may isolate nutrients from food sources or create them synthetically. Testing often involves ensuring that the products contain the stated ingredients in the correct amounts. However, unlike pharmaceuticals, these products are not usually subject to rigorous clinical trials to prove efficacy and safety before they are marketed.

    Approval Process

    In the United States, vitamins and dietary supplements are regulated by the Food and Drug Administration (FDA) under the Dietary Supplement Health and Education Act (DSHEA) of 1994. Under DSHEA, manufacturers are responsible for ensuring the safety and labeling of their products before they reach the market. However, the FDA does not approve dietary supplements before they are sold. Instead, the FDA can take action against any supplement that is found to be unsafe once it is on the market.

    Drawbacks

    One of the primary drawbacks of dietary supplements is the lack of pre-market approval, which means that the burden of proving safety is often on the consumer or the FDA post-market. This can lead to situations where unsafe or ineffective products remain on the market until sufficient adverse events are reported. Additionally, the quality of supplements can vary widely between manufacturers, and contamination with other substances is a known risk. Although, given the competitive nature of these products and the number of distributors, questionable products are usually forced out of the market early.

    Herbal Preparations

    Development and Testing

    Herbal preparations include products made from plants or plant parts, used for their supposed medicinal or therapeutic properties. The development of these products is often rooted in traditional medicine practices, although modern herbal preparations may undergo some degree of scientific research. Testing for herbal preparations can vary widely; some are backed by clinical studies, while others rely on anecdotal evidence or traditional use.

    Approval Process

    The FDA considers herbal supplements as foods, not medicines. So, they are not subject to the same testing, manufacturing, and labeling standards and regulations as medicines.

    This means they do not require pre-market approval by the FDA. However, in other parts of the world, such as Europe, herbal products may undergo more rigorous testing and regulation.   All herbal products that display an intended use must be accompanied by a box warning stating: “These statements have not been evaluated by the Food and Drug Administration.  This product is not intended to diagnosis, treat, cure or prevent any disease.”

    Drawbacks

     The primary concerns with herbal preparations are the variability in potency and the potential for contamination or adulteration with other substances. Additionally, the lack of standardization in the preparation of herbal products can lead to inconsistent effects. Herbal supplements, unlike medicines, do not need to be standardized to make sure of batch-to-batch consistency.  Some herbs can also interact with prescription medications, leading to adverse effects.

    Homeopathic Medications

    Development and Testing

    Homeopathic medications are based on the principle of “like cures like,” where substances that cause symptoms in a healthy person are believed to cure similar symptoms in a sick person when taken in highly diluted forms. The development of homeopathic remedies typically involves diluting a substance repeatedly until little to no trace of the original substance remains.

    While counterintuitive, homeopaths believe that a homeopathic medicine is more powerful the more times the active ingredients have been diluted.    A 6X potency indicates that the drug has been diluted at a ratio of 1 to 10 for a total of six times.   A C potency means the dilution ratio is 1 to 100.  The higher the numeral, the lower the concentration of active ingredients in the medicine. 

    Testing in homeopathy is controversial, as traditional scientific methods, such as randomized controlled trials, often find no evidence that homeopathic remedies are more effective than a placebo.  Some supporters claim that homeopathic remedies are developed for a specific patient making general testing irrelevant.

    Approval Process

     In the U.S., homeopathic medications are subject to regulation by the FDA under a different framework compared to dietary supplements. Historically, these products were allowed to be sold without pre-market approval as long as they were prepared according to the guidelines of the Homeopathic Pharmacopeia of the United States (HPUS) and the FDA’s Good Manufacturing Practices.  All products are required to be clearly marked as “homeopathic”.  In recent years, the FDA has increased scrutiny of homeopathic products, particularly those marketed for serious conditions, or containing potentially harmful ingredients, as well as those for eye conditions, and all homeopathic injectables.

    Drawbacks

    The major drawback of homeopathic medications is the lack of scientific evidence supporting their efficacy. Most scientific reviews and clinical trials have found that homeopathic remedies do not perform better than placebos. Moreover, because homeopathic products are so highly diluted, they are generally considered safe, but they may delay patients from seeking effective medical treatments for serious conditions.

    Patent Medicines

    History and Evolution

    Patent medicines have a colorful history. They began in the 19th century and were popular into the early 20th century before evolving into the over-the-counter industry that we now know. This class includes many modern over the counter medications produced by reputable drugs companies and also medications of dubious quality and effectiveness produced in garages and basements.

    In the late 19th and early 20th centuries, medicine wagons and medicine shows became popular vehicles for the promotion and sale of patent medicines. These traveling shows often combined entertainment with health claims, featuring acts such as music, magic tricks, and even wild west performances. At the center of the spectacle, a charismatic “doctor” or salesman would tout the benefits of their patent medicine—a proprietary formula claimed to cure a wide range of ailments.

    Patent medicines of this era were largely unregulated, and their ingredients were often a secret. Some contained alcohol, opium, or other stimulants, which provided temporary relief or a placebo effect. Because there were few laws governing their production and sale, these concoctions could be marketed without scientific proof of their efficacy or safety.

    Medicine shows traveled to rural and urban areas alike,  attracting customers who had little access to conventional medicine, particularly those in remote regions. Unfortunately, these products were often ineffective or even dangerous. The rise of the Pure Food and Drug Act of 1906, which required the labeling of ingredients and restricted misleading claims, signaled the decline of these shows and the broader patent medicine industry.

    A few of the original patent medicines stayed on the market until the late 20th century. The most famous of these was Carter’s Little Liver Pills which was touted for curing headaches, constipation, dyspepsia and biliousness. Lydia Pinkham’s Vegetable Compound which was sold for “female complaints “, is still on the market though it has been significantly reformulated. A number of medications on the market now could be considered as the descendants of early patent medicines, perhaps the best known of these is Geritol

    Approval Process

    Modern patent medicines fall into the category of over the counter (OTC) drugs.  Preparation of these medicines must either follow a monograph established by the FDA (essentially a recipe book) or undergo New Drug Application (NDA) process.   All patent medicines must comply with strict labeling standards and include accurate ingredient lists, dosage instructions, and warnings. Any health claims must be supported by scientific evidence.

    Drawbacks

    There are several drawbacks to over the counter (patent) medications. There’s a significant risk that people may intentionally take more than the recommended doses. This is particularly dangerous with some medications such as Tylenol which can lead to liver damage. People may use medications for a longer than the recommended period.  They may also be used in an attempt to treat conditions for which they are not intended. They may mask symptoms of a more serious condition leading to a delay in seeking appropriate medical care.

    Conclusion

    Vitamins, supplements, herbal preparations, patent medicines and homeopathic medications each occupy a unique space in the health and wellness industry. While they offer consumers more choices in managing their health, the differences in how these products are developed, tested, and regulated are significant. As a consumer, it’s essential to be informed about these differences to make safe and effective choices.

    I’d like to thank my friend Steve Kaplan, a Registered Pharmacist, who is also my coauthor for this post.

    The Pot Predicament

    Recently, the Charleston City Council passed a bill to reduce the penalties for the possession of marijuana for personal use. This started me thinking about marijuana and its long intertwining with my generation.  I first became aware of marijuana in my early teenage years, more than sixty years ago.  At that time, possession of marijuana for personal use was a crime, as it still is in much of the country now, and it remains a federal crime. Soon after I became conscious of the whole thing, marijuana was incorporated into President Nixon’s war on drugs.

    This is a war which sadly we continue to lose. This doesn’t stop us from pouring resources into a part of that war that doesn’t need to be fought. For as long as I can remember, we have continued to prosecute and imprison people who possess marijuana for their own use.  I’m not going to discuss possession of marijuana for distribution, that’s a separate problem, one I think will take care of itself if we properly address marijuana for personal use.

    Laws against personal use of marijuana remind me much of the failed experiment of prohibition. If people want something enough, they will find it regardless of what the law says.  Most of the people imprisoned for personal possession of marijuana represented little or no threat to society as a whole and no one benefited from their imprisonment.

    I know the arguments for and against. The health arguments on the pro side say it relieves glaucoma, chronic pain and anxiety. On the con side, there are arguments saying that it is addictive, it can cause cognitive delay and accelerate the development of psychosis. There have been many arguments surrounding marijuana as a gateway drug. I haven’t seen any convincing evidence that restricting personal use of marijuana makes any difference in use of other drugs.  The only exception may be those cases where people become hooked on fentanyl or heroin that has been used to lace their marijuana.

    My argument against laws criminalizing personal use is that they don’t work. We have spent millions, perhaps billions, of dollars and hundreds of thousands of law enforcement hours to enforce laws that in the long run have no real benefit.

    I think it would make better sense to legalize marijuana for personal use. That way, like the alcohol and tobacco industries, it can be regulated with inspections and oversight activities. Customers would know it had not been contaminated with other dangerous drugs. It could also be taxed and distributed through businesses that would benefit from legitimate sale.  The tax revenue could be used to fund drug treatment plans for our serious opioid crisis. That is the one war on drugs that we must win but in which we continue to fall further behind.  Redirecting funds from marijuana enforcement to opioid treatment and enforcement will help save lives. 

    If personal use of marijuana is legalized, criminal distribution will rapidly fall away as there will be no profit.  The street corner pot dealer will become a historical footnote, much like the prohibition era bootlegger.

    I know some of you are thinking I must be an old hippie sitting around my living room smoking a joint and listening to the Grateful Dead. Even though I came of age in the Age of Aquarius, I’ve never tried marijuana and have no plans to do so whether it’s legalized or not. I have no objection to it, it’s just that as a younger man I preferred beer, as I got older, I migrated to wine and martinis, and now I’m too old to change.

    The bottom line is this: we live in an age of limited resources, and we need to decide how we are going to utilize those resources. I would like to see us take those financial and human resources and utilize them to address the opioid and methamphetamine crises. We are currently wasting too many of these precious resources trying to enforce unnecessary and ultimately unenforceable laws against personal possession and use of marijuana. If we legalize personal possession, we will reduce crime and all but eliminate the illegal trafficking in marijuana.

    That is my grumpy opinion.

    Page 1 of 8

    Powered by WordPress & Theme by Anders Norén