Medicare Lessons from Peanuts

By Ryan Hoerger

Charlie Brown’s struggles kicking the football are well-documented. Whenever he runs to try, his friend Lucy always pulls it away, leaving Charlie lying on his back, duped once more.

In proposing legislation to raise the eligibility age for Medicare to 67, the Republican Party and its wealthy special interests are taking a page straight from Lucy’s deceptive playbook. Aging members of the workforce have spent their entire careers paying into the system, and conservatives are now trying to whisk away two years of government-provided health insurance that they both expect and deserve at the last second.

Under false pretenses of fiscal responsibility, Republicans are pushing this legislation as a chance to permanently reduce the size of government. Yes, the Baby Boomers are crossing the threshold into Medicare eligibility, which has people legitimately concerned about the program’s sustainability. But there are better ways to resolve the problem than hanging vulnerable citizens out to dry and sacrificing our moral backbone.

Any member of Congress who supports this policy risks both significant economic damage to the country and great political peril.

What would increasing the eligibility age do for the deficit? Actually, next to nothing. The Congressional Budget Office’s revised estimate says the policy could save Medicare $19 billion over eight years, if enacted in 2016. This pales in comparison to the whopping $716 billion dollars that Medicare saves over 10 years under the Affordable Care Act.

In fact, raising the eligibility age could plausibly make things worse. Cutting off the youngest Medicare beneficiaries eliminates the program’s healthiest individuals, upsetting the program’s risk pool. Health insurance is predicated on the healthy subsidizing the sick; by dropping coverage of its healthiest participants, Medicare will be forced to charge higher premiums in order to cover care services for aging beneficiaries, who are living longer (and costing more) thanks to new, expensive medicinal breakthroughs.

As a price setter in the healthcare industry, rises in Medicare’s costs will ripple through the entire healthcare industry. As premiums for Medicare increase, so will premiums for private insurance policies. This will accelerate the increase in overall healthcare spending, not just for Medicare – precisely what the United States cannot afford.

None of this will come to pass under the ACA, so Americans can be thankful that the Democrats were first to tackle healthcare reform. But although the reasonable policy and political choice should be clear, Republicans have dug their heels into the ground in protest of anything and everything Obama, threatening to repeal and replace the landmark law with harmful policies like a phased-in age increase.

Like Lucy, conservatives have used smooth-talk to persuade citizens into trusting them with their healthcare interests. The Republican approach remains the same as: let the market operate free of government interference.

That’s right, apparently the market that has denied (affordable) healthcare to millions of Americans and whose industry-wide growth rate outpaces growth in U.S. GDP doesn’t need any help to succeed.

And like Lucy, who benefits from her cruel football ploy, the winners in the current market are hospitals, doctors, and pharmaceutical and medical device companies, all profiting at the expense of the American patient.

Let me remind everyone, especially congressional Republicans, that Obamacare is expected to drive down industry-wide premium costs and save $716 billion in Medicare, all while insuring up to 32 million previously uninsured Americans. Yet Republicans have compared the ACA to the Holocaust, branding it “evil” and “racist.”

As currently constructed, the Republican plan for healthcare and deficit containment imposes costs and cuts on future Medicare beneficiaries, with negative ramifications for the entire healthcare sector. If Congressman John Fleming (R-La.) truly believed that “Obamacare is the most dangerous piece of legislation ever passed in Congress,” I’d like to see him try to pass a policy that is by all measures economically and politically inferior.

Yes, we did do something similar in 1983 by gradually raising the eligibility age for Social Security. But put simply, provision of needed medical services is not as easily suspended as a monthly lump-sum check. Seniors can choose to save money rather than go on vacation. They can’t choose to not suffer a stroke.

To recap the Republican alternative to the ACA: Lost benefits. Higher premiums. More uninsured Americans. These results do not deliver the fiscal “responsibility” that the GOP has always promised – this is fiscal futility leading to loss of credibility.

At a certain point, America’s Charlie Browns will realize that it’s not fun to play with Lucy anymore.




[viii]   Social Security Administration Press Office. “Social Security Fact Sheet: Increase in Retirement Age.” Social Security Online. Social Security Administration. Web. Accessed 12 Sept. 2013. .

New Public-Private Partnership for the Research Triangle


President Obama addresses a crowd at North Carolina State University.  Photo © Ryan Gorczycki.

I got a call early this morning. A friend had an extra ticket for President Obama’s speech at North Carolina State University and was wondering if I wanted to go. It was an easy decision. How often do you get to see the President of the United State in person? It may be less than an once-in-a-lifetime opportunity.

On this day, the President was here to announce a new institute to be based at North Carolina State University titled the “Next Generation Power Electronics Institute”. According a White House press release, this is the first of a series of three new manufacturing institutes, which was proposed by President Obama during his 2013 State of the Union address. Each institute is designed to bring together companies, universities, and other academic and training institutions.

The initiative was launched as a competition, and the first was won by a group led by North Carolina State University. In the partnership, the Department of Energy will contribute $70 million over five years, which will be matched by another $70 million from the winning team of businesses and universities, along with the state of North Carolina.

In this new “Next Generation Power Electronics Institute”, the winning team will develop the next generation of ‘wide bandgap semiconductors’. Obama teased the crowd by asking if anyone knew what a ‘wide bandgap semiconductor’ was, and how he had just been learning about them himself earlier that day in his tour of the company Vacon. Obama said that the wide bandgap semiconductors are special, because they use up to 90 percent less power than normal semiconductors.

It was good to see this public-private initiative happen, because it seemed so non-partisan. While government money is being spent, it is not huge, and it helps to form a partnership between the product inventors and researchers, and its potential producers and users. Obama put the initiative within the context of globalization, stating that if the U.S. wants to have the good jobs of the future it has to compete with the other countries of the world and be the first to create and make the best of high tech products such as the wide bandgap semiconductor.

Why Should California Declare a Drought Emergency? To Convince Californians it’s Real.

While the Midwest and Northeast dug their cars out from under the polar vortex this past week, much of California roasted. Ski resort owners nervously eyed their brown, bare mountains. Catholic Bishops called on parishioners to pray for rain. And Mendocino County, just north of San Francisco, declared a state of emergency, citing an “imminent threat of disaster.”

For the third year in row, California is suffering through drought conditions that are anything but trivial. The state relies on snowmelt for around one third of its public water supply, and snow conditions look increasingly bleak. The first snow survey of the winter showed that in the Sierra Nevada, snowpack levels are dwindling at 20 percent of normal. That’s the same reading scientists got in 2012, making both years the driest ever recorded.

And it’s not just snow. Rain is a huge problem, too. In Los Angeles, where it usually rains only 15 inches per year, a mere 3.6 inches reached the ground throughout all of 2013. To put that number into perspective, New Orleans usually sees 3.5 inches of rainfall in October alone – its driest month of the year.


For California’s 38 million people and 45 billion-dollar agriculture industry, continued drought could spell disaster. So Governor Jerry Brown now faces an important decision. Pressure is mounting—from state lawmakers, farmers, and local water districts—for the governor to declare a state of drought emergency.

But what would an emergency declaration do?

As the Sacramento Bee reports, historically, there haven’t been clear guidelines on when to declare a drought, or what happens afterward. A drought declaration would force federal officials to pay attention to the crisis, potentially accelerating federal relief. But some speculate that a drought declaration would send a message of economic hardship, and Governor Brown has so far sidestepped the question.

Growing up in Southern California, I remember the conservation measures we had to take during the drought of the late 80s and early 90s. “If it’s yellow, let it mellow” became a popular model in our San Diego home. In Los Angeles, the mayor implemented mandatory water rationing, slapping big penalties on anyone who wasted water. And in Santa Barbara, residents applied green paint to their dried out lawns.

But the reality is that even with a tremendous drought every decade or two (and several smaller droughts in between), most Californians hardly ever have to consider the state’s water problems. In San Diego—where our climate is often reminiscent of the Anza Borrego desert—luscious lawns and golf courses are still the norm. We may have low-flow toilets, but rarely can I remember anyone talking about taking shorter showers during non-drought times, or making sure not to waste water while washing the dishes or brushing one’s teeth.

It’s time for all Californians, and residents in other drought-stricken states, to realize that having enough water is a luxury that may not be around for long. After all, climate change is threatening to make our water shortages even worse. A report from the Natural Resources Defense Council shows that, due to climate change, around one third of all U.S. counties will face higher risks of water shortages by 2050.

As Governor Brown considers declaring a drought emergency, perhaps he should look to his own citizens as his audience. A drought declaration would not only draw the attention of federal officials. It would also serve as a wake-up call for Californians, underscoring the crisis at hand. It’s time we get serious about water conservation in the long term. A drought declaration could be the first step to real, sustainable lifestyle changes that keep both our water use and our water crises under control.

Bruce Jentleson Blogs from Jordan: Syria, Israeli-Palestinian Peace Process, Economy Top Discussions

Duke Political Science and Public Policy Professor Bruce Jentleson is in the Middle East on a 10-day trip, as part of a delegation organized by the Center for American Progress visiting the United Arab Emirates, Jordan, the West Bank and Israel. This is his third ISLAMiCommentary blog post about his trip.

by BRUCE JENTLESON for ISLAMiCommentary on JANUARY 9, 2014:

Bruce Jentleson (photo by Jim Wallace)

Bruce Jentleson (photo by Jim Wallace)

We’re now in Jordan, the second leg of our Center for American Progress Middle East trip designed to gain a better understanding of key issues in the region that affect and are affected by US policy. Our meetings here have included key advisors to King Abdullah and officials from the Ministry of Foreign Affairs and other Jordanian government agencies.

Whereas in the United Arab Emirates our foreign policy discussions focused principally on Egypt and Iran, in Jordan we addressed these issues but talks here were more focused on Syria.

Other than the people of Syria, who have been bearing the tragic burden of this civil war, Jordan has been feeling the impact more than any other nation.

The data and analyses in the recent Needs Assessment Review of the Impact of the Syrian Crisis on Jordan done by the United Nations are deeply disturbing. Close to 600,000 Syrian refugees have come to Jordan, equivalent to about 10% of the Jordanian population.  To get some sense of what this number means, imagine that Canada’s population of 35 million ALL fled to join the 314 million people of the United States.

With only about 20% of Syrian refugees in Jordan living in refugee camps, and the rest in cities and rural communities, the societal impact has been widespread. Already crowded schools are becoming overcrowded. About 80 schools have had to do double shifts to accommodate Syrian children — and even then only a small percentage of Syrian kids are getting schooling.

Jordan’s budget deficit problems have been exacerbated by the refugee crisis. The cascading effect has been especially hard for the Jordanian poor for whom social services and public resources are already strained.

Overall, the Central Bank of Jordan estimates that the impact of the Syrian crisis cut Jordan’s GDP growth by 2 percentage points in 2013, which, according to the UN could “threaten not only to derail the development trajectory but also stunt economic growth and development for years to come.”

… The Israeli-Palestinian peace process was also a key topic in our discussions with Jordanian officials. Jordanians are especially complimentary of the diplomacy that Secretary of State John Kerry has been investing. For all the talk about a “pivot” to Asia, Secretary Kerry has been showing that he understands that the Middle East isn’t going away, and that as hard as these issues are today they are harder tomorrow. King Abdullah had had a lunch meeting with Palestinian President Abu Mazen just before we met with the King’s policy aides. The mood is hopeful of further progress and a genuine peace, but understandably cautious and concerned about whether this will come to fruition.

As a professor I tend to spend much of my time reading and researching, and while that has its own tremendous value, there is also so much to be learned from engaging directly with those who work in the policy world. I have appreciated the opportunity to listen to the fresh perspectives and ideas that they bring to the table and field-test my own theories and analyses.

Last night, US Ambassador to Jordan, Stuart Jones, hosted a dinner for our group to engage with Jordanian business, government and political leaders. These included some business leaders headed to Washington shortly to meet with Senators, executive branch officials and US business leaders on a range of commercial initiatives. And here too a Duke connection: Ambassador Jones is a Duke alum, and two of his children are currently Duke students!

While not quite as elegant as the dinner with Ambassador Jones, it turned out that what the New York Times called the best shawarma in all the Middle East was a few blocks from our hotel, a great lunch stop as you can see! (below)

Next leg, Israel…

Bruce Jentleson (far right) and colleagues sampling the local shwarma in Jordan.

Bruce Jentleson (far right) and colleagues sampling the local shawarma in Jordan.


Bruce W. Jentleson is Professor of Public Policy and Political Science at the Sanford School of Public Policy, Duke University, and affiliated faculty with the Duke Islamic Studies Center. He is also a Distinguished Scholar with the Woodrow Wilson International Center for Scholars (Jan.-June 2014), and Co-Principal Investigator with the Duke-American University-UC Berkeley “Bridging the Gap” initiative. Jentleson’s areas of expertise include Middle East peace and security, international conflict prevention, global governance, international security, and U.S. foreign policy. In 2009-11 he served as a Senior Advisor at the State Department. His publications include “American Foreign Policy: The Dynamics of Choice in the 21st Century” (W.W. Norton, 5th edition 2013). Current projects include U.S. policy in the new Middle East, genocide and mass atrocities prevention, and a study of leading statesmen/women of the last century. In Fall 2013 he taught the Coursera MOOC (Massive Open Online Course): “21st Century American Foreign Policy.” 

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Power. It’s What’s For Dinner


I recently noticed that the Panera Bread near Dupont Circle in Washington D.C. added several menu items with a strange common ingredient: power. There’s the Winter Power Kale Salad, the Power Chicken Hummus Bowl, the Power Breakfast Egg White Bowl, and of course the Low-Fat B-Green Power Smoothie. Yum?

What does power taste like anyway?  A loaded question I’m sure the Panera marketing geniuses had in mind when creating these new food items.

Panera wants us to think we’re buying more than just 18 grams of protein and zero carbs when we buy their power foods. Like buying a shampoo means getting fabulous hair and equally fabulous dating prospects (and sex), or like buying a certain brand of basketball shoes means playing like LeBron and having the cheerleaders finally want you (and sex), buying a Power Steak Lettuce Wrap means getting power heretofore unavailable with a mere turkey sandwich (and guess what else).

While these “power” foods are sold at Panera shops around the country, I wonder if this branding is particularly effective in a place where power hungriness often seems especially insatiable: Washington D.C. By my observation, this city has more Panera Bread restaurants per capita than just about any other. And they all appear consistently packed with customers buying powerful oatmeal and the like.

I would caution consumers to be skeptical and question whether “power” is worth the added cost to a breakfast wrap. Until Panera starts selling Black Power Bean Burgers, Flower Power Eggs Florentine, and Turtle Power Soup, I think a turkey sandwich will satisfy my hunger just fine.

Bruce Jentleson on the UAE: Up on Renewable Energy, Down on Political Islam

by BRUCE JENTLESON for ISLAMiCommentary on JANUARY 8, 2013: 

Our Center for American Progress delegation just finished three plus days in the United Arab Emirates; a visit designed to gain a better understanding of key issues in the region that affect and are affected by US policy.

While I’d been to both Abu Dhabi and Dubai before for conferences, those were more self-contained. This trip involved much more direct engagement with political leaders.

The agenda included meetings with cabinet members (the UAE’s Foreign Minister, Minister of Energy, and Minister of State), tours and briefings at the Masdar City renewable energy project and Dubai Ports, a visit to the joint US-UAE Al Dhafra Air Base, dinner discussions with business leaders, and a meeting with the US Ambassador.

Renewable Energy and Economic Growth 

There is much that is impressive about the UAE, and I don’t mean just the glitz of Dubai (I’m not much for indoor skiing in the desert.)

Noteably, Masdar, a wholly-owned subsidiary of the Abu Dhabi Government’s Mubadala Development Company, is building from scratch a planned free-economic-zone “green city.”

And Masdar and MIT, in collaboration with the Abu Dhabi government, have come together on a project that established a leading graduate research university —  Masdar Institute — focusing on alternative energy, sustainability, and advanced technology. These and other projects make the UAE a world leader in renewable energy.

While it may seem paradoxical for a leading OPEC oil producer to be investing in renewables, it has both a near-term economic rationale (free up more oil from domestic consumption for export) and is indicative of longer-term strategic planning. Our meeting with the Minister of Energy provided a fuller sense of the UAE energy policy, including nuclear energy.

The Dubai Ports operation — the Jebel Ali port is the 3rd busiest in the world — is quite sophisticated; getting to actually see it operating was amazing.  Also, Dubai just won the international competition for Expo 2020 , and is planning economic growth around that. (The six-month-long World Expo, held every five years, has never been held in the Middle East, Africa and South East Asia in the history of the event until now.)

Gender Parity and Human Rights 

Particularly impressive was a meeting with Minister of State Reem Al Hashimi. She is one of four women ministers in the UAE Cabinet. Her portfolio is a broad one, including having been the point person for winning the UAE’s Expo 2020 bid. This too was a frank discussion.  For example, the UAE is #1 in the Arab world in gender parity but #123 in the world rankings for the same, so, as she explained, much has been accomplished but there’s much to be done.

Not so impressive — the UAE’s overall record on human rights. Our delegation did not get to meet with civil society groups and didn’t get very far in trying to raise issues such as the ban on some US NGOs from operating in the UAE, or the nine-month detention in Dubai of Shezanne Cassime, an American  charged with defaming the country’s image abroad with his satirical YouTube video on Arab youth culture. (That said there were reports out today that he will soon be released)

Political Islam: Just Say No? 

In terms of foreign policy, the UAE has been a close ally of the United States. Its troops were part of the coalitions in the Iraq and Afghanistan wars, and also the Libya 2011 intervention against Qaddafi.

While one does get a sense of many shared interests, on two issues our group had some particularly robust discussions with UAE officials.

One was the emergence and strength of political Islam in many parts of the region and particularly in Egypt with the Muslim Brotherhood (MB). The UAE has been a staunch supporter of Egypt’s military regime that took over from the Brotherhood this summer – and the UAE together with Saudi Arabia has given $16 billion in aid. The UAE government view of the MB and political Islam generally is essentialist; convinced that it is an unabashed adversary and must be squashed in all forms and all traces.

My own view, as I’ve written here and here, is that such an approach is likely to feed into radicalization, and make the very outcome to be avoided more, not less, likely. Political Islam is here to stay. It will be in the political mix more often than not. No question there are always terrorism risks amid instability and uncertainty about the shape successor regimes take. But while transnational links to Al Qaeda or other similar actors certainly need to be taken into account in shaping our relations, and their significance weighed hard-headedly, this must not automatically trump other factors.  Making further assessments of the goals, strategies, visions and leadership of different Islamist parties and movements in different countries is necessary. Policies need to be tailored to oppose those inimical to our values and threatening our interests, while remaining open to those with which coexistence and cooperation may be possible even though we have differences.

Another issue in our discussions with officials was Iran. While they do stress the threat posed by Iran, and some of their own particular issues such as the disputes over the Abu Musa and Greater and Lesser Tunbs Islands, they are not as staunch as Saudi Arabia and its Sunni-Shia cold (and not so cold) war.

Still we had some robust (good diplomatic word, so I’ll say it again) discussions around these questions: Is the Rouhani regime just a charm offensive, a gambit to feign change and get the world to let its guard down? Or is this a real opportunity, both on the nuclear proliferation issue and for further possible improvements in US and other countries’ relations with Iran — that could have broader constructive effects for Middle East security?

Duke Blue

And yes I even found some Duke blue presence on the trip. The US Ambassador’s mother was a librarian at Lilly Library. And I was wearing my Duke hat when visiting the US air force base, which prompted one of the officers to say “you guys played great the other night, tough loss” – and he meant the football team!

On to Jordan next …


Bruce W. Jentleson is Professor of Public Policy and Political Science at the Sanford School of Public Policy, Duke University, and affiliated faculty with the Duke Islamic Studies Center. He is also a Distinguished Scholar with the Woodrow Wilson International Center for Scholars (Jan.-June 2014), and Co-Principal Investigator with the Duke-American University-UC Berkeley “Bridging the Gap” initiative. Jentleson’s areas of expertise include Middle East peace and security, international conflict prevention, global governance, international security, and U.S. foreign policy. In 2009-11 he served as a Senior Advisor at the State Department. His publications include “American Foreign Policy: The Dynamics of Choice in the 21st Century” (W.W. Norton, 5th edition 2013). Current projects include U.S. policy in the new Middle East, genocide and mass atrocities prevention, and a study of leading statesmen/women of the last century. In Fall 2013 he taught the Coursera MOOC (Massive Open Online Course): “21st Century American Foreign Policy.”

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A Higher Minimum Wage: Not Actually a Bad Policy

Wage Pic

Raising the minimum wage will do more good than harm. Income inequality is at historic highs, and the minimum wage is worth less now than 40 years ago—a typical earner makes less than poverty level. Economists split hairs over particulars, but on the whole, an increase will boost low-wage workers’ fortunes, without large negative effects on employment. A higher wage floor will put many hard-working Americans on better footing.

I started thinking about this issue a few weeks ago, when I stumbled on a street demonstration in my home city of St. Paul, MN (see the picture). It was the day after Black Friday and protesters had just marched through the parking lots of Walmart and Target. I was waiting for a bus. They were calling for a higher minimum wage. I decided to look into it.

The federal minimum wage is $7.25 per hour. Many localities set wages above this rate. Washington D.C. just approved upping theirs to $11.50. Sea Tac, a suburb of Seattle, now has a $15 wage floor. New York State, California, and New Jersey recently upped their minimums. Congress has raised the federal minimum wage 29 times since its inception in 1938 (at 25 cents!), most recently in 2007.

Earlier this year two Democrats introduced the Fair Minimum Wage Act in Congress. It aims to raise the minimum wage to $10.10 by 2015. President Obama supports the measure, but Republicans in Congress do not. In general, a large majority of Americans favor raising the minimum wage; businesses are split.

Two-thirds of minimum wage earners are adults, and one in four is raising children. Even with full-time hours, a minimum wage salary pays only $15,080 per year, one-third less than the poverty level. The current minimum wage is worth less now than in the 1960’s.

If intuition tells you that amount is not enough to live on, you’re right. Taxpayers pick up the slack. For example, half of all fast food employees receive some kind of public assistance, $7 billion in total per year.

An increase to $10.10 would affect many who make above the current minimum. The Economic Policy Institute, a left-leaning think tank, estimates that 17 million workers—about one fifth the hourly workforce—would receive pay increases with the new law.

Really smart economists are divided over the effects of an increased minimum wage. A higher wage floor increases incomes, which stimulates spending, and may even drive employment. But it may also force companies to decrease personnel to account for higher labor costs.

Many business leaders feel strongly that a wage floor will hurt workers. “Arbitrarily raising the cost of labor would increase, not reduce, the unemployment rate among young, less-skilled workers,” Bruce Josten of the U.S. Chamber of Commerce said in a statement. James McNerney Jr., the CEO of Boeing, even hinted that higher labor costs could force companies to relocate, even though research suggests that most outsourced jobs are high-paying.

Microeconomics 101 teaches that as the price of labor rises, the demand for labor will decrease. No one really disagrees with this. However, studies have shown that in practice, an increase in the minimum wage improves the fortunes of low-wage workers without massive layoffs. Unlike other anti-poverty policies, this one adds nothing to the federal budget. It may even shift some of the burden back to private companies (remember that $7 billion for fast food workers?).

The United States is in a period of vast income inequality. Jared Bernstein of the non-partisan Center on Budget and Policy Priorities argues that the minimum wage “sets an important labor standard: the government will compensate for the sever lack of bargaining clout among our lowest-wage workers by setting a floor below which we won’t allow their wages to fall.”

Yes, we as a society need to have a broader conversation about our inequities, but as its name implies, a fair minimum wage should be the least we do for the most vulnerable in our society.


Guarding against unneeded health prevention

A recent New York Times article pointed to the risk of taking dietary supplements, stating that new data suggested that dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from seven percent 10 years ago. The article was preceded by other recent articles on blood pressure, multivitamins and anti-bacterial soaps. All four related in some way to guarding against excessive health prevention measures.

We are often told by advertisers of the benefits of certain health-maintenance products such as dietary supplements, drugs and the like of the improved health we can have by taking these products, yet we often lack the time to research and understand if they are truly beneficial for us. Often, we assume that the government maintains some sort of checks on health products, although government’s role can often be limited. As was pointed out in the New York Times article, Americans spend an estimated $32 billion on dietary supplements every year, but a 1994 federal law prevents the Food and Drug Administration from approving or evaluating most dietary supplements before they are sold.

Often in the political arena, we say that we don’t want government to hinder our economy with a lot of red tape. Regarding our health, our statement should be different, regardless of party affiliation. We need strong government institutions to make sure that consumers are not mislead. While proper, routine use of multivitamins may be of very low risk (and benefit), the use of an herbal supplement by a teenage boy to “burn fat” in the New York Times article damaged his liver to the point that he was advised to no longer play sports. A strong system of regulation backed by thorough research is important in the health arena. The challenge, of course, is that the needed research can often be expensive and long-term, with conclusions that are not always black and white.