Presidential candidates and health care—watch them carefully

Politically, I’m a leftie. That should be no surprise to anyone who knows me. But when it comes to science and medicine, my politics are irrelevant. Given that John McCain has already made some questionable public statements regarding vaccines and autism, this seems like a good time to see what the democrats are saying.

Over at Hillary’s website, we can examine her positions on health care. She makes special mention of autism. Some of her recommendations sound quite reasonable and good, such as improving access to services for autistic children. But she repeats the questionable though popular idea that there is an “autism epidemic”, something that is far from proved. She makes mention of providing funding for evidence-based treatment, but also gives a shout-out to finding “environmental factors”, which is code for “toxins, mercury, vaccines” and all other kinds of hogwash. Sure, politicians have to appeal to everyone, but in appealing to everyone, it’s possible to appeal to no one strongly. Compromise over how to spend defense or highway money is one thing, but science should be guided by science, not the mercury militia.

Obama’s statement on autism is far more vague.

What I find interesting about both candidates’ websites is that they both feature autism prominently. That’s nice—we certainly need to learn more about autism. But why pick that over, say, heart disease, stroke, tobacco abuse, and cancer, which affect the health of far more Americans than autism ever will?

So what of McCain? His health care info also focuses on economics, which is fine.

McCain makes a very interesting statement about health education. He invokes personal responsibility, which is a common Republican phrase that happens to be important to health care. He then says:

Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise – vital life information.

Does anyone see what he left out here? Sexually transmitted diseases are on the rise. What about sex education as part of health education? You can’t teach children about obesity, blood pressure, and diabetes, and then leave out one of the nations biggest health problems—unless you are trying to appease a certain constituency.

And like the Dems, he has an entire link to autism, something he doesn’t have for heart disease, cancer, or anything else. In his blurb, he also gives lip-service to “environmental factors”.

The point is not that autism doesn’t deserve funding. It most certainly does, as long as that funding is directed into evidence-based investigation, and not more studies looking at disproven hypotheses such as vaccines and “toxins”. The real point is that all three candidates, when speaking of health care, need to focus on what harms and kills most Americans. The Dems are actively speaking out on access. All three should at least include realistic plans to encourage health care initiatives that make use of evidence and not emotion.


  1. First of all I would like to agree with McCain`s policy as he focuses on economics related to health care because without making it more stable it would be hard to improve the quality at all. The same is with the health education. As working for a Toronto life insurance company I`ve observed that the lack of information is the main cause of a lot of troubles and it generally concerns Canada as well. I`m also very curious how the candidates will put into practice their plan which seems to me quite utopian.

  2. Why the focus on autism? Even if it has a lower lifetime incidence than heart disease, with a childhood diagnosis rate of 1/150-1/200 (fairly accepted numbers now), it is quite common and good treatment can positively affect an entire lifetime not just the age 40 or 50+ lifetime. At 1/150, almost every school in the country has someone diagnosed with autism and the more we can improve the education quality for these children, the better we all are.

    If you had to pick one and only one topic for policy issues, then I wouldn’t pick autism, but that’s a false choice. At least on Obama’s page, he lists multiple issues.

    Yes the parents and publicity are part of it and why it’s on all the candidates pages, but even without parent activism, autism is worthy of top level research and policy attention on diagnosis and treatments.

  3. Since genetics and environment have not passed the “correlation proves causation” scientific test, then where should the “evidence based” studies go? How can scientists even determine what evidence to use for a disorder that is subjectively diagnosed with a subjectively determined set of diagnostic criteria that has subsequently changed and expanded with every revision of the diagnostic criteria?

  4. Chuck. This is an issue with virtually every mental illness and provides challenges for diagnosis, treatment, and long term studies of disease. A good book that discusses this issue along with many other interesting topics is “Perspectives in Psychiatry” by McHugh and Slavney.

    That said, diagnoses usually change because the changes reflect our better understanding of a topic.

    As for genetics vs. environment in autism, identical twins are both on the autism spectrum 70-90% of the time depending on study. Fraternal twins both have autism ~5% of the time. The population rate is around 0.5-0.75%. In this case, the science has come down fairly heavily that genetics are a major component.

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