Author: Steve Boren

  • The real cost of “free”

    The real cost of "free"

    It’s an old tactic from the lowest and sleaziest of all street pushers: They offer a free "taste" of their illegal drugs.

    Pssst… Over here… Just a taste.

    They know their "tasters" will come back — and when they do, they’ll pay big.

    Big Pharma has used the same trick for years — but the Internet is helping them bring it to new levels. A study in the Archives of Internal Medicine found "free" online offers for half of the top 50 prescription drugs.

    Here’s how it works: You do a search for something like high cholesterol levels — a largely bogus fear to begin with, by the way, since I consider anything in the 200-300 range to be perfectly acceptable.

    So you do your search and… ZAP! Your favorite Internet search engine serves up a page that LOOKS like it might have real information — the title of one link I found reads "What is High Cholesterol?" — but are really just Big Pharma fronts that lead to a drug page with a free trial offer.

    Often, you don’t even need to do a search — the free offer finds you. I logged on to CNN.com the other day and at the top of the page, almost like one of the news headlines, was a big yellow box with "Get your free trial of CIALIS."

    Pssst… Over here… Just a taste, right?

    But like those hardcore street hustlers, Big Pharma knows you’ll be back for more… in the form of a full prescription. When all is said and done, over the course of a year you’ll have saved an average of five percent off the price of the drug, according to the study.

    A lousy nickel off every dollar.

    All for a med you probably never would have asked for — or paid for — on your own. In fact, one study last year found that patients who get "free" samples pay 40 percent more for meds over six months, and 20 percent more six months after that.

    The only thing "free" about that sample is the free flow of money from your pocket… right into the thick leather wallets of the Big Pharma fat cats.

    The researchers found that these ads play up the "free" part of the offer — so much so that you probably won’t even notice the fine print, where they hide the risks and side effects. You also need to hand over personal info for your coupon, so Big Pharma can keep tabs on you.

    The researchers also found that these offers tend to be for drugs still under patent — so if you want to keep using them, you’ll have to pay up, since generic versions don’t exist.

    So the next time you see one of these offers… remember that in Big Pharma’s world, there’s no such thing as a free drug.

    "Free" is just another word for everything to lose,

    William Campbell Douglass II, M.D.

  • Feds turn to Big Pharma for painkiller help

    The feds turn to Big Pharma for painkiller help

    The feds think we need some help dealing with prescription painkiller abuse.

    Get ready for the punchline here — because you’ll laugh until it hurts so bad you may need those drugs yourself.

    Big Brother has turned to Big Pharma to help curb the abuse of opioid meds, which include morphine, oxycodone and methadone. And the drug makers have responded by calling for voluntary training for doctors and pharmacists… from the feds.

    Naturally, they want you, Mr. and Mrs. American Taxpayer, to pay for it.

    That’s what you get when you ask for Big Pharma’s help dealing with the problems created by their own meds.

    Self-regulation has been a clear failure when it comes to drugs. Companies are routinely fined hundreds of millions and even billions of dollars for shifty, shady practices like illegal marketing.

    And somehow, we’re supposed to trust THEM to come up with a risk-management plan to guide docs and pharmacists.

    Isn’t that what the feds are supposed to be doing? If drug safety isn’t one of the prime functions of the FDA, someone please tell me what is.

    Opioid painkillers caused 13,800 deaths in 2006 alone. In other words, in a single year these drugs alone killed more Americans than swine flu ever has, and probably ever will. In fact, these killer meds were responsible for 40 percent of all poisoning deaths that year.

    And those aren’t even the scary numbers!

    What’s really frightening is that 5.2 million Americans ADMIT to using these drugs inappropriately, according to a recent survey. And that doesn’t take into consideration all the users who won’t acknowledge their painkiller problem, and all the folks who simply lie about their drug use.

    And Big Pharma won’t stop there, either. They’ve quietly gotten untold numbers hooked on these powerful and addictive meds for unproven off-label uses like migraine headaches.

    But to the drug companies, these aren’t millions of people with opioid problems. They’re top customers — and anything that cuts back on their numbers will reduce profits.

    So sure… they’ll help all right. They’ll help make sure there are no real changes to the status quo.

    The FDA only wants "more specifics" from Big Pharma on its plan, but I can tell you specifically right now that it stinks.

    The companies want the Drug Enforcement Agency to offer voluntary training to doctors and pharmacists.

    Never mind that the DEA currently does no such thing. Never mind that only an act of Congress could make that happen. Never mind that this plan shifts the burden of addictive drugs to the taxpayers. Never mind that it wouldn’t stop the army of Big Pharma pushers… er… salesman from undoing any negative effects of a brief government-sponsored training seminar.

    But that’s what happens when you let the crooks make their own rules.

    Keep reading for more Big Pharma shenanigans — and how they target your wallet with "free" offers.

    William Campbell Douglass II, M.D.

  • Slow brain leads to slow muscles for those over 40

    Slow brain leads to slow muscles for those over 40

    We all know that many of the physical feats we were able to perform in our 20s aren’t quite so easy in our 40s. But as it turns out, that could have less to do with your body and more to do with your mind.

    New research indicates that brain decline has a direct effect on how quickly you can perform even the most basic physical acts. No matter how fit or toned your muscles may be, if they’re not getting signals from your brain quickly, they can’t act quickly. It’s that simple.

    For your brain cells to act quickly, they need to be well insulated with a substance called myelin. Myelin binds to the brain cells and nerve fibers and has a lot to do with how well electrical impulses are carried.

    According to the study’s lead researcher Dr. George Bartzokis, a neurologist from UCLA, the decline in the amount of myelin in the brain is one of the reasons why it’s hard to be a world-class athlete after 40.

    The purpose of this study was not to figure out how to extend the playing time of star athletes, but to find one more clue in the battle against Alzheimer’s disease.

    Most people who have a neurological disease like Alzheimer’s have a buildup of amyloid plaque, a toxic protein that impairs the function of your brain cells. Bartzokis reasons that, like muscle action, memory relies on the same electrical impulses. He has done previous research that indicates that there could be a gene that’s linked to Alzheimer’s that could retard myelin repair.

    But there’s hope: there are some basic health tips that will help keep your brain full of myelin. There are no surprises here: as I’m always telling you, mind and body are inextricably linked, so maintaining physical health keeps your mind sharp:

    1) Stay active; both physical and mental activity can speed myelin repair.

    2) Pump yourself full of omega-3 fatty acids — they may be as beneficial for myelin levels as they are for heart health

    3) Beware of elevated stress and hormone levels, which could damage myelin.

    Giving your brain a boost,

    William Campbell Douglass II, M.D.

  • States cut pointless anti-tobacco funding

    States cut pointless anti-tobacco funding

    Remember those zillion-dollar tobacco settlement funds that were supposed to pay for anti-smoking propaganda?

    Well, now politicians are deciding they need that money for other things — probably more bridges to nowhere — and those funds are drying up.

    That didn’t take long, did it? Those government clowns burn through piles of cash faster than I can light up a fine Dominican cigar.

    The 1998 settlement requires Big Tobacco to make huge annual payments to the states… with the understanding that a significant portion of the money go toward tobacco-related programs like anti-smoking campaigns.

    But a new report finds that state governments cut $103.4 million, or more than 15 percent, from their anti-tobacco propaganda funds, despite collecting more cash from that settlement than ever before.

    And in the coming year, those states will collect more than $25 billion from that tobacco settlement fund and tobacco taxes… but spend just over 2 percent of it — $567.5 million — on tobacco-prevention programs.

    I’ve never known a politician who could keep his grimy hands out of the cookie jar, and this latest news shows just how badly they need to spend every dollar in sight on pork-barrel projects.

    And with money tighter than ever, they’re raising taxes, adding fees and pinching from every fund in sight.

    Normally, I’d be outraged.

    But in this case, I’m as pleased as punch — because the anti-tobacco movement is one of the most underhanded, misguided, ill-informed nanny-state campaigns ever created. The ridiculous "public service" spots paid for with these funds are among the worst commercials on TV — every bit as bad as Big Pharma’s drug ads when it comes to misinformation and half-truths.

    And that’s saying something.

    If you enjoy smoking, take my advice: Keep right on enjoying it, until they pry that last butt from your tobacco-stained fingertips. Just remember to take the smoke into your mouth, not your lungs — the membrane inside your cheeks will absorb everything you need to get all the benefits.

    Then be sure to exhale your second-hand smoke in full view of the tobacco-loathing, money-burning nanny-staters.

    Seeing right through this smokescreen,

    William Campbell Douglass II, M.D.

  • When docs ask instead of order

    When docs ask instead of order

    It’s easy to take medical risks when it’s not your own body at stake.

    Docs often forget that — or some just don’t give a hoot — as they volunteer their unknowing patients to be Big Pharma’s next set of human guinea pigs… and too many patients just go along for the ride without asking questions.

    But a new study shows patients are much less willing to board the Big Pharma drug bus when they know where it REALLY stops.

    The study found that patients are as complacent as sheep when a doc TELLS them what to do. But when a doc ASKS for their input, they’re far more likely to thumb their noses at Big Pharma meds and pick less risky treatments.

    Researchers at Yale University let patients watch videos in which a doctor described a drug along with a low risk of a serious side effect.

    In some cases, the video was followed by instructions that they take the drug. In others, the patients were asked to make a choice.

    And it turns out those who were given the choice were much less likely to take the new drug.

    I can hear the whines now. "They’re only patients! When the heck do they know?"

    I’ve always found they know a lot more than most docs will ever give them credit for. What they don’t know, it’s up to us doctors to tell them… and by that I mean the whole truth, not just a line from some drug salesman’s propaganda sheet.

    Believe me, most folks are perfectly capable of figuring it out when we give them all the information they need. But too many dictator docs expect patients to walk into the office and submit to their every command, pop every pill and lie back for every test and procedure — no questions asked.

    Don’t put up with that. If your doc won’t invite you into the process, politely thank him… walk out… and then invite yourself to a new physician’s office.

    You’re not a sheep, and you’re no one’s guinea pig. If docs don’t like it, too bad.

    William Campbell Douglass II, M.D.

  • Better-Than-Almost-Anything Cake

    Better-Than-Almost-Anything Cake

    The combination of rich ingredients produces a decadent, caramel-soaked cake that’s sure to be a hit!

    Prep Time: 10 min
    Total Time: 3 hours 3 min
    Makes: 15 servings

    1 box Betty Crocker® SuperMoist® German chocolate cake mix Water, vegetable oil and eggs called for on cake mix box1 can (14 oz) sweetened condensed milk1jar (16 to 17 oz) caramel, butterscotch or fudge topping1
    container (8 oz) frozen whipped topping, thawed1
    bag (8 oz) toffee chips or bits

    1Heat oven to 350°F (325°F for dark or nonstick pan). Bake cake as directed on box for 13×9-inch pan.

    2.Poke top of warm cake every 1/2 inch with handle of wooden spoon. Drizzle milk evenly over top of cake; let stand until milk has been absorbed into cake. Drizzle with caramel topping. Run knife around sides of pan to loosen cake. Cover and refrigerate about 2 hours or until chilled.

    3. Spread whipped topping over top of cake. Sprinkle with toffee chips. Store covered in refrigerator.

    High Altitude (3500-6500 ft): Follow High Altitude directions on cake mix box.

    Make the Most of This Recipe With Tips From The Betty Crocker® Kitchens

    Success

    The cake may stick to the wooden spoon handle while you’re using it to make the holes, so occasionally wipe off the handle.

    Did You Know… The caramel topping will be easier to drizzle if it has been kept at room temperature. If refrigerated, remove the lid and microwave on High about 15 seconds.

    Special Touch Instead of the toffee chips or bits, coarsely chop 5 bars (1.4 oz each) chocolate-covered English toffee candy, and sprinkle on top of the cake.

    Nutrition Information:

    1 Serving: Calories 510 (Calories from Fat 190); Total Fat 21g (Saturated Fat 9g, Trans Fat 0g); Cholesterol 60mg; Sodium 480mg; Total Carbohydrate 75g (Dietary Fiber 1g, Sugars 57g); Protein 6g Percent Daily Value*: Vitamin A 4%; Vitamin C 0%; Calcium 15%; Iron 4% Exchanges: 1 1/2 Starch; 3 1/2 Other Carbohydrate; 0 Vegetable; 4 Fat Carbohydrate Choices: 5
    *Percent Daily Values are based on a 2,000 calorie diet.

  • Diabetes: The most ignored health danger

    Diabetes: The most ignored health danger

    Since I write about the dangers of diabetes so often, I suppose that I take it for granted that people see the disease as I do: as one of the greatest (and most easily avoidable) risks to your health.

    Unfortunately, this is far from the case.

    A new CDC survey reveals that most Americans are so clueless about the dangers of diabetes and the horrific impact it can have on their well being that many survey respondents actually ranked cancer, plane crashes and shark attack as health issues that they feared more than diabetes.

    Yes: shark attacks. And no, I don’t get it, either.

    Understandably, cancer topped the list of dreaded health issues, but statistically people are at far greater risk of developing diabetes than cancer. While 10 percent of Americans will be diagnosed with a form of diabetes, only six percent will get cancer.

    According to Ann Albright of the American Diabetes Association, the sponsor of the survey, "Our point is not that people shouldn’t be concerned about cancer; we are trying to help people put things in a more accurate perspective." Here’s some perspective: stop worrying about being eaten by a shark, and start worrying about what you’re eating. You’ll probably live longer.

    Taking a bite out of diabetes,

    William Campbell Douglass II, M.D.

  • Don’t quit your day job: Nightshift linked to cancer

    Don’t quit your day job: Nightshift linked to cancer

    It may be time to take the term "graveyard shift" literally. A new study has re-affirmed the old medical suspicion that night work can shorten your life. And before you write off this story as something that should only concern night watchmen and cab drivers, you should know that fully 20 percent of the working population of developed countries earns their living at night. As hard to believe as it sounds, the International Agency for Research on Cancer, a branch of the World Health Organization, is actually going to add night work to its list of probable carcinogens. This concern is nothing new, though. The medical suspicions about the potentially deadly side effects of night work have been around for more than a generation.

    Richard Stevens, a professor at the University of Connecticut Health Center, was the first to see a link between the night shift and cancer. He developed his theory while searching for an answer as to why the incidence of breast cancer in women suddenly spiked in the 1930s, when industrialization made a round-the-clock labor force one of the hallmarks of a successful economy. Of course, many doctors and researchers thought that Professor Stevens’s theory was, well … a little nutty.

    But it turns out that he was probably right. The reason? The hormone melatonin. Melatonin is a powerful ally in the body’s fight against tumor development, and it’s usually produced by the body at night. The theory is that night work causes such disruption in your circadian rhythm that it short-circuits melatonin development, opening the door for all manner of nasty, lethal cancers.

    There are skeptics who say that the WHO’s "probable carcinogen" qualification just means that the night work/cancer link is possible. But if you ask me, this newest study is merely the latest in a long line of respected research that has made the same connection. And to me, this reveals a very strong link. If you’re a nine-to-fiver who’s about to stop reading because you don’t think this has anything to do with you, you may just want to stick around for a few more sentences…

    What’s true for shift workers who are awake in the middle of the night is equally true for ANYONE whose sleep is continually disrupted – including insomniacs and frequent business travelers. If you’ve ever said, "This jet lag is killing me," this study proves that you may be more right than you think.

    If you ask me, it’s more than just a melatonin deficiency at work. If you’ve ever done any night work, you know how unnatural and disorienting it can be. I certainly don’t miss my days as a resident, when midnight-to-eight a.m. shifts were common. With the possible exception of certain teenagers, humans are simply not nocturnal animals. Your body’s natural rhythms are delicate and easily disrupted, and this disruption can lead to the breakdown of critical functions. Certain bodily processes like cell division and DNA repair happen at regular times.

    And anyone knows that not getting enough sleep makes your immune system vulnerable, making it just as tough for your body to do battle with potentially cancerous cells as with the common cold. Unfortunately, there doesn’t seem to be a cure-all for the night workers’ potentially deadly predicament. Many of my colleagues say that it is imperative that night workers sleep in a darkened room once they get home from work to help maintain the body’s light/dark balance.

    I have a suggestion of my own: Don’t quit your day job. Turns out it’s good for you.
    William Campbell Douglass II, M.D.

  • Are painkillers killing PSA test results?

    Are painkillers killing PSA test results?

    At what point will the healthcare community decide that it’s time to cut bait on the dreadfully inaccurate PSA test? Now the news has come out that taking aspirin or other common painkillers can actually cause an inaccurate PSA reading.

    A new study revealed that men taking aspirin and other commonly used, non-steroidal anti-inflammatory drugs (NSAIDs) had PSA readings that were 10 percent lower than the men in the study who did not take those drugs.

    "This raises questions that will have to be answered in a larger clinical trial," said study’s lead author Dr. Eric Singer, chief of urology at the University of Rochester.

    How’s that for an understatement?

    In spite of this research based on data from 1,300 men from all over the country, Singer is not ready to believe that the shocking implication of this study should be the death knell for the PSA test.

    Believe me: I’m all for being prudent, and in the past I’ve complained about the relatively small sample size of some studies that are published in medical journals. But that’s what drives me nuts: doctors have made a bigger deal in the past over test results based on groups much smaller than the ones used in Singer’s research.

    This is hardly the first bump in the road for the PSA test. It’s a dirty little secret of modern medicine that the PSA is wildly ambiguous, and often downright inaccurate – and all this was known before finding out that aspirin has the potential to toss a gigantic monkey wrench into PSA test results.

    According to an Associated Press article from earlier this year, the majority of prostate biopsies among men with elevated PSA levels did NOT reveal cancer – while many with "normal" PSA scores actually have the disease.

    It’s hard to say how many men who are given the PSA test are also on a daily regimen of aspirin therapy for heart issues, but I’m sure it’s more than a few.

    One more reason to toss the PSA right where it belongs – in the trash.

    Trashing the PSA,

    William Campbell Douglass II, M.D.

  • Popular air fresheners may have deadly scents

    Popular air fresheners may have deadly scents

    The next time you come across a kitchen that smells "lemony fresh," or get a whiff of a cool mountain glen in your t-shirt, don’t breathe too deeply.

    According to researchers from the University of Washington, air fresheners and fragranced laundry products often emit literally dozens of chemicals – some of which are considered toxic by federal law.

    And the worst part is that none of the potentially hazardous chemicals that are thrown off by these "fresh-smelling" products are even listed on the label of ingredients. University of Washington researcher Ann C. Steinemann, PhD, said, "I didn’t find a brand that didn’t emit at least one toxic chemical."

    As shocking as this may seem, there’s a part of me that’s not the least bit surprised. After all, I’m a bright guy and I realize that laundry detergents and air fresheners that smell like a cleansing summer rain storm aren’t made from fresh-picked mountain flowers after a sun shower. There are chemicals – toxic and potentially deadly ones – that are replicating these odors. Of course the manufacturers of these products are already in full cornered-animal mode. They’re proclaiming that the products are safe when "used as directed," and that the chemicals in question are present only in amounts not known to cause health issues.

    But you’ve got to wonder, don’t you? Steinemann, a professor of civil and environmental engineering and public affairs at the University of Washington, says her idea for the revealing study was born of the fact that she had for years been told by many people that household cleaners and air fresheners caused them to have dizzy spells, or had spurred bouts of headache, asthma, shortness of breath – even seizures.

    Steinemann’s study closely examined six popular consumer produces: liquid spray air fresheners, plug-in air fresheners, fabric softeners, laundry detergents, dryer sheets, and the kinds of solid disc deodorizers used in airliner toilets. Steinemann found that these six products emitted a staggering 100 volatile organic compounds (VOCs).

    But to me, the most disheartening discovery of Steinemann’s study came when she turned to federal law to find out what laws were on the books to protect consumers from this kind of thing. As it turns out, there’s no law that requires disclosure of all chemicals in fragrances.

    It’s an outrage to say the least. Steve Gilbert, a toxicologist not associated with the study, put it very succinctly: "At the very minimum, we should have a right to know what’s in these products."

    Your best bet is to stop using store-bought air fresheners altogether. Try the real thing instead – cut open a lemon or orange, gather some mint leaves, or just open a box of baking soda.

    William Campbell Douglass II, M.D.

  • Thoughts on the End Game

    01.22.10 04:50 PM

    When I was at Rice University, so many decades ago, I played a lot of bridge. I was only mediocre, but enjoyed it. We had a professor, Dr. Culbertson, who was a bridge Life Master at an early age. He was single and lived in our college, playing bridge with us almost every night. He was a master of the “end game.” He had an uncanny ability to seemingly force his opponents into no-win situations, understanding where the cards had to lie and taking advantage.

    Traveling to London and on into Europe, I have some time to think away from the tyranny of the computer. Over the last year, and especially the last few months, I have written in depth about the problems we face all across the developed world. We have no good choices left, so making the correct unpleasant choice is now our most hopeful option.

    As I wrote in my 2010 forecast, this year is a waiting game. There are so many choices we must make, and the paths we will take from those choices vary wildly. But make no mistake, we are coming close to the end game. Some countries and economies are closer to that point than others, but the entire developed world is lurching, in almost drunken fashion, towards our economic denouement.

    Over the next several months, we are going to start to explore various aspects of the end game. Whither Japan? Are they actually, as I think, a bug in search of a windshield? What does that mean for the world? How safe is the euro? Everyone over here seems to think Germany will bail out Greece. A breakup seems unthinkable to the people I've been talking to (so far). But what about Spain? Italy? Can you spell moral hazard?

    The Fed has said it will exit quantitative easing (QE) at the end of March. But what if mortgage rates rise? Where do we find $1 trillion (plus!!!) in US savings to fund the deficit, assuming foreigners buy about $400 billion? By definition, savings and foreign investment and the federal deficit must add up to zero. (We will go into that later – just take it as gospel for now.) How can we run 10% of GDP deficits if the Fed does not print money (as they did by buying Fannie and Freddie paper, which became treasuries, as I outlined last week)? That would require almost a 10% savings rate – with it all ending up in treasuries. How can that happen? Really?

    But before we get into that, a few housekeeping items. First, more than a few of you have written to say you are not getting the letter as usual. There are some problems when your distribution list is 1.5 million closest friends. We try to fix them, working with the various ISPs to stay “white-listed.” It is actually a lot of work for Doug and my publisher. If for whatever reason your letter does not get into your inbox, just go to www.investorsinsight.com and find the letter there. And we are working on other mechanisms as well to insure you get this letter. And thanks for letting us know of problems. Rest assured, we do not randomly drop any of my closest friends from this list.

    Second, the invitations are starting to go out for our annual Strategic Investment Conference (co-sponsored by my partners Altegris Investments) which will be April 22-24 in La Jolla. In addition to David Rosenberg, Dr. Lacy Hunt, your humble analyst, Niall Ferguson, and George Friedman, my good friend Dr. Gary Shilling has agreed to come. There are several more rather exciting announcements I will be making in a few weeks. This conference will sell out. Unfortunately, for regulatory reasons, it is limited to accredited investors. If you have not already received an invitation, contact your Altegris Investments professional, drop a note to me, or register at www.accreditedinvestor.ws and you will get a call and an invitation.

    This year we are going to focus on “The End Game.” I can guarantee you lively debate, fun times, and over-the-top wines – plus, you will be with people who are simply the coolest ever. The speakers are all friends who “get it.” They called the crisis well in advance. These are the guys who sit and think every day about how this will all end up. The panels are going to be fun. Do not procrastinate. Register now.

    This Time is Different

    “But highly leveraged economies, particularly those in which continual rollover of short-term debt is sustained only by confidence in relatively illiquid underlying assets, seldom survive forever, particularly if leverage continues to grow unchecked.” – Carmen M. Reinhart and Kenneth Rogoff from their new book, This Time is Different.

    I am reading (on my new Kindle as I travel through Europe) a very important book, which I will be referring to a lot in the future. Reinhart and Rogoff have catalogued over 250 financial crises in 66 countries over 800 years and then analyzed them for differences and similarities. This is a VERY sobering book. It does not augur well for the developed world to blithely exit from our woes. The book gives evidence to my adamant statement that we have a lot of pain to experience because of the bad choices we have made. This is the entire developed world, and the emerging world will suffer, too, as we go through it. It is not a matter of pain or no pain. There is no way to avoid it. It is simply a matter of when and over how long a period.

    In fact, Reinhart and Rogoff's research suggests that the longer we try to put off the pain, the worse the total pain will be. We have simply overleveraged ourselves, and the deleveraging process is not fun, whether on a personal or a country basis.

    Let's look at part of their conclusion, which I think eloquently sums up the problems we face:

    “The lesson of history, then, is that even as institutions and policy makers improve, there will always be a temptation to stretch the limits. Just as an individual can go bankrupt no matter how rich she starts out, a financial system can collapse under the pressure of greed, politics, and profits no matter how well regulated it seems to be. Technology has changed, the height of humans has changed, and fashions have changed.

    “Yet the ability of governments and investors to delude themselves, giving rise to periodic bouts of euphoria that usually end in tears, seems to have remained a constant. No careful reader of Friedman and Schwartz will be surprised by this lesson about the ability of governments to mismanage financial markets, a key theme of their analysis.

    “As for financial markets, we have come full circle to the concept of financial fragility in economies with massive indebtedness. All too often, periods of heavy borrowing can take place in a bubble and last for a surprisingly long time. But highly leveraged economies, particularly those in which continual rollover of short-term debt is sustained only by confidence in relatively illiquid underlying assets, seldom survive forever, particularly if leverage continues to grow unchecked.

    “This time may seem different, but all too often a deeper look shows it is not. Encouragingly, history does point to warning signs that policy makers can look at to assess risk – if only they do not become too drunk with their credit bubble – fueled success and say, as their predecessors have for centuries, “This time is different.”

    A small confession. I am in a London hotel, it is late on a Friday, and my mind is slowing down. So rather than ramble, I am going to hand you off to Van Hoisington and Dr. Lacy Hunt, two of the brightest economists I know (Lacy will be at my conference). The following is their latest quarterly letter. I have already read it five times. It is THAT important, and chock full of intriguing concepts.

    They also reference Reinhart and Rogoff, and offer up a very contrarian view about deflation. Open your minds, and let's jump in.

    Quarterly Review and Outlook – Fourth Quarter 2009

    Hard Road Ahead

    The U.S. is facing a long and difficult road as it attempts to correct the over-indebtedness and wasteful expenditures of the past two decades. Both current and historical research help us to understand where we are in the continuing economic crisis, and to put it in perspective.

    The brilliant U.S. economist Irving Fisher first highlighted the fact that an economy's debt level could have a deleterious impact on economic growth if it is, in fact, excessive. At $3.70 of debt for every dollar of GDP, U.S. debt is excessive (Chart 1). Fisher pointed out that the unwinding of debt levels results in prolonged economic distress, and we certainly agree. In 2009, the book This Time is Different – Eight Centuries of Financial Folly, by Reinhart and Rogoff, shed new light on the role of debt by compiling a database that looked at financial crises in 66 countries over a period of 800 years. The main standard in explaining more than 250 crises studied is whether debt is excessive relative to national income, even though idiosyncrasies apply in each case. They reiterate that this old rule (excessive debt) continues to apply, and this time is not different.

    Research and the Deflation Risk

    We glean five important factors from this work that pertain to our present situation. First, financial imbalances occur when aggregate domestic debt is excessive relative to income, regardless of whether the government or private sector is accumulating the debt. Once debt becomes excessive, countries do not grow their way out of the problem; they must go through the time consuming and often painful processes of debt repayment and increased saving.

    Second, whether the domestic debt is externally or internally owed is not as critical as the excessiveness of the debt.

    Third, government actions, even involving sizeable sums of money, are far less helpful than they appear. As the book states, “Infusions of cash can make a government look like it is providing greater growth to its economy than it really is.”

    Fourth, Reinhart and Rogoff cover countries in debt crisis with a host of different conditions, such as growth and age of population, political regimes, technology status, education, and other idiosyncratic features. Nevertheless, economic damage as a result of extreme over-leverage has remarkably similar results, whether the barometer of performance is economic output, the labor markets, or asset prices.

    Fifth, further increasing leverage to solve the problem only leads to greater systemic risk and general economic underperformance.

    The real question for financial participants is whether all these influences result in inflation or deflation, and the authors' research details both outcomes. As is widely feared here in the U.S., they outline that many countries have had the right circumstances and mechanisms to inflate away their debt overhang, and, in fact, have done so by debasing their currency. Those particular circumstances are not currently present in the United States.

    According to Reinhart and Rogoff the norm is that major economic contractions lead to deflation. Importantly, they call our present economic circumstances the “second great contraction.”

    Thus, not only has the historical “qualitative” research on the subject of deflation chronicled the deflationary impulses emanating from overindebtedness (Fisher's 1933 “Debt-Deflation Theory of Great Depressions”), but also modern “quantitative” methods have now essentially confirmed this conclusion. Over-indebtedness and major contractions lead to deflation.

    Debt Overwhelms Monetary Policy

    It has been more than a year since the Federal Reserve began a massive expansion of Federal Reserve Bank credit, from $1 trillion to $2.2 trillion, flooding the banking system with reserves. This unprecedented action naturally raised inflationary fears since it was assumed that this was the beginning of a monetary creation process which would eventually lead to job and income growth, excessive expenditures, and finally massive price increases.

    If the economy were not in the throes of writing down bad debts that were caused by a massive decline in asset prices, it is possible that the money supply (M2) in response to this increase in reserves could have expanded by $4 trillion, or 96%. According to the late Nobel prize winning economist Milton Friedman, an increase in M2 of that magnitude would have been highly inflationary. However, M2 did not explode. Instead, in the past twelve months this aggregate has risen only 3%. This is less than 1/2 of the average growth rate over the past fifty years (Chart 2).

    If, as Friedman assumed, the velocity of money is stable (MV=GDP) then nominal GDP expansion in the ensuing quarters can be expected to grow about 3%. If prices rise about 1.5%, then real GDP growth would also rise about 1.5%, which is far below the level of growth needed to employ new labor force entrants and existing unemployed or to more fully utilize our present unused capacity in our factories. In the last six months the growth rate of M2 has slowed to near zero. If this pattern continues, it would be rational to expect GDP to grind to zero with no change in the price level.

    The very first step toward an inflationary cycle has to be to get the monetary aggregates expanding vigorously. That cannot be accomplished with the Fed “printing money”, i.e., adding more reserves into banks that cannot or will not make loans. The reason this process has not begun (and will not for a time) is the overhang of excessive indebtedness and asset price depreciations. No one needs to borrow, or has the resources or balance sheet to borrow, and banks are busily writing off bad debt. Irving Fisher warned of that process (note our Third Quarter 2009 quarterly letter).

    Over-indebtedness Creates Excess Supply

    Despite the concurrent developments of little money growth and declining loan growth (Chart 3), the fear nevertheless remains that an inflation surprise might be just around the corner. The reason to discount this notion is that excessive debt has contributed greatly to a flat, or perfectly elastic aggregate supply curve. A country's inflation is determined by the interaction of aggregate supply and demand. Friedman wrote that a large increase in money in the hands of the non-bank public would be inflationary because he assumed a normal upward sloping aggregate supply curve (Chart 4). In this case the aggregate demand for goods (depicted as the demand curve Line A) would shift outward to Line A1, and thus prices would naturally rise. You will note what happens to prices if a demand curve B is intersecting the supply curve in the so-called Keynesian range where it is flat. If aggregate demand increases to B1, prices do not change.

    Whether the supply curve is in a flat, normal, or upward sloping position depends on the extent of excess resources in the economy. Today it is obvious that the U.S. economy has plentiful excess resources, so any increase in demand will result in little price change. This will be the case until our unemployment rate of over 17% (the U6 measure) drops by a considerable amount and we begin to use our factories well above our current 68% utilization rate.

    Thus, our current economic circumstances guarantee there will be no surprise inflation. Employing those who are out of work and fully utilizing our resources will be a slow process. More importantly, it will take time to get the monetary engine reignited. Banks will have to begin lending and people and companies will have to determine that prospects are good enough to take the risk for expansion and investment. It will take years for these processes to get started because of our over-indebtedness and falling asset prices.

    The consequences of excessive debt are already painful at the household level. The civilian employment to population ratio, a highly important barometer of the average household's standard of living, fell to 58.2% in December, the lowest reading in 26 years and down from a peak of 64.7% in April of 2000 (Chart 5). Thus, the standard of living has worsened as the debt to GDP ratio has marched steadily higher. With debt to GDP still rising, a further deterioration of the standard of living is inescapable.

    Debt and Fiscal Policy

    Deficit spending only provides a transitory boost to the economy. It initially raises GDP, as it did in the second half of 2009, but then the effect dissipates and later is reversed, as financial resources available to the private sector are reduced. In a separate research study Rogoff and Reinhart write, “At the height of Japan's banking crisis in the 1990s, repaving the streets in Tokyo became a routine exercise. As a result, Japan's gross (government) debt-to-GDP ratio is now nearly 200% and a drag on what once was a vibrant economy.” Our present high deficit situation suggests that taxes will rise (including those of state and local governments), depressing economic activity further. In addition to the expiration of the 2001 and 2003 tax cuts, the Obama administration is proposing substantial taxes on financial institutions to pay for the cost of the financial bailout. Since the tax multiplier is high, this will reinforce the drag on economic activity from the lagged effects of deficit spending.

    Treasury Bonds

    Since 1990 Treasury bond yields have steadily moved downward in line with a more benign inflationary environment (Chart 6). Those yearly declines in yields continued last year with an average interest rate of 4.07% versus 4.28% in 2008. Obvious sharp reversals have occurred in their downward trend due to shifts in psychology reacting to generally transitory factors, as we saw in 2009. To remain fully invested in long Treasuries in this high volatility environment requires a simple discipline based on the academic literature which demonstrates that over time bond yields move in the same direction as inflation (Fisher equation).

    Presently, we view the inflationary environment as benign because: 1) the U.S. economic system is overleveraged and academic research confirms that this circumstance leads to deflation; 2) monetary policy is, and will continue to be, ineffectual as efforts to spur growth are thwarted by declining asset prices, loan destruction, and adverse regulatory influences; 3) the federal government's spending spree will necessarily cause taxes and borrowings to rise, further stunting any economic growth. These factors ensure that inflation will be quiescent. Interest rates easily can and do rise for short periods, but remaining elevated in a disinflationary environment is contrary to the historical experience. We are owners and buyers of long U.S. Treasury debt.

    Van R. Hoisington
    Lacy H. Hunt, Ph.D.

    Home Again

    I get home next Thursday night and wake up to write the next Thoughts from the Frontline. I have to say that these trips really get me fired up, as I visit lots of clients and serious hedge-fund managers who challenge me to think. Plus, I get some time to ponder the big picture.

    I was asked a lot about what the vote in Massachusetts meant. My take, for what it's worth, is that it is part and parcel with the election of Obama in 2008. The voters in this country are increasingly getting scared. They may not mind that we will tax the golden goose a little more, they just want to make sure we do not kill the goose (Peggy Noonan's column). While they may not be sophisticated in economics, they understand intuitively that you can't run deficits at the current levels forever. That risks killing the goose. Obama was elected with a promise of change. McCain was seen as more of the same. The recent elections (Virginia, New Jersey, Massachusetts) were pointedly saying, this is not the change we had in mind.

    This is part of the equation that will give us the direction of the end game. How will the Democrats respond? Will we see the moderates wrest back control from the progressive wing? Blue dog Democrats allying with Republicans (the more things change…)? Can Republicans actually articulate a program and path to fiscal responsibility, or will they just sit on their hands, hoping the Democrats implode (a very bad idea!)? Stay tuned.

    Ok, it is time to hit the send button. Last week I was with my partners at Altegris for our annual planning meeting in the mountains of Santa Barbara. It was idyllic. Part of the meeting was about the conference, and I am telling you, this is going to be the best ever.

    Have a great week. I will be uber-busy, but there will be a lot of good times and great conversation. And I will be ready to get back home.

    Your thinking about the end game analyst,

    John Mauldin


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