Actually, it is the Washington Post science writer Rob Stein who sings a fascinatingly disgusting story of arms and the man -- research about the "virtual zoo" of microbes festering on the human body's largest organ.

Yes, it's the skin.

Stein writes that swabbing the forearms of three healthy men and three healthy women  "revealed that human skin is populated by a diverse assortment of bacteria, including many previously unknown species, offering the first detailed peek at this potentially crucial ecosystem.

"The work is part of a broader effort by a small coterie of scientists to better understand the microbial world that populates the human body.

There is unquestioned social good in having pharmaceutical companies discover beneficial drugs and use their marketing prowess to ease pain and save lives. Such is the case with medications aimed at helping people quit smoking and prevent cervical cancer. But two questions must be asked: What is the real motive and what is the real cost?

In the case Merck, the cost to vaccinate young women against the cancer-causing human papillomavirus is about $360; cheap enough for an American family to avoid the devastating cost of cancer but too steep for the underdeveloped world.

Does it really need to cost that much, or is the price merely Merck's way of recovering profits lost in the Vioxx disaster? And is the price so high because it pays for the army of lobbyists now at work in at least 20 states trying to make HPV vaccinations required by law?

The (subscription-only) <i>Wall Street Journal</i>, which yesterday examined the Merck campaign, today goes after a similar mixing of good message with questionable motive.

Conservative Gov. Rick Perry of Texas did something the other day that astounded the public health community. By executive order, he  mandated vaccination for girls as young as 11 against the human papilloma virus, which causes most cervical cancer later in life.

He did so probably for the wrong reasons. He took legislators off the hook lest they had to vote against parents who would rather have their daughters die of cancer than be told there is a sexual component to the disease. And by having the state mandate a drug, insurance will have to pay for it and the result will be a windfall profit for Merck & Co., Inc., the maker of the vaccine and employer of Perry's former chief of staff.

The debate over Medicare cuts is heating up. Recently, the president announced his budget cuts of nearly $70 billion for Medicare spending over the next 5 years. The impetus comes from the notion that current Medicare spending is unsustainable. For those who are ardent supporters of this reform this thing was long overdue.

According to the Economic and Budget Issue Brief, Part B of Medicare would cost the taxpayers about $158 billion in the year 2006. Out of this about 38% goes to payments for physician services. This makes physician payments a natural target for cost reduction strategies. According to the same Congressional Budget Office (CBO) report if current measures are undertaken then physicians would see a decline in payments anywhere from 25 to 30% over the next several years.

Youth fitness is a huge health problem because research has shown that eating habits and propensities toward obesity start in earliest childhood. So it is commendable that President Bush has lent the weight of his office to a public  service campaign  involving Hollywood, Madison Avenue and the fast- and packaged- food industries.

"One way for this nation to cope with the issue of obesity is to get people outside - -  whether it be through sports or hiking or conservation, " Bush said.

The art of selling is as much a part of medicine as having a solid knowledge base at least when it comes to promoting patient compliance. As the son of a career salesman I learned the value of bonding with customers, finding commonalities and offering a simple view of the product in such a way that the customer could forge a relationship with what is being sold. Selling the concepts of wellness and prevention is more difficult than writing prescriptions for antibiotics.

My nurse practitioner and I launched MyPhotoDiet.com in June 2006. The website offers a 90 day weight loss plan using photographs of all meals and snacks to illustrate portion sizes. We made the diet extremely simple so that the person on the diet does not even need to learn a new recipe . They only need to take the food that they have in their grocery bag and put it on the plate so it looks like the food in the picture and the diet takes care of itself.

Facing a Democratic Congress about to hold hearings exposing a "Republican war on science," President Bush did what for him was instinctive. He quietly shoved his executive authority up the public's nose by ordering every science-based regulatory office in government to be run by a political appointee.  

There is a temptation to call Bush a sore loser, or worse, citing this executive order as one more example of ideology trumping evidence. The stripping of authority from expert civil servants will delay effecting any controversial rule or regulation that might protect the public health at the expense of industry and will outright kill others, the facts be damned.

Sharon Begley, the esteemed science columnist of the Wall Street Journal (subscription required), notes a trend of philanthropists shifting their dollars to private industry in order to get new cures to patients faster than by funding ever-newer and slower generations of lab researchers and rats.

"It's a sign of desperation. One reason there have been so few drug breakthroughs lately is that the profit motive actually works against the development of new pharmaceuticals. Drug companies suffer from blockbuster-itis, the belief that only billion-dollar almost-sure things need apply for development. As a result, even the most brilliant discovery may not be translated into a drug unless it has 10-figure sales potential. Also, short time horizons on the part of venture capitalists, who generally want to see their biotech bets pay off in three years, don't mesh well with the lengthy drug-development process."

 And the Washington Post reports that one-time liberal Rep. Pat Schroeder, now a lobbyist for academic journals, has hired a public relations "pit bull" to Swift-Boat disease advocacy groups and the National Institutes of Health. Seems Ms. Schroeder and her academic publisher constituents hate the idea of free access to new science and will do anything necessary to preserve their monopoly on knowledge. 

"The fix? For a six-month fee of $300,000 to $500,000, (the consultant) told the association's professional and scholarly publishing division, he could help -- in part by simplifying the industry's message to a few key phrases that even a busy senator could grasp. Phrases like: 'Public access equals government censorship,' and 'government [is] seeking to nationalize science and be a publisher.'"

The Coalition Against Institutionalized Child Abuse (CAICA) brings its readers news about an ever-growing multi-billion dollar industry where children are being warehoused for profit.

We understand the need for children's programs and facilities. We also understand there is an industry that most people are not even aware exists. We are talking about children whose parents, for one reason or another, decide to send their child to a facility or program away from home. We have seen where sometimes it was necessary and others times parents feel they acted in haste and out of desperation, feeling that they could have solved the issues at home.

A legislator's survival is dependent on his/her ability to listen to
his/her constituents and then act accordingly. They say that
constituents do not voice concerns about current constraints on medical
care so they act accordingly by turning a deaf ear to the concerns
voiced by the medical profession. Doctor's abilities to control
disruptive changes to their profession, no matter how well intended or
forcefully presented to legislators, will go unheard without public
support. As a group doctors do not control votes and therefore do not
control legislative decision making. Survival for the profession in
this situation may depend on its ability to change the minds and
actions of constituents (patients) who will, in turn, change the minds
and actions of legislators. Constituents hold the key to both physician
survival and quality medical care in today's new pay for performance
medical reality.