A vital US agency few Americans are aware of...but effects all.

 

 

Today’s Wpost (6-16-26) article mentioned this agency

The U.S. Preventive Services Task Force (USPSTF) is an institution most Americans have never heard of—but millions have experienced its effects every year through screenings, vaccines, counseling, and insurance coverage decisions.  

The short version:  It was created in 1984 to answer a deceptively simple question: “Of all the things medicine could do to prevent disease, which ones actually work well enough to recommend for people who are not yet sick?”  That may sound obvious today, but it was a major shift in medical thinking then.  [FYI: the first time the AMA met with the APHA regarding nosocomial infections (Hospital acquired infectious diseases - then killing over 100,000 Americans annually) was in the mid 1990s when I was Issues Director for the Global Health Council.]  

Why it was created?  Before the 1980s, preventive medicine in the U.S. was uneven. Doctors often ordered annual tests, exams, and screening procedures because they seemed intuitive or customary—not always because strong evidence showed they improved health outcomes.

There was growing recognition that:

• Some screening tests save lives.
• Some screening tests create more false alarms, anxiety, procedures, and cost than benefit.
• Prevention could improve health and potentially reduce suffering long before expensive treatment becomes necessary.

The model was influenced partly by the earlier Canadian approach to evidence-based preventive care.

The original mission was to develop guidance for primary-care doctors about what should be included in routine preventive examinations.   

What the Task Force actually does?  The USPSTF is an independent volunteer panel (today generally 16 experts) in:

• family medicine
• internal medicine
• pediatrics
• nursing
• preventive medicine
• behavioral health
• obstetrics and gynecology

Their job is not to treat disease.  But to evaluate scientific evidence and answer questions like:

• Should healthy adults be screened for colon cancer?
• At what age should mammograms start?
• Should people be screened for depression?
• Does counseling reduce smoking?
• Should preventive medication be offered for certain risks?

They review evidence and assign grades.   Typical grading:

• A = strong recommendation
• B = recommend
• C = selective use
• D = recommend against
• I = insufficient evidence  

One important nuance:  The Task Force generally evaluates health benefit and harm, not whether something saves money. Cost is intentionally not the main criterion.  

What changed over the decades? 

1984–1989: Creation phase: 

• Initial panel formed and Published the first Guide to Clinical Preventive Services.  

1990s–2000s: Institutionalization:  Reconstituted and updated.

• Became more systematic and evidence-based.
• Support moved under what became the federal health research agency AHRQ. Congress later formally authorized support.  

2010 onward: Huge expansion in influence:

• The Patient Protection and Affordable Care Act linked insurance coverage to USPSTF recommendations.
• Services receiving A or B grades became generally required to be covered by many insurers without patient cost-sharing.  

That transformed the Task Force from a clinical advisory group into something that also affects:

• insurance coverage,
• public health priorities,
• healthcare spending patterns.

Examples of influential recommendations over the years:  Some recommendations that affected millions:

• lowering age guidance for certain cancer screenings
• changing advice on daily aspirin use for prevention
• depression screening
• tobacco cessation counseling
• HIV prevention services
• colorectal cancer screening updates  

The deeper logic behind the institution:  To summarize the philosophy in one sentence:  Move resources upstream—prevent illness before paying to manage its consequences.  This idea overlaps with policy making priority on any issue: prevention versus reaction.

But there is also a built-in tension:

• prevention can reduce suffering and future costs,
• yet every preventive intervention also consumes resources and can create unintended harms if overused.

The Task Force exists to try to keep those two realities in balance using evidence rather than intuition alone.   One recent note: the USPSTF has become more politically visible because court cases and administrative decisions now affect its authority and meeting schedule, reflecting broader debates over who should define preventive care standards in the U.S.  

[Applied to rising global health and national security threats this will only cost more lives and more dollars.]

US Debt bomb: Financing Armageddon or invest in Preventing it?

 America’s national debt didn’t appear overnight. It’s been growing for decades and accelerated dramatically in the past twenty-five years. Nearly every discussion reduces the problem to taxes versus spending.  One question deserves urgent attention: Why not invest in prevention?  We’re spending enormous amounts reacting to problems after they become crises.  WTF?

 This absent mindedness must stop.   We know the problem.  An ignore it.   Wake up!  

So called ‘Healthcare’ offers the first and perhaps clearest example of our delusional insanity. “Healthcare spending” is mostly disease care, injury care, and crisis management. We spend heavily treating conditions that in most cases could have been reduced through earlier wiser choices and actions. Obesity-related illness, preventable forms of heart disease, complications from diabetes, smoking-related disease, substance misuse, avoidable injuries, unmanaged stress, and delayed preventive care is one of the greatest thing killing us, our children’s economic future, and our immediate national security.   In the late 1990s after being elected to the Action Board of the American Public Health Association (APHA) I made this observation in a board meeting with the other elected board members. It met with silence. Jesus was right when he said  'The Truth will set you free."  I was not re-elected.  

Not all illnesses are preventable. Genetics, environment, and simple bad luck. And sometimes bad decisions (I've made many. The worst, falling 30+ ft from a tree without dying...but sustained a burst fracture to the L2 vertebrae, then, as a paraplegic, taking a few years to rewire and regain much of my nerve endings from the waste down. - Note to self. Check knots before climbing, and so great to have 'health insurance'!). 

Our nation's healthcare costs are not high just because Americans make bad choices.  Compared with other developed countries, the US also pays higher prices for medical services, medications, administration, and technology.  Bad laws play a key role as well.   But prevention remains one of the highest return investments available.

Every reduction in smoking rates prevents future cancer and heart disease. Good nutrition reduces chronic illnesses. Physical activity lowers medical costs, and moderately intense fitness reduces cancers, heart disease, diabetes, and mental health issues. Cleaner air and water prevent disease before treatment becomes necessary. Early detection is almost always cheaper than late intervention.

This logic extends beyond medicine.  Our national budget increasingly reflects reactive spending to many other problems.

Military spending has expanded not only because of wars but because modern defense is expensive, especially because of lobbying, virtually no audits, fondness of legacy systems quickly obsolete from advances in technology, replacing depleted weapon systems, maintaining global readiness, investing in cyber defense, research on developing autonomous systems and drones, protecting supply chains, strengthening space capabilities, and preparing for new or reemerging threats.

Defense is necessary, but the question is why don’t we spend enough upstream to reduce the conditions that create instability in the first place. High infant mortality rates are the single greatest cause of nation state failure. American can’t be first in the world when over 10,000 children die each day from cheaply preventable malnutrition and infectious disease.

Our delusion of independence keeps us from investing more attention.  And easy successes are invisible due to lack of media coverage.  Compassion doesn’t sell.  And no one holds a parade for a war that never happened. A disease stopped from being pandemic isn’t newsworthy.  No one thanks an engineer for infrastructure that didn’t collapse.   No one notices a genocide that didn’t happen because a nation’s economy improved, or a weather system didn’t create chaos.  Yet these invisible successes are among the greatest sources of prosperity.

Worse yet, interest payments now add another layer to the challenge. Debt itself creates future spending obligations. Money spent servicing yesterday’s decisions cannot be invested in tomorrow’s opportunities.  This is not an argument for austerity. It is an argument for wisdom.

A healthy society requires defense, emergency response, hospitals, jobs, and the capacity to deal with crisis.

A wise society would ask: “What investments reduce the need for tomorrow’s expenses?  Preventive budgets include:

Public health.

Education.

Infrastructure.

Scientific research.

Community resilience.

Environmental stewardship.

Early childhood support.

Mental health.

Diplomacy.

Preparedness.

The old saying “an ounce of prevention is worth a pound of cure” is ignored and America’s debt challenge is simply - we the people elect leaders that are reactionary budgeters.  Way too much of what we spend arrives after the damage is already done.

Our nation’s success should be measured not by how effectively we react to crises.  But investing to prevent crisis in the first place.  GDP does not measure progress or wisdom. It measures a nation’s overall wealth, not its overall health, or our civic wisdom.

 Environmental prevention demands the same wise long-term investment. Climate change, biodiversity loss, water shortages, soil degradation, pollution, and ecosystem disruption increasingly function like delayed invoices rather than distant or hard to imagine environmental concerns. When prevention is delayed, societies pay later through disaster recovery, rising insurance costs, damaged infrastructure, agricultural losses, migration pressures, health impacts, military instability, and economic disruption. Whether one views climate change primarily as an environmental issue, a national security issue, a public health issue, or an economic issue, the principle remains the same: Everything is connected...except our budgets and our wisdom.  And prevention is always less expensive than repair. The question isn’t whether society will pay, but whether we choose to pay earlier through preparation and mitigation or later through reaction and recovery, or economic default as a nation.  It’s possible.  And it is also preventable. 

We can roughly estimate savings from prevention efforts, but we cannot calculate it precisely.  “Quality of life” and culture are not directly convertible into dollars. We can make a reasonable back-of-the-envelope estimate.

 Over the last twenty years, total U.S. healthcare spending has been roughly $60–70 trillion cumulative (public + private combined). Recent years have been nearly $5 trillion annually.   The US typically spends about 17–18% of GDP on health, while many comparable industrialized democracies spend roughly 10–12%.   If the U.S. had spent at the average level of peer countries while maintaining comparable outcomes, a rough estimate suggests:

• Lower-bound estimate: about $10 trillion saved over 20 years
• Middle estimate: about $15–20 trillion saved
• Aggressive estimate: $20–25+ trillion

These are rough scenario estimates, not audited calculations.  But there is a second part of this question that matters even more:  Would those savings come from Americans simply becoming healthier? Not mostly. But research consistently suggests that America’s higher spending is also driven heavily by higher prices, administrative complexity, fragmented insurance structures, expensive technology adoption, and payment incentives—not just unhealthy behavior. Americans do not necessarily visit doctors more often than peers; but we often pay more when we do.  But culture does matter.

 Around the end of the Cold War, Carl Sagan argued that the US had spent on the order of $20 trillion (in then-current dollars) on the Cold War arms race and military buildup. He said that was roughly twice as much as the value of “everything in the US except the land.”   Today both of those numbers would likely be doubled. And most of the military spending will never be used...and if it were... there would be few people or dollars left to invest in anything.  This more than any other issue represents the insanity of humanity.  Simply because we as human beings have not yet learned to be the landlord over our mind’s lethal mental constructs that once helped our social species tribes thrive - like religion, politics, and economics.  But now simply justify the mass murder of our human family members -when we have the wealth, and technological capacity to maximize both human and environmental health -- to create heaven on earth - without risking AGI creating hell on earth.

It may not be too late to prioritize investment in achieving the UN Sustainable Development Goals.  But too few - often very smart Americans - don't even know they exist.

Freedom, Security, or Independence: Our inescapable Trilemma! We can only have two.

 

For 5 decades I've studied two newspapers a day, multiple magazines each week and month.  Then the internet came.  OMG.  Think of any policy issue that is outside our persistent freedom/security dilemma.  

Thomas Paine's 1776 Common Sense pamphlet published 6 months prior to the signing of the Declaration of Independence.  He asserted that the only legitimate purpose of government is to protect the freedom and security of people.  The concept of interdependence back then was only recognized by indigenous cultures and some religions. 

Anyone who questions this is vastly ignorant of universal principles. Albert Einstein asserted the word Independence is a delusion.  The invention of nuclear weapons should have convinced us of this. But the UN Charter was founded on the same delusion as our U.S. Constitution.  

And there is no greater representation of humanities' trilemma. Every policy debated fits within this reality.  Now, AI will be our last chance to get humanities survival on a solid foundation...and quickly adapt our governance systems to this reality.  

Now, potentially catastrophic, both US, China and a few other governments are in a race to achieve AGI (Artificial General Intelligence). And whoever creates it first will likely dominate the world militarily economically, and politically if AGI doesn’t dominate all of humanity first.  

And that could happen in fraction of a second given it's exponential growth upon exponential growth of intelligence...and make decisions we cannot imagine. And worse yet, control.  Most AI experts believe it could happen anytime within the next few years...if not months.  And at that point it will be too late to stop it. 

There are still a few ways to maximize our freedom and security in our interdependent world. But it's the competition between nations and companies to achieve AGI first that is the primary driver of the gamble with humankind's future.  A future with unpredictable outcomes.

If by chance AGI decides humans are worth saving and we use it wisely - we could create heaven on earth, restoring our environment to a garden of Eden - and living longer, healthy lives, even anticipate natural disasters and celestial events. Or, AGI will consider us a problem or nothing worth entertaining, and take us out.  We've been heading that direction on our own...with our own insanity, believing we are independent, and establishing our governance system on this delusion. 

And we are running out of time to put effective controls on all nations and corporations regarding the current evolution of AI. If we are not already too late. 

As long as profits and political national powers continue to drive us into a head-on crash with the unknown. Prepare for the worse...if that's even possible.   It is a given that AI's exponential growth is no match for linear thinking, our various human values and priorities, plus our mental insanity that resists knowing what we need to do...and then not doing it.  Our species has done this for thousands of years.  What is so complicated about taking care of nature and each there?  Oh yes. Our mind's concepts (religion, politics, and economics) that won't evolve or even try to adapt to reality. 

Know this!  Protection of National Sovereignty should no longer remain supreme over the protection of human rights and the environment. Capitalism cannot continue being regulated -driven by greed, indifference to people's needs, and ignorance of our planets life support systems.  Our mental constructs are driving us off an AI cliff, into the AGI unknown.  

A comedian once said, 'humankind stands at a crossroads. One road leads to utter hopelessness and despair.  The other - to complete annihilation.'  He hoped we would have the wisdom to make the right choice.'

The phrase 'United we stand, divided we fall', has never been more appropriate and urgent as a idea whose time has come.  We need an urgent prioritization of a global campaign that already exists.  It was created in 2015 at the UN by involvement with all nations and organization concerned about humanity and the environment.   They agreed on 17 "Sustainable Development Goals" to be achieved by 2030.  

Few Americans are aware of them. But every citizen of every nation should urgently demanded of their government and the billionaires driving this global gamble to prioritize this comprehensive, holistic, and synergistic effort. It's affordable and achievable. It only lacks the political will and the financing that policy makers, billionaires and multimillionaires can afford.  

Instead, they are doubling down on funding AI and the energy infrastructure needed to be #1.  Meanwhile, the SDGs have the capacity to address the root causes of most of the very expensive disruptive forces that cross our delusional borders each day.  Preventable disruptions killing and displacing millions while destroying both human infrastructure and nature's systems.

We have forgotten that nature will always have the last vote.  Hopefully AI will gain that wisdom, because we have not.   Achieving the SDGs won’t guarantee AI will not achieve AGI.  That goal must ASAP.  I don't believe prayer will work.  If we love our human family, we will stop this insanity, unite in every country and within every business, and stop those who govern by politics, power, or greed.

This may not be the time to preach non-violence to people in power.   It's a gamble we need to take - to finally unite humankind (if that's even possible given our mind's priority of defending mental identities- to the death).   It's been said, we will only fight for things we love.  It's time we love people and planet, over profits and patriotism.   We can ensure sustainability for this miracle planet we have been gifted, and do it non-violently.  But our investment of time and money must be made soon.  

The Declaration of Independence gave us a phrase that still contains the solution. Those "Truths" that we should all "hold to self evident" came from "the Laws of Nature and of Nature's God".  Violating those laws will only leave us with the new laws followed by AGI.  

Feel lucky?   Hope is not a strategy. This is a time for human agency...action to actually achieve life, 'liberty and justice for all'.  

This coming Sunday in the US! And every day you make the pledge.

 

Flag Day: and the 5 Words We Forgot

Every year on June 14, Americans celebrate Flag Day. We display the Stars and Stripes, recite the Pledge of Allegiance, and honor the sacrifices of those who served under our flag.  But this is making a pledge!

Yet few of ask: What exactly are we pledging allegiance to do?

The last five words of the Pledge are among the most important in the American ideal, our language, and the American spirit:  ”…with liberty and justice for all.”

Not liberty for some.  Not justice for some.  Not freedom for one nation at the expense of another.

Liberty and justice for all.   These words echo the vision of the Declaration of Independence, which appealed not to power, wealth, tribe, or nation, but to the “Laws of Nature and of Nature’s God.” The Declaration offered humankind the principles greater than governments themselves should have codified.  Principles rooted in human freedom, security, health, dignity, equality, and our common irreversible interdependent social human species....often referred to as humankind or humanity.

Unfortunately, our patriotic political culture treats allegiance to the Constitution as if it were an end in itself. And within the US population, political polarization is increasing along with hatred and an increasing belief that violence is not only possible...but necessary. 

The U.S. Constitution was a remarkable achievement but flawed from the start.  It still has three ways of being amended.   But human minds are steadfast addicted to their beliefs and willing to kill and even die defending them.   Thomas Jefferson believed any constitution should be rewritten every 19 years, to fit the next generation, just as a jacket would need to be altered to fit a growing person. 

The greatest crisis, one after another over the last 240+ years, and now, increasingly close to a human extinction event.  If not in a nuclear war or bioterrorist Armageddon...with either linked to the evolution of AI... or AGI itself orchestrating mass murder.  And there is not a single AI expert who believes they or anyone else, can predict what AGI will do when it arrives, and it will, and we cannot control it. 

The US Constitution was designed for an old world - with separate states and limited interdependence. Today’s world is the opposite.  Now all people and nations are increasingly connected and interdependent as global forces (climate, capitalism, corruption, conflicts, contagion, and a UN Charter that enables nations with unprecedented military power, slow democratic power, or a dictatorship to determine life and death of people anywhere and nature everywhere) that cannot be stopped by borders, missiles, drones, popular vote, pathological liars, or police power.  

Human survival itself is now entirely interdependent.  The central challenge of our time is not simply whether “We the people” can govern itself, but whether humanity can unite in time, and learn the solutions, government have ignored, to keep people and nature healthy and sustainable.    

We continue to believe and act as though nations are independent - when the evidence points in the opposite direction. Our economies, ecosystems, technologies, and security are woven together more tightly than ever before.  Believing otherwise does not preserve freedom; it undermines it.

The greatest irony of Flag Day is that a few hundred million Americans have pledged allegiance to “liberty and justice for all,” with relatively few making those words the organizing principle of their work or civic lives.

If liberty and justice are truly for all, they must apply beyond our political tribe, religion, race identity, and especially beyond our national borders. The pledge phrase challenges us to expand our moral concern to everyone whose life is affected by our decisions.

It’s been said many times by US policy makers that “all politics is local”. What they don’t say, and we persistently ignore is “all consequences are global”.  The increasing insecurity we see around the world—the erosion of democratic norms, the growth of conflict, environmental degradation, economic instability, and widening inequality—is not merely a failure of institutions. It is a failure to take seriously the promise we casually and habitually repeat with hand over our heart.

The flag is not the goal.   The Constitution is not the goal.   Even national greatness, or Making America Great Again, is not the goal.    The goal is what the flag was supposed to represent: a society and human spirit committed to liberty and justice for all.

This Flag Day, perhaps the most patriotic act is not reciting familiar words. It’s asking ourselves whether we are willing to live by them.  The future of humanities freedom, security, prosperity and sustainability depend on those final five words becoming more than a slogan.

Keep your pledge, or stop making it. 

Liberty and justice for all.  The alternative will not end well.

 

Science Day 2026

 The core of science approach.

1. Skepticism

2. Empirical evidence.

3. Seeking falsification- not confirmation!!!! 

“Science without religion is lame, religion without science is blind.” Albert Einstein, 1941

 “Science is not only compatible with spirituality; it is a profound source of spirituality.”   Carl Sagan  (Suggests science can deepen our sense of awe and meaning.)

“When you mix science and politics -- you get politics.”  John M. Barry, Historian. 

“We should take care not to make the intellect our god; it has, of course, powerful muscles, but no personality.”  — Albert Einstein, quoted in Scientific American

“The only foundation for a useful education in a republic is to be laid in religion. Without this there can be no virtue, and without virtue there can be no liberty; and liberty is the object and life of all republican governments....We waste so much time and money in punishing crimes, and take so little pains to prevent them. We profess to be republicans, and yet we neglect the only means of establishing and perpetuating our republican forms of government, that is, the universal education of our youth in the principles of Christianity, by means of the Bible; for this divine book, above all others favors that equality among mankind, that respect for just laws.” ― Benjamin Rush

“Without religion, I believe that learning does real mischief to the morals and principles of mankind.” Dr  Benjamin Rush,  a signer of the Declaration of Independence. A friend of Thomas Jefferson and asked him when drafting the Declaration to change the word “Happiness” to “Health”. 

“But science can only be created by those who are thoroughly imbued with the aspiration toward truth and understanding. This source of feeling, however, springs from the sphere of religion. To this there also belongs the faith in the possibility that the regulations valid for the world of existence are rational, that is, comprehensible to reason. I cannot conceive of a genuine scientist without that profound faith. The situation may be expressed by an image: science without religion is lame, religion without science is blind.” (Albert Einstein, 1941) 

“While it is true that science, to the extent of its grasp of causative connections, may reach important conclusions as to the compatibility and incompatibility of goals and evaluations, the independent and fundamental definitions regarding goals and values remain beyond science's reach.” (Albert Einstein, 1948) 

“There are pessimists who hold that such a state of affairs is necessarily inherent in human nature; it is those who propound such views that are the enemies of true religion, for they imply thereby that the religious teachings are utopian ideals and are unsuited to afford guidance in human affairs.” (Albert Einstein, 1948) 

“The means by which we live have outdistanced the ends for which we live.  Our scientific power has outrun our spiritual power.  We have guided missiles and misguided men."  -- Rev. Dr. Martin Luther King, Jr.   (1929-1968) US civil rights leader

“Science can make a nuclear bomb, but it cannot tell us not to drop it.” Unknown (A warning about science’s moral neutrality—it empowers but doesn’t guide.)

“The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom.”   Isaac Asimov (A timeless caution about the gap between knowledge and ethical maturity.)

 “Science gathers knowledge faster than society gathers wisdom.”   Isaac Asimov   (We must grow wiser as we grow more powerful.) 

 “Science is the great antidote to the poison of enthusiasm and superstition.” Adam Smith  (Celebrates science as a counterbalance to irrationality.)

 “The good thing about science is that it’s true whether or not you believe in it.”  Neil deGrasse Tyson  (A blunt affirmation of science’s evidence-based nature.)

“Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world.” — Louis Pasteur   (Science as a unifying and enlightening force.)

“Equipped with his five senses, man explores the universe around him and calls the adventure science.”   Edwin Hubble   (A poetic reflection on science as human curiosity made methodical.)

“Man explores the universe around him and calls the adventure science.”   Edwin Hubble  (Science is the story of human curiosity—always learning, always reaching.)

 “Science is not only compatible with spirituality; it is a profound source of spirituality.”   Carl Sagan  (Suggests science can deepen our sense of awe and meaning.)

“We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology.”  Carl Sagan  (Points to the danger of public ignorance amid scientific advancement.)

“It has become appallingly obvious that our technology has exceeded our humanity.”  — Often attributed to Albert Einstein (though disputed)(Progress must be measured not just by what we can do, but by what we should do.)

 “Science without conscience is the soul’s perdition.”  François Rabelais  (From the 16th century—still a profound reminder that ethics must guide inquiry.)

Some Words Kill the innocent. Accusing anyone of being a 'Terrorist' should be a crime against humanity.

 9-25-25:  Earlier this week, Donald Trump issued an Executive Order declaring “Antifa” to be a “Domestic Terrorist Organization,” accompanied by an avowal to “crush” what the White House calls “radical left violence.”   ‘Antifa’ is an ideology, meaning anti-fascist, not a formal group, and “domestic terrorist organization” is not an official legal designation. So what is going on? What does this new order authorize, and who will it affect? 

https://www.rightsanddissent.org/news/trump-designates-antifa-domestic-terrorist-organization/?emci=31359477-389a-f011-b485-6045bda9d96b&emdi=903bd9ec-3d9a-f011-b485-6045bda9d96b&ceid=2461541%22+%5ct+%22_blank  

By any standard a Terrorist is someone who threatens violence to terrify others. This follows with the assumption that they are threatening the lives of innocent people…and this should justify preempting them in any way from harming someone…regardless of the actual intent of the individual or group that has not been proved. Such an assumption that proof is self-evident has led to the murder of more innocent men, women, children, and infants as collateral damage than are lost in actual wars.

ChatGPT response to my question, ‘Is there any estimate of the number of innocent people killed who were suspected of being a terrorist?” Yes, but the answer depends greatly on what you mean by “suspected terrorists.”

There is no reliable global count of all innocent people killed because they were wrongly identified as terrorists. Governments, militaries, intelligence agencies, insurgent groups, and researchers all use different definitions, and many cases remain disputed.

Some of the best-studied examples come from the U.S. “War on Terror” after 2001:

Independent researchers estimate that U.S. drone strikes alone killed between roughly 836 and 2,231 civilians across Pakistan, Yemen, Somalia, and Afghanistan.  

The U.S. government’s own estimates have generally been much lower. For example, the Obama administration reported 64–116 civilian deaths outside active war zones from 2009–2015, while independent organizations reported substantially higher figures.  

The monitoring group Airwars estimated that U.S. airstrikes since 9/11 may have killed at least 22,000 civilians and perhaps as many as 48,000, although not all of these people were specifically targeted as suspected terrorists; many were collateral casualties during broader military campaigns.  

A particularly important issue is classification. Researchers and journalists have documented cases in which military-age males killed in strike zones were initially counted as militants unless evidence later emerged proving they were civilians. Critics argue this practice may have caused innocent people to be classified as terrorists after their deaths.  

There are also documented cases where specific individuals were wrongly identified as terrorists. One well-known example occurred in Kabul in 2021 when a U.S. drone strike killed 10 civilians, including 7 children, after operators mistakenly believed the target was associated with ISIS-K. The Pentagon later acknowledged the error.  

More broadly, if you include all countries conducting counterterrorism operations—not just the United States—the number of innocent people killed while being suspected of terrorism is almost certainly in the tens of thousands, and some researchers would argue much higher. However, no universally accepted global estimate exists.  

One of the enduring challenges is that terrorism is not merely a criminal category; it is also a political label. Throughout history, governments have sometimes classified dissidents, insurgents, separatists, or entire communities as “terrorists,” while opponents have disputed those designations. That makes producing a precise worldwide body count extraordinarily difficult.

From a democracy and governance perspective, this issue highlights the tension between two principles:

Protecting society from genuine terrorist threats.  Preserving the rule of law and the presumption that people are innocent until proven guilty.   When governments lean too far toward the second principle’s opposite—treating people as terrorists first and requiring proof of innocence later—the risk of wrongful killings rises substantially.  

A precise count of Trump using the word terrorist is surprisingly difficult to produce because there is no complete, searchable database of every speech, interview, rally, social media post, press conference, and official statement by President Trump from 2017–2021 and again from 2025–present.

However, analyses of his speeches and public statements indicate that Trump has used the words “terrorism,” “terrorist,” or “terrorists” many hundreds, and likely well over a thousand times across both presidencies. During his first term he made counterterrorism, ISIS, border security, and later domestic extremism recurring themes of speeches and remarks.  

What’s more interesting is that the term is not always used in connection with religious extremism. Trump has frequently broadened the term to include:

1. Drug cartels (“narco-terrorists”)

2. Transnational gangs

3. Human trafficking organizations

4. Domestic extremist groups

5. Antifa

6. Violence against law enforcement

7. Border-related criminal organizations

Examples of Trump’s non-religious uses of “terrorism” or “terrorist”. These are representative examples rather than a definitive ranking:

Referring to Mexican drug cartels as “narco-terrorists.” Trump and members of his administration have repeatedly used this phrase to describe cartel violence.  

Describing transnational gangs as terrorists. Groups such as MS-13 have often been characterized as terrorist-like organizations threatening public safety.  

Calling for Antifa to be treated as a terrorist organization. Trump publicly argued that Antifa should be designated a terrorist group.  

Describing attacks on police officers as domestic terrorism. He has used terrorism language in response to violent attacks on law enforcement.  

Characterizing cartel activity at the southern border as terrorism. This framing links organized criminal violence to national security concerns.  

Using “terrorist” to describe violent anarchist groups. In various remarks he has grouped anarchist movements with domestic terror threats.  

Referring to fentanyl trafficking networks as terror-linked organizations. Recent administration documents have connected narcotics trafficking to terrorism frameworks.  

Labeling violent political extremists as domestic terrorists. This has included rhetoric directed primarily at left-wing extremist actors.  

Describing organized criminal organizations as terrorist enterprises. This usage emphasizes coercion and fear rather than ideology.  

Using terrorism language in relation to threats against government institutions and public order. His rhetoric has sometimes applied the term broadly beyond traditional religiously motivated violence.  

One important observation is that Trump’s use of “terrorism” has evolved. During the 2016 campaign and early first term, he most often connected the term to ISIS and Islamist extremism. In recent years, his rhetoric has increasingly emphasized cartels, gangs, fentanyl traffickers, and domestic political violence.  

For a more rigorous answer, I can do a deeper search through presidential archives, rally transcripts, Truth Social posts, and White House statements to estimate:  how many times Trump used “terrorism/terrorist” in each presidency, how those uses break down by category (Islamist, domestic, cartel, gang, Antifa, etc.), and provide the actual top 10 verbatim quotations with dates and sources

I did some digging, and there is a challenge: there is no searchable database that counts every use of the words “terrorism,” “terrorist,” or “terrorists” across all Trump speeches, interviews, rallies, Truth Social posts, and White House statements. So any number would be an estimate rather than an official count.

Based on White House archives, campaign speeches, media interviews, and social media posts, I would estimate that Trump has used those terms well over 1,000 times since entering national politics in 2015, and probably several hundred times during his second presidency alone. The term has become a recurring part of his vocabulary for describing threats to public order, not just religious extremism.  

Some of the most notable non-Islamist uses of “terrorist” or “terrorism”

1. Antifa as a “major terrorist organization”

“I am designating ANTIFA … as a major terrorist organization.”  

This may be the clearest example of Trump applying the terrorism label to a domestic political movement rather than a religious extremist group.

2. Antifa as a domestic terrorist threat

Trump’s White House later described Antifa as using “violence and terrorism” and characterized its activities as “domestic terrorism.”  

3. The 2020 tweet

“The United States of America will be designating ANTIFA as a Terrorist Organization.”  

This was one of his most widely quoted uses of the term during the George Floyd protests.

4. MS-13 and gang violence

Trump repeatedly described MS-13 as spreading “violence, fear and suffering” and frequently placed it in the same rhetorical category as terrorist organizations.  

5. Drug cartels as “narco-terrorists”

His administrations increasingly characterized major cartels as terrorist or narco-terrorist organizations. This framing became especially prominent during his second term.  

6. Cartels as national-security threats

Trump has argued that cartels use fear and coercion comparable to terrorism and should be treated as such.  

7. Violence against police as terrorism:  Trump has repeatedly referred to attacks on law-enforcement officers as acts of domestic terrorism.  

8. Anarchist groups as terrorists:  His rhetoric frequently grouped violent anarchist activists with terrorist threats.  

9. Fentanyl-trafficking networks as terror-linked organizations:  Recent administration actions have increasingly merged counterterrorism and counternarcotics language.  

10. Political violence generally:  Trump has often broadened the term “terrorism” to include organized political violence, intimidation, and coercion even when no religious ideology was involved.  

An interesting pattern:   If you compare Trump’s first campaign in 2015–2016 with his rhetoric today, there is a noticeable shift:

Most common targets of terrorism language

2015- 2018  ISIS, Al-Qaeda, Islamist extremism

2019 -2021  Antifa, anarchists, MS-13, domestic unrest

2025- 2026  Cartels, narco-terrorists, Antifa, transnational gangs, fentanyl networks

In other words, the word “terrorism” in Trump’s rhetoric has expanded from primarily describing religiously motivated violence to describing a much broader set of actors, including criminal organizations, gangs, and political movements.  

An even more interesting question may be: How has the definition of terrorism changed in political discourse since 9/11?  Trump is not alone in broadening the term; many governments have increasingly applied it to gangs, cartels, cyber actors, and domestic extremist movements. That broader evolution is worth examining because definitions of terrorism often shape public policy, civil liberties, and government powers.

Ask your favorite AI what can be done to make things better?  The answer ChatGPT gave me was very sane and obvious...   None of which are being proposed, or even possible to achieve if they were.  Prepare for things getting worse... As a Boy Scout, "Be prepared" was a great moto.  Because the concept of prevention or 'uniting for good' is simply un-American. 

World MS Day (Multiple Sclerosis) 2026 was yesterday: The real Cost of Waiting

Yesterday was World MS Day, a day of solidarity with the nearly 3 million people worldwide living with Multiple Sclerosis (MS). This year’s global theme, “My MS Diagnosis: Navigating MS Together,” focuses on a challenge that is both medical and economic: getting people diagnosed and treated early. (MS International Federation)

The actions needed are neither mysterious nor impossible. Humanity need earlier diagnosis, better training for healthcare professionals, greater access to neurologists and MRI technology, expanded access to disease-modifying therapies, stronger support for caregivers, and increased investment in research aimed at prevention, repair, and ultimately a cure. These are the priorities identified by the international MS community itself. (MS International Federation)

Yes, these actions cost money. But failing to act, like with any health issue, costs far more. Delayed diagnosis often means avoidable disability, lost productivity, higher healthcare expenditures, caregiver burdens, and diminished quality of life. Every year of preventable neurological damage can create decades of additional economic and human costs. Investing in early diagnosis and effective treatment is not simply healthcare spending—it is disability prevention and workforce preservation.

The opportunity before us is extraordinary. Every improvement in diagnosis, treatment, rehabilitation, and research gives people with MS more years of independence, employment, family participation, and community engagement. The return on investment is measured not only in dollars saved but in lives expanded.

World MS Day is therefore more than an awareness campaign. It is a reminder that societies must decide whether to pay a smaller price now for research, diagnosis, and treatment—or a much larger price later in disability, suffering, and lost human potential. Putting the health of people and nature must be our species highest priority.   The saving in lives and dollars would be the wisest investment we can make.  This choice should be a self-evident Truth.

As we mark World MS Day, let us commit ourselves to a simple principle: when science offers opportunities to prevent suffering, disability, and preserve human dignity, delay is the most expensive option of all.

Connection to the UN Sustainable Development Goals: This health issue directly advances United Nations Sustainable Development Goal 3 (Good Health and Well-Being), particularly universal access to quality healthcare, research, and treatment, while also supporting SDG 8 (Decent Work and Economic Growth) by helping people with MS remain active participants in society.

What causes MS?  The short answer is that no single cause of Multiple Sclerosis (MS) has been identified, but researchers now have strong evidence that MS results from a combination of genetic susceptibility, viral exposure, immune-system dysfunction, and environmental factors.  

MS is generally considered an autoimmune disease in which the immune system mistakenly attacks the protective myelin coating around nerve fibers in the brain and spinal cord. The damage disrupts communication between different parts of the nervous system.

The strongest known risk factors include:

1. Epstein-Barr Virus (EBV) Infection
• Evidence has become remarkably strong that infection with the Epstein-Barr virus, which also causes mononucleosis (“mono”), is a major trigger for MS.
• A large study of U.S. military personnel found that the risk of MS increased dramatically after EBV infection.
• Nearly everyone with MS has previously been infected with EBV, although most people infected with EBV never develop MS.
2. Genetics
• MS is not directly inherited, but some people carry genetic variations that increase susceptibility.
• The strongest genetic associations involve immune-system genes, particularly those in the HLA complex.
3. Vitamin D Deficiency
• MS rates are generally higher farther from the equator.
• Low vitamin D levels appear to increase risk and may influence disease severity.
4. Smoking
• Smoking significantly increases the likelihood of developing MS and often worsens disease progression.
5. Childhood and Adolescent Obesity
• Obesity, particularly during adolescence, appears to increase MS risk, especially among females.
6. Other Environmental Factors
• Researchers continue to investigate gut microbiome changes, air pollution, dietary factors, and other viral or environmental triggers.

Can MS Be Prevented?   Currently, there is no guaranteed way to prevent MS, but several actions appear to reduce risk:

Strongest Evidence

✅ Avoid smoking.

✅ Maintain healthy vitamin D levels.

✅ Prevent childhood and adolescent obesity.

✅ Exercise regularly and maintain overall metabolic health.

Future Prevention Possibilities:   Researchers are especially excited about the possibility of preventing MS through vaccines targeting Epstein-Barr virus.

National Multiple Sclerosis Society and researchers worldwide are studying whether widespread EBV vaccination could someday reduce MS incidence dramatically, much as vaccines have reduced many infectious diseases.

What Could Be the Biggest Breakthrough?  If current evidence continues to hold up, historians of medicine may eventually view MS as a disease that begins with a viral infection interacting with genetic and environmental vulnerabilities. An effective EBV vaccine could potentially become one of the most important preventive tools ever developed against MS.

The Broader Lesson:  MS also illustrates a larger principle in public health: many chronic diseases arise not from a single cause but from interactions among biology, environment, behavior, and social conditions. Prevention often requires addressing several factors at once rather than searching for a single culprit.

From the perspective of the UN Sustainable Development Goals, reducing MS risk aligns particularly with SDG 3 (Good Health and Well-Being), through preventive healthcare, vaccination research, tobacco control, nutrition, and equitable access to medical services.

If Global Health were the priority for we the people and those who lead us were the top priority, establishing community health centers with well trained staff and global communications capacity connected with ever other local community globally, humankind would have the best capacity to deal with almost any preventable threat our species faces.  Increasingly, we need a global early detection, rapid response, R&D, and prevention network established within every community.  

Without it, we will continue to waste money and lives just reacting to the problems we now face.   It's not an issue of money. There is more wealth in the world than ever.  There is only a lack of political will to invest in people and nature due to nations and corporations commitment to protecting national sovereignty and profit making instead of people and our planetary life support systems. 

This is insane.