Monday, January 26, 2015

You can’t vaccinate against this

  Master curmudgeon H.L. Mencken wrote, "No one ever went broke underestimating the intelligence of the American people."

  Mencken wrote this knowing that, as societies go, ours is a beacon of higher thought and inquiry. At the same time, he bemoaned "the virulence of the national appetite for bogus revelation."

  Which brings us to measles and Disneyland.

  Through no fault of its own except for its embrace of huddled masses, Disneyland has taken a horrific hit -- ground zero for a seven-state outbreak of a disease that considered eradicated 10 years ago.

  The cause? Blame Google.

  That, and an alleged expert named Andrew Wakefield.

  British medical journal Lancet gets much blame, too, for publishing a paper by Wakefield in 1998 that pointed to vaccinations as a cause of autism. Lancet since has retracted the study, stating in no uncertain terms that Wakefield's claims are "proven to be false."

   Since then, Wakefield has lost his license to practice medicine in Great Britain. Far from contrite, he sought and found another place to continue claiming what the science will not support. That place? Well, Texas, of course.

   What was that about Google? How does it share the blame? Simple. The search engine assures that one can find a nation for any revelation, bogus though it may be.

   In light of the Disneyland outbreak, which has been blamed squarely on families' refusing to vaccinate their children, the Washington Post did a "where is he now" story on Wakefield and reported that he had found a "sympathetic community in his adopted state of Texas."

   As the Post's Terrance McCoy writes, those who refuse to vaccinate their children "frequently harbor a deep distrust of government." And as the magazine Nature wrote in denouncing Wakefield's claims, many who skirt vaccinations on such pretenses "often suggest that vaccination is motivated by profit and is an infringement of personal liberty and choice."

   It is revealing, in light of such assertions, that Wakefield's own profit was among the criteria leading other scientists to suspect the purity of his claims. He pocketed $600,000, for one thing, by way of attorneys who were suing vaccination makers.

  Ah, the profit motive; the prophet motive.

  For some reason thinking about all those people massing in Disneyland makes me think of another fantasy-filled attraction in California — this one at the resort of Racho Mirage. That's where the Koch brothers – Charles and Dave, recently invited Republicans who consider themselves presidential material to prove it to them.

   If they could pull that off, would-be candidates like Rand Paul, Marco Rubio and Ted Cruz would have access to donor wealth beyond their wildest dreams.

   To do this, they would have to demonstrate their purity in rejecting all that science linking players like Koch Industries to climate change.

   You might say that like the state of Texas, the Koch petrochemical empire is a country unto itself – at least it is when it comes to spewing out carbon dioxide.

    Now, it's true that the core constituency these candidates will  court for the GOP nomination are inclined not to believe a word of what an overwhelming majority of scientists says about climate change and man's role. But we need to assume that most of the research on which Cruz and Rubio, et al., will rely on this matter will have been done by Koch Industries.

   Pursuant to that, the nation is in for some true enlightenment as Cruz assumes chairmanship of the Senate subcommittee that oversees NASA and Rubio chairs the subcommittee that oversees the National Oceanic and Atmospheric Administration — NOAA. These are the agencies that just declared the year past to be the warmest on record.

  Disregard the science, America. Google up whatever suits you. Oh, and don't let a little fever spoil that planned trip to Fantasyland.

  Longtime newspaperman John Young lives in Colorado. Email: jyoungcolumn@gmail.com.

Monday, January 19, 2015

Vision vs. blindness on health coverage

  When he noticed weird stuff floating in his right eye, he didn't blink. He called an eye doctor.

  The next day, 24 hours after the abnormality introduced itself, he had eye surgery – a vitrectomy -- that very likely spared him the loss of sight in that eye from a detached retina.

  If he'd postponed action, said his ophthalmologist, this might not have been possible. Done early, the procedure has a 90 percent success rate.

  The rapid response was possible because he didn't pace the floor wondering if he could afford the doctor's visit. With his health insurance, all he would owe was a co-pay if his deductible was met.

  Not so for the person without. The procedure costs $7,000-plus. Anyone got that kind of change on hand?

  It's just one of the many dramas that opponents of the Affordable Care Act want to ignore when it comes to non-elective medical care.

  One of those people is Sen. Rand Paul, an ophthalmologist himself. To his credit, as with many in his profession, Paul has done eye surgeries for people without health insurance. But charity covers only one at a time in this and many other specialty fields.

  Paul says that if we allowed the free market to dictate health care, more people would be served at lower cost. He uses the example of LASIK surgery, which is not covered by most insurance, and for which the price has become more affordable due to competition.

  The difference, of course, is that LASIK is elective, not urgent, and someone who decides to do it, if that person can afford it, can shop around for the most affordable cost. The man with the floaters in his eye had no time to shop around.

  Paul needs to face the fact that health care generally doesn't fit so neatly into the template set forth by free-marketeers.

  Left to make their own rules, insurance companies would extend favorable premiums to those who don't need much coverage — until they do — and health care costs overall would continue to soar.

   Drug companies would continue to enjoy virtual monopolies. Providers would set whatever prices they see fit, knowing that the scarcity of their service will obviate any competition.

  Regardless, the government would continue to provide a sizable portion of health care via programs like Medicare, Medicaid and CHIP. These are programs from which this nation will retreat.  

  Medicare and Medicaid cover the surgery for a detached retina because of its urgent need. That means that in all states that have refused to expand Medicaid under the Affordable Care Act, a vast swath of people are in great danger of calamity.

   When it studied 20 states that have refused federal dollars to expand Medicaid, Harvard Medical School calculated the human cost to be 16,526 preventable deaths a year – 3,000-plus in Texas, 2,000-plus in Florida.

  Sixteen thousand deaths. That's 9/11 times five. And what have we spent since 9/11 to prevent another 9/11?

  Whatever the Department of Homeland Security of the Pentagon might conjure in the "war on terror," the returns from investing in health care are clear. Preventive care saves lives and averts catastrophic costs. It's undeniable. Yet we are told that society cannot afford to be smart about the spending of tax dollars in that way.

  The resistance to Medicaid expansion is one thing. At the same time, opponents of the Affordable Care Act are rooting for a Supreme Court ruling that effectively would abolish health-care exchanges the federal government set up for recalcitrant states that didn't want to set up their own.

  Ah, yes, what a coup that would be: a ruling that pulls the plug on health policies used by more than 3 million Americans. It'll be worth one big touchdown dance by people who have all their needs met by the status quo.

  With the help of health coverage, one man was able to sustain his vision. It is wrong and foolish for the blindness of policymakers to deny that same urgent help to millions of others.

  Longtime newspaperman John Young lives in Colorado. Email: jyoungcolumn@gmail.com.

Tuesday, January 13, 2015

To the future? Who needs roads?

  It's 2015, you know, and a tea party fantasy looks to be realized.

  No, we're not talking about Republican control of both houses of Congress. We're talking about the fantasy that begat a sequel to "Back to the Future."

  If you recall, the last lines in this first movie came from old Doc Brown, in his flying DeLorean, when he said, "Roads? Where we're going, we don't need roads."

  Well, it's 2015, the year in which "Back to the Future II" is set, and just ask the Republican Party: We don't need roads. With flying cars and hover boards, roads are obsolete.

  Sen. Elizabeth Warren hit on that fantasy when Majority Leader Mitch McConnell called the Keystone XL Pipeline the "first bipartisan infrastructure bill of the new Congress." And how dare President Obama threaten to veto it?

  Warren mocked the primacy and pretext attached to Keystone. That pretext is a few thousand part-time jobs.

   "What if we focused on highways instead?" Warren asked. The American Association of State Highway and Transportation Officials estimates that long-last passage of a permanent highway bill would create 8 million jobs.

   The infrastructure that affects us all – delivers our families and our goods, our ambulances, our school buses -- truly is languishing. Former Secretary of Transportation Ray LaHood, one of two Republicans on Obama's first Cabinet, has described that infrastructure as "on life support."

   We heard a lot about the Alaskan "bridge to nowhere" in an election past, and umbrage swelled. The real problem facing everyone, however, is bridges to somewhere, and the thoroughfares connecting them.

   The Transportation Department rates 70,000 bridges as structurally deficient. Maybe that's a high number devised by paper-pushers currying tax dollars. OK. If it were one-seventh of that – if it were 10,000 deficient bridges -- would that not trouble you?

   Here's something a do-nothing Congress would rather not hear discussed: The federal Highway Trust Fund -- which gets its money from the federal gas tax -- is almost insolvent.

   And it's no mystery why spending per capita on infrastructure is at its lowest point since 1947, according to LaHood. As a percentage of income, federal revenue is at its lowest point since just about the same time – 1950, to be exact, back before Chuck Berry, man.

   Yes, as Tax Day approaches, you'll be told that an insatiable federal government takes more and more. In truth, that's as far from reality as traffic lights in the sky.

   And don't let anyone convince you that this nation is resources-poor. To this point, according to costofwar.org, we've spent $1.57 trillion in Iraq and Afghanistan, and without a murmur from today's Republican deficit hawks.

  Say what you will about the Obama stimulus legislation – but acknowledge that it was for building and sustaining things this country needs, rather than rebuilding what we destroyed in war.

  Last week Obama issued the audacious proposal of providing a community college education free for all Americans who maintain adequate academic standards. Projected price tag? Sixty billion dollars over 10 years. Out of the question, yes? Well, guess what? We spent more than that -- $96 billion – last year alone in drawing down our forces in Iraq and Afghanistan.

  And so – of course we can't afford roads. And why do we need them anyway? Most people of means have monster SUVs and big-butted trucks that are sold on their capacity to go where the heck they want – off-roading, creek-bedding, mountain-scaling.

  That being the case, a 21st century infrastructure trend is what we shall call pop-ramps. As the rest of us are stuck in a traffic jam at the nearest interstate, those who can do it simply yank a right, over the curb, and high-tail through the weeds to the nearest service road.

  So you see, Sen. Warren is out of touch about priorities. She just needs a bigger vehicle.

  Longtime newspaperman John Young lives in Colorado. Email: jyoungcolumn@gmail.com.