Winners and losers in ObamaCare

November 1, 2013

Chart based on Jonathan Gruber’s calculations here, in The New Yorker.  Gruber was on PBS’s NewsHour a few days ago, opposite a cranky old man from the Heritage Foundation who seems to be offended that he gets a fat paycheck.  Transcript and much more information, here.  Video of entire segment (including report on House hearings on the “glitches”), below.

Jonathan Gruber, a professor in MIT's Department of Economics Photo: M. Scott Brauer

Jonathan Gruber, a professor in MIT’s Department of Economics Photo: M. Scott Brauer

Gruber was interviewed by economics reporter Paul Solman earlier, and that appeared on NewsHour’s blog, on October 1; that transcript is here.

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Heritage Foundation urges that Africa be poisoned

May 7, 2011

Oh, not outwardly anti-Africa, but stupidly so.

The extreme right-wing Heritage Foundation lashed out at health care workers and scientists fighting malaria in Africa and Asia for World Malaria Day, April 25 (HF’s post showed up on May 5).  If these malaria fighters really were smart, HF’s Jane Abel wrote, they’d just poison Africa with DDT instead of protecting children with bednets and working to improve medical care.  According to Abel, DDT is safe for everyone but mosquitoes, and more effective than anything else malaria fighters use — so they are stupid and venal, she asserts, for not using DDT.

Here’s her post:

Environmentalists celebrated World Malaria Day last week (and Earth Day the week prior). Meanwhile, thousands of African children died of malaria.

While these activists may make themselves feel like they’re saving the world, they are ignoring the best possible solution to Africa’s malaria problem: the use of DDT to wipe out the Anopheles mosquito.

Even though the World Health Organization resumed promotion of DDT in September 2006—realizing it had the best track record for saving the lives of 500 million African children—environmentalists are still emphasizing the use of bed nets instead. DDT treatments almost completely eradicated the disease in Europe and North America 50 years ago, but today an African child dies every 45 seconds of malaria.

Providing sub-Saharan Africans with bed nets has had far from acceptable success in delivering the amount of protection needed from mosquitoes. The World Bank touts the fact that 50 percent of children in Zambia are now sleeping under nets as a good thing, but what about the other half who are left defenseless against a killer disease? The Democratic Republic of the Congo had only 38 percent of children under nets in 2010.

One would question why, in the 21st century, people should have to live inside of a net in order to be safe from malaria. The world has a better solution, and it’s not the quarantine of African infants. Dr. John Rwakimari, as head of Uganda’s national malaria program, described DDT, which is nontoxic to humans, as “the answer to our problems.”

World Malaria Day 2011 had the theme of “Achieving Progress and Impact” and aims to have zero malaria deaths by 2015. If the world really wants to make progress and increase the number of lives saved from malaria, it needs to embrace for Africans the best possible technologies available today, and that means DDT.

Here’s my response, which I predict will not show up at HF’s blog in any form*:

DDT is toxic to humans — just not greatly and acutely so.  Ms. Abel should be aware of recent studies that indicate even limited, indoor use of DDT in the end produces a death toll similar to malaria.  But we digress on just one of the errors assumed by Ms. Abel.

If DDT could wipe out malaria-carrying mosquitoes, WHO would not have slowed or stopped its use in 1965, years before anyone thought about banning the stuff.  By 1965 it was clear that overuse of DDT in agriculture had bred mosquitoes that are resistant and even immune to DDTJonathan Weiner noted in his Pulitzer Prize-winning book, The Beak of the Finch, that today every mosquito on Earth carries at least a few copies of the alleles that allow mosquitoes to digest DDT as if it were a nutrient.

DDT cannot be a panacea for malaria.

Please do not forget that malaria is a parasite disease, and that mosquitoes are only the carriers of it.  To truly eradicate malaria, we need to cure the humans — and if we do that, the mosquitoes do not matter.  With no infected humans, mosquitoes have no well of disease to draw from.  Without infected humans, mosquitoes cannot spread malaria.

Only 38 percent of children in Congo sleep under bednets?  I’ll wager that’s twice the percentage of kids that were ever protected from malaria in Congo by DDT.  In actual tests in Africa over the past decade, bednets have proven to reduce malaria by 50 to 85 percent; DDT, on the other hand, reduces malaria only 25 to 50 percent under the best conditions.  If we have to go with one and not the other, bednets would be the better choice.  Nets are much, much cheaper than DDT, too.  DDT applications must be repeated every 6 months, at a cost of about $12 per application per house.  Nets cost about $10, and they last five years.  Nets protect kids for $2 a year, better than DDT; DDT protects kids for $24 a year (that’s 12 times the cost), but not as effectively as nets.

Also, it’s important to remember that DDT has never been banned in Africa.  DDT non-use is much more a result of the ineffectiveness of DDT in many applications — why should we expect Africans to throw away hard-earned money on a pesticide that doesn’t work?

Finally, it’s also good to understand that, largely without DDT, malaria deaths are, today, at the lowest point in human history.  Fewer than 900,000 people a year die from malaria today.  That’s 25% of the death toll in 1960, when DDT use was at its peak.

Ms. Abel assumes that all Africans are too stupid to use DDT, though it might save their children.  He states no reason for this assumption, but we should question it.  If Africans do not use DDT, it may well be because the local populations of mosquitoes are not susceptible; or it could be because other solutions, like bednets, are more effective, and cheaper.

Ms. Abel has not made a case that DDT is the best solution to use against malaria.  DDT cannot improve a nation’s medical care delivery systems, to quickly diagnose and appropriately treat malaria in humans.  DDT cannot make mosquitoes extinct, we know from 66 year of DDT use that mosquitoes always come roaring back.  DDT cannot prevent mosquitoes from spreading malaria as effectively as bednets.

Maybe, just maybe, as evidenced by the dramatic reductions in malaria deaths, we might assume that modern Africans and health care workers know what they’re doing fighting malaria — and they do not need, want, or call for, a lot more DDT than is currently in use.

It’s too bad Heritage Foundation fell victim to so much junk science, and that the otherwise august press release operation pushes the grand DDT hoaxes.  Just once, wouldn’t it be nice if these conservative echo chambers would, instead of recycling the old, wrong press releases of other conservatives, would do a little research on their own, and get the facts right?

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*  It’ll be fun to watch.  I sent my response early, early in the morning while rushing to get a presentation ready, and I made a couple of egregious typos, including identifying Jonathan Weiner as “Stephen Weiner.”  If HF wished to embarrass me, they’d publish that one out of their moderation queue — but I’ll bet that even with my typos, they can’t allow the facts through.  Also, for reasons I can’t figure, some guy named Thurman showed as the author of HF’s piece on May 5.  So I had referred to Mr. Thurman instead of Ms. Abel.  Interesting technical glitch, or story, there.

_______________

Update, May 8:  As we should have expected, Steven Milloy’s Junk Science Side Bar also went on record as favoring the poisoning of Africa rather than the fighting of malaria.  Milloy makes claims that DDT will beat malaria (ostensibly before it kills all life in Africa), but his sources don’t support the claim.  Milloy is always very careful to never mention that, largely without DDT, the death toll from malaria is at the lowest point in human history.  Instead he notes that while malaria fighters promoted World Malaria Day, lots of African kids died of malaria.  That’s true, but misleading.  Because of the malaria-fighting efforts of those Milloy tries to impugn, far fewer African kids die.  Contrary to Milloy’s insane and offensive claims, it’s not alright that “only people” die.  Milloy asserts implicitly that, but for environmentalists, thousands or millions of children would survive that do not know.  That’s not true:  Because of the work that Milloy denigrates, millions fewer die.  It wasn’t environmentalists who overused DDT and rendered it ineffective in the fight against malaria, it was Milloy’s funders.  Follow the money.


Another way to tell Republicans and opponents of health care reform have lost their minds, or their hearts, or their conscience

August 1, 2009

Republicans and opponents of health care reform make Dave Barry look like the prophet Isaiah with greatly improved accuracy.  You couldn’t make this stuff up if you tried, as Dave Barry often says.

I have the right to protection, pleads this innocent little boy, in a poster for the State of Arizona Crime Victims Services division of the Department of Public Safety.  The Heritage Foundation ridicules federal support for child abuse prevention programs as unnecessary federal intrusion.

Included in the massive health care reform bill is some extra money to help out states and communities that have had difficulty getting effective programs going to combat child abuse.  Pilot programs demonstrated that community health workers could provide a few parenting programs and dramatically reduce child abuse.

These are programs that prevent dead babies.

According to the text of H.R. 3200, “America’s Affordable Health Choices Act,” starting on page 838 is a description of a program under which states and communities can get money to fight child abuse, if they have large populations of poor families, where child abuse is a problem, and where anti-child abuse programs need more money.  That’s pretty straightforward, no?  [That’s a hefty .pdf file, by the way — more than 1,000 pages.]

Parenting instruction and help can be offered, in private settings, and in homes where struggling parents need help most.

Money goes to states that want it and can demonstrate a need.  Parenting help programs are purely voluntary under H.R. 3200.

Who supports child abuse?  Who would not support spending some of the money in health care reform to save the saddest cases, the children who are beaten or starved or psychologically abused?

Is it not true that the prevention of child abuse would contribute to better health care for less money?

This is politics, you know.  Non-thinking conservatives pull out the stops in their desire to drive the health bill to oblivion, claiming that these anti-child abuse sections are socialism, liberty-depriving, and a threat to the designated hitter rule.  (I only exaggerate a little on the third point.)

This isn’t stripping liberties is it, we want someone else coming into our homes and telling us how to raise our children and live our lives.

This is right out of the Book 1984. If you had not read it I suggest it.

“Right out of 1984?”  Isn’t this a violation of  Godwin’s Law?

The Heritage Foundation appears to have taken a turn to radicalism, now advocating against fighting child abuse, and calling anti-child abuse programs a “stealth agenda.”

Have the Heritage Foundation, and these other people, lost their collective minds? They complain about the provisions of this bill because — this is their words:

One troublesome provision calls for a home visitation program that would bring state workers into the homes of young families to improve “the well-being, health, and development of children”.

Well, heaven forbid we should improve the well-being, health and development of children!

It is fair to conclude from this report that the Heritage Foundation does not want to prevent dead babies.

Years ago, when Father Reagan presided over the Conservative Church, one of the Heritage Foundation favorite deacons, a guy named Al Regnery, was appointed to be assistant attorney general over programs dealing with youth — juvenile delinquents, drug users, etc.  His chief qualifications for the job included that he was a faithful aide to Nevada Sen. Paul Laxalt, and that he toed the party line on almost all issues, including shutting down federal funding for programs that might prevent juvenile delinquency, or treat it.

Republicans controlled the Judiciary Committee under Sen. Strom Thurmond, so Regnery’s confirmation was never doubted.  But as if to throw gasoline in the face of advocates of anti-delinquency programs, When Regnery drove up to the Senate office buildings for his nomination hearing, his car had a generally humorous bumper sticker.  “Have you hugged your kid today” showed on about 200 million of the 100 million cars in America at the time — it was a cliché.  To fight the cliché, Regnery had the anti-fuzzy bumper sticker, “Have you slugged your kid today.”

When the issue hit the news, Regnery backpedalled, and said it was just a joke sticker that he probably should have taken off his car under the circumstances, but he forgot — and Regnery disavowed the bumper sticker, as humorous or anything else.

Comes 2009, we discover that the Heritage Foundation wasn’t kidding — slugging your kid is acceptable behavior to them, and creating programs to fight child abuse, is evil — to the Heritage Foundation.

Ronald Reagan would be ashamed of them.  Somebody has to be ashamed — there appears to be no shame at Heritage Foundation offices.

One wouldn’t worry — surely common sense American citizens can see through these cheap deceptions —  except that Heritage has a massive public relations budget, and there is a corps of willing gullibles waiting to swallow as fact any fantasy Heritage dreams up — see this discussion board on ComCast, where the discussants accept Heritage claims at face value though anyone with even a dime-store excrement detector would be wary; or see this blogger who says he won’t let the feds “take away” his liberties (to beat his children, or the children of others?); or this forum, where some naif thinks the bill will create a federal behavior czarGlenn Beck, whose religion reveres children, can’t resist taking a cheap shot at Obama, even though doing so requires Beck to stand up for child abuse.

Beck falls into the worst category, spreading incredible falsehoods as if he understood the bill:

This doesn’t scare me! No way. Just the crazies like Winston Smith — you know, the main character from “1984.”

When did we go from being a nation that believed in hard work and picking yourself up by the bootstraps, to a nation that wants government to control everything from our light bulbs to our parenting techniques?

This bill has to be stopped.

Gee, Glenn — when did we go from a nation that thought government was for the people, as demonstrated by the Agricultural Extension Service, or the Air Traffic Control System, or the Tennessee Valley Authority, to a nation that fights to bring back Czarist Russian government in the U.S.?  Stopping this bill won’t resurrect Czar Nicholas, and it will kill at least a few hundred American kids.  Excuse me if I choose living American kids over fantasies of a new and oppressive monarchy.

These people are not journalists. Beck isn’t like Orwell — maybe more like Ezra Pound, in Italy.  These people are not commentators, or columnists.  These people are not editorial writers.  They are not, most of them, lobbyists who give out  information for money, having sold their souls away from the angels of serious public discourse.

They are crass propagandists. They should be regarded more like the guy Tom Lehrer warned us about, the old dope peddler in the park, who always has just a little bit of poison for the kids or anyone else.  (“Don’t worry; you won’t get hooked.”)

How many other provisions of the health reform act are being distorted by conservatives in a desperate attempt to keep President Obama from “looking good,” despite the costs to America’s children and families?

These attacks on the health reform bill fall out of the category of robust discussion.  They disgrace our polity, and they erode the dignity of our democratic system.

Please share the information on this bill:

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Below the fold:  An example of the type of program Beck and Heritage call socialism, 1984-ish, and dangerous.

Read the rest of this entry »


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