Wednesday, February 28, 2007

Lack of dental care causes catastrophe in poor family

Mary Otto has a story in the Metro Section, page B1, of today's Washington Post, "For Want of a Dentist: Prince George's Boy Dies After Bacteria From Tooth Spread to Brain," link here. Because of difficulties with Medicaid and finding dentists who took it, the boy had six abscessed teeth, and one of the abscesses leaked to his brain, causing fatal encephalitis, after $250000 of care at public expense. Prince George's MD is the poorest suburban county in the DC area.

I can relate this to personal experience. In 2004, I had a peridontal infection that spread below the gum and resulted in permanent numbness in the chin and lip on the left side. The literature on this is scary, since "numb chin" is often associated with metastisized malignancies, especially lymphomas. The dentist had done numerous root planings and treated it with a synthethic penicillin, but insufficient dose. The left side of my face swelled up and I had trouble opening my mouth. I went to a specialist, and it was treated with clindamycin, which quickly resolved all the swelling, although the numbness remained. It may be that a small seed or particle got down beneath a peridontal pocket and produced the infection. Cat scans were inconclusive.

Monday, February 26, 2007

Congressional Digest has pro-con on national service and resuming the draft

The September 2006 issue of Congressional Digest featured the stunning pro-con debate “Should the All-Volunteer Force Be Replaced by Universal Mandatory National Service”? Congressional Digest Pro & Con features debated presentations in the spirit of the “Opposing Viewpoints” book series.

The issue discussed some of the current volunteer organizations sponsored by state and federal government. These include AmeriCorps (state and Vista), and Citizen Corps (Neighborhood Watch, Community Emergency Response Team (CERT), Volunteers in Police Service, Medical Reserve Corps. Also discussed was the Senior Corps, including Foster Grandparents (age 60 and up), Senior Companions (age 60 and up) and Retired and Seniors Reserve Program (age 55 and up). Some of these pay small stipends. Also mentioned is the Peace Corps. It is not necessarily easy for someone to transition into involvement with these. For example, to become a Foster Grandparent, one should have experience as a parent or working with children.

Also mentioned, or course, is the Peace Corps, which has volunteers as old as 82, but is not as easy to join later in life as one would imagine.

The issue also discussed the current contingent Selective Service law, and covered some details that I did not encounter in my discussions with them before my 1997 book. Student deferments had been a big controversy during the Vietnam war, and the first national lottery was held on Dec. 1, 1969. Under current law, if the draft resumed, college students could postpone induction only until the end of the current semester. The first priority for a draft would go to someone in his calendar year in which he turns 20. This eliminates the uncertainty of waiting until 26. Females could not be drafted now, although it is easy to imagine that if the draft resumed, there would be considerable political pressure to include females.

One particularly obscure area of draft law includes surviving sons. Contrary to popular belief, the “last son to carry the family name” (still an important concept to some people) can be drafted unless the family has already had a military death (in most cases).

In 2003 there were media reports that the Selective Service System in some areas was looking for “volunteers” to meet on local boards.

There is some debate in this issue on the controversy over the possibility of resuming the draft. Charles Rangel (D-NY) has twice proposed it, with little success, on the theory of sharing sacrifice, and that politicians would be less likely to become reckless about committing the U.S. to war (like in Iraq) if their own kids were at physical risk. Ron Paul of Texas provided a Con. But Charles Moskos of Northwestern University was a very strong Pro. He listed forms of the pseudo-draft, such as the “Poverty/Economic Draft”, “National Guard/Reserve Draft”, “Stop-Loss (Back-door) Draft”, “Individual Ready Reserve Draft”, “Recruiter Fraud/Misrepresentation/Intimidation Draft”, “Socialization-to-Militarism Draft”, “Target Latinos Draft”. He did not mention his “don’t ask don’t tell” regarding gays in the military in this article, but in other communications he has said that resuming the draft should end “don’t ask don’t tell.”

William Galston, a Brookings Institute Senior Fellow in Governance Studies, has suggested a mandatory 18-month national service. He writes:

“Numerous studies have documented the rise of individual choice as the dominant norm of contemporary American culture, and many young people today believe that being a good person -- decent, kind, caring and tolerant – is all that it takes to be a good citizen. This duty-free understanding of citizenship is comfortable and undemanding. It is also profoundly mistaken.”

However Galston does not favor the military draft alone. He talks about Woodrow Wilson and the concept of “universal liability to service” during World War I. He mentions the concept of “spectator citizenship.”

The national service debate comes up as it underlies a moral rift that society has always had: how burdens, especially those among generations, must be shared, and how the risks of defending freedom are to be distributed. The political left likes to cast this in terms of class warfare or struggles among groups, whereas conservatives like to hide it in terms of family values and public morality (even evading the question of whether conscription is a form of involuntary servitude or fails to respect the value of human life -- I always found it interesting that at one time the law could prosecute both abortionists and draft-dodgers). The volunteer movement carries the unpleasant idea that government can steer individualists into some kind of mandatory socialization, and idea more accepted in other countries like Israel. The Bush administration has try to suggest decentralizing this with faith-based initiatives. But a debate on “participatory citizenship” sounds inevitable.

My correspondence with Rep Moran (D-Va) on this matter is at this link.

My earlier (2004) editorial on the draft and national service is at this link.

Update: March 11, 2007

On March 11, 2007, on CBS 60 Minutes, Andy Rooney called for conscription "whenever the United States decides that it really needs to go to war, in Iraq or anywhere else" so as to share the burden and not scrape "the bottom of the barrel." He also indicated that he never thought he would say that.

Thursday, February 22, 2007

Employers cracking down on health care costs

It should come as no surprise that not only are employers requiring employees to pay more for weaker coverage, they are sometimes taking a more paternalistic attitude toward unhealthful employee behavior or inclinations, particularly smoking. A story by Michael Conlin in the Feb. 26 2007 Business Week (story here, might require a subscription or charge) "Get Healthy or Else -- Inside One Company's All Out Attack on Medical Costs", discusses a lawn care company in Ohio, Soctt's Miracle Gro, where both executives and line employees apparently are pressured to listen to "health coaches." Employees have been fired for positive nicotine tests.

Back on Feb 2004 ABC hard run a story about a Michigan benefits company, Weyco, and its policy of prohibiting smoking even off duty. Apparently it still does. Here is Weyco's current link on its policy. The company has a Feb 2005 essay by Howard Weyers, "Why Business Should Get Serious About Smoking," link here. I originally had reported this story on one of my domains, here, footnote 123c.

As far as I am concerned, cigarette smoking is gross. Health textbooks in high school show health and smoke-ruined lungs, the latter filled with black soot. The pictures are quite graphic. Furthermore, cigarette smoking reduces peripheral circulation and causes men to go bald in the legs.

I have always been concerned that one can make arguments like this about high-risk sexual behavior because of HIV, although actual experience shows that HIV has become much more manageable for employers than many other conditions.

Friday, February 16, 2007

Robert P. George on "Families and First Principles"

The February 12, 2007 issue of National Review has an interesting essay by Robert P. George, “Families and First Principles: The conservative fight to protect life and defend marriage,” on p. 31. The author mentions his book, Making Men Moral: Civil Liberties and Public Morality, a very expensive university-style book (Clarendon) dating back to 2002. I just ordered a more recent book . A more recent book that may have a similar perspective is The Meaning of Marriage: Family, State, Market and Morals (2006, Spence), which I just ordered from Amazon. These books might fit into earlier reviews I have done on other books dealing with individual sovereignty v. public morality (such as Elizabeth Foley’s book).

The professor draws a dichotomy between principle and practicality. Incrementalism, in order to gain pragmatically moral results, may be OK if we keep our eye on the underlying principles that protect his idea of freedom. (Some people might see this as giving in to humanism.) George goes on to discuss two biggies: protection of the right to life, and then preserving traditional marriage.

I have to admit that even in my own thinking, I can respect an absolutist position about taking the life of any conceived human being. Except in the case of rape, underage sex, or incest, the man and woman had to consent to what they did to produce the baby, so the philosophical defense of “choice” can be challenged by this consent, in order to defer to an absolute right to life. But the most productive argument here is George’s outline of the moral problems of creating life for the purpose of destroying it to harvest organs to cure the sick. George does provide a lucid outline of the quagmire of “stem cell research” here. Add to all of this the (Aldous Huxley “Brave New World”) risk of creating “designer babies” to meet the preferences of parents (either to produce “perfect kids” like Clark Kent, or, ironically, to create kids with disabilities like those of the parents).

Absolute reverence for human life has meaning at the other end, too. George talks about “condition of dependency” mainly with reference to the unborn and children, but similar arguments could be mounted about the elderly and severely disabled adults, particularly as medicine can prolong life forever but where society is unable to pay for it. Here there is the inevitable conflict between societal solutions (universal health care, which could lead to rationing, or maybe even euthanasia) and pressure on individuals to take more responsibility for others – and this leads naturally to marriage.

The second part of the essay talks about marriage, and gets into same-sex marriage, and makes the usual arguments for a federal constitutional amendment banning it. He makes a specious analogy to the “half slave half free” problem, although that is true even with conventional marriage today (think of the complications for some couples caused by community property v. traditional property states).

He also agrees that “civil unions” or “domestic partnerships” as imitations of marriage should be banned (as in the Virginia Marshall-Newman amendment passed in 2006), although he supports contractual relationships among adults to effect most of the practical benefits (hospital powers of attorney, property sharing, protection of wills from challenge) as long as they are not predicated on sexual relationships per se. That may sound benign enough.

What I have a concern with personally is what George leaves out. And that is what most “conservatives” conveniently leave out. The modern era, post 60s Civil Rights and post Stonewall, has allowed adults – especially homosexuals and especially many women of more independent temperament even when heterosexual – to live rewarding and productive adult lives, often expressed through career and work or often through art, media, film, religion, or whatever else – without family commitments and without having children at all. Other entries on these blogs and sites have talked about the low birthrate issues, especially in conjunction with eldercare, filial responsibility, and longer life spans. But the prevailing question has to be: what effect does “competition” with “non-family adults” have on families? In a world facing a growing array of “inconvenient truths” should additional sacrifices be expected from those without families to benefit those with?

Few conservatives have been willing to face this kind of question squarely in recent years. Some may see it as a canard. But if I look back to the 1950s or so, I see how in previous generations there was an “unwritten law” that you provided for a family (and showed loyalty to your own biological family) before you did anything else with your life. Justice Scalia, in his clumsy dissent in Lawrence v. Texas (2003) tries to say that. Rationalism, coupled with individualism, made this kind of intellectual sloppiness (where the family -- with all of its gender-associated pampering -- was an area where the same sense of individual accountability didn't always have to apply) untenable. An unpleasant reality, for many people, is that modern conservatism would define personal success, especially for men, in terms of ability to “compete” to provide for a family or at least for other people besides oneself.

In my own life, the impositions on my own personal freedom at times have been quite real. The details are in my own books and other writings, and may fit into what may becoming: a new national discussion on the obligations of citizenship, given all the new “inconvenient truths.” But is forcing subordination of “singletons” to those with “real family responsibility” good for marriage? I don’t think it is.

Thursday, February 15, 2007

Airlines can't get their act together when planes are stuck on tarmac

It's happened again. On Feb 14, during an ice storm, passengers were stuck for 11 hours or so in a Jet Blue plane at Kennedy during an ice storm. The plane was supposed to go to Aruba. Again, the media reports show that conditions on the plane were horrendous.

Later media reports indicated that up to tenJet Blue planes were held up for hours departing or arriving.

In December, American Airlines stranded passengers for 10 hours in Austin, TX. Fort Worth Star Telegram by Trebor Bansteer story is here.

But it happened to passengers of Northwest Airlines in Detroit in December 1999. This story by Claire Cummings of The Dallas Morning News discusses both incidents.

There are efforts in Congress to force airlines to return passengers after three hours, and provide services while passengers are trapped. This would be the so-called "Passenger Bill of Rights" legislation. But why are airlines unable to respond to such obvious crises in customer service? Snow and ice from December through March are common in places like Detroit and New York, as are severe thunderstorms everywhere.

I travel by air a few times a year and personally have a very good experience with few cancellations.

Another Valentine's Day Blizzard catastrophe happened on I-78 on Pennsylvania, with a 50-mile backup, lasting 13 hours, after a truck jacknifed.

Wednesday, February 14, 2007

NCLB and senioritis: more PT, drill sergeant

Amit R. Paley has a story in the Feb. 14, 2007 The Washington Post, "'No Child' Commission Presents Ambitious Plan," here. A commission now proposes testing all graduating high school seniors one more time in reading and math, and all high school students at least once in science. Bill Gates is supposedly behind this proposal, and nobody objects to the idea that employers give input into what they need. When I substitute teach, I tell students, when the lesson plans call for a classwork to be collected at the end of the period, that the class will be a sword drill for "the workplace." I had some idea what the grade 1-8 ideas for reading and math are last year when I scored some SOL (Standards of Learning in Virginia) binders. Nobody disputes that some other pairs of eyes besides the original teachers' looking at student accomplishments is a good thing. And if teaching is your profession, there is nothing wrong with being measured on how well your students do, although I have some other ethical (from a "libertarian" perspective) issues with scoring by race and ethnicity.

Students who do have difficulty with academics may think they have a good reason to wonder why they are hustled about it. If I can make a living as a pop musician or model, why do I need to know how to factor polynomials? That's probably a fair question. It sounds like this is some kind of scheme to provide moral justification for an individualist meritocracy. But by that reason, why don't we measure things like physical fitness? (That gets into a boondoggle of areas that will raise loud objections, I know; but on principle it is a good question.) Why not measure, say, hours of or accomplishments in community service? One point to bear in mind is that, given the problems we face in the future (all of those "inconvenient truths" that challenge us today), it's reasonable to want everyone prove that he or she can carry his or her own weight. That is the attitude of the workplace, after all.

Monday, February 05, 2007

Texas Governor Rick Perry strikes controversy over mandatory HPV cancer vaccine

First, it is medically controversial that we have a cancer vaccine at all, even if this has been anticipated for decades. Only a few cancers are definitely proven to be connected to viruses, although many more are suspected, as we have learned with experience with HIV and various lymphomas. HPV, related to viruses that cause benign tumors caused warts, definitely, with one strain, can cause cervical cancer. And there is now a vaccine that should prevent it if given to young women.

What about the mandatory aspect of Texas Governor Rick Perry's order? Actually, there is an opt-out provision, but the idea of big government pressure is certainly offense to any sort of libertarian spirit. It is insulting to parental rights. Remember, this is a vaccine against a sexually transmitted disease. But the worst thing is that it presumes that any young girl is going to "submit" to intercourse at sometime in her life, that this will not be a personal choice or decision that a woman will take full responsibility for. One can even draw this kind of thinking out all the way to the attitude toward women (as chattel) that seems to be practiced in some radical Islamic societies. A particularly disturbing observation seems to be that Merck lobbied for this executive order, and put its own fiancial interest above any objective thought about the underlying social and political principles.

Imagine the questions we will ask ourselves if we ever have an effective vaccine against HIV.

On the other hand, if we had effective vaccines against H5N1 and avian influenza, there would be a much more compelling, and less invasive argument, for free universal vaccination.

Friday, February 02, 2007

CDC issues guidelines emphasizing closings in case of pandemic avian flu

The Centers for Disease Control in Atlanta issued guidelines as to how a pandemic of avian influenza could be controlled, on Feb 1, 2007. The main link at the CDC seems to be this: This is the parent site, and it does offer RSS syndicated feeds of news releases.

Two of the major news stories are by Donald G. McNeil of The New York Times, 2/1/2007, p. A12, “Closings and Cancellations Top Advice on Flu Outbreak”, and David Brown of The Washington Post, “CDC Issues Guidelines For Battling Flu Pandemic: School Closings Likely, But Restricting Travel Not Suggested”, p. A3 on the same date. The Post also has a correlated story by Mr. Brown, “Tiny Mutations Can Limit Influenza Spread, Study Finds; Re-Created Spanish Flu Virus Less Contagious After Changes”.

The CDC organized its recommendations into Categories resembling those of hurricanes. The 1957 and 1968 pandemics would have been category 2. I had the 1957 flu in October of 1958, when I was a sophomore in high school, and missed one week. It caused extreme congestion. I did not have another absence of comparable length in my whole high school experience. Most years I have been vaccinated. It appears that adults exposed to these strains in youth may have more resistance to most outbreaks today in middle age.

Avian influenza reached humans in Egypt and Nigeria, and killed over 50% of people known to be infected. As a practical matter, if it became transmissible human-to-human readily, it would probably adapt to the human host and become much less lethal. Still, the 1918 Spanish influenza had a 2% mortality rate in the U.S. and 20% in some parts of the world. The likely extreme variability in individual susceptibility raises profound moral and ethical questions in control. Some persons (probably older adults in middle age) will not be susceptible at all and will resent the economic harm caused by closings.

States have the authority to close schools and gatherings, but will look to the CDC for guidance. More severe categories would lead to closings not only of schools, but also sports events, theater, movies, and the like, and could do extreme permanent economic damage to these industries; although the Internet might provide some creative ways to adapt. The Post article describes “Pandemic America” as one in which people will not have a choice about restricting their social and commercial loyalties to family and community. This has a profound relevance to our social debate on such matters as individualism, blood loyalty, family values, gay rights, and individual sovereignty and personal autonomy, even private property rights as we have come to enjoy them.

The NY Times article mentioned evidence that the 1918 epidemics in St. Louis and Cincinnati may have been milder because of a pre-spring epidemic in those cities conferred resistance.

On 2/2/2007 Britain reported an H5N1 outbreak on a turkey farm (Reuters story by Luke MacGregor).

Representative Jim Moran 's (D Va 8th District) letter to me on June 1, 2006 on this topic is available here. It is certainly disturbing.