COVID-19 and “Herd Immunity”

I’ve heard a lot of takes, even from more mainstream and even “liberal” sources in the United States that the goal is to control the spread of the virus so it doesn’t overwhelm our health care system, but let it spread through the human population in some sort of “controlled” manner until we eventually reach “herd immunity”. I shouldn’t be surprised, I guess. We have deep eugenicist roots in this country. As I wrote elsewhere, the Nazis got a lot of their initial ideas and even laws directly from us. We had mandatory sterilization laws long before they were implemented in Germany and the last ones were not removed from the books until the 1950s. However, involuntary sterilization remains a legal practice in the United States to this day. It just normally requires a court order rather than a blanket law. A lot of race theory and the racism it supports is based on eugenics. Racism and eugenics are intertwined and threaded throughout our society.

So I shouldn’t be surprised. I know this is who we are. I know this is who we have always been. In this instance, though, the sheer callousness toward mass death and suffering astounds me. That’s what this perspective entails. Yes, the outcomes become immensely worse if our hospitals are overrun. The direct deaths from COVID-19 grow dramatically because there isn’t capacity to save everyone that could otherwise be saved. And because the health care system is overwhelmed all cause mortality also spikes. Lots more people die when the hospitals are overwhelmed.

But even if it were feasible to allow the virus to spread through the population without containment in some sort of controlled manner so that it did not overwhelm our hospitals, that would mean millions of people would die and millions upon millions more would suffer tremendously and some subset would have permanently damaged health and wellbeing from the disease. In the US, we have a population of 330 million people. The absolute best case is that COVID-19 has a 1% mortality rate. It could be as high as 3%-4%, but let’s assume the lowest possible estimate. That’s up to 3.3 million people dead. Let that number sink in. But it’s worse even than that. An estimated 10% of victims will be seriously ill and require hospitalization. The typical term of hospitalization is 10 or more days with incredible suffering. And we are already seeing that some of those who survive suffer permanent chronic and disabling effects. That’s not surprising. SARS-CoV-1 and MERS demonstrated the same thing. So that’s up to 33 million people hospitalized, on the verge of death, and possibly permanently disabled.

And that’s in the United States alone. With a global population of 7 billion, even if herd immunity could be achieved with as small a percentage as 60% of the population immune, that means at least 42 million people globally will die. As far as I’m concerned, anyone who can consider that an acceptable outcome is a morally deficient human being.

On this issue I wholly agree with Dr. Richard Beck in his post on moral fragility. “We like to think we’re moral, loving people. We are not. Our affluence had masked our depravity.” The fact that we have contemplated trading lives for money demonstrates that depravity, even if we ultimately move away from the morally reprehensible choice. However, we are not moving away from it. A significant portion of our citizenry, even crossing ideological lines, have embraced their depravity and are trying to justify it as somehow moral.

However, even for those willing to make that morally depraved tradeoff, it does not appear feasible to have some sort of controlled spread. This virus is far too contagious. I’ve been watching the estimates of the median rate of transmission creep up from day one and they started at levels supporting exponential curves. The rate of transmission is called R0 or R-naught. The R0 of a virus represents the median number of people each infected person will infect without any controls or mitigation in place. The most recent study I’ve seen has been prepublished by the CDC’s own journal, Emerging Infectious Diseases. It’s scheduled for the July issue so it is still in review and may change, but it’s as credible as any preprint can be.

High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2

The study calculated an R0=5.7 for SARS-CoV-2. For comparison, seasonal flu has an R0=1.3. One of the most infectious diseases, measles, has an R0 of 12-18.

I want to let that sink in for a moment.

The first implication should be clear. The idea of controlled spread of a disease that contagious represents magical thinking. There is no way to allow slow, controlled spread through a population even if you’re willing to make the immoral trade of a large number of human lives for whatever monetary or economic benefit you believe you’ll receive. Once the virus is allowed out of containment, it will spread in an uncontrolled manner every single time.

The second implication should also be clear. There is no path to any sort of herd immunity absent a vaccine. The paper provides the formula for herd immunity. In its simplest form, it’s just 1-1/R0. For R0=5.7, that requires 82% of the population to be immune. And that’s moving up into the 95% required for herd immunity to measles, something we were only able to achieve through a vaccine.

And, of course, the talk of immunity revolves around the naive assumption that exposure to the virus results in some sort of natural, lifetime immunity to it. There is nothing that indicates that’s a reasonable or likely assumption and quite a bit of early evidence that it is wrong. A lot of people with light exposures don’t have the right sort of antibody cells that encode immune system memory. But that’s true even of some who were seriously ill. They are finding that others do have the right sort of antibody but there isn’t yet any data that indicates the degree of natural immunity or how long it lasts. It’s good there appears to be a mechanism that produces the antibodies with memory. If there weren’t, it’s my understanding that a vaccine wouldn’t be possible. But it does not appear to operate at all evenly across the human population as a result of infection and recovery. A well-designed vaccine would have a much higher and more consistent rate of effectiveness. The early data also present a clear warning: If you’ve had COVID-19 and recovered, DO NOT assume you are immune! Wait until tests and supporting data clearly support the likelihood that you personally are immune.

So what do we need to do? The answer is not a mystery. It’s perfectly straightforward. We need to do what most other countries are already doing or preparing to do. First we must suppress the initial outbreak. That means a full lockdown until virus levels fall to whatever our capacity in an area to perform the second step might be. (That will not be consistent around the country.) We have not yet suppressed the initial outbreak anywhere in the United States. We are still at step one across the entire nation.

The second step is containment: test, trace, and isolate (TTI). It requires extremely widespread and easily available testing with reasonably rapid results. Some places, like nursing homes, will require multiple rounds of 100% testing of staff and residents. Health care workes require regular universal testing. Everyone working in close, frequent contact with others must be tested regularly. Test. Test. Test. As much as possible of the entire population in a region must be tested over time and continually retested. Every positive must be isolated until they are recovered and all their contacts who might possibly also have been infected must be traced, tested, and isolated as well.

If TTI fails in an area and containment is broken, the virus will begin to spread again in an uncontrolled manner. Once that happens and testing detects it, the area must immediately go back into full lockdown mode until the new outbreak is once again contained. However, even with full TTI in place, it is not likely that all restrictions will be able to be relaxed anywhere.

That cycle will continue until a vaccine is discovered and through vaccination herd immunity is achieved without mass death and suffering. That is and has always been the only moral choice and if this virus is as contagious as it appears to be, it’s also the only practical choice.

Those who do not follow those steps will see their hospitals overrun and their death rates skyrocket precisely as we saw in Italy, Spain, and New York. It’s not a question of if; it’s a question of when. And right now, the ‘when‘ is only weeks away for many parts of this country.

Discovering I’m Autistic During the Rise of American Fascism

In the past year and a half, my personal self-understanding has increasingly been framed and explained through the lens of my discovery that I am and have always been autistic. That personal journey has been juxtaposed against the national resurgence of fascism, active white supremacy, and neo-nazism respresented and fueled in the mainstream primarily by and through Trump, white evangelicals, and the GOP.  That deeply personal revelation and our ongoing national tragedy have been intertwined in my experience and perception almost from the outset.

You see, I know my history.

For some reason, many people don’t seem to be aware that the Nazis didn’t only target their Jewish citizens. A number may be aware that they also targeted homosexuals. Comparatively few seem to know about the “Law for the Prevention of Progeny with Hereditary Diseases” instituted in 1933. The law instituted mandatory sterilization for people with conditions considered inheritable. That included people with learning disabilities and mental illnesses. And the Nazi propaganda machine began actively targeting disabled people as a burden on society.

And that process of dehumanization culminated in “Operation T4” instituted in 1939. Operation T4 was the name given to the program of euthanizing disabled people. In the first two years, 70,000 people were exterminated, mostly using poison gas. That process of mass extermination was the precursor and test bed for their later “Final Solution”. By the war’s end, an estimated 275,000 disabled people had been killed.

But I really do know my history.

The state mandated eugenics movement originally took root and grew here in the United States. The first state level forced sterilization law was instituted in a state here in 1907. By 1931, 28 states had such laws. The Nazis modeled their law after the laws then in place here in the United States. Those laws resulted in the forced sterilization of over 64,000 people. The eugenics movement was at least partially discredited after the horrors of the Holocaust were revealed to the world. But forced sterilizations still continued in places in the US throughout much of the 20th century.

I knew my history. And I’ve always tried to stand with the marginalized and use whatever voice and attention is afforded me as a white male to help, or at least not hurt, groups with less privilege in our society. But the ongoing process of discovering that I’m autistic has also involved recognizing the way that very identity places me squarely in an often targeted group.

In the not too distant past, that would have been an interesting fact, but less directly relevant for me in my day to day life than for many other autistic people. I am older and well-established. I am white. And I am male. Individually, those all carry weight. Collectively, they are powerful indeed, much more so than an autistic identity I had long since learned to conceal to some degree and with some success from a hostile world.

But my autistic self-discovery has been juxtaposed at every step with the resurgence of hate and politically powerful authoritarianism in this country. Hate requires targets. Fascists and bullies love to target first those they perceive as weak or unable to fight back. As a result, the disabled are often among the first groups targeted. We witnessed ridicule of a disabled journalist first-hand from the candidate himself during the campaign. The GOP has been increasingly targeting the disabled for some time now. And those attacks have often been embedded in policy decisions in many spheres this year, even failed ones like the most recent attack on Medicaid by the GOP. Or rather, their failed attempt as of this writing. I’m not so naive as to believe they’ve given up.

And that reality has been a factor in a number of the choices I’ve made. While I haven’t actually told very many people in my personal life about my diagnosis, I’ve made no secret about it in my online life. I did not create a pseudonym and I’ve clearly published that fact in my various profiles. And I’ve created an online autistic footprint that cannot be retracted at this juncture. Work has an official coding system which is voluntary and kept in confidence, but used for aggregate reporting purposes. I updated that information. Those and similar actions place me front and center. If and when they come for disabled people in earnest and with targeted policy, I intend to be standing front and center. They will damn sure have to come through me if I have anything to say about it.

Or at least that’s my hope and intent. I have no illusions about my individual strength, power, or ability. I fade quickly in crowds. I’m confused and easily contained, at least in the immediate term, by direct confrontation. Hell, most days it’s a personal victory for me to overcome whatever resistance, anxiety, or fear makes it so hard for me to make a damn phone call. I’m not really a hero or defender, at least until or unless you threaten my children.

But I can write. Words are my tool and my soul. And I can place my name and my autistic identity in the public sphere. I can preemptively make myself a target who will be difficult to ignore when they do come for those with developmental disabilities. I don’t necessarily feel disabled much of the time, but that’s the appropriate socially constructed box for my identity. And the fascists don’t and won’t care how I feel.

I’m also not under any illusion that my actions will make a difference. I’m just one person. I’m just one voice. And while it helps immensely to be a white male in our society, it won’t magically amplify my voice or confer power I lack.

So why be public at all?

It’s something I can do. It will likely have little, if any, impact as our national descent continues. It’s not the only thing I can do. I can continue to write letters to Congressmen who will ignore them. I can donate where I think it might help. I can continue to vote. But I’ve lived an autistic life without the benefit of a descriptive label; I simply believed I was broken and deficient. Having discovered that I’m not alone, in a sense affirming that I’m really human, I want to stand with that group, whatever the cost.

GOP Lies: Social Security

While it’s true that these days the GOP relationship with truth and reality has become strained to the point of non-existence, their lies about Social Security stand out as both particularly egregious and especially cruel. Moreover, much of the time, the worst of these lies are simply allowed to stand, relatively unchallenged. Yes, attempts to debunk them exist, but much of the public discourse either treats the claims as fact or allows them to stand as reasonable arguments.

In this post, I hope to debunk some of the worst of the assertions. Few people read my blog, so I don’t expect to have any particular impact on public discourse. But at least I’ll have a post which I can reference in future discussions.

First, there are no major structural deficiencies in Social Security that form an impending crisis. If you examine most of the discussions, you’ll find an often unchallenged assumption that Social Security has major problems. That happens in several interesting ways.

One common tactic involves the use of the broad term “entitlements” to lump Social Security, Medicare, and remaining social welfare programs like Medicaid, SNAP, free/reduced school lunches, WIC, and TANF together into a single large pool. When politicians speak generally about “entitlement reform” they are engaged in a form of newspeak deliberately intended to make their constituents believe they are talking about cuts to welfare programs for the “undeserving” rather than Social Security and Medicare.

Of course, that particular deception only carries them so far, as George W. Bush discovered when he tried to attack Social Security directly. Most Americans, including most GOP constituents, understandably responded with outrage. Interestingly, the GOP learned that lesson and proceeded to abuse it in 2010 with their coordinated and well-funded attacks against the ACA. (Anyone who confuses the Tea Party with a “grass-roots” movement is, frankly, either dishonest or an idiot. It was a well-funded and coordinated nativist movement playing off fears and prejudices that ended up spinning out of control and attacking its host.) That’s why we saw people earnestly waving protest signs that said patently absurd things like, “Keep the government out of my Medicare!”

And that’s the grain of truth embedded in the term “entitlement”. The overwhelming majority of Americans now view Social Security and Medicare as something they’ve somehow “earned” and thus do not consider them “government programs”, but rather something to which they are “entitled”. And in a sense I agree with that broad attitude, but not because any single individual has somehow “earned” their benefits. Rather, Social Security represents a form of “pay as you go” social insurance. Collectively, we all contribute throughout our working prime to support those who are past that prime, surviving spouses and minor children of those who die during those prime years, and those who through disability are fully or partially unable to work. And we then reasonably expect our society to provide us those same benefits when we or our loved ones require them.

Lumping all those things together and then claiming that “entitlement” growth is out of control represents a deliberate effort to make people think a given pundit or politician is talking about whichever group the hearer considers the “undeserving” in order to set up a pivot toward dismantling Social Security. So far, at least, those efforts have been unsuccessful. That does not mean they won’t be successful in the future. The reality, of course, is that the only program growing at unsustainable rates has been Medicare. The ACA appears to have had some impact on that growth rate, but it was never designed to fix our entire health care system, so its impact will likely be limited. The problems in Medicare actually reflect the broader problems in our overall health care system. Out of all the components that make up that system, Medicare is actually the most efficient. It’s certainly not the cause of the problem and while it can impact it to some degree, Medicare can’t by itself fix the system within which it operates. But that’s a topic for another day.

More recently, proponents for dismantling Social Security have been asserting that there are major structural deficiencies in Social Security and we need to make major cuts in benefits before the whole thing collapses. They might blame changing demographics while pointing to assumptions made back in the early decades of Social Security to support their wild claims. There is, of course, one major problem with all their hand-waving and bellicose grandiosity.

We already reformed Social Security to correct its structural defects in the 1980s. Sadly, many Americans seem completely unaware not only of historical events, but even those events that have happened in their own lifetime. By the 80s, the children being born were in the generation that would come to be known as the Millenials. There was no demographic surprise about the small size of Generation X relative to the Baby Boomers. The entire reform effort was a pretty big deal involving lots of analysis and input from all sectors in a truly bipartisan effort. (This was back well before the GOP went completely off the rails.) And it was successful.

In fact, there is only one structural problem that has arisen since that reform. And that problem is directly related to the extreme explosion of inequality, in itself also a direct result of government policy, in our country. One of the decisions made at the time was to cap overall earned income subject to the Social Security tax at 90% of all earned income. While the cap was indexed to inflation, nobody anticipated that income at the top would grow from 11% then to roughly 25% of all annual earned income today. That concentration of income has reduced the overall percentage of income subject to the social security tax from 90% to 83% and falling. While that’s not sustainable over the course of decades, the fix is simple. The cap must be adjusted so at least 90% of all income is subject to the tax again.

Personally, I believe the cap should be eliminated altogether. After all, we don’t cap the Medicare portion of the tax. But a compromise that would compensate for the years we’ve collected less than 90% while ensuring that at least 90% of all annual earned income is subject to the tax moving forward would fix the only structural problem that has developed in Social Security since the last major reform. It’s worth noting that this problem could also be addressed by reducing the concentration of earned income at the top. So addressing our current extreme inequality would also “fix” Social Security.

While the current insane version of the GOP is obviously incapable of accomplishing even something that straightforward, it’s also not a crisis. Yes, we’ll need to fix it at some point over the next forty to fifty years and the longer we wait, the more expensive the fix will be. But it’s a problem we will still be able to fix at almost any point along the way. That’s what makes the frantic hand-waving so absurd. Think about it. The basic claim is that if we don’t do anything to fix Social Security, in four decades we might have to cut benefits. And their solution to that “crisis” is to cut benefits now.

As an aside, I can’t help but compare that reaction to the GOP take on an actual looming crisis with climate change. While the consequences of climate change will take decades to unfold, unlike Social Security it really does require action today. We spent decades reaching this point and even if we acted aggressively right now, it’s likely too late to repair much of the damage we’ve done. The longer we wait, the worse the consequences will be. Yet the GOP is in almost complete denial about that actual looming crisis in favor of ones with no basis in reality.

And that takes us to one of the most commonly promoted ideas for cutting benefits — raising the retirement age. I believe Jeb Bush most recently floated that proposal, but it’s widespread throughout the GOP and even among some so-called “serious” Democrats. But this proposal is actually deeply cruel. It’s simply not physically possible for many people to work much longer than they already do. Our bodies get old. They get weaker. And we become more prone to illness and injury. Nothing about that fundamental reality has changed.

While that’s most clearly true in physically demanding blue collar jobs, the impact is actually much broader. My oldest daughter is an intensive care nurse, one of the professional service occupations (though perhaps one not as widely respected as it should be). The job requires significant and ongoing education and skill. However it is also a physically demanding job. And even in the jobs, such as mine, that rely almost entirely on intellectual capability, we have no guarantees. Alzheimer’s is only considered “early onset” when it strikes before age 65. And that’s only one of myriad ways our ability to perform can be impaired by age.

Underlying these proposals to increase the retirement age is the idea that people are living significantly longer now than they did fifty years ago. That’s simply untrue and represents, at best, a naive understanding of life expectancy. At worst, it represents a prime example of what Mark Twain meant about lying with statistics. Dr. Aaron Carroll does an excellent job unpacking these statistics in his Healthcare Triage episode on life expectancy. He also includes other links on the topic. If you’re interested in the topic, check out his full post. But the video is included below.

We have greatly improved the average life expectancy at birth, but primarily by reducing infant and child mortality. The average life expectancy at age 65 has improved overall, but not by all that much. Moreover, the improvements are not evenly distributed across all groups and it’s actually fallen in some groups. Therefore, claims that we need to increase the retirement age because people now live longer are simply untrue. The only real question is whether or not the people repeating those claims are ignorant, misinformed, or lying — not to imply that those categories are mutually exclusive.

In closing, I’ll note that we actually have one of the lowest levels of effective social insurance in the industrialized world. Rather than trying to cut or limit Social Security, we should actually be working to expand and improve it. It has proven to be remarkably effective and efficient and is certainly one of the reasons the latest financial crisis did not spiral into another Great Depression. (Benefits like SNAP and unemployment insurance also mitigated the impacts of the financial crash.) It’s time to end the lies.

James Baldwin for Esquire Magazine in 1960

The below was posted by Kristin Howerton at Rage Against the Minivan. I decided to share it on my little blog as well. It’s sad that when you scratch the surface, there’s been so little change in fifty years. The below could have been written today.

Thoughts on Obama and the Current Political State

I posted the following as a comment on a post by Fr. Ernesto. I thought I would go ahead and publish it here as well. It may make more sense if you also read the post, but I think most of the thoughts stand on their own.

I believe DecodeDC has a much better reality-based analysis, particularly comparing the results of statewide referendums with elections results. I also agree with their analysis that it’s extremely unlikely the GOP will actually get the voter message polling indicates, especially since, ironically considering the election results, GOP approval is even lower than that of the Democrats.

https://soundcloud.com/decodedc/episode-59-gop-wins-bigbut-theres-more-to-the-story

With that said, your comment about Obama going down as one of the 10 worst presidents strikes me as laughable from a historical perspective. History focuses on the major achievements and failures of an administration. So far, at least, Obama really hasn’t had any of the latter — certainly nothing like Nixon or some of the others in the bottom ten. And he has some major wins in the plus column. What do people think of first when FDR is mentioned? The New Deal, of course, of which social security is one of the enduring aspects. LBJ? The Great Society, with its linchpins of medicaid and medicare. And while it falls short of those two measures, the ACA is easily third on that list for the past century. At least, I can’t think of anything else comparable. And the ACA is here to stay. Witness the way Mcconnell had to prevaricate in Kentucky on the issue just to get reelected or the comments of Kasich in Ohio. Moreover, Obama knows it’s his signature achievement, so I expect him to defend it.

Outside that, though much less sexy, Obama did achieve moderate financial reform. Dodd-Frank certainly isn’t the return of Glass-Steagal, which is what we really need. But it does have some real teeth and is a significant improvement over where we were. The Treasury Department and other agencies do now have real power to act in a crisis, which was a major question and issue in 2008.

He’s been fairly typical of post-Vietnam presidents on foreign policy. He’s at least avoided embroiling us in a foreign ground war on questionable pretexts like his predecessor, so that’s a plus. That could change still, I suppose, but hopefully not.

I’m not a particular fan of Obama and really wish a different Democrat had been president these past six years. I don’t believe anyone would have been much more effective against the scorched earth tactics of the GOP, but someone more seasoned might have avoided some of the mistakes Obama made during the first two years when he actually had a Congress in which he could accomplish something. The comparison to Clinton in the 90s is really an apples to oranges one. The GOP he worked with largely knew it still had to govern and tended to set some of its rhetoric aside once elected. (That was true even of the firebrands like Gingrich.) It looks like many of the current crop actually believe the nonsense they spout and intend to actually try to implement it, which, as Kansas and Pennsylvania have demonstrated, is a disastrous course.

I would tend to rate Obama right now somewhere in the middle of our Presidents with one really big, game-changing achievement.

Given that the GOP is unlikely to hear the actual voter message and nothing in their underlying demographics changed in this election, I predict they’ll continue their current course. And 2016 looks likely to follow the course of the last two presidential election cycles. Hopefully Democrats will learn something, but I’m not particularly optimistic about that either. Everything has been reduced to winning the next election and pretty much anything else has fallen by the wayside. Not sure what it would take for things to change.

It doesn’t help that we’re mostly down to two or three wings of one party rather than two actual parties. Democrats have mostly become the Wall Street friendly moderate wing of the Republican Party (with a few exceptions like Al Franken here and there). That’s certainly where Obama lies on the political spectrum. I guess when the GOP purged all the moderates from their party, they had to go somewhere. The GOP now finds itself almost in a war between its far right conservative wing and radical right wing factions. That’s the reason Boehner has had such a hard time since 2010 and I don’t see things improving with this election. As they’ve repeatedly demonstrated over the past four years, to the radical right wing faction, ‘compromise’ means getting what you demand in full without giving up anything. That’s why the GOP leaders have continually been forced to renege on negotiations. Personally, I don’t think that’s been all bad, since I thought some of the compromises Obama and the Democrats appeared willing to make in 2011 and 2012 were phenomenally poor ones. We were saved by the radical right wing’s apparent inability to accept victory with a few token concessions. The problem with no meaningful, organized pull from the left is that the starting point for any ‘negotiation’ today is actually right of center. So today, moderate right-wing Republican policy victories like the ACA are decried as ‘liberal’ because they are somewhat to the left of the now almost entirely far right GOP. (For anyone wondering, the actual left wing position for health care reform has always been some form of Medicare for everyone.)

At this juncture, I think the odds are in favor of at least one more government shutdown next year and perhaps more. I don’t expect much else to happen and I expect the plight of the American people to worsen. And I think plight is a good term for the current state of things. Most Americans now believe the next generation won’t do better than their own. And unless things dramatically change, I tend to side with them.

The High Cost of Being Uninsured

When people talk about the risks and costs of no healthcare insurance in the United States, they often talk about the risk of something catastrophic, such as a major illness or serious accident. Those risks are significant, of course, but I think there’s another major cost that isn’t being discussed nearly as much. If someone in the US doesn’t have insurance, they are effectively charged dramatically more for everything than someone with health insurance is charged. My wife has had a number of surgeries and procedures over the past few years, so I’ve been able to see that dynamic in action repeatedly, but it’s there with everything from ordinary doctor’s visit to prescription drug costs. If you look at statements, it’s usually called something like the “insurance adjustment” and it’s often massive. I’ve seen the adjustment equal nine-tenths or more of the billed amount.

Remember, this is the amount the charge is reduced before either the insurance company or the individual pays anything. And that single fact is massively important. Let’s say that an individual or family, even with the ACA subsidies, can only afford a bronze plan with a $5,000 or so deductible before it pays much. With subsidies, such plans tend to be pretty inexpensive and should be in the reach of most everyone. A lot of people look at that amount and think the plan doesn’t provide any benefits for them until they have more than $5,000 in health care expenditures.

Nothing could be farther from the truth.

Because of this hidden benefit of being insured, a single ER visit for a minor fracture with x-rays could end up costing hundreds, if not thousands of dollars more for the uninsured patient than for the insured patient even if the insurance company doesn’t actually pay a cent because the deductible has not been reached. Even the difference in the amount charged for a single, simple office visit will likely be more than a month’s subsidized premium for a bronze plan.

Now, if you think the above is a horribly broken system, then I agree with you. But that’s reality in the US today. And as long as that’s the case, the benefits of being insured in America don’t start when the insurance company begins paying. They begin immediately and you receive those benefits even if the insurance company never pays anything at all.

So if you still have no health insurance and either don’t think it’s worth it or don’t believe you can afford it, you need to reevaluate your decision. It’s invaluable and almost essential in the US as things work today and you really can’t afford not to have it.

Saturday Evening Blog Post – June Edition

In this month’s edition of the Saturday Evening Blog Post, hosted by Elizabeth Esther, I chose to share something different from what I usually do and add the link to my post on The Psychological Side of Celiac. The SEBP is a fun opportunity to share something you’ve written and read posts that others have written. Hop over to it and take a look.

Saturday Evening Blog Post – May Edition

In this month’s edition of the Saturday Evening Blog Post, hosted by Elizabeth Esther, I chose a post from my ongoing, though intermittent, series, Why I Am Not An Atheist. The SEBP is a fun opportunity to share something you’ve written and read posts that others have written. Hop over to it and take a look.

Saturday Evening Blog Post – April Edition

In this month’s edition of the Saturday Evening Blog Post, hosted by Elizabeth Esther, I chose my post, Speaking of God – Trinity. If that post interests you, consider reading my entire Speaking of God series. And a leave a link to your own favorite April post at Elizabeth’s blog.

If you’re interested in the whole Speaking of God series, here are the links.

• Speaking Carefully about God
• How to Speak of God
• Trinity
• A Good God

Pink Slime – But Not At HEB

ABC has been airing a series of reports on so-called “Lean Finely Textured Beef” better known as pink slime. In their initial report, former USDA scientists outline how the agency, which is supposed to be a regulatory agency but is in fact essentially run by the industry they purport to regulate, over-ruled their recommendations against allowing BPI to label pink slime as beef. Take a moment to watch the report and discover what you’ve been eating.

In the follow-up segment below, ABC checked with top supermarkets and Whole Foods to see which ones included pink slime in their ground beef. (And in this case, a refusal to answer is as good as an admission that they do.) Although we try to buy organic beef, I was very happy to see that HEB, the supermarket at which we shop, does not add pink slime to their ground beef. I would have to be pretty desperate before I would do any grocery shopping at a place like Walmart. (Of course, that was true even before this report. It just confirms that as a wise choice.)

And it also appears the schools will at least have the choice whether they get beef with or without pink slime from the USDA starting next fall. I only have one child left in public school and she can’t eat the food provided at her high school even if she had any desire to do so. But all parents who have kids who eat school lunches should contact their school districts and make their wishes known.

Of course, pink slime is only one problem among many in our poorly regulated, highly industrialized, and fundamentally immoral food production industry. (It can hardly be honestly called farming or ranching anymore.) When I look at the sheer scope of the depths into which we have sunk over the past four decades, it can be overwhelming. But all we can do is tackle one problem at a time as we try to restore some minimum level of integrity to our regulatory agencies and overall industry.

Personally, I think a great place to start is full disclosure. It should be easy for us to determine what’s truly in the “food” we’re consuming and everything about the way it was produced. GMO? Label it. “Natural flavor”? Fully disclose everything included in the flavors, including any binding agents. Make the categories simpler and require that products be appropriately placed. We have organic, non-organic, processed, and imitation foods. We need to have mandatory, easily understood, and well-defined categories like those. (We used to require that imitation food include that on the packaging. Removing that requirement certainly hasn’t made things better.)