Sunday, July 31, 2011

Back at the Cafe

I have another post up at the Episcopal Cafe.  It's about heat and hummingbirds and current affairs.  Go over and give it a buzz.

I do want to commend to your  attention Notre Dame’s Science of Generosity Initiative, to which I refer in the post.  It might seem a stretch to most folks to think about studying generosity scientifically.  On the other hand, there are many expressions of human behavior and human personality that we study.  We study hope and optimism.  So, why not study generosity?  Go over and browse for a while.  You'll find interesting papers to think about, and a blog that's updated regularly.  I think you'll find it interesting.  If you're at all like me, you'll find some of it just fun.

Wednesday, July 20, 2011

Costs and Effectiveness and Vaccine Policy

I have written before about issues related to the costs of vaccines (for example, here and here).  They are expensive to develop, and have inherent risks.  At the same time, they’re not the greatest profit generators, in part because they’re used once or twice, unlike, say, cholesterol drugs that patients take regularly for years and years.

Today there was an interesting story on NPR’s All Things Considered.  Titled, “Rising Costs Complicate Vaccine Guidelines,” it looks at a meeting of the Advisory Committee on Immunization Practices (ACIP).  According to the ACIP web site,

The role of the ACIP is to provide advice that will lead to a reduction in the incidence of vaccine preventable diseases in the United States, and an increase in the safe use of vaccines and related biological products.

The Committee develops written recommendations for the routine administration of vaccines to children and adults in the civilian population; recommendations include age for vaccine administration, number of doses and dosing interval, and precautions and contraindications. The ACIP is the only entity in the federal government that makes such recommendations.

The NPR story focuses on a difficult place in our health care: the point where we discuss balancing cost and effectiveness.  While the specific vaccine in the example is for meningitis, it offers a good examination of all those difficult questions: at what cost do we treat, and with what effect? Who makes that decision, and on what basis? Each decision has both costs and benefits, and each choice excludes other choices.

Take a few minutes and listen.  It won’t give definitive answers (although it does tell us what ACIP decided in this case), but it will bring us back to important questions.

Friday, July 15, 2011

Political Thought for 7-15-11 (2)

I want to propose a new definition of tax equity.  When folks talk about fair taxes, some talk about the actual amount paid, or the rate at which income is taxed.  Sometimes someone even talks about taxes paid as a percentage of income.  I want to offer a new definition: I want to tax the wealthiest at a rate whereby their tax bill will affect their purchasing power to the same extent as it does someone living on minimum wage.  Too much?  I'd be satisfied if it affected their purchasing power to the same extent as it does mine!  But, the true measure of equity would not be dollars paid, or tax rate, or even percentage of income, but purchasing power.

Political Thought for 7-15-11 (1)

I can't imagine voting for anyone who appears to have failed American History in high school and college - who imagines, as we have recently seen, that the families of slaves were intact in any meaningful sense.  I can't imagine voting for someone who doesn't remember from their class that the Gilded Age was only gilded for those who had the gelt.