For a Republican presidential candidate, doing the decent thing turns out to be a political liability.
Perry faces several problems along these lines. The first was his decision to grant in-state college tuition to illegal immigrants. Perry gets attacked regularly from the likes of Romney and Santorum, and boos from the audience whenever he defends the plan. Santorum -- in a statement that reveals a bit too much about his own bias -- suggested that the in-state tuition “was an attempt to attract the illegal vote – I mean, the Latino voters.” The argument is that the in-state tuition only encourages illegals to cross the border with their kids in tow so that eventually their sons and daughters will be able to get the lower tuition not available to them if they stayed in Mexico. (To be eligible for the lower tuition, an illegal must have resided in the state over three years.) Of course, taking steps to see that kids who came into this country through no choice of their own get an education and the chance to better themselves is simply not heartless enough for many Republicans.
Perry also gets criticized for his executive order (never implemented) that mandated girls in Texas get the HPV vaccine. Michele Bachmann characterized the mandate as “innocent little 12-year-old girls” being “forced to have a government injection through an executive order,” putting Texas more or less in the same category as Nazi Germany. And, in an act of incredible irresponsibility, Bachmann claimed, against all evidence, that HPV vaccines can cause “mental retardation.” Meanwhile, cervical cancer strikes about 12,000 women a year and kills about 4,000. The vaccine will prevent the viral strains that cause about 70 percent of those cancers.
Perry also catches heat for opposing the colossally stupid 1200-mile fence along the entire Texas-Mexico border. Santorum says Perry is weak on immigration because he opposes the fence. I suppose we need go no further than Robert Frost: "Good fences make good neighbors."
Romney has his own problems with being a decent human being. He has to defend his universal health care initiative requiring residents of Massachusetts to buy health insurance. The result of this legislation is that more than 98 percent of Massachusetts’ residents now have health insurance, including 99.8 percent of all children, making Massachusetts’ rate of uninsured the lowest in the country. The plan has not contained costs as intended, but 88% of medical doctors in Massachusetts say that health care in the state is as good or better since the plan has been in place. In another demonstration of her higher intelligence, Bachmann claimed in a debate that the Massachusetts plan violated the constitution – but, on further questioning, could not cite which provision it violated.
On the other hand, if you want to avoid the boos and get the Republican crowd cheering wildly, you only need remind them of Texas's death row executions. In the September 7 debate, when moderator Brian Williams began a question by telling Perry that his state “has executed 234 death row inmates, more than any other governor in modern times,” sudden applause erupted throughout the audience.
10 comments:
Just to play devil's advocate, for so many reasons the HPV thing is pretty strange.
It's not completely clear why there should be a mandate for the HPV vaccine in the first place. The vaccine falls into a newish category of not readily communicable diseases. The justification of previous State vaccine mandates was that w/o such vaccinations children could get sick and - at school - endanger the wellbeing of other children. Essentially a civil liberties issue. We see this today with the MMR vaccine... parents, fearful of autism, aren't getting their children vaccinated, which is leading to increased rates of (readily communicable) measles, mumps, and rubella.
The vaccine is also expensive and complicated to administer. It costs $400 for the medication itself and is given over something like 6 months in three shots. So, it costs the state a lot, and invariably some percentage of children will not get all three shots.
Lastly, the PAP test is extremely effective in diagnosing pre-cervical cancer cells, and the incidence of those with cervical cancer is very very low among women who go for an annual PAP test. So, in many ways, the HPV vaccine is a solution looking for a problem... or, an expensive solution to a problem that already has a much cheaper solution.
My last gripe is a bit more speculative. We don't know how long the vaccine lasts. I think they know up to 5 or 10 years at this point, and it could potentially last a lifetime. But it could also last just 15 years, at which point you'd need to get a booster shot.
I know the real issue is that parents think the vaccine is a get-out-of-jail-free card for pre-marital sex... more troubling though is how quickly it's become a mandated vaccine - and the amount of lobbing on the part of Merk to get it there.
The real scandal regarding cervical cancer is that there are 50 million uninsured who can't get these necessary annual PAP tests.
As I was reading your comment I was asking myself, "Then what was the political/economic impetus behind such a thing?" and then you mentioned Merk.
What a clear, intelligent summary of the situation. You should send your comment into the NYT or some such place.
Why can't we find real news like this in the press?
Mike, For one, I am making the larger point of whenever any Republican candidate lifts a finger to do something at least ostensibly designed to help peoples' health or welfare, they immediately get branded as some kind of monster. The sorts arguments you make in your comment are not what the other Republican presidential candidates are saying.
In any event, perhaps this just reflects my lay ignorance. I know that the PAP test is very effective, and has dramatically reduced deaths caused by cervical cancer, and agree with you that insurance policies should cover them. The PAP test should be our first line of defense against cervical cancer.
The civil liberties issue, however, I'm not buying. It's like saying that wanting one's child to be taught creationism is a civil liberties issue. The fact is, the state already requires immunization against a host of diseases including tetanus, which does not qualify as a communicable disease. The additional intrusion of this HPV immunization imposes very little additional restriction on anybody's liberty.
I confess that I have not studied the pros and cons of the HPV immunization. All I know is that we were strongly encouraged by our pediatrician to have Ellen vaccinated against HPV, and that the Advisory Committee on Immunization Practices recommends the same. I, who have no medical training, am not going to second guess these folks
As I said in the original post, cervical cancer is the 2nd leading cause of cancer deaths among women around the world. In the United States, about 10,000 women get cervical cancer every year and about 4,000 are expected to die from it. According to the ACIP, studies show that the vaccine is both safe and effective.
Here's what Dr. Kenneth Alexander, a pediatric infectious disease expert at the University of Chicago Medical Center, told Reuters after Bachmann made her statement about the HPV vaccine causing mental retardation: "There are people out there who, because of this kind of misinformation, aren't going to get their daughter immunized. As a result, there will be more people who die from cervical cancer."
Myk, My point doesn't really fit into what you were saying, and it certainly wasn't an argument against your points. I should have begun my comment "As and aside...", so as to have been clearer. I was more just musing on the situation.
But I agree with you. Anything that seems to have a whiff of government-sponsored beneficence turns them into rabid dogs.
I'm not really up on the legal basis for mandatory child immunizations, but I've always been under the impression that they have a public health / civil liberties rational. Tetanus is a strage one, but obviously not as wrapped up in sexual politics like HPV, and therefore not something people would be up in arms about.
And I think the HPV immunization is probably a good bet - it's certainly safe and effective - but I think it is still a bet and not one that we are sure will be favorable in terms of cost/benefit. A large portion of these women will presumably still be getting PAP tests, so we aren't really taking some obvious cost off the books by providing this vaccine. And the cost we are adding ($400) is high on account of it being new and on patent. That money may be better spent on information campaigns targeting women over 40 to get PAP tests, or funding free clinics that perform this service in areas where rates of cervical cancer are high, for example.
I also suspect that the elephant in the room in these policy debates is that the vaccine prevents some of HPVs more visible, though non-life-threatening, side-effects. THAT may be where you get the savings.. less visits to the OB-GYN/dermatologist over unsightly warts. Who knows...
And thanks Jim.
Mike, On reflection, I think that I probably overstated my case and realize that we don't have much of a disagreement after all. For one, just because something is a good idea for people to do doesn't mean it should be required by law. I really don't know the pros and cons of mandatory HPV immunization. I at least agree with your logic that the administration of the vaccine is complicated, and unwilling participants will probably do a bad job of complying with the regimen, which won't help anybody.
I think, mostly, that I was reacting to Jim's comment following yours in which he immediately plays the cynicism card, suggesting that HPV immunizations are just another scam and a payoff to Merck. I just wanted to make it clear that, quite apart from the issue of mandatory vaccinations, HPV immunizations are not a scam and have value as a safe and effective way to prevent cervical cancer.
And, who knows what Perry's motivation was in issuing his executive order? In my limited experience of politics, what politicians love to do is line up their agenda so that they can do something that help both the public and themselves at the same time. And they try to avoid doing things that don't accomplish both ends. It may be that Perry saw his HPV immunization order as a way to both reward Merck and do something worthwhile for the public.
In 2009, Perry signed a bill into law mandating meningitis vaccines for all college students. Novartis Pharmaceuticals, one of the drug companies who made the vaccine, was also a handsome contributor to the GOP. Was this decision also politically motivated, or was Perry trying to save lives? The colleges my children attended had their own requirement that their students have meningitis vaccinations. Were these schools also paying off some debt to Novartis, or did they think the vaccination was just a good idea?
I think it's too easy to simply assume the worst of everybody. The fact is: motives are murky and usually mixed. As psychologists tell us, often people don't recognize or fully understand their own motives when they act. How is someone like me, who knows Perry only through the media, supposed to be able to figure out his personal motive?
And, how relevant is motive anyway? A policy which benefits the public doesn't lose its beneficial character because it was instituted as the result of some unscrupulous motive.
I believe your quote that except for psychopaths, people generally try as hard as they can to do what is best. (I know that is not the right quote. Help me out here.)
However, I recently watched Burzynski concerning the pharmaceuticals and the FDA. One can't help to be a bit skeptical after that.
The full quote is "Try to remember that except for a very few psychopaths, most people on most days are doing the best they can."
"I recently watched Burzynski concerning the pharmaceuticals and the FDA. One can't help to be a bit skeptical after that."
Was this in jest? I am really terrible at deciphering internet sarcasm. The Burzynski Infomercial was the FDA doing its job...hopefully we'll see positive trial 3 for the sake of cancer patients, willing to bet however trial 3 will reveal Burzynski as a seller of snake oil. If anyone want to watch the movie/commercial... http://www.youtube.com/watch?v=H0ibsoqjPac
"The plural of anecdote is not data"
No, this time it wasn't necessarily sarcasm—perhaps a little humor, but also skepticism over the motives of the big pharmaceuticals. Yes, it definitely was an extended infomercial of sorts. He very well may be a charlatan, but it also raised questions about the independence of the FDA as it seems to be financed in in part by the pharmaceuticals. I'm sure you understand the situation better than I.
Oh, I was probably further influenced by watching Vanishing of the Bees which also criticized the relationship between the FDA (and EPA) and the drug companies like Bayer.
I guess I was unaware until recently about all the money spent and the lobbying efforts by the pharmaceuticals to influence government decisions.
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