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business carbon emissions economy education growth healthcare immigration income inequality poverty Presidential debates Rule: Ask The Question Rule: Cite The Basis terrorism

Town Hall Debate: Public Asks The Questions

For the second Presidential Debate, which will be in a Town Hall format, half the Questions will come from the public. You can still get yours in by submitting them to this site. I’ve included mine below. Some are from my previous blog since they were not asked in the first debate.

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Environment

Background: Renewable energies have become more cost effective than fossil fuels in price per mega-watt hour, with wind & solar thin film at $55 & $43/MWH, vs. gas & coal at $65 & $108/MWH, respectively.
Question: How much will you invest in renewables, and how many new jobs would that create?

Background: Many politicians, Democrat and Republican alike, publicly support taxing carbon as a way to incentivize fossil fuel industries to cut carbon emissions.
Question: Do you favor a tax on carbon, and if not, how would you fight climate change?

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Immigration

Background: Immigrants are twice as likely as US-born to become entrepreneurs, and half as likely to become incarcerated. They pay more into Medicare, Social Security and taxes than they receive in benefits.
Question: Do you support a path to citizenship for unauthorized immigrants and what is it?

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Healthcare

Question: What is needed to stem the costs of healthcare, while still covering everyone?

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Economy / Jobs / Inequality

Background: Historically, healthy GDP growth was at least 3%. In the last several years, it has been stalled at less than 2%. The projections for this year are 1.6% (IMF) and 1.8% (Federal Reserve).
Question: How would you increase GDP growth, and what data or studies support your ideas?

Background: Small businesses comprise 39% of GNP, 52% of all U.S. sales, and employ 54 million people (57.3% of private workforce).
Question: How would you foster small business growth, and what data supports your ideas?

Background: The Earned Income Credit supplements low income worker’s wages, but the Guaranteed Minimum Income covers the unemployed well as low income employed, and is actually backed by many Republicans.
Question: Do you favor the Earned Income Credit, or a Minimum Income to help the poor?

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Education

Background:  The quality of education is critical to a nation’s economic health and standing in the world.
Question:  If investing in the future is important, what would you do to improve education?

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Terrorism

Background: Terrorists have been known to use US aggression against them as a recruitment tool for other terrorists.
Question: How will you effectively fight terrorism without fueling further recruitment?

Background: Wars have proven too costly to fight, but we have other options to draw on for our security: partnering with allies, intelligence gathering, foreign weapons sales and foreign military training.
Question: How would you fight terrorism, while minimizing spending and lives lost?

What are your Questions?

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healthcare Rule: Ask The Question Rule: Cite The Basis Rule: Correct Inaccuracies Rule: Cover The Topic Rule: Mountain Out of Molehill Rule: Out of Context Rule: Sin of Omission vaccine autism link

Toxic Vaccines? : Frank Bruni vs. Robert Kennedy Jr.

There is nothing more exasperating than seeing a news report on an important but esoteric subject that includes controversy and competing facts, and having no better sense at the end of it, what the truth is. Such describes the media coverage of vaccine safety which was recently elevated in the news after California made vaccination mandatory for children attending public or private schools.

I am not an expert in medicine, economics, the environment, or any other such field, any more than I am a journalist, and I can’t take time to become any of these just to prove that the media is falling down on the job. This is the whole point of Advance The Dialog–neither I, nor the public, have the time or imperative to get to the bottom of complex issues on our own. We are too busy living our lives. The media, however, does, and their failure to do so puts the public in an untenable position.

A review of my through-the-looking-glass quest for the truth on toxic vaccines proves the point.

The weekend following CA’s new vaccination law, I came across 3 articles that touched on it. Two of them were in the San Jose Mercury News– 1 profiling a CA state senator & pediatrician’s fight for the bill; the other, an editorial by a university professor & health org VP who declared mandatory vaccination a “moral choice”.

The first article discusses sensationalist aspects of the vaccine controversy, including “anonymous death threats” the senator received, his “coolness under fire”, accusations of his taking bribes, and more. The second one asserts that the benefits outweigh the risks, and cites a discredited 1998 study linking mumps vaccine to autism as the main justification used by vaccine-choice advocates. It also cites the book “Deadly Choices” as clarifying the misunderstandings and “flawed science” that fuel the vac-choice movement.

Okay, the first is meant to be just a profile, the second does cite 2 bases to make it’s point. Despite that, science-lite doesn’t cut it since: (a) the issue is too important, and (b) we have no way of verifying what is true (short of reading “Deadly Choices” & other books, thus becoming an expert!). Avoiding the science behind the vaccine controversy over an extended period of time is a Sin of Omission, rife in the media. In addition, mischaracterizing the controversy as ‘safe vaccines vs. no vaccines’ is a False Choice and misleads the public since toxins can be removed from vaccines, making it a ‘safe vaccines vs. unsafe vaccines’ debate.

But the third article was the real whopper. In his July 5, Sunday NYT column, Frank Bruni launched a broadside against Robert Kennedy Jr., and his fight to remove thimerosal (which contains mercury) from vaccines, offering very little substance. In the 1,153 word article, he bestowed a mere 48 words on scientific ‘fact’, writing: “As it happens, aluminum isn’t present in all vaccines and not all mercury is created equal and equally risky”, and “The problem isn’t just that most respectable scientists reject any such connection, but also that thimerosal has been removed from — or reduced to trace amounts in — most childhood vaccines.”

His shortage of facts notwithstanding, Bruni does cite those few things which, if true, sound reasonable, right? Maybe, until you see RFK Jr.’s response, that is.

Kennedy, who is not anti-vaccine, just pro safe-vaccines, writes: “In fact there are massive doses of mercury in some meningitis vaccines – now mandated for all schoolchildren in New York – and in vaccines given to pregnant women, infants, and annually to public school kids.  Mercury remains in mandated pediatric HepB, HIB, and DTap vaccines at double the concentrations deemed safe by EPA.  To [] those vaccines, pharmaceutical companies recently added aluminum adjuvants that [] dramatically amplify the neurotoxicity of the remaining mercury. Finally, pharmaceutical companies merely reduced mercury levels in [] vaccines [for] American children. We continue to send [] pediatric vaccines fully loaded with mercury to children [] in Asia, Africa, Latin America, and the Middle East, a practice that will haunt our country in many dreadful ways.”

He adds: “In defending thimerosal safety, Bruni alludes to the debunked industry canard that the ethylmercury in vaccines is less persistent in the body and therefore less toxic than the heavily regulated methylmercury in fish. However, the best and most recent science shows that ethylmercury is twice as persistent in the brain (Burbacher et al 2005), and 50 times as toxic as methylmercury in fish (Guzzi et al 2012).”

So, far more specific data being cited (and sourced!) than in Bruni’s column. Kennedy takes the lead. And it’s just the tip of the iceberg. Reading the rest of his rebuttal, plus his Mercury & Vaccines page, he offers a mountain of evidence, all sourced, including for his claim: “thimerosal [is] linked to neurological disorders now epidemic in American children, including ADD, ADHD, low IQ, speech development delays, and tics.” Summing up, Kennedy says he and his team “found no published study proving thimerosal safe.”

Bruni sources his claims and position only indirectly: “I sided with the American Medical Association, the American Academy of Pediatrics, the National Institutes of Health and the Centers for Disease Control and Prevention”–a Who’s Who of national health orgs, to be sure. But Kennedy answers, citing 4 Federal studies, which, along with an internal whistleblower, “paint CDC’s vaccine division a cesspool of corruption due to scandalous conflicts with the $30 billion vaccine industry.”

Nevertheless, it is hard to dismiss esteemed national orgs such as these. Presumably, they’ve looked into this and have data supporting their position that vaccines are safe. They would have had to, wouldn’t they? If so, then what is it? In this recent Washington Post article, Kennedy claims: “There are 500 studies that we’ve collected and footnoted [in his book Thimerosal: Let the Science Speak], and not a single one of them shows that thimerosal is safe [] except for the 6 studies funded by CDC and the vaccine industry [] that are fraudulent. And we explain how they created the fraud.” Pretty big claims to go unchallenged if they are wrong, wouldn’t you say?

Ironically, Bruni, a science journalist, disparages the safe-vacciners for using the internet for their research, calling it a “sinkhole for the gullible”. He writes: “The anti-vaccine agitators can always find a renegade researcher or random “study” to back them up, …confusing the presence of a website with the plausibility of an argument.” Yet he, a journalist, refuses to do the spadework–his job–for us. Hmm… physician, heal thyself?

You can see the impossibility of all this. It will take more than just citing this book, or that scientist, or that reputable organization, to get at the truth. It will take getting into the science and having the media interview experts, Ask Questions, Correct Inaccuracies, and call out Oversimplifications, Sins of Omission, Mountain Out of Molehills, and the like.

If you don’t believe me, do your own research (and become an expert). You can start with The Big Picture’s interview with Kennedy in the 2-part video below. In it, Kennedy lays out the entire uninterrupted history of the presence of thimerosal in vaccines, exposes compromised studies of its safety, and more. Also, check out the links embedded above and at end. I’ve added notes for easy reference, including quotes from Dr. Martha Herbert & Dr. Mark Hyman (both collaborators on Kennedy’s book), as well as the late Dr. Bernadine Healy– “respectable scientists”, all.

This controversy isn’t going away any time soon. Finding the truth is a process and Advance The Dialog provides tools. There is too much at stake here to ignore. When the debate between those tasked with knowing and verifying the science behind health safety (national health orgs, the news media) and advocates for the public (Kennedy, et al.) is this factually lopsided, I smell a rat.

ATD Rule breaks: Cite the (Scientific) Basis, the others mentioned above, plus Cover the Topic.

Additional Ask the Questions:
o What would the cost be to remove or replace the preservative Thimerosal in vaccines?
o What would the cost be for further ‘susceptibility studies’, as Dr. Bernadine Healy suggested?
o Are there other studies linking autism to something besides vaccines?

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Additional References

July 2014 Washington Post profile of RFK Jr.’s fight for vaccine safety:
From Dr. Mark Hyman (physician, founder & medical director of the UltraWellness Center): “The bottom line, we shouldn’t be injecting a neurotoxin into pregnant women and children. … the issue isn’t whether thimerosal is causing these problems [but] whether it is toxic and a potential contributor to neurodevelopmental disorders.”
From Dr. Martha Herbert (pediatric neurologist & autism researcher at Harvard): “We know from the biological literature that extremely low doses [of mercury] are harmful. … To me, it’s a no-brainer. Why would you put a neurotoxin in vaccines?”

April 2015 Sharyl Attkisson, “What the News Isn’t Saying About Vaccine-Autism Studies”:
Sharyl Attkisson: “To be clear: no study to date conclusively proves or disproves a causal link between vaccines and autism.”
Contains long lists of scientists who found possible autism link, the institutions and universities where research was done and some of the specific studies

May 2008 CBS’s Sharyl Attkisson interview of Dr. Bernadine Healy:
Bernadine Healy (former physician, cardiologist, head of NIH, president American Red Cross) quotes:
”We do have the opportunity to understand whether or not there are susceptible children — perhaps medically, perhaps they have a metabolic issue, mitochondrial disorder, medical issue — that makes them more susceptible to vaccines, plural, or to one particular vaccine, or to a component of vaccines, like mercury.”
“An [Institute of Medicine] report from 2004 basically said, ‘Do not pursue susceptibility groups. Don’t look for those children who may be vulnerable.’ I really take issue with that conclusion.”
“If you look at the the research that has been done, … the question has not been answered.”

April 2008 Bernadine Healy, US News & World Report, Health:
Healy: “Population studies are not granular enough to detect individual metabolic, genetic, or immunological variation that might make some children under certain circumstances susceptible to neurological complications after vaccination.”

Focus for Health (vaccine/autism site), 37 scientific papers linking thimerosal to autism

National Health Organizations:
Centers for Disease Control
“CDC, FDA, and the National Institutes of Health [NIH]) have reviewed the published research on thimerosal and found it to be a safe product to use in vaccines.”

Food & Drug Administration
“Lacking definitive data on the comparative toxicities of ethyl (contained in thimerosal)- versus methylmercury, FDA considered ethyl- and methyl-mercury as equivalent in its risk evaluation.”
“Blood levels of mercury did not exceed safety guidelines for methyl mercury for all infants in these studies.”
“The FDA is continuing its efforts to reduce the exposure of infants, children, and pregnant women to mercury from various sources.”
Contains Table of Thimerosal Content of Vaccines Routinely Recommended for Children 6 Years of Age and Younger

National Institute of Health
“Today, routinely recommended licensed pediatric vaccines currently being manufactured for the U.S. market are either thimerosal-free or contain markedly reduced amounts of thimerosal. An exception to this is the influenza vaccine, which is available in a variety of formulations, some of which contain thimerosal, while others do not. Thimerosal remains in some vaccines given to adults and adolescents, as well as some pediatric vaccines not on the Recommended Childhood and Adolescent Immunization Schedule.”

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healthcare Rule: Ask The Question

Vote on Ask The Question: Affordable Care Act

With the media’s focus on cancelled plans, higher premiums and the website launch, ATQ Poll turns its attention to other ACA issues:  Medicaid expansion, access to doctors and hospitals, and employer sponsored plans.

What benefits and costs (coverage, financial) do states weigh when deciding whether to opt in vs. out of ACA Medicaid expansion?

The goal of this question is to expose the decision making process that states use in determining whether to opt-in or out of Medicaid expansion, and to do so in clear, monetary/human, cost/benefit terms.

At last update, 27 states have opted-in for MC expansion, 21- out, and 2 (PA, TN) are on the fence.  The decision pivots on 2 considerations: the cost of expanding MC vs. not, and additional people covered with the expansion vs. not.

The terms of cost in ACA are:  the government pays 100% for 3 years, 90% thereafter.
Coverage:  CBO estimates 3 million people will be left uncovered in states that opt-out.

With such favorable terms for opting-in, and the high human cost of not, why are so many states choosing to opt-out?  It seems to come down to a cold assessment of whether the 10% saved in states that opt-out (starting year 4), will more than cover the ER expenses incurred by those left uninsured.

Some states claim that additional 10% will strain their budgets. Others (PA, AR) have requested funds for private insurance, leading one to Ask if that is more cost effective for them than MC, and how.  In this NYT article, the reasons against opting-in in Tennesee are left vague: Republicans are against it (why?), and a previous state system failed.  Groups in favor of opting-in include Democrats, the Chamber of Commerce, poverty & health groups, one of which claims 400,000 will remain uninsured and drive costs up with ER visits.

A refrain heard in the news and echoed by TN’s Governor, is that Medicaid does not control costs.  With at least as many claiming otherwise along with a plethora of other hotly contested issues, the media must start invoking Cite The Basis, Ask The Question, and other Rules if we are ever to resolve these disparities and further our knowledge on what specifically is good, and what is not, about Medicaid.

The News Hour provides an example in this discussion which, comprehensive though it is, still hilights such points of disagreement or lack of specifics where an ATQ or CTB could have illuminated so much more.

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Why are insurers dropping hospitals & doctors from their plans?

There have been numerous stories on doctors and hospitals being ‘dropped from plans’ but nothing explaining why.  The obvious guess is that it has to do with negotiated payment apportionment between doctors and insurance companies, the assumption being- they are less favorable to doctors under ACA.

In this CNN video, Tom Harris explains that he’ll have to find a replacement for his allergy doctor of 20 years, who is being dropped from his plan, and is too expensive without the coverage.

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His doctor, Robert Eitches says he doesn’t know “which, if any, insurance plans he’ll accept”, and “has already stopped taking Medicare” (for which the reimbursement rates to doctors have been lowered).  As for the insurance, his admission that he is considering “not taking any insurance at all” despite regretting the loss of patients he has bonded with, makes no sense whatsoever and is not followed up with additional questions or information from CNN.

Was Dr. Eitches ‘dropped’ from the plan by the insurance company?  Or were the terms changed that caused either Dr. Eitches to drop the insurance, or Mr. Harris to drop the doctor due to higher out-of-pocket expenses for him?  And if Dr. Eitches takes ‘no insurance’, does he not deny other patients his services?

In a CNN debate moderated by Candy Crowley, Sen. (& Dr.) Barrasso, states: “in New Hampshire, Anthem Blue Cross/Blue Shield is excuding 10 of 28 hospitals”.  Howard Dean’s response: “that’s the insurance commissioners fault”, is the only explanation given.  There is no follow up query from Ms. Crowley on what role insurance commissioners have, or what the “fault” of NH’s is.

How many businesses are reducing employee hours to part time levels and how many workers will lose healthcare coverage due to that?

Stories of employers reducing workers hours, or the workforce itself, to avoid having to insure them under ACA have been anecdotal and remain unquantified.  In an economy of high unemployment and where many of the ‘job gains’ have, in fact, been either low wage or part time, this is an important question.

In this CNBC segment, 2 surveys were compared.  One with 400 people participating showed a negative effect, the other with 60,000, showed no effect.

The impact of ACA on small businesses is shown from the business owner’s perspective in this interview of two of them.

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Matt Tyler, of Vickers Engineering, employs 175 people and says his insurance cost in 2014 will increase by 50% (11% taxes & fees, the rest ACA changes), and will be shared with employees.  He is further concerned about the lack of flexibility and growth of healthcare in future years.  Beezer Molton, of Half Moon Outfitters, has 120 employees, 90 of which are part time. He says they will adapt by pushing for still more part time employees to mitigate risk going into 2015.

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So, the initial impact of ACA is just beginning to be discovered.  One expert says it will take 3 years for ACA to ramp up.  Given the many testbeds in it for cost control, it will take that, and years more, for the system to settle out.  The issue of overall health costs is not dealt with in this poll, but it is one of the most important elements that will ultimately determine the success or failure of ACA. As with many complex issues, the consideration of time and long term thinking is critical in evaluating policy solutions, mandating the incorporation of it into any media discussions deemed honest.