Where’s The Harm?

It has been pointed out to me that I’ve been hammering on the theme of people being credulous idiots lately, and at least a few people have asked me what the big deal is. It’s hardly as if willful ignorance is an invention of this new Century; people have been doing things that they know to be harmful to themselves or to the world at large for millennia, and the planet and the human race are both still here. But there were two stories that turned up on the news aggregation sites this week that I think demonstrate that our world really is getting more dangerous – and the penalties for refusing to face the truth are no longer limited to an increased chance of public embarrassment…

First, there was the story on Gizmodo (also mentioned on the Cracked website) about a line of stickers being sold through Gwyneth Paltrow’s website that are purported to somehow promote your health. The ad copy for these things originally claimed that they made use of a material used by NASA for space suits, but once the folks at NASA called shenanigans on that it was toned down to a more generic new-age pseudoscience word-salad. I’m calling this product an extraordinary example of harmful and malignant nonsense, not because there is any reason to believe that affixing stickers to your skin is actually harmful, but because this product sells for up to $120 USD for a package of 24. You could buy quite a lot of vitamins and nutrients for that kind of money, whereas these “health” stickers will do you approximately the same amount of good that you would get from just taking 120 dollar bills and setting them on fire…

The second story was a great deal less light-hearted: CBS News is reporting that the state of Maine has just confirmed its first case of measles in twenty years. There’s no word yet on how many people in the region may have been exposed to the disease, or how many of those people may have refused to vaccinate their children against this completely preventable and potentially fatal disease because a bunch of celebrities appear to have latched onto a single completely-discredited study. We are justified in asking whether any of this would be happening if people weren’t more afraid of a supposedly possible side-effect of the vaccine than they are illnesses that are known to have a non-zero chance of lethality, however…

Now, I will be the first to admit that I have no credentials in medicine or the life sciences, but as a management professional and a student of failure analysis I’ve learned more than I really wanted to about people doing things for the wrong reasons. The fact is that working out and eating well is difficult and time-consuming, whereas slapping a sicker onto your skin is easy. Learning about disease, immunization, public health concerns or statistical probability is hard; taking the word of some celebrity clown on television is easy. Working to make yourself better informed, better equipped, or more capable of dealing with problems is difficult; just believing what you want to believe for no apparent reason is much too easy…

It has been said by people much wiser than I am that belief in conspiracy theories is one of the ultimate ways of dealing with life as just one person among billions in the midst of a world that does not care about any of us. It you believe somebody is trying to trick you, then you believe that they care about you, you see. I would submit that embracing the belief that you know better than people who have spent years in medical school and decades in research is the ultimate way of declaring yourself a person of importance in a faceless society. But it’s also what gets you epidemics of obesity, opiate addiction, poverty, illiteracy, malnutrition, and diseases that were all but eradicated decades ago…

And if the same idiotic principles are applied to Global Climate Change, Civil Rights, International Relations, Wealth Inequity, Renewable Energy, Nuclear Proliferation, or artificial damage to other aspects of the Earth’s biosphere, then we really could be looking at the end of life as we know it on this planet…

Frankenfood

We’re starting to hear more and more loud wailing and gnashing over genetically modified food products, or “Frankenfood” as people on the “against” side of the issue delight in calling it. It’s tempting to dismiss these folks as neo-Luddite fear-mongers who are against these new foods simply because genetically modifying anything is unfamiliar and therefore scary. Unless, of course, you study history or have just been around long enough to remember how other “perfectly safe” miracles of science like DDT, thalidomide, or cyclamates worked out in the long run; in which case, it’s hard to blame people for being at least a little dubious. I still think the purple tomatoes are a nice touch, though…

A story being reported by the BBC Online site describes a new strain of purple tomatoes that have been genetically engineered to contain an anti-oxidant pigment which is believed to have anti-cancer benefits if consumed regularly. No one is really sure how much impact diet has on any form of cancer, let alone whether high levels of anti-oxidants will really help you avoid getting cancer; most of the evidence to date has been more along the lines of “we know these things are good for you in other respects, and they MIGHT help prevent cancer, so why not?” It’s a difficult argument to refute, really; if a single weird-looking fruit is good for your health, and might have anti-cancer benefits, where’s the harm in eating one? It’s not like this is some new scientific development that could turn out to have unexpected side effects later, is it?

Well, actually it is. There’s apparently also some debate about whether these actually taste like tomatoes, not to mention the fact that they look vaguely disturbing. But what makes this entire controversy so amusing is that up until the 17th Century, tomatoes were believed to be poisonous by many cultures, including Great Britain and its North American colonies. As it turns out, the leaves and stems of the tomato plant ARE poisonous (they contain glycoalkoloids), but the fruit is both safe to eat and actively good for you. There was even one celebrated case in the American colonies where a tomato proponent declared that he would publically eat a sack of the red fruits (to prove they were safe) while the local tomato detractors swore he’d keel over from the acid within the first few seconds. What seems to have gotten glossed over in the amusing historical accounts (and contemporary accounts) of this incident is that if our tomato fancier had tried eating the entire plant during his demonstration, it actually might have killed him…

So is genetically modified food any less safe than food bred to have specific characteristics of color, shape, size or flavor the old-fashioned way (e.g. through hundreds of generations of selective cross-pollination)? This remains to be seen, but I should probably point out that unless all of the food you’ve eaten in the last ten years has been taken from plants and animals you raised yourself, you’ve probably already eaten some of this stuff, and unless you move to a farm and start raising all of your own food through completely organic methods, there is a near-certainty that you will be eating some of these products again in the next ten years. Regardless of how we feel about Frankenfood, it’s already here…

I still think these tomatoes look disgusting, however…

Shooting the Flu

Readers of last year’s posts about the flu vaccines occasionally available to the public in this country will recall that I’m a bit skeptical about the whole thing – not because I’m a raving skeptic about most things (although I am) and not because I personally can’t use flu vaccines because I appear to be allergic to the compounds used to create them (although I am), but rather because just about every flu season we are confronted with stories about artificial shortages of vaccine, random pricing for flu shots (with as much as 400% price variance reported) or vaccines that don’t appear to work on this year’s strain of flu. It’s reading these stories in the news that makes the whole process so difficult to take seriously…

Now, it has often been pointed out to me that I lack any training in biology or medicine, and it’s probably unfair of me to judge this process on a purely business basis. This year’s story about the flu vaccines being off-target in Canada, which was sent out by The Canadian Press this week, demonstrates the point. Apparently there are three different families of virus circulating, each with many different specific strains, any of which may not be effectively controlled by any one specific iteration of the vaccine. It might be possible to combine multiple iterations of the vaccine into a single shot, but the story goes on to say that this might not help (you’d still need to get the specific iteration to kill the specific bug that’s attacking your system), but it would dramatically increase both the level of difficulty experienced in making the vaccine and the cost we’d be charged for it…

From a business standpoint, of course, the idea of a preventative product that costs a lot of money, can easily make you as sick as the disease it is intended to prevent all by itself, and has an excellent chance of not working in the first place seems so absurd that you’d have to wonder why anyone is even allowed to sell it. From a medical standpoint the concept of a treatment that has a nonzero chance of preventing a debilitating (and occasionally fatal) illness from infecting the patient is a wonderful thing, particularly when you consider all of the debilitating (and occasionally fatal) diseases for which there is no such preventative, and the possibility of the shots not working is a non-issue, since the field can never offer an absolute guarantee, anyway. From a consumer standpoint, it probably comes down to a judgment call…

If you’re one of those people in the high risk group, the chance of having to deal with a mild reaction to the flu shot is probably worth avoiding a severe reaction to the virus (e.g. several weeks in bed, pain and weakness, occasionally death); if you’re young, vigorous, disease-resistant or all of the above, it might not be, and if you’re allergic to flu shots then the whole matter is irrelevant. The point is that this is another one of those decisions that can not be made on a cost-benefit basis, or indeed, on any type of business basis. As absurd as it might seem to purchase a product on the terms offered for flu vaccines, the idea of letting an insurance or health care company make that decision for its customers on a cost-benefit basis is completely repugnant...

In the long run, if you want to take your chances on a flu shot that may or may not even work on the strain of flu you encounter, that should be your choice, and you shouldn’t be thwarted by profit-seeking insurance companies or pharmaceutical laboratories that can’t seem to make enough vaccine to last through the winter without accidentally tainting a huge lot of it. I’m just going to keep warm and take a lot of vitamin C…

The Hidden Costs

I was reading an article about the cost of school lunches going up when it occurred to me that the new energy crisis is going to change everything -- not just in car-oriented Los Angeles, but everywhere in our country. And it will hit everyone, even those people who were foresighted enough to buy fuel-efficient cars in an attempt to minimize the rising cost of gas. The sad fact is, even if you are running your personal transport off of used fry oil from the dive down the street, this one is still going to bite you...

Now, I don't mean to suggest that the school lunch story itself isn't a huge issue; worth far more attention than the few lines I'm giving it in this one obscure blog. The simple fact is that these subsidized meals have a huge place in the lives of the very poorest children in our society, in many cases making the difference between life an starvation, and even the most cold-hearted pragmatist can grasp the advantage of eliminating expensive crimes (to obtain food), expensive court costs and incarcerations (when people are tried and imprisoned for stealing food), and expensive treatments for deficiency diseases (when children do not get the right food). It’s even relatively easy to convince people that keeping these kids in school has both short-term (they stay out of trouble now) and long-term social benefits (they have a better chance of getting jobs later), and that getting fed is one of the most immediate reasons for going anywhere in the human experience…

But there’s not much point in making an argument if no one is going to take the other side, and in this case the only people who are going to argue against subsidized school lunches are a handful of neocon extremists (who hate every program that benefits anyone less fortunate than themselves – government subsidies are for giant corporations, not kids!) and a handful of delusional do-gooders who somehow feel that if school lunches were not made available, these kids would get better food (from where remains a mystery). Let me instead point out that one of the major costs cited in the article is an increase in the delivery costs of food, and that the cost of fuel is in fact driving up costs in all aspects of our food supply chain (e.g. tractor fuel costs more, delivery truck fuel costs more, energy to run food processing plants costs more, energy to run supermarkets costs more, and so on)…

And that’s just the tip of the iceberg…

Unless you purchase everything you buy direct from the factory, the cost of bringing your goods to market is going up. Unless the factory gets all of its raw material from the fields behind it, the cost of getting the raw materials to the factory is going up. Unless the factory runs directly on solar, geothermal or hydroelectric power, the cost of making your goods is going up, and so on. The fact is that for decades the U.S. economy has run on the basis of unlimited cheap energy, and now that energy is no longer unlimited (or cheap), the whole house of cards is starting to come down around our ears. And with China, India and other emerging countries likely to continue increasing their own demand for energy, this trend is unlikely to reverse itself…

This is not to suggest that we should deal with the crisis by running in circles making little shrieking noises. What I mean to suggest in this particular rant is that the world in which we live is changing before our very eyes, and like the people living in any other time of dynamic change, we must adapt to it. And in this particular case, when all of the politics and social engineering are over and done, it is going to fall to us, the business people and management professionals of the world, to find a way to make it all work again, or at least function in some acceptable new way, under these harsh new conditions. But if we can’t do this without destroying those programs (like the school lunch program) that keep our most vulnerable and fragile citizens from suffering and dying, then we have already lost…

Public Health and Ethics

There has been a lot of ink spilled lately about the preparation of flu shots for the upcoming flu season, with many agencies in the United States advocating that anyone from an at-risk group (e.g. small children and the elderly) be immunized, and since this year it looks as if there will be enough vaccine to go around, anybody else who is likely to be exposed to the flu get vaccinated as well. Some companies and agencies are offering flu shots essentially at cost; a number of retail establishments have been using them as “loss leaders” – merchandise offered at below cost as a measure to bring people into the store, where they will, presumably, make additional purchases at regular price. Other sources are offering the shots at a reasonable markup, and many insurance companies cover these vaccinations through regular health care providers.

It seems like a good idea, if you consider the statistics. The World Health Organization estimates that there are 25 to 50 million cases of influenza in the United States each year, resulting in 150,000 people being hospitalized and 30,000 to 40,000 dying. On a global scale, WHO estimates somewhere between 3 and 5 million people will be ill enough to require hospitalization (whether they get it or not) and as many as 500,000 will die. Historically, there were about 1.5 million deaths in the 1957 flu season (the so-called Asian Flu), and about 40 million in the 1918-1920 Spanish Flu epidemic – more than the total number of soldiers killed in both World Wars combined. In fact, the WHO estimates that more people have died in the last hundred years from the flu than perished in the Black Plague outbreaks.

So why is this an ethical question?

The problem here is that the people who are advocating that the public all get flu shots, advertising the effectiveness of flu shots, and lobbying politicians at various levels to support influenza immunization programs are the same companies who are making the flu vaccines in the first place – and that none of these companies are nonprofit organizations. Here’s a typical example: the website about influenza paid for by Sanofi Pasteur. The wide availability of these vaccines, and the large number of potential sources for them, helps keep the price down, but these companies are still urging the public to make use of a product on which they make money, for the public good.

It doesn’t sound like a big problem; influenza is a genuine risk to public health, and the vaccines really do help to prevent it. But this is a slippery slope argument; it’s one very small step from there to advocating that any product your company makes that could prevent illness or improve overall public health be universally purchased, and only a slightly larger step from there to arguing that any product or service that serves the public good (anti-missile defense units, oil wells in sensitive public lands, hidden surveillance cameras build into all public places) be made available as a public service. The debate over socialized medicine is full of these sorts of questions, and I don’t propose to settle or even raise that issue here; my question is much simpler: Is it ethically sound to permit people to advocate an action that will earn them a large profit as being for the public good? Even if it really IS for the public good? And if so, where do we draw the line on companies charging money (often very large amounts of money) to relieve human suffering? It’s not as simple as it looks…