A lead story on AOL last week was “Teen Dies from Vaccine.” Farther down in the story was the “admission” that no definitive link had yet been established between the vaccine and the girl’s death and that over a million girls had already received the British vaccine against cervical cancer. In the United States over the past decade, if not longer, a growing number of parents have been keeping their children from receiving vaccines for fear that the children will suffer adverse side effects, ranging from autism to death.

The problem with both the news story and the parental reaction is that they represent the equivalent of medical no-nothingism and an unwillingness to understand as well as a failure to comprehend the magnitude of what vaccines have prevented over the years. Many of the vaccines are administered to prevent what we in western European-derived cultures would term “childhood diseases,” with a feeling that such diseases are mild and would be an inconvenience at worst. Unhappily, this is an illusion.

I’m old enough to remember classmates in leg-braces and iron lungs as a result of polio, now prevented by a vaccine. My mother remembers classmates who died of whooping cough, and an acquaintance whose child was born severely handicapped because the mother caught the measles when she was pregnant. Now… those are anecdotal, although we tend to remember the anecdotes better than the statistics. The statistics are far grimmer, if less emotionally binding. Even today, whooping cough [pertussis] kills 200,000 unvaccinated children annually, mainly in the third world [or 2 million in the past ten years], and, in 1934 alone, before the vaccine was widely administered in the U.S., more than 7,500 children died from it. Measles killed thousands of U.S. children every year prior to the adoption of the vaccine. The U.S. averaged 30,000 cases of diphtheria annually, with some 3,000 deaths each year.

Are these vaccines safe, though, ask the skeptics? For roughly 99.9% of the population, yes, but there is always a tiny, tiny fraction of those vaccinated who may suffer side-effects, as with any medicine. The early version of the pertussis vaccine, for example, did have some adverse side effects, often severe, for a minute fraction of children, including, I might add, one of my own daughters, but those who suffered from such side effects were a minuscule fraction of those vaccinated, and in the U.S., that version of the vaccine is no longer used.

Despite years of overwhelming statistics and the reduction of death rates to the point where some diseases, such as smallpox, have been virtually eliminated, anti-vaccination advocates still proliferate, preying on the fears of those who understand neither science or medicine. The plain fact is that, no matter how “safe” a medical procedure or medicine or vaccine is deemed to be, there will always be someone — one of a very few individuals — who will suffer an adverse reaction. In comparison, for every food ever developed, there is some one who is allergic to it — often fatally — but we don’t advocate no eating wheat because some people have gluten disorders, or peanuts because others might die from ingesting them.

The problem with the media highlighting isolated adverse effects or deaths from vaccines is that — given the anecdotal nature of the human brain and the fact that anecdotes affect us far more strongly than do verified facts and statistics — such reports create and have created a climate of opinion that suggests people’s children are “safer” if they’re not vaccinated. The lack of vaccine-generated resistance/immunity in a population then allows the return and spread of a disease and, as I’ve noted above, such diseases aren’t anywhere as “mild” as most people tend to believe. After all, measles is estimated to have wiped out more than half the Native American population, and was documented in decimating the Hawaiian population.

Mild childhood diseases? Nothing to worry about? Just worry about the vaccines. Think again.

Amazon and other booksellers are offering enormous discounts on Dan Brown’s latest book, in some cases, according to the Wall Street Journal, at as low as 52% of the list price. Now, I’m not privy to the inside pricing discounts, but I’ve been led to believe that the top discounts to the major book chains are “officially” set at 47% off list price, and promotional and shipping allowances can add another five percent to the margin of the large chain bookstores. If… if that’s so, then the profit margin on The Lost Symbol is slightly less than $2.00 per hardcover.

Now, bookstores won’t sell my books for less than a margin of close to $6.00. So how can they possibly sell The Lost Symbol so cheaply in these times when book sales are lagging? According to all the trade press, they’re doing it in the hopes that book buyers will also buy lots of other books as well.

Well… maybe…

But consider the fact that The Da Vinci Code sold more than 43 million copies in hardcover in its first three years and that Random House held off issuing a U.S. paperback version for three years because the hardcover kept selling so well. If The Lost Symbol sells as well, and initial sales certainly suggest it might, even at the highly discounted initial sales price, the “profits” on the hardcover sales, of just one book, are likely to approach $100 million. Then, too, book stores have this habit of increasing the “discount” price after several months, and certainly after a year, and these back-end hardcover sales help boost total profits.

One of the problems with this kind of pricing is that it has a tendency to hammer the less profitable stores or chains, such as Borders. When a large chain, such as Barnes and Noble, is profitable, then a book like The Lost Symbol merely adds to those profits, and B&N can price aggressively to maximize total sales. In order just to remain competitive, however, a weaker chain, such as Borders, has to match the B&N price, and thus cannot price to gain a larger profit margin per unit sold. Since the chains have decided to compete primarily on pricing, and since Borders has bought into this, not that Borders has that much choice at this point, Borders is simply hanging on, trying to keep from losing more market share. Since B&N has something like 300 more superstores than Borders, often in generally better locations, overall, a blockbuster like The Lost Symbol may help Borders, but not nearly so much as B&N — or even Walmart, which doesn’t even try to offer more than a token limited book stock.

The other problem with this kind of pricing is that, overall, it reflects higher prices for hardcovers, because publishers tend to follow the “base prices” of the lead titles. Even if The Lost Symbol never sells at list price, all the other books of similar genre, size, and scope are likely to be priced within a dollar or two of the Brown book, and at most, they’ll be discounted at either 20% or 34%… and they might not even top out at the 528 pages of The Lost Symbol. This isn’t just an academic point, either, since there have been recent lawsuits over publishers’ discounting policies, particularly those involving the major chains and how they affect independent bookstores and smaller regional book chains.

Call the high discount on a blockbuster predatory… even short-sighted, but in terms of the competition it’s not insanity, and much as they’d like you to think so, it’s not even a loss leader. Lower-profit, but not a loss leader.

Lately, the health care debate has centered around the cost of health care insurance, and a number of commentators have made the judgment that the President’s or the Congressionjal plans ares “unaffordable,” but what exactly do they mean? Oh, I know, the idea is that people don’t have the money to pay for health insurance, and the dictionary-derived definition of “unaffordable” is (1) “to have insufficient means for” or (2) “to be unable to meet the expense of.”

The problem with this analysis and these judgments is that “unaffordable” runs a range of personal definitions from “it’s physically and financially impossible” to “I’d rather spend the money somewhere else because paying for health insurance will really cut our/my lifestyle.”

There’s no doubt that there are millions of people in poverty who simply can’t afford any form of health insurance, but based on my observations and experience, there are also millions who choose to gamble with their health care costs for any number of reasons. The problem with this sort of gambling is that society is left with the choice of either (1) picking up the costs in one way or another, either through higher insurance premiums for those who pay, or through longer waits and less adequate care for everyone, or higher taxes on lots of someones or (2) denying care to those who cannot pay, and letting people suffer or die. It’s politically quite clear that the second option is not feasible, at least not overtly.

Moreover, as health care costs continue to rise, and they will, given the remarkable advances in medical technology, insurance costs will also rise, and more and more individuals and families will be tempted to opt out of insurance as costs of care and insurance increase… because those costs will reduce the funds available for other goods and services.

Every day, my wife and I see this happening. I’ve mentioned how many students lack health insurance because their parents won’t pay for it, although most plans will cover [if the parents will pay] students through ages from 21-25. The university discontinued its student plan because not enough students would opt for it. In many cases, the parents have incomes above the cut-offs mentioned in the plans now before the Congress, but choose not to pay health insurance. They take vacations, buy new cars, and many even have toys such as snowmobiles and ATVs. Their children also have cars and cell phones and don’t have any trouble eating out whenever they want. They do protest that they can’t afford sheet music and text books, but they do have all sorts of electronic gadgets.

But… many of these people are among those protesting the President’s push for health care reform. People are now screaming that requiring insurance will squeeze people, force small business to close if they’re required to come up with insurance for employees, and they’re furious about the idea that those families who make more than $66,000 (or $88,000 in the other legislative proposal) will have to pay thousands in tax penalties if they don’t buy health insurance.

But who is supposed to pay for their health costs if something goes wrong… as it often does?

Let’s look at this in terms of a personal example. My wife and I are fairly healthy individuals, and for ten years after she took her position here at the university, we incurred relatively few major medical costs. Then some eight years ago, we took a vacation to Yellowstone. We were walking, not even hiking, along a gentle slope, and she turned to take a picture. Somehow, she set her foot down wrong and slipped, just slightly, and snapped her ankle and leg in two places. She wasn’t carrying extra weight; she was in excellent physical condition; and she didn’t have osteoporosis. It was just a freak accident. A year later, after two operations, months in a wheel chair, and physical therapy, she was finally able to walk close to normally… and, of course, after more than $40,000 in medical bills. We were insured, although the co-pay wasn’t insignificant, but the total wasn’t even close to the cost of more major medical events, such as trauma care from severe auto accidents or cancer treatments, etc. Exactly how many people have even $40,000 to spend on medical costs?

The total savings of the average 60-year old male in the United States amount to something like $50,000, yet the size of the average house has doubled in the last generation, and just compare the size of the “average” American car or SUV to a car of the 1940s or early 1950s. Credit card bills have skyrocketed… but millions of Americans are furious that government is trying to force insurance coverage so that those already covered — or taxpayers — don’t have to pay more.

As I discussed earlier, medical cost savings are close to a red herring. The rate of cost increases may be held down, but total medical costs aren’t going to decrease — not unless we decide not to treat people or to treat them a lot less extensively.

The entire issue is about who’s going to pay for what… and how, and all the arguments avoid that basic issue. Those who are covered now don’t want their coverage costs to go up and their benefits to go down, and those who aren’t covered seem to want someone else to pay for their care. In some cases, particularly in cases of documented poverty, it’s clear that people need help, but it’s also clear that there are more than a few people out there who claim that health care insurance is “unaffordable” because they want a standard of care they don’t want to pay for, and they resent the possibility of being told that, one way or another, they’re going to have to pay the bill one way or another.

So… the questions remain: “unaffordable” for whom, and why do so many claim it is unaffordable, given the American standard of living?

The past year has been filled with argument and controversy, the latest examples being all the violent arguments over health care reform and the outburst of South Carolina Congressman Joe Wilson — of “You Lie!” infamy.

We’re living in a time that’s becoming more and more of an “in-your-face” era, where the right to say and do anything in any place has become more and more apparent… and extolled as a societal virtue of sorts. This hasn’t happened overnight, of course, but the signs have been there. Some ten years ago, I was attending a community symphony performance of Handel’s Messiah. Unfortunately, a young man sitting in front of me kept talking during the singing. I tapped him on the shoulder and politely requested that he stop talking during the performance. He ignored me, and if anything, began to talk more loudly, as if the singers and I were intruding on his conversation. When I placed my hand on his shoulder, he became abusive and threatening for a moment… but he did stop talking — until after the concert when he suggested that my behavior was unbelievable and that if I weren’t so much older, he’d have knocked my block off — except his language was far ruder than that. He was disturbing everyone in three rows…if not more… but my asking him to be polite was absolutely insufferable? We’d all come to hear the concert, not him.

We have students texting in classes, shooting each other in schools and on the streets, and their parents threatening lawsuits against teachers who attempt to maintain discipline. We have talk show hosts and now politicians reaching new lows in their language and demeanor while effectively inciting violence or violent reactions to those with whom they disagree.

Less and less are people working things out, and more and more they shout, demanding that their opponents accept “the truth.” Since each side has a “truth,” all the shouting does is widen the gaps. “Tell it like it is” only means “tell it like I see it.” While there’s nothing wrong with telling your side of the story, it’s only one side. Sometimes, it’s the “better” side. Sometimes, it’s not, but the unspoken assumption today is that when “I” speak, it’s the truth, while “you” speak, you lie. And it’s far from persuasive when either side shouts the “truth.”

It used to be that what held groups together were small things, like manners, civility, a respect for the others as individuals, even when everyone’s views were not precisely the same. And there were people in those groups who tried to work out solutions on which most people could agree. And there was a recognition that resources were limited, and that not everyone could have everything.

These people, these manners and mannerisms, and these recognitions, were a form of glue, glue that held groups and societies together. The problem today is that everyone praises the individuals and the traits that divide society, and leadership seems to be defined by who shouts the loudest and in the most abusive manner, rather than by who tries to solve the problem. No one recognizes, let alone praises, the glue that once held us together.

How about a national day in praise of glue?

There’s a local primary election going on today where I live, and at least two of the candidates are running on a “common sense” platform. From what I can determine, and I know one of them fairly well, outside of the use of the term, their approaches to civic government differ considerably, but each is clear about the fact that he is the “common sense” candidate. But before I muddy the waters even more, I’d note that the dictionary definitions of “common sense” are “practical understanding” or “sound judgment.”

That said, after spending some twenty years in and around national politics, my instinctive reaction is to immediately distrust anyone who uses the term “common sense” in a political arena. The realistic translation of the term is more like: “Given my values, biases, background, and feelings, this is what makes sense to me.” The problem, of course, is that many of the rest of us may not share those values and feelings, and what is “common sense” to him or her may seem like anything but that to others.

Then, when you mix “common sense” with politics, unfortunately, the results are often anything but what reflects “sound judgment” on a larger scale. Why? Because politics requires compromise, and politicians tend to reflect the views of the majority of their constituencies, and those constituencies can and do have very different views. On the local level here, for example, the city council agreed to sell the condemned junior high school building to the university because renovating it would cost far more than building a totally new facility and because the empty building sat where it was surrounded on three sides by the university. On those grounds, the sale seemed to make sense… except the sole municipal swimming pool — which was not condemned — was located on the property. The university demolished the condemned structure and replaced it with a parking lot until the university could obtain the funding for a new theatre center [still pending with the state legislature], and leased the swimming pool back to the city for two years at a token fee.

The city council proposed to replace the swimming pool with a full-scale recreational center, including a better and larger pool, which seemed like a good idea to many, since there isn’t such a public-access facility of that nature closer than fifty miles away. One group in the community protested the spending of taxpayer funds at this time of financial difficulty as showing no common sense or fiscal restraint. Another group said that it was only common sense to have a recreational facility for a rapidly growing city — and to have a swimming pool to support the swimming programs at the two high schools, which have among the better swim teams in the state. A third group claimed it was only common sense to replace the pool with a better pool, but not to spend the money on a larger recreational center. One can cite “common sense” arguments for all three positions, but the debate ended up in a free-for-all requiring a ballot initiative on which proposal to adopt — which turned out to be, from what I can determine, a sort of compromise building that will be more than just a swimming center, but far from a full recreational center… and then last week, the council revealed that they’d under-budgeted for the facility now under construction.

So much for common sense — and this was just about one building in one small city/large town.

The current national debates involve far greater costs and complexity, and incredibly involved trade-offs between costs and life-and-death situations, and when someone starts in on “common sense,” take a good hard look at just whose “common sense” viewpoint he or she is espousing, because common sense evaluations rest on who gains and who loses, and what costs are borne by whom, and who “gets” and who does without.

And I won’t even call that observation “common sense.”