Last Friday night, the comedian and social critic Bill Maher stated that vaccinations for the swine flu did no good. In a discussion with heart surgeon and former Senator Bill Frist, Maher went on to say that immunizations aren’t that helpful for any diseases and then proceeded to claim that because the flu virus mutates so quickly, immunizations do no good. Maher ignored both Frist’s statistical proofs and his personal experiences as a doctor, dismissing the statistics out of hand and the experience as “anecdotal.” Not only that, but he apparently dispatched a twitter message to thousands suggesting that anyone who got a swine flu vaccination was an idiot. Since I’ve just recently discussed the ignorance of the anti-vaccine advocates, I won’t deal in detail with the medical side here, but with an equally troubling aspect of Maher’s totally false assertions.

Frankly, I’d always thought Maher was more intelligent than that, but clearly he’s out of his depth when talking about diseases. Yes, the flu virus does mutate, but the mutations in the course of a year don’t render the vaccination ineffective, and in fact, one of the reasons why young people, those under 30, are at so much greater risk than older adults is because those who are older have been exposed to flu strains and vaccines with similarity to the H1N1 strain, and those past exposures have given them greater resistance, and in some cases, immunity.

But what concerns me most about Maher’s ignorance and arrogance — and he was arrogant and patronizing in the interchange — was what it reveals about too many of the current generation of commentators and comedians. If I claim something untrue and libelous about someone, particularly in print, I could face a lawsuit and be responsible for damages. If Maher, or any other popular media figure, purveys blatantly wrong information that could lead to someone dying because they decided not to be vaccinated, there’s no effective way to prove that the individual refused vaccination solely because of Maher’s comments, even though those comments create and reinforce an unfounded belief among some segments of the population that vaccines are ineffective and dangerous. In effect, Maher and others who purvey falsely dangerous information get a free pass.

The First Amendment effectively guarantees the freedom of the press [and media] to allow writers and talking heads to spout any nonsense they want, but the problem with this is that in our media-driven culture, all too many people take as gospel what their favorite “talking head” says. That’s one reason why so many Americans believe things that aren’t true and that may be harmful, or in this case, deadly to them. Yet trying to legislate a fix here is far worse than the problem, because, unlike the case for vaccines, many public issues aren’t nearly so clear-cut as to what is “the truth,” and all too often government itself has a vested interest in misrepresentation.

Thus, public figures, whether they like it or not or whether they accept it, do in fact have a social responsibility not to set forth total falsehoods as truth. The right to freedom of speech may allow a freedom from moral and ethical standards of conduct, as too many public figures seem to demonstrate at least upon occasion, but those freedoms do not make the purveying of falsehoods ethically correct. And when a public figure forthrightly advocates a course of conduct that creates a public hazard or danger, the rest of us have a responsibility to bring such to light those falsehoods and misstatements.

So I’ll put it as clearly as I can. Maher’s words were not only flat-out wrong; they were blatantly socially irresponsible… and, with thousands of lives at stake, that is inexcusable.

The other day my brother and I were discussing social networking — Facebook, MySpace, Twitter, E-mails, etc., and he made the observation that, apparently for most people, “It’s important that you’re in touch, not that you have anything important to say.” Or even that you have anything at all to say.

Twitter is, of course, unless I’m already outdated, the latest phenomena, and it’s epidemic. But why? Messages are limited to something like 140 characters, enough to say, “Here I am in suburban metropolis, going to Vortex [or whatever]” or “At San Diego ComicCon, and Neil Gaiman’s here…” Why should anyone really care? And yet, they obviously do.

College campuses are filled with students, and more and more, they don’t talk to each other face to face. The moment a class lets out, most of them are on their cellphones — those that weren’t already texting under their desks in class — connecting to someone, and oblivious to anyone around them, so much so that students have been known to walk in front of oncoming cars… and not just occasionally, either. It’s not even remarkable when a high school girl receives something like 20 twitters/text messages in less than a half hour… or that none of them convey any information to speak of.

So… why are so many people working so frantically to “stay in touch,” especially given that it’s not that cheap? Since human beings come from simian stock, is this fad a form of “verbal grooming?” Or is it an attempt by the communicators to reassure themselves that they really do mean something to someone in a universe that we as humans have been forced to realize is so vast as to reduce even our entire solar system to comparative nothingness? Or perhaps an effort to fill some sort of emptiness with the sound of a familiar voice… or at least the letters texted by a friend?

It’s clear that I’m incredibly dated and old-fashioned, at least in the social communications sense, but I’d rather hear those words and voices in person. It’s not that I don’t have a cellphone, because I do. I just never carry it except when I travel. When I do travel, I use it to obtain information, such as directions to the bookstore I’m going to visit. Although I do know how to use a GPS and could certainly use an IPhone or a Blackberry, I’ve no interest in putting my entire life on one of them, not after watching what happens to people when they lose them or break them… or even when they don’t, because they’re always checking them, as if their communications device happens to be more important than the people around them. Just what does that tell you about how they feel about you?

I even forgot the cellphone when I went to WorldCon in Montreal, and it wasn’t even close to a disaster. Getting information from a live person suits me fine, but, with the increasing depersonalization of communications involving commerce, with the endless message menus, I wonder just how much longer that will be possible.

And yes, when I travel, I do call my wife to touch base — generally every night, not every five minutes. But that may be because we’re more connected in the ways that count.

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?