A Stitch in Haste

Texas governor Rick Perry has mandated compulsory vaccination against human papillomavirus (HPV) among prepubescent girls:

By issuing an executive order, Perry apparently sidesteps opposition in the Legislature from conservatives and parents' rights groups who fear such a requirement would condone premarital sex and interfere with the way parents raise their children.

Beginning in September 2008, girls entering the sixth grade — meaning, generally, girls ages 11 and 12 — will have to get Gardasil, Merck & Co.'s new vaccine against strains of the human papillomavirus, or HPV.
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"The HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer," Perry said in announcing the order.

"If there are diseases in our society that are going to cost us large amounts of money, it just makes good economic sense, not to mention the health and well-being of these individuals to have those vaccines available," he said.

This is, of course, utter nonsense.

There is a very simple distinction between HPV / cervical cancer and the traditional childhood diseases such as measles, mumps or polio that we target for universal mandatory vaccination — HPV is not casually contagious; neither is cervical cancer.

Or, in the language of economists, there are objectively identifiable, and substantial, positive externalities to universal vaccination against traditional childhood diseases. No such externalities exist in the case of HPV and cervical cancer.

(Incidentally, the connection between HPV and cervical cancer is itself barely measurable. Furthermore, HPV infection is neither lethal nor debilitating; it is, in fact, generally asymptomatic. This is, for the most part, a faux crisis concocted by Merck to scare people into wanting its vaccine.)

It's unfortunate, meanwhile, that the opponents of compulsory HPV vaccination are not those who oppose the "compulsory" part, but rather the "vaccination" part (i.e., radical conservatives who irrationally conclude that vaccination will somehow catalyze teenage promiscuity).

If you follow Governor Perry's reasoning (which, ironically, sounds a lot like Paul Krugman's reasoning), then you must conclude that it would be also a proper function of government to require parents to force feed vitamins to their children, or to impose mandatory infant male circumcision. There is no cognizable difference.

After that can come mandatory daily viewings of Sesame Street, or violin lessons, or summer camp. For "the health and well-being of these individuals."

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Governor Perry mentioned "good economic sense" — especially for Merck and its conflict-infected lobbyists:

Merck has doubled its spending on lobbyists in Texas this year, to between $150,000 and $250,000, as lawmakers consider the vaccine bill for girls entering the sixth grade.

Also, the drugmaker has hired one of the state's most powerful lobbyists, Mike Toomey, who once served as Republican Gov. Rick Perry's chief of staff and can influence conservatives who see him as one of their own.

Mind-boggling. How skillful a hustler does Perry have to be to issue this executive order with a straight face?

All politicians are, by definition, moral defectives. So too, apparently, are their former chiefs of staff. And shame on Merck for their unbrazen and unethical rent-seeking.

(Latter links via Medpundit.)

UPDATE: Merck has suspended its lobbying efforts for mandatory vaccination laws, apparently in response to the public outcry after the Perry incident.

If the story of how Merck bought Texas Governor Rick Perry's executive order requiring an expensive and not entirely effective HPV vaccine for all schoolgirls couldn't convince you that all politicians are, by definition, moral defectives, then perhaps you should scroll down the playlist a bit:

Two state lawmakers backing a controversial plan to buy iPods for every schoolchild in Michigan were among a group of politicians who made a trip to California that was paid for at least in part by Apple, the maker of iPods.
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The $36-million iPod proposal was unveiled last week at a news conference called by [House Speaker Andy] Dillon to discuss the state's budget crisis and House Democrats' plans to address it.
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Dillon defended the trip in a statement issued by his office Tuesday night. He said he was "one of several lawmakers to take this trip, and I am more convinced than ever that the future for our children lies in education. As we move to the technology age and the knowledge-based economy, it would be irresponsible to separate technology from our K-12 system.

Sure -- and video games improve hand-eye coordination. Does that suggest taxpayer-subsidized Xboxes for every kindergartner?

And did you notice the "budget crisis" reference? Even if one could argue that iPods -- all 100 million of them -- are somehow a "market failure" inviting government subsidization, is a budget crisis the best time to commence the subsidization?

Just because a good or service helps children learn does not make it a public good. A pebble of (potential) positive externalities, drowned in an ocean of strictly private utility, is not an automatic prescription for taxpayer underwriting. iPods may be a great learning tool, in between playlists. All the more reason for parents to pay for them rather than taxpayers.

Shame on Apple for its despicable rent-seeking. And shame on these politicians for using schoolchildren as an excuse to yet again bilk taxpayers to feed their political egos.

(Via Raw Feed by way of TechDirt.)

Remember the controversy when Texas Governor Rick Perry prostituted himself and his office to a pharmaceutical company by ordering compulsory vaccinations for pre-pubescent girls against a disease not communicable in the classroom (which is the only legitimate justification for mandatory inoculation of schoolchildren in the first place)?

Well, if the slope is slippery enough, Perry could go down in history as a rank amateur:

Immunotherapeutic strategies offer another unique approach to relapse prevention. Such strategies are based on the development of vaccines to generate antibodies to the drug that block its entry into the brain and thereby interfere with its effects. Cocaine and nicotine vaccines are already in clinical trials, and [the National Institute on Drug Abuse] has requested proposals to develop a methamphetamine vaccine.

The two all-important words in that passage are "relapse prevention." At this point, the Warriors on Drugs assure us, the idea of a "anti-high vaccine" is strictly intended to apply only to drug abusers.

But here's the problem: If any and all drug use is "drug abuse" -- as the Warriors on Drugs tend to insist -- then why should a vaccine, once developed, be limited to "relapse prevention"? Why not use the inoculation pre-emptively, before the user becomes an addict? Indeed, before he ever becomes a user in the first place? Why not just eliminate the risk in advance?

The government could start by making (via taxpayer money, of course) the "no high" vaccines available for free -- or maybe even paying people to take them. Next could come the only modestly coercive programs: those convicted of drug crimes, for example. Then those convicted of violent crimes. Then any crime.

People on welfare would be next -- surely a "no cocaine" vaccine is a reasonable string to attach to a welfare check?

Next up: the military. They already have restricted liberties (including a general no smoking policy). Just add one more shot to their vaccination regimen in basic training.

Want to immigrate to the U.S.? No problem, and welcome! But first you have to get a "no pot" shot.

"Just say no" is already a requirement for federal student aid -- if you have a drug conviction then you're ineligible. So why not just cut to the chase and replace "Just say no" with "Just roll up your sleeve" as a precondition to receiving a Pell Grant?

Then, finally, along will come the Rick Perrys: Just vaccinate every child against marijuana, cocaine and meth -- and perhaps nicotine or even alcohol -- when they enter kindergarten.

Admittedly, that's a long, steep slope. Let's start back at the top: "Temptation vaccines" (my term) are being researched, or at least contemplated, for the following substances: methamphetamine, cocaine, marijuana and nicotine. The government bureaucracy funding these researchers has not indicated any interest in using such vaccines on schoolchildren. Point conceded.

Now the hasty stitches can begin in earnest:

--Nicotine is a legal substance. As shocking and awful as this may seem to some, children have a right to be allowed to grow into adults with the ability to enjoy a cigarette. Personal autonomy, even in the context of smoking, matters.

--Marijuana is a legal substance in some places. A child also has a right to grow into an adult with the ability to enjoy pot in Amsterdam. Personal autonomy, even in the context of Dutch pot, matters.

--Marijuana (and perhaps someday even cocaine or meth) may become legal substances in the future. Reasonable people, in the face of overwhelming evidence, are realizing in greater numbers just how nonsensical and disastrous our War on Drugs, and especially the War on Marijuana, have been.

What if an "alcohol vaccine" had been developed in 1918 and administered to children (or adults for that matter) against their will, only to see Prohibition lifted in 1933? Would Prohibition even have been lifted? ("What's the point? Nobody will want to drink anyway?")

The response of politicians and bureaucrats to the discovery that citizens have differing tastes and preferences should not be to give them the equivalent of an "enjoyment lobotomy." Freedom of choice, even a "bad" choice, is -- or was -- the American way. To constrain personal choice, even a "bad" personal choice, is to constrain the human soul. And the disease of runaway paternalism is a far greater public health threat than any that the government can save us from.

There is nothing wrong, indeed there is a lot quite right, about developing such vaccines (privately) as an option for competent adults. But children deserve the chance to grow up unimpeded and unmolded by the subjective priorities of politicians and bureaucrats (or even parents). We are just starting to understand, and undo, the damage of indoctrination cloaked as public education (not to mention pseudo-education). We are just starting to appreciate the value of a child's untampered intellectual, spiritual, emotional and sexual development.

Is now really the time to start mucking around with their neurochemistry?

(Via Drug Policy Alliance -- which jumps to Doomsday a bit too quickly in my opinion. But their dystopian nightmare is certainly plausible.)

For discussion #1: Compare and contrast (a) a hypothetical program in which parents could choose to vaccinate their minor children against nicotine (i.e., a legal substance), with (b) infant male circumcision.

For discussion #2: Compare and contrast this program with the "chair of torture" from A Clockwork Orange. How about parents sending their minor children against their will to cure-the-gay "reparative therapy" facilities?

To review: The pharmaceutical company Merck bought an executive order from Texas governor Rick Perry mandating that all pre-pubescent schoolgirls be vaccinated against HPV, via Merck's expensive and not entirely effective Gardasil vaccine. This despite the fact that HPV, unlike the infamous childhood diseases of generations past, is not casually communicable in a classroom setting (i.e., there are no positive externalities that justify government compulsion).

The Texas legislature undid Perry's despicable rent-seeking maneuver. Which means they did the right thing -- if only for a few weeks:

Fitness guru Dr. Kenneth Cooper of Dallas teamed up with Sen. Jane Nelson, R-Lewisville, to author legislation that would require schools to monitor students' health to prevent childhood obesity.
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The wording in the bill that describes the required testing tool mirrors language on the Web site for Cooper's FitnessGram, developed in 1982 to measure health and fitness levels of children.
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The FitnessGram would cost about $230 for each child when purchased from its distributor, Human Kinetics. The nonprofit Cooper Institute receives $30 from each sale. ... [T]he Cooper Institute will apply to be the vendor.

First of all, "making money from selling stuff" is hardly my definition of "nonprofit" (cf., the scandalously "profitable yet supposedly non-profit" AARP).

Meanwhile, do educrats, school nurses and PE instructors really need a $230/student test to tell them something that a scale and tape measure can't?

I will, however, give Cooper credit for one thing: he is a far slicker huckster than the marketing department over at Merck:

But Cooper said he believes so strongly in the testing regimen that he is willing to put that money back into the program. He also said he will help raise the money to implement the program, which could cost between $5 million and $8 million.

One must admit, it takes a lot of creativity (and chutzpah) to buy a monopoly franchise from a state government and then repackage it as "philanthropy."

You may have heard that the Texas legislature, along with its counterparts in California and Florida, essentially dictate the educational curricula for the entire nation because textbook publishers have little choice but to produce the books that those three states, at 30% of the market, want to buy. This "Fitnessgram" snake oil may well exhibit the same economics. Even if Cooper "charitably" discounts his program or otherwise "gives back" his "nonprofit profits," he will still have bought, from Texas politicians, a market share that will allow him to undercut other providers of such services (see generally, "economies of scale"). And of course he will be able to ("philanthropically") leverage the Texas contract in his marketing: "Used by all Texas schools...." or "The official fitness program of the Texas Education Agency..."

Like I said: chutzpah.

To the extent that a "War on Childhood Obesity" should be waged at all, it might -- somehow -- be the case that more is needed than a scale and tape measure -- I'm skeptical. But surely it -- whatever "it" is -- can be done for less than $230/student every year, and done in a way that doesn't unduly enrich (reputationally if not financially) a single rent-seeking person or firm, no matter how "non-profit" or "philanthropic" they pretend to be.

(Via Junkfood Science -- which peeks under the hood of the "FitnessGram" program and finds it -- to use its own terminology, "underfit.")

As with any tax return, the interesting details aren't necessarily on the main form...

The Internal Revenue Service expects to lose more than $37 million by using private debt collectors to pursue tax scofflaws through a program that has outraged consumers and led to charges on Capitol Hill that the agency is wasting money for work that IRS agents could do more effectively.

...but more often on the attachments buried underneath:

Three firms were awarded contracts: Pioneer Credit Recovery, based in the western New York district represented by Rep. Thomas M. Reynolds (R), who supported the program and recently announced his retirement; the CBE Group of Waterloo, Iowa, the home state of Sen. Charles E. Grassley (R), who helped create the program; and Linebarger Goggan Blair and Sampson, a law firm based in Texas, home to President Bush.

Pioneer Credit employees have given congressional candidates and political action committees $117,450 since 1995, including $16,250 to Reynolds. CBE Group employees have given $9,372 during that period, including $2,500 to Grassley. Linebarger Goggan, one of the nation's largest collection agencies, has extensive government ties. The firm, its employees and their spouses have given PACs and federal candidates in both parties $423,260 since 1995.

The notion of the government retaining private debt collectors is not by itself an abomination, any more than is hiring private vendors to run cafeterias in government office buildings or army bases. The abomination does not even necessarily derive from the net losses — which could, hypothetically, be attributed to start-up costs and the like.

The unarguable scandal here is instead the fact that these three collection agencies (sorry, two collection agencies and one "law firm" — with emphasis on the air quotes) simply bought a federal contract from two powerful members of Congress (powerful at the time, that is). Apparently no competitive bidding, no minimum performance requirements, no real-time oversight. Just grease some politicians' palms and enjoy the feast. At least until the next election.

And still liberals think we should turn over the entire health care sector to political people and political processes like this (or this). Because, of course, only Republican politicians sell their votes and power, right?

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P.S. Did someone say "Grassley"?