Critically Thinking

By Charles Reichley

August 16, 2006

 

Do we spend enough to fight AIDS?

 

Every year there is another round of stories saying America isn’t doing enough to stop the spread of AIDS.  To be sure, AIDS is a bad disease, and it once was a death sentence.  While it is now largely treatable with medication, it’s still something nobody should have to endure.

 

Despite the world’s best efforts, the number of new cases rose to a record of almost 5 million last year.  The real progress has not been prevention, but treatment, with fewer people now dying of AIDS than contracting it.  This means the number of people infected is increasing.

 

In the United States, the number of new cases has remained steady at about 40,000 a year, thanks in part to over $700 million dollars a year spent on prevention.  Now some people say we could cut that number in half by spending another $400 million (about $20,000 per year per prevented case).  They claim that preventing 12,000 cases would save more than that in medical costs, noting that costs are skyrocketing as patients live longer and have better access to expensive but necessary treatments.

 

There is doubt as to whether spending more money would help.  In 2001, the Centers for Disease Control launched a major effort to cut new cases, and it had no effect. But why is it that, over 20 years after the discovery of HIV and the ensuing panic, we need to spend more money on prevention?

 

99 percent of new AIDS cases in 2004 came from three categories:  male-to-male sexual activity (46 percent), heterosexual activity (31 percent), and IV drug use (22 percent). To prevent infection as an illegal drug user, you can stop taking illegal drugs, or use a clean needle each time you shoot up.  To prevent the spread of AIDS by sexual activity, you can stop having sex, use a condom each time you have sex, or have a monogamous relationship with an uninfected partner.

 

If everybody read my column, we just saved four hundred million dollars.  But obviously it’s not that easy.  One problem is that drug users won’t get clean needles and don’t want to stop taking drugs, and men don’t want to stop having sex, and don’t like using condoms. 

 

Part of the problem is our success in managing the disease.  You can now live a relatively normal, healthy life with HIV, so people engaging in high-risk behaviors aren’t as concerned with taking precautions to prevent infection.

 

Also, while the costs of treatment are high, government programs subsidize or pay for treatment for many infected people, removing the monetary incentive high-risk people have to protect themselves.  These programs actually help prop up the cost of the drugs, since otherwise many of those infected wouldn’t be able to afford the prices and the companies would have to reduce the costs.

 

Government spending on AIDS research for 2007 is almost $3 billion, higher than any other major disease (Heart disease is second at $2.3 billion).  Relative to the number of people affected, HIV spending is vastly higher than other recurring diseases.  We will spend over $3,000 per HIV/AIDS patient next year, while spending only $50 per diabetic patient, even though diabetes kills five times more people than AIDS each year.

 

We also spend billions on treatment programs for those who have HIV.  We spend more for HIV/AIDS than any other disease including heart disease and cancer, which can strike anybody at any time with little chance of prevention.

 

Part of the problem is political.  For most communicable diseases, the health care strategy is to isolate and report cases to prevent the spread of disease.  But with HIV/AIDS we adopted a strategy of silence, hiding the identities of those infected.

 

The argument against publicizing HIV infection was that it can’t be spread casually – in other words, because it is hard to spread, we don’t provide the information people need to make informed decisions to prevent the spread.  And when people suggest ways to provide that information, they are often called bigots or homophobes.

 

Still, if spending $400 million would save over $650 million in health care costs, it would be a good thing, freeing up millions to spend on other diseases.  But until there is good evidence that spending more money would actually change the behavior of the at-risk population, the money can be better spent on prevention and cure for illnesses that can’t be so easily prevented, or successfully treated.   Medical funding shouldn’t be driven by special-interest politics.

 

© 2006 Media General. Part of the GatewayVA Network.
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Critically Thinking

By Charles Reichley

August 9, 2006

 

Lebanon is Latest front in War on Terror

 

War.  It’s a word that unfortunately we hear too often these days.  War is not a good thing.  War is, at its core, a failure of civilized society.  Most people hate war.  War causes the death of human beings – combatants and non-combatants, aggressors and bystanders, able-bodied men and women and children.

 

So I wish Israel would declare a cease-fire.  I wish Hezbollah would stop the shelling.  I wish people would stop killing each other.  Like a beauty queen contestant, I wish for world peace.

 

But life involves hard choices. Sometimes those choices are between bad and worse.  War can be preferable to the alternative.  So I might wish and end to the war in Lebanon, but I support Israel defending itself against aggression, as the alternative would undoubtedly be worse. I support the “war on terror” as preferable to surrender.

 

But we cannot actually fight a “war” with terror, or terrorism, or even terrorists.  Terror is an emotion.  Terrorism is a tactic.  Terrorist is a participant.  War is not fought against individuals, but against groups, usually nations.  We can’t win the war on terror without involving the nations harboring the terrorists.

 

In his speech following the 9/11 attacks, President Bush said “We will pursue nations that provide aid or safe haven to terrorism. Every nation in every region now has a decision to make: Either you are with us or you are with the terrorists. From this day forward, any nation that continues to harbor or support terrorism will be regarded by the United States as a hostile regime.”

 

Afghanistan did not attack us on 9/11.  But Al Qaeda was in Afghanistan.  So America gave Afghanistan an ultimatum: “They will hand over the terrorists or they will share in their fate”. They refused, and we declared war, holding Afghanistan accountable for acts of war perpetrated by people within their borders.

 

Now Israel is in a war with “Hezbollah” in Lebanon.  By confining the conflict to a “terrorist faction”, Israel’s hands are largely tied.  The people of Lebanon are treated like innocent victims, and if Israel’s attacks are not narrowly focused they are condemned.  This even though many  “innocent victims” strongly support and provide support to the terrorists, and even though Hezbollah is firing rockets from residential areas to draw Israeli fire, causing civilian casualties they can use in their propaganda battle.

 

But Lebanon is a sovereign country, and should be held responsible for acts of war launched from its borders.  Israel should not bargain with Hezbollah; but with the government of Lebanon.  If Lebanon cannot control its own people, then Lebanon should suffer the consequences.  Lebanon must defeat the terrorists in its midst, or else share their fate.

 

Armies cannot “defeat” individuals.  War is not a police action. Winning a war requires breaking the will of the people – NOT the army, which consists of true believers trained to fight to the death, but the civilians who support the war effort.  For example, in World War II, we bombed the cities of Germany and Japan, killing hundreds of thousands of people, because those people supported the war effort, and to demoralize the citizens, to make them weary of fighting.

 

The “war on terror” has become too focused on the terrorists.  These combatants are people who relish dying for a cause, and we’ll never kill them all.  Until we defeat the “civilian” support for these armies, we will never end this “war on terror”.

 

Civilization consists of nations given sovereignty over people and property based on physical boundaries.  We need to hold nations responsible for the actions of the people within their borders.  We need to stop targeting terrorists, and fight the nations that allow terrorists to operate in their midst.  We must give nations a reason to denounce and defeat the terrorists in their countries.

 

The latest battle in the “war on terror” is raging in southern Lebanon. The world can choose to hold Lebanon accountable, to embrace the possibility of a true victory over terrorism.  But sixty dead in Qana have broken our resolve, and instead of victory we are headed for another stalemate.  People hate war, and will do almost anything to stop it.  So Hezbollah will live to fight another day, terrorists around the world will breathe a sigh of relief, nations will continue ignoring evildoers in their midst – and most of us will just be happy the fighting has stopped.

 

 

© 2006 Media General. Part of the GatewayVA Network.
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That's my opinion, even if somewhat uninformed according to at least one loyal reader.

 

Read it at the Potomac News online website: Vulcan Quarry Should Get Approval

My column of July 5th dealt with the issue of flag burning, and my opposition to the constitutional amendment to "protect the flag".

 

Summary:

It pains me to see a flag burned – not because of a blackened piece of cloth, but because of what it says about the protestors and those who support them.  We all have things we want to change in our country.  But to trample on Old Glory is to reject the very nation we live in, to show disrespect for our culture, our heritage, and our country.  To spit on the symbol is to spit on the Republic for which it stands, and reveals those protestors for what they are.

 

So flag burning may do us a service, by revealing the perpetrators as unworthy of serious consideration.  As we do with children who express their anger by stomping their feet demanding attention, flag-burners deserve nothing more than to be put in a time-out, to be ignored until they can behave as civilized people.

 

Read the entire column at the Potomac News online site:  And to the Republic, For which it Stands

 

 

Critically Thinking

By Charles Reichley

Wednesday, June 28, 2006

 

Have We Lost Our Compassion?

 

“Do unto others as you would have them do unto you.” We have long embraced this “golden rule”, treating each other with respect and compassion. The hallmark of our society was our humanity, civility, and kindness to others. 

 

There have always been some among us without those qualities, but it seems that our society is losing the desire for compassion.  Instead, we’ve become selfish, self-centered, and ever-less likely to think about how our words and actions effect others.

 

It is clear politicians are no longer treated like human beings, even by people in the same party. The Virginia Senate Democrat primary shows how acceptable it is to “dehumanize” your opponent.  When James Webb called his opponent “the anti-Christ of outsourcing”, few people criticized the decidedly “inhuman” reference.

 

Last year Senator Salazar (D-Col) apologized after using the term “antichrist” to describe members of a religious organization.  But Webb did not apologize, and continued to use the phrase.  His supporters attacked those who suggested calling another human “the devil” was inappropriate.

 

 But that’s just politics. What brought home to me our loss of compassion for others was the story of the sleeping Cable Guy.

 

A local Comcast customer was having trouble with his new cable internet service.  After some difficulties, he finally had a service technician in his house.  The technician needed assistance from the office, and was put on hold for an hour. While waiting, the technician fell asleep on a couch. The customer’s response?  He videotaped the sleeping man, and posted it on the internet.  As a result, the technician was fired.

 

We know little about the technician.  He could be a hard-working man, with a wife and kids, working long hours with little sleep.  Who among us hasn’t drifted off during a sermon, a long meeting, or at other inappropriate times? Why not just wake the guy up? Why humiliate him in front of the entire world?  The customer’s anger at the company was directed at the technician, with no thought to the damage it would cause. 

 

When I heard this story on CNN, the reporter sounded gleeful, and seemed to think it a fitting punishment to ruin a man’s life for falling asleep waiting on hold.  It’s easy to hate a faceless company.  But where is our compassion for this man, a human being like us?

 

The internet is part of the problem.  Anonymity and physical isolation make it easy to say things that civilized people wouldn’t say in public.  E-mail complaints are often harsh and cruel compared to in-person complaints.  And the internet gives us a world-wide receptive audience for our diatribes.

 

The web offers the opportunity for debating problems and finding common solutions, but it rarely lives up to its potential.  You are much more likely to find childish insults, personal attacks, vulgar racial, ethnic, and sexual slurs, and baseless accusations of wrongdoing. The “search for common ground” with our fellow man is replaced by the simpler “seek and destroy” of faceless opponents.  Instead of working through our differences, we draw lines in the sand and hurl invectives hoping to demonize our opponents.

 

Insensitivity is spreading like a cancer over our society.  Every interaction is another opportunity for mayhem. Instead of putting ourselves in “the other man’s shoes”, we want to “bury him with his boots on”.  If a cashier isn’t polite enough, we lodge a formal complaint.  If a radio host says something we don’t like, we organize a letter-writing campaign to get them disciplined or fired.  If a celebrity makes a child-rearing mistake we call them unfit mothers, or worse. When we feel the least bit harmed, we seek revenge, our pound of flesh, with not a care in the world how our actions impact someone’s life and livelihood.

 

People are human beings, worthy of respect.  There are few truly evil people in the world, but you wouldn’t know it from our modern discourse. We used to care about people as people, now we want to dehumanize them so we can ignore them, attack them, and destroy them, without feeling any guilt. 

 

So tonight, some cable technician is sitting with his wife and kids, explaining why they had to cancel their summer vacation because he lost his job for nodding off waiting on hold.  And too many people see nothing wrong with that, because we’ve lost our capacity to see others as fellow human beings.  Life itself has become a game to us, and we’ve forgotten that real people are suffering from our words and actions.

 

© 2006 Media General. Part of the GatewayVA Network.
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