Giuliani also clueless about AIDS

July 23, 2007

Back after an absence – in which I had some medical boards to tend to, and my wife had a baby – I realize that some things never change, such as ignorance and hypocrisy.

Let’s take Rudy Giuliani, the former mayor of New York on 9/11 (as he would like to be remembered, he reminds us). The man is campaign for president of the United States representing the Republican party – not the party of Lincoln mind you, but the political party of self-rightous, war-crazed, torture-friendly conservative idiots who have come to power. I just mentioned “ignorance and hypocrisy” because you have to be either ignorant or a hypocrite to support a twice-divorced, drag-dressing man spouting “conservative family values”.

Giuliani also clueless about AIDS

But I digress. On a campaign stop in Cedar Rapids, Iowa, after the usual prepared remarks, the questions came. And here is were it gets stupid:

Asked about increasing federal support for HIV medications, Giuliani discussed what he considers appropriate federal responsibility in health care. “I don’t want to promise you the federal government will take over the role,” he said, drawing applause and shouts of “all right.” Then, in some interesting twists, he turned the HIV question into a 9/11 answer:

“My general experience has been that the federal government works best when it helps and assists and encourages and sets guidelines… on a state-by-state, locality-by-locality basis. It’s no different from the way I look at homeland security. Maybe having been mayor of the city, I know that your first defense against terrorist attack is that local police station, or that local firehouse.”

WTF? He was asked about AIDS, specifically HIV medications for HIV/AIDS patients, and his answer was… 9/11! It seems Giuliani has the routine pat down. Someone asks him a difficult question, and the answer is the same: 9/11! It is similar to Bush’s answer. Whereas Bush goes back to “the terrorists attacked us on 9/11”, Giuliani goes back to “I was the mayor of New York on 9/11!”, as if that is going to get him off the hook. So far, it has, but lets see if the public can stand that load of B.S. right up until the 2008 election.

By the way, there is another conservative idiot that had some problems on AIDS prevention – remember John McCain?

Reporter: “Should U.S. taxpayer money go to places like Africa to fund contraception to prevent AIDS?”

Mr. McCain: “I haven’t thought about it. Before I give you an answer, let me think about. Let me think about it a little bit because I never got a question about it before. I don’t know if I would use taxpayers’ money for it.”

Q: “What about grants for sex education in the United States? Should they include instructions about using contraceptives? Or should it be Bush’s policy, which is just abstinence?”

Mr. McCain: (Long pause) “Ahhh. I think I support the president’s policy.”

Q: “So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?”

Mr. McCain: (Long pause) “You’ve stumped me.”

By the way, that McCain campaign is non-existant, so Giuliani better wise up and stop acting like a hardliner when it comes to HIV/AIDS.

But it’s not just HIV/AIDS that Giuliani is being a conservative idiot. Take health care for example:

Giuliani’s health-care plan is firmly based in the private sector. He proposes a $15,000 tax exemption for individual health insurance. “If you can find it cheaper, you can keep the difference.” He said with 50 million to 100 million Americans participating, this would create a marketplace for affordable individual plans: “Lots of people would buy private health insurance if it was as attractive as employer plans.” All plans would have to have some co-payment, to encourage people to make choices about their care.

In an extended analogy, Giuliani likened the cost of health care to the price of TVs in the early 1950s — prices were high because the marketplace was small. With a larger marketplace prices of TVs have gone down and quality has improved with advancing technology. “It happened because there was a free market,” he said. His analogy missed some realities – you won’t die if you can’t get a plasma TV, but you might die if you can’t get to the doctor.

But Giuliani mocked the idea of mandated coverage: “If the government had said, everybody has to get a TV, and we’ll help you pay for one if you can’t afford it, what would have happened to the price of TVs? When you promise these simplistic results you get disaster, like welfare.”

Giuliani also said a promise of universal health care was misguided:

“We don’t want socialized medicine. Maybe you should go see ‘Sicko,’ see if you agree with Michael Moore that we should have the Cuban health care system. That’s where the Democrats are taking us… All the places that have government-run health care, it’s inferior to us. We’ve got to preserve our private system. People will have to earn some of that access. Let’s not become a nanny state. You don’t help somebody when you make them dependent. You make it within their realm to do it, but give them a chance to earn it. The system gets destroyed when you start making big promises.”

Buddy, we already have some socialized medicine. It’s called Social Security, Medicare and Medicaid. What’s more, we want more of it. Also, his claim that “all the places that have government-run health care, it’s inferior to us” is a load of shit, and he knows it (didn’t he just claim to see Sicko?). Even if he did not watch Sicko, the U.S. health care system is ranked 37 out of 191 countries, 2 notches above Cuba.

What’s hysterical is that all the places that have government-run health care are SUPERIOR to us. Way to go, Mr. Giuliani.

McCain’s “Straight-Talk Express” train might be in the scrap heap, but Giuliani is definitely picking up the slack.

Lesson for ALL presidential candidates: flunk AIDS, prepare to lose the U.S. presidency.

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Hell Just Froze Over – Mandatory HPV Vaccination in Texas?

February 3, 2007

Did hell just froze over because of Texas?

Yes my friends, apparently hell just froze over:

HOUSTON, Feb. 2 — Texas on Friday became the first state to require all 11- and 12-year-old girls entering the sixth grade to be vaccinated against a sexually transmitted virus that causes cervical cancer.

Averting a potentially divisive debate in the Legislature, Gov. Rick Perry, a Republican, signed an executive order mandating shots of the Merck vaccine Gardasil as protection against the human papillomavirus, or HPV, starting in September 2008.

Mr. Perry’s action, praised by health advocates, caught many by surprise in a largely conservative state where sexual politics is often a battleground.

“I had no idea; I was absolutely caught off guard,” said Representative Jessica Farrar, Democrat of Houston, who sponsored a bill to require the vaccinations starting this September. “Normally, the governor does not take things like this upon himself, although I’m glad he did.”

If you live in Texas and see some snow falling, it is not due to global warming, it is because Gov. Rick Perry – a stalwart conservative republican who is against abortion and stem-cell research – finally recognized that doing the right thing is not such a hard thing to do:

“Requiring young girls to get vaccinated before they come into contact with HPV is responsible health and fiscal policy that has the potential to significantly reduce cases of cervical cancer and mitigate future medical costs,” said Mr. Perry, who was re-elected to his second full term last November.

And it is official as well:

It is Republican Gov. Rick Perry who issued an executive order directing the state’s Health Human Services Commission (HHSC) to get ready to administer the HPV vaccine in girls at noted ages before they enter sixth grade.

The order, effective September 2008, also directs HHSC and the Department of State Health Services (DSHS) to “make the vaccine immediately available to eligible young females through the Texas Vaccines for Children program for young women ages 9 to 18, and through Medicaid for women ages 19 to 21,” says the statement of the governor’s office on its website.

See? It wasn’t that hard. Good for you, Gov. Perry. So every parent must vaccinate their school-aged girls with Gardasil, right? Wrong:

Under the order, girls and women from 9 to 21 eligible for public assistance could get free shots immediately. The governor’s office said parents could opt out of the school program “for reasons of conscience, including religious beliefs.”

Ahh, I see. So at least he didn’t completely screw over his conservative friends. I wonder what is the point of having a mandatory vaccination program if parents can opt out because of religious beliefs, but I digress. Time and education will eventually replace misinformation and stereotypes.

But I wonder, did Gov. Perry did this out of the goodness of his conservative heart, or because the scientific evidence finally convinced the guy? If by “scientific evidence” you mean “my former Chief-of-Staff, who is now a lobbyist for Merck, told me this would mean truckloads of money for them and for me”, then yes, he was convinced:

Is Perry’s order politically motivated? No one knows. But, USA Today has reported today that Perry has several ties to Merck, the maker of the HPV vaccine, and Women in Government, a not-for-profit organization comprised of state woman regulators, which some watchdog has claimed is too cozy with Merck.

Media has reported that Women in Government is quite active in promoting the Merck’s vaccine, which analysts say is positioned to make Merck more than billion dollars a year. According to USA Today, Mike Toomey, Perry’s former chief of staff, serves as one of the drug company’s three lobbyists in Texas. Perry’s current chief of staff’s mother-in-law, Texas Republican state Rep. Dianne White Delisi, is a head of Women in Government.

“Perry also received $6,000 from Merck’s political action committee during his re-election campaign,” USA Today says.

Ah, now everything seems to make sense. A conservative politician from Texas is opposed to everything this vaccine stands for, and knows he can lose his conservative base over this, but he can make up those votes from the other side, and make a ton of money for his friends at Merck in the process.

Now let me play Devil’s Advocate for a moment. Is there a conflict of interest here? Very likely. But are Gov. Perry’s actions regarding mandatory HPV vaccination wrong? Well, no. Merck does make the damn vaccine, and a generic will not become available in a long time. This vaccine represents a huge leap forward for women’s health. At around $400 for 3 shots over an 8-month period, it is expensive, and most health plans will NOT cover it. But while preventing cervical cancer is morally and medically correct, it is not exactly sound fiscal policy:

Mr. Perry says it makes sense to use the vaccine to prevent cervical cancer which would otherwise cause a large burden on medical expenditure. But does this mandatory inoculation of the HPV vaccine really save medical costs?

On average, a 5-year treatment for a case of cervical caner would cost $11,000, early studies show. For a 5-year span, about 5800 new cases of the disease are expected to be diagnosed in Texas, which means the medical cost for five years is 63.8 millions or 12.8 million a year.

In Texas, there are about 6.31 millions people now under age 18, meaning the number of girls who are required to receive the HPV vaccine each year is about 0.35 million. The total number of girls to receive the vaccine is 1.76 million, meaning that Merck can rake in 630 million dollars in five years or 126 million dollars in the vaccine sales in Texas alone with Mr. Perry’s order.

The cost for the first year would be double the price tag as girls both at age 11 and 12 will receive the vaccine. The calculation is based on the price of the vaccine at $360 per girl.

It seems that this state mandatory vaccination can save about 700 women’s lives a year in Texas at a cost of 126 million dollars a year spent on the preventive vaccine. These 700 women would otherwise need 7.7 million dollars for treatment of their cervical cancer.

Perry’s order can save some women’s lives, but it does not save money.

I am not saying that vaccinating women with Gardasil is not worth it – it is. It does make sense from a public health point of view, because cervical cancer it is the second most common cancer in women after breast cancer. Gardasil, the HPV vaccine, will definitely be most valuable in the developing world, where most women don’t have access to a yearly PAP smear. But the big fight, the one that will set the precedents for other countries to follow, is taking place in the United States and Texas, of all places, just landed a knockout blow.