From: stephen@sprunk.org   
      
   On 27-Apr-15 12:29, Adam H. Kerman wrote:   
   > Stephen Sprunk  wrote:   
   >> On 27-Apr-15 11:26, Adam H. Kerman wrote:   
   >>> After the Disneyland epidemic, there have been numerous   
   >>> newspaper stories pointing out schools that are simply failing to   
   >>> follow up with families that failed to immunize their children or   
   >>> take extreme measures to keep unimmunized children at home. In a   
   >>> mere handful of cases, parents expressed objections that might be   
   >>> allowable exceptions, but that sure as hell wasn't true in most   
   >>> cases.   
   >>   
   >> The problem was traced to a handful of schools, where a large   
   >> fraction of parents had deliberately not immunized their kids.   
   >> There is no evidence of a widespread enforcement problem.   
   >   
   > That would be your evidence right there.   
   >   
   > I was still commenting on nonsense in my state; for all I know,   
   > Caliphonia law allows numerous exceptions beyond "sincerely held   
   > religious beliefs" or recognize the latest fad as a religious belief.   
      
   The courts are not allowed to question whether a claim of a "sincerely   
   held religious belief" is legitimate; someone swearing it is true is   
   required to be taken at face value.   
      
   Part of the problem in this particular case is that Jenny McCarthy and   
   her ilk had _specifically_ told people to use this exception to get   
   around the immunization requirement, even though their (unfounded)   
   concerns were about autism and had nothing to do with religion.   
      
   Even if such claims were legitimate, though, there is still a public   
   health issue in areas where such people are a large enough fraction of   
   the population for herd immunity to fail.  Should we allow children to   
   die simply because their idiot parents believe in fairy tales?  Don't we   
   have a moral obligation to protect those children too?   
      
   > Schools simply knew which kids they hadn't received immunization   
   > certificates from. The problem wasn't that parents were asserting an   
   > allowable exception to mandatory immunization, because that just   
   > doesn't come up without followup.   
      
   In at least some cases, the parents _had_ affirmatively refused and   
   cited the exception allowed in California law; they said so in TV   
   interviews.  I don't think anyone, except perhaps the CDC, has data on   
   every single kid since medical and school records are confidential.   
      
   >> My point is that the law _allows_ parents to not immunize their   
   >> kids, so you can't blame lack of immunization on enforcement   
   >> anyway; there is nothing to enforce.   
   >   
   > Do you have a reading comprehension problem? My comment was specific   
   > to SCHOOLS not enforcing immunization requirements. I made no comment   
   > that immunizations aren't mandatory for children under school age, or   
   > that the law doesn't mandate the recommended immunization schedule at   
   > the recommended age. But the kids who got sick in the Disneyland   
   > epidemic were generally school-age children who spread the disease to   
   > other children at school.   
      
   You're the one with the reading comprehension problem, apparently.  The   
   law allows parents to not immunize their kids--including kids who are   
   enrolled in public schools.  All they have to do is say they don't want   
   to do so and, in some states, sign a waiver.  See above.   
      
   >> Whether those certain schools gave up on asking because so many   
   >> parents were refusing or the schools tried but the parents claimed   
   >> the exemption, the result is the same: the kids of stupid parents   
   >> got sick from a preventable disease, costing the public millions of   
   >> dollars.   
   >   
   > Gee, that's odd: When you're trying to prevent very infectious   
   > diseases from spreading throughout a community, followup can be quite   
   > effective. How the hell do you persuade anybody if you never follow   
   > up?   
      
   What is the benefit of "following up" if the parents can refuse?  Why do   
   you think the answer will be different then?  If they're stupid enough   
   to refuse the first time when they enrolled their kid, that's not going   
   to cure itself.   
      
   >> The only solution is to remove the exceptions--and to provide the   
   >> immunizations for free, as a matter of public policy, to those who   
   >> cannot afford them.   
   >   
   > It is free wherever such programs are available, and they are widely   
   > available and have been for many many decades. If you can't find   
   > free immunization for your kid, it's because you live in an isolated   
   > rural area, in which case, who cares. You're not going to spread the   
   > disease.   
      
   Are you aware of any states that make exceptions in their mandate for   
   people living in rural areas?  And where is the line, exactly?  All it   
   takes is one infected person attending a HS football game to spread the   
   disease to hundreds or even thousands of others.   
      
   Herd immunity greatly reduces the probability of such events, but it   
   doesn't reduce the impact when they do happen.   
      
   > You've been wrong about this for several followups now, and wrong in   
   > particular for defending that earlier stupid statement. Obamacare has   
   > nothing to do with mass innoculation, and it's a lousy way to achieve   
   > it.   
      
   Obamacare is relevant to the extent that universal coverage helps pay   
   for the costs of complying with such mandates.  Heck, the insurance   
   companies _like_ mass inoculation because it's statistically cheaper   
   than paying for sick people.  (That's why, for instance, they have   
   chosen to cover the HPV vaccine; treating one woman for cervical cancer   
   costs more than inoculating _thousands_ of healthy girls.)   
      
   >> Here, you can't enroll a kid in school without their immunization   
   >> papers--or signing the waiver.  Yes, some churches or charities   
   >> may occasionally offer them for free, but one can't rely on that as   
   >> a matter of public policy, and the very need for free clinics was a   
   >> damning indictment of our entire health care system.   
   >   
   > Why aren't they reliable? Charities have always sprung up when   
   > public policy lags behind. In fact, I'll go further: No country would   
   > EVER have social reform if there weren't social reformers. Government   
   > has to be dragged kicking and screaming, and then tends to do too   
   > little too late, but spends a lot of money being ineffective.   
   >   
   > You really really have to be determined NOT to get your kids   
   > immunized to avoid these free or low cost mass innoculation   
   > programs.   
      
   Not everyone goes to church, either regularly or at all, and free   
   clinics are few and far between.  I see drug stores offering flu   
   vaccines, but you have to pay for them, and they're not cheap--and they   
   don't work very well, unlike the mandated vaccines.   
      
   The only way for it to be reliable is for the vaccine to be provided in   
   _every_ school, which is unlikely unless it's state funded--and most   
   taxpayers are insured, so they don't want to pay for that.  Even then,   
   as long as you allow parents to refuse, it's still not reliable.   
      
   And you still have to address homeschooled kids, but they're a much   
   smaller risk to the general public--for now.   
      
   >> Also, since Obamacare went into effect, many free clinics have   
   >> shut their doors because most of their patients are insured now, so   
   >> there is no longer enough demand to justify them.  That's a major   
   >> win.   
   >   
   > Not at all, given that insurance is a rather expensive way to go   
   > about paying for ongoing medical care for people that aren't sick   
   > enough to require hospitalization, or just require regular health   
   > advice.   
      
   "Regular health advice" is still incredibly expensive in our system if   
   you don't have insurance.  Based on what my doctor billed my insurance   
   company for my last visit (my annual physical) before applying their   
   "network" rates, as long as I visit him at least three times per year,   
   insurance is cheaper.  Women of childbearing age are supposed to see   
   their OB/GYN twice a year anyway (and have to, if they want birth   
   control pills), and most kids need more than that.  And that's for   
   people in good health.  My parents spend half their (fixed) income on   
   medical bills, and that's _after_ Medicare plus the supplemental from   
   their pension plan eat most of the costs!   
      
   Yes, if you're a male between certain ages and in excellent health, it   
   might be cheaper to be uninsured, but all it takes is one slip on an icy   
   sidewalk to go negative for years--or be bankrupted.  For just about   
   everyone else, insurance is generally cheaper.   
      
   S   
      
   --   
   Stephen Sprunk         "God does not play dice."  --Albert Einstein   
   CCIE #3723         "God is an inveterate gambler, and He throws the   
   K5SSS        dice at every possible opportunity." --Stephen Hawking   
      
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