The Free-Fall in Fertility

According to studies and continued observation by local endocrinologists, the men of mid-Missouri are undergoing a crash in sperm levels. The problem started cropping up in the mid-1990s, and was cemented during a 1999 study which compared healthy sperm levels between major metropolitan areas. For use in comparison, Columbia, MO was used to help establish a baseline, assuming that the presence of fewer toxic pollutants would lead to higher, healthier levels.

However, it was not to be. Columbia residents' levels maxed out at 57% of the levels of males in New York City, for example; observe the graph at the right for more detail. Most stunning is that Missouri men came from different backgrounds and lifestyles, were of varied ages and professions, and were both long-term and short-term residents of Columbia.

Researchers participating in the 1999 study reexamined Missouri sperm and subjected it to detailed tests for pesticides and chemicals known to be in use in the region. Three pesticides were found to have statistically significant links with the low sperm counts, with two more possible contributors identified as well. One of these pesticides, diazinon, was banned from residential use in 2004, yet still allowed to be used in agriculture. Whatever the case, a follow-up study was conducted by the Centers for Disease Control, with results expected this summer. We will be following this closely, rest assured, for professional and personal reasons.

As the researchers in the article state, blaming one chemical or one pesticide is likely in error. Much more likely are the complex and subtle interactions between varying doses of several chemicals incipient to the lifestyle in the region, coupled with other environmental and lifestyle factors. It is impossible to predict how cocktails of chemicals administered over a lifetime in low doses will interact within the human body. If you would like to know more on this kind of research, check out the research on chemicals in adults, newborns, and pets.

But let us be clear- this is more than likely not a mid-Missouri problem. Whatever the cause is, it is highly possible that these results could be repeated throughout the mid-America region. If there are demonstrable links between pesticide use and low fertility in males, this is something that demands our immediate attention. We will be awaiting the CDC report, and hope to talk about this more in the future.

Energy in the USA: Temporary Measures vs. Systemic Problems

For years, the SUV has served as a particularly potent symbol of American consumption and excess; it seemed to be fueled on hubris alone, considering our willingness to persist with such maddeningly inefficient vehicles used for such ill-suited purposes. I'll never forget rolling into Home Depot one day, and seeing a new, blinged-out H2 with the vanity plate "8 MPG." Oh, dear driver, haven't you heard- do not taunt the automotive gods?

Well, consider that thunder called down from on high. By now, you have surely heard that GM is downsizing production of SUVs in the face of widespread consumer migration (panicked flight?) to more efficient vehicles. Plants will be closed, positions will be eliminated, and stunningly, the Hummer division is likely to be spun off from the GM marque, if anyone can be found willing to take on that albatross. In effect, GM is stating that the business model of large, inefficient vehicles is no longer a viable way to do business in this new landscape. Rapidly losing market share to more fuel efficient vehicles, particularly those from overseas, GM has taken a look at the marketplace and reached a painful conclusion. According to CEO Rick Wagoner, "These higher gasoline prices are changing consumer behavior and rapidly," said Wagoner. "We don't think this is a temporary spike or shift. We think it is permanent."

That is a major leap, and a huge realization by one of our largest automotive companies. There will always be a niche in the market for SUVs and pickups, but that's just it- a niche. The days of pickups and SUVs lining the nearest big-box parking lot are numbered.

And so we turn to Washington for guidance in these tough times. President Bush, rock us with some wisdom. How can we escape this potential death knell for unrestrained gasoline consumption, that which underpins our whole economy and serves to exacerbate these economic strains we all suffer? How will we navigate our way from here?:

Bush, reaching back to the earliest days of his administration, resurrected GOP demands for new drilling in the Alaska wilderness, fewer restrictions on oil refineries and other measures aimed at lowering fuel prices through higher production.

Sigh. Members of Congress, what say you?

"Only President Bush could allow Big Oil to write our nation's energy policy," said Senate Majority Leader Harry M. Reid (D-Nev.).

Senate Minority Leader Mitch McConnell (R-Ky.) responded, "It's clear that, on the production side of the equation, this new majority is not interested in doing anything."

An eye for an eye makes the whole world blind, and tit-for-tat makes the whole world complacent. And all the while, oil companies are making record profits while crying out for greater refinery capacity and access to domestic oil reserves.

This, to me, seems like a lot of old solutions to new problems, new realities and unavoidable truths. The elephant in the corner that no one, not Congress, the Administration, or the two men vying to lead the next one, want to step up and accept responsibility for the fact that energy consumption in the US is out of control, and drastic measures need to be undertaken to alleviate the pressure. We need leadership to focus the on the issue that Alternatives Must Be Sought, and the systemic problem of energy consumption will not be alleviated by any of the whole rack of half-measures dreamed up by those in power. Not gas-tax holidays, not clean coal, not CAFE rules that take effect in 20years, none of that.

We talk a lot about increasing supply to match demand. Why not approach it from another angle? Why isn't there serious discussion on reducing demand? As the article states, while increased coal capacity creates more greenhouses gases, and nuclear plants create lethal waste, the only byproduct of "negawatt" projects are increased wealth. While there are several problems with large-scale energy reduction efforts, there are still huge opportunities for investment and profit by companies positioned to take advantage. Reducing demand through projects such as LEED construction standards, appliance efficiency, and urban planning innovation are a start. Not more, not less- a step in the right direction.

No one wants the economy to be torn to shreds in a rapid switch to alternative energies, so if that is the case, we had better get started on that switch now, while it can still be palatable and advantageous. Let's start with reducing our demand on a large scale, more than just using better lightbulbs or EnergyStar refrigerators. Keep going with that, and don't take the easy way out. This does not mean switching out Saudi oil for Louisiana Coast oil or oil shale from Utah- just another band-aid. Let's take this energy effort all the way. Let's not run up to the edge, screech to a stop, and convince ourselves that we've done all we can do. Let's see this one through.

It's been said before, so all that means to me is that I don't have to find the link here- but it's time to cut the subsidies to oil companies and send that money to investing in a new energy infrastructure. Wind, solar, tidal, you name it, we need a much more diverse portfolio. Subsidize the development of hybrid or clean cars that actually fill the needs of American customers- vehicles that can do the work on the farm, or haul our goods cross-country, and keep them affordable for the common man and woman. Your Prius is not up to the task. Furthermore, it's time to put some kind of financial incentive on reducing energy consumption at the home, municipal, or state level. Yes, by 'incentive' that might mean 'disincentive.' That's how it works.

As it were, we actually have a case study to draw from. I originally wrote about this on my other blog, but the city of Juneau, Alaska recently had some severe power difficulties. After avalanches severely hampered the ability of power companies to send electricity to the city, rates rose sky-high. With enough forewarning, residents of Juneau were able to cut their power consumption by 30%.

In one week. The entire city. Encouraging, to say the least, and it speaks volume to the abilities we have to reduce consumption with the right incentives.

Think about the money to be made on all these possibilities. Think about the kind of investment that is possible, even for those rooted in the old energy economy. This is how we have to view the problem- not even as a problem, but a grand opportunity to preserve and enhance our way of life. It's not about limping along to the next season, hoping that supply will stay stable, and the economy will allow us to keep doing things as they have always been done. The world is changing far too quickly to count on that. It's about finding a new way to live, and a new way to organize our economy. If we do it right, we will all win.

We just need to shut up, face up to it, and try. Shall we?

The Geography of High Gas Prices

Looks like it's going to be a gasoline-themed week this week; it's on your minds, it's definitely on ours, so let's run with it, shall we?

Today's view comes from the International Herald Tribune, observing how although the national average is now over $4.00/gallon, the pain at the pump is much more acute in rural regions across the US.

People are giving up meat so they can buy fuel. Gasoline theft is rising. And drivers are running out of gas more often, leaving their cars by the side of the road until they can scrape together gasoline money.

The disparity between rural America and the rest of the country is a matter of simple home economics. Nationwide, Americans now spend about 4 percent of their take-home income on gasoline. By contrast, in some counties in the Mississippi Delta, that figure has surpassed 13 percent.

As a result, gasoline expenses are rivaling what families spend on food and housing.

The article explains many factors that led to this standard. Rural areas are by nature spread wide and far-flung, with many workers having long commutes over less-maintained roads, and often in older, larger vehicles with suitable awful mileage. Jobs are scarce enough in rural areas, and workers may have little choice but to seek work hours away. Economists are saying that if this keeps up, it could accelerate the loss of population and tax base to urban jobs, even reaching the point where working less would be the most economically viable choice for those that remain.

It's a pretty dicey, touch-and-go situation. I don't know if any readers out there want to offer their input, but I know I'd like to hear it.

Gas Prices and Gas Taxes -- A different look...

I was doing a little browsing this morning before heading to work and came across the following an article in the Washington Post discussing the price of gasoline and its effects on things like fuel efficiency, etc.

The author proposes using a tax as a means of setting a price floor for gasoline, so that our government is in direct control of curbing demand -- leading to a ripple effect throughout the automotive industry. In essence, the idea is that high gas prices are accomplishing what congress, through fuel efficiency and ethenol mandates, could not -- a transformation in America's automotive fleets from gas-guzzling SUV's to more fuel efficient compact cars and hybrid vehicles.

When the US government is setting the price of gasoline above $4/gallon, the government has control of where the money goes -- and the author believes this means the government could essentially refund the money back to consumers through a cut in payroll taxes to offset any pain felt at the pump.

Check out the original article in the link above, and start discussing whether you think it makes sense. I gotta get to work. :)

There's Manure on this Farm Bill

Democrat Tom Harkin Recently made the following statement regarding the 2008 Farm Bill:

“Farmers in Iowa and around the country are beginning to plant for the season. Here in Washington, Congress is fulfilling its promise to enact a farm bill that’s good for all America – farming families and rural communities, nutrition assistance for low-income Americans, fresh fruits and vegetables for school children, more sources of renewable energy and conservation of our natural resources and a disaster program.

“Like any compromise bill resulting from hard bargaining among regional and other interests, this farm bill is far from perfect. But no piece of legislation is. It includes significant reforms, as well as these major advances. It deserves the President’s signature.

“Inexplicably, the White House seems intent on destroying the harvest just as the seeds are being planted."

Pay particular interest to the second paragraph... the one in which Harkin lets us all know that included in this important piece of "compromise" legislation is a handful of givaways to "regional and other interests."

The entire committee passed version of the bill can be found here, if you're interested. But I'm going to talk about a few items in the bill which concern me.

Most agregious, in my mind, is a $126-million tax break for racehorse owners. That's no joke. Food prices are rising every day, fueled (literally) by continued subsidies for the production of ethenol from corn (known to most of the rest of the world as a food source) and the ever-rising cost of oil (which leads to higher transport costs), yet our congress thinks we need to give a tax break to millionaire playboys and girls who own racehorses.

But, that's not the end of the problems. According to TIME, "the top 10% of subsidized farmers collect nearly three-quarters of the subsidies, for an average of almost $35,000 per year. The bottom 80% average just $700. That's worth repeating: most farmers, especially the small farmers whose steadfast family values and precarious family finances are invoked to justify the programs, get little or nothing."

It goes on. The bill does nothing to fix the "commodity farm program." The policies in place under current rules are hurting local growers of fruits and vegetables AND consumers. But, that seems to be the goal, as the larger national-scale producers don't want the competition that comes from growers at a local-scale at a reduced price. Solution? -- Slap on heavy penalties to growers of fruit and vegatables who are using land previously used for the favored crops of the farm subsidies (corn, soybeans, rice, wheat and cotton). A farmer could decide to grow nothing at all on the land and be better off than if he or she decided to grow a fruit or vegetable.

These kinds of policies do nothing to actually HELP small farmers or consumers. Farmers should be allowed to grow whatever is in their best interest to grow.

The bill also calls for a reduction in the McGovern-Dole International Food for Education Program for overseas schoolchildren. This coincides with the current rise in food prices worldwide. This is also not acceptable.

But, in the end, as Harkin says, "compromise" is the rule of the day -- this IS congress, after all. The bill does provide for several important programs for some of America's neediest families by way of increasing the food stamp program and a sizable boost in dietary and nutrition programs.

Having grown up on one, I know that farms contain a fair share of manure. But, as bad as it smells it DOES make the soil more fertile. Are these "compromises" simply a necessity to move important gains forward, or can we do a better job of targetting the policies which really need changed without giving money away for racehorse owners?

I think you know where I stand. How about you?

Your Medical Records: Public Property?

Whenever we go to the doctor, we naturally assume that the doctor and their staff are going to safeguard our medical records, personal data, and financial information from exposure or theft. Granted, sometimes people cannot be counted on for that, but the general sanctity of our personal information at the doctor's is something that we expect- and that the medical establishment is in our corner on this one. However, like most assumptions depending on the Good Faith of Those in Government, it is false.

The first thing you need to know: you do not technically own your medical records. The copyright law on medical records is murky at best- your doctor actually owns your medical records and holds them in trust, but legally, they belong to him or her, as they did the work to fill them. Conversely, there are arguments that you own the paper they are printed on, but your doctor actually owns the content, which is where the real value lies. Murkier still, if these records are being kept electronically, the software firm that designed the database actually owns your records, with end-user licensing, proprietary software and Digital Millennium Copyright Act issues coming into play. There has been no strong precedent or finality in sorting through these issues.

Recently, the Institute of Medicine convened a workshop on what has been termed the "learning healthcare system," and how it promises to revolutionize clinical, lab research, and pharmaceutical data reporting in order to ensure greater outcomes for patients. Sounds great, I will admit, as most things do in theory. The question is, are you willing to allow a government agency or private firm harvest your full data, remove personally identifiable information, and make it part of a public database? This is exactly what dozens of agencies, research labs, hospitals and private firms are salivating over. You are the sum total of your data, and now that data would be public.

Consider the following scenario.

You go to the doctor, for that raspy throat and burning sensation that has plagued you on and off for the past few months. The medical transcriptionist enters your intake form into a database using your national patient identification number, assigned randomly by the overseeing agency. As your symptoms and personal information are entered, they are tacked onto the end of your patient file, sitting somewhere on a massive server, able to be instantly recalled anywhere, anytime, by anyone with proper access. Triplicate forms are replaced by three computing sites in California, North Carolina and Minnesota. After taking down your symptoms, they enter that data for a cross-reference against the region, your age group, your medical history and your gender, seeking patterns and explanations.

"Hmmm, interesting," the doctor taps his stylus on the screen. "Based on the aggregate data for your age and health cohort, we've had a 70% improvement rate on the reduction of coughing fits with this treatment program."

"I don't have many coughing fits," you say. "It's more of a sensation, a burning."

"It is probably just a different manifestation of the same symptoms," he replies coolly. "I'm prescribing a three week drug regimen for long-term relief, but short-term relief can be had by this spray. Please pick up the sheet from the front desk on your way out. Make another appointment in two weeks if you haven't improved."

As you drive home, you pop the first pill of your three-week treatment, choking it past a protesting throat. The spray, a peculiar-tasting concoction, is actually starting to work, to your and you are certainly pleased that it is reliable. Pulling into your house, you see a strange car in the driveway. Oh yes- the home appraiser is due today to give their final assessment. You have been optimistic, as home values have finally been rising after the collapse of the market years ago. As you enter, your husband looks sick to his stomach, and the appraiser seems to be actively trying to console him.

"Honey, this gentleman has some bad news." He looks at you with a mixture of anger, disbelief, and despair.

"I'm sorry, ma'am, but we simply had to take these other factors into account," he sputters. "While your property itself is highly valued, we cannot ignore the medical data for this neighborhood," Your stomach drops and twists up, all at once. "There are remarkably high respiratory disease rates in this county. It's all right here, if you want to review it- two standard deviations above the mean rate nationwide. Best as we can tell, it is due to coal-fired power plants a few hundred miles away. This is public information, after all, and our supervisors insist that we access these databases in our assessments. I'm sorry."

He hands you a bound report. There it is, in black and white: your county has been flagged as needing immediate attention to ambient air quality, with high levels of many types of pollutants, illustrated by colors wafting over multiple states, right over your home. Another page shows a map with your county glowing red, at the tail end of a trail of bright colors leading hundreds of miles southwest. 'Respiratory Illness Rates,' it reads. You take another spray, mind empty, heart racing, future plans fleeing before the pained truth in your hands.

Meanwhile, in a computing center in San Diego, or Durham, or St. Paul, an IT sub-contractor has just gone to get a smoke. He does not log off his workstation. An office supply courier enters the office. Updated files are compiling by the second on-screen, awaiting de-identification to add to the database. Opportunity knocks. Your record pops up just as he plugs in a flash drive, and begins entering commands.

Scary picture, yes? It is entirely possible with the technology in place. But the real questions is, when you weight out the pros and cons- Is it worth it?

You might not believe it after the above story, but there are demonstrable positives to this plan. For instance, with a national database, there can be instant follow-up on successful (and unsuccessful) treatments on any number of illnesses, from the flu to heart disease to cancer. Medical research could be conducted in real-time, effectively, with results updated to the minute. It could provide a sort of early-warning system for regional disease outbreaks, as alerts could be sent to area hospitals upon spikes of certain symptoms in a given population. A consolidation of medical records serves only to increase access, with the hope of giving you, the patient, better medical care.

There are a lot of "could's" in the paragraph above, because this is all strictly theoretical, and no one knows in practice how wieldy or useful this proposed database could be. For instance- doctors nationwide, and potentially worldwide, would have to perfectly align reporting, terminology, and symptomatic description conventions to fit the needs of this database, removing all subjectivity and likely removing a layer of the analysis of you, the patient. In forming an analysis, a doctor would rely on you as the sum total of your data, and may not have that supplemental relationship of knowing you personally, your attitudes and lifestyle, that could add color to a diagnosis. Deeply entrenched attitudes on what constitutes research and data would have to be reformed- as one speaker put it, "every patient walking through the doors is a research subject." All these things could cripple any potential system simply by making it useless for practical application. But the security issue stands out as paramount. Do you honestly want to sign over your medical records into a massive database, knowing what you know about the government's esteem for your personal data? For all the promises that are made, and all the complex and wonderful systems they propose, they are still designed and operated by flawed people. There is a limit to the security that can be put in place.

It is no surprise that some of the biggest HMOs, pharmaceutical companies and government agencies are all worked up about it. They have a lot to gain from this. Do you? There is really no guarantee that this system is going to produce measurable positive outcomes for the patient. Until such time as I can see what this will do for me, I will keep that medical history private, locked up tight, where it should be. Only the person in the white coat standing next to me should have access at that time. I am not your research subject. Until such time that I can have absolute faith in the inviolability of these records, consider them off-limits- that is my prerogative as a patient, and yours.

Quick Hit from Omaha, Nebraska...

From the Omaha World-Herald, the big news this week relates to the untold thousands of levees protecting the Mississippi and Missouri river watersheds. A significant number of these levees are not listed on any inventory by the Army Corps of Engineers- meaning no one has any kind of idea what shape they are in.

According to Robert Bea, a University of California at Berkeley levee expert, many of these levees have fallen into disrepair, and even at peak efficiency, were only able to protect against common floods- not floods on par with the Great Flood of 1993. Thousands more levees exist outside the control of the Corps, built and maintained by private citizens to protect land that has become much more valuable and populated since those levees were built. Many of these largely ad hoc levee are not maintained or even known to exist by anyone but their owners. Bea is not optimistic about our prospects.

"Once they do get an inventory," Bea said, "I think we're not going to like what we find." Read on below...

"Majority of levees are unmapped and uncertified." Elizabeth Ahlin, Omaha World-Herald, 5.11.08

"Army Corps says Condition of many levees a mystery." Jim Salter (AP), Omaha World-Herald, 5.12.08