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Representation of Diversity – Or not

I never relay where I work on my blog. Or on social media. Why do I do that? Because anything I post is my opinion alone, and doesn’t relate in any official capacity to my work. All I will say is that right now I am BORED OUT OF MY FREAKING MIND, since I have been unable to report to work for the last 3 weeks. And as time passes, that boredom is gradually transforming to being PISSED OFF.  PISSED OFF at our elected officials who can’t do their jobs, and allow others to do theirs.

So instead of working on a journal paper I REALLY need to finish, instead of creating graphics to support that paper…I made this graphic. Showing how complete unrepresentative our political representatives are, particularly if you’re in the GOP. 88 PERCENT of the GOP House and Senate are white males. Mostly RICH white males, who’s life experience can’t possibly relate to the hardship they’re causing millions of Americans right now.

116th US Congress - Demographics

Demographics of the 116th US Congress. If you’re a rich, white male, you’re WELL represented. If you’re primary mission life is the acquisition of wealth, you’re well represented. If you’re a minority? A woman? Well, you’re kind of screwed.

We now return to our regularly scheduled program…

I’ve not blogged in several weeks. The reason…I largely “unplugged” during that time period. Given what was at stake in the election Tuesday, I just HAD to unplug. Unfortunately that meant staying unplugged not only from the political ugliness, bigotry, misogyny, and hatred that is life under the Trump administration, but also from my website, blog, and posting of bird photos.  To get back in the swing…a photo from one of my favorite bird encounters EVER in South Dakota…the only dark-phase Gyrfalcon I have ever found. As we head into the middle of November, we’re getting close to the time where there’s the potential to see these gorgeous rarities in the central part of South Dakota!  I’m REALLY looking forward to my periodic winter trips to the Fort Pierre National Grasslands, as I search for these guys, Snowy Owls, Ferruginous Hawks, Golden Eagles, Prairie Falcons, and other wonderful winter raptors.

As I get back in the swing of my normal online life, I do want to limit or eliminate the vast majority of political commentary on my blog.  It’s not that I don’t have a lot to say, as I DEFINITELY do in this horrible political climate. But keeping my blog primarily focused on birds, birding, and photography is one way to stay sane in such an environment.  However, I simply have to give a parting blog shot regarding the last couple of months, and the election. If you’re in the GOP and are offended by this…GOOD.  That’s what’s called a “conscience”, something your entire party seems to have lost.  Some points:

  • To my fellow Democrats...PLEASE STOP THE DOOM AND GLOOM that many seemed to adopt even after Tuesday. Saturday Night Live NAILED Democratic attitudes since 2016 (and admittedly, before that).  We have had some major traumas over the years, not the least of which is winning two elections by (2000, 2016) by ALL measures the rest of the civilized world uses, only to have our archaic, unfair electoral system award the most powerful office in the world to the person who received the fewest votes. I get it. I get the trauma. I at least understand the paranoia and pessimism that has permeated our party over the last 18 years.  But Dems…TUESDAY WAS AN OVERWHELMING SUCCESS.  Was it perfect? Hell no. I too was devastated by Gillum’s loss in Florida.  I too am incredibly upset about the situation in Georgia, with Kemp apparently squeaking out the narrowest of wins thanks to his own manipulation of Georgia’s voting rolls. And of course there’s Beto, the charismatic face of the election for Dems. That man has a VERY bright future in politics.  The fact that he lost, by 2.5% in ultra-red Texas, doesn’t diminish that future, nor does it diminish what he accomplished. Yes, the Senate seat didn’t flip.  But thanks to Beto, the face of Texas politics has begun to change. Thanks to Beto, it’s very likely two US House seats flipped blue that wouldn’t have otherwise. Dems…WE WON THE HOUSE!! Despite unprecedented gerrymandering by Republicans, despite the need to win the overall popular vote by a whopping 6% just to have a CHANCE to win the House…we flipped it. And not just flipped it, Dems are likely to have a healthy majority of about 231-204.  We also flipped at least 7 governorships, which is an incredibly powerful accomplishment given those governors will have a say in redistricting and eliminating gerrymandering after the 2020 Census. It was a massive success, and we now have a check on the most corrupt administration America has ever known.  Dems, PLEASE LEARN TO CELEBRATE OUR SUCCESSES, and stop wallowing in self pity.  It serves no purpose and only diminishes our progress. Keep fighting the good fight. WE ARE MAKING PROGRESS.  Don’t give in to the despair and pessimism.
  • To Republican Americans...WAKE…THE…FUCK…UP.  I’m going to be blunt. If you’re in the GOP right now and continue to vote for the GOP, there are only three possible categories in which you fall.
    • #1 — You’re a racist — Nothing new here.  Trump won the election in 2016 by fanning the flames of latent racism. Down the stretch in 2018, what did he focus on? The economy? Health care? No…he talked incessantly about the dangers of immigrant hoards taking over the US.  Never mind that the oft-mentioned “caravan” consists of political refugees fleeing violence in their own country, and that a majority of them are women and children. They were presented as a major threat to the American way of life…and a huge chunk of the GOP ate it up.  Given what we’ve seen for almost three years now, since Trump announced he was running back in 2015, the man is an clearly an unabashed racist. Trump campaigned for the GOP on a platform of racism, and GOP voters responded with a resounding YES…THIS IS WHAT WE WANT. THIS IS WHAT WE STAND FOR.  In the long term…you’re destroying your own party. The 2018 elections are just the start. A party built on racism is unsustainable in the long term. From that perspective, I’m glad to see the GOP revealed for what they have been ever since the racist dog whistles that began with Nixon…a party of and for white America, a party that no longer pretends to even try to represent all Americans.  In the short-term however…it’s incredibly destructive.
    • #2 — You’re ignorant — Another huge chunk of the GOP (and indeed, of Americans as a whole). Let’s face it, Americans on BOTH sides often vote on reflex. They vote for a “D” or an “R”. They are completely ignorant of the issues. The don’t know the candidates or what they stand for.  Other than the outright racism demonstrated by the GOP, the second biggest threat to American democracy is apathy.  Trump was RIGHT a couple of weeks ago, when he said the Florida bomber and the mass shooting disrupted GOP momentum.  Despite every illicit, immoral, outright disgusting action taken by the Trump administration over the last 2 years, GOP numbers were rising somewhat as the election approached. Why? Americans can’t be bothered to account for 2 years worth of reprehensible behavior!  It’s forgotten! Ask most people what Mueller is investigating for example, and you’re likely to be met with a blank stare (or an outright lie). Ask about the huge number of indictments of Trump officials…I guarantee the vast majority of Americans don’t remember anything about Manafort, Cohen, and the rest of the corrupt crew.  Americans just…don’t…care.  TRUTH DOESN’T MATTER.  It’s MUCH easier to digest the drivel that’s spoon fed to them by state TV (otherwise known as Fox “News”) than it is for them to learn the truth of what’s really happening. Of course I can’t give this class of GOP voters a pass. That ignorance, the outright apathy, is almost as destructive as GOP racism.  But at least from a moral standpoint, apathy and stupidity is somewhat less disgusting than GOP racism.
    • #3 — You’re a CEO — Or perhaps not a CEO, but a wealthy business owner. Someone who wants to perpetuate a system with the worst income inequality in the world. Someone where corporate or personal profit is the ONLY thing that matters…morality be damned.  In other words…someone exactly like Trump.  From a morality standpoint, clearly this is just as despicable as the racist sect of the GOP.  These are people that simply do not care about the racism, the misogyny, the bigotry, the spread of hatred…as along as it doesn’t interfere with the most business-friendly, least worker-friendly administration in American history.

Despite the election results, it’s still going to be a very rough next few years. We’ve already seen that, where within 12 hours of the election results coming in, the Trump administration makes their move to bury the Mueller investigation.  The response from GOP politicos?  A yawn.  Other than a few outgoing politicians (e.g., Jeff Flake), or the VERY rare class of GOP politicians who seem to actually have any  morality (e.g., incoming Senator Mitt Romney)…there were no condemnations of the complete flout of the rule of law.  There were no calls in the GOP to protect the investigation. For a morally bankrupt party like the GOP, it’s the end result that matters. Nothing else.  The truth? Irrelevant. The LAW? Irrelevant.

The 2018 election was a powerful rebuke of GOP immorality. It’s a WONDERFUL start, but we’ve got a long slog ahead.

And we now return to our regularly scheduled program.  Birds…photography…nature…a MUCH needed distraction in today’s environment.

Juvenile Gyrfalcon - Falco rusticolus

It’s time!! Getting close at least. Of course I’m talking about our WONDERFUL South Dakota winters, and the birding opportunities that we have. Yes…yes…it’s a cold, glacial hell here in winter. But we do often have incredible numbers of raptors, including the chance to see US mega-rarities. Gyrfalcons are the big prize for me in the winter. This photo from a few years ago is the ONLY dark-phase Gyrfalcon I’ve seen…a gorgeous, gorgeous bird.

Bye-bye Birdie…Repubs set to gut Endangered Species Act

Greater Sage Grouse -- Centrocercus urophasianus

A Greater Sage Grouse, one of many species that have been considered for protection under the Endangered Species Act in recent years. In the case of this species, political and economic interests won, and Sage Grouse were removed from consideration for protection. The partnership between conservative political groups and economic interests has been very successful in recent years in fighting species listings on the ESA, and with an environmentally hostile Republican Congress now emboldened with a new Republican President, the ESA as a whole has never been under more of a threat.

Mention “Greater Sage Grouse” to a birder, and you’ll get an enthusiastic discussion of a unique, large bird with spectacular breeding displays.  Mention Sage Grouse to a hunter, and you’ll get an enthusiastic discussion of a wily game bird that’s much sought after, particularly as numbers and hunting opportunities decline.  Mention Sage Grouse to energy developers, real estate developers, and conservative politicians in the West, and “Sage Grouse” is a four-letter word. As the U.S. Fish and Wildlife Service (USFWS) considered the species for protection under the Endangered Species Act (ESA), it sparked a fierce political battle, with Republican politicians in the West teaming with oil, gas, and real estate interests to fight protection.  Despite populations of Greater Sage Grouse declining by over 50% in the last 40 years, and despite the loss of vast areas of former sagebrush habitat, in 2015 the USFWS decided not to list the species under the ESA. It’s disingenuous to discount the impact political pressures had on that decision, as the Greater Sage Grouse still faces significant threats due to habitat loss.  However, one of the contributing factors in the USFWS decision not to list the species was, ironically, widespread conservation efforts that started happening in the West after the species was being considered for listing.  In effect, the threat of listing, and the very existence of the ESA, sparked protections that may have substantially reduced threats to the species. Without the ESA and the threat of legal protection, those conservation efforts likely would never have occurred.

There are other species where equally contentious political battles are currently being waged.  The Lesser Prairie Chicken was listed as “Threatened” under the ESA in 2014, and for good reason. On the global IUCN “red list” of threatened species, the Lesser Prairie chicken is listed as “vulnerable” to extinction, primarily due to the loss of >85% of its original habitat.  Only 20,000-40,000 birds are left, a number that is 98% lower than before settlement of the Great Plains. Despite the obvious scientific reasons for listing the Lesser Prairie Chicken, in 2015, a court order vacated the USFWS decision to protect the species. An energy development group, the Permian Basin Petroleum Association, had teamed with a number of counties in New Mexico to sue the government to prevent listing.  After the court order, the USFWS released a statement that the court order was contrary to the actual scientific, biologic evidence, and that protections were still required to ensure the species was preserved. However, in a very disappointing move to conservationists, the USFWS decided not to appeal the court ruling.

Bald Eagle - Haliaeetus leucocephalus

Sights like this have become incredibly common in many parts of South Dakota as Bald Eagle numbers continue to increase. Bald Eagles were one of the original species included on the Endangered Species Act. With their precipitous decline up through the 1970s, the story of the Bald Eagle was in fact one of the driving forces behind the very establishment of the ESA. Despite countless success stories such as this, the ESA is under a threat unlike any other in its 40+ year history, all due to political and economic interests that value short-term monetary gain over environmental and conservation concerns.

Western states and associated economic interests have wielded considerable political power in efforts to derail listing of species under the ESA, The Lesser Prairie Chicken is but one example.  Political battles against the ESA have ramped up substantially since the Northern Spotted Owl listing in the Pacific Northwest (PNW) resulted in the eventual establishment of the Northwest Forest Plan, resulting in major changes in forest management in the region. Those politically opposed to the ESA use the Spotted Owl case as a rallying cry, citing (supposed) massive job losses in the timber industry as a result of the Northwest Forest Plan. However, after the Northwest Forest Plan was enacted, an economic analysis of the first 10 years of the plan found that 40% of communities in the region experienced some economic decline, 37% experienced economic gains, while the rest were relatively stable.  The economic impacts were thus decidedly mixed, not the economic disaster that was foretold, and it was also very difficult to disentangle the economic impact of the Northwest Forest Plan from other economic and political impacts on forestry in the Pacific Northwest.  At the same time the Northwest Forest Plan was beginning to take effect, there was substantial increases in competition for timber products from other timber-producing regions such as Canada, Russia, New Zealand, even the elsewhere in the U.S. (primarily the southeastern U.S.).  Asian economic declines and a sharp decline in demand for PNW timber in Asian markets also strongly contributed to timber industry declines in the region. However, the perception that it was the ESA and the Northern Spotted Owl that “killed the economy” in parts of the PNW is still widely held among those without a complete economic and political understanding of timber industry declines in the area.

It’s been disappointing to see the lack of political will to uphold the ESA and the scientific research that supports decisions to list or not list a species. Given the strong biologic evidence to support listing of the Lesser Prairie Chicken, and given that the 2015 court order to vacate the ESA listing occurred under the watch of a Democratic Obama administration, the decision not to appeal the ruling was viewed as a betrayal by many conservation groups.  However, it’s a sign of the power of political and lobbying groups that have rallied against the ESA in recent years. Even with a Democratic administration that is far more supportive of conservation concerns, the protective power of the ESA has eroded.  Scientific research and the actual biological basis on which ESA listings SHOULD be based have instead been replaced with the influence of politics and economics.

This weekend, we’re shifting to a new administration that will undoubtedly be much more hostile to conservation and environmental concerns than has been the Obama administration. The stocking of the Cabinet and other key government positions with businessmen who are openly hostile to environmental regulation ensures that stories like that of the Lesser Prairie Chicken will become increasingly common, where science and biologic need are dismissed in favor of short-term economic concerns.  The lack of political will to support provisions of the ESA will remove the regulatory and enforcement “bite” of the law, regardless of what happens with the law itself.

Even more distressing, however, are discussions about directly confronting the ESA itself. Rob Bishop (Republican, of course), head of the House Natural Resources Committee, states that he would “love to invalidate” the ESA.  Think about that.  The head of the Congressional Committee tasked with overseeing and preserving the nation’s natural resources, stating that he’d like to remove the very law that has been instrumental in preserving our national symbol, the Bald Eagle, as well as countless other plant and animal species

We’re a country where a wide swath of the electorate knows more about Kim Kardashian’s latest fashion statement than they do about the Affordable Care Act, what’s happening in Syria, the real state of the economy, or other issues that are truly important.  It’s that ignorance, that apathy, that enables the election of a narcissistic, childish, pig of a man to the most powerful position on the planet.  Here’s hoping that someday soon, we all snap out of that apathy, start paying attention, and hold politicians accountable. Otherwise we’re in serious danger of losing all the great strides we’ve made in conservation and environmental protection in the last several decades.

 

 

 

 

Why “Alex” > “Olivia” > “Nate” — Health care in America

Three Happy Children

Three happy children, “Alex’, “Olivia”, and “Nate”, living in a world where Alex will receive better health care than Olivia, and Nate will receive the worst health care of all 3, all because of their socioeconomic status.

We’re two weeks into a new Congress that smells blood in the water.  Other than a flurry of legislation designed to limit transparency and ethics oversight (always a great sign when that’s their first thought when they arrive in Washington), the major focus has been the dismantlement of Obamacare (the Affordable Care Act, ACA).  What is abundantly clear is that those voting to “repeal and replace” the ACA, without having ANY idea of what they might eventually replace it with, are oblivious to the impacts of the law on real Americans.  What follows is a NOT so hypothetical story of three children, “Alex”, “Olivia”, and “Nate”, and what health care policy in the United States means to them.

Alex, Olivia, and Nate are all young teenagers or pre-teens.  Each has Type-1 diabetes, the auto-immune version where their own misguided immune system has attacked and destroyed the islet cells in their pancreas’ that make insulin.  For the rest of their lives, they will be dependent upon insulin injections.  It’s a life fraught with risk. If you don’t control your blood sugars well, you’ll have frequent hyperglycemia events (high blood sugar). Over time, that will contribute to kidney disease, eye disease, cardio-pulmonary disease, and peripheral nerve damage. If you’re extremely vigilant and try to control your blood sugars very tightly, you’re more likely to have hypoglycemic events (low blood sugar), a dangerous condition that can cause seizure, coma, and even death.  Long-term blood sugar control is measured with a patient’s “A1C”, a hemoglobin-based measure from your blood.  A “normal” A1C is less than 6.5. The higher a diabetic’s A1C is, the worse their long-term blood sugar control, and the higher their risk for complications.

There’s little doubt the ACA is a god-send to Type-1 diabetics like these Alex, Olivia, and Nate.  No longer can they be refused insurance coverage for their pre-existing condition.  Diabetes is an expensive, life-long disease, but thanks to the ACA, they will no longer be subject to lifetime maximum payouts from insurance companies.  For parents helping them transition to an adult life and the responsibility for their own health insurance, the ACA allows parents to cover children on their insurance until they turn 26.  Things are much better with the ACA, but even with the ACA, we’ve got a long way to go in providing equitable health care in the United States.  With that as background, here is the not-so-hypothetical story of Alex, Olivia, and Nate and their battle with Type-1 diabetes…and the American health care system.

“Alex”

Alex is a young teenager who was diagnosed with Type-1 diabetes at a very young age.  His family would be considered  upper-middle class. Alex’s family has a very good, comprehensive health care plan, with insurance provided through one of Alex’s parents. Alex has had access to some of the best care a young diabetic can have. For over 10 years, Alex has had an insulin pump, a small device that holds a reservoir of insulin.  His pump automatically provides a steady stream of insulin all day long (the “basal” insulin), just as the body normally does, to try to keep blood sugars stable. His pump also makes it easy to administer insulin at meals.  He simply estimates how many carbs he’s eating, enters that number in the pump, and the pump provides the proper amount of insulin required to process the sugars in that meal. Alex checks his blood sugar very often (8-10 times a day), but was still occasionally experiencing both hyperglycemic and hypoglycemic events.  In addition to his pump, his family pursued a “continuous glucose sensor” (CGM), another medical device that automatically checks his blood sugars every 5 minutes.  The CGM even has a cell phone app, where his parents are alerted on their cell phones if his blood sugars need attention. He no longer faces the dangerous “nighttime lows”, a hypoglycemic event that may occur at night when a patient is asleep and less able to respond. If Alex’s blood sugars start to drop anywhere close to dangerous levels, an alarm will alert both him and his parents that action is needed.  Alex’s A1C levels have typically been right around 7.0, just a bit above that of a “normal” person.  With the new CGM, it’s likely that will go down even further.  Alex’s care is expensive.  The insulin pump and the CGM both costs thousands of dollars, as do the yearly supplies that support those devices.  Along with the costs of insulin, doctor visits each month, and other supplies, Alex’s health care costs without insurance would be in the 10s of thousands of dollars per year.  Even with what’s considered quite good insurance, his parents pay a lot out of pocket each year for the pump, CGM, and supplies. They can afford it, however, and Alex’s long-term prognosis and risk of complications is much lower than Olivia’s or Nate’s.

“Olivia”

Olivia is a pre-teen who has had diabetes for about 5 years.  Her family would be considered middle-class, perhaps lower middle class. Olivia’s family has a health care option through a parent’s employer, with coverage that isn’t nearly as good as what is provided by Alex’s insurance. Olivia’s family would like a better insurance plan, but their income is high enough that they’re not eligible for subsidies under the ACA that might enable them to “shop around” and find better insurance.  Olivia’s insurer covers only part of the costs of an insulin pump, and does not cover costs for a CGM.  Olivia’s family cannot afford the out-of-pocket costs that would be required to get an insulin pump, so Olivia does not have an insulin pump, or a CGM.  Her insulin control relies on frequent injections, with a daily “long-acting” insulin that is meant to mimic the basal insulin (the steady, day-long drip) provided by Alex’s pump, and “short-acting” insulin that is given with every meal.  Olivia doesn’t like needles, but as a young diabetic, she’s learned to tolerate them. Olivia knows Alex, and marvels at his pump, which frees Alex from the 4-6 daily injections that Olivia gets.  Olivia checks her blood sugar as frequently as Alex, 8-10 times per day, which helps keep her blood sugars under control.  She can respond when blood sugars are low or high, but it means another injection (for high blood sugars).  Without a CGM, she’s more subject to unnoticed hypoglycemic or hyperglycemic events.  Unlike Alex, who “feels” when his blood sugar is low, Olivia has no such physical feelings or warning signs when her blood sugars go low.  She recently was hospitalized after a severe, nighttime hypoglycemic event, when extremely low blood sugar results in seizure and a short period of unconciousness.  With her diligence in checking blood sugars, however, those events are minimized. Her A1C is significantly higher than Alex’s, usually around 8.0 to 8.5.  Compared to Alex, she’s thus not only at risk of unnoticed high or low blood sugar events, she’s also more likely to develop longer-term complications such as heart disease, kidney failure, or eye disease.

“Nate”

Nate is a teenager who was diagnosed with diabetes about 10 years ago.  He lives in a single-family home, a good home with a very loving mother, but paying the bills is a struggle.  The only health insurance available to Nate’s family prior to the ACA was a “catastrophic care” policy with very high deductibles and much poorer coverage than either Alex or Olivia receive.   After Nate was diagnosed, the economic struggles meant pinching pennies on health care. It even meant pinching pennies on the administration of insulin. At difficult times, Nate’s family would avoid carbohydrate-laden meals, in order to save money on the amount of insulin needed to treat Nate. Visits to the endocrinologist were few and far between, as Nate’s mother couldn’t afford them.  Nate’s blood sugar control was very poor prior to the ACA, with A1C’s typically over 10.  Under the ACA, subsidies are available, including both tax credits and cost sharing subsidies, that ensure a plan on the ACA marketplace can’t cost more than 9.5% of a family’s income. After the ACA, Nate’s mother enrolled in a marketplace plan and obtained a health care plan that was much better than the poor health care option provided through her employer.  However, Nate’s insurance is similar to Olivia’s, in that only partial costs of an insulin pump would be covered, and a CGM is not covered.  Nate’s mother cannot come close to paying the out-of-pocket costs that would be required for an insulin pump. Nate relies on shots much like Olivia does.  Nate’s mother is extremely thankful for the availability of ACA coverage, as without it, even the cost of insulin would have been very difficult for her to pay under her employer’s poor, catastrophic coverage insurance.  However, the family still struggles with everyday costs, including costs of health care. With the only available, affordable ACA plan, coverage is worse than either Olivia’s or Alex’s.  Nate’s situation has improved, but his family is still forced to make extremely difficult healthcare decisions, regarding both health care and other, every-day expenses.  With another sibling with asthma and other problems, covering health expenses is difficult even with the ACA and tax credits.  Visits to the doctor are fewer for Nate’s family than for Olivia’s and Alex’s. Blood sugar control has improved for Nate with the better insurance from the ACA, particularly as the family doesn’t feel the need to “scrimp” on insulin, yet Nate still has A1C levels that approach 10 at times.  Nate is at substantially higher risk of long-term complications than either Alex or Olivia.

Comparing Alex, Olivia, and Nate

Alex > Olivia > Nate.  That’s the situation in today’s health care system, where your level of care is directly related to your ability to pay.  With Type-1 diabetes, blood sugar control is LIFE.  There are tools available that assist a Type-1 diabetic in maintaining blood sugar control, but those tools are of no use if a family can’t afford them.

In all likelihood…Alex will outlive Olivia.  Olivia will outlive Nate.  It’s as simple as that, when blood sugar control is the key to a long, happy life for a diabetic.  Particularly a type-1.  It has NOTHING to do with the love of a family, or the desire to keep blood sugars under control.  The parents of Alex, Olivia, and Nate all love their children very much, and would do anything to keep them as healthy as possible.  It simply boils down to economics. Even if insurance provides some access to advanced treatment options, that’s useless if the family can’t afford co-payments or other fees required to get those advanced options.

The ACA is far from perfect, but also a much, much better situation than we had prior to the ACA. The ACA is a step in the right direction, but more is needed. Instead, we’re heading backwards.  The split between the “haves” and the “have nots” has never been more evident in the United States, and as the not-so-hypothetical case of Alex, Olivia, and Nate shows, that divide is also still clearly evident in how we dispense our health care.

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