Stick with the facts

Posted: Feb 03, 2006 10:00 AM
Any consultant worth his salt knows that “The urgent always crowds out the important.” To wit, it’s “important” for Company A to have a long-term program to improve its widgets. But that long-term plan doesn’t matter if Company A can’t make its payroll this week. Just staying in business is “urgent,” and it takes priority.

However, like so many other concepts, this doesn’t apply to the federal government.

Consider global warming. Human-caused climate change might generate changes that lead to “practically a different planet,” James Hansen, the head of NASA’s Goddard Institute of Space Studies, told The Washington Post. “We can’t let it go on another 10 years like this. We’ve got to do something,” he added.

Of course, any successful response will come from the private sector, not the government. It will be fun, though, to look back in 2016. By then, American automobiles might run on tap water, our factories could be powered by nuclear fusion and our planet will certainly be cleaner than ever in history. We’ll be able to smile when we remember Hansen and Gore’s warnings.

But in the interim, the federal government is scrambling to throw money at global warming, in an attempt to “do something.” Washington spends $2 billion a year on the “important” topics of global warming and climate change. Meanwhile, at least one “urgent” problem isn’t getting enough attention. Autism.

The Centers for Disease Control says, “between 1 in 500 (2/1,000) to 1 in 166 children (6/1,000) have an Autism Spectrum Disorder.” That’s a crisis by any measure, but it’s flying under the radar screen. “Total NIH support for autism research was approximately $74 million in 2002,” the National Institute of Health reports on its Web page.

Autism may be getting less attention simply because it is more controversial. The CDC isn’t even sure there’s “a real increase in the incidence of autism as opposed to increased awareness and acceptance of the diagnosis.”

But even more controversial is the fact that many think the increase in autism is tied to vaccines, especially thimerosal, a longtime vaccine additive that’s half mercury. If that proves true, it would be a big problem for the government. The number of vaccines the CDC recommends a child get before turning two has almost tripled since 1988. At the same time, the rate of autism diagnoses has gone from 1 in every 10,000 children to 1 in 166.

In any event, the government is too involved in our children’s health care. In a paper last fall dealing with Medicare, Richard Dolinar, M.D. warned against allowing “government micromanagement of medical care.” He wrote that, “Physicians would be compelled either to follow government treatment guidelines or to suffer financial consequences, regardless of whether a particular guideline is in the best inter¬ests of a particular patient.”

That warning accurately describes the current CDC vaccination schedule: The federal government sets standards for patient treatment, the state governments mandate that each patient must receive that treatment and pediatricians dutifully provide it. The idea of doing what’s best for each individual patient doesn’t exist as we scramble to do what’s best for “the greater good.”

Government guidance even causes medical professionals to ignore common sense. Amy Anderson, a licensed practical nurse with Endwell Family Physicians in New York, recently told the Binghamton Press & Sun-Bulletin that combination vaccines, where one shot immunizes against more than one disease, are a good idea. The body responds better when it receives more than one vaccine at a time, she told the paper.

That makes no sense. Doctors won’t vaccinate a child who’s fighting off a cold or fever, because his immune system isn’t operating as efficiently as it should. So how can it be safe to inject five different things into the child all at once?

Giving each shot alone and then waiting a few months to make sure the child had responded well would be far more reasonable. But that would require multiple visits to the doctor.

So, for everyone’s convenience, the CDC recommends combining shots. “The use of combination vaccines is a practical way to overcome the constraints of multiple injections, especially for starting the immunization series for children behind schedule,” a May 1999 CDC report said. But health care should be based on what’s best for the patient, not what’s easiest for the doctor or the parent.

Preventing global warming may (or may not) be important. We actually won’t know for decades. But finding out what causes autism (so we can cure it) is urgent. Let’s keep our priorities in line.