On the wonders of capitalism

In his letter (Mailbag Aug 18) Mr. Brenan pointed out “how quickly free enterprise corporations managed to develop and produce” the Covid vaccines, and implied that the “wondrous successes under capitalism” would not have been possible if the whole program had been managed by the government. 

While we celebrate the entrepreneurs and the competitive force of the “free market”, let us not forget that it is the basic research by scientists and academicians whose salaries are bankrolled by taxpayers and whose grants are issued by government-run agencies that made those advances possible. They are the ones who took the painstaking steps to understand the molecular biology and who developed laboratory technologies that made the mRNA vaccines possible. Private companies merely scale up the technology to an industrial level, and market the products at the highest allowable profits. Even then, they benefit plenty from government subsidies and tax-breaks. Among other examples of how capitalists pick up the fruit of government-funded research include the internet, GPS, and robotics, and many clinical applications in medicine.

To simplify that government is all inertia or that capitalism is the driver of all creations is to ignore the fact that our American success stories has always been the delicate balance of public-private cooperation, with basic research coming from government agencies and funding of industrial development coming from private investors. Beyond this, the continuing role of government is proper regulations and consumer protection. It is when legislators and capitalists are cozy bed-fellows that we all lose.

(Submitted on Aug 18, and published on Aug 25,2021 in the Gazettte Times, Corvallis)

January 6, 2021

As our TV screens flashed images of the mob incited by President Trump storming and vandalizing the US Capitol, commentators stated that January 6, 2021 will be remembered as another “day of infamy” in our history. May I suggest that actually it should be remembered as a “good day” for America. Sad, shameful, terrifying, of course, all of the above, and more; but in the end - a good day, for two reasons:

First, it was a long overdue wake-up call that spoke louder than any of Trump’s previous actions his populist and political supporters had chosen to ignore. But our democratic institutions survived by the end of the day, just enough perhaps to begin more soul searching and positive changes. Mental health therapists know that sometimes patients have to “hit the bottom” before climbing up the road to recovery. Maybe we just did.

More importantly, Georgia’s election results are a tsunami against the entrenched power of “Deep South traditions”. Dr King, J Baldwin, and many legendary civic leaders would have cried with joy and pride on this day. Disfranchised people have finally flexed their muscles with their votes, and from now on, will remember and teach their children the power of civic involvement.

On Jan 6, 2021, we survived an insurrection by white supremacists and political conspiracy theorists, and we proved that people cannot be marginalized forever. It was very painful; it was not easy. But I feel that a new chapter is being written. God Bless America.

(Submitted to the GT, Jan 7, 2021)

Lessons from the Covid-19 pandemic

One year after the first case of Covid-19 was reported in China, what have we learned from the pandemic?

Trying to answer that question in 600 words would be like drawing an apeirogon made of an infinite and ever-expanding number of images. I shall therefore leave the recounting of stories of sacrifice, resilience, and complex human emotions to writers, poets and artists. The lessons I am sharing here are rather dry and non-sentimental – focusing on the role of public health in our lives.

To begin, let’s examine why some countries – like S Korea, Japan, Taiwan, Viet Nam and New Zealand, are coping much better than most industrialized countries of the Western hemisphere, thus cutting a path to fewer humanitarian challenges and economic problems. These countries all have universal healthcare coverage, and primed by experience with SARS1 virus two decades ago, have maintained a vigorous public health system. They readily contained isolated cases and small outbreaks before they got out of hand, using the classic combination of testing, contact tracing and quarantine, social distancing and temporary lockdowns when feasible, pairing temporary laws with social awareness and health education (handwashing and face masks) to maintain public trust. Second wave outbreaks are also quickly dealt with the same rigor.

Here, more than just exposing the inequalities and dysfunction of our healthcare system, the pandemic has shed light on non-medical determinants of health: outcomes are strongly correlated with differences in social class and wealth, living environment, education and work conditions, and access to healthcare. It also exposed the fragility of employer-based insurance and many issues in our workforce.  These topics, albeit important, are beyond the scope of this essay.

What started as localized, uncontained outbreaks are now a devastating tragedy, leaving an uneven toll of economic, medical and psychological scarring across our land. We have world class scientists and epidemiologists, the best medical technology, yet so far have failed miserably. So, what went wrong? Instead of being proactive in implementing early comprehensive and preventive measures, our mitigating actions continue to be reactive, too little, too late, and too often fractured by political chauvinism contradicting scientific recommendations, generating confusion and loss of public trust.

This loss of confidence in public institutions has deeper roots – a general suspicion against official authorities in general and against academic and scientific figures in particular, seen as elitists. Conspiracy theories, riding on the fears and prejudices that living with uncertainty and anger brings, only magnify the problem. 

But lessons from this pandemic don’t need to be just gloom and doom. Out of challenges and necessities, new ways of thinking and problem-solving will emerge. Pandemics come and go, and I am confident that science and technology can control the Covid virus. But we should remember that infectious agents thrive by exploiting our human vulnerabilities. For some, it may be the weakness in our immune system caused by age or underlying medical conditions. But as a nation, our vulnerability comes from self-inflicted wounds – the social rifts and fractures that are more difficult to bridge and heal. 

Too often laws are crafted to favor special interests, but public health laws are created to make all of us safe by improving human behavior, asking of us self-discipline and social responsibility. They are the most equitable, the easiest to comply with, and the most cost-effective laws – just think how many lives and societal costs are saved by laws requiring car-seat belts, bike helmets, and immunizations. But laws and institutions only work if the public is engaged and committed. All of us should give public health, and ourselves, another chance to succeed in stopping the pandemic.

(Submitted to the Gazette-Times of Corvallis, OR, on Dec 10; published on Dec 18, 2020)

Confessions of an atheist

It seems awkward for an atheist to join in the Interfaith voices, but may I share with you my thoughts about God and religion. They have evolved during various stages of my life.

Children have an innate gift for detecting hypocrisy, apparent when the whole story is not told.  School books seldom mention the fact that gunboats and slave ships followed missionaries, that cathedrals and temples, just like royal palaces and empires, were built with huge taxes on peasants and the blood and bones of artisans and serfs. In my rebellious youth, I readily embraced Karl Marx’s proposition that “religion is the opium of the people”, promoted by kings, politicians and priests who use God to shield their abuse of power.

As an adult equipped with abstract thinking but starting to feel that my feet are made of clay, I pondered, like others, about the existence of a Creator. How else can we explain the wonders and mysteries of life, and who do we pray to when other humans have failed us? Voltaire quipped: “If God did not exist, it would be necessary to invent him.” Pascal proposed that believing in God is one’s best bet: If I believe in God, but God does not exist, I have lost nothing; if God exists and I don’t believe in him, I would be damned! So why take the risk of not believing in God? Ben Franklin simply stated: "Religion is useful". All very true, maybe, but hardly a spiritual journey, if God exists only to satisfy our human caprices or relieve our insecurity.

Now, I am an old man no longer asking questions for which answers can only be imagined or fabricated. On the death of a young child or the loss of thousands of lives from a natural disaster, please don't tell me "God works in mysterious ways". Even if there actually were a God, his/her words would likely come to us filtered through the minds and lips of fallible humans. Still, I respect individual choice of religious beliefs and practices, so I don’t question the faith of folks who claim to have been blessed by a divine life-changing experience, especially if it moves them to do good things. Myself, I have rediscovered the hero of my youth, Albert Camus, and his existentialist-humanist “faith” – if you can call it a faith. In his plague-stricken city, when asked whether he believes in God, Dr Rieux answered: “No – but what does that mean? I’m fumbling in the dark…under the vast indifference of the sky”. To attain peace, he put his compassion (from the Latin, to "suffer with") to work, find meaning in life by bringing relief to others. Not for heroism, but out of empathy. Driven by social decency, not charity. 

Secularism means to separate human values from religious considerations, while atheism implies a denial of God's existence. But labels don't say much to me anymore. What matters is putting to work our innate human empathy, our duty to others, and our common resilience in times of adversity, whether God exists or not. Still pained by all the injustice and violence unabated by prayers, I long for a humanity not divided between the saved and the damned, the sinners and the pious, the faithful and the infidels. I can’t say much about Heaven or Hell, but here on earth, where I live, I want to reach out to others, and work together for a better Karma for our common humanity and other living things.  With only my social human conscience to guide me, unchained by religious dogmas. God's mercy not needed.

Published in the Gazette Times, Corvallis, November 14, 2020

(Chinh Le was raised in Viet Nam in the Confucian-Buddhist tradition. He is currently a member of the Unitarian Universalist Fellowship of Corvallis. The views expressed here are strictly his own.)

More on Statin drug recommendations

The headline of the Aug 25 "To Your Good Health" column reads: "Over 70? It might be time for a statin!". The case in point: a healthy 71 year-old man with no pre-existing cardiovascular condition was given an estimated 19% risk of having a heart attack or stroke in the next 10 years. The risk would be reduced to 15% if he takes a statin drug, a "reasonable plan" if the patient does not mind taking the medication.  

Because of a paucity of data, previous guidelines had been controversial for the role of statins for the primary prevention of cardiovascular diseases for healthy elderly persons. Confirming Dr Roach's advice, a new observational, retrospective study of VA patients published in the J Amer Med Assoc, July 7, 2020, reported a 20-25% decrease in death rate and a 10% reduction in cardiovascular disease when comparing statin users with nonusers. Limitations noted: it may make 2-5 years for benefits to appear, and the incidence of stroke was unaffected.

Impressive as the statistical results may appear, let's look at the other side of the coin: If one were to extrapolate the case cited by Dr Roach in a population-based analysis, the cost-effectiveness to the individual and to society would be as follows: for 100 healthy elderly individuals prescribed a statin for 10 years, 4 would benefit, while for the other 96, the medication would do nothing. 

Medical statistics are important in making health decisions. But it depends on how you frame your observations.

(Submitted Aug 27, published Sept 4, 2020 in the Gazette Times, Corvallis)