"Put that kid out in the dirt ..." (17 April 2014)

It would have been some time in the mid-ish 1940s, perhaps 1947 or so, when I was a small child and — my mother's story went — she took me to a pediatrician who told her "Put that kid out in the dirt and get him around more kids."

            The pediatrician was concerned that my mother was keeping me too clean and sanitized and that I wasn't contracting childhood diseases in childhood and, well, just seemed unnaturally clean.

            The pediatrician had solid experience and evidence for the importance of getting childhood diseases in childhood — a human male, especially, doesn't want mumps in adulthood — but the rest was mostly prejudice, reinforced a little from what was becoming a real science of immunology. Still, that advice stemmed mostly from literal prejudice, in a morally neutral sense: he had judged before a lot of evidence was in that there was just something, well, unhealthy about keeping kids too sanitized, deodorized, and antiseptic.

            I went on to participate in grammar-school football and played line until the other kids outgrew me too much for me to block; but I did play football in robust Chicago wind and rain and mud, and there was no danger then or later that I'd ever be crazy clean.

            I went further on to take 18 hours of Microbiology in college and work three summers doing Micro, more or less. Among the lessons I was taught was, "Bacteria are ubiquitous, pretty much everywhere on Earth except deep in an active volcano or in the bloodstream of a healthy mammal"; and I learned that the human mouth is, bacteriologically speaking, filthy. At least I got more growth plating out a swab from the mouth of a healthy person — me, for a "normal" every few days — than I got plating out a squashed fly.

            And beyond that I read at a fairly young age Mary Douglas's great book Purity and Danger (1966) and figured out that many US customs rationalized as hygiene — and sometimes useful for hygiene — had more to do with purity and a kind of ritual/social cleanliness than anything very scientific.

            So I've been fascinated even more than usual the last year or so with stories reaching the lay media on the American crazy-clean concern with skin sanitizers and antibiotics and high-tech birthing of babies and gloves of latex or plastic on the hands of people not performing surgery or CSI work. I've been fascinated with increasingly insistent suggestions that in some areas of hygiene in a broad sense we have gone overboard and moved from diminishing returns to "counter-productive" to, in public health terms, self-defeating.

            We didn't have the term "microbiome" when I was preparing to enter the Microbiology biz or working on a project in gastroenterology, but we were well aware of the importance of gut bacteria and other gut microorganisms, and it was standard folklore that if one took antibiotics, one should eat real yogurt, the kind with what I learned to call "active cultures."

            (I learned to call them that the first time I asked the counter-guy at a frozen yogurt place if there were living bacteria in their product, and he said "No! Of Course Not!", and I told him that was too bad 'cause this frozen yogurt stuff looked good but I was taking an antibiotic and I wanted to send some "friendlies" down into my gut to take up niches — I didn't say "niches" to him — that might otherwise be filled by organisms I really, really didn't want to play host to. He got his boss, who told me to ask about "active cultures" and served me up some in a concoction I can't call healthful — not with the caramel topping and other crap I loaded it up with — but one I really enjoyed.)

            It's way too early for definitive statements, but it feels right to me that "food allergies, asthma, celiac disease[,] and intestinal disorders like Crohn's disease have been on the rise," and obesity to boot, and that part of the reason for the increase would be America's overkill of the microorganisms that share our environment and bodies (NPR 14Ap14).

            That old pediatrician back in the 1940s prejudged the issue, but his "instincts" were right and his advice good. My primary-care physician in the 1980s had more data to go on — if still nothing definitive — but he was right to comment that "a lot of Americans shower and bathe too much" and advise me that aging skin shouldn't have a lot of soap and hot water run over it seven days a week (not even in the American Midwest, where water falls right out of the sky).

            Do vote for bond issues for sewers and sanitation and clean water. Do get your inoculations and definitely get your kids shot up for preventable diseases. But lay off a little on the hand-sanitizers, showers, and surgical procedures — as in C-sections here — that aren't absolutely necessary. And definitely throw children out of the house fairly frequently and point them toward a bunch of other little germ-bearers looking for dirt to play in.

Zero Tuition: Who pays? Who profits? (1 Feb. 2015)

            It's not a name you'd know, but he's important for the current debate on zero or low tuitions at community colleges, and for reducing tuition and fees at four-year colleges and universities.
            As described in a memoir by the Director of the Bureau of the Budget of the State of Illinois in the Ogilvie administration in the late 1960s, "there was a fellow by the name of David Eisenman who had been at the university [of Illinois]. David worked the tuition issue very hard […,] and our thesis on tuition was that low tuitions are a massive subsidy to middle class and upper middle class families. If you really wanted to assure equal access to educational opportunity, what you should be doing is charging high tuitions and then [use] the Scholarship Commission as a vehicle for providing assistance above tuition and fees to low income families to get their kids in the university system." 
            What State legislatures did, of course — mostly for reasons other than class equity and fiscal fairness — was reduce subsidies to public higher education, eventually drastically, with only small increases in scholarships and grants.
            And so the cost of public higher education was shifted significantly to students and their families, even while the those costs increased and then continued to increase.
            In part, that's fair, especially with four-year institutions: most Americans pay taxes, frequently "regressive taxes" like the sales tax, or often-oppressive ones like property tax; only some people go on to higher education, and the ones who go to the big, prestigious public research universities tend to be well-to-do, and even community college students aren't often the wretched of the Earth.
            In larger part, the high-tuition/high-fees system is unfair and unwise: it's depriving young people chances their elders had for inexpensive higher education — those who received The G.I. Bill, "War babies" and Boomers like me who paid only token tuition — because it's depriving the American Republic of a large body of well-educated citizens, and because it's depriving the American economy of educated people who can help America survive and thrive in what will be increasingly sharp global economic competition.
            The non-solution so far has been mostly student loans, which has been great for bankers but not even good for most others. The banks get nice capitalist profit on the loans, while the risks get socialized: your tax dollars in action guaranteeing (for the banks) at least part of the loans.
            It didn't and doesn't have to be that way.
            Here is another name you probably don't know but should: the Honorable John J. Gilligan, Governor of the State of Ohio 1971-75 and sufficiently an advocate of an alternative that it was sometimes called "the Gilligan Plan." It was more commonly known as "Pay As You Earn," or PAYE, and the idea has been around — and implemented on a very small scale — for nearly half a century.
            The version of PAYE I have pushed is one in which the Federal government advances to any qualified resident enough money to actually afford a college or university education: which can be a substantial sum for married people with families, "nontraditional students" such as we had with veterans under the G.I. bill.
            This sounds expensive, and the original outlay would be very large; PAYE would, however, save money and could turn a modest profit.
            PAYE advances are loans that must be repaid, and repayment can be through a surtax on one's Federal income taxes at a rate set by actuaries so that the basic program breaks even, with former students paying back their loans if they can afford to and as they can afford to, and with a time limit on how long they must pay.
            If you graduate and go on to make a lot of money, you pay back the loan with interest; if you don't make a lot of money — or hardly any at all — then you pay back what you can.
            But you do pay back: A well-funded IRS has shown itself to be very, very effective at getting the sovereign capital "P" People money we're owed. And it makes far more business sense to collect money from people who have been out working for a while and have money than to start dunning immediately recent graduates who are broke.
            The rates can be set so that students can pay full freight for the cost of their educations, but between market forces and government arm-twisting, students should have to pay no more than that. Capital expenses, research, public service (including providing cheap semi-pro sport), top-heavy administrations, and other frills — those can be subsidized by the States and, with luck, in some areas subsidized a good deal less.
            As a former college teacher, the major advantage I see to the plan is that it would attract more full-fledged adults to college campuses and help concentrate the minds of younger students. For sure, it will limit the weirdness of the American State's offering more or less adequate, more or less free education to people's children when those children are children, and then asking parents of legal adults to pay for further educating for their adult offspring, helping to reduce our current over-load of "adult children."
            (My slogan as a teacher: College Is for Grownups, not what a couple of my students called, in two very fine essays, "College: Half-Way House to Adulthood," and "College: The Four-Year Vacation.)
            As a very-long-term US resident, I like the idea of reducing subsidies to the well-to-do while helping "to assure equal access to educational opportunity."
            As a taxpayer, I also like the possibility of driving down college costs if colleges have to compete for students who themselves have to pay for their educations, and at the same time having all taxpayers who are paying attention highly conscious that we are putting up money, at least for a while, to support those colleges and universities.
            Many banks will lose a sweet source of income, but right about now a lot of Americans might well say, "Screw the banks"; the money the banks are not lending to students they might put toward carefully-vetted local mortgages and loans to small businesses: that social-responsibilty stuff they may recall from old movies like It's a Wonderful Life.
            So my vote is for "No" to zero tuition, but an emphatic "Yes" to investing in education, but investing with high probability of high return on the investment, starting, crassly, with getting back the money.