Tag: Covid-19

President Bill Clinton – Public Vaccinations

The Impact of Economic Decisions by American Presidents Series

President Bill Clinton – Public Vaccinations

Most decisions by American presidents and other world leaders do not have an immediate impact on the economy, especially regarding the macroeconomic issues of employment and inflation. For example, President Franklin Roosevelt’s bank holiday, President John Kennedy’s tariff on imported steel, and President Ronald Reagan’s Economic Recovery Tax Act had limited immediate effects on the economy, but their long-term effects were significant. The accomplishments or problems of a previous administration may impact on the administration that follows.

For example, President Biden faced criticism about the economy during his administration. The jobs created with the Bipartisan Infrastructure Law and the interest rate policy of the Federal Reserve Bank to lower inflation did not show results until years later. The drop in Real Disposable Income from the administration of President Trump is another example. Real Disposable Income is a measure of income that is adjusted for inflation. The drop between the administration of President Bident and Trump is the result of extended unemployment benefits, people working from home during the pandemic when businesses were closed, and stimulus checks from the government. The economic transition following the end of the pandemic had a significant impact on the economy.

PresidentGDP GrowthUnemployment  RateInflation RatePoverty RateReal  Disposable  Income
Johnson2.6%3.4%4.4%12.8%$17,181
Nixon2.0%5.5%10.9%12.0%$19,621
Ford2.8%7.5%5.2%11.9%$20,780
Carter4.6%7.4%11.8%13.0%$21,891
Reagan2.1%5.4%4.7%13.1%$27,080
H.W. Bush0.7%7.3%3.3%14.5%$27,990
Clinton0.3%4.2%3.7%11.3%$34,216
G.W. Bush-1.2%7.8%0.0%13.2%$37,814
Obama1.0%4.7%2.5%14.0%$42,914
Trump2.6%6.4%1.4%11.9%$48,286
Biden2.6%3.5%5.0%12.8%$46,682

This series provides a context of important decisions by America’s presidents that are connected to the expected economic decisions under the second administration of President Trump. The background information and questions provide an opportunity for small and large group discussions, structured debate, and additional investigation and research. They may be used for current events, as a substitute lesson activity or integrated into a lesson. 

In the case study below, have your students investigate the economic problem, different perspectives on the proposed solution, the short- and long-term impact of the decision, and how the decision affects Americans in the 21st century.

The Economic Problem

Public health decisions in the United States have historically been determined by states. (Tenth Amendment) Massachusetts is the first state to require that children have a smallpox vaccine before going to school to prevent the spread of smallpox in schools. Children in the United States receive immunizations through both private and public providers. The federal government has supported childhood immunization since 1963 through the Vaccination Assistance Act. Since 1994, the Vaccines for Children (VFC) program has provided additional support for childhood vaccines. In 2002, 41% of childhood vaccines were purchased by the federal government through VFC and 43% through the private sector. Thirty states have vaccine requirements for students going to college. See the list of vaccines required for K-12 schools on page 8 of the Center for Disease Control document: CDC Document

Adult immunization is primarily performed in the private sector. Since 1981, Medicare has reimbursed the cost of pneumococcal vaccine for its beneficiaries; influenza vaccine was added in 1993. The cost of vaccinations has increased significantly in the past 20 years.

The greatest fear in the 19th and 20th century was the spread of unknown or viral diseases. Major epidemics in the United States are cholera, flu, polio, HIV/AIDS, SARS, H1N1, and Covid-19. Vaccines were developed for smallpox and rabies. The virus, poliomyelitis, was a highly contagious disease with symptoms including common flu-like symptoms such as sore throat, fever, tiredness, headache, a stiff neck and stomach ache. Polio also affected the brain and spinal cord, which could lead to paralysis and also death. President Franklin Roosevelt was infected with poliomyelitis in 1921. The disease first emerged in the United States in 1894, but the first large epidemic happened in 1916 when public health experts recorded 27,000 cases and 6,000 deaths—roughly a third in New York City..

Epidemics are costly in the loss of human lives, medical and hospital costs, and absence from school and work. Because preventive health measures and vaccines save money, they are considered by economists as a public good. For example, the average billing costs for non-complex Covid-19 hospitalizations averaged between $31,000 and $111,000. Complex cases with hospitalizations averaged between $132,000 and $472,000. The average hospital cost in New Jersey for Covid-19 in 2020 was $377,198. Source

There were 6 million Americans hospitalized in 2020 with Covid-19. If we estimate the average hospitalization cost at $100,000, the cost of the epidemic would be around $60 billion. If we estimated the cost a5 $50,000, the cost would be $30 billion. The cost to the government in providing vaccines for free in 2020 was $25.3 billion. According to the National Institutes of health, the U.S. government purchased 1.2 billion doses from Pfizer and Modern at a price of $20.69 peer dose. Source. A total of $53.6 million was appropriated in 1956-57 for the polio vaccine.

Analyze the information in the image below to discuss if public health programs are best administered by the states or the federal government.

Questions:

  1. If the cost of a vaccine is $20.69, should the government pay for free vaccines for the general public or encourage people to get vaccinated at their own expense?
  2. Should the cost of vaccinations be the responsibility of private health insurance for people not covered by Medicare?
  3. Is public health a burden that should be shared by government, individuals, and health insurance companies?
  4. To protect the public from an epidemic or the flu, measles, pneumonia, etc. should the government rely on the approximately 40,000 private centers of medical offices and retail pharmacies to distribute and administer the vaccine or use the approximately 6,000 public health clinics and hospitals? Which distribution strategy is the most effective and why?
  5. Should the government encourage masks, hand washing, and other methods to prevent the spread of an epidemic instead of free or subsidized vaccinations?

Activity #1

  1. Invite the school nurse, doctor, and or representative from a health insurance company to your class to discuss the costs and benefits of vaccinations to contain the spread of epidemics.
  2. Research the policies on immunizations and vaccinations by other countries (Japan, Britain, Denmark, Mexico, Canada) Mandatory Vaccinations: The International Landscape   Mandatory Childhood Vaccinations
  3. Meet with your Math teacher to analyze the hypothetical costs of hospitalizations, preventive health care, and productivity costs for staying home from work.

Positive Externalities:

Vaccines against contagious infectious diseases have strong spillover effects, since immunization protects not just those being immunized but others as well. Since the benefits extend beyond those individuals who choose to get vaccinated, the public benefits of vaccines are larger than the individual benefits.  However, the price of the vaccine (i.e. $20) only benefits the person who paid for it out of pocket. The benefit to the public or larger society is the result when a significant majority is vaccinated and protected.

Economists evaluate the costs and benefits. For example, the government could subsidize the cost by 25% or 50%. The government (state or federal) could provide an incentive and pay individuals to get vaccinated or offer a tax credit or deduction. Public health strategies might include charging less than the market price for vaccines, paying individuals to immunize, or making immunization compulsory. The government can also mandate vaccinations by law.

The economic problem becomes more complex when we consider that some health issues like cancer, tetanus, or diabetes are not contagious. Also, vaccines for HIV/AIDS and Human Papillomavirus (HPV) benefit specific populations. The Public Health Service act of 1972 provided grants to state and local governments for immunizations and vaccine purchases. President Clinton’s administration in 1994 launched the VFC (Vaccines for Children) These provided funds to support schools requiring immunizations, with allowances for religious or moral exemptions.

View the image below from the Center for Disease Control (CDC) and validate its accuracy, bias, or misinformation.

Activity #2:

  1. Interview your school’s administration regarding the policy for vaccinations for students, teachers, and staff.
  2. Research the vaccination policy at state and private colleges in your area.
  3. Meet with a travel agent or use the source from Wikipedia regarding vaccination requirements from countries.  Source  If the United States discontinues its financial support for vaccinations will this have an impact on Americans travelling to other countries?

Questions:

  1. What is the most effective way to protect public heatlh?
  2. Are the benefits of free or subsidized vaccinations greater than the costs of hospitalization and loss of life?
  3. Should federal programs also include subsidies for preventive health such as mammograms, colonoscopies, blood pressure screening, etc.
  4. Public education is paid for by taxpayers and through money raised by state governments.  Should public health follow a similar model or is it different?
  5. Are the economic benefits of government funded vaccinations more important than the scientific evidence or the fact that they may not be effective for everyone and in some cases result in death?

Lights, Camera . . .  Survey! Americans Give History a Screen Test

Lights, Camera . . .  Survey! Americans Give History a Screen Test

Pete Burkholder

(Reprinted with permission from History News Network, https://historynewsnetwork.org/article/180008)

The results are in and it’s official: we are a nation of watchers. As Americans retreated to the security of their own homes amid the ravages of COVID-19, their love affair with screens only increased. According to the website Eyesafe and the Nielsen television ratings company, adults spent an average of thirteen hours, twenty-eight minutes per day watching a screen in March 2020. That represents a daily increase of three hours, twenty minutes, relative to the third quarter of the previous year. Of those, live television viewing went up by over two hours each day for five-and-a-half hours total, while time-shifted watching increased by nearly twenty minutes. Streaming video-on-demand viewings likewise spiked eighty-five percent over comparable three-week periods in 2019 and 2020. What seems clear is that what we know about the world around us is increasingly dependent on electronic boxes of various sizes and dimensions, and on the content providers who fill them.

As a historian, I’m always intrigued by how the public learns about the past, which is why my colleagues and I recently ran a national poll to find out where people get their historical information. The results of that survey, a collaboration between the American Historical Association and Fairleigh Dickinson University, and funded by the National Endowment for the Humanities, indicate that historical consumption is a microcosm of the trends outlined above. Yet those same results, which will be published in full this summer, expose some fascinating incongruities as well.

First, the trends. Asked where they’ve gotten their information about the past since January 2019 (that is, pre-COVID to present), respondents showed an overwhelming preference for screens. Out of a range of nineteen possible sources, the top three choices – documentary film and TV, fictional film and TV, and TV news – were all video. More traditional forms of historical information simply weren’t competitive: museum visits (tenth place), non-fiction history texts (twelfth) and college courses (dead last) trailed television and film by significant margins. That said, the great bugaboo of recent disinformation, social media, likewise assumed back-of-the-pack status, coming in at fourteenth place. Although use of social media has remained robust during the pandemic, most respondents to our survey didn’t seem to view such platforms as having much to do with history, per se.

The incongruities emerged when we asked survey-takers to rank the perceived trustworthiness of those same sources above. Only documentary film and TV stayed in the top three, though it now trailed both museums and historic sites. While TV news ranked third as a go-to source for history, it fared miserably in terms of reliability, coming in fifteenth. Fictional films and TV did even worse at seventeenth. Few respondents had taken a college history course since January 2019, but history professors were still highly trusted, garnering fourth position. The same was true for non-fiction books, which moved up the scale to sixth, despite being sparsely utilized. A bit of a disjuncture thus emerges. Whereas the public reports largely turning to video for its historical information, those same viewers are skeptical of much of what they see on their screens.

Our survey couldn’t determine exactly what people were watching, a topic that awaits further investigation. But respondents’ high utilization of, and obvious trust placed in, documentaries – and their corresponding distrust in news and dramatizations – begs a certain amount of cynicism. Although one can find quality programming in the current state of “docu-mania,” there’s a proliferation of disinformation as well. Such nonsense as Mikki Willis’s Plandemic, or the all-day conspiratorial marathons on the History Channel (Ancient Aliens, anyone?), are wrapped in a patina of documentary that lends them unmerited credibility.

Meanwhile, news programs that may strive for factuality, and that are avidly consumed by history-minded viewers, were largely dismissed by our respondents as unreliable. Here, our survey reflects broader distrust in news services that have been assaulted by several years’ worth of “fake news” accusations. In a national survey from the 1990s similar to ours, people likewise looked askance at dramatized history on film and TV, but they have consistently devoured it nonetheless, if Academy and Emmy Awards are any indication. And just as documentaries can deceive, fictionalized video renditions of the past can be quite edifying if one bears in mind how to read historical films as cultural artifacts.

The increasingly simple ease of access to video media may explain a lot about current consumption habits of historical information. But if so, it bodes ominously for sources of the past deemed more trustworthy, yet which take more effort (reading books) or intentionality (visiting museums) to engage. Maybe we shouldn’t be surprised by such disjuncture. After all, the nation’s alcohol consumption has surged during the pandemic despite the drug’s well-known detrimental health effects. People knowingly acting against their own self-interests in where they turn to for historical information is thus not an isolated phenomenon.

If there’s a glimmer of hope, it’s that Americans – no matter their age, race, gender or political affiliation – are often in agreement when it comes to their history consumption habits and views on the reliability of sources. Sixty-seven percent of our respondents in the 18-29 age bracket reported watching dramatic films and TV to learn about the past, a statistic that barely moved for the 65+ age cohort (66%). Meanwhile, 87% of those identifying as Democrats said they trusted documentaries somewhat or a great deal, compared with 84% of Republicans.

They may be watching very different historical programming, but the public’s preferences and attitudes toward it align more often than not. In a country as deeply divided as ours, that’s no small matter.

Do Not Spit at Random: Public Health Lesson for Elementary School

Prepared by Alan Singer

In the 1950s and 1960s the revolutionary communist-led government of China enlisted elementary school-age students to educate adults about the need for public health measures. The Chinese campaign against spitting in public was actually not new or communist inspired. In the late 19th century, as immigrants poured into
overcrowded urban areas, tuberculosis bacterium (TB) was responsible for a pandemic that caused the death of one in seven people in the United States
and Europe. It New York City, spitting on a public conveyance was made illegal in 1896 and spitters were subject to arrest and a fine of up to fifty dollars. Signs were placed in street cars and on the subway system warning that spitting spread TB.
When the signs proved to be an inadequate deterrence, health officers, known as the Sanitary Squad, conducted random raids at subway stations arresting hundreds of scofflaws. The city also launched public health campaigns distributing flyers
and schools were enlisted to educate children about the spread of the disease.

This play was performed on street corners in Hangzhou and Shanghai by Young Pioneers, children between the ages of nine and thirteen. In the 1950s and again during the Corona virus pandemic today, China uses poster art to teach
public health lessons. Classes can act out and discuss “Do Not Spit at Random” on Zoom. This version of the play is from a New York City multicultural curriculum package (1967).


Questions for discussion include:

  1. Who are the Young Pioneers?
  2. In your opinion, why are they involved in the public health campaign?
  3. What are some of the arguments and social pressures used to make the Passer-By clean up the spit?
  4. If you lived in China at that time, would you have joined the Young Pioneers? Explain.
  5. Do you think student plays like this one would help in the current Corona virus pandemic?
    Explain.
    As a follow-up, students can write their own plays teaching people how to be safe during the Corona virus pandemic and create public health posters.
    Do Not Spit at Random (188u-yao sui-ti t’u t’an) by Fang Tzu
    Setting: Street corner of Hangzhou, China, the early 1960s. A young girl Pioneer with a megaphone comes out from a crowd in the street or from among the audience in a theater.

Characters:
 Young Pioneer (Hsiao-Ying)
 Passer-By (Ch’em Jung-fa)
 One of the Crowd
 Crowd
 People’s Police
 Mother

YOUNG PIONEER. Dear uncles and aunts, please do not spit at random. Spitting at random on the ground is a most deplorable habit. It helps to spread germs and disease, and so may affect our health harmfully. Dear uncles and aunts, if you want to spit, please do so into a cuspidor. If there is no cuspidor at hand, then spit into a handkerchief.

PASSER-BY (walks across a stage with a briefcase, makes noise as if going to spit).
Hmm …hawk…choo! (Spits phlegm on the ground.)

YOUNG PIONEER (seeing the passer-by spit, hurries away from the crow to overtake the man, or leaps onto stage from below). Uncle, uncle, don’t spit on the ground. Please rub it away with a piece of paper.

PASSER-BY. My young friend with the cuspidor so
far away, where do you think I should spit.

YOUNG PIONEER. You can go up to the cuspidor. It’s only a few steps away.

PASSER-BY. I’d have to go there and come back again. How do you think I am going to catch my bus?

YOUNG PIONEER. Uncle, don’t you know there are many germs in spittle? When it dries the germs will be scattered everywhere, and, by breathing the air, people may be infected with such diseases as typhoid, diphtheria, tuberculosis –

PASSER-BY. I am not a tubercular. So there cannot be any germs in the phlegm I coughed out.

YOUNG PIONEER. It is a social obligation to refrain from spitting at one random. If everyone spits and insist that there can be no germs in what he has spat, how can we be patriotic and keep ourselves in good health?

ONE OF THE CROWD (speaks from the crowd or from the audience, in a theater). Rub the spittle away quick! (A large crowd gathers around the passer-by)

PASSER-BY (irritated). Hmm. You want me to squat there and rub away the spittle? But I have no time for that. Besides, I’m not used to doing that sort of thing. (Prepared to go.)

YOUNG PIONEER. Uncle, uncle, don’t go. I haven’t finished with you yet.

PASSER-BY. I have to go home now to my dinner and have no time to carry on a conversation.

ONE OF THE CROWD. Hey, you come back here! There can’t be a more unreasonable man than you.

PASSER-BY. How so?

YOUNG PIONEER (offering a piece of paper). Uncle, please rub it away with this piece of paper.

PASSER-BY. I won’t do it!

YOUNG PIONEER. How can you refuse to carry out a social obligation?

PASSER-BY. Are you lecturing me?
(Here a number of actors come out of the crowd to speak, or speak from among the audience, or some may go up on the stage.)

CROWD. What? You are trying to assume airs? Don’t argue with him. Call the police. Police! Comrade police!

PASSER-BY. I won’t rub it. I promise not to spit again.

CROWD. Comrade, what is your unit?

PASSER-BY. That’s none of your business

CROWD. Why isn’t it my business? When you refuse to carry out a public obligation, everyone is entitled to criticize you.

PEOPLE’S POLICE (enters). What’s happened here?
(At this moment the crowd becomes larger.)

CROWD. He spat at random and refuses to accept criticism. He would not listen to the advice of a child. And he’s such a big man. He is no better than this child. And he is a Party member too! Probably a backward one.

PEOPLE’S POLICE. All right, it’s clear to me now. (Addressing the crowd.) Comrades! What do you think we should do with such a man?

CROWD. He should be criticized and fined. He should be made the subject of a wall newspaper. A cartoon should be drawn of him for all to see. He should be taken to the police station.

PEOPLE’S POLICE. Oh, well, if you will not rub it away, I’ll do it for you. But, first of all, may I know what unit you belong to?

PASSER-BY. As for that – (The voice of a middle-aged woman is heard offstage calling someone.)

MOTHER. Hsiao-ying, Hsiao-ying!

YOUNG PIONEER. Oh, Mama!

MOTHER. There you are. We’ve been waiting for you a long time. The meal is cold. Won’t you hurry home to your meal?

YOUNG PIONEER. I haven’t finished my work yet.

MOTHER. Work? What sort of work?

YOUNG PIONEER. Someone has spat on the ground and refuses to accept criticism. Unless he cleans it off, I am not going to let him go.

MOTHER (recognizes the passer-by). Oh, is that you, Comrade Ch’en?

PASSER-BY. Er – es, it’s me, Teacher Wang.

MOTHER. Hsiao-ying, who is it that refuses to accept criticism?

YOUNG PIONEER. Mama, there he is.

PEOPLE’S POLICE (addressing mother). Comrade, do you know which unit this comrade belongs to?

MOTHER. He is the accountant of the cotton mill. He is Comrade Ch’en Jung-fa.

PEOPLE’S POLICE. Good, thank you. (Addressing the passer-by.) I think there’s only one way now.
(Draws a circle round the spittle on the ground with a piece of chalk and is about to write down the name of the passer-by and the unit to which he belongs.)

PASSER-BY (frightened). Comrade, don’t! Don’t write down the name of my unit! (Addressing the crowd.) Comrades and my young friend, please pardon me this once. You may write my name there, but please do not write the name of our mill too. Our mill has already signed a patriotic health pact.

PEOPLE’S POLICE. Yet you break the pact?

PASSER-BY. All right, I’ll clean it, I’ll clean it. I promise not to do the same thing again.

PEOPLE’S POLICE (to mother). Comrade, your child is really a good Young Pioneer, a young heroine for the elimination of the seven pests (mosquitoes, flies, rats, sparrows, and so forth) and for public health. If everyone eliminates the seven pests in earnest and maintains public hygiene as she does, our cities and the countryside will be rid of the seven pests sooner, disease will largely be wiped out, people will be healthier than ever, and the nation will be more prosperous and stronger.

MOTHER. Hsiao-ying, hurry home to your meal.
It’s already cold.

YOUNG PIONEER. Mama, my group leader isn’t here yet. I’ll go home when he come to relieve me.

MOTHER. Oh, well, I’ll have to warm the meal again anyway.

YOUNG PIONEER (speaking through megaphone and coming toward crowd in the street or toward audience in theater). Dear uncles and aunts, please do not spit at random. Sitting at random is a most deplorable habit.