Leslee KulbaLocal News: Asheville and HendersonvilleOpinion

On public health and morality of the herd

 

By Leslee Kulba – In the interest of transparency, the Buncombe County Commissioners have taken to scheduling discussions of expenditures that ordinarily would be on the consent agenda as new business. The action, it has been noted, is “more motion than action.”

The problem under former management wasn’t a lack of public presentation so much as appending so little information to the online agenda as to render members of the public unable to even begin asking questions.

Noting there were already eleven items of new business, some with subheads, before the commissioners added another three, one staffer in the audience remarked to another about the so-called transparency, “We’ll do that for awhile until we realize why we don’t do it that way.”

One of the items added to new business was a request to change the commissioners’ Nov. 6 meeting to Oct. 30, because Nov. 6 is Election Day. Noting the new date was Halloween eve, Commissioner Joe Belcher said he wasn’t going to wear a costume; and to wit, Commissioner Al Whitesides replied, “Just come as you are, Joe.”

As the commissioners moved into their published agenda, Dr. Jennifer Mullendore, medical director for Buncombe County Health and Human Services, presented information on immunization. The presentation came at the request of Commissioner Jasmine Beach-Ferrara, after she had heard an alarming segment on BPR.

Mullendore showed a slide depicting “community immunity.” It rhymes. Another one showed the percentage of the “herd” that had to be immunized to prevent the spread of four diseases for which vaccines are available. The next slide showed a herd of strange-looking creatures, one of which was a different color. It read, “This is Ben. He is immunocompromised ….”

Mullendore explained North Carolina allowed exemptions from vaccination for two reasons. The first was a medical condition, such as the Ben thing had, where his health would be compromised by the vaccine. Mullendore said that exemption required a signed note from a medical doctor who had evaluated the person in question. The other was for practitioners of bona fide religions that prohibit vaccination. All that was needed in this instance was a note signed by a parent.

Mullendore said North Carolina offered no exemptions to people who oppose vaccination for philosophical or personal beliefs. Later, while talking about what can be done to get children immunized, one strategy was to deliver, “messaging to address moral values of the vaccine-hesitant.” Asked to elaborate, she said the “vaccine-hesitant” were typically concerned about individual liberty and purity. When Commissioner Ellen Frost asked if there were common traits among the “vaccine-hesitant,” Mullendore said they are typically well-educated and they do their research. They are also well-off, so access to immunization was not the issue.

During public comment on another issue, citizen Don Yelton pointed out the irony in trying to educate the public against something practiced by the well-educated. Regardless, to educate the educated, Mullendore recognized they would rebel against being sermonized, but they might be more responsive to hearing the message from a peer. The plan was then to plant seeds with individuals and get them to share the word with their faith communities or other social groups. Once several cooperative cells were onboard, it would be easier to enforce top-down measures.

Another tack for “increasing immunization uptake” was advocating for stricter state requirements. California, for example, does not allow conscientious objections ever since measles broke out at Disneyland. Following her remarks, the man in the Joe Belcher costume said in a roundabout way that liberty, purity, and the right to make decisions with which one was comfortable mattered.

Personal liberty came up again when the commissioners decided not to take any action on changes to employee insurance plans Interim County Manager George Wood said would help close a $1.5 million budget deficit. Wood had suggested offering employees the choice between an 80/20 plan and a high-deductible plan with a HSA; and doing away with the rich-by-any-standard 95/5 plan. Belcher said he would accept no change in insurance without a wellness plan, and this time it was Commissioner Mike Fryar who stood up. He said it was a free country, and it was not for the commissioners to order and arrange employee lifestyle choices. Fryar said he was tired of telling people what to do and when to do it.

To that, Chair Brownie Newman explained that freedom wasn’t free so long as taxpayers were subsidizing it. Largely due to pressure from county employees, the commissioners voted unanimously to protect employee insurance as-is this year and postpone consideration of cutting the amount of unused leave time employees can cash-in – even if it meant raising taxes. Borrowing from Claude-Frédéric Bastiat, if the county’s insurance plans were in the best interest of the people, employees could reach out to the community to find willing individual sponsors.

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