Articles

Apr 20 2017

The economics of climate change

Author: DakotaBirder • Discussion: No Comments
Norfolk - Hurricane storm surge risks

A map showing downtown Norfolk and the surrounding areas, and likely storm surge inundation areas under different categories of Hurricanes. Should a category 4 ever strike the area, most of the region will be flooded. However, coastal flood risks in the area go well beyond the risk of hurricane-related storm surges. Coastal flooding events are becoming increasingly common as sea levels rise, with huge economic impacts on the region. Map Source: Source: Virginia Department of Emergency Management, Commonwealth of Virginia Storm Surge Inundation Maps.

This is the the week the Trump administration may announce their intentions to stay or abandon the Paris climate agreement. There’s some indication that Trump may actually be getting cold feet about abandoning the agreement. However, given the other moves the administration has already made, stating they’re sticking with the agreement may just be window dressing, as reversing Obama’s Clean Power Plan likely makes it impossible that the U.S. could actually meet the agreed upon levels of greenhouse gas reductions. With an administration full of climate-change deniers, it may not seem like there’s a lot of long-term hope that the U.S. will be a meaningful player in trying to mitigate the worst potential climate-change scenarios. However, there is hope…

The New York Times had a great piece yesterday about the Norfolk, Virginia area, and the potential impacts of climate change. What makes the piece wonderful is that it localizes the impacts of climate change and shows how it’s already changing people’s lives. Norfolk, like most coastal cities, is likely to be heavily impacted by climate change and the resultant sea-level rise in coming decades. In the case of Norfolk, however, those impacts have already arrived. Sea-level rises, coupled with sinking coastal land overall in the area, means that the relative sea-level is now 18 inches higher than it was at the start of the 20th century. As the story notes, locals have become accustomed to learning the “dry” spots for parking their cars, avoiding parking in areas where wind-blown tides may bring water inland. The impacts go far beyond the minor inconvenience of finding a dry parking spot, however.

As stated in the New York Times piece, Elisa Staton bought a house in the Larchmont-Edgewater area of Norfolk in 2005.  There were never any records that it had been flooded. Her flood insurance was reasonable, and although the house was within the 100-year flood zone, she wasn’t worried. In the last 10 years, her house has twice flooded. Her flood insurance rates skyrocketed, and the house she purchased for $320,000 was worth perhaps half of that original value. The story notes that flood insurance premiums are rising by as much as 25% a year, and that for every $500 annual increase in flood insurance cost, the value of a house goes down by about $10,000. Short-term remedies include “re-purposing” lower-level rooms to “low value storage space”…in effect reducing the habitability of lower-level rooms in order to get breaks on insurance premiums. Longer-term remedies typically involving raising the house and allowing for increasingly frequent coastal flood waters to flow under the habitable space of a home.  However, even those measures are likely doomed to fail, as relative sea levels in the area may rise by an astounding 6 feet by 2100.

So why did I say there’s some hope regarding climate change, after pointing out the damage Trumps administration has done to U.S. efforts to mitigate greenhouse gases? The current administration may be completely inept on climate change issues, but eventually, basic economics is going to force the hand of government.  The Norfolk story quantifies economic impacts for just one small coastal area in the U.S. In 2008, Norfolk hired a Dutch team (a country well-versed in dealing with coastal flooding and inundation) to develop a climate-change adaptation plan for the city. The price tag? At least $1 billion. That “100-year flood plain” that Elisa Staton’s house was found, where 2 coastal inundation events have occurred in just the last 10 years?  There is over $1 trillion in property in 100-year coastal flood plains along the eastern seaboard of the U.S.  The story does a great job talking about insurance and other economic impacts as well.

Economics.  That’s why there’s hope. Politicians are too short-sighted. As politics has become more partisan in the United States, governing for the long-term welfare of the people has been replaced by governing for the next election cycle.  Climate change impacts? When the next election is a year or two away, climate change is the last thing D.C. politicians worry about.  At a local level however?  With coastal home prices plummeting in areas like Norfolk, you can certainly imagine that local politicians have to address climate change and the resultant economic impacts in their area.  Local residents who feel their livelihoods and homes threatened by climate change will demand it.

That’s where there’s some hope, in the local-level, aggregate response to the economic impacts of climate change. As stories like Norfolk’s become more and more common, the sheer economic impacts of climate change will have to be addressed at the larger state and national scales. Business interests increasingly recognize the devastating impacts climate change may have on their bottom dollar, and realize they can’t ignore the issue.  Our own Defense Department recognizes the threat of climate change to disrupting populations across the globe and introducing instability. At some point, D.C. politicians are going to have to follow suit.

 

Feb 28 2017

Facts trump Fear: A FACT-based assessment of Mountain Lions in South Dakota

Author: DakotaBirder • Discussion: No Comments
Mountain Lion - Puma concolor

A full-grown Mountain Lion on the prowl. No…no…not my photo! This is a wild animal roaming in Yellowstone National Park. You see, like 99.999% of South Dakotans, I will never see, much less photograph, a Mountain Lion in this state. That, despite Mountain Lions seemingly posing as much of a threat to human health and safety as disease, war, famine, and pestilence combined. At least in the minds of many misguided South Dakotans.

I should just avoid the internet.  My blood pressure might be greatly improved if I were able to do that. It’s bad enough that we have Orange Hitler as our president, with a bunch of mini-Hitlers running all of the Cabinet departments. It’s bad enough that the normal news outlets that I check every day, such as the Washington Post or the New York Times, are now dominated by depressing and often downright sickening news stories about how everything that makes America, America, is now being being systematically dismantled.  What’s worse is that the same “alternative facts” political world we live in has permeated EVERY facet of American life, where fact, reason, and logic mean absolutely nothing any more.

Yesterday I was on Facebook when I came across a South Dakota “gentleman”, posing with a huge shit-eating grin on his face as he held up a dead Mountain Lion that he’d just shot and killed. OK, “gentleman” isn’t the word I want to use here, but I’m going to try to stay civil in this post.  Just the facts…so let’s call him “Gentleman Joe”.  It was a BIG mountain lion…160+ pounds…and evidently shooting a BIG Mountain Lion makes Gentleman Joe some kind of hero in the minds of many who were commenting on Facebook.  Normally I’d see something like that, roll my eyes, get a little sick to my stomach at the whole thought of it, and then move on to the next post. OK, who am I kidding…If you know me, you’d KNOW I was going to respond after seeing that.  As I I scrolled down, I noticed a manifesto from “Jim Bob” (I’m sure some relationship to Gentleman Joe, if not by blood, then by ideology).  Jim Bob was praising Gentleman Joe for the great kill, going on with his thoughts about just how much safer South Dakotans were thanks to his kill.

According to Jim Bob, the Mountain Lion horde of the South Dakota Black Hills are taking over the state. According to Jim Bob, it’s seemingly impossible to go outside in the Black Hills nowadays without the imminent threat of a Mountain Lion attack. In Jim Bob’s eyes, the proliferation of Mountain Lions in the Black Hills is akin to nuclear weapon proliferation during the Cold War, and evidently, poses just as much of a threat to humanity.  In Jim Bob world, it’s not safe to wander outside in the Black Hills. Gentleman Joe was indeed a god-damned American HERO for saving a scared South Dakota populous from the Mountain Lion scourge.

White-tailed Deer Fawn - Odocoileus virginianus

Yes, this IS my photo. I know what you’re thinking…TERRY! YOU HAVE A FAMILY TO THINK ABOUT!?!?! How could you risk so much getting this close to a dangerous killer? OK…ridiculous, you say? How much threat does a lil’ White-tailed Deer pose? SCIENCE MY FRIENDS! And the numbers don’t lie. THIS creature is MUCH more likely to kill or injure you than is a Mountain Lion. If you live in South Dakota, it’s not the creature at the top of the page that is a threat to your life.

I responded with facts, providing the TRUE story of Mountain Lions in the Black Hills, and their supposed threat to health and well-being of South Dakota’s citizens. Jim Bob, clearly not accustomed to facing the world of reality, threw a few half-hearted digital haymakers in Facebook response before slinking back to his hole.  He had nothing to respond with, no evidence to back his claims.  But as he departed the digital conversation, it was quite clearly that the barrage of facts I provided did nothing to change his mind. Those facts?

There’s been a grand total of ONE…count them…ONE confirmed Mountain Lion attack IN THE ENTIRE RECORDED HISTORY OF SOUTH DAKOTA.

Even that one event, in 2008, was an unfortunate encounter that resulted from a lion defending a kill, rather than the lion actively seeking out a human being.  Ryan Hughes was ice fishing on Sheridan Lake in March of 2008 when he headed to the shoreline and came across a Mountain Lion crouched down in the cattails, feeding on a fresh kill (thought to be a fox).  When Hughes first spotted the Mountain Lion, he was a mere 5 feet from the lion and its kill. The surprised lion reacted, dropping it’s food and scratching and biting Hughes. Hughes received minor injuries, and was treated and released from a local hospital for minor scratches and bite marks.

Well over 150 years since settlement of South Dakota, and this one, chance encounter is the ONLY MOUNTAIN LION ATTACK EVER RECORDED ON A HUMAN BEING in the state. However, according to Jim Bob, it’s absolutely essential that “heroes” like Gentleman Joe actively thin out the Black Hills Mountain Lion population.  According to fearful, small-minded men like Jim Bob, it’s a matter of public SAFETY.

I have no doubt that for tiny-penis men like Jim Bob, Mountain Lions ARE something to fear (am I still being civil? OK it’s getting borderline). It’s a scary world when you’re an insecure, weak little man-child (yeah, definitely crossing the border now).  Toting a gun into the wild and blasting away at wildlife?  It’s great for boosting those testosterone levels and boosting the confidence of weak she-men like Jim Bob (I am WAY south of the border…bye-bye civility).  But stating Mountain Lion hunting must be done as a matter of public SAFETY?

Deer Collision Risk - State Farm

From State Farm Insurance, a table of the top 5 riskiest states for car/deer collisions. If only there were some natural predator capable of saving us from the Deer threat…

One attack in over 150 years, in a state that covers over 75,000 square miles. Depending on the estimate and year, recent estimates of the number of Mountain Lions in the Black Hills have varied from 200 to 400. Generally they’ve thought to have stabilized around 250 in recent years. It’s a very healthy, strong lion population, yet despite their substantial presence in an area that’s so heavily used for recreation, there just haven’t been any attacks on human beings, much less any serious injury or fatality caused by a Mountain Lion.  That fear from tiny penis she-men isn’t limited to people in the Black Hills region.  Even here at the opposite end of the state near my town of Brandon, there have been stories of fear from the likes of Jim Bob.

While permanent breeding populations of Mountain Lions in South Dakota are almost exclusively found in the Black Hills, wandering individuals are occasionally found elsewhere in the state and region, even here in southeastern South Dakota. In 2014, there were a few sightings of a Mountain Lion just north of Brandon, where I live. A lot of the reports are rather “bigfoot” like, such as a reported brief glimpse of what might have been a Mountain Lion in the headlights of a speeding car on a highway.  But according to this piece from 2014, some in the Brandon area believed that Mountain Lions were setting up shop in the region. A quote from one of the landowners just north of where I live in Brandon?

Those spottings are just a sampling of the evidence of what Heggen said is a long-running pattern of the lions, which are solitary animals, being a nuisance in his area.

Yes, Mr. Heggen. It’s a “long-running pattern” of Mountain Lions roaming the Brandon Area.  They are a long time “nuisance” here in extreme eastern South Dakota, an area that’s 90% corn and soybeans and unlikely to EVER host a Mountain Lion for any length of time. They have indeed been spotted from time to time. I even know of a guy at my work who has seen one in the area.  But as the story above notes, in 2013 there were only 6 recorded Mountain Lion sightings in the entire state outside of the Black Hills.  Only three of those were in the eastern half of South Dakota. It’s not exactly a “long-running pattern”, and it’s a far cry from Mountain Lions being a “nuisance” in the area. More quotes from the Brandon-area story:

“But we don’t have any raccoons, skunks, possums or even pheasants running around anymore. And for a while, we didn’t even see any rabbits, although we’ve seen a few smaller ones lately,” he said.

 

“I’m guessing they (the lions) are eating them,” Heggen said. “They aren’t scavengers like coyotes.” He said that what he fears most is having his 5-year-old son being harmed by one of the lions in their farmyard.

Mountain Lions Killed - American West

From the Mountain Lion Foundation, a graph of the number of Mountain Lions killed by hunters in the American West from 1900 to the present day. In the last 20 years, hunters have generally killed 3,000 to 4,000 lions a year. In South Dakota in 2017, Game Fish & Parks are allowing up to 60 Lions to be killed.

Once again, let’s return to the facts…ONE CONFIRMED ATTACK IN THE ENTIRE HISTORY OF THE STATE, yet people like this are evidently fearful for the lives of their families.  There are other ridiculously speculative comments in the story, such as one time some cows were spooked by something (clearly HAD to be a Mountain Lion, right?), or that one fall he didn’t see any deer while harvesting his corn (Eegads!  More Mountain Lions!!). Please spare me the anecdotal bullshit about all the poor little animals in the area disappearing, and attributing it to roving Mountain Lions. Trust me, we have PLENTY of deer, raccoons, skunks, opossums, pheasants, and rabbits running around this part of the state.  It’s hard to drive any road in the area and not notice all the road kill on the sides of the road.

I’m perhaps being a little (ok, more than a little) harsh on people like this, but as a scientist, my biggest pet peeve in this world are fearful, ignorant human beings who ignore fact, logic, science, and reason, and instead let their innermost fears and emotions rule their lives. The vast majority of people in the Black Hills, an area that may indeed have one of the highest Mountain Lion concentrations in all of North America, will never even SEE a Mountain Lion in their lifetimes, much less have an encounter or an attack.

I also realize it’s not just the fear of men (with tiny penises) that drives this hatred of Mountain Lions, and the “lionization” (ha-ha) and hero-worship of those who kill them. No, beyond the fear, it’s INSECURITY, and their need to KILL, to express their manliness, that also drives attitudes like those of Jim Bob. That rationalization that it’s up to THEM to SAVE us from the Mountain Lion scourge…that attitude certainly plays to their insecurities, and it’s a great excuse for those who just love to go out and kill things.

On the latter point, hunters in general often have a problem with predators like Mountain Lions, for the simple fact that Lions are competition for the same kinds of prey that hunters like to target. As this story from 2010 points out, Mountain Lions likely kill just as many deer in the Black Hills as do hunters. The entire anti-Mountain Lion vibe in that part of the state simply boils down to this basic statement from this story:

Some hunters don’t like the increased competition from lions, said Mike Kintigh, GF&P regional supervisor in Rapid City.

A Mountain Lion kills a deer, that’s one less deer for hunters to kill.  In the minds of “Sportsmen” who think like this, targeting Mountain Lions is a win-win proposition.  It gives hunters the chance to kill a large, challenging animal, while at the same time reducing a major predator of game such as deer and elk.How do you combat some of the “fact-challenged” rhetoric from the anti-Lion crowd in South Dakota?  Facts don’t seem to have any impact on people like this, but as a scientist, it’s quite easy to shoot down the “logic” of these folks with some basic empirical evidence and numbers.

  • ONE — Again…in the entire history of the state, only ONE recorded attack of a Mountain Lion on a human being, and that was an obvious case of just being in the wrong place at the wrong time, surprising a mountain lion on its kill.
  • THREE — In all of Eastern South Dakota in 2013, there were only three confirmed Mountain Lion sightings. No, East River paranoids, Mountain Lions are not in any way a “nuisance” or any kind of threat in the 30,000+ square miles east of the Missouri River. Let’s at least keep the argument just to the Black Hills region.
  • 250 — That’s the roughly the number of Mountain Lions currently thought to be in the Black Hills. In an area of about 5,000 square miles, that puts the number at about one Mountain Lion for every 20 square miles.  That’s a high density for anywhere in North America, much less for such a heavily used area like the Black Hills.  Yet again, despite the number of lions and the potential for interaction with the thousands of visitors and residents in the Black Hills, dangerous encounters have been non-existent.
  • 5,500 — That’s how many deer may be killed every year in the Black Hills by Mountain Lions.
  • 90,000 — Roughly the number of deer killed by hunters every year in South Dakota in the 2000s…during the exact time period when researchers believed Mountain Lion populations were at all-time highs in the Black Hills, with potentially 400 individuals present.
  • 69% — Recent success rate of hunters targeting deer in the Black Hills.  Evidently the Mountain Lions have left one or two deer for human hunters.  No, hunters, Mountain Lions are not wiping out the Black Hills deer population.
  • #5 — South Dakota was recently ranked as the 5th most likely state for a driver of a vehicle to strike a deer.  One in 70 South Dakota drivers on average have a claim related to a deer collision.  Perhaps a little NATURAL population control would benefit South Dakotans, particularly since the risk of any negative consequence (aka, an attack) is far less than the odds of being struck by lightning.  If only there were some SCIENCE to back this up…hmmmm……
  • 155 — That’s how many lives in the eastern United States would be SAVED over a 30-year period in the eastern United States, IF Mountain Lions were reintroduced into the area.  The number comes from a detailed socioeconomic analysis of the impacts of reintroducing Mountain Lions in the East. The savings come from the reduction in deer populations that would result from the introduction of their most effective natural predator, and the resultant reduction in deer-car collisions.  The same study found that over $2 BILLION in insurance costs would be saved over the 30-year period.

Not to let something as mundane as “science” get in the way of the thinking of people like Jim Bob, but if that many lives and insurance dollars would be SAVED in the eastern U.S. by reintroducing the Mountain Lion, how many avoided collisions in the Black Hills are a result of the presence of Mountain Lions?  How many lives have thus been SAVED by the presence of Mountain Lions in the Black Hills?  If you’re doing a cost-benefit analysis, that would be XX number of lives saved, compared to…ZERO lives that that EVER been lost in the state as a result of a Mountain Lion’s activities. What? That’s all speculative you say?  Not so fast my friends, SCIENCE TO THE RESCUE AGAIN!! From the same socioeconomic analysis:

South Dakota offers a test case example of how effective this solution might be. Cougars have been slowly migrating East: They only recolonized the Black Hills in western South Dakota in 2005. When Gilbert and her team looked at mountain lion recolonization in the western part of South Dakota, they found that from 2005–2012, deer-vehicle collisions fell by 9 percent, resulting in $1.1 million in annual societal benefits for the citizens of western South Dakota. (A 9 percent reduction in seven years is roughly on par with the 22 percent reduction, which researchers think will take 30 years from recolonization.) By avoiding an estimated 158 deer vehicle collisions annually, auto insurers are already saving roughly $630,000 a year in payouts in the Black Hills.

DATA!  REAL DATA showing the decline in deer-auto accidents in South Dakota that occurred RIGHT when Mountain Lion populations were spiking in the region.

If you support Mountain Lion hunting in South Dakota, please spare us all the bullshit.  It’s NOT a safety issue.  Not to let facts spoil your storyline, anti-Mountain Lion, crowd, but from a safety standpoint, there’s absolutely no doubt that South Dakotans are safer WITH Mountain Lions than without.

SCIENCE!! NUMBERS!! FACT!!!

If you’re going to spout off about the need to “control” Mountain Lions, skip the crap about safety.  It’s clearly about either 1) your COMPLETELY irrational fear of a beautiful creature that’s MUCH less likely to harm you than is your hair dryer, shaver, or random bolt of lightning, or 2) your desire to KILL a creature for no other reason than the enjoyment of the “sport”.

For more information, here are some of the journal and news articles mentioned in this blog post:

Jan 15 2017

Why “Alex” > “Olivia” > “Nate” — Health care in America

Author: DakotaBirder • Discussion: No Comments
Three Happy Children

Three happy children, “Alex’, “Olivia”, and “Nate”, living in a world where Alex will receive better health care than Olivia, and Nate will receive the worst health care of all 3, all because of their socioeconomic status.

We’re two weeks into a new Congress that smells blood in the water.  Other than a flurry of legislation designed to limit transparency and ethics oversight (always a great sign when that’s their first thought when they arrive in Washington), the major focus has been the dismantlement of Obamacare (the Affordable Care Act, ACA).  What is abundantly clear is that those voting to “repeal and replace” the ACA, without having ANY idea of what they might eventually replace it with, are oblivious to the impacts of the law on real Americans.  What follows is a NOT so hypothetical story of three children, “Alex”, “Olivia”, and “Nate”, and what health care policy in the United States means to them.

Alex, Olivia, and Nate are all young teenagers or pre-teens.  Each has Type-1 diabetes, the auto-immune version where their own misguided immune system has attacked and destroyed the islet cells in their pancreas’ that make insulin.  For the rest of their lives, they will be dependent upon insulin injections.  It’s a life fraught with risk. If you don’t control your blood sugars well, you’ll have frequent hyperglycemia events (high blood sugar). Over time, that will contribute to kidney disease, eye disease, cardio-pulmonary disease, and peripheral nerve damage. If you’re extremely vigilant and try to control your blood sugars very tightly, you’re more likely to have hypoglycemic events (low blood sugar), a dangerous condition that can cause seizure, coma, and even death.  Long-term blood sugar control is measured with a patient’s “A1C”, a hemoglobin-based measure from your blood.  A “normal” A1C is less than 6.5. The higher a diabetic’s A1C is, the worse their long-term blood sugar control, and the higher their risk for complications.

There’s little doubt the ACA is a god-send to Type-1 diabetics like these Alex, Olivia, and Nate.  No longer can they be refused insurance coverage for their pre-existing condition.  Diabetes is an expensive, life-long disease, but thanks to the ACA, they will no longer be subject to lifetime maximum payouts from insurance companies.  For parents helping them transition to an adult life and the responsibility for their own health insurance, the ACA allows parents to cover children on their insurance until they turn 26.  Things are much better with the ACA, but even with the ACA, we’ve got a long way to go in providing equitable health care in the United States.  With that as background, here is the not-so-hypothetical story of Alex, Olivia, and Nate and their battle with Type-1 diabetes…and the American health care system.

“Alex”

Alex is a young teenager who was diagnosed with Type-1 diabetes at a very young age.  His family would be considered  upper-middle class. Alex’s family has a very good, comprehensive health care plan, with insurance provided through one of Alex’s parents. Alex has had access to some of the best care a young diabetic can have. For over 10 years, Alex has had an insulin pump, a small device that holds a reservoir of insulin.  His pump automatically provides a steady stream of insulin all day long (the “basal” insulin), just as the body normally does, to try to keep blood sugars stable. His pump also makes it easy to administer insulin at meals.  He simply estimates how many carbs he’s eating, enters that number in the pump, and the pump provides the proper amount of insulin required to process the sugars in that meal. Alex checks his blood sugar very often (8-10 times a day), but was still occasionally experiencing both hyperglycemic and hypoglycemic events.  In addition to his pump, his family pursued a “continuous glucose sensor” (CGM), another medical device that automatically checks his blood sugars every 5 minutes.  The CGM even has a cell phone app, where his parents are alerted on their cell phones if his blood sugars need attention. He no longer faces the dangerous “nighttime lows”, a hypoglycemic event that may occur at night when a patient is asleep and less able to respond. If Alex’s blood sugars start to drop anywhere close to dangerous levels, an alarm will alert both him and his parents that action is needed.  Alex’s A1C levels have typically been right around 7.0, just a bit above that of a “normal” person.  With the new CGM, it’s likely that will go down even further.  Alex’s care is expensive.  The insulin pump and the CGM both costs thousands of dollars, as do the yearly supplies that support those devices.  Along with the costs of insulin, doctor visits each month, and other supplies, Alex’s health care costs without insurance would be in the 10s of thousands of dollars per year.  Even with what’s considered quite good insurance, his parents pay a lot out of pocket each year for the pump, CGM, and supplies. They can afford it, however, and Alex’s long-term prognosis and risk of complications is much lower than Olivia’s or Nate’s.

“Olivia”

Olivia is a pre-teen who has had diabetes for about 5 years.  Her family would be considered middle-class, perhaps lower middle class. Olivia’s family has a health care option through a parent’s employer, with coverage that isn’t nearly as good as what is provided by Alex’s insurance. Olivia’s family would like a better insurance plan, but their income is high enough that they’re not eligible for subsidies under the ACA that might enable them to “shop around” and find better insurance.  Olivia’s insurer covers only part of the costs of an insulin pump, and does not cover costs for a CGM.  Olivia’s family cannot afford the out-of-pocket costs that would be required to get an insulin pump, so Olivia does not have an insulin pump, or a CGM.  Her insulin control relies on frequent injections, with a daily “long-acting” insulin that is meant to mimic the basal insulin (the steady, day-long drip) provided by Alex’s pump, and “short-acting” insulin that is given with every meal.  Olivia doesn’t like needles, but as a young diabetic, she’s learned to tolerate them. Olivia knows Alex, and marvels at his pump, which frees Alex from the 4-6 daily injections that Olivia gets.  Olivia checks her blood sugar as frequently as Alex, 8-10 times per day, which helps keep her blood sugars under control.  She can respond when blood sugars are low or high, but it means another injection (for high blood sugars).  Without a CGM, she’s more subject to unnoticed hypoglycemic or hyperglycemic events.  Unlike Alex, who “feels” when his blood sugar is low, Olivia has no such physical feelings or warning signs when her blood sugars go low.  She recently was hospitalized after a severe, nighttime hypoglycemic event, when extremely low blood sugar results in seizure and a short period of unconciousness.  With her diligence in checking blood sugars, however, those events are minimized. Her A1C is significantly higher than Alex’s, usually around 8.0 to 8.5.  Compared to Alex, she’s thus not only at risk of unnoticed high or low blood sugar events, she’s also more likely to develop longer-term complications such as heart disease, kidney failure, or eye disease.

“Nate”

Nate is a teenager who was diagnosed with diabetes about 10 years ago.  He lives in a single-family home, a good home with a very loving mother, but paying the bills is a struggle.  The only health insurance available to Nate’s family prior to the ACA was a “catastrophic care” policy with very high deductibles and much poorer coverage than either Alex or Olivia receive.   After Nate was diagnosed, the economic struggles meant pinching pennies on health care. It even meant pinching pennies on the administration of insulin. At difficult times, Nate’s family would avoid carbohydrate-laden meals, in order to save money on the amount of insulin needed to treat Nate. Visits to the endocrinologist were few and far between, as Nate’s mother couldn’t afford them.  Nate’s blood sugar control was very poor prior to the ACA, with A1C’s typically over 10.  Under the ACA, subsidies are available, including both tax credits and cost sharing subsidies, that ensure a plan on the ACA marketplace can’t cost more than 9.5% of a family’s income. After the ACA, Nate’s mother enrolled in a marketplace plan and obtained a health care plan that was much better than the poor health care option provided through her employer.  However, Nate’s insurance is similar to Olivia’s, in that only partial costs of an insulin pump would be covered, and a CGM is not covered.  Nate’s mother cannot come close to paying the out-of-pocket costs that would be required for an insulin pump. Nate relies on shots much like Olivia does.  Nate’s mother is extremely thankful for the availability of ACA coverage, as without it, even the cost of insulin would have been very difficult for her to pay under her employer’s poor, catastrophic coverage insurance.  However, the family still struggles with everyday costs, including costs of health care. With the only available, affordable ACA plan, coverage is worse than either Olivia’s or Alex’s.  Nate’s situation has improved, but his family is still forced to make extremely difficult healthcare decisions, regarding both health care and other, every-day expenses.  With another sibling with asthma and other problems, covering health expenses is difficult even with the ACA and tax credits.  Visits to the doctor are fewer for Nate’s family than for Olivia’s and Alex’s. Blood sugar control has improved for Nate with the better insurance from the ACA, particularly as the family doesn’t feel the need to “scrimp” on insulin, yet Nate still has A1C levels that approach 10 at times.  Nate is at substantially higher risk of long-term complications than either Alex or Olivia.

Comparing Alex, Olivia, and Nate

Alex > Olivia > Nate.  That’s the situation in today’s health care system, where your level of care is directly related to your ability to pay.  With Type-1 diabetes, blood sugar control is LIFE.  There are tools available that assist a Type-1 diabetic in maintaining blood sugar control, but those tools are of no use if a family can’t afford them.

In all likelihood…Alex will outlive Olivia.  Olivia will outlive Nate.  It’s as simple as that, when blood sugar control is the key to a long, happy life for a diabetic.  Particularly a type-1.  It has NOTHING to do with the love of a family, or the desire to keep blood sugars under control.  The parents of Alex, Olivia, and Nate all love their children very much, and would do anything to keep them as healthy as possible.  It simply boils down to economics. Even if insurance provides some access to advanced treatment options, that’s useless if the family can’t afford co-payments or other fees required to get those advanced options.

The ACA is far from perfect, but also a much, much better situation than we had prior to the ACA. The ACA is a step in the right direction, but more is needed. Instead, we’re heading backwards.  The split between the “haves” and the “have nots” has never been more evident in the United States, and as the not-so-hypothetical case of Alex, Olivia, and Nate shows, that divide is also still clearly evident in how we dispense our health care.

Jul 26 2015

Tree Nazis strike again in South Dakota

Author: DakotaBirder • Discussion: 1 Comment
Tree cutting - South Dakota roadsides

Another one of my (former) favorite birding spots, hit by the South Dakota Tree Nazis. If they have their way, no habitat of any kind will be left in the state, and we’ll have a nice homogeneous landscape of corn and soybeans.

Sigh…this is getting old.  I went out this morning to do a bit of birding, and thought I’d try “Ditch Road” north of Sioux Falls.  It’s a spot I like to go to in the mornings.  Ditch road has a ditch that often holds water, with thick trees and shrubs on either side.  The stretch I like to bird is on the west side of the road, so there’s some nice light as I drive it in the morning.

As soon as I turned the corner on to Ditch Road, my heart fell.  Yet another of my favorite birding habitats in the area has fallen prey to the South Dakota Tree Nazis.  If you haven’t heard of the group, they’re an evil underground effort to ensure that all of South Dakota is homogeneous corn and soybeans, and that every little bit of remaining bird habitat is removed.  “Spook Road”, another favorite birding spot just east of my home town of Brandon, has also fallen prey to the Tree Nazis.

In both cases, thick shrubs and trees lining the road have been completely removed.  From the rumors I’ve heard, it’s local and county government efforts to satisfy new insurance requirements.  I’m not sure if it’s true, but I had heard that due to an accident involving someone becoming injured or killed in a vehicle strike on roadside woody vegetation, insurance companies pressured local governments to remove woody vegetation that’s anywhere close to a roadway.

Trees aren’t exactly widespread on the South Dakota plains.  Urban areas certainly have plenty of trees, but otherwise they are typically restricted to riparian areas and fencelines.  In the case of the aforementioned Spook Road, there’s about a 3 mile stretch where a small creek intermittently crosses the road, and it’s the thick riparian/roadside trees and shrubs that were removed.  In the case of Ditch Road, it truly is a very thin strip of tree and shrub habitat, perhaps 30 yards wide in total, but it’s always been a very productive birding location for me, particularly in spring when migrant passerines move through.

And now, like many of my other favorite birding locations, the Tree Nazis have destroyed it.  As the photo above shows, ALL vegetation on the side of the ditch closest to the road has been removed.  I guess I should be thankful the Tree Nazis were feeling gracious, and left the vegetation on the far side of the ditch. It’s a far too common site though in the area, with trees along fencelines, shelter belts, and other roadside trees being removed at an incredible rate.

The South Dakota Tree Nazis have many splinter groups operating in the state as well, including the South Dakota Wetland Destroyers who have been incredibly active in the last couple of years, drain-tiling and destroying every tiny remaining spot of wetland in the area.  For an area that historically was chock-full of little wetlands, I now have to drive a ways to find a functional wetland with any kind of decent birding.

I’ve got a LOT of photos on my main website that were taken on Ditch Road. After what I saw today, all of those photos may now just be a remembrance of a time when Ditch Road had decent birding, before the Tree Nazis did their work…

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