West of the Rotunda

The Idaho legislature spent no Idaho taxpayers’ money when it established a Maternal Mortality Review in 2019. The annual administrative cost was estimated to be $27K and “grant money” would fund it.

The legislature loves setting up panels and commissions and not having to pay for it. Still, this barely passed the House. All the representatives from my district supported it.

The guy who pushed for this spent some years on it, and he even approached me to sponsor it in 2016, my last year in the Senate. I warned him, a Democratic sponsor would be the kiss of death. Further, I just wasn’t sure the recommendations would be welcome, since at the time, the legislature wouldn’t even consider Medicaid Expansion. Maybe I was getting cynical. Shame on me.

It’s not like I don’t support this sort of activity. For years, as county coroner we reviewed childhood deaths in my jurisdiction. Examining cases can teach us a lot. I found the childhood fatality reviews very helpful as I considered public policy. Former Governor Otter finally made these reviews a statewide policy in an executive order in 2012.

This panel has also made recommendations the legislature has ignored.  Mainly, they suggested reviewing the “Religious Shield Laws” that prohibit prosecution of parents for neglect if a child dies from a treatable condition if the parents have religious beliefs blocking medical care. No such change has come before the legislature.

The MMR was directed to review deaths of women who were pregnant or had been pregnant within a year of their death and make recommendations for policy or procedural changes. The first report  for 2018 is out. I don’t think their recommendations will be welcome.

Idaho has few maternal mortalities; there were only ten found for 2018. Still, the review panel thought almost all could have been prevented.

One of their recommendations was for maternal Medicaid coverage to be extended to 12 months after birth. It’s cut off at 6 weeks now.

Can you imagine our legislature doing that? Think of what it would cost!

Again, I apologize for the cynicism.

But the legislature’s attitude is no secret. When asked about spending on Medicaid in the budget committee, Representative Caroline Troy (R-Genesee) said: “I’ve never believed that Medicaid accomplishes what we want- which is the health of our citizens. So, for many of us this (funding) is a bitter pill to swallow.”

I think that is a prevalent attitude amongst our elected representatives. Remember, she even voted for the Maternal Mortality Review.

There is overwhelming evidence that good prenatal care saves money and saves lives. Idaho generously extended Medicaid coverage to pregnant poor women decades ago. There must have been some support for this back then. Has it faded now?

I hope not.

But will the MMR recommendation to consider expanding coverage to 12 months after delivery even be considered? Apparently not from one of the representatives who voted to establish the review.

Don’t get me wrong, I understand this behavior. I see it every day. People make an appointment, come in a see me in the clinic, share a concern with me, then ignore my advice.

I’ve never carried a baby, it’s just not in my biology. I sure respect those who do. I did my share of prenatal care and deliveries. For many, this blessed event is a healthy and life growing experience. But, from my experience, not for all. I greatly appreciate the work this Maternal Mortality team has done, and I value their perspective and recommendations. I only wish our elected officials had the wisdom to at least consider, maybe act upon, the recommendations they wisely asked for.

It is true that the Idaho Legislature’s Constitutional mandate is to appropriate money. And it is true that the State of Idaho got a big check from the Federal Government this last summer. It came to around $1.25B dollars, from that CARES Act. And it is true that most of this big pot of Federal IOU’s got spent without any legislative action.

Keep in mind, the Idaho general fund annually spends about $4B of our state tax dollars. The legislature usually appropriates the $3.4B in Federal dollars we spend too.

Now, for the first few weeks of this legislative session, we have heard how the Idaho legislature is upset with our governor for his “unconstitutional” actions. But it seems their most pinched-face arguments have to do with restricting “freedoms”, not the money.

Will the legislature put this big pot of money received and spent on the books? Will it be part of the Joint Finance and Appropriations actions? I haven’t heard such rumblings.

Back when my hip didn’t hurt so much and those marble stairs to the third floor of the Capitol didn’t intimidate me, I served for a few years on that committee, JFAC. One Senator made a point that the Federal dollars for transportation were not in the budget request for the Department of Transportation. We were just voting on the Idaho dollars. He argued that the Federal dollars needed to be included in what was voted on. I agreed with him. We didn’t turn the money down, or quibble about it, we just made sure it was part of the accounting. I guess money for gravel and asphalt is good money.

It would be a lot of work to review, vote on and approve all those millions, about a billion, already out the door. But if the legislature wants to have a power play with the governor, this is where they have clear Constitutional standing. I don’t hear gripes about how this money was spent, though. They must trust the governor it went to the right places. Maybe they just trust that this was good money.

Likewise, we heard this last week that Idaho’s federal money for the Medicaid program will be boosted this year, so Governor Little told JFAC he was taking the proposed $30M in Medicaid cuts off the table for this year. I wonder if that is good money?

Idaho’s tax revenues have sure weathered the Covid storm. Every month for the last nine months we have beat predictions. Right now, it looks like the state will be sitting on a $600M surplus just for this fiscal year. And our reserve fund balances are about $500M.

But there’s one thing we know for sure, that Medicaid Expansion money was bad money. Idaho passed up on it for four years until an initiative passed. But it’s coming in the door now. So, it seems, some federal dollars are good, some are bad.

I can understand the reluctance about Medicaid money. There is a requirement that the state has to spend it’s share for every federal dollar we take. In regular Medicaid, the match is about 3:1; that is, 3 federal dollars require one Idaho dollar. For Medicaid expansion the match is 9:1. Nobody likes getting into long term obligations if you expect instability.

But I’m going to argue, the fact that Idaho expanded Medicaid eligibility right before we got hit with the pandemic helped stabilize our economy. Many studies in many states have shown such a benefit, so I’m not just making this up.

And all that money Brad sent out the door last summer has probably helped our tax revenues too. But if he would have been playing by the book, he should have called the legislature into session for the appropriation. But hey, it was good money, right?

I got my second Moderna immunization for Covid 19 this Friday. The first was pretty smooth, I noticed no side effects at all, not even a sore arm. The second one made my arm much sorer and I felt a little funky the day of the shot, but pretty much back to my usual stiff and sore old-man-self by the second day. So now I guess I’m pretty darn immune. I hope you all are soon.

Lots of folks are expressing hesitancy like I did a while back. They are waiting to see. Mostly it’s seniors and health care workers at the front of the lines. I’m both. And, that’s probably how it should be. Still, as a country we are slow to embrace this immunization. We all have our reasons.

I once visited Cuba and met with some of their health care providers. They had an immunization story to tell. Not that it’s a valid comparison, but it’s telling.

No need to tell you they are a communist country. Fidel was still alive when I visited back in the early 2000’s. Their health care system was pretty remarkable. Everybody had a doctor, and every doctor had a list of the patients they were responsible for. The public health bosses decided the country should be immunized against meningitis, the meningococcal variety. It is a rare but pretty lethal bacteria that can cause meningitis and sepsis (blood infection). They got the necessary doses, publicized their campaign, and got the local clinics ready.

This is an island about half the size of Idaho with about ten times as many people.

They were expecting the campaign to last a week, but when Monday rolled around, they found they had immunized the target population (folks under 20, about 3 million residents) by noon. I heard this story from the Cuban director of Public Health. He might have been bragging. I have not been able to verify the “by noon” statement, but multiple sources confirm the immunization program. Cuba has reduced mortality from meningococcus by >95% since 2002.

I’m not saying Brad Little needs to take lessons from Fidel Castro. But I would ask you to consider just what is the role of public health in this state.

Most of the time when we think of health it’s a pretty personal consideration. We choose whether to see the doctor, take the pill, get the test, lose weight and exercise. But public health crosses over into personal choice when one person’s actions affect others. Cuba, communist and all, puts a lot of emphasis on that crossover. Here in Idaho, we’re still pretty much thinking about ourselves.

When somebody is spreading a disease, they can be ordered to be isolated or quarantined by the Director of the Department of Health and Welfare. This was the authority for Governor Littles “stay at home” order last March. Boy, has that got some legislators twisted up. Maybe it did you too. It sure hit some businesses hard.

Public health districts serve regions of multiple counties. Their board members are appointed by the commissioners of the counties in the districts. They actually have little authority to issue orders, unless you have rats in your restaurant.

Now, there have been requests, even orders that people wear masks made by some municipalities.

Idaho is now seeing a significant decline in cases and deaths in the last couple months.  Our peak was in early December. Who knows if the first peak back in July, starting in June would have been higher without our “stay at home” time.  The immunizations are rolling out, slowly to be sure, but they are coming. You’re going to have to decide if you want one.

So just who, in this wild west state should have some authority about public health measures? If you were the Public Health boss, what would you do?

The Idaho legislature is back at work, so we ought to be paying attention to where our leaders want to take us.

The first thing to note, is they, the House and the Senate both seem to be mad at the Governor. We are early in the session, so maybe they will make up, but so far there have been more bills, resolutions, constitutional amendments proposed about the Governor than any other topic. Mainly, they want to limit his power to make them wear masks, stay at home. It seems they aren’t right sure about how to do this. To quote Speaker Scott Bedke: “We’re telling the governor we’re going to keep flipping switches until we get this right.” Boy, that gives me confidence.

And this from the House leader who supports a proposed Constitutional amendment that would allow the legislature to call itself into session whenever they choose.

The Governor shot back, that the legislature is “playing politics”. It turns out that a couple of the bills proposed (switches threatened to be flipped) would indeed end the emergency declaration, but would have no effect on stay at home orders or mask mandates. It would just send away tens of millions in Federal aid the Governor has been happily spending.

Playing politics, Brad? C’mon, they are politicians after all.

But honestly, given the Idaho legislature’s history with getting its way with the Idaho Constitution, this idea of calling themselves into session whenever they choose might make some sense. Let’s examine their track record.

You all might not remember, but the legislature recently got its shorts in a twist about reviewing administrative rules. As a reminder, the legislature passes laws like, “No bad dogs”. Then the administration has to clearly define a bad dog so you and I and the enforcement folks would know one when we saw one. For years the Idaho legislature has spent the first month of dark and chilly January in Boise reviewing and approving these rules. Only a few of the thousands reviewed would get rejected. The rejected ones mainly had to do with what schools could teach and how. Remember, our legislators know what’s best for us.

Anyway, this rules review is tippy-toeing close to a Constitutional line. Separate but equal branches of government and all. The legislature writes the law, but then tells the Administrative branch how they should enforce the law.

So, the legislature, in its wisdom, thought if we get this authority in the Constitution, they’d be golden. Their first run failed. The second time they got money and support from the Freedom Foundation and the Farm Bureau, and we voters passed this arcane Constitutional Amendment.

Golden, right? What happened the two years after they got their clear authority? The Idaho legislature failed to approve any administrative rules. This was even after spending months in tedious meetings. So, we put this authority for them to review administrative rules in the Idaho Constitution, and then they don’t do it.

Governor Little declared victory and rewrote all the rules, making lemonade by winnowing out about a quarter of the thousands of pages. Brad can put a positive spin on most things. I’m surprised he’s mad about “playing politics”.

Back to the proposed Constitutional amendment for the legislature to call itself into session at their own choosing. If it’s anything like their rules amendment they got passed, we might all be in luck. Let’s say they get this proposed amendment through the House with 2/3rds, and the Senate with 2/3rds as required, it goes on the ballot and the majority of voters approve it. If the legislature stays true to form, soon as we give them what they want, they’ll stop doing it.

Imagine, an Idaho without 105 Representatives and Senators meeting in Boise 4 months each year. Just give them their request and they’ll go away. Could it be that simple?

I’ve written before about “thinking like a virus” but I admitted in that piece, viruses don’t think. They are just information and a vector for transmission of that information. Without a host to build more of them, they are inert. The information is crucial.

We are hearing now of Covid mutations. They carry different information. It doesn’t sound like the virus is more or less deadly; it just spreads easier. Further, it seems the immunization is still effective against these mutants. Isn’t it amazing that such an organism can change, adapt so quickly?

But we humans are struggling with information and its transmission right now. Just like Covid, some of us can get infected with information and it does us little harm. Others get pretty sick. Think of the guy who drove a couple hundred miles to a pizza place in Washington DC to save the trapped, abused kids in the basement he had read about on the internet. He walked in with his AR, only to find there was no basement for that building. As he was getting booked he said, “I guess the intel on this was weak.”

Consider how information affects you. There’s so much out there these days, we are awash in it. But some can change your life; some washes past you like river water. I always thought of this when giving a patient a diagnosis. That information can change your life, either way.

We have all heard the phrase about something on the internet “going viral”. Why are we humans so quick to spread things? Is it because the platforms (big business, maybe the biggest nowadays) the vectors for this information make it so easy? “Share”, click, it’s done. There is no doubt these big businesses think about this more than you or I do. But we get their products for free, don’t we? They are so nice. 😉

Information by itself, not acted upon, much like a virus, floating in the air, is inert. But if that virus finds a warm body that can build more of it, it replicates, multiplies, spreads.

If information on the internet finds a host (you or me) and we dismiss it, it dies. But if we take it in, think about it, act on it, even if only to “share” it, we have propagated, replicated it. It spreads.

Our immune systems are in charge of identifying harmful viral infections and getting rid of them. Most times they succeed. Other times not.

Sometimes viruses don’t cause us much harm. Think of the lowly wart on your finger or toe. It’s a viral infection your body just hasn’t identified. And it’s not causing much harm, is it? But cervical warts cause cancer in women, and they die from it, or they used to. Nowadays we have an immunization. Cervical cancer is disappearing as a killer of women.

Our brains are supposed to protect us from harmful information. But just like our immune systems, our brains can ignore small insults, weak signals. It takes a healthy immune system to deal with viruses and a healthy intellect to manage the sea of information we are swimming in.

The most important question in all of this has to do with how, each of us, will deal with the information infections we get daily. Is our intellectual immune system healthy enough to limit the spread of toxic information? Or are we at risk to become infected, not show symptoms, and spread the illness to others?

Viruses and information can both be toxic, though neither is always so. As we struggle with managing our current Covid pandemic, the parallels with our struggles in this information age are evident. I predict neither the virus, nor the information plague will wipe us out. But both could make us pretty miserable if we aren’t up to the test.

We had two powerful demonstrations in our nation last week. One was lawful, orderly, tedious and impressive. The other was destructive, unlawful, with no clear purpose.

The first was the US Senate runoff election in Georgia. In case you missed it, two Democrats got elected to the Senate in a state that has only elected Republican Senators for the last twenty years.

How did this happen? Pretty simple, really, but awfully hard to accomplish: turnout. Almost as many Georgians voted in the runoff as in the general election in November. Twice as many voted as in the last runoff election in 2008. Georgians showed up at the polls, cast their ballots, actively participated in this representative government.

The state of Georgia ran this runoff election according to their rules; they followed their laws. About half the people’s candidates lost; about half had their guy win. I’m sure there’s disappointment and elation. But the outcome should be seen as a win for us all, if we have any hope for our Republic.

I don’t find this encouraging because “my side” won. It’s really not about whose side wins, it’s about this Republic working for our citizens.

The effort was incredible. Getting people interested in voting, aware of the choice before them, then getting them to the polls or to fill in their absentee ballot is hard work. It takes a lot of organizing, a lot of effort. The effort was made, and the results rewarded the effort.

Yes, the margins were slim, but the outcome was clear.

Doesn’t a turnout like that just thrill you? Doesn’t such voter engagement restore your faith in our Republic?

If not, then maybe you found the second demonstration more meaningful.

For weeks right wing Trump supporters have talked about “occupy the Capitol” on unregulated, fringe social media sites. President Trump even set the date, January 6^th in a tweet he sent out December 6^th calling for a “big demonstration” in the Capitol. He knew then, and his followers figured out soon enough, that this date would be when the Electoral College Votes would be certified by Congress.

I’m sure the crowd was encouraged by the actions of many, our President in particular. I can’t help but think that the wave of Republican elected officials who tried to support one state (Texas) suing other states about how they ran their elections also egged the crowd on. For elected Republicans to abandon one of their fundamental beliefs, state’s rights, to support a demagogue surely signaled that the crowd was correct in their adulation. Heck, even Idaho elected officials jumped on board: Governor Little, both Congressmen, many legislators suddenly needed to follow the roar of a crowd.

State Attorney General Lawrence Wasden was a man with integrity in the face of this furor. He refused to add Idaho’s official imprimatur to this blasphemous document. Boy, did he catch it. But if you’re not making somebody mad, you’re not really standing for something, are you?

Can you imagine Idaho being sued by Oregon on how we run our elections?

As the crowd formed on Pennsylvania Avenue, our President, Donald Trump, called for them to march up to the Capitol. “I’ll be with you”, he promised.

You’ve all seen the videos of the Trump, Confederate, Gadsden (even Idaho) flag waving crowd .as they pushed into the US Capitol building. You’ve seen the pictures of the posturing, pissing and selfie-taking mob.

So, you need to be thinking right now how these two demonstrations touched your heart. If the boring slog of talking to neighbors, or strangers about the importance of their vote doesn’t touch you, then I must say, I fear for our Republic. If instead you were roused and supportive of the riot trying to disrupt our legal processes, maybe this Constitutional form of government just doesn’t suit you. We need to be deciding, each of us.

The recent report of our President calling the Georgia Secretary of State and threatening him to “find me some votes” made me wonder if I’d messed up some years ago when I lost my last election.

It was a close race. The local paper even called me at midnight to get a quote. They said they were going to call me the winner. I was watching the returns real close. “I don’t think you ought to do that.” I warned them. “I actually think I’m going to lose.”

“C’mon, you’re way ahead. We’re going to call it for you.”

“Well, I think that would be a mistake, but you write what you write, I guess.” They went ahead and put the wrong report out in the morning paper. I said something like, “Win or lose I’m glad to have served this district.”

I knew I had lost by the time I went to bed.

In the morning I called and left a message on my opponents answering machine, congratulating him and went for a dog walk. A neighbor I passed (who didn’t vote for me) congratulated me on winning. I had to correct her. Her guy won.

Maybe I should have called the county clerk. Maybe she had a bin of votes under a table somewhere. Was I just a wimpy loser Idaho Democrat? Maybe real winners know how to “find votes” even after they are tallied.

Instead of looking over the fall fields and calling the dog back, maybe I should have made that call. I knew the county clerk pretty well. But I didn’t. I trusted that the voters had spoken. And asking someone to cheat is worse than cheating yourself. The thought, honestly, never occurred to me then.

The three times before when I had prevailed, I had never won by much. It was always about 1-2% difference between me and the other guy. But I always thought my job, when elected was to serve and represent all the folks in my district, not just the ones who voted for me. Maybe that’s stupid. After all: “Elections have consequences”.

Nowadays, elections for our representative government are treated more like a team sports event; we just want “our side” to win. It’s less about what the candidate actually stands for, their integrity, or character than what color jersey they have on. And the color of the jersey determines what you think of their character.

I thought local elections would be more about the individual, but I learned quickly otherwise. The color of your jersey really matters.

The Republican loyalty for our President is strong. It’s like he can do no wrong. If he makes a phone call to a foreign leader trying to get dirt on a political opponent, or tries to “find votes” in an election he lost, justification will be found. This jersey loyalty, whether a red one or a blue one, is not healthy.

Four years ago, after losing, I could not have imagined making such a call. I guess I can now. I can imagine it. But I can’t imagine actually doing it. It’s just not the right thing to do.

We have such a poisoned attitude about the public servants we elect, no wonder we distrust them. We should be electing people we respect, not granting loyalty to their jersey color. When we elect a representative, we are saying something about ourselves.

Serving in the Idaho Statehouse for 6 years I came to know some very honorable, even noble people. I was inspired by their work, their character. I tried to learn from them and let them know when I found them inspirational.

Winning an election doesn’t change your character. Losing one doesn’t really either. The people we elect are probably just a reflection of the character of us, the people they represent. It can be a painful mirror to look in.

Maybe it’s the dark and cold, or some recent book I read, but I have found myself reflecting on the aspirational phrase of one of our countries founding documents: “the pursuit of happiness”.

Jefferson drafted the Declaration of Independence and used the inalienable rights of man to justify the colonies rebellion against the sovereign king.

“Pursuit” didn’t mean chasing after, but rather “living as”. Much like my wife pursues gardening; she grows plants, she has me dig up and move plants, occasionally she allows me to prune the plants. She’s not chasing gardening, she’s doing it. And it brings her great happiness.

So, I wonder if we as a nation have given up on the pursuit of happiness. From what I can see nowadays, most folks, congress and our President included, seem to be pursuing rancor. Bitterness is the flavor of our national drink. Let’s change that.

Jefferson’s other inalienables, life and liberty, were not placed in this short list as contrast, but rather as a cohort. Without life, pursuit is moot. Without liberty, the pursuit is limited. I believe he chose these three rights because they support one another; or they should.

A friend recently mentioned that the Constitution defined the pursuit of happiness as an inalienable right. I had to correct him that the phrase was in our Declaration of Independence. Nowhere does the Constitution define such a right. It was just too general, not specific enough. But I believe the founders had such a phrase in mind as they drafted the constitutional mechanics of government. Indeed, the Preamble references the purpose of the “Common Good” for the following document. Let us take such to heart.

Government cannot make one pursue happiness, but it definitely can get in the way of such a pursuit. The founders and subsequent amenders placed specific limits on government, so we would be free to pursue happiness.

But that doesn’t mean any act of government reduces my liberty or blocks my pursuit of happiness. I greatly appreciate that I don’t have to stop and pay tolls. I would much rather pay a tax at the filling station. I accept that we need money for roads. The gas tax supports the common good. But toll roads work for many states. The states are the incubators for this balancing of life, liberty and the pursuit.

I also felt liberated when, after a recent doctor visit, I was told I didn’t owe anything. I hadn’t had to spend time shopping for insurance, I hadn’t had a copay. I am now a Medicare recipient. Some might describe this as an infringement on their liberty, a universal health insurance for the elderly. But the elderly don’t. Survey after survey has shown Medicare enrollees are satisfied with their health insurance. No surprise, since we Medicare beneficiaries get about 15% of the annual Federal budget to support our liberty.

If your sense of liberty demands that everybody just gets out what they pay in, then we should make a law against insurance. But most people agree to pool their risks on a home fire. They pay the premium, and don’t wish their house will burn down. Most people agree to share risks with their neighbor when they buy car insurance. But as a country, we just have not concluded that we are all in the health care risk pool together.

And I believe our citizens pursuit of happiness has been stifled by the lack of universal health care coverage.

But we have solved these problems as a country before. We have built roads, we have sewer systems, we have schools and stadiums, all with community, state or sometimes federal support. We all need to keep our eyes open about who gets what benefits.

We need to pursue the common good. Vote for people who will.

I don’t give gifts easily. My wife does. I’ve asked her how to do better. She says it’s simple: just pay attention to those around you, think of what they want or need, and chose something that might please them. Oh, and it’s best if you know their size and what colors they like.

I haven’t wrapped these up yet. I’m going to ask you all if I’ve missed the mark.

For Idaho Republicans I bought some canvas and a Speedy-Stitcher so they can make modifications to their Party tent. I’m not sure whether they want to keep making it bigger, or split that circus tent into smaller sections. I figure they can vote on that.

Idaho Democrats were harder to buy for. They are so rare, it’s hard to really know what they might want or need. I found some old Cecil Andrus and Frank Church political buttons on Ebay but the shipping cost more than the buttons so I passed. I have a whole pile of voter registration forms in an old backpack, I was thinking of giving these, but then I remembered, that’s where I got them, from the Idaho Democratic Party. It’s really bad form to re-gift, my wife says. Then, I thought of the old stand-by: a bottle of Idaho Whiskey. So, I got some at the liquor store, but I hadn’t tasted it before, so I opened it before wrapping it to just have a sip. Do you think they’d mind getting a half bottle? It’s not bad.

Brad, our Governor could stand a heartfelt gift this dark season. I’ve been trying to think about what he might want or need. It seems like everybody has an opinion about that. Some seem to think he needs a backbone, while others would send him a muzzle and handcuffs. I got him a bottle of that Idaho Whiskey and I didn’t sip but a little out of that one. It’s mostly full. I better get it wrapped up soon.

Our Lieutenant Governor, Janice McGeachin seems to have everything she wants right now, so I didn’t think I should give her anything. She’s got a taxpayer funded part-time job, with taxpayer funded staff and a fancy office, and the Governor never asks her to do much. Plus, she gets all the free press coverage she wants. But then I remembered the legislature will be starting up soon and she has to run herd on the Senate. That’s her most taxing obligation. I found an old five-pound maul in my tool shed she can use for a gavel whenever either of the Democrats rise to speak. I might put a bow on it. Would that be sexist?

Attorney General Lawrence Wasden really needs some Christmas cheer, all the griping we hear about him. He wouldn’t sign Idaho up for that Texas election lawsuit to support Trump; boy did some of his Republican tent folks singe him. But I’m getting a little self-conscious about another trip to the liquor store. I keep telling them these are gifts for others I’m getting. They just smile and nod. I have a nice pair of oven mittens that say they can handle hot coals. I’ll wash them up and send them off. What do you think?

If you give a gift to one person, and not the next, feelings might be hurt, so I made a list of all the folks in the Statehouse. By the time I got down to the Treasurer and the Controller, I realized maybe a Christmas card would have to do. We have a bunch of cards we got at an Idaho Democratic Fundraiser. They show a donkey/elk with Christmas lights in the antlers. They’ll do, I guess.

Next year I’ll ask my wife to do the gifts. This is hard.

I have always been skeptical of new medical developments. So, when I heard about this Covid immunization being rolled out so quickly based on Messenger RNA, my knee jerk reaction was a quiet wince. For some reason, the hottest new treatment often becomes the fastest recalled drug.

But then I did some studying. Not on Facebook, not in chatrooms, but looking for reputable, balanced reports. Most folks aren’t much attracted to balanced information these days. Call me a dinosaur.

It turns out this mRNA technology has been around for a while. I hope you remember your high school biology. DNA was discovered in the 1950’s. Messenger RNA (mRNA) was discovered in the 1960’s. DNA stores the record of what proteins your cell should build. MRNA carries that record to the protein building factories.

Thirty years ago, it was shown you could inject mRNA into mice muscle and the cells would make the protein message. In 1993 they even showed they could immunize mice against influenza with mRNA.

So where has this technology been for the last thirty years? No surprise, they’ve been trying to make a profit. They’ve been trying to match this new technology with a disease; one with a big return on investment. Most licensed drugs that use mRNA are for inherited metabolic diseases. The patients live a long time, will need the drug for their lifetimes, and it works. Demand is predictable.

There’s not much profit in the immunization business. Most flu shots are made in chicken eggs or other cells; there is one that is approved that is recombinant. MRNA medicine developers just haven’t seen much profit in the flu shot market. But now, a pandemic comes along.

It turns out you can make mRNA pretty fast. And that’s what we need: lots of doses, well distributed. Idaho is set to get 14,000 doses in the initial shipment. If Moderna gets their vaccine approved Idaho should get 89,000 doses before Biden’s inauguration. The FDA rushed emergency use approval last week for Pfizer’s shot, reportedly with a White House gun at their head. That inspires confidence.

First priority for the shots (you need two, weeks apart) are health care workers and nursing home residents. Idaho has about 80,000 heath care eligible, 20,000 nursing homes residents. So, you can see we might be a bit short to start with.

If it keeps snowing like this in North Idaho, we might need a dog sled team to deliver them.

Many questions linger. Will immunity last, will it be protective? Will there be long term side effects? Since we haven’t taken the time to study these questions, we will be finding them out in real time. In our own experiences.

The real question that nobody can answer is, will people be willing to get immunized? In this atmosphere, maybe not. The numbers have bounced around a bit in a running Gallup poll. The most recent numbers show about 60% say YES, but 20% say NO and 20% maybe. Of course, the analysis of these choices makes good speculation.

We have a lot of information at our fingertips. I just looked all this stuff up about mRNA vaccines on my laptop. Remember, I avoided Facebook and chatrooms and hyperbolic sites. But most people don’t make important decisions based on information.

Last month, Covid was the leading cause of death in Idaho. We have been seeing, week on week, a steady rise in cases, and deaths. Remember, deaths lag cases. December, January, despite the snow and cold will be grim in this state.

I can’t escape my skeptical nature. But I can manage it. Information, study and reflection help me manage. I am in the “health care worker” category, and I’m in the age group most likely to have a serious infection. I will take the shots when they are offered. But I might not be in the front of the line.