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Commentary on The Capital Markets- Category [Editorial]
2017-07-11 07:00 by Karl Denninger
in Editorial , 285 references
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Here we go....

Were it not for the provision that Pat Toomey, the Pennsylvania Republican, put into the Senate's proposed health care reform, this legislation would be moderately important but hardly momentous. Toomey's provision, however, makes it this century's most significant domestic policy reform.

It required tenacity by Toomey to insert into the bill a gradually arriving, but meaningful, cap on the rate of growth of per-beneficiary Medicaid spending. It is requiring of Toomey and kindred spirits strenuous efforts to keep it there, which reveals the Republican Party's itch to slouch away from its uncomfortable but indispensable role as custodian of realism about arithmetic.

Well, no it doesn't and he isn't -- that is, being realistic about arithmetic.

The argument in this article is that the expansion in cost is all about "mission creep."  Nonsense.

The facts are that medical spending has gone from ~3-4% of GDP to nearly 20% and continues to accelerate.  This of course means that ultimately it would exceed 100%, which is impossible.

Unfortunately the choking off of economic vitality has already started to take place from this growth in expense and is now threatening to drive the nation into a permanent state of economic funk -- masked, for a short while, by alleged "gains" in health care spend.

You can see this now in the employment report.  The one sector that continually gains people at an astounding rate is health care.  Yet almost none of those people are actual health care providers -- that is, doctors and nurses.  They're all administrators and salespeople, which is great for them (they get a paycheck) but horrible for you (since you pay for it.)

Remember this fundamental truth: Services are all about passing money from one person to another; they actually make nothing.

This means that while you can be a "service-based" economy under those services must be the making of things -- goods!

If the entire economy is predicated on you pumping me full of drugs because I eat like a total jackass and drive my blood sugar and body weight to massive heights what do I produce in actual goods in the economy in order to earn the money to pay you with?  

The sad answer to that today is "damn little", and that's where it all comes apart.

There is a certain level of this activity that is both necessary and healthy.  The gal who cuts my hair every month keeps me from looking like Tarzan, which has tangible benefit.  The doctor who sets my broken leg -- likewise.  But what happens when the amount of money that I spend exceeds the amount of physical output I generate?

I now become a net negative impact to GDP.

Like...... here.

FORT LAUDERDALE, Fla. (AP) — Amy Bernard and her brother kept their mother out of a nursing home as long as they could, until Parkinson’s and dementia took their toll and she was seriously injured in a fall.

Bernard is happy with her mother’s nursing home care, but it comes at a steep price: $7,000 per month, an amount that would be way beyond the older woman’s means if not for Medicaid, which picks up $3,000 of the tab.

Don't take this the wrong way: I am not suggesting that these facilities are not needed in many cases, because they are.

But think about this folks: $84,000 a year?  What the ****?

Think about that one.  What sort of insane skim is going on in these places?  Let's say you have a floor with 20 double rooms, so 40 fairly-severely impaired people per floor.  You need two qualified nurses on-staff and present 24x7 per floor, so that's eight full-time equivalents (3 shifts plus weekend coverage is 4 people for 24x7, and yuou need two of them.)  You also need available on-call and on-staff during normal hours at least a couple of physicians.

Let's look at the numbers.  We have 8 people making somewhere between 50-75,000 a year -- let's call that a half-million in salary.  This is an annual burden of $12,500 per person in the place for full-time, 24x7 coverage with two said highly-capable people.   Now add to this the ordinary requirements of a two-in-one room residence (e.g. a reasonable long-term rate in a modest hotel, which is about what the furnishing levels look like in these places) along with food and you're around double that.  There's some balance here - the shower/tub/toilet is all "ADA compliant" of course, but that's not much more to install than standard fixtures (again, hotels do this all day long!)

Where the hell is the rest of the money going?

Remember that nursing homes are not "hospitals."  They're not "intensive care" or anything like it.  They have available trained medical assistance and intervention on a 24x7 basis but even for someone wit dementia we're not talking about an isolation ward environment -- or a jail!  It's essentially a place where you have shared access to a nursing staff if you need assistance at any given point time, along with some degree of supervision.  It removes the "leave your stove on by accident and burn down the house" risk, in short, along with light to moderate daily medical assistance.

But there's no way that sort of level of living assistance should cost $84,000 a year.  It does only because we have set up a medical system that skims off half or more of every dollar spent and has generated a crazy number of entities who now rabidly fight to protect their ability to steal.

This has to stop folks, and it will stop.

There is a good way for it to stop and a really bad way.  The really bad way is to do nothing about this politically. This fanged monster will continue to consume the economy until it forces GDP negative to a sufficient degree that state and federal budgets collapse.  This day is coming and soon -- my best guess is that we have less than five years remaining.  That same estimate I made in the 1990s, by the way, was only off by about three years -- and that's truly frightening, in that this means that not only I but many others have known for two decades not only what was going to happen but roughly when and yet nothing has been done politically about it.

The second, and good way, is to force into the light price and enforce all anti-trust laws.  This will bring the market into the game and costs will fall like a stone.  If there is one nursing home charging $84,000 a year and a second one that the long-term hotel converts and charges $20,000 how long does the first one remain in business unless it gets the skim out of its operation and dramatically reduces its operating costs?

This is not limited to nursing homes, of course -- it's everywhere in the medical system.  From routine diagnostics, to hospitals and even at your local doctor's office the skim is outrageous, it's aggressive and it's eating the nation alive.

We must stop it, and stop it now or will consume us economically.

To start with we can go right here, which would instantly end the "uninsured" extortion games.  Read to the bottom and click that link, and you'll find the rest of the answer as well. 

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2017-07-04 01:00 by Karl Denninger
in Editorial , 378 references
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It was not that long ago that a group of men and women in this nation decided they had enough.

They didn't have electric power. They didn't have Teslas. Most homes didn't have any sort of "plumbing"; there was an outhouse, as the named implied, out back -- which was little more than a pit and a shack around it.  Taking a bath required heating water over a fire, which then could be poured into a tub; a "shower" was unheard of. Indeed these people didn't have cars; they rode horses or walked, and many could not afford a horse, so feet it was.  There was no "welfare", no AFDC and no Obamacare. If you didn't work you either found someone who took pity on you -- privately -- or starved. They did have firearms, but not because someone gave them to them, and in fact the government kept trying to confiscate them or limit what they could own or where they could carry them.

The genesis of the American Revolution was a modest but real increase in taxes that the Crown attempted to impose, especially on what was at the time an effective national beverage -- tea.  I remind you that at the time the effective tax rate in the Colonies was a mere 2%, and the increase proposed was tiny.

Yet it, along with a government that wanted to tell people how to live, pushed the nascent Americans far enough over the edge that they grabbed rifles and told the soldiers -- and the Crown to "get out."

The Crown didn't originally think they meant it.  There were skirmishes.  It's a commonly held, but false, belief that suddenly people started shooting out of nowhere.  In fact there were multiple small acts of violence that just never caught fire.  Lexington and Concord, however, were a different matter, and both took place on April 19th 1775, or more than a year before the Declaration of Independence would be signed.

Every man who signed his name to that document did so in a time of war and as a knowing and intentional act of treason.  Had the Revolution failed those who survived the fighting would have been hanged, and they knew it.

Not only was the nation at war for more than 12 months before the founders signed the Declaration it would be June 21st, 1788, years after the last rifle shot rang out, before the Constitution would be ratified.

Between all those events were plenty of people sticking up the middle finger to varying degrees.

Most did so very quietly.  In fact the name "three percenters" comes from the very small percentage of those who did so violently.

Some of the most-effective protest isn't violent.  Violence makes it easy for the government to corral you and ship you off somewhere; indeed, it's nearly certain to happen.  You only "win" in a violent protest if you win entirely and the odds are very much against you since most revolutions fail and of those that succeed the next government is often worse than the previous one with the new leaders deciding to kill anyone who might challenge them as their first act in power!  Thus unless you're one of the (very few) "favored" you hang anyway, even though you "won"!

On the other hand non-violent economic resistance is not only often effective for you it's a hell of a lot safer.  There are few "regimes" throughout history that manage to actually enslave the population.  Most of them don't go that far by a long shot; they instead try to obtain compliance through hand-outs and building your "expectations" to unrealistic levels at which point you voluntarily put up with their crap.

Look around you folks.  I can't tell you how many people I've had respond to me that it's impossible to run a household on anything less than $60,000, $100,000 or more a year in "income."  In that range more than half of what you make is actually going to someone else, and yet you work your ass off at that level for most people.

Today for young people it's economically dangerous to try for what was formerly just a function of hard work.  How do you go to college now without either taking on debt or getting your parents to foot the bill?  Don't think the second option leaves you as a young graduate "safe" either; by definition those who "can pay a lot" drive up the price for everyone else; that's simple supply and demand, and when fueled by a debt bubble you now have a built-in "expectation" of what you "should" be able to make.  What happens when that doesn't materialize post-graduation?

Now consider how much easier is it to work at a level of making $20,000 or $30,000 a year......

Can you do any of that in a big city and not be living in a slum with shootings going on all around you on a daily basis?  Probably not.  That becomes a problem for not only the older folks but the younger ones if their "expectations" are that they can live in the Chicago area, for example, where $500,000 houses come with $20,000 annual property tax assessments and the cheap houses ought to have a machine gun turret on the roof!

But can you make it work -- easily -- in some corner of Arkansas or Alabama?  Hell yes.

So what keeps you from doing it?  Is it really all that important to have the parochial existence?  The manicured lawn?  The big city life?  The Lexus or Mercedes?  The "access" to all those supposed things?  Does any of that really bring you joy, or are you just a hamster on the wheel trying to make enough money so you don't drown while preserving the facade for your neighbors, associates and kids?

You know damn well I'm right.

When you boil it down here's the problem with deciding to be a hamster: It only works if everyone else around you is willing to do so as well.

As soon as any material percentage of people (like myself) hop off the wheel you're all ****ed because unlike the hamster wheel in your kid's pet cage a human hamster doesn't have enough body mass by himself to actually turn the wheel.  He needs thousands of others on the wheel with him to fund the crazy and there is a point that can rapidly occur where there is insufficient mass remaining to turn the wheel at all.

Exactly where is that point?  You don't know and neither do I, but that it exists is fact.

We're going to find that point in the realm of public spending and "promises".  Illinois is just one example, but hardly the only one.  Those who think it's an isolated incident or even confined to "blue states" are in for a very rude shock, because the biggest part of this game is not state or locality-specific at all -- it's federal.

What will be your option when the wheel comes to a halt?  Do you think you'll have plenty of time?  Years, even decades to change your mind and take action to mitigate the disaster?  History says you're wrong; how long did Greece get before things got ugly?  Have they really gotten that much better since?  There are myriad examples through the last 50 years alone, say much less if you go back further.  The warnings are present if you care to look for decades but nobody listens until it's too late -- every time.

There apparently was a fossil found of a man in Pompeii.  He was masturbating when he got buried, which, if you think about it, is remarkable.  Vesuvius gave plenty of warning that it was going to blow up, but the people of Pompeii did not leave.  They did not take any action at all to save their own asses, despite knowing they were sitting right next to a literal bomb.  When the final cataclysm came it was so fast that the man rubbing one out didn't even have time to contemplate what was about to happen to him -- or perhaps he did indeed, realized he was screwed, and took those last few seconds to try to gain one final bit of pleasure before he was engulfed.

Happy 4th folks.  Now go pay homage to that which this nation lost decades ago, and no, Trump hasn't reignited it.  That there are no protests that cannot be contained within the Mall's boundaries in DC, not toward Trump but toward a government that has enabled and continues to enable the systematic looting of everyone in this nation to the tune of trillions every single year tells me everything I need to know about the path this nation is on.

Trump is just Vesuvius' warning, being ignored.

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2017-07-03 07:00 by Karl Denninger
in Editorial , 245 references
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There is one, you know.

It was quite interesting in the 1990s going from being a common private person to someone who ran a corporation.  You become a public person immediately, and then if you start appearing in the media in any way (and most such people do, eventually) then the rules shift even further.

See, those who are deigned a "public figure" have an entirely different set of rules that apply when others talk about them.  As an ordinary private person if someone calls you a "slut" in print that's probably actionable.  You might not be able to get any money in a lawsuit (most likely because the person who did it doesn't have any) but -- it's actionable.

On the other hand once you cross the rubicon into being a public figure all that changes.  Virtually anything is in-bounds, with a very few exceptions.  One of the few remaining exceptions is a direct allegation of a specific and serious crime.  For instance you can't call someone a child molester unless they actually are, public figure or no.

But "slut"?  Sure.  And further, the boundaries on "invasion of privacy" and such mostly disappear too.  They don't completely disappear -- someone who manages to sneak a camera into your bathroom and publishes a picture of you nude is still going to hang for it, but beyond that most things are fair game.  Thus, paparazzi.

And this leads to a fairly interesting question.  See, political figures in particular are the most public of all, and there is a long history of candidates throwing slime at one another -- sometimes true, sometimes not.  It's almost-never actionable in any sort of legal or political sense, except at the ballot box in that it can (and sometimes does) blow up in the slime-thrower's face.

We also have a long history of the media choosing a side and then failing to report the truth, or worse, lying outright to get a desired outcome.  Vietnam's Tet Offensive was one such glaring example.  Cronkite admitted, years later, that he knew damn well that Tet was a massive loss for the North -- they hadn't gained a single yard of ground and lost men and machinery at an utterly astonishing rate.  Yes, we took casualties too, but all things considered not very many at all.  Yet it was his coverage of that offensive (which was the North's attack, I remind you) that ultimately swayed public opinion here in the United States sufficiently to force an end to the war.

We had won, in short, because the North was literally out of soldiers; they spent them all, plus a bunch of untrained kids, on a failed attack in which some estimates were that they lost 10 men to every one of ours.  In the next months leading to President Johnson deciding not to run for re-election we had lost 4,000 men but they lost over 58,000.

It was a slaughter and yet it was portrayed as a great "loss" for America on every single nightly newscast.

Cronkite and the rest of the crew responsible for that were never held to account for their intentionally-slated "coverage" bordering on outright lies.

Who remembers Zimmerman? The news media deliberately placed their logo so as to prevent you from seeing a gash on his head when he was taken to the police department after he shot Martin and claimed that Zimmerman was uninjured in the altercation.  That was a bald, intentional lie; we only have left as the point of debate their motive.  Was it simply to frame Zimmerman (who I remind you was acquitted; the truth eventually came out) or did the media intend to foment a race riot and the literal destruction of Sanford, FL?

It is against this backdrop that CNN and it's executives all the way up to their CEO, and one must presume the rest of the media, emboldened with billionaires such as Amazon's Bezos who owns the Washington Post, have run an incessant narrative that "Russia elected Donald Trump."

Unfortunately for CNN cameras, including really small ones, are now cheap and can be had anywhere and everywhere. What has been seen over the last week or so is a series of videos recorded by Project Veritas in which CNN producers state that they know the Russia story is bull**** but are running it for ratings -- that is, money --  since they are aware it drives half the nation into a bloody froth and, perhaps worse, that voters are "stupid as ****" and thus they believe they'll be able to get away with it.

Now we get to the fun part.  We shall see whether indeed voters are "stupid as ****", and further, whether they will sit back and be abused like this for profit not only by CNN but by other media outlets owned by people who additionally own or control other businesses and against which their ire can be taken out.

Like, for example in the case of the Washington Post and Jeff Bezos, Amazon.

Yes, it may be true that half the nation is driven into a bloody froth by any negative story on Trump.  But what's also true is that both halves now have proof that the story is a knowing lie and, perhaps worse, the half that does get driven into a bloody froth just might not be as stupid as CNN believes and just might decide to turn their anger on those who not only intentionally exploited their political views but believes they are too stupid to realize they're being lied to.

We shall see, but if these firms are (from a business perspective) burnt to a zero-stock-price crisp I shall merrily enjoy the show with a nice glass of good Scotch.

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2017-07-01 15:33 by Karl Denninger
in Editorial , 1703 references
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Hmmm....

A doctor who killed another physician at a New York City medical center and wounded six other people before taking his own life had sent an email to a newspaper blaming hospital officials for wrecking his career, the New York Daily News reported on Saturday.

Yes, it was all the hospital's fault.

Let's see what we know.  The "doctor" was an immigrant; from Nigeria, it appears.  Reuters "mentions" that he obtained a medical degree from Dominica, but doesn't mention a few other things.

Like, for example, that his name is a muslim northern Nigerian name.  He apparently threatened to kill his co-workers, if this source is to be believed, and then carried out that threat.  Oh, and he has three prior arrests, all involving allegations of various improprieties with women, dating back to 2003.

It appears that he came to New York for the explicit purpose of carrying out this act; CBS New York says he was living in California, which certainly implies he went to a hell of a lot of trouble and this was no "random" incident.

All of this leaves far more in questions than answers.  Like, for instance, how did he get any sort of medical license at all?  How did he come to be in the United States?  I can see why you'd admit someone with an advanced degree to the United States (that sounds perfectly ok) but why was he allowed to remain once he started getting in trouble with women and having serious charges filed against him?

Where did he get the gun?  If he was a foreigner (and not a citizen or green card holder; there's no mention of whether he ever was naturalized or had permanent residency) he couldn't legally buy one, so where did it come from?  Was it bought (with all the restrictions on same) in California?  We can assume it wasn't bought in New York since he wasn't a resident there -- or at least not legally bought in New York.  Or was it, when he used to live there?  If so, was it properly documented when he moved to California (yes, they have extremely strict gun laws there.)

I could go on for quite a while, but I think you get the point -- and yet in the media, thus far, there is damn little mention of any of this -- especially on the question of why a guy who comes here and then gets arrested for sexual abuse and unlawful imprisonment wasn't immediately expelled!

So much for respect for women among the media and our government, eh?  What's next?  Formal recognition by the federal government of FGM as "appropriate" or even worse, "a matter of religious freedom"?

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2017-06-30 07:00 by Karl Denninger
in Editorial , 364 references
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There's a meme flying around the last few days that has managed to "snag" a few people I know on Zuckerpig's site related to vaccinations.

I've seen two variations of it.  One "features" a kid (but not an infant) who cannot be vaccinated because she's immunocompromised and a "attenuated" live vaccine could kill her.  The other features an infant too young to have been vaccinated against the evil (in this case, whooping cough.)

Both are attempts to shame people who are "anti-vaxxers", and take a shot at the autism claims.

Let's start there.

There is no evidence that vaccines in fact cause autism. Zero.  There are a lot of claims that said occurs, but there's no scientific evidence for it.

The "meme" is basically a my kid got screwed because of you evil bastards who didn't vaccinate your kids.

The problem is that the meme is false.

Let's deconstruct it because down this road lies a dangerous and false set of beliefs.

First, there's the explicit claim that "if your kid was vaccinated mine would not have gotten sick."

This is false unless every single kid is vaccinated with vaccines that are 100% effective.

But most of these memes include a kid who can't be vaccinated either due to age (too young) or immune compromised.  Therefore if exposed they are likely to get ill.

Second, no vaccine is 100% effective.

Behind the dangerous falsity of these memes is a blatantly false claim about how "herd immunity" works.  It does not prevent disease from being transmitted, in short.

What herd immunity does is attempt to prevent transmission from turning into epidemic.

That is, let's say you have measles.  It doesn't matter why you have measles.  Maybe you didn't get vaccinated whether for "conscious objection" reasons or not (e.g. you're a refugee) or maybe the vaccine failed (and yes, they do!)  It doesn't matter why you have measles, all that matters is that you do have measles.

Measles happens to be extremely contagious.  That is, if you have it and come close enough to someone to transmit it, and they are not immune (either from vaccination or previous exposure) the odds are extremely high they will get it.  Different diseases have different efficiency of transmission; some like chicken pox and measles are very easy to transmit, others like HPV or HIV require direct intimate (bodily fluid) exchange.

Herd immunity has exactly nothing to do with the singular event of someone who has a disease coming into contact with the unprotected person.  If that happens and the vector is completed then the odds of infectious transmission are extremely high.

What herd immunity does is make the percentage of people who are immune high enough that the probability of the infected person contacting a susceptible person and transmitting the disease falls below the infectious percentage (that is, what percent of those who come into contact will get it.)  So long as that number is <1.0 for anyone who has the disease then you have what is called "herd immunity" because the infection cannot reproduce at a rate sufficient to nail everyone who is susceptible.

You'd think that herd immunity would make a disease eradicated because with an insufficient transmission rate it would quite-quickly wind up disappearing.  You'd be right about that except for one problem: For it to work you must reach that level for all populations that can serve as both reservoirs and impacted entities (which may include species other than humans.)  If you do that the disease literally disappears.

So why do Whooping Cough, Chicken Pox and Measles still exist?

Because there are populations where that level of immunity was never achieved.

Who are those people?

Do you really want the bad news?

They're largely illegal immigrants and refugees -- that is, people from third-world ****holes where there is no vaccination and thus those diseases are still common.

So if you actually want to reduce the risk of your little kid getting Whooping Cough then you want to kick out every single illegal immigrant and every refugee, and prevent any from coming into the country until they are both vaccinated and quarantined for a sufficient time to know their immunity is good.

The fact is that we have "herd immunity" for most common diseases for which vaccines are available today in the Untied States and other western nations, despite the few "objectors."  The exceptions are nearly all traceable to not those scared of autism but rather to refugees and illegal immigrants, both of whom come in without any documentation as to their immunization status and in many cases with not only no immunizations but latent disease as well!

That's where the problem is but what you have to understand is that the random risk of someone, even if we kick all those people out, getting past the screening or simply having a vaccination failure -- and it does happen -- still exists.

In short if your kid is either incapable of taking the vaccines or is too young to have done so herd immunity does not protect them from the singular infection that could hose them.  If someone who has failed immunity to said disease for whatever reason, including not of their own fault, is shedding the virus (or whatever) and manages to meet the transmission requirements to your kid they're going to get sick -- period.

Vaccines are also not without risk.  The HPV vaccine, for example, has a record of occasionally causing Guillian-Barre syndrome.  Some cases of this "side effect" are fatal and many cases that are not fatal produce permanent partial paralysis.  Since HPV is a sexually-transmitted disease and cannot be transmitted by casual contact to claim that everyone "must" have said vaccine is an outrage -- that is a matter of personal choice where one must weigh the risk (very small, but real) of a severe adverse event against the risk of transmission of the condition through voluntary or violent sexual encounter.

Frankly, I don't think anyone has the right to make that decision for someone else and thus it's a decision that should be made by adults at the time of turning 18.  That's my view and others may differ; one of the pleasures (and pains) of being a parent is that you get to choose in that regard for your kids -- but not for mine.

There are, however, some states that have tried to mandate it for anyone in schools and from my perspective what that amounts to is an admission that the school cannot manage to keep kids from ****ing one another in the buildings and on the school grounds, which says a lot about their level of competence in running said school!

So let's not conflate "vaccines" into one bucket, because they're not.  There are those that I believe you can make a very clean argument for -- DTaP, MMR and Polio being the poster children for that group.  Why?  It has nothing to do with "herd immunity" but everything to do with the fact that if you contract these conditions they are dangerous and can kill or permanently and severely harm you and the vaccines, while not 100% effective, are extremely good at providing lifetime protection against the disease in question.  Here the balance of risks and benefits are clearly on the side of choosing the vaccination.  If you draw the "short straw" and get harmed by the vaccine that's awful but you are far more-likely to get injured or killed by the disease itself and remember -- herd immunity does not prevent you from getting sick -- it only prevents your illness from turning into an epidemic!

Then there are those vaccines that have a less compelling argument: Varicella (Chicken Pox) is in that category.  That's a live (attenuated) vaccine.  Further, in up to a third of the people vaccinated it fails to provide complete protection -- that is, if exposed you will get the chicken pox and can transmit it anyway, although it will likely be a milder case!  Whether that one's worth the risk (and there are some risks, but not terribly severe ones) is an open question.  Chicken Pox almost never produces any permanent harm in someone who gets it, which makes the balance much harder to accurately estimate -- but since the vaccine itself is an attenuated virus the risk of taking the vaccine is rather low too.  Note that one of the "memes" circulating relates specifically to Chicken Pox exposure to an immunocompromised person and the vaccine has a 30% failure rate.  So much for the claim in the meme that the transmission was "preventable" -- the truth is that it probably was not as the odds are much higher that the person who gave the kid the pox was vaccinated but had a partial failure than someone who wasn't vaccinated at all.  (Note that the zoester vaccine, given to older adults for shingles, is even harder to evaluate -- shingles sucks but since the vaccine for it too is attenuated the risk of it giving you shingles if you have an un-diagnosed immune problem is quite real and, if it happens, you're hosed.)

Finally, in the next (and last) bucket we have the HPV vaccine (and others that are similar and undoubtedly will be developed in the future.)  That vaccine only protects against some strains of HPV, not all and thus might lead someone to engage in riskier behavior than they would otherwise believing they are immune from that condition.  Since virtually all cases of HPV transmission are a result of voluntary intimate contact anything that causes people to believe they're immune from a potential bad outcome but is less than 100% effective might actually increase, rather than decrease, the risk of disease.  In addition there is a small but non-zero risk of a severe or even deadly side effect.

In short you cannot take all of these different immunizations as a "package"; they each have individual risks and benefits and must be evaluated on that basis.

Finally, the bottom line when it comes to vaccination is that, to nearly a 100% degree, they are all about personal benefit in the form of immunity (partial or complete) conferred in the person vaccinated.  The side effect of "herd immunity", if achieved, prevents transmission of the disease in question from turning into an epidemic but does not, in any case, prevent one infected person from infecting a second susceptible person.

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