“News” meant to obfuscate, rather than to elucidate

Twice in the last two days, liberals have thrown at me the fact that America has a higher infant morality rate than countries with socialized medicine — even, they add, higher than “third world countries.”  I respond by repeating to them the famous saying Mark Twain popularized, about “lies, damn lies, and statistics.”

What I had to explain to my friends is that comparing infant morality rates from one country to another is meaningful only if the countries being compared use the same methods to tally those statistics.  It turns out, though, that America is an information honest broker, while other countries, especially socialized medicine countries, are not:

Q: If socialized medicine is so bad, why are infant mortality rates higher in the U.S. than in other developed nations with government or single-payer health care?

A: U.S. infant mortality rates (deaths of infants <1 year of age per 1,000 live births) are sometimes cited as evidence of the failings of the U.S. system of health care delivery. Universal health care, it’s argued, is why babies do better in countries with socialized medicine.

But in fact, the main factors affecting early infant survival are birth weight and prematurity. The way that these factors are reported — and how such babies are treated statistically — tells a different story than what the numbers reveal.

Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics.

When Canada briefly registered an increased number of low weight babies previously omitted from statistical reporting, the infant mortality rose from 6.1 per 1,000 to 6.4 per thousand in just one year.

According to research done by Canada’s Bureau of Reproductive and Child Health, “Comparisons of infant mortality rates by place and time should be adjusted for the proportion of such live births, especially if the comparisons involve recent years.”

Norway boasts one of the lowest infant mortality rates in the world. But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States.

Pregnancies in very young first-time mothers carry a high risk of delivering low birth weight infants. In 2002, the average age of first-time mothers in Canada was 27.7 years. During the same year, the same statistic for U.S. mothers was 25.1 — an all-time high.

Some of the countries reporting infant mortality rates lower than the U.S. classify babies as “stillborn” if they survive less than 24 hours whether or not such babies breathe, move, or have a beating heart at birth.

Forty percent of all infant deaths occur in the first 24 hours of life.

In the United States, all infants who show signs of life at birth (take a breath, move voluntarily, have a heartbeat) are considered alive.

If a child in Hong Kong or Japan is born alive but dies within the first 24 hours of birth, he or she is reported as a “miscarriage” and does not affect the country’s reported infant mortality rates.

The length of pregnancy considered “normal” is 37-41 weeks. In Belgium and France — in fact, in most European Union countries — any baby born before 26 weeks gestation is not considered alive and therefore does not “count” against reported infant mortality rates.

Too short to count?

In Switzerland and other parts of Europe, a baby born who is less than 30 centimeters long is not counted as a live birth. Therefore, unlike in the U.S., such high-risk infants cannot affect Swiss infant mortality rates.

Efforts to salvage these tiny babies reflect this classification. Since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.

The parents of these children may view socialized medicine somewhat differently than its proponents.

Or to put it more simply, socialized medicine countries refuse to include in their infant mortality rates fragile newborns.  America, however, counts all live births as, well, live births, so, unsurprisingly, America, reporting honestly, has more deaths to tally when these same fragile infants die.  This means that, when news stories blithely compare infant mortality under the private American system to any other country’s socialized system, American readers are totally unaware that they’re seeing apples compared to oranges.  The news stories are meaningless and misleading, but nobody knows that.  Readers think they’re well informed, when they’re actually misinformed.

Interestingly, both of my friends, when I explained this to them, instantly switched over to maternal mortality rates, which they claim are lower in all sorts of other countries too.  It didn’t seem to occur to them that, if the infant mortality rates are subject to statistical jiggery-pokery, there’s a substantial likelihood that the maternal mortality rates are too.  They were both shocked when I suggested the possibility that a socialized medicine country might report a mother’s death simply as a “stroke,” rather than a “stroke incurred during labor.”  If this is the case, comparing maternal morality rates across borders would again be a futile exercise in apples and oranges comparisons.

My friends were also taken aback when I suggested that America’s statistics might be affected by the fact that, unlike any other country in the world, America is truly a cultural and genetic melting pot.  That is, unlike countries that have fairly homogeneous populations, America has pockets-of-this and blends-of-that, all bringing to the table different diseases, different diets, different culture practices, and different histories of longevity:

Roughly a century ago, many Swedes immigrated to America. They’ve done very well here. Only about 6.7 percent of Swedish-Americans live in poverty. Also a century ago, many Swedes decided to remain in Sweden. They’ve done well there, too. When two economists calculated Swedish poverty rates according to the American standard, they found that 6.7 percent of the Swedes in Sweden were living in poverty.

In other words, you had two groups with similar historical backgrounds living in entirely different political systems, and the poverty outcomes were the same.

A similar pattern applies to health care. In 1950, Swedes lived an average of 2.6 years longer than Americans. Over the next half-century, Sweden and the U.S. diverged politically. Sweden built a large welfare state with a national health service, while the U.S. did not. The result? There was basically no change in the life expectancy gap. Swedes now live 2.7 years longer.

You can observe the same phenomenon when looking within the U.S. Last week, the American Human Development Project came out with its “A Century Apart” survey of life in the United States. As you’d expect, ethnicity correlates to huge differences in how people live. Nationally, 50 percent of Asian-American adults have a college degree, compared with 31 percent of whites, 17 percent of African-Americans and 13 percent of Hispanics.

Asian-Americans have a life expectancy of 87 years compared with 79 years for whites and 73 years for African-Americans.

Even in struggling parts of the country, Asian-Americans do well. In Michigan, for example, the Asian-American life expectancy is 90, while for the average white person it’s 79 and for the average African-American it’s 73. Income and education levels are also much higher.

David Brooks uses these facts to do his typical fence straddle (“Trust me, I’m a conservative, even though I espouse almost exclusively Progressive policies”), but he still manages to make a good point about America — we aren’t like other countries.  Trying to compare our vast, sprawling, diverse, lively country to a culturally static country such as Japan (where they all eat fish), is illogical.  But the news outlets do it all the time, and credulous readers lap it up, assuming they they are knowledgeable, when they are merely increasingly confused.

The same type of faux information showed up in two AP stories yesterday.  The first attempted to downplay the (to Democrats) worrisome stories about an agitated citizenry, determined to break the Democratic lock on power.  It therefore opened with, and spent a long time spinning, the fact that voter turnout was low, and incumbents did all right in the three primaries held yesterday:

It turned out anger didn’t translate at the ballot box.

Voters in North Carolina and Ohio kept their incumbents while those in Indiana turned to an old Capitol Hill hand — Republican Dan Coats — in Tuesday’s primaries despite the nation’s bottom-of-the-barrel support for Congress and frustration with the Washington establishment.

Coats, who was recruited by the National Republican Senatorial Committee, won with nearly 40 percent of the vote, and will face Democrat Brad Ellsworth, whose nomination is assured. The candidates are seeking the seat held by retiring Democratic Sen. Evan Bayh.

Message clear:  Nothing to see here, folks.  Your fellow citizens are happy with the status quo so, come November, you can just sit back and relax.

Only the person with the patience to read past the spin will get a hint of the real story, which can then be augmented by actual honest news brokers.  James Taranto did precisely that, and came up with a very different truth from that which the AP spun:

Then we get three paragraphs about Coats, who left the Senate in 1998, when the popular former governor Evan Bayh announced his candidacy, and is now seeking the seat being vacated by Sen. Bayh. The dispatch picks up with this:

Turnout was exceptionally light in Ohio and North Carolina, a possible indication that voter anger over economic woes, persistently high unemployment and Congress itself wasn’t influencing elections–and, perhaps, a reflection of the limited influence of the conservatives and libertarians who make up the fledgling tea party coalition.

“We rebuilt the pyramids and recarved the Grand Canyon in our spare time,” joked poll worker Dina Roberts, who saw only 147 voters in nearly 12 hours at her downtown Indianapolis polling site.

By the end of the day, however, the Republican turnout in the Indiana Senate primary was the highest this decade, including presidential election years.

Compare this with National Journal‘s coverage:

Turnout among Dem voters dropped precipitously in 3 statewide primaries on Tuesday, giving the party more evidence that their voters lack enthusiasm ahead of midterm elections. . . . By contrast, GOP turnout was up almost across the board.

And National Journal, unlike the AP, has numbers (all voter counts are rounded to the nearest thousand):

• Ohio Democratic turnout was down to 663,000 from 872,000 in 2006. Four years ago, neither the candidate for governor nor for senate (both of whom prevailed in the general election) had a primary opponent, whereas this year there was a competitive primary for the open seat now held by Sen. George Voinovich. On the Republican side, 728,000 voters turned out, even though the highest-ranking office with a contested primary was secretary of state.

• In North Carolina, 425,000 Democrats turned out to vote in a competitive primary to challenge Sen. Richard Burr–a turnout of 14.4%, down from 18% in 2004, when the Senate primary was uncontested and the incumbent Democratic governor “faced only a gadfly candidate.” On the Republican side, 373,000 voters turned out this year for an uncompetitive primary, up from 343,000 “in the equally non-competitive primary in ’04.”

• The Indiana Republican primary attracted 550,000 voters, up 14.6% from 2006, when Sen. Richard Lugar ran unopposed.

The high Republican Senate turnout in Indiana is no surprise, given that the primary was competitive and the seat is open. (The same is true, however, in Ohio on the Democratic side.) Bayh’s late withdrawal precluded a primary for the Democrats, who are expected to “hand-pick” Rep. Brad Ellsworth to oppose Coats. The victory of the establishmentarian Coats supports the AP’s suggestion that the results reflect “the limited influence of the conservatives and libertarians who make up the fledgling tea party coalition”–although John Fund counters in today’s Political Diary email newsletter (subscribe here) that Coats’s unimpressive 39% showing suggests that “his latest career as a lobbyist and recent move back from Virginia worked against him.”

Once again, the person who took the time to read the news served up to him through the ordinary byways of American communication would end up being less informed than the person who didn’t bother reading the news at all.

AP was on a disinformation roll yesterday, because there’s a second story that seeks to mislead people like crazy.  AP’s reporting on the Times Square bomber — even though (sadly) he wasn’t a . . . what did President Obama call them? Ah, yes, a “Tea Bagger” — strives to assure Americans that Shahzad was merely a disaffected proud American who was psychologically destroyed by Bush-era policies:

Not long ago, Faisal Shahzad had a pretty enviable life: He became an American citizen after emigrating from Pakistan, where he came from a wealthy family. He earned an MBA. He had a well-educated wife and two kids and owned a house in a middle-class Connecticut suburb.

In the past couple of years, though, his life seemed to unravel: He left a job at a global marketing firm he’d held for three years, lost his home to foreclosure and moved into an apartment in an impoverished neighborhood in Bridgeport. And last weekend, authorities say, he drove an SUV loaded with explosives into Times Square intent on blowing it up.

The bomb didn’t go off, and Shahzad was arrested on a plane in New York as he tried to leave the country. He was in custody Tuesday and couldn’t be reached for comment. Authorities say he is cooperating and has admitted getting explosives training in his native Pakistan.

Shahzad’s behavior sometimes seemed odd to his neighbors, and he surprised a real estate broker he hardly knew with his outspokenness about President George W. Bush and the Iraq war.

“He mentioned that he didn’t like Bush policies in Iraq,” said Igor Djuric, who represented Shahzad in 2004 when he was buying a home.

You can read the rest of this carefully written piece of disinformation here.  Again, the message is clear:  Nothing to see here, folks.  Just move along.  It’s all George Bush’s fault, and the “magic negro” in the White House will make it better.  Ignore the radical Muslim behind the curtain.

Oh, wait.  That AP story made no mention of Muslims or Islam, did it?  (You can confirm this by doing a word search on the article.  No “Muslim.”  No “Islam.”)  Since it avoided those powerful words, the AP story didn’t even have to bother telling readers to ignore the radical Muslim behind the curtain, because, in AP world, there are no radical Muslims.  Just angry Bush-era victims.

When you think about it, this was a pretty profound oversight.  Why?  Because the guy traveled to Pakistan and trained in a Taliban camp, that’s why:

U.S. and Pakistani investigators are giving increased credence to links between Times Square bombing suspect Faisal Shahzad and the Pakistan Taliban, with one senior Pakistani official saying Mr. Shahzad received instruction from the Islamist group’s suicide-bomb trainer.

[snip]

Pakistani investigators also are probing Mr. Shahzad’s possible connections with Jaish-e-Muhammad, an outlawed Islamist militant group, after the arrest Tuesday of Tohaid Ahmed and Mohammed Rehan in Karachi. A senior Pakistani government official said the two men were believed to have links to Jaish. Mr. Ahmed had been in email contact with Mr. Shahzad; Mr. Rehan took Mr. Shahzad to South Waziristan, the official said.

There, Mr. Shahzad received training in explosives in a camp run by Qari Hussain, the official said. Mr. Hussain is a senior commander with Tehrik-e-Taliban Pakistan, the Pakistan Taliban’s formal name, and trains suicide bombers, the official said. Mr. Hussain is also a cousin of Hakimullah Mehsud, the Pakistan Taliban’s chief. The 30-year-old Mr. Shahzad has admitted to investigators that he received training from militants in Waziristan, U.S. officials said.

So, while everything in the AP story is probably true, the AP somehow managed to ignore entirely the big, burqa-clad elephant standing in the middle of the whole story.  Someone relying solely on the AP for news would, once again, end up being misinformed, rather than informed.

Y’all see where I’m going here, so I won’t lard this post with all the gross misinformation about the effect of Arizona’s immigration laws.  Suffice to say that the laws are not the equivalent of Nazi era race laws, despite everything the press is reporting to the contrary.

We live in an age with an overwhelming amount of information.  Most people don’t have the time, the energy or the interest to sift through the data.  Instead, they do what they’ve always done:  they rely on the media outlets that have served America for so many years.

The challenge for us conservatives is to get people to realize that those media outlets are not honest brokers.  Indeed, they are so dishonest that, through omission and misleading reporting, they are ensuring that those Americans who think they are amongst the best informed are, in fact, probably the worst informed.  Rather than hard facts, they are dealing with an ugly amalgam of ambition, distraction, uglification and derision, all meant to cloud the understanding and to corral voters into backing policies that are extremely dangerous for America.

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Comments

  1. TommyC says

    Wow, that is a lot of stuff in one post.
     
    I’ll pick on the first topic – infant mortality.  In 2007, the US had an infant mortality rate of 6.4, while Greece had a rate of 5.3.  Any liberals planning to go to Greece to have their baby?  Or what about Cuba?  Michael Moore says they have superior health care, and he should know.

  2. Libby says

    Thanks for the thorough debunking of the infant mortality rates!  I’ve only seen this detailed in the news once, yet the erroneous statistics are constantly hyped by the MSM and faux-experts  like  Michael Moore without challenge. As the mother of a child born with multiple heart defects, I can vigorously confirm that the best place on earth to have a sick child is the USA. During our first meeting with our pediatric cardiologist – 20 weeks into the pregnancy (wonder if they’re checking for these things in Cuba?) – we were overwhelmed by the descriptions of the three very complex, yet routine, surgeries required to fix my son’s heart (surgeries that had only been used in the last 20 yrs). The doctor reassured us by mentioning that at least in the US we have these treatments; if were were in Canada or the UK they are not even an option (tough luck, kid).  So I’d imagine another factor in the statistics is that in the US we attempt to save the imperfect and premature kids instead of withholding the difficult life-saving measures.  My son is in great shape thanks to the expert care of so many doctors and nurses, and two surgeons who are literally some of the best in the world at the heart surgeries he needed – and where else in the world would you find them? Certainly not anywhere there is socialized medicine.

  3. Allen says

    I would also like to point out that these statistics are misleading in another way. For example, you will often see that the U.S. falls in around 30th  for certain things vis a vis healthcare. All of these essentially revolve around life expectancy. Life expectancy includes infant mortality. It also includes murder, suicide, car accidents, and other things that say nothing about a healthcare system. These lists often show that the U.S. is below other industrial countries, but how far? The answer is: not to any statistically significant degree. This imples two things, which is what is important to keep in mind for the healthcare debate: 1. A publically funded system (Canada) will not statistically improve your life expectancy; 2. Spending more money per capita (US) does not buy you any better health care from a life expectancy standpoint. To me those are important facts to consdier when one thinks about healthcare.

  4. TommyC says

    Lifestyle and heredity are the most important factors impacting life expectancy (unless you live in a war zone).  The health care system, while not exactly a minor factor, is not the most important factor.
     
    Both life expectancy and infant mortality are poor measure of the overall quality of a health case system.  Suppose I happen to hate going to doctors and don’t exercise and eat like a pig.  Should this be an indictment of the health care system?
    Statistics such a cancer survival rates relate more directly to the quality of the system but don’t provide any kind of overall metric.
     
    I have my own personal metrics.  When time is of the essence, how long does it take to get in to see your family doctor or a specialist?  How long does it take to get and MRI or any other kind of test?  How competent are the health care professionals you see?  Do you get to decide, in consultation with your doctor(s) the course of treatment?  Are we continually getting more effective treatments?  For a good health care system, I think the answers are obvious.  I think that we in the USA have the best health care system in the world.
     
    I think, however, that with the direction we are heading in with Obamacare, all my metrics are going to get worse.  I don’t think anyone can make a good case that any of them will get better.

  5. garyp says

    Thank you, Thank you, Thank you.
    “The truth will set you free”
    I enjoy reading you (I read every day even if I don’t always comment).
    My mother thanks you, my wife thanks you, my sister thanks you and I thank you!

  6. Al says

    I had not known about the 30 cm length requirement to be considered “alive” in Switzerland. US physicians who support current the current health care system in the US get repeatedly beaten up with the infant mortality stats. “Lies, damn lies, and then there are statistics.”
    And I can corroborate Libby’s experience from the other side of the examination table. Life saving cardiac care for any babe born in the backwaters of Southern New Jersey is a phone call and a chopper ride away.
    But of course, the real problem is the corrosive anti-truth perspective that most of the news organs have if that truth supports anything American. The willful blindness to the truth by liberals makes me wonder how they are able to make rational decisions about their own lives. I suppose we are seeing the beginning of the end for liberal economic policies in Greece.
    Anyway, I echo garyp’s comments. Thanks as always, BW.
    Al
     

  7. TommyC says

    To support Al’s point:
     
    I was reading and watching coverage of how so many on the left are having such a hard time accepting the obvious motives of the Times Square bomber.  First it was a 40-something white guy taking off his sweatshirt; they wanted to believe it was a Tea Party motivated bomber.  Then a lone incompetent whacko, then someone frustrated by foreclosure.   Then a lone jihadist.   Of course, none of these (except incompetent, thank goodness).  It was what anyone with any sense knew all along.
     
    So I asked myself, how can we trust people who are so willfully blind to reality to set policy?  Liberals, while fond of calling themselves ‘reality-based’, cling to the way they wish things were rather that the way they obviously are.   That is what they are doing with the bomber, and that is what they do with almost everything else.
     
    I have another modest example here.  Liberals seem to think that on an international scale, if we treat others ‘nice’, then they will see that our hearts are in the right place and respond in kind.  Given that the entire course of history gives lie to the notion that this will work, it is pretty remarkable that they continue to cling to such notions.

  8. Deana says

    I can vouch for the whole infant mortality smoke and mirrors that the left likes to use to attempt to convince us of the need to adopt socialized medicine.
     
    When I was in nursing school at a university in Virginia, almost every professor would mention that statistic.  Note:  the claim was NEVER examined even in passing.  Instead, each professor would , at most, say, “Now, why do you think that countries like Poland and Spain and Romania (or whatever) has lower infant mortality rates than we do?  Do you think it could be because we don’t have socialized medicine?”  And there might be a minute of discussion.  I would always raise my hand and explain that it was because of the different methods used to gather statistics.  At most, I’d get a “Well, it could be that.”
     
    At the end of my time there, I met with the Director of Curricula and discussed my concern at how professors were consistently promoting the “need” for socialized medicine while never discussing the problems with that system or acknowledging the vast benefits of our current system.  I distinctly recall saying that it was very concerning to me that we were constantly being told that people “had to” show up at ERs because they just couldn’t get care elsewhere.  I knew it wasn’t true because I was working in an ER at that time and my eyes were not deceiving me.
     
    I asked this woman to consider providing students with a copy of the article like the one Bookworm linked to.  (Dr. Bernadine Healey also has written about this exact issue.)  She would not do it.   I spoke to hear about this and related concerns I had for 90 minutes, trying to convince her of the importance of providing students with all the data, all the facts.  She simply repeated over and over again that it “didn’t matter” how countries collected their infant mortality data – it was “overwhelmingly evident” that the U.S. wasn’t providing adequate health care to its citizens.
     
    I recently received a request to donate money to the school where I completed my B.S.N.  I will not be donating to them.  Instead, I donate money to Hillsdale College – a school I never attended, and a campus on which I have never set foot.  And it gives me great pleasure.

  9. suek says

    Deana…
    Are you working on whatever you have to work on in order to become a PA?  I suspect we’re going to need you!
     
    If we don’t succeed in reversing HealthCare in some way, we really are going to be in a mess.  And then actually doing something that will be helpful instead of just trying to milk the right cows.  I’m reminded of aphids – ant “cows”…the ants tend them like cows, stroking them with their antenna to get them to exude a sweet substance that the ants use as food.  The aphids, of course, are eating your plants to get their nourishment.  The more employment that the government can establish within itself, the more socialist we become – the HealthCare bill established something like 129 new departments.  There’s really no way to really have socialism without the government employing nearly everybody – and then where does the money come from?  Government doesn’t produce anything.  But by being the prime employer, it can “nourish” those who agree with it, and condemn to poverty those who don’t.  Along with all the other problems…

  10. TommyC says

    The biggest problem with the direction Washington is leading us is simply this : rather than being successful by providing a good or a service that others are willing to pay for, you become ‘successful’ by having the best political clout.  Any economy that depends on political favor rather than a free market is going to head downhill.

  11. Danny Lemieux says

    Deana says, “I asked this woman to consider providing students with a copy of the article like the one Bookworm linked to.  (Dr. Bernadine Healey also has written about this exact issue.)  She would not do it.   I spoke to hear about this and related concerns I had for 90 minutes, trying to convince her of the importance of providing students with all the data, all the facts.  She simply repeated over and over again that it “didn’t matter” how countries collected their infant mortality data – it was “overwhelmingly evident” that the U.S. wasn’t providing adequate health care to its citizens.”
    What is happening to society where otherwise intelligent people seem committed to to totally ignoring facts and incapable of confronting reality. Is it mass infantilization?
    We have masses of our own people who, even after the destruction of 9/11, cannot accept that Islam has it in for Western Civilization, even as Muslims plot to erect a triumphalist mosque at the site of the World Trade Towers collapse and car bombs are discovered in Times Square, not to mention the Ft. Hood attack. Had that car bomb gone off, I am sure that there would still be mass denial that Islam had anything to do with it.
    We have European socialism hearing the first crunching signs of structural demise  as the EUro-socialist welfare Titanic meets icy reality.
    Facing full collapse of the European model, our leaders’ response is that we need to work even faster at emulating the EUro-State Model before its total collapse.
    Facing total world meltdowns in national debt obligations, our leadership’s response is to more-than triple those obligations.
    We have world leaders, facing massive energy deficits in the future and colder winters to come  instead opting to spar with “green” wind mills.
    We have otherwise educated and wealthy citizens following false prophets of climate change like lemmings while waxing eloquent about the glories of a socialist society that would destroy their wealth and security, even as they complain about their wealth and security being destroyed.
    We have an American government that seems committed to forcing Israel to disarm, convinced that it is the key to a lasting peace with the Palestinians and the rest of the Muslim world.
    Did some evil James Bond movie character drop LSD into the world drinking supply?
     

  12. says

    ” I have another modest example here.  Liberals seem to think that on an international scale, if we treat others ‘nice’,”
     
     
    That’s only cause they hate conservatives and want to see Iran and other nations hurt the people they hate.
     
    This isn’t cause they are idiots. It is cause they are sadists.

  13. Deana says

    suek –
    No – I’m stopping at my BSN.  I went to school for years and years in other fields before becoming a nurse and I’m tired and broke.  But yes – you are right.  Nurses are going to have a major role in health care in years to come.  I have very mixed feelings about that.
     
    Danny –
    Awesome post!  I hadn’t thought of all that but everything you said is true.  It’s scary, truly.
     
    Deana
     

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