Tuesday, May 26, 2020

If You're going to be a Raging Asshole, Own that Shit

It will come as little to no surprise to those who know me that once again I am full of crap. For all of my talk about wanting to start conversations and promote rational dialog, after too much news and social media and a bad day out and about trying to do my grocery and pharmacy shopping in COVID-land I cut loose with a good old fashioned mouth foaming, obscenity spewing Facebook rant about… well, about pretty much everyone who doesn’t think like I do.

Like most self-indulgent rants it felt good at the time and to my amusement, I started seeing likes and other reactions to my rant.

Haha. Hey, that’s funny, I’m getting more reactions to this than I do to things I write seriously. Hey, maybe I should start writing all my posts as if I was going to have Samuel L. Jackson read them. Haha. Ha? Wait. I’m not sure that’s funny. Did I just get attention by going Def Comedy Jam? Is this really any different than the shock style media that I complain about so much?

Over the course of the next day, I watched my off the cuff rant get more traction and more re-distribution than everything else I have written put together. At last count, it was up to 12 shares (yeah, I know, not exactly viral, but it’s still more than anything else I’ve published), some of them from people that I not only don’t know but with whom I have no mutual friends. These are friends of friends of friends (or even more distant) who are reposting my rant. In some cases, people are apologizing for the language even as they share it.

Oh crap, maybe I should revise it. Maybe I should add a disclaimer. Maybe I should just take it down, would that remove all the shares? This is definitely going to come back to haunt me if I ever run for president. Or just maybe I should take this and figure out how I could have gotten the same reaction without the four “Fuck”s, two "Fucking"s,  and one “Assholes”. Admittedly just removing the profanity wouldn’t stop it from being a self-indulgent rant, but it would be a start.

The main conclusion I have come to though is that I need to own it. One of the many things I lecture people about is being aware that there are no take-backs on the internet. If you say it, you’ve said it and you don’t get to un-say it. For better or worse I wrote this and I hit "post".

So for those of you who are not on Facebook or who missed it, here then, in all its glory, is my most popular piece of writing to date. Originally posted 5/25/2020

You know what? Fuck subtlety. Fuck eloquence. Fuck trying to find clear, non-accusatory ways of saying things. 
What the fuck is wrong with people? Are Americans really so fucking stupid they won't even act to protect themselves if not others? 
Now not only am I seeing macho young rednecks at the store without masks I'm seeing people who are either in or bordering on high-risk demographics walking around without masks looking vaguely defiant. It's like they are just waiting for someone to call them out on it so they can make their stand for the right to stupidity. 
This is not that fucking complicated. It turns out that lots of countries figured it out in time to stop the spread at a few thousand cases and a few hundred deaths. 
Yes, I know the argument that you can't compare the US to New Zealand or South Korea. The US has more people, it is more spread out, blah blah blah. So let's compare the US to China.
China has over 4 times the population of the US. When COVID-19 hit China absolutely nothing was known about it. They started with zero information and zero time to prepare.
In Mainland China there are fewer confirmed CASES, around 83,000, than there are confirmed DEATHS in the US, Over 98,000 and climbing. Let me repeat that in case it wasn't clear. In the United States more people have DIED of COVID-19 than all of Mainland China's cases put together, Active, Recovered, and Dead.
When China passed 1,000 dead in February people were horrified. "The Chinese government doesn't care about its people. How can they let this happen? Why don't they do more?"
When Italy passed 10,000 deaths in March people were horrified.
Sometime today or tomorrow the US is going to pass 100,000 confirmed dead from COVID-19. Where is the horror? Where is the shock? Where is the call for action? Why is it that all we are hearing is from the idiot fringe who want to pretend that everything is OK and we should go back to Business as usual?
Newsflash Assholes. This is not the Flu. Over the last 10 years Flu deaths in the US have ranged from 12,000-61,000 Per YEAR. Again, the worst death toll in the last 10 years was 61,000 in a year. We are approaching 100,000 dead in 3 months. What will it take for you to take this seriously? Do COVID-19 deaths have to exceed all other causes put together? Guess what? Keep it up and we will get there.
Your boredom and bad hair month are NOT more important than people's lives.

Tuesday, April 14, 2020

The Case Against Donald J Trump

The United States has, far and away, the largest COVID-19 outbreak in the world, now accounting for over a quarter of all confirmed cases globally. As of 4/11/2020 the US had exceeded 20,000 deaths from COVID-19 surpassing both Spain and Italy. The US death toll is now over 23,000 and rising. The vast majority of those deaths were entirely preventable. Those deaths are on the heads of Trump and all the lackeys who enabled him to delay an effective response.

Anyone with the least knowledge of history will tell you that the way to deal with an epidemic or pandemic is to identify it early and contain it before it gets established. The way the coronavirus outbreak in South Korea was handled proves that it was containable.

While I am not any kind of a fan of Bush the Younger, even he was able to see that "If we wait for a pandemic to appear, it will be too late to prepare. And one day many lives could be needlessly lost because we failed to act today."
In 2005 after reading an advance copy of John M. Barry's "The Great Influenza" about the 1918 Spanish Influenza pandemic George W. Bush set out to spend $7 billion building out his pandemic preparedness plan.

Not only did Trump fail to act, he actively dismantled the work done by the previous two administrations to try to prepare for the pandemic that they believed was inevitable.

The Trump administration disbanded The Global Health Security and Biodefense unit of the NSC in May 2018.


The USAID PREDICT program arose from the efforts Bush started and Obama continued. Over a 10 year period it identified some 1,200 viruses with the potential to cause human disease and pandemics, including over 160 novel coronaviruses. In 2019 the Trump administration defunded it. PREDICT ceased fieldwork in September of 2019.  

Starting in January 2020 (if not earlier) Trump and other members of his administration have consistently misrepresented the severity of the coronavirus and the outlook for its spread in the US. Trump has wasted precious time arguing about reporting methodology and trying to downplay the numbers out of concern that the truth would make him look bad.


Trump’s dismantling of the institutions intended to combat this exact type of threat and his failure to act once the outbreak was in progress make him culpable for the thousands of deaths that we have already seen and the thousands still to come.

Friday, April 10, 2020

Yet Another Health Care Story

This is Health Care in the United States in a nutshell…

Over four months ago my doctor prescribed a new medication for me. This was a change in medication for a long-standing condition that my insurance company is well aware of.
The pharmacy where I get all my prescriptions (because it is the only one my plan allows) informed me that the insurance did not go through and was requiring prior approval. I advised the doctor’s office and they said they would take care of it.

Next call to the pharmacy the claim was still not going through pending prior approval.
Back to the doctor’s office. They assured me they had sent it in, but saw that it was not approved and would resubmit. This began a cycle of calls to the insurance company and the doctor’s office in which the insurance company said that they had sent the PA back as incomplete because it was missing information and the doctor’s office saying that they had entered everything.

Fast Forward to March. After hearing yet again from the insurance company that the doctor’s office wasn’t responding and the doctor’s office claiming that they had re-submitted the request two weeks more recently than the insurance company was claiming they had seen an update I finally set up a conference call with both at the same time. The results of this call were

  1. The last person I talked to at the insurance company was wrong, they had received the recent submission.
  2. The recent submission had also been bounced due to missing information
  3. The piece of information that was causing the automatic kick out (turns out this is not the same as a rejection, the form was being auto processed out on the missing field with no human intervention) was an end date to the prior approval request.
    1. Apparently for a prescription prior approval to be considered it must have a start and end date.
  4. The insurance rep providing this information could not make the changes directly, the doctor’s office would have to re-submit.
  5. The insurance rep gave the nurse an 800 number to call for quicker processing and advised her not to use the online system

Because it was late in the day when this conversation took place and because the rep said it took at least 24 hours to process the request once it came in I gave it a couple of days before I called the pharmacy and asked them to re-run the prescription.
Still not going through. Back on the phone with the insurance company. This time the automated system at the front end told me that I had a recent prior approval and that it had been rejected. The first rep I spoke to couldn’t explain why but offered to transfer me to the PA department. “Yes, Please”. Then after several beeps and static the call dropped.

A total of four calls (the first three were dropped when they tried to transfer me) to the company finally got me through to a PA representative who could look at the submission and the rejection. He read through it several times muttering to himself things like “ok, that’s the right diagnosis” before he found the issue. The doctor’s office had entered exactly the correct diagnosis code for this medication, but prior to doing that had answered NO to an earlier question that should have been yes. The question was “Does the patient have XXX”, where XXX is exactly what they had put in the code. At this point, we don’t know why the nurse answered no to that when that is exactly what the doctor said I had, but the upshot is that now that the PA has gone in, been reviewed and rejected the doctor’s office only gets one more try to re-submit before it is frozen and requires an appeal.

So over the course of 4+ months, there have been at least 3 or 4 re-submissions that apparently didn’t count due to the lack of an end date. Once the end date was added the form was rejected because the wrong box on line 1 was checked. The Caremark PA rep can’t update the form even though he could see that the diagnosis code was clearly correct. And if everything doesn’t go right next time the whole thing goes into an even more complicated appeals process.

Here’s the real kicker though. I have what is considered “good” insurance. This is coverage that would cost me upwards of $600/month if I was paying out of pocket. As health insurance in the US goes I am probably in the top 5-10% in terms of coverage and access, and I still can’t get a prescription filled because of clerical and procedural errors. That is the state of health care in the richest country in the world.

The only upside is that I can state with confidence that at least 4 different people have jobs just to tell people like me why we can't be treated.

Saturday, March 21, 2020

Coronavirus Math and Our Future

Someone please tell me that my math is wrong…
Seriously, I really hope my math is wrong, because if it isn’t the plain truth is that the US is in worse shape than either China or Italy with regard to Coronavirus and COVID-19.
If you are among the people wondering if we are over-reacting to the Novel Coronavirus outbreak, the answer is resoundingly no.

I’m basing all my starting numbers on the current data in Wikipedia
(which seems to be pulling numbers from each state's health and human services sites)

The Daily Rate of Spread (DRS) in the US has been over 40% for the last three days (1). In contrast Italy is holding steady around 15% (2). If we extrapolate forward with a DRS of 40% in the US and 15% in Italy the total number of confirmed cases in the US will pass Italy on Thursday, 3/26. That will also be the day we break 100,000 cases. If the reports from China can be believed they have had no new cases in three days. They are holding steady at around 81,000 confirmed cases, we will pass that on 3/25 (3).

Now here’s the bad news. Even at 15% Italy is still in horrible shape. If Italy continues from where it is today with a DRS of 15% they will reach 10% of the total population infected in 34 days, 20% in 39 days, 30% in 42 days, 40% in 44 days, 50% in 46 days, 60% in 47 days and 100% in 51 days.

So what does that mean? Italy is already seeing it’s healthcare system badly overloaded with 53,578 cases nationally. Globally the mortality rate for COVID-19 is around 4.2%. In Italy the mortality rate is 9%. The disparity is at least partially due to the overloaded medical system.
At 10% infection they would have over 6,000,000 cases. With a 9% mortality rate that is over half a million fatalities. Even if they could get the mortality rate down to the 4.2% global average it is over 250,000 dead. That is just in the first month, and that assumes the mortality rate does not increase farther as the hospitals become more and more overloaded.

Now translate that to the United States. Currently the mortality rate in the US is around 1.2%. This reflects the availability of the level of medical care required in serious cases. As hospitals start to reach and exceed capacity we can expect to see the mortality rate rise toward the global average.

According to a study conducted by the Harvard Global Health Institute (4) and then modeled by ProPublica (5) if 20% of the US Adult population is infected within 6 months most of the country will hit or exceed 100% of hospital bed capacity and some areas will exceed 200%. At 40% infection within 6 months most areas of the country exceed 200% capacity. To have any chance of current hospital capacity being able to meet the COVID-19 load in addition to normal demand the total number of cases would have to stay below 20% for 12 months and below 40% for 18 months.

Even if the US miraculously dropped to a 10% DRS starting today we would still hit 10% of the population infected in 79-80 days, 20% in 87 days, 30% in 91 days, 40% in 94 days, 60% in 98-99 days, and 100% in 104 days. At the current 40% DRS we will hit 10% in 23 days, 40% in 27 Days, and 100% in 29 Days.

If you project that into human impact, at 10% infection there are over 33 million cases in the US. Even at the current US mortality rate of 1.2% that is almost 400,000 dead. At the global average of 4.2% it is 1.3 million dead. If we were to see a mortality spike like in Italy as hospitals can’t keep up you are looking at over 2.5 million people dead. That is almost 1% of the total population. If we do not get the spread under control 60% infection nation wide is a very real possibility. 60% of the US population is over 198 million people. Even at 1.2% mortality that is over 2.3 million people dead. At 4.2% it's over 8 million. At 9% almost 18 million people. That is roughly 5% of the population. 1 in 20. Think about your family, friends, coworkers. That is probably more than 20 people. Who's not going to make it?

To stay below 20% of the population infected in the first 6 months we would have to get the DRS down to 4%. To stay below 20% for 12 months we would need to get it to 2%. To stay below 40% in 18 months we need to get the DRS below 1%.

The window to do this is very small. If we stay at 40% DRS for two more days then the target to stay below 20% infection in 12 months drops to 3% DRS.

So are we overreacting? No. If anything we are still underacting. At the current DRS or even one quarter of the current DRS even the current mortality rate will be devastating. As hospitals are stressed beyond capacity the mortality rate will only increase. If we don’t get out ahead of this and contain the spread millions will die. The CDC guidance for Preventing the Spread of Coronavirus (6) is the bare minimum we should be doing.
That’s not hype, that’s not alarmist, that’s math.
Unless my math is wrong. Someone please tell me my math is wrong.

Sources
1. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States
2. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
3. https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_pandemic_in_mainland_China
4. https://globalepidemics.org/2020/03/17/caring-for-covid-19-patients/
5. https://projects.propublica.org/graphics/covid-hospitals
6. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

Saturday, January 18, 2020

Has the Great American Experiment ever faced a greater challenge?

When asked what form of government we had ended up with Benjamin Franklin is famously quoted as responding "A Republic, if you can keep it."

As far back as Plato there has been a fear that Democracies or Republics will naturally devolve toward demagogues and tyrants. A representative republic on the scale proposed for the new United States of America was a radical notion even without the expansion that would follow.

Now, as we stand with an unstable narcissist in the White House elected on a platform of racism, hatred and outright lies, it seems like the worst fears of the framers have come to pass. Every new piece of information that surfaces about this presidency highlights Trump's unfitness for the office he holds.
See the WaPo excerpt from “A Very Stable Genius: Donald J. Trump’s Testing of America"

The framers of the constitution were well aware of the historical tendencies of republics and tried to build in safeguards to protect the country they envisioned. Those safeguards have steadily eroded and are in jeopardy of collapsing entirely.

It has been over 230 years since the Constitution of the United States was ratified, and with the possible exception of the American Civil war in the 1860s I don't think we have ever been closer to seeing the Great Experiment Fail.

I don't know what it will take for the Great Experiment to survive this chapter. The mechanisms exist in the constitution to reclaim the government from the Oligarchs, but that requires winning elections. Democracy has always been predicated on the notion of an informed, engaged voting population.
Currently it appears that the elections in the Unites States are being won through manipulation of a highly malleable voter base. Professor Jonathan Metzl recently examined aspects of this in interviews with Boston University Today "Are White Americans Harming Themselves by Backing GOP Policies?" and the Tennessee Star "Vanderbilt Professor Says Racial Prejudice Keeps Rural Tennesseans From Embracing Obamacare".

In terms of the legitimacy of elections themselves it is hard to tell whether things are getting better or worse. With recent court decisions overturning heavily gerrymandered districting in Michigan and North Carolina it seems like there is progress on that front, but at the same time direct hacking of voting systems is on the rise. See Page 7 of the Worldwide Threat Assessment

The bottom line is that if we want to keep our Republic we will have to singularly and collectively commit to building voting coalitions that can defeat the bought and paid for servants of the oligarchs by large enough margins to make it impossible to steal the elections.

Sunday, October 13, 2019

A Shortage of Outrage

I would not have thought it was possible but I’m finding that I am running an outrage deficit. There are so many utterly appalling situations in our country right now that I can’t process it all. As angry as I am I can’t track everything at once. As I look at any given situation and try to determine how to respond I know I am losing track of several others that are just as, if not more, pressing.

I think a big part of my problem is that I don’t know what to do about any of the most critical issues.
I know that nothing I say will matter. Best case 40-50 people might see this blog. Most of them are already the choir.
I am exhausted from battling a non-stop series of archetypally first world problems in my own life. It makes the prospect of trying to face the big issues crushing.
No amount of money that I can bring to bear will move the needle. (Admittedly I have not emptied my financial resources to prove this.)
But the biggest problem is that I just don’t know where to start. I don’t know what has to be the highest priority.

How do you pick between children being separated from their parents and held in cages and the US standing aside to allow ethnic cleansing of our allies? Both are horrifying. Both need immediate action. People are dying faster in one, the other has been allowed to persist longer and is closer to home. In both cases there is a point at which if it is not addressed it will be too late. In both cases it is already too late for far too many people.

This does not even begin to get in to things like police being called for a wellness check by a concerned neighbor and responding by shooting the resident they are supposed to be checking on, in her own home, through the window. This is just the most recent in a seemingly endless saga of violence by police and toward police in an increasingly antagonistic and polarized relationship between the police and the public.

At the heart of much of this we have a nominal Chief Executive who seems to swing between being utterly immoral, greed driven, and self-serving on the one hand and totally unhinged on the other. The avenues available to deal with this lunatic are too slow to help those who are endangered by his orders and are dependent on rules of law that seem to be increasingly meaningless. As Trump becomes more and more blatant about his belief that he is above the law I have to wonder if there are any federal law enforcement agencies that aren’t compromised. The FBI, DEA, ICE, CBP, and USMS all report to DOJ or DHS, both of which are firmly under the White House thumb. So even if the House of Representative were to start issuing contempt of Congress citations who is going to enforce them? As far as I can tell the House of Representatives has one Sergeant at Arms who has one deputy. While they can place an individual in custody if they are on the premises it seems unlikely that they are going to go out of the building to find and arrest individuals held in contempt (e.g. for non-compliance with a subpoena).

There is unquestionably sufficient evidence for the House to pass articles of Impeachment, but to what end? Trump has already stated that he considers the impeachment investigation unconstitutional and invalid. There is no reason to believe that he would acknowledge the validity of a Senate trial even if it happened.
I see no reason to believe that McConnell would not block the reading, debate and vote on any articles of impeachment just like he has blocked so many things.
For that matter, if we reach the 2020 election, if the votes are counted and reported accurately, and if it turns out that Trump has lost is there any reason to believe that he will accept that result and leave office?

I have not even touched on the fact that we are rapidly running out of time to try to slow and reverse the damage we have done to the one and only habitable planet we have access to. Which could ultimately (and sooner than we used to think) render how we treat each other moot.

Does it seem like this post is chaotic and all over the map? Welcome to what I am trying to process. This is the whole point. In a situation like this how do you pick a starting point and make any headway?

The United States of America was founded on high ideals. Historically we have fallen short of those ideals, time and again, but at least it seemed like we were trying to do better and be better. Now we have a very vocal part of the population arguing that we need to abandon those ideals and become, in essence, an isolationist theocracy.
The Great American Experiment is hanging in the balance. We have failed to stop a cheap huckster from assuming the highest office in our country. We have failed to stop the sale of our democracy to the highest bidder. We have given power to self serving demagogues who are patently unfit to hold it.
Fixing this situation will not be easy if it is even possible.

I don’t know how to start. I don’t know how to move the needle. I’m not sure I believe that slow and steady wins this time. I would very much like to hear from anyone who has any idea what to do first.

Sunday, August 18, 2019

Privilege from the inside. Part 6 of a multi-part series.

Part 6

In which Darrin starts to reexamine everything he thought he believed regarding social justice, racial and gender equality and the whole concept of privilege.


I feel like I should pause here to note that this is where things start getting more interpretive. What follows is how various pieces of information started to coalesce in my thoughts on my way to reaching some of the views I now hold. I know there are people who may disagree with my interpretations of both American history and my own family history. I’m not going to caveat every point at which I make a logical leap or reach a conclusion by saying this is just how this registered with me at the time. Just bear in mind that I’m relating an evolution in personal thought, not sociological research.

At the end of part 5 I had just gotten to the point where I had a glimmer of understanding that things I had taken for granted my entire life were not the norm for some or even most people. As I started to realize the impact that educational opportunities and advantages were having I got to thinking about my family history and where those opportunities started. I had the advantage of having college educated parents, but where did that start? The short answer is that on both sides of my family I am at least the third generation to go to college.

My belief at the time, and it doesn’t take much investigation to confirm this, is that children of college educated parents are more likely to go to college themselves and more likely to be successful there. See Footnote. So education is a self perpetuating cycle. If you come from a family that goes to college you are more likely to go to college and your kids are more likely to go to college. But is that racial privilege or socio-economic privilege? Well, I think it’s both really. You only have to go back a couple of generations to get to a time when higher educational opportunities for people of color were extraordinarily limited. My college educated grandparents were contemporaries with people who were former slaves or the children of former slaves and were still struggling to be recognized as human beings. The educational advantages of being white in the US in the early 20th century are undeniable. So the cycle of education starts at a time when college opportunities for people of color were almost non-existent. I guess you could say that it is socio-economic privilege that has it origins in racial privilege.

One of the other evolutions in my thinking came from taking my mandatory US History classes. I have always thought of myself as being fairly well versed in history, but it turns out that there were aspects of economic history that I had neglected. I had always thought that the vast majority of the economic impact of slavery was mainly in the plantation economy of the south. Without going too far down the rabbit hole of 18th and 19th century US economics I came to understand that the slave trade and slave labor fueled US industry and the economy even in areas that did not have large scale slave ownership. While this doesn't change my long standing statement that I have never owned slaves and as far as I know none of my ancestors ever owned slaves, it did change my belief that no one in my family had benefited from slavery and more specifically my belief that I had never benefited from slavery. I now believe that I was and still am benefiting from the history of slavery. The economic structure of the country I grew up in was founded on slave labor. I'll come back around to this in another post, because the idea that even if I was not directly responsible for something I may still have benefited from that thing becomes a recurring theme.

I read a few books around the same time that made big impressions. One was “Coming of Age in Mississippi” by Anne Moody, another was “The Autobiography of Frederick Douglass”. Those were both assigned reading in school. After I graduated I read “The Autobiography of Malcolm X” and “Black Like Me” by John Howard Griffin. I won’t try to get in to what I took away from each of those books, but one consistent thing that became clear was that there is no way for me to viscerally understand what it is like to grow up and live as a black person in the United States. This may seem trite. After all we all know the old cliche "Before you judge a man, walk a mile in his shoes." But what if the gap is so profound that you can never make that walk? What if the worlds you live in are so fundamentally different that they can't be internalized in less than a lifetime?

Somewhere in all of this it started to dawn on me that there had been a fundamental flaw in how I was thinking about privilege. This is where the definition of privilege that I have been including in every post starts to come in to play. It took me 20+ years to stop associating privilege, and in particular white or male or white male privilege with what I thought I was hearing when I was 17 (See Part 2 for a recap). I finally started to understand that privilege means something other than having everything.

I think as a culture when we hear the word privilege we tend to think of extremes. We hear privilege and we think of Ethan Couch, the affluenza teen whose defense four killing four people while driving drunk was that he had grown up too rich to know right from wrong.  We hear privilege and we think of a C student getting into Harvard because his family donated a building. We hear privilege and think of Brock Turner getting sentenced to six months for assult and rape and only serving three. Or maybe that’s not cultural perception, maybe that was just me. Be that as it may, once I stopped thinking of privilege as having everything and started thinking of it as having one thing that is not generally available to other people I started being able to see privilege everywhere I looked.

I said in the chapter intro to this post that I reexamined a whole slew of things and I’ve focused mainly on racial and economic privilege.  I may try to delve more into gender bias in a future post, but for now this has taken me far too long to write, so I’m going to hit publish and move on.

privilege

[priv-uh-lij, priv-lij]

  1. a right, immunity, or benefit enjoyed only by a person beyond the advantages of most:
  2. a special right, immunity, or exemption granted to persons in authority or office to free them from certain obligations or liabilities:
  3. a grant to an individual, corporation, etc., of a special right or immunity, under certain conditions.
  4. the principle or condition of enjoying special rights or immunities.



Footnote

Only about 30 percent of 18 to 24 year olds whose parents did not graduate from high school reach college, compared to about 85 percent of 18 to 24 year olds where the householder has a bachelor’s degree or more from college. 
Day, Jennifer C., and Curry, Andrea E. (June 1998). School Enrollment-Social and Economic Characteristics of Students: October 1996 (Update). U.S. Bureau of the Census, Current Population Reports, P20-500. Washington, DC: U.S. Government Printing Office.