It would be impossible to really recap the book or the range of thoughts that it inspired.  Frankly, it landed in the middle of a Venn diagram of my personal and professional interests–gay rights, politics/public policy, and public health.  I think one line in the prologue really captures the essence of the book:

In those early years, the federal government viewed AIDS as a budget problem, local public health officials saw it as a political problem, gay leaders considered AIDS a public relations problem, and the news media regarded it as a homosexual problem that wouldn’t interest anybody else.

There were exceptions to all of these generalizations and that is the element of the book that gives a reader hope in such a tragic situation; that despite these obstacles, many stood up.  Others eventually rose to the occasion.  However, what speaks most to Shilts’ intelligence and fairness as a reporter and author is that almost none of the characters are portrayed in a flat or villanous way.  Shilts doesn’t pulls punches, but he gives everyone he describes a very human depth.  Almost every person is made real through both their bravery and shortcomings.

I think that every gay man and woman who didn’t live through this time should read Shilts’ account.  It gives a history and context to the struggles that our community faces that is easy to overlook when you enter the community after it has come so far.

All of that said, a really interesting point came up in my discussion of the book with a colleague.  I had been telling him about my adventures in blogging and he asked a fascinating question: “What if there had been the internet and social networking in 1980?”

It’s fascinating for so many reasons and highlights exactly what online communities can do. Without the internet, the general public is limited in both the community within which it can communicate, and more importantly, it is subject to the filters of the mainstream media; represented solely by the few prominent lobbying and advocacy organizations; and rarely heard by policymakers.

Now blogs and online organizing can drive a news story into the mainstream media.  Look at Philip Spooner from Maine’s No on 1 campaign (or any number of countless examples).  Where the media was squeamish talking about gay men or sex, people with the internet wouldn’t have had to live in ignorance of the epidemic that was exploding in the country’s major cities (and eventually beyond).

When public health departments wouldn’t adequately educate or stopping behaviors that were dangerous to the public health, the internet would have offered Google, WebMD, and online forums to find out more about what puts people at risk.

When an administration claimed that AIDS was its “number one public health priority,” the internet would have allowed facts and reports ignored by the media to be made public.  Policymakers could have had their feet held to the fire and heard from real people more easily.

When lobbying and interest groups failed to represent the broader gay community, people could have organized online on their own. The voice of the community would not have been one consensus determined by those who saw the disease as “bad PR.”

Instead of holding valuable research and science from the public and other researchers in order to be published in prestigious medical journals,  research could have been more quickly peer reviewed and published.  Instead of worrying about careers, researchers could have communicated vital science to the broader scientific community in a timely fashion.

I’m not so naive as to think that the internet would have fixed all of these situations without any drawbacks.  The internet creates a cacophony of voices with a certain number of complete wackjobs.  But more important–and in true democratic nature–the views that resonate with more people rise to the top.

Bottom line: it’s impossible to tell exactly what would have come from this bizarre–and probably idealized–alternate history I’ve imagined.  I can say two things with absolute certainty, though:

1. The internet and blogosphere would have it would enabled a broader conversation.  People would have been able to organize themselves and demand better of the media, advocacy groups, and local and federal governments.
2. The struggles we face today for equal rights do not face the limitations that were witnessed in the 1980s.  We can–and more importantly DO–organize and communicate online to increase the impact of our voices.  The DNC will hear from angry donors, the No on 1 campaign received over $1 million dollars from ActBlue, and campaigns can organize volunteers to call and visit from around the nation.  That’s why I write here and hope it resonates beyond the people I could have simply told over the phone.

Update: A few edits were made from the original post for clarity.

I immediately had three thoughts:

1. His argument boils down to the fact that we should keep people smoking for the tax revenue.  Is this really the country we want to be?  Yes, it’s your choice to smoke, but should we want more people to live shorter and unhealthier lives simply for a revenue stream?
2. I don’t feel bad for people who will have to pay more for their cigarettes.  As far as I’m concerned, by purchasing cigarettes, you are accepting the tax burden—I don’t consider this raising taxes on the poor, I consider it an investment in the future health care of smokers. Especially if such a high percentage of these people are low income, we’ll (as a nation) likely be paying for their health care.
3. He seems to be saying that they smoke because they are lower income, when in fact we could have a case of chicken and the egg.  One could argue that both a lower income and a tendency to smoke may come from another common factor like level of education (this is a statistical fact, I’m in no way saying if you smoke you’re unintelligent–even Obama was[is?] a smoker).  Or perhaps they are lower income because they spend massive amounts of money on their habit.  One article cites $5 as the average cost for a pack of cigarettes.  If you smoke a pack a day, that’s $1,825 per year for just the cigarettes, not including any indirect expenses (see this article for a fuller picture of the cost of smoking).  For a little perspective, 20% of Americans made under $19,000 in 2006.  A smoker in that 20% of Americans is spending 10% of their annual income on cigarettes.

YAOUNDE, Cameroon — Pope Benedict XVI said condoms are not the answer to the AIDS epidemic in Africa and can make the problem worse, setting off criticism Tuesday as he began a weeklong trip to the continent where some 22 million people are living with HIV…

…On the contrary, [condom distribution] increases the problem.”

Wyden and Cooper’s approach also has a big following among health-care wonks, among them, noted bioethicist Ezekiel Emanuel — brother of White House chief of staff Rahm Emanuel — who has been tapped to play a big role in health-care reform in the Obama Administration’s Office of Management and Budget. Emanuel and Wyden teamed up in December to write an op-ed piece in the Wall Street Journal on the limits of employer-based health coverage. And though during the election campaign Barack Obama criticized John McCain for proposing a plan that, like Wyden’s, would make employer-provided health benefits taxable, the Administration has suggested in recent weeks that it is open to such an approach.

Important to note that Christina Romer was both unwilling to say that Obama was considering this, or that he wouldn’t consider it, on Meet the Press this week.  She unwillingness to answer the question was striking and it seemed to me like the politically safe and less attention grabbing line would have been, “Nothing is off the table as we move forward in a bipartisan spirit.  Blah, blah…”  Then again, I don’t think Romer is their strongest spokesperson (which is in no way commentary on her incredible intellect).

Update: Politico also has a piece up on health care.  The image of 9 Senators sitting around throwing out ideas is Capra-esque.  Their Baucus quote on how discussions should be run really sums up his thoughtful approach to policymaking:

“Don’t say no to anything for at least five to 10 minutes,” Baucus said, explaining the meetings. “Let’s just figure how we do all this.”

I was struck at the end by the fact that, while Bush didn’t attack during any of his speech to Congress, I don’t remember him striking a tone like this:

But I also know that every American who is sitting here tonight loves this country and wants it to succeed. That must be the starting point for every debate we have in the coming months, and where we return after those debates are done. That is the foundation on which the American people expect us to build common ground.

10:06: Tomorrow, the thing most people will remember will be Ty’Sheoma Bethea.

“For seven years, we have been a nation at war. No longer will we hide its price.”

9:54: Quite a lively section on agri-business, no bid contracts and other wasteful spending.  Reminds me of the House of Commons.

Awkward moment around reducing the deficit.  I do kind of enjoy when he hits back by calling out the previous administration on passing on a deficit.

9:50:

“And dropping out of high school is no longer an option. It’s not just quitting on yourself, it’s quitting on your country – and this country needs and values the talents of every American. That is why we will provide the support necessary for you to complete college and meet a new goal: by 2020, America will once again have the highest proportion of college graduates in the world.”

I’m excited by the Hatch-Kennedy bill on National Service.  Looking forward to finding out more…

Science and Healthcare:

“We have also made the largest investment in basic research funding in American history – an investment that will spur not only new discoveries in energy, but breakthroughs in medicine, science, and technology.”

Republicans (on whole) didn’t stand for SCHIP.  That’s an image that’ll get you re-elected…

Obama mentioned bringing together all parties on health care reform, but Kennedy already has been.

9:33: Go home, Roland!

There is a strong emphasis on the theme of responsibility–especially in programs for those facing foreclosure and bank bailouts.

Apparently we don’t mess with Joe Biden?  Former Bush people (and a lot of others) who believe so deeply in the formality of the office will not be so happy with lines like that.

Health reform mentioned at least 5 times in the first 10 minutes.

9:20: Obama started his list of places where the promise of America lies with laboratories.  Stem cell ban lifting soon?

9:17: I can only imagine the joke that Biden just made when Obama cut off Pelosi.