Category: Health Care

Monday Wake Up Call – January 9, 2023

The Daily Escape:

Kennebunk, ME – January 2023 photo by Eric Storm Photography

Buried in the McCarthy debacle last week was some good news on the abortion front. From the NYT:

“For the first time, retail pharmacies, from corner drugstores to major chains like CVS and Walgreens, will be allowed to offer abortion pills in the United States under a regulatory change made Tuesday by the Food and Drug Administration.”

The online magazine STAT asked an interesting question: (emphasis by Wrongo)

“When the Food and Drug Administration lifted some — but not all — of its restrictions on an abortion pill this week, it raised questions about why these rules were there in the first place. Mifepristone, the drug in question, has been used by over 3.7 million Americans to end early pregnancies since its approval in 2000, is more than 97% effective, tends to have only mild side effects such as cramping, with severe ones occurring in fewer than 0.5% of patients. So why was it on a list of prescription drugs requiring extra precautions and red tape, alongside opioid painkillers?”

More from STAT:

“Many reproductive rights advocates celebrated the change. But to others, the agency hadn’t gone far enough. Having the drug on a list of medicines that require a risk mitigation strategy gives the false impression that it’s dangerous, they argue. To them, it should be treated like any other pharmaceutical that’s been proven safe and effective.”

That might help to ensure greater access at a time when some states have banned it.

Mifepristone pills are already used for more than half of pregnancy terminations in the US. There has been growing demand for them since the Dobbs decision by the Supreme Court overturning Roe v Wade, the 50-year old federal right to abortion.

With Conservative states moving quickly to ban or sharply restrict abortion, these pills have become the focus of political and legal battles, all of which can influence whether an individual pharmacy will dispense the medication.

The availability of mifepristone through pharmacies will probably vary depending upon location. Deep Red areas will probably have fewer pharmacies willing to dispense it – a combination of more pharmacists exercising their right to substitute their morality for a woman’s, and a fear by the pharmacy of negative consequences ranging from boycotts to fire bombings.

Abortion pills are only a small percentage of any pharmacy’s sales, but they could have a big impact on its public profile. Such calculations will influence a pharmacy’s decision, as will the fact that in about half of the US states, abortion bans or restrictions would make it illegal or very difficult for pharmacies to provide abortion pills.

So, yes, this is a positive development, but it won’t be a panacea: Some Republican-allied group will soon start a court battle to try to reverse the FDA’s policy. Eventually, it will come before the six Christian justices on the Supreme Court. This is a battle for civil rights. It needs to be fought on every level from local to federal, and every incremental victory matters.

We can’t let what may happen down the road prevent us from celebrating a win. The Republicans and the Conservative movement aren’t omnipotent gods. We still live in a world where working, fighting, and voting can make a difference.

Consider this: The Republican’s House majority is due to just 6,670 votes out of 107 million cast, says Inside Elections, a nonpartisan publication. That means every vote cast in 2022 mattered. And if a few more in the right places had been cast, it could have made a generational difference.

Time to wake up America! Every year that American women can continue to access abortion, (chemical or otherwise) matters. Every effort to stem the tide of the many actions that are threatening our civil liberties matter. All of this says we still have the power to change America for the better.

To help you wake up, listen to John Mayer perform his 2006 Grammy-winning hit, “Waiting on the World to Change” from his third studio album, Continuum. The song is kind of an apologia for Gen Y’s well-documented apathy, but even that has changed quite a bit in the 17 years since it was written:

Sample of lyrics:

Me and all my friends
We’re all misunderstood
They say we stand for nothing and
There’s no way we ever could
Now we see everything that’s going wrong
With the world and those who lead it
We just feel like we don’t have the means
To rise above and beat it

[Chorus] And we’re still waiting (Waiting)
Waiting on the world to change
We keep on waiting (Waiting)
Waiting on the world to change
One day our generation Is gonna rule the population
So we keep on waiting (Waiting)
Waiting on the world to change

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Monday Wake Up Call, Abortion Editon – July 18, 2022

The Daily Escape:

Barn with cotton candy clouds, Allegre, KY – July 2022 photo by Fuller Perspective Photography

The Supreme Court’s overturning of Roe has opened a Pandora’s Box of ethical and legal issues. The infamous story about the pregnant 10 year-old Ohio rape victim who was forced to travel to Indiana to receive an abortion is the best example. It was reported in the Indianapolis Star on July 1.

After the Dobbs decision, Ohio Governor Mike DeWine (R) had issued an executive order putting in force a 2019 law that had banned nearly all abortions after six weeks of pregnancy. The 10-year-old was reportedly six weeks and three days pregnant.

Then we saw a Right-wing smear campaign:

  • A WSJ editorial called the Indianapolis Star’s report a “fanciful tale“, and claimed that there is “no evidence the girl exists.”
  • Tucker Carlson said that the story of the 10-year-old girl who had to travel to Indiana to get an abortion was “not true.”
  • Ohio Attorney General Dave Yost said in an interview with USA Today, that the story was likely a “fabrication.”
  • The New York Post, which, like Fox News and the WSJ, is owned by Rupert Murdoch, published an opinion piece by law professor Jonathan Turley under the headline “Activist tale of 10-year-old rape victim’s abortion looks like a lie.”

All of those shouts and murmurs soon disappeared when a 27-year-old man from Columbus, Ohio, Gershon Fuentes, was arrested and charged with impregnating the 10-year-old Ohio girl. Apparently, Fuentes “confessed to raping the child on at least two occasions.”

Subsequently,  the WSJ recanted and published a different editorial correcting the record. Why would they accuse the Star of fabricating a story? From Judd Legum: (emphasis by Wrongo)

“There is a reason why so many people, particularly on the right, were eager to push the idea that Bernard’s story was a lie. If they acknowledged the story was true they would have to answer this question: Do you believe that a 10-year-old rape victim should be forced to give birth?”

By the way, Covid appears to have increased early-onset puberty around the world. Getting your period “early” now means when you’re younger than 8. People who think a pregnant 10-year-old strains credulity should bear this in mind.

The Nieman Lab, a Harvard-based group focused on journalism on the Internet, took the WaPo’s Glenn Kessler, author of their “Fact Checker” column to task for not checking his facts about the Star’s reporting. One of Kessler’s so-called “facts” was: (brackets by Wrongo)

“An abortion by a 10-year-old is pretty rare,” Kessler notes…..[but] The Columbus Dispatch reported that in 2020, 52 people under the age of 15 received an abortion in Ohio.”

Your mileage may vary, but if one under-15-year-old gets an abortion every week in Ohio, it can’t be thought of as “pretty rare”. The press needs to wise up and get the data before diving headfirst to a conclusion.

There are other ways the Dobbs decision will impact lives. Unsure doctors in Texas are already turning away ectopic pregnancies, fearing legal liability. According to The Lily (a WaPo newsletter):

“…a South Texas woman diagnosed with an ectopic pregnancy was refused an abortion by her doctor…..she was advised to seek help out of state.”

Under the unclear Texas law, a doctor who removes an ectopic pregnancy that is not actively causing the patient to bleed to death may face legal consequences.

It doesn’t end there. The laws surrounding in vitro fertilization (IVF) could also be facing threats of lawsuits even though these women aren’t seeking abortions. Slate reports:

“Fertilizing eggs in a Petri dish often results in extra embryos, which are usually frozen….Leftover embryos are frequently discarded or donated to research….In some abortion-restrictive states, this may no longer be possible. Louisiana defines “a viable in vitro fertilized human ovum” as a “juridical person which shall not be intentionally destroyed,” and at least five states have introduced bills establishing fetal personhood.”

States probably won’t ban IVF outright, but as some countries have done, they may limit the number of embryos that can be created in an effort to prevent embryo destruction. All of this would make IVF far more difficult and expensive than it is, and it could possibly reduce the number of IVF clinics in those states.

This is the tip of the iceberg of the issues women will have post-Dobbs. Technology will always be ahead of our laws and ethics. Just as will some men’s (and religions’) need to control women.

Time to wake up America! Elect a filibuster-proof Senate this fall. To help you wake up listen to Willie Nile, perform his ode to Covid, “The Day the Earth Stood Still”:

Sample lyric (that could be about the end of Roe instead of Covid)

So if you feel some heartache
And if you feel some pain
And if you see some lonely soul
Standing in the pouring rain
Offer up some kindness
Compassion if you will
And remember well the way it was
The day the earth stood still

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Saturday Soother – June 18, 2022

The Daily Escape:

Rainy morning, with Vista House at Crown Point in right foreground, Columbia River Gorge, WA – June 2022 photo by David Leahy Photography

Wrongo has written before about the crushing burden of consumer debt in the US. Medical debt is an American disgrace, and Noam Levey, Kaiser Health News (KHN) Senior Correspondent has written an excellent piece about it. He says that 100 million people in America, some 41% of adults, owe some level of debt to healthcare providers.

But most studies don’t reveal the actual extent of the debt because much of it appears as credit card balances, loans from family, or payment plans arranged with hospitals and other medical providers. To calculate the true extent and burden of this debt, KHN partnered with NPR, and the Kaiser Family Foundation (KFF) to conduct a nationwide poll designed to capture not just bills patients couldn’t afford, but other forms of borrowing used to pay for health care.

The results are contained in the KFF Health Care Debt Survey. The KFF poll found that half of US adults don’t have the cash to cover an unexpected $500 health care bill. As a result, many simply don’t pay their medical bills. The flood of unpaid bills has made medical debt the most common form of consumer debt in America.

Over the past five years, more than half of US adults report they’ve gone into debt because of medical or dental bills. Moreover, a quarter of adults with health care debt owe more than $5,000, and about 20% with any amount of debt said they don’t expect to ever pay it off.

Debt incurred for health care is forcing many families to cut spending on food and other essentials. The poll also found that millions are being driven from their homes or into bankruptcy:

So, if 100 million people were in debt and 17% declared bankruptcy or lost their home, that’s 17 million people! The KFF poll found that the debt is also preventing Americans from saving for retirement, investing in their children’s educations, or buying a home. And debt from health care is nearly twice as common for adults under 30 as for those 65 and older. And that age cohort is supposed to be much healthier than the elderly.

Perversely, about 1 in 7 people with medical debt said they’ve been denied access to a hospital, doctor, or other provider because of unpaid bills. An even greater share (two-thirds) have put off care that they, or a family member need because of the cost.

Hospitals are among the culprits. They are capitalizing on their patients’ inability to pay. Hospitals and other medical providers are pushing millions of patients who can’t afford to pay into credit cards and other loans. These are high interest rate loans, carrying rates that top 29%, according to research firm IBISWorld.

This collections business is fed by hospitals, including public university systems and nonprofits granted tax breaks to serve their communities, who sell the outstanding debt to collections companies.

Welcome to the best country on earth, (maybe) one that doesn’t have the best health care system (and certainly one without  health insurance for all). We have a system which shackles 100 million people to medical debt while at the click of a computer mouse, we send $billions in armaments overseas before those same dollars are recycled into the coffers of our Military-Industrial complex.

That’s all for this week. It’s time for our Saturday Soother, when we take a break from the J6 public hearings and whether Ginni Thomas was another Trumpist plotter. Let’s focus on calming ourselves for whatever insults are coming next week.

Here at the Mansion of Wrong, we’re engaged in an air conditioning project, adding more central air to our home. Hey, we’re aware of the crummy stock market, and the rampant inflation, but consume we must.

To help you clear your head on this warm weekend, grab a seat outdoors and brew up a cup of Supernatural coffee ($18.45/12 oz.) by Lee, MA’s own Barrington Coffee Roasting Company. This espresso is said to have flavors of Concord grape, dark chocolate, plum and tangle berry pie!

Wrongo has no idea what tangle berries look like, much less what they taste like.

Now, put on your wireless headphones and listen to the “Adagio for Oboe, Cello, Organ and Strings”, also known as “Elevazione” or “All’Elevazione” by Domenico Zipoli.

Zipoli was an Italian Jesuit priest who lived much of his life in what is now Argentina. He studied with Scarlatti, became a Jesuit, worked as a missionary, and died in 1726 in Argentina at age 38. If fate had granted Zipoli another 20 to 25 years, he might be regarded today as a major composer. Here it’s performed in 2015 by the Collegia Musica Chiemgau conducted by Elke Burkert :

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Monday Wake Up Call – January 31, 2022

The Daily Escape:

Mount Saint Nicholas, Glacier NP, MT – January 2022 photo by Jack Bell Photography

Anyone else thinking that our national party bus is about to stall out in the slow lane on America’s Boulevard of Broken Dreams?

Here’s an under-the-radar story: In 2020, the Trump administration hatched a plan to gradually transition traditional Medicare over to private firms. It’s called Direct Contracting (DC) and is operated by Direct Contracting Entities (DCEs). Currently, there are 53 of them in Phase One of an experimental program operated by the Centers for Medicare and Medicaid Services (CMS).

Under the program, the DCEs receive a fixed amount of money annually to cover care for each traditional Medicare enrollee whose primary care doctor (or group) has signed up with that DCE. The DCEs must pay for all of the care of those people assigned to them. To date, the CMS has auto-assigned hundreds of thousands of people to DCEs.

Since no one on Medicare has voluntarily signed up to work with a DCE, it’s unlikely they know of, nor understand what’s happening. And the CMS doesn’t require DCEs to tell people that they have the right to opt-out.

The idea behind DCEs is to shift a portion of the financial risk of the elderly’s medical care away from traditional Medicare by capping the payments to a third party that’s responsible to pay for it. This is the latest in many efforts by CMS and Congress to control the rising costs of healthcare.

Wrongo and Ms. Right have recently noticed a blizzard of direct mail offers to convert our traditional Medicare to an all-in insurance program. It’s probable that some of these are from DCEs.

The anticipated advantage of the DCE experiment is that Medicare’s out-of-pocket costs will be capped. The DCEs contract with CMS is for an agreed-upon annual payment. They have to pay for care and also make a profit based on that fixed revenue amount from the government. In addition to the normal profits from providing services, DCEs can keep as much as 40% of the money they don’t spend on care.

But there’s no such thing as a free lunch, and it seems to Wrongo that this creates yet another financial incentive to deny otherwise necessary treatments. It’s possible that the DCEs could pay doctors to steer patients away from specialty care. This means that someone enrolled in a DCE has reason to worry that their primary care doctor might limit their access to more costly care.

Direct contracting is supposed to be a pilot program, yet Medicare has no plans to limit the number of people it enrolls in these new plans. Instead, Medicare has announced plans to enroll 100% of traditional Medicare members into DCE-like programs by 2030.

Congress did not authorize the wholesale overhaul of traditional Medicare, so why is this happening? And so far, the Biden administration appears to be willing to continue playing Trump’s cards.

Many of the DCEs are owned by Private Equity (PE) firms. It doesn’t take a chess master to see that the PE firms will ultimately sell out to the insurance industry. And it wouldn’t be a big leap from that to fully privatize Medicare.

Time to wake up America! Did we elect Biden to privatize Medicare? The word “privatize” should scare the hell out of Americans. But unfortunately they’ve been fooled into believing that by some magic miracle of economics, it’s to their benefit.

To help you wake up, today we spend a few minutes with Neil Young. Wrongo appreciates Neil Young saying he wanted his music removed from Spotify if Joe Rogan is allowed to continue spewing his anti-Vaxx trash there.

This was an easy business decision for Spotify. They picked the popular podcaster Rogan with the $100 million-plus exclusive deal, over the cranky 76-year-old rocker whose last gold album was nearly two decades ago. Someone who hasn’t been on the Billboard charts since 1982.

Joni Mitchell and Dave Grohl have now said they will follow Young in leaving Spotify.

Let’s watch and listen to Neil Young playing “Hey Hey, My My” at Farm Aid in Champaign, Illinois on September, 1985. Young is a co-founder and board member of Farm Aid, along with Willie Nelson and John Mellencamp:

Neil won’t burn out or fade away.

Sample Lyric:
Out of the blue
and into the black
You pay for this,
but they give you that
And once you’re gone,
you can’t come back
When you’re out of the blue
and into the black.

“You pay for this, and they give you that”. Listen up Medicare!

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Young Americans Are Suffering

The Daily Escape:

View from Franconia Notch, NH – November 29, 2021 photo by Mel Elam. Looks cold.

There’s plenty of Covid news. We’re concerned about the new Omicron variant while we’re also seeing another surge of the Delta variant around the country. It’s important to remember that half of what you’re reading about Omicron now, and for the next several weeks, is going to be wrong or mistaken.

The problem is that we can’t be sure which half is wrong.

It’s troubling how prevalent Long Covid has become. The NIH reported on an Italian study that found 87% of people recovered and discharged from hospitals showed at least one symptom even 60 days after release. The commonly reported problems were fatigue (53.1%), worsened quality of life (44.1%), shortness of breath (43.4%), joint pain, (27.3%) and chest pain (21.7%).

One symptom of Long Covid that wasn’t reported is emotional distress. This is particularly evident in younger Americans. The just-released Fall 2021 Harvard Youth Poll, surveyed 2,109 Americans aged 18-29, between October 26 and November 8. In addition to their usual questions about politics, they also asked these young Americans about their mental health and Covid. They found that half of them say they’re a different person because of Covid. Here are the results:

Overall, 51% of 18-29-year-olds say that Covid has changed them. What’s particularly striking is that 61% of young women say they’re different now than they were before Covid. Contrast that with men in the survey, just 40% of whom said that they have changed.

While the survey can’t tell us exactly how they’ve changed, there’s some insight because 51% also say that Covid had a negative impact on their life. And there wasn’t a partisan divide: 51% of Democrats, 51% of Republicans, and 52% of independents said that Covid impacted them negatively.

There’s something worse going on though. These kids are a mess mentally. More than half (51%) report  that several times in the last two weeks they felt down, depressed, and hopeless, while 25% have had thoughts of self-harm.

In addition to the majority of youth who express depressive symptoms, and the 25% who express thoughts of self-harm, the study also found that a significant number show traits associated with generalized anxiety disorder:

  • 38% of young Americans report feeling nervous, anxious, or on edge in the last two weeks
  • 36% have been worrying too much about different things
  • 32% have been easily annoyed or irritable
  • 30% have had trouble relaxing
  • 22% report feeling afraid, as if something awful might happen
  • 20% have not been able to stop or control worrying
  • 16% have been so restless that it is hard to sit still

The causes of these emotional problems are diverse. The respondents listed the following as their top five reasons for worry: School or work (34%), personal relationships (29%), self-image (27%), economic concerns (25%), and Covid (24%).

But Covid can easily be seen as the primary driver behind all of these issues. The pandemic brought fear of losing one’s own life or that of an older loved one. The lockdowns impacted school and work, with people having to use technology as a work around for face to face interaction. People were cut off from friends and family. Dating died. Retail businesses that primarily hire the young closed, or sharply reduced their staffing, causing historic job losses and reduced paychecks.

The CDC reported in 2020, that from 2007 to 2018, the suicide rate among persons aged 10–24 had increased 57.4%. Let’s hope that isn’t what will happen to this cohort going forward.

Wrongo and Ms. Right have 12 grandchildren. Ten are between 18-29. A few graduated from high school, college, and grad school during the pandemic. And some of those graduates seem stuck in bad grooves, unable to land the jobs they wanted, or in some cases, a job at all.

They seem to swing between two poles, either feeling unqualified for the job they want, or being unwilling to settle for the jobs they are offered. A few grandchildren with college degrees say they are unqualified for even entry-level positions in their field of study.

These kids broadly represent what the kids in the Harvard study say about changes in their lives during Covid. Young Americans must really hate what we’ve done to them.

Their sense of despair is a common theme in other polling of American adults. But the deep unhappiness and pessimism displayed in the Harvard poll was a startling turn in an age group that might be expected to have more optimism, given that they are at such an early stage of their adult lives.

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We’d Better Build Back

The Daily Escape:

Sunset, Herring Cove, Provincetown MA – October 18, 2021, photo by Karen Riddett

“Men must either govern or be governed.”   ̶  Elihu Root, 1912 Nobel Peace Prize Winner

Wrongo has never cared for Biden’s “Build Back Better” slogan. He prefers “We’d Better Build Back.” The focus should be on what could happen if we remain on the track favored by Sens. Manchin and McConnell, along with McConnell’s Republican colleagues.

We’d better build back from the wreckage of the Trump presidency. We’d better build back from the wreckage caused by Congressional inaction for the past 20+ years.

Wrongo is currently reading “Wildland, The Making of America’s Fury” by Evan Osnos, journalist at the New Yorker. Osnos says in the Prologue, (pg. 13) that September 11, 2001, and January 6, 2021, were two cataclysmic events in American history, and that the intervening 20 years was: (emphasis by Wrongo)

“…a period in which Americans lost their vision for the common good, the capacity to see the union as larger than the sum of its parts. A century and a half after the Civil War, America was again a cloven nation. It’s stability was foundering on fundamental tensions over the balance between individual freedom and the protection of others, over the reckoning with injustice, and over a basic test of any political society: Whose life matters?”

Umair Haque makes the importance of building back clear in a way that only someone living abroad can:

“America has the rich world’s lowest quality of life, by a long way — after all, Americans will die 5–10 years younger than Spaniards or Germans, but even that understates the issue. It is uniquely a dismal life: nowhere else do we see opioid epidemics, kids massacring one another at schools, having “active shooter drills…”

Haque points out that the fundamentals of a decent life: A living wage, universal access to healthcare, affordable education and housing, and a secure retirement are no longer within reach for the average American.

That’s why we’d better build back.

Step one is to deal with the threats to democracy. We will soon know if the Democrats can actually rouse themselves from their Republican-lite slumbers to pass the Freedom to Vote Act to help get this done.

Step two is to pass the Build Back Better Act, Biden’s social spending bill. It’s now clear that the bill will need to shrink in order to pass. And like the House and Senate, America doesn’t agree on which of its big-ticket items are most important, but shrinkage is on the agenda.

The bill has remained popular in the polls. One thing that’s clear from public surveys: People want to pay for the bill by taxing the rich.

A Vox and Data for Progress poll, conducted between October 8-12, found that 71% of voters support raising taxes on the wealthiest 2% of Americans to pay for the bill. Eighty-six percent of Democrats and 50% of Republicans back that idea. Other tax provisions that could be included in the bill, like tax increases on corporations and capital gains, were supported by more than 65%. Increasing corporate taxes is Wrongo’s preferred policy approach to raising revenues.

Vitally important to the job of building a better country is the proposed new spending on health care, long-term care, childcare, and clean-energy jobs. These ideas are supported by 63% of voters in the poll.

The wisdom of the framers has given us an unrepresentative Senate. That unrepresentative Senate has given us the filibuster, which can be changed, but apparently not by our current Democratic Senators.

And despite its popularity, Biden’s social spending bill won’t be passed in its present form until Joe Manchin and Krysten Sinema get what they want removed from it. A real question is whether we have moderate Democrats or just mediocre Democrats who are willing to kill democracy as we know it for some phony principle.

But you can bet it’s not just Manchin and Sinema. There are at least 8-10 other Democratic Senators with substantial bases of wealthy contributors who feel the same pressures and are perfectly happy to have the whole package scaled down, delayed, and possibly killed.

This brings us to step three. Elect better Senators, but how? We were taught in school that in a democratic republic, you get the politicians that the voters (or at least those people who are allowed to vote) want.

This means we need better voters.

How do we get them? It’s hard to know how to do that, except you know, PASS THE FREEDOM TO VOTE ACT!

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Monday Wake Up Call – September 20, 2021

The Daily (no) Escape:

More than 660,000 white flags have been put on display at the National Mall in Washington DC in memory of Covid victims. The display is called “In America: Remember”, organized by artist Suzanne Brennan Firstenberg.

“Reality is that which, when you stop believing it, doesn’t go away”  ̶  Philip K. Dick

And a corollary: Delusion requires passionate and unyielding belief to keep pesky facts from intruding. This is why for some people, cults are a viable form of social organization.

The Covid vaccines save lives. America has an abundant supply. The shot is free. But many Americans remain unvaccinated. Some don’t have access, but it appears the vast majority of the unvaccinated are making a decision that appears to be driven in part, by their politics.

The WaPo reports that:

“Since May of this year, more than half of the deaths from the coronavirus have been in states that voted for Donald Trump. There have been 239 deaths per million among red-state residents, compared with 150 per million in blue states.”

And for vaccinations, states that voted for Trump in 2020 have lower vaccination rates. Here’s a chart:

Are Republicans following a political strategy with vaccines? Brian Beutler thinks so:

“To grasp that Republicans encouraged COVID spread to harm Biden, you don’t have to believe, in a conspiracy-addled way, that they convened in secret and built a playbook for maximizing infections. You simply need to observe that a critical mass of conservative elites view undercutting Biden and Democrats as a political lodestar, and make immensely consequential governing and broadcast decisions on that basis alone.”

According to the NYT, that thinking has led to 16,200 preventable deaths since July 1 nationwide. And it’s important to realize that most deaths occurring now are preventable in a way that was absolutely not the case at the start of the pandemic.

Following on Phillip Dick’s quote above, a reality is that Covid is now a preventable disease.

Ignoring reality, Red State governors are actively discouraging vaccination and masking. They are actively encouraging a preventable but deadly illness to spread. They are putting the entire nation at risk of a vaccine resistant variant. They’re threats to our national security.

Polls show that Biden’s approval rate has slipped, in part due to the Covid surge. Covid may be hurting Biden politically, but it’s hurting Red State Republican constituents literally (and seriously). The Red State Covid fatality rate isn’t high enough to really hurt their vote totals except in marginal districts. The Republican bet is that the intensity/turnout advantage they get from anti-Vaxx deniers will pay off in the 2022 mid-terms.

They seem to have internalized that a pandemic combined with pandemic denialism helps them. In 2020, the Republican ground game benefited from the fact that Covid denialists were more willing to go out in public. They used the fact that their voters were more likely to vote in person to push Trump’s Big Lie election-fraud theories.

But here we are. They’re living in a world where the virus is fake, and thousands of people are dying from taking the vaccine. They’re taking Ivermectin and anti-malarial drugs because the fake virus is a little threatening, but not bad enough to take the vaccine. It can be deadly, but “it isn’t for me” because it’s a liberal conspiracy.

But the “reality” is that excess deaths from all causes since February, 2020 according to the CDC is 830,400. Last year, the age-adjusted all-cause mortality rate in the USA rose by 15.9%. This is by far the biggest one-year rise in that rate in the 120 years that official records have been kept for this basic measure of overall public health.

Time to wake up Red Staters! Many of the GOP higher ups (and their media lackeys) think that you’re not masking or taking the vaccine, will hurt Biden and the Democrats. Maybe you should be thinking about the greater harm that following their lead may bring to you and your family.

To help you wake up on this last Monday of summer, listen to the Foo Fighters, who are going through a “disco discovery” stage wherein they call themselves the Dee Gees, cover the Bee Gees’ “You Should Be Dancing”:

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Americans Die Earlier Than Europeans

The Daily Escape:

The Barber Pole, Vermillion Cliffs National Monument, AZ – May 2021 photo by Dave Coppedge

Derek Thompson in The Atlantic says that America has a death problem:

“According to a new working paper released by the National Bureau of Economic Research, Americans now die earlier than their European counterparts, no matter what age you’re looking at.”

Covid deaths are excluded from the study.

Before the 1990s, average life expectancy in the US was not much different than it was in Germany, the United Kingdom, or France. But since the 1990s, American life spans leveled off, and then fell behind those in similarly wealthy European countries.

We started hearing about America’s declining longevity when Anne Case’s and Angus Deaton’s 2015 study showed that White mortality in the US was rising. They called the new trend “deaths of despair”, caused by increased deaths by suicide, drug overdose and liver disease associated with alcohol.

Now, the bad trend has spread to all Americans:

“Compared with Europeans, American babies are more likely to die before they turn 5, American teens are more likely to die before they turn 20, and American adults are more likely to die before they turn 65. At every age, living in the United States carries a higher risk of mortality.”

The study collected data on American life spans by ethnicity and by income at the county level, and compared the data to those of European countries, locality by locality, allowing for direct comparisons. It explodes the myth about America having the best medical outcomes.

More from Thompson:

“Americans are more likely to kill one another with guns, in large part because Americans have more guns than residents of other countries do. Americans die more from car accidents, not because our fatality rate per mile driven is unusually high but because we simply drive so much more than people in other countries.”

Americans also have higher rates of death from infectious disease and pregnancy complications. And all of this is over and above our terrible Covid death rate.

One reason for the differences in mortality is that unlike Europe, America doesn’t have a robust public health system. These systems are at their core, a multidisciplinary delivery of services in our towns and cities that work to solve health problems before they require hospitalizations.

The US public health system has significant gaps in capability and delivery. It is both fragmented, and weak politically. The politicization of public health in the Covid crisis has caused some local public health officials to quit or retire. Some have been physically threatened just for doing their jobs. Approximately 1 in 6 public health officials have left their jobs in the past 18 months.

By contrast, our European peers have robust public health service delivery in most locations.

The researchers found some significant findings. First, Europe’s mortality rates do not vary much between rich and poor communities. Residents of the poorest parts of France live about as long as people in the rich areas around Paris. From the study:

“Health improvements among infants, children, and youth have been disseminated within European countries in a way that includes even the poorest areas…”

Second, White Americans living in the richest 5% of counties still die earlier than Europeans in low-poverty areas:

“It says something negative about the overall health system of the US that even after we grouped counties by poverty and looked at the richest 10th percentile, and even the richest fifth percentile, we still saw this longevity gap between Americans and Europeans…”

The study also shows that Europeans in impoverished areas seem to live longer than Black or White Americans in the richest 10% of counties.

Third, America has a surprising US longevity success story: In the three decades before Covid, average life spans for Black Americans surged, in rich and poor areas, and across all ages. As a result, the Black-White life-expectancy gap decreased by almost half, from seven years to 3.6 years.

The study credits the Medicaid expansion in the 1990s, which covered pregnant women and children and likely improved Black Americans’ access to medical treatments. The expansion of the earned-income tax credit and other financial assistance have gradually reduced poverty. Air pollution reduction is also a factor. Black Americans have been more likely than White Americans to live in more-polluted areas, but air pollution has declined more than 70% percent since the 1970s, according to the EPA.

Let’s give the last word to Derek Thompson: (emphasis by Wrongo)

“For decades, US politicians on the right have resisted calls for income redistribution and universal insurance under the theory that inequality was a fair price to pay for freedom. But now we know that the price of inequality is paid in early death—for Americans of all races, ages, and income levels. With or without a pandemic, when it comes to keeping Americans alive, we really are all in this together.”

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Sunday Cartoon Blogging – August 8, 2021

The Commonwealth Fund’s August 4 report says that the US health care system ranked dead last among 11 wealthy countries, despite spending the highest percentage of GDP (17%) on health care.

The report considered 71 performance measures in five categories: access to care, the care process, administrative efficiency, health care equity and health care outcomes. The countries analyzed in the report include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the US.

America ranked last on access to care, administrative efficiency, equity, and health care outcomes. We performed well in rates of mammography screening and influenza vaccination for older Americans, as well as the percentage of adults who talked with their physician about nutrition, smoking and alcohol use. But we had the highest infant mortality rate and lowest life expectancy at age 60, compared with all the other countries.

Eric Schneider, the lead author and senior vice president for policy and research at the Commonwealth Fund:

“The US has two health care systems. For Americans with the means and insurance to have a regular doctor…reported experiences with their day-to-day care are relatively good, but for those who lack access, the consequences are stark.”

Our poor performance is nothing new. The US has been in last place in all seven of these studies that the Commonwealth Fund has released since 2004. This is another failure of our political system. Our politicians talk but never act.

On to cartoons. There were lots of Cuomo cartoons, little on Covid, the Olympics or infrastructure this week.

Someone should tell Cuomo the “I Grope Everybody” defense is a terrible defense. A good rule in life is not to touch people you’re not supposed to be touching. Keep your hands to yourself:

Gov. DeSantis explains Florida man’s definition of how to end Covid hesitancy:

The GOP also predicted Sharia law in America, the end of Christmas and death panels:

Remember when Obama wore a tan suit and Republicans went nuts? This week, Biden wore a tan suit to announce the big jobs increase. It was also Obama’s birthday week. It’s an obvious attempt to troll conservatives:

The summer of our discontent:

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Our COVID Data Is Inaccurate, And It’s Going to be Spun

The Daily Escape:

Sand Harbor State Park, Lake Tahoe, CA – 2020 photo by debarnec

Happy belated tax day! Two disturbing articles about both the accuracy and reliability of COVID-19 data were in the NYT yesterday.

First, the collection and reporting of data is increasingly reliant on outdated technology to deliver test results:

“Health departments track the virus’s spread with a distinctly American patchwork: a reporting system in which some test results arrive via smooth data feeds but others come by phone, email, physical mail or fax, a technology retained because it complies with digital privacy standards for health information.”

The problems are compounded by human error:

“These reports often come in duplicate, go to the wrong health department, or are missing crucial information such as a patient’s phone number or address.”

Before the pandemic, nearly 90% of laboratory test results for diseases tracked by public health departments were transmitted digitally. But the need for substantially greater Coronavirus testing has brought many more players into the public health arena, including companies that usually run employment screening tests, and small clinics that usually test for diseases like the flu and strep throat.

This has increased the share of lab tests coming to public health departments via fax and phone.

The result is unreliable information. The Times quotes Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists: (emphasis by Wrongo)

“Nationally, about 80% percent of coronavirus test results are missing demographic information, and half do not have addresses…”

Hard to trace an infected person without an address. America’s health system is a jumble of old and new technology that make it difficult to track what’s really going on with the COVID pandemic.

Also, the Trump administration’s guidelines on demographic data haven’t taken effect yet. In June, they required laboratories to report a patients’ age, race and ethnicity, so public health officials could better understand the demographics of the Coronavirus pandemic. But, those rules won’t take effect until August, and they only state that laboratories “should” provide patients’ addresses and phone numbers. They do not mandate it.

Dr. Frieden, former CDC director says:

 “You’ve got hundreds of laboratories and thousands of tests. Nothing is interoperable because they haven’t been mandated to do that.”

Other countries have a unique number identifier for each patient, something that Congress refuses to provide in the US. Instead, data often come to public health authorities using only the information that laboratories need to track the record, not the details that public health officials need to help manage the disease.

Anyone who has healthcare knows that patients routinely fill out the same information on multiple forms in multiple offices. The need for doctors and testing services to use fax machines betrays the fundamental lack of modern technology in some health care settings.

And remember, it’s not for lack of money: There’s plenty of money in the US health care system.

The second item regarding COVID data is more troubling. The NYT reports that: (emphasis by Wrongo)

“The Trump administration has ordered hospitals to bypass the Centers for Disease Control and Prevention and, beginning on Wednesday, send all coronavirus patient information to a central database in Washington — a move that has alarmed public health experts who fear the data will be distorted for political gain.”

From now on, HHS, and not the CDC, will collect daily reports about the patients that each hospital is treating, how many beds and ventilators are available, and other information vital to tracking the pandemic.

This is seen as an inherently political move by outside public health experts. The NYT quotes Nicole Lurie, who served as assistant secretary for preparedness and response under former President Obama:

“Centralizing control of all data under the umbrella of an inherently political apparatus is dangerous and breeds distrust….It appears to cut off the ability of agencies like C.D.C. to do its basic job.”

This is more disturbing than finding out that the data are terrible. Alex Azar, who runs HHS, is a Trump crony and has clearly used his position to be helpful to Trump’s re-election campaign.

If there ever was any hope for a dispassionate, reasoned, and scientific FEDERAL response from Trump, it is certain that these two problems, one with the quality of the data, and the second with how it will be spun as it is reported, show we’re doomed.

How many health care workers will have to die? How many people living in states run by Trump’s personal bootlickers will get the treatment that they need?

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