Category Archives: Public Health

Healthcare: Next Steps

We had our day of glee over the abject failure of the GOP. And let’s recap: they had SEVEN YEARS to come up with a replacement and chose not to. It’s critical to understand why they didn’t, because it affects what we do moving forward. The Republicans never developed a replacement because they don’t want government to have any part of healthcare (or social services of any sort). Their goal is to dismantle not just the ACA, but Medicaid, Medicare and then Social Security. As a side dish – public education, environmental protection, etc. That’s their goal. And when your goal is death, you’re never looking to develop a treatment plan.

The AHCA bill was a tax bill, plain and simple. Its thrust was to create a trillion dollars in savings so that Ryan and crew could enact the tax cut bill they want: without the savings, it will be harder to decrease monies paid by individuals making over a million a year. They’ll likely make some progress, however, on corporate tax dismantling. More on that below.

It went down in flames for several reasons: yes, the protests certainly gave cover to Republican in moderate districts, especially those that Hillary Clinton carried last year. Don’t underestimate that, and DON’T STOP!!! But the overarching reasons are all on the Republican side: they have to do with the Freedom Caucus which stood en bloc in the face of direct threats from the White House. They couldn’t care less what their party thinks of them, they’re not afraid of Trump and Bannon, they don’t even care that much about their constituents. They are ideologues with no understanding of how government functions, only how to stop it. Their goal is NO government, and they’re too stupid to understand that “NO government” is synonymous with “Failed State” and “Anarchy”. In our planning, we need to consider the best ways to leverage them. Remember, this was never going to pass the Senate, and we suspected that when the first draft was published in early March. (See paragraph six in this link.)

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The Week in Review

There is an old saying that a week is a lifetime in politics.  In most weeks, there is a lot happening either behind the scenes or at lower levels (e.g., committee hearings and markups on bills that nobody is watching).  It is the rare week, however, that so much is taking place front and center competing for the attention of the American public.

The big story of the week was the non-vote on and the collapse of the Republican effort at major health care reform — the so-called Affordable Health Care Act (a name that in itself was an attack on the bill that it was trying to “repeal and replace,” the Affordable Care Act.   There are several significant aspects to this non-event.

First, despite their efforts, Donald Trump and Paul Ryan could not get the sizable Republican majority in the House to pass a bill (forget the exact details of the last version of the bill, they could not get a majority behind any version) on one of the top Republican priorities of the past seven years.  While Trump may have been a great negotiator, it is very easy to reach a two-sided deal.  (Of course, it’s possible that Trump’s belief in his negotiating skill may be one of his great delusions.  He may have just been offering the right deal at the right time and actually have been taken to the cleaners in his business negotiations.)When you have three or more sides to a deal, however, it becomes very difficult to keep everybody on board.  This problem is particularly true in politics — when one faction thinks that a bill is too conservative and the other faction thinks that the bill is too liberal, there really isn’t any change that could make both sides happy.  At that point, it’s not really about negotiating but selling.

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Protecting Democracy

democracy-header1Every day, more nominees. I never thought I’d actually be rooting for Mittens so there will be at least one adult in the room.

If you’d told me that “President of these United States” was an entry-level elected position, I would have laughed.

Who could have predicted that the Weekly World News would have gotten more right over its years of publication than what is shown on most news stations. (At the very end of this post is the best story EVER about the Weekly World News.)

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A Note from your Doctor: Zika and Dengue

zika mosquitoWhile we’re less than a hundred days out from the election of our lifetimes, Rio will open on Friday night, and one of the considerations there will be Zika. OK, in addition to the crime, pollution, corruption and other dangers. But what about other places? Do we have a problem with mosquito-borne illnesses? Yes we do, and we need to protect ourselves and our kids.

Because I like you and try to avoid making your eyes glaze over, I’m going to skip the virology involving words like serotype, macrophages, Fc receptors and antibody-dependent enhancement. Bottom line: there are a number of different types of mosquitoes and many of them carry multiple diseases. Sometimes an infection with one disease makes infection from a second disease more pronounced. This is likely the case with Dengue intensifying the effects of  Zika. And don’t think Zika problems are limited to fetuses: Guilliane-Barre is another potential complication.

Remember that when you’re bitten by a mosquito, they take some blood from you while laying down potential infections. If a mosquito bites an infected person (Dengue, Zika, West Nile, Chikungunya, etc.) they will pass it on to the next victim she bites. (Only females suck blood.)

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