Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

December 14, 2022

Wondering on Wednesday 12/14/22

 


Ready... Set... Wonder!

In no particular order, I'm wondering tonight about holiday parties. You know, the kind we host or attend, with family, or coworkers, or friends and neighbors. Or, you know, the kind attended by Associate SCOTUS Justice Brett Kavanaugh. The party in question was hosted by "far-right operative" Matt Schlapp, who runs the Conservative Political Action Committee (CPAC), the group that's hosted both Donald Trump flag-kissing events and Hungarian right-wing strongman Viktor Orban

In a planned leak of party attendees, Kavanaugh's name is at the top of the list; other names below his include some with business before the Court. The linked article provides some details on that, and also notes

If Kavanaugh was a judge in any other federal court, his attendance at Schlapp's party might have violated Cannon 2 of the Code of Conduct for United States Judges. Specifically, Kavanaugh is permitting Schlapp and others to, at a minimum, "convey the impression" that they have special access.  

A judge should neither lend the prestige of the judicial office to advance the private interests of the judge or others nor convey or permit others to convey the impression that they are in a special position to influence the judge.

We know Kavanaugh's not the only one, nor are the conservative justices alone on stuff like this. But with all the focus on Justice Clarence Thomas, his wife Ginni, Justice Samuel Alito and his parties, and the leaks, I can't help wondering why Kavanaugh didn't just find a quiet bar somewhere to share some holiday cheer. 

Speaking of "all the focus on" people, I'd be remiss if I didn't mention Brittney Griner, the WNBA star and world's most famous vaper. Griner, you know, was released from her Russian prison camp in an exchange for convicted international arms dealer Viktor Bout who had served more than half his 25-year sentence. Not released along with Griner? Former Marine Paul Whelan, who's been held in Russia on espionage charges. 

I don't know enough to talk intelligently about whether any trade for Bout would have been a good idea, and I certainly don't know diddly about the negotiations that led to the exchange. All I do know is lots of people were arguing about whether we should have brought home the vaping 'woke' black lesbian National Anthem protestor, or if we should have brought home the white former presumably straight presumably non-vaping Marine.

Noticeably missing from any of the arguments? The fact that Whelan was a staff sergeant in the Marines, until he was busted down to private, and was given a bad conduct discharge. I have to wonder this: if people were as aware of his military history as they are of her National Anthem history, would they think he was really all that much better a trade

And speaking of history, there's Texas, which has a long history of interjecting into things that the government doesn't really need to get involved in: keeping pregnant women on life support against their wishes, or providing bounties to folks who report women seeking health care, or wanting to investigate parents of trans children for child abuse, for example.  

And, we learned, the Lone Star State is still interested in interjecting where it doesn't need to be. As the WaPo reported, Texas AG Ken Paxton went looking for info on transgender Texans. 

“Need total number of changes from male to female and female to male for the last 24 months, broken down by month,” the chief of the DPS’s driver license division emailed colleagues in the department on June 30, according to a copy of a message obtained by The Washington Post through a public records request. “We won’t need DL/ID numbers at first but may need to have them later if we are required to manually look up documents.”

That's what Department of Public Safety staff were asked to provide, based on a verbal request from Paxton. And they found "more than 16,000 such instances," which led them to tell the AG they couldn't provide the data he asked for.

So, what's the wondering, you're wondering? Simply, this: what the actual hell is going on down there? What compelling government interest is there in having this data? Is it because their plan to charge parents got shot down, so they're going to attack adults instead? Or is it because Paxton's a Texas-sized jerk? 

What's got you wondering these days?

April 18, 2020

The Irony Board: Time to Fold the Laundry

Looks like I've got quite a pile building up on the Irony Board. I guess it's time I took care of at least the stuff that's related to the COVID-19 pandemic.

First up? Science!
Isn't it at least a little bit ironic that so many science deniers, whether it's climate science or vaccine science or teaching science in schools, are so eager to see people move forward with experimental uses of drugs to fight the coronavirus?

And also isn't it at least a little bit ironic that the folks who say the virus is "a deep state hoax" and "the numbers are a lie" are also gung ho (on social media, anyway, where everything is true...) about drugs like remdisivir? Why would we need to work so hard to solve for something that isn't even a problem?

And isn't it also ironic that, when people are so demanding of other scientists, across a wide spectrum of applications, even down to their political affiliation, none of the same people seem remotely concerned that the tests we're seeing for these drugs frequently don't include control groups, so we don't really understand how they're working compared to people getting a different drug or a placebo?

I totally understand the desire to have some kind of therapeutic meds available to help treat people who end up getting infected with the coronavirus, but I also think that we should practice good science, including informed consent, and trials done under commonly accepted scientific practices - not just fast science, no matter how good the intentions.

Next up? Geography!
I find it at least somewhat ironic that the people who have long complained about how upstate New York - the real upstate, which includes Central NY, Northern NY, the Southern Tier, Western New York, the Fingerlakes region, the Adirondacks, and the Capitol District -  is constantly being screwed and all our money is being stolen to pay for New York City and so on, to the point where we should split the state to get away from downstate  are now all up in arms about two things that happened long ago, but only suddenly are hot topics.

The first issue? Gov. Cuomo not purchasing 16,000 ventilators back in 2015. These folks would have been apoplectic at the thought of the Sonofa Gov spending more than half a billion dollars on ventilators that would be sitting in a warehouse somewhere, doing nothing for who knows how many years, absent a pandemic like the 1918 flu, which at the time was nearly a century back in our rear-view mirror. But because Donald Trump said it on a Fox Town Hall from the Rose Garden, this is now a fact - Cuomo failed to by ventilators.  Never mind the "empty cupboards" of the Strategic National Stockpile, which the current administration failed to refill - because that's different, or something.

The second issue? The realization that many hospital beds have been closed in New York, most of them in New York City where the impact of the coronavirus is being felt most intensely. The anti-Cuomo, anti-downstate folks have been complaining about that as well, because the virus is only an issue there, it's hardly having any impact here and now we are going to have to take their sick people because there aren't any hospital beds for them.

And why aren't there any beds? Here's an op-ed in the NY Post from 2013 on hospital closures, written by the chair of the Pataki administration's Berger Commission, who said that (at that time) 18 hospitals across the state had been closed, including 12 in New York City. That's something that people up here would have been happy about, no longer throwing good tax dollars - good upstate tax dollars - out the window.

But now, also from the NY Post from March of this year, we learn that NY has thrown away thousands of hospital beds and that's going to make it harder for the state to deal with the pandemic.
New York has lost a staggering 20,000 hospital beds over the last two decades to budget cuts and insurance overhauls, complicating local and state efforts to battle the coronavirus, according to records and experts.
Both articles are good reads, presenting the arguments for and against doing something in each of these cases. And in each case, our elected officials, representatives of both major parties, made decisions they thought best for the citizens and taxpayers of New York.

What can we learn from these at least a little ironic lessons?  A few things, I think.
  • Irony is everywhere.
  • What we don't want today we might need tomorrow, so when we get what we want, we may come to regret it. 
  • Our elected officials are human - and imperfect - as are we.
  • Many times, the ideas of one party are the ideas of the other party.
  • We'd probably be better served if we focused more on the ideas and less on the people.
  • 'We' includes me. 

April 17, 2020

TGIF 4/17/20


To all the nurses and doctors and respiratory therapists, and lab techs and 
pharmacists and housekeeping staff and IT staff and office staff and
cafeteria staff and supply clerks and delivery drivers and every single 
other person who works in the healthcare field, whether at a hospital or 
a clinic or a lab or a doctor's office, who are fighting each and every 
day for us, and caring for our loved ones and holding their hands
when they pass, and who are bringing new life into this crazy world we 
live in, often far from home because they go where we need them to go 
and to the scientists that are working on tests and vaccines and therapeutics; 

and to all the 911 operators and dispatchers and EMTs and police officers 
and firefighters who put their lives on the line to help us when we 
need it most, and keep the peace when nerves are frayed, and to
the public, and to the folks who operate our public
transportation systems, the subways and buses and
trains and help people get where they need to be;

and to all the school bus drivers and teachers and administrators and 
secretaries and aides and janitors, who are feeding children, seniors and 
shut-ins and seniors, and who are doing their best to teach and 
help students find new ways to learn and to continue to thrive, and who
are finding creative ways to let their students know that they
are loved and missed, and that things will be OK; 

and to all of the restaurant workers, the cooks and owners and wait staff
and delivery drivers and cashiers and the folks running food out to us in
curbside pickup spots, the bakers and donut makers and ice cream makers
who are keeping people smiling while they keep a social distance, and to the 
gig workers, the Grubhubbers and Doordashers, who do for some what 
they don't want to do themselves;

and to all of the people working in grocery stores, liquor stores, home stores,
warehouses, gas stations and other essential businesses, and the, UPS and 
FedEx and Amazon drivers, and the men and women of the United States
Postal Service, and all the other people that are keeping us moving and
keeping things moving and keeping checks and bills and catalogs
and cards arriving, and sending them where they need to go;

and to all of the charities, the non-profits, the NGOs that are playing a 
part in keeping people safe, helping cover rent and utilities 
and whatever else is needed, and to the food banks and food pantries 
and their workers who are putting in long, long hours making sure that 
mile-long lines of people can get food, and to the farmers who are donating 
their crops so that others can eat, and to the tens of thousands, maybe millions of people who are donating their time, money, effort, ingenuity, and creativity to help others in ways large and small; 

and, yes, to the politicians, the public servants, the good ones, who sit
and stand in front of microphones every day and tell the truth, who
talk straight, and straight from the heart, who show sympathy and
empathy and humanity as they tell us about more deaths, and more
infections, and more recoveries, and even when they give us more guidance, 
when it restricts us, and who get yelled at by us, and by those who
should be helping, instead of using gratitude as a bargaining chip;

and to everyone who is doing their level best to do what we're being
asked to do, to help protect others, and maybe even ourselves, and to anyone I missed.  

Thank you. 

TGIF, everyone.
Stay safe.

July 27, 2017

Trump in Transition (v20)

"After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow Transgender individual to serve in any capacity in the US Military.

Our Military must be focused on decisive and overwhelming victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you."

No, Mr. Trump, thank you for being so considerate of our tax dollars and how the military blows them on healthcare.

People have actually investigated this issue, the burden of the "tremendous medical costs" that would become crippling to the military if transgender members were allowed to serve. For example, here is some info from an article in Scientific American (which might actually be somewhat of an oxymoron under the Trump administration):
June 2016 study from the RAND Corporation estimated that there were between 1,320 and 6,630 transgender active-duty service members — out of 1.3 million service members in total — and noted that not all of them would seek treatment related to gender transitioning. The study also estimated that the cost associated with medical care for gender transition would only increase military health care expenditures by between $2.4 million and $8.4 million each year — an increase of between 0.04 and 0.13 percent.
The same article references another study, too:
September 2015 study published in the New England Journal of Medicine reached similar cost estimates.
 The study estimated that there were about 12,800 transgender service members who would be eligible for medical care. But it hypothesized that fewer than 200 would require care for gender transition each year, based on the percentage of transgender people who sought such care outside the military and the percentage of Australian service members who sought transition-related care.
The overall estimated cost to the Pentagon: $4.2 million to $5.6 million — what the study’s author called “little more than a rounding error in the military’s $47.8 billion annual health care budget.”
It's good that Trump is paying attention to out of control costs in the military, even as he proposes massive increases in military spending. Perhaps he's aware of this article in the failing NY Times back in 2010 which discussed comments by former Bush and Obama administration Defense Secretary Robert Gates, who tried and failed to make changes to the military's health insurance program:
"Health care costs are eating the Defense Department alive," Mr. Gates said in a much-noticed speech in May. Defense budget analysts say that rising health care costs will make less money available for new weapons, repairs to a worn-out arsenal and quality-of-life programs like schools on military bases. 
"In the long run, it could actually limit our ability to field a military of sufficient size," said Todd Harrison, a senior fellow for defense budget studies at the Center for Strategic and Budgetary Assessments in Washington.
That's some scary stuff right there, don't you think? Military healthcare costs may actually be putting you and me in jeopardy!

There's lots of information on efforts to reign in these costs, including raising the minuscule 'enrollment fee' for the military's TRICARE insurance plan, which is offered for life even to the millions of military retirees who now work in the private sector and are eligible for health insurance through their jobs. As Robert Gates and others who came after him found, the military lobby is large, it is active, and it has the ear of Congress, so change does not come often, or quickly.

But, the reality is, not accepting or allowing trans people to serve in any capacity - not as translators on the front line, not as analysts, not as cyber experts, not as drone pilots -- isn't going to make a dent in the military's health care budget.

But there is something that can be done that would make a dent, I think: accepting and allowing only people who choose a lifetime of dependent-free living. Single, no kids, no baggage, and no plans to ever stop being singe, kidless and baggage-free.

According to the 2015 Demographics Profile of the Military Community (emphasis added),
Overview of Military Families Across the Active Duty and Selected Reserve population, there are 2,120,505 military personnel and 2,783,141 family members, including spouses, children, and adult dependents.
Here are some facts about those dependents:
  • Of the military personnel, 43.1 percent are single with no children, 34.9 percent are married with children, 15.6 percent are married without children, and 6.3 percent are single with children. 
  • Overall, 41.2 percent of military personnel have children in 2015, compared to 39.9 percent in 2000. 
  • Of the 1,758,365 total military children in 2015, the largest percentage are between birth and 5 years of age (37.5%), followed by 6 to 11 years of age (31.3%), and 12 to 18 years of age (24.2%). Fewer children are between 19 and 22 years of age (7.0%); however, children ages 21 to 22 must be enrolled as full-time students in order to qualify as dependents. 
  • More than half (50.5%) of military personnel are married
  • Of the 1,012,251 military spouses, nearly one-quarter (23.5%) of spouses are 26 to 30 years of age, while 21.3 percent are 31 to 35 years of age, 20.3 percent are 41 years of age or older, 20.1 percent are 25 years of age or younger, and 14.8 percent are 36 to 40 years of age.
I would suggest that providing healthcare for these 2.78 million freeloaders is considerably more costly than it is to provide health care for a small handful of trans people who may decide to transition on the government's dime.

Not only that, but the constant disruption of worrying about spouses, adult dependents, and children while trying to achieve decisive and overwhelming victory must be a huge and bigly burden on our troops, their commanders, and even on Trump's personal generals. We clearly need to nip that worrying in the bud.

And we certainly cannot continue to abide the more than 6% of military people who are single parents -- that is completely unacceptable! We know the only good family is one with a daddy and a mommy who are married to each other.

And here's another idea - check out this graphic, again, from the 2015 Demographics Report:



There were more than 865,000 civilian DoD employees?  For heaven's sake, outsource them! Get them off the government payroll and into the private sector where they belong!

Have the Dealmaker in Chief personally negotiate a cut-throat bargain with the private companies to give us these services on the cheap. Let the private sector treat these budget-suckers like the rest of Americans are treated -- you know, the people caught in the pro-business, market-driven deregulate-a-thon who go to bed every night wondering if they'll still have benefits when they wake up in the morning.

And the best part of my plan?

No one has to check anyone's 'particulars', if you will, to make the decision. It's clean, clear, and straightforward; no messing around in medical records, and no brightly-lighted inquisition rooms required.