Tag Archives: healthcare

110. 260-Days of Trump

11 Oct

What is the state of our union after 260 days of D. Trump (DT) in office?

The most serious situation that our nation faces, is the threat of a war with North Korea, and even worse, the path to a World War III. What Trump says in this respect, may be the usual scattered thinking. But a possibility is that he is truly focused on bringing the greatest possible pressure on KJU to back down and stop making nukes. That is why he was angry with Rex Tillerson because negotiation efforts would dilute the powerful pressure. But as usual, no one really knows exactly what DT was thinking.

Diagnosing Trump has become very popular. One of the latest contributions to this topic is a book by Bandy X. Lee et. al.: The Dangerous Case of Donald Trump. Dr. Brandy Lee (no relation to me) is a forensic psychiatrist and a member of the Yale faculty. She and her co-authors have distinguished careers. Needless to say, this book documents abnormalities and makes recommendations regarding his use of our nuclear arsenal. As I have stated in previous blogs, I think that DT has at least a moderate Alzheimer’s disease, and according to recent research, his confessed lack of sleep would be a major contributor to this condition. Sleep is the only time that waste products in the brain are washed out. When your brain is full of waste, Alzheimer’s progresses. This involves a gradual loss of memory and mental functioning.

An extremely destructive goal of Trump is to attack the legacy of Barack Obama. DT does not have any goals that benefit our country in general; his emphasis is only on winning and keeping foolish campaign promises. The first repeal and replacement of ObamaCare by the House was labeled by DT as “mean.” Later he wanted to pass a similar Senate bill at any cost, regardless of content. With no regard to the terrible effects, he has worked to destroy such Obama accomplishments as Iran Nuclear Deal, the Paris Climate Agreement, various trade agreements, DAKA immigration order, and various orders and legislation related to financial regulations. He also is reducing science research funds and changing science policies, which can affect our world leadership in this vital area. On the other hand, China is increasing its science budget and may take over world leadership in this area. Since much of manufacturing and related research is based on science, this would give China (and maybe other countries) a major financial advantage.

An ongoing and shabby situation is that Trump’s cabinet members are often at odds with the President. His staff has traveled all over the world trying to assure leaders that Trump will back them up and accept existing treaties. Failures in this area are dangerous and can cause some allies to join with Russia or China. Many feel that the major role of several cabinet members is to “contain” DT and keep him from making destructive statements and tweets.

A few Republican Congressmen are starting to directly attack DT’s  competence. Senator Bob Corker has been blunt is his criticism and Senate leader Mitch McConnell has supported Corker.

Polls have indicated a decreased voter support with respect to trust and accomplishments. His only clear accomplishment was not legislative, but was the appointment of a Supreme Court Justice (Neil Gorsuch) — a trivial thing since the Senate is GOP controlled.

Trump has alienated and belittled numerous Republican leaders that are necessary for passing legislation he backs. There are many more than the few mentioned above. He has also insulted a Gold Star family, numerous reporters, and black athletes that are trying to fight unfair treatment by police. On the other hand, his condemnation of Neo-Nazis, KKK, etc., was weak and only approached what is appropriate, when reading speeches prepared by others. His instinct to keep all supporters regardless of character supersedes any moral imperative.

Certainly, one could write a book about these first 259 days in office. I see this period as a steady decline of effectiveness and general support — and legitimate polls agree. Recently, I have been wondering whether the election of Trump represents a fate for the USA, like the fall of the Roman Empire. Avoiding this “fall” could be impeachment, but having Mike Pence as President could be worse, and the impeachment process is long and debilitating. What is already happening and may increase is to contrive legislation and a cabinet structure to contain and ignore Trump actions. But “containment” will not prevent the confusion and alienation caused by his Tweets and spontaneous utterances. Although disadvantageous in many ways, I do advocate impeachment.

Just in, as I am writing this blog! Relevant to USA downfall is more information on Russian ads that influenced the election. Google, Facebook, Twitter, and Instagram all were used by Russians and all the CEO’s have attempted to suppress this info. Our survival is truly affected the influence of foreign powers. When will DT and Republicans awake and put our country on the right track?

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108. Imminent Danger of POTUS

28 Aug

The investigation of Trump and his associates is going slowly (as expected), but the dangerous actions already taken, and worse decisions in the future, are so dire that we must think about quick action. Congress must consider the consequences of his continuing in office. Below, I have listed some of these grim possibilities:

Naive and blatant coercive interactions with certain countries, such as North Korea and Pakistan (and even China and Russia) can move us closer to disastrous situations and even horrible world wars.

Further reductions of government regulations, which could result in serious health factors due to air and water pollution.

Other losses of regulations affect the financial stability of major banks and investment houses. When there are failures, ordinary taxpayers lose money by bailing them out.

Failure to raise the debt ceiling will cause the USA to default on loans. The
consequence of this would be:
1. A lower credit rating will cause an increase in the interest the USA is paying on its loans, and the result is that we, the taxpayers will lose.
2. With less trust in the US dollar, we could lose our Reserve Currency status.
Reserve currency is the money used for international trade, which currently is the US dollar. There are numerous benefits to this status.
3. The US is a world leader in many ways. With a poor credit rating, world respect would diminish.

Trump has alienated many of our traditional allies by egocentric dealings and accidental insults. Allies are helpful for many kinds of international problems and conflicts.

Trump encourages alt-right groups, so that our world-wide reputation for the respect of human dignity is being diminished.

Our traditional system of free public education could be compromised and human resources would be diminished. He sets a bad example for children, by his support of violence and his aberrant actions.

Failure to support climate change remedies can lead to disastrous and costly human migrations, storms, floods, and the formation of new deserts.

Trump has allowed Russians to infiltrate our society and elections. He tends to ignore or even support Russia and has made little progress in fighting cyber-crime.

Trump re-writes history according to his own needs. He tells blatant lies and fails to coordinate with assistants, which causes confusion and distrust at home and abroad.

His attacks on the press undermine a system that is vital for any democracy.  This encourages ruthless leaders abroad to attack, jail, or even murder reporters.  It is telling that so many media organizations are critical of him.  He should be supporting traditional reliable sources like the NY Times, CNN, and the Washington Post.

106. Health Care for All

30 Jul

It is already a basic USA value to help everyone with at least some types of health problems. If a homeless person is lying in the street with severe injuries, he will at least get minimal care. Covertly, Republicans might not agree with this, but on the record they would have to support it or be castigated.

Given this premise, that in practice, everyone will get health care if needed, then it does make sense to require everyone pay for it. The simplest and most agreeable implementation is Medicare for all. Remember that our POTUS promised health care for all at good rates, in his campaign.

I suggest that we greatly increase taxes for rich folks by having higher rates and by closing tax loopholes. If you are extremely rich, then your taxes will be extremely high. If you have no income, then no tax. If you have a small regular income then you could have a very small increase. As income increases, then the percent allotted to health care expense also gradually increases. Lower and middle class people will pay a little more and wealthy people a lot more. Why should wealthy people pay a lot more: because they use a lot of resources and because much of their wealth has been gained by unfair influence on Congressional financial (tax, subsidies, IRA’s, etc.) legislation.

Note that I am not against people who become rich through hard work and intelligence. It is extreme wealth and wealth unfairly gained that bothers me; particularly when there is substantial poverty in our nation. Many very wealthy people have stated that they would not object to increased taxes.

Countries with universal health care include: Austria, Belarus, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine, and the United Kingdom (see Wikipedia).

 

105. Balancing Rich vs. Poor

8 Jul

Our country (USA) now has a certain established income (mostly from tax), and established expenditures. An increase or decrease in any source of income or expense will, as a general rule, either raise or lower the nation debt. To keep the budget constant and free of debt increase, you must keep all parts of it about the same, or set up see-saw rules: up in one area, down in another, and visa-versa. (These rules hold in general, but there can be minor complications.)

So if someone proposes more military spending then there will be less for other areas, for example, infrastructure spending. If we take away huge amounts of income by lowering taxes for the rich, then there could be less for Medicaid, education, environmental protection, or something else.

Trump and Republicans have always proposed decreasing our national income by lowering wealthy taxes. This by itself would increase the national debt. Further, Trump wants to greatly increase military spending. So now we have a lot of spending, with the consequence that other programs will suffer. Rich folks will buy more luxury items, and will be more effective in influencing Congress. And poor people will suffer as their special programs (such as Medicaid) will be diminished. There is a clear ethical problem: less luxury for millionaires (even billionaires) versus the deaths of people who lack health care.

For Trump, having a powerful military is very important because it is helpful in coercion, forcing other countries to go along with his plans. After all, his political and negotiating skills don’t seem to be very good, so he needs a very powerful military to get his way. Also, his political mistakes can be minimized by showing off his military might — similar to the displays of armaments by North Korea.

Another bonus for very rich people would be eliminating the inheritance tax. The cut-off for this tax is the inheritance of five-million dollars so it only applies to rich folk. The vast majority of U.S. citizens support the continuation of this tax.  I have noticed that when Trump mentions inheritance tax, it is very quickly and with a lowered voice.

If the Republicans can achieve the above goals, which make wealthy people even richer, then these are some of the areas that could be adversely affected:
education, health care, State Department functions, Planned Parenthood, Medicaid, Medicare, infrastructure improvement, scientific research, medical research, various tech programs, environmental protections, etc. Let’s ask Trump to do with the Military, what he has proposed in other situations — lets hold the extra spending and make it more efficient instead.

 

104. Underemphasized Political Facts

5 May

I listen to a lot of political commentators and government leaders. It disturbs me that many important factors are rarely mentioned. Here is a list of very important facts that should affect political judgments:

1. The inheritance tax (a.k.a. death tax) is only for very rich folks and starts at $5.45 million. So when GOP people want to end it, it is done to support millionaires and take money away from us.

2. Tax simplification does not help ordinary folks, as their tax is already simple. It helps rich folks cheat, because there are fewer rules governing their very complex returns. Fewer tax categories are always designed by Republicans to make rates lower for high earners, not you and me.

3. When highly respected conservative George Will says a fellow Republican, Donald Trump, cannot “think and speak clearly”, it is significant.

4. Scientists have found that lack of sleep seriously promotes Alzheimer’s disease. Pres. Trump brags about the little time he devotes to sleeping.

5. Those who believe that Bill Clinton’s affairs tarnish his wife Hillary, should recognize that Trump, the actual candidate, has worse transgressions.

6. In Trump’s recent interactions with Chinese President Xi Jinping, he was the losing negotiator. Trump was forced to reverse his accusation of currency manipulation while China only reinforced previous policies.

7. Our House of Reps. just passed a healthcare bill for which there was little time to read and discuss, and was not evaluated by the Congressional Budget Office. This bill is also not consistent with Trump’s many promises, which proves he has no ideals and just supports rich Republicans and himself.

8. There is a tendency for commentators to look for one cause for each result. The recent Dem. loss by Hillary is one such case. Most likely, is that a combination of 7 or 8 factors (mostly “dirty tricks”) lead to the defeat. Please see my Blog Number 95.

9. Trump would have lost most of his followers if he told them in advance of his cabinet choices of several Wall Street billionaires, and his extreme conflicts with personal business interests. He has not done any divesting.

10. In the last 50 years or so, Republicans have always favored very rich folks over ordinary citizens. This is clear if you go to GOP candidate web-sites and examine their U.S. Budget plans. Current plans are to increase U.S. debt by lowering taxes for the rich, and offset this with reductions in services and programs for the rest of us.

11. FBI Director Comey has excuses for making announcements of Hillary investigations, but the bottom line is that he violated Justice Dept. rules. Almost all FBI investigations are secret and not announced until the final result. Investigations of Republicans were secret.

12. Republicans want to decrease regulations because that helps their rich industrial donors and Wall Street.  But most regulations are designed to protect the citizens from air and water pollution, hazards in the workplace and elsewhere, and taxpayer bail outs for bankrupt financial institutions.  Regulations are based on actual abuses and now are being eliminated in a secretive way.  There are supposed to be hearings on such matters.

103. Republicans Hate ObamaCare: Why?

28 Apr

“Insurance companies must use more of the premiums they receive for patient care rather than administrative costs…” (see reference below)

As I watched a number of news programs, it became apparent that commentators were not fully aware of the ACA (ObamaCare) provisions, or for whatever reason, ignored some of the most important points.

I am already familiar with most of the significant features, but I decided to search for a good summary. Here is one that is very useful and authoritative by Norma Goodwin, MD:
12 Simply Stated Features of the Affordable Care Act/Obamacare
The above (beginning) quotation is from this very useful summary (search Internet for this title). This feature alone, can explain why the GOP wants to abolish the ACA rather than just improve it. Rich insurance company owners don’t want to be limited in their lust for profits.

There are a few additional points that I would like to emphasize. There is much discussion about “pre-existing conditions.” But often overlooked are many other features that are critical (life-and-death) for good heath care. These include:

1. Eliminates annual and lifetime insurance policy limits.  Many people have died because their insurance money ran out.
2. Parent insurance coverage for offspring up to the age 26.
3. Medicaid is supported, but some states have refused to accept the free financial support.
4. Medicare is protected and now many preventive screenings are included.
5. Costs for vital medications are reduced.
6. Other provisions of the ACA are designed to lower the general cost of health care, and improve the quality of care.

The ACA is not perfect, but includes many great ideas. Keeping it will insure that the people will be well taken care of. New plans by the GOP will eliminate many more citizens from insurance coverage, decrease the quality of care, and will insure that rich insurance company owners will become even richer. Hopefully, some day we will have a “single payer” system, a Medicare for all.

100. Basic Causes of Greatest Concern

10 Mar

In my 100 blogs to date, I have tried to cover important governmental, social, medical, and related issues, that profoundly affect our way of life. In this, my 100th blog, I will list some of our most significant current issues, and maybe some possible solutions. I know that my blogs are sometimes imperfect and not very original, but my purpose is to increase the number of voices urging important changes and understanding. So here is a list of ideas to emphasize:

Our American founding fathers when creating the Constitution and other rules, were afraid of the kind of populism that we see today. So they tried to move important decisions away from the ordinary citizens and towards more responsible and intelligent leaders. Here are two examples supporting this lack of trust:
1. The establishment of an electoral college, to prevent direct citizen voting.
2. Until 1913, senators were elected by state legislatures, and not the people.
The founding fathers were afraid that ordinary people could be scammed by unscrupulous politicians. They anticipated someone like our current President.

Societies that over emphasize capitalism and the importance of financial success, foster corruption so that clever manipulators accumulate vast wealth, much of which belongs to the people. It is apparent that anyone (or party) in office for a long time will drift away from the people’s needs and develop methods for increasing their wealth. These methods include donating to Congressmen who will legislate tax loopholes and unfair subsidies.

An age requirement for U.S. President is not enough. Tax returns must be required and other financial and business details provided. It is too easy for very rich people, once in office, to make decisions best for their businesses and not for the country. A notable example is the transport minister for Azerbaijan, formerly a part of the Soviet Union. His covert construction contracting, participation in money laundering schemes, and wide-ranging contacts made him extremely rich at the expense of the citizens.

Corruption and unjustified accumulation of wealth, is not limited to politicians. Almost every vital service needed by the people, such as healthcare, education, and insurance, has cheated the citizens and made administrators (and others) hugely wealthy. Many of these rich people donate to Congress and through resulting legislation, make themselves even richer. Donations to congressmen has shifted vast amounts of money away from ordinary citizens, to undeserving administrators (making many millions of dollars). For example, median total compensation for ceos of major teaching non-profit hospitals is 1.35 million. Many make much more. Is it right that many millions of dollars are given to hospital administrators while poor people are being rejected (even die) for lack of insurance? Important services should be provided by the government at little or no cost. I feel that administrators and certain others should be allowed to become somewhat rich, but not extremely so.

Clarification: All “Western” or developed countries are a combination of capitalism with some socialistic features. Pure capitalism allows the unlimited accumulation of wealth with no financial protections for the citizens. Pure socialism is an economy totally controlled and owned by the state. In the USA (and many other major countries) capitalism is primary, and there are “social programs” in areas such as healthcare, education, and supporting the poor. Shifting some funds from the very rich to the very poor through taxation changes and programs like Medicaid is not “socialism,” it is simply the addition of a “social program.”

Last but not least, is the unethical and self-serving practices of many doctors, dentists, and other healthcare practitioners. Diagnoses and treatments are often are more determined by cash-flow than by what is most beneficial for the patient. Here are some examples. In the area of severe back-pain, diagnosis is usually a defect in the spine, and the possibility of simple excessive muscle strain and tension is ignored. Procedures for spinal defects are very expensive whereas procedures for muscle tension simply involve (at no cost) frequent muscle stretching. Here is an example from dentistry. Several years ago, my teeth would develop a dark blue hue, which could be removed by a professional teeth cleaning. Two dentists I went to urged me to double my teeth cleaning sessions, and spent little effort in trying to determine the cause. Fortunately, I was able to figure this out myself, and saved a lot of expense. The blue colored mouthwash I was using, dyed the teeth, and there was even a warning on the label. I could provide a lot of other personal examples, and many are described in previous blogs. An excellent book on this subject is “Confessions of a Medical Heretic”, 1979, by Robert Mendelsohn, MD. This is an old book, but still very applicable to many current physicians (but definitely not all).

Is there a quick fix for all of the forementioned issues? No, but major efforts to improve education could be transformative. Knowledge is important, but developing an ability to reason and research is even more relevant. Still, I have a sneaking suspicion that our current administration would fear a well-informed electorate.