China– We (the U.S.) Have No Long Term Strategy

“Washington bears much of the responsibility for what has happened. In the years after the Tiananmen Square massacre in 1989, administrations of both parties touted the absurd theory that the best plan was to let China get rich and then watch as freedom and democracy evolved as byproducts of capitalist development.”

“But did capitalist competition, that ravenous machine that can chew up anything, change China? The regime’s politics did not change a whit. What did change was the US, whose business leaders now approached the Chinese dictatorship with obsequious smiles. Here, after all, was an exciting new business partner: master of a realm in which there were virtually no labour rights or health and safety regulations, no frustrating delays because of squabbles between political parties, no criticism from free media, and no danger of judgment by independent courts. For European and US companies doing manufacture for export, it was a dream come true.”

Medicynical note: The problem the U.S. faces is that China’s leadership is smarter at every level of government than ours. Trump is inexperienced, has no strategy and has only a very limited repertoire of responses.

Trump and The United States Are Failing

Despite ample warning, the U.S. squandered every possible opportunity to control the coronavirus. And despite its considerable advantages—immense resources, biomedical might, scientific expertise—it floundered. While countries as different as South Korea, Thailand, Iceland, Slovakia, and Australia acted decisively to bend the curve of infections downward, the U.S. achieved merely a plateau in the spring, which changed to an appalling upward slope in the summer. “The U.S. fundamentally failed in ways that were worse than I ever could have imagined,” Julia Marcus, an infectious-disease epidemiologist at Harvard Medical School, told me.”


“Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.”

Medicynical note: The Soviet Union failed because,in part, of U.S. economic and military policies in the 70s and 80s. The US is failing now because of money driven healthcare non-system and an incompetent administration elected (in part) because of Russian assistance in the last election. Trump has bungled the response to the pandemic.

The Bad Joke of American Healthcare

American healthcare in a nutshell.

“Mr. Aita, who lost his job at a record store at the start of the pandemic and is uninsured, received a document at the end of his visit estimating he would owe $1,157. If the hospital had tested him for coronavirus, the federal fund could have covered the visit entirely.”

“Last week, he received a medical bill for the visit that was only $350. He initially thought this was good news — that the hospital had dropped his charge. But when he looked into the issue, he learned this was an additional charge from the doctor who saw him.”

“I understood that if it was related to Covid, it would be taken care of,” Mr. Aita said. “It’s a pandemic, I’m unemployed, and now I’m dealing with the stress of this situation.”

Medicynical note: the design of the American non-healthcare system is elegant. From its lack of disclosure of prices to the multi tier pricing (whatever the market will bear), to the oh so clever linking of coverage to employment and finally to the cynical price gouging patients with the most serious illnesses.

To clarify, by linking health insurance to work insurers have a sure fire mechanism of cleansing their beneficiaries. Those that cost the insurer the most are automatically eased out of insurer’s liability by them having to stop working when they become ill.

In reality what our system does best is collect revenue. Healthcare? Patient outcomes? Not really the primary concerns.

Obamacare (the affordable Care Act) tried to correct some of these distortions but the REPUBLICANS AND TRUMP have diligently worked to undermine its’ benefits and maintain our grotesque triad of ineffectiveness — 1. millions uninsured, 2. the most expensive health care in the world–by far, and 3. mediocre quality care.

That’s America in the 21st century, a fading, mediocre world power with a government that really really really doesn’t want to be responsible……….for anything. VOTE.

Chaos……the Trump touch

Covid-19 Coverage

  • “As COVID-19 hospitalizations in the US approach the highest levels seen in the pandemic so far, national efforts to track patients and hospital resources remain in shambles after the federal government abruptly seized control of data collection earlier this month.”

Medicyical note: Incompetence at every level of the executive branch. If Trump involves himself you can be sure the outcome will be incoherent, dishonest and self-serving. Over 150,000 dead.

He’s Literally Killing Us– Trump’s Fatal Errors

“The current U.S. outbreak is especially stark when compared to other large, high-income countries. All have few cases today compared to the United States.”

Medicynical note: Trumps ignorance has been on parade for months. His refused to listen to and follow informed medical advice. He actively undermined informed medical policy. He proudly hired and promoted the unqualified. Meanwhile people who should have known better in the Republican Party showed sheep-like obeisance as this stupid man undermined American democracy in four short years. And it’s sad to me that the best the other side can do is a geriatric placeholder who without question will be an improvement but who also does not inspire great confidence in the future.

Were the ideals of the postwar generation and after a mirage? I’m beginning to think so.

Bad Management– The Trump Downfall……again

“But their ultimate goal was to shift responsibility for leading the fight against the pandemic from the White House to the states. They referred to this as “state authority handoff,” and it was at the heart of what would become at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations.” (emphasis Medicynic)

It’s worse then that because after the “handoff” the president and his feckless vice president actively undermined the states’ public health messages.  Think of that our government at war with………itself.

Screen Shot 2020-07-19 at 7.49.20 AMMedicynical note:  Trump’s instinct is to first engage in magical thinking and when that doesn’t work blame somebody, anybody at all, else.  His scapegoats so far are an honor roll of competent people and organizations who were right. 

Trump’s campaign slogan should rightfully include “the worst ever.”

They were wrong……and I don’t mean Dr. Fauci

Ignored experts.  Crippled the CDC.  Politicians in charge of pandemic response.  What in the world could possibly happen?

“President Trump and his top aides decided to shift primary responsibility for the coronavirus response to the states during a critical period of weeks in mid-April, eagerly seizing on overly optimistic predictions that the pandemic was fading so the president could reopen the economy and focus on his re-election, a Times investigation found.”

“The investigation revealed that key decisions about the handling of the virus during that crucial period were made not by the better known coronavirus task force, but by a small group of White House aides who convened each morning in the office of Mark Meadows, the president’s chief of staff.”

“One of their goals: to justify declaring victory in the fight against the virus. In that effort they frequently sought validation from Dr. Deborah L. Birx, a highly regarded infectious diseases expert, who was the chief evangelist in the West Wing for the idea that infections had peaked and the virus was fading quickly.”

Screen Shot 2020-07-18 at 1.15.30 PM

Medicynical Note:  With the best experts in the world at his disposal what does Trump do?  He ignores warnings from the previous administration. He stops funding the pandemic response team.  He cuts funding to the CDC and WHO.  He ignores the advice of international experts and our own U.S. based experienced epidemiologists and scientists.  He engages in magic thinking–it will go away like a miracle.  And wouldn’t you know he selects the least competent to provide advice–Jared, Navarro, Azar and yes Birx (to be clear Birx is probably a competent self-promoting medical bureaucrat but appears by all the information available to be an incompetent inexperienced epidemiologist).

Bad choices and the worst results in the industrialized world.  Trump’s confederacy of dunces.

French Hydroxychloroqin Study Invalid

In particular, he condemns the decision by Raoult’s team to exclude from the study’s final results six patients who took hydroxychloroquine, including four whose condition worsened, one of whom eventually died during the study period (none in the control group died). There were also other inconsistencies, such as supplemental material mentioning that a number of asymptomatic patients were included for study while the study’s actual language claimed that it was an examination of hospitalized patients (people without symptoms are unlikely to have been hospitalized for covid-19).”

Medicynical note: Trump’s favorite study was crap…… fitting.

Human Life vs Money? In the U.S. Money Wins……….Every Time

Late last month, Carsyn Leigh Davis turned 17 in an intensive care unit bed in Naples, Florida. Two days later, at 1:06 p.m. on June 23, she died at a children’s hospital across the state, in Miami, where she’d been transferred for last-ditch “heroic efforts” at saving her life. She was the latest of 3,281 deaths in the state from Covid-19 at the time; as I write this, less than two weeks later, the toll is now 3,841.”

Medicynical note: Over 130,000 have died, with several hundred more dying each day. Our president is out playing golf or over-ruling his experts. The U.S. is like no other place, ignorance rules and money wins…..

Whoops…..Asleep at the Wheel, Again

Since at least February, and possibly as early as March 2019, the United States has had compelling intelligence that a committed adversary, Russia, paid bounties to Taliban-linked fighters to kill American troops in Afghanistan. American service members were reportedly killed as a result.”

“To this day, the president of the United States has done nothing about it.”

Medicynical note: How do you excuse such incompetence. First you deny that there were ever reports on Russian targeting of U.S. servicemen in Afghanistan. If that fails you maintain that if there were reports all of the responsible parties in government didn’t see them or weren’t briefed on them. And then when it turns out they were printed in presidential briefing materials, you say they were never fully proven……all this while the President promoted Russian interests several times…….over U.S. interests. Is this incompetence, Or treason?