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Our Shame

“The Trump administration has identified nearly 500 parents deported from the U.S. without their children, according to a recent court filing in a lawsuit related to family separations at the border. Many were not given the option to reunify with their children.”

Medicynical note: Some day when the Trump era reaches it’s well deserved end it will be known for this. These kids will rival Argentina’s disappeared and in 20 years there will be movies and exposes of the immorality of the United States in the Trump administration.

Nice going.

Here is a remarkable and yet entirely unremarkable story. The Commerce Department announced this morning that the country’s trade deficit last year was the biggest in US history. It’s $891 billion for merchandise, $621 billion when the service sector is added in, and $419 billion with China alone. Each is a record. The Post reports that the overall number tops the previous record of $838 billion in 2006, but it doesn’t seem like those numbers are adjusted for inflation or judged relative to the overall size of the economy. So possibly there should be an asterisk after biggest ever. (This Reuters article says biggest since 2008 when adjusted for inflation.) Still however you slice it, for all President Trump’s yakking and fairly disruptive trade wars, the problem has actually

Honor system and capitalism, really?

“The patent system is often explained as an exchange between inventors and the public. By filing for a patent, the inventor can get a period of exclusivity. In return, the public gets to see how the invention works. This is sometimes called the “patent bargain.” The Theranos story reveals that the system fails to live up to this ideal.”

“Early Theranos skeptics tended to be scientists who had heard the company’s extravagant claims and had asked the obvious question: does the tech really work? In 2014, a pathologist wrote that he was skeptical Theranos was using proprietary technology for many of its tests. Other scientists expressed frustration that Theranos had not shared its methods with the scientific community nor offered any evidence that the methods worked.”

Heartwarming story or grotesque parable? Only in America!

“Farnan met Blaze’s mother at OSF Children’s Hospital and quickly became like family. Blaze’s mom didn’t live near the hospital and couldn’t pay for all the care he needed at home. So, she put her son in the care of a trustworthy person – his nurse.

“The good Lord put us where we are for a reason,” Farnan said. She and her husband took Blaze into their home and gave him the intensive care he needed.

The day of his second surgery in March 2018, Blaze’s mother asked Farnan if she and her husband would consider officially adopting her son.”

Medicynical note: The U.S. stands alone in the industrialized world. Only here would a woman have to give up a child because she could not afford the necessary healthcare. But then again we are the only country that separates asylum seeking parents from their children and then professes no responsibility to reunite them.

In American health care money comes first.

“The rabies immune globulin is a complex product, made from blood plasma donated by volunteers who have been immunized against rabies. Three manufacturers make the product, and there are no shortages right now, the Food and Drug Administration says. Currently, the average wholesale acquisition price — the amount paid by wholesalers that then mark it up when they sell it to distributors or hospitals — is $361.26 per milliliter, according to Richard Evans, a drug industry analyst at SSR Health, part of the boutique investment firm SSR LLC. “

“Using that average, the cost for the 12-milliliter dose Parker received would have been $4,335.”

Medicynical note:  Learning the cost of a service in a hospital is like an adventure in unexplored territory. The best you can do is fumble around and keep asking. More often then not, you will get an estimate which is wildly inaccurate and excessive.

Hospitals seem to have an infinite number of prices for the same service. The most expensive of which is that charged those least able to pay, i.e. the uninsured individual.  In this case the pricing for the medication (rabies immune globulin) was several multiples of the actual cost.  This was added on to ER fees which I presume included the physicians fee and the facility fee.  The insurer, in this case did not have a contract with the facility and was charged significantly more than other insurers but much less than the price quoted originally.

But that of course is the nature of health care in the U.S.  The system is not designed to provide value or even excellent healthcare, but rather to maximize revenue.  In private for-profit companies (as well as most “non-profits” ) the fiduciary responsibility of the company’s management is to maximize revenue and provide profit for stockholders or sponsoring organizations.  As a result we have the most expensive health care in the world with the highest cost/capita, the most bankruptcies from health care costs, and the most uninsured citizens (in an industrialized country).

Krugman

“the U.S. is truly exceptional — that is, it performs exceptionally badly. Americans whose parents have low incomes are more likely to have low incomes themselves, and less likely to make it into the middle or upper class, than their counterparts in other advanced countries. And those who are born affluent are, correspondingly, more likely to keep their status.”

“If Tea Party types got their way, we’d see drastic cuts in Medicaid, food stamps and other programs that aid Americans with low income — which would in many cases leave low-income children with inadequate medical care and nutrition. We’d also see cuts in funding for public education. And on the other end of the scale, we’d see tax cuts that raise the incomes of the wealthy, and the elimination of the estate tax, allowing them to pass all of that money on to their heirs.”

Medicynical note: in case you weren’t sure: “Oligarchy is one of numerous English words for a type of rule or government. Some of these words, such as plutocracy, have an exceedingly similar meaning (both may be used to refer to rule by an economic elite, but oligarchy often has the additional connotation of corruption). “

Sadly this description of a government of, by, and for……money……is accurate.

In the past the 10 oldest presidents were:

Ronald Reagan: 69 years old.

William Henry Harrison:68 years old.

James Buchanan: 65 years old.

George H.W. Bush: 64 years old.

Zachary Taylor: 64 years old.

Dwight D. Eisenhower: 62 years old.

Andrew Jackson: 61 years old.

John Adams: 61 years old.

Reagan as you know suffered early Alzheimer’s disease at the end of his presidency. Harrison died from pneumonia contracted it is thought at his inauguration. And Buchanan was probably the worst president before the current one.

What’s the point of this? The lead republican for 2020 was elected at age 70 and be 74 years at the time of the next election.. Biden will be 78, Sanders will be 79, Clinton will be 73, Warren will be 71.

Our experience with the elderly presidents has been at best mediocre and at worst a disaster. We can and must do better.

Healthcare in the US is an elaborate revenue generating enterprise. Care is a secondary objective.

This from an expat in Taiwan.

“According an American expatriate who shared the story of his ER visit in a Taiwanese hospital, Americans are being taken to the cleaners when we go to the doctor. We live in a country that claims to be the greatest in the world, but where an emergency trip to the hospital can easily bankrupt someone.

Kevin Bozeat had that fact in mind when he fell ill while living in Taiwan and needed to go to the hospital. He didn’t have insurance and he had no idea how much it was going to cost him. He shared the experience in a now-viral Facebook post he called “The Horrors of Socialized Medicine: A first hand experience.”“

After A two year break, not that there is a groundswell of demand, I’m going to restart this site.  My emphasis will be on medical issueS and the US political scene.

While somewhat of a downer this article outlines  the challenges we will be facing as we continue to  denying climate change n theLilliputian trump era.

“Once upon a time in America, we could all argue about whether or not U.S. global power was declining. Now, most observers have little doubt that the end is just a matter of timing and circumstance. Ten years ago, I predicted that, by 2025, it would be all over for American power, a then-controversial comment that’s commonplace today. Under President Donald Trump, the once “indispensable nation” that won World War II and built a new world order has become dispensable indeed.”

“As Washington’s global power fades and its world order weakens, Beijing is working to build a successor system in its own image that would be strikingly different from the present one.”