Culp was Culpable…..and not very good at his job

Our Republican candidate for governor loses job. He hasn’t been there for months– used annual leave and leave of absence.

Not a good candidate IMHO.

Medicynical note: He hasn’t worked for months (annual leave and leave of absence). The community learned they didn’t need a sheriff in this one police officer (him) town.

In addition he wasn’t a good sheriff. He mishandled a rape case– not believing the victim. The rapist was later convicted. He also refused to enforce a gun control law that was passed by the state legislature and public referendum because …….you know, he didn’t agree with it. He also ran on the notion that attempting to control a pandemic was an infringement of his “right” to infect others.

Republicans lost by a 60-40% landslide.

Trump’s Failures

The COVID pandemic is raging in the U.S. and Trump thinks he handled it perfectly. His low standards is literally killing us.

Medicynical Note: Benign neglect is Trump’s approach and it has resulted in thousands of deaths. His fear of failure, his remarkably short attention span and his obvious intellectual shortcomings have contributed to the fiasco.

Sadly Covid Kills…..Republicans too

It’s a sometimes fatal disease.

“David Andahl, a Republican candidate for the North Dakota state legislature, won election on Tuesday, but the 55 year old won’t be taking office. Unfortunately, Andahl died of the coronavirus last month.”

“Andahl, who was known as a “Trump Republican,” died of covid on October 5, according a report last month in the Bismark Tribune. Mail-in voting started on September 24, which meant that ballots in the central North Dakota district couldn’t be changed under state law.”

Medicynical note: one of 230,000 COVID deaths that Trump supporters ignore presumably because of the “economy.”

Why? I don’t know. But as I’ve said before money makes people do funny things.

Health Care– America’s Shame (And I’m not talking about COVID)

A patient with a relatively minor surgical problem learns that the system is not design to offer value. She thought she was quoted an exact price for a surgical procedure.

“Because Qiu thought she was getting a deal on her usual 30% share of the bill, she decided to go ahead with the polyp removal on Nov. 5, 2019. As she sat in the waiting room filling out forms, staffers let her know she needed to pay in full before the surgery.”

Then came the actual bills

“Palomar Health billed Blue Shield $22,219.64 for the polyp removal, which the insurer negotiated down to $8,576.79. Blue Shield paid $5,769.72 and stated in an explanation of benefits document that Qiu was responsible for a $334.32 deductible and $2,472.75 coinsurance.”

“Because Qiu had already paid $1,873.20 on the day of surgery, the hospital billed her an additional $933.87, which meant Qiu was on the hook for the remainder of her 30% coinsurance.”

“These figures don’t include the fees Qiu paid for anesthesia or her doctor’s services.”

Medicynical note: What’s pathetic about our system of revenue production, sometimes known as healthcare in the United States is that it’s designed to maximize costs…….not quality of care.

The simple fact that a hospital staffer misinformed a patient isn’t a legal reason to force a hospital to lower a bill, Brousse said.”

“Initial estimated bills can be full of asterisks and “weasel words,” said Akshay Gupta, co-founder of CoPatient, a medical bill review and patient advocacy company.”

“”Even though she tried to be diligent, obviously she still didn’t know that she would need to get something that was legally enforceable,” said Gupta.”

So at one of the most vulnerable times in a person’s life the U.S. medical system of revenue production kicks in with a price that isn’t a price, excessive billing, and obfuscation that would embarrass a used car salesman (with apologies).

The CDC….Another Trump Disgrace

The CDC has been neutered, shamed, and blamed amid the novel coronavirus pandemic and global crisis. From internal missteps that bungled the country’s rollout of diagnostic testing to blatant political interference and strong-arming on critical public health guidance, the CDC has gone from the world’s premier public health agency to a silenced, overridden, distrusted afterthought in the US response—an agency stripped of its ability to collect even basic health data from hospitals during a raging pandemic.”

Medicynical note: A beloved institution trashed by Trump and his misfits. Once the authoritative epidemiology in the world now the tool of an incompetent Presidency. It will take years to fix……if a competent government follows Trump.

COVID:What Went Wrong–EVERYTHING

In many states the response to the COVID outbreak mirrors that of Trump’s government, I.e. chaotic and incompetent

“As the government shifted its coronavirus reporting system, numbers have vanished from CDC Web pages. News organizations have had to sue for information about racial disparities in deaths. In many Florida counties, officials won’t tell parents whether there are coronavirus cases at their children’s schools.”

“Iowa is no exception. The state has refused to release its pandemic plan, which guides its response to the coronavirus, saying the document is “confidential.” The health department’s covid-19 dashboard doesn’t list hospitalizations among health care workers or outbreaks in congregate facilities such as homeless shelters and prisons.””

“In July, state auditor Rob Sand said Iowa’s system for reporting test results was rife with “illegal and unbusinesslike practices, inefficiencies, and apparently pointless risks.” He criticized Iowa’s use of medical privacy laws to justify its secrecy.”

Medicynical note : Delay and obfuscate seems to be Iowa’s policy. “

It wasn’t until May 5, more than seven weeks after the first Postville cases were diagnosed and 15 days after Agri Star requested help, that a state testing strike force finally came to the plant. Over 450 workers were tested for current and past infections.”

“Iowa did not make the results of that event public, and Guerrero said the state provided no interpretation when it sent the company its lab report.”

People are dying and some are playing politics.

Vaccines– game plans for now

We now have the official clinical trial designs for the three biggest and most advanced coronavirus vaccine trials: Moderna, Pfizer/BioNTech and Oxford/AstraZeneca. Now, as for you, J&J, Novavax, Merck, and all the others that are pushing into efficacy trials as fast as possible – don’t think for a moment that you won’t be expected to do the same. But this is a good start. So how do these trials differ?”

“Let’s start off with some background, starting with “vaccine efficacy” (VE), which is pretty much what it sounds like: the percentage difference of infection by the virus between the vaccinated group and the unvaccinated control group. The FDA has already said that they want to see 50% at least (i.e., the vaccine cuts the rate of coronavirus infection at least in half). All of these trials have different subgroups, especially broken out by age and/or pre-existing conditions, and there will be not only an overall VE for the trial but separate VEs determined for all of the predefined subgroups. As is standard, the trials will be using what’s called a Cox proportional hazard regression model to assess the differences between the various groups – I won’t go into the details here, but that’s how you get the eventual figures of “Group A is 2.1x less likely to get infected than Group B” and so on. The Cox model actually gives you the “hazard ratio” (HR) which is just the opposite of the VE, so a 60% HR would mean a 40% VE.”

Medicynical note: the companies’ plans sound fine if they stick to them. The Russians And Chinese are prematurely, IMHO, marketing their not fully tested vaccines around the world. Their reach may be making these companies nervous as does the ignorant political prodding from Trump.

Guns, Racism and Greed……the Downfall of America

And hovering above the violence in our country is the false prophet lure of so called “2nd amendment rights.” Unlimited weapons in a once civil culture has led to a degradation of order; of increased threats to minorities; to increased threats to police; and ultimately will lead to the end of that once civil society.

I don’t understand the sirens call of unlimited access to weapons of mass death in our culture. It leads nowhere good.

Our enemies around the world are delighted by our unique chaos–not seen in any other industrialized country. Gun manufacturers are delighted and shamelessly profit. Immature militant sycophants march around with assault weapons on all sides of the culture war and end up killing innocents and not so innocents to what end? Our police are fearful and as a result often over-react putting themselves and others in jeopardy.

In other cultures with stricter gun laws it is a rare once a year or every few years event that a police officer is killed in the line of duty or kills a suspect. Is there a lesson we can learn or have we permanently lost our collective minds.

Trump and The Russians

The Russian campaign for President…….of the United States……….becomes clear.

“Over all, the Senate report was a bipartisan endorsement of the finding that Russia tried to intervene in 2016 on behalf of Mr. Trump’s election and that the campaign welcomed the assistance. It also hinted that Mr. Manafort may have known about the Russian efforts to hack Democratic emails and dump them into the public sphere, as it did through WikiLeaks.”

Medicynical note: During these four years the U.S. has abdicated its leadership role in the Middle East, torn apart NATO, fatally bungled the public health response to a pandemic, created the largest peacetime federal budget deficit in history (before and after the pandemic started), created an immigration crisis that undermines America’s reputation as a nation of immigrants, and destroyed overseas markets for U.S. agriculture.

And while doing so Trump repeatedly kowtowed to Putin, his idol. All so that Trump can build a Trump hotel in Moscow.

Actions Have Consequences…….Iran

Trump-think………he doesn’t.

“The United States argues that even though it has left the nuclear deal, it retains the right as an original “JCPOA participant” to trigger the “snapback” of sanctions over any issue that violates the agreement, even though it no longer is a participant in it.”

Medicynical note: The U.S. abrogated, i.e. dropped out of the Iran nuclear treaty three years ago and in doing so unilaterally broke from the agreement with its actions . We now want to claim we have the authority to impose more restrictive sanctions to be implemented by all the signers of the treaty– all of whom have continued supporting the treaty.

In the U.N. Security Council vote only the Dominican Republic sided with the U.S. All others either opposed the U.S. action or abstained. Under Trump we went from a united front with Russia, China and our NATO allies to now being isolated with the D.R. Well done Donald.