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Tag: Politics

A War on Science is a War on Us

By KIM BELLARD

We’re in the midst of a major U.S. election, as well as hearings on a Supreme Court vacancy, so people are thinking about litmus tests and single issue voters – the most typical of which is whether someone is “pro-life” or “pro-choice.”  Well, I’m a single issue person too; my litmus test is whether someone believes in evolution. 

I’m pro-science, and these are scary times.

Within the last week there have been editorials in Scientific American, The New England Journal of Medicine, and Nature – all respected, normally nonpartisan, scientific publications – taking the current Administration to task for its coronavirus response.   Each, in its own way, accuses the Administration of letting politics, not science, drive its response. 

SA urges voters to “think about voting to protect science instead of destroying it.”  They cite, among other examples, Columbia Law School’s Silencing Science Tracker, which “tracks government attempts to restrict or prohibit scientific research, education or discussion, or the publication or use of scientific information, since the November 2016 election.”  Their count is over 450 by now, across a broad range of topics in numerous federal agencies on a variety of topics.   

The SA authors declare:

Science, built on facts and evidence-based analysis, is fundamental to a safe and fair America. Upholding science is not a Democratic or Republican issue.

Similarly, NEJM fears:

Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.

Jeff Tollefson, in Nature, warns:

As he seeks re-election on 3 November, Trump’s actions in the face of COVID-19 are just one example of the damage he has inflicted on science and its institutions over the past four years, with repercussions for lives and livelihoods. 

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Talking Politics in the Exam Room: A Physician’s Obligation to Discuss the Political Ramifications of Science with Patients

By HAYWARD ZWERLING

I walked into my exam room to see a patient I first met two decades ago. On presentation, his co-morbidities included poorly controlled DM-1, hypertension, hyperlipidemia, and a substance abuse disorder. Over the years our healthcare system has served him well as he has remained free of diabetic complications and now leads a productive life. Watching this transformation has been both professionally rewarding, personally enjoyable, and I look forward to our periodic interactions.

At this visit, he was sporting a MAGA hat. I was confused. How can my patient, who has so clearly benefited from America’s healthcare system, support a politician who has tried to abolish the Affordable Care Act, used the bully pulpit to undermine America’s public health experts, refused to implement healthcare policies which would mitigate COVID-19’s morbidity and mortality, and who minimizes the severity of the coronavirus pandemic every day. Why does he support a politician whose healthcare policies are an immediate threat to his health and longevity?

My brain says, “You are the physician this patient trusts to take care of his medical problems. You must teach him that COVID-19 is a serious risk to his health and explain how the President’s public health policies threatens his health. You must engage in a political conversation.”

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Trump’s “Compstockery!”

By MIKE MAGEE

As we witnessed in last week’s Republication convention, when in doubt, go with the golden oldies. Australian songwriter Peter Allen said as much in the fourth stanza of his classic song, “Everything Old Is New Again”, which reads:

“Don’t throw the past away

You might need it some rainy day

Dreams can come true again

When everything old is new again”

In fact, there’s nothing original in Trump’s playbook, and that includes his postal service gambit. Manipulating and militarizing the US Postal Service dates back to 1873 in the form of one Anthony Comstock, a zealot who was fond of describing himself as a “weeder in God’s garden.”

A savvy New York City insider, he created the New York Society for the Suppression of Vice declaring himself committed to stamping out smut. But to accomplish this task, he needed a hammer. He turned to political allies in the United States Postal Service who provided him with police powers and the right to carry a weapon.

Still, the weapon was of little use without a law to enforce. So he turned to his friends in industry who reached out to Congress.  “An Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles of Immoral Use” was passed on March 3, 1873, ch. 258, § 2, 17 Stat. 599. Forever after known as the Comstock Law, the statute’s lofty intent was “to prevent the mails from being used to corrupt the public morals.”

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The 2020 Pandemic Election

The 2020 US election will be vicious, with a nasty pandemonium following a nasty pandemic.

By SAURABH JHA, MD

When the COVID-19 pandemic is dissected in the 2020 presidential election debates, Donald Trump will be at a disadvantage. The coronavirus has killed over 100,000 Americans and maimed thousands more. The caveat is that deaths per capita, rather than total deaths, better measure national failure, and by that metric the US fares better than Belgium, Italy and the United Kingdom. New York City owns a disproportionate share of the deaths, but this hyperconnected megapolis is an outlier whose misfortunes can’t be used to draw conclusions about administrative competence for the country as a whole.

Nevertheless, even after introducing nuance, the numbers aren’t flattering. President Donald Trump may claim that the US dodged the calamity predicted by the epidemiological models, which foretold millions of deaths. To be fair, we don’t know the counterfactual — Jeremiads aren’t verifiable. The paradox of successful mitigation is that we can’t see the future we dodged, precisely because we avoided it.

Reducing the death count logarithmically, rather than merely arithmetically, won’t be celebrated because as bad as the worst case scenario could have been, the situation still looks awfully bad. Many still disbelieve the high death toll predicted by epidemiologists early on, particularly Trump supporters who believe the response to the virus, specifically the economic shutdown, has been criminally disproportionate. One can’t simultaneously believe that COVID-19 is no more dangerous than the seasonal flu and that Trump saved millions from the coronavirus. The constituency that acknowledges the lethality of COVID-19 and credits Trump for decisive action against it is small.

Triangle of Incompetence

Trump’s challenger, former Vice President Joe Biden, will charge that fewer Americans would have died had the Trump administration acted earlier. Trump may be accused of having blood on his hands, but such rhetoric is unnecessary. Biden’s team can simply show a montage of Trump’s bombast where he downplayed COVID-19’s lethality, dismissed doctors’ concerns about the shortage of personal protective equipment or exaggerated how well the US was containing the pandemic. Incidentally, the most iconic picture of the administration’s scornful indifference is the current vice president, Michael Pence, visiting a hospital without a mask, surrounded by health-care workers wearing masks.

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We Can’t Breathe

By KIM BELLARD

I was wondering what might crowd COVID-19 off the news.  The historic economic devastation caused by it has been subsumed into it, just another casualty of the pandemic.  In better times, perhaps SpaceX’s efforts would inspire us.  But, no, it took the police killing of yet another person of color to take our attention away.  

Now, let me say right off that I am not the best person to discuss George Floyd’s death and the woeful pattern it is part of.  I have certainly been the beneficiary of white male privilege.  I’ve never been unjustly pulled over or arrested.  I haven’t taken part in the protests.  But people like me need to speak out.  Writing about anything else right now seems almost irresponsible.  

OK: you’ve seen the video. You’ve heard Mr. Floyd protest that he can’t breathe, that the officer was killing him.  You’ve seen other officers stand by and not do anything — some even assisting — even as bystanders pleaded for them to let Mr. Floyd breathe.  It’s disturbing, it’s distressing, and it’s nothing new.  

I saw a video from one of the resulting protests where another officer restrained a protester — a black man, of course — in exactly the same way, although in this case another officer eventually moved the officer’s knee off the protester’s neck.  He’d learned what that video looked like.

There now have been protests in over 140 U.S. cities, with the National Guard mobilized in almost half the states.  Most protests have been peaceful, but there has been looting and there have been shootings. It’s a level of civil unrest not seen since the 1960’s.

And we thought it was bad when we just wanted the grocery stores to have toilet paper again, when wearing a mask was considered a hardship.

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Liberal Elite More Deadly Than Coronavirus

By MIKE PAPPAS, MD

As the coronavirus pandemic spreads, millionaires and billionaires, who have been key to oppressing the working class, are trying to position themselves as everyday Americans. We need to understand them for what they are: beneficiaries and key supporters of the capitalist system that helped create this crisis.

My name is Mike. I’m a physician in NYC working on the front lines of the coronavirus pandemic. I’m also a socialist and member of Left Voice.

It was recently reported that a 17-year-old boy in Lancaster, California died suddenly, likely of coronavirus. The boy, who had no previous health conditions, was sick for only a few days. On Friday he was healthy and by Wednesday he was dead. On Wednesday, he went to urgent care as he was not feeling well, but since he had no health insurance, the urgent care center declined to treat him. He was directed to transfer to a nearby hospital, but en route, he went into cardiac arrest. He arrived at the nearby hospital, was revived, but died hours later.

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Understanding #Medicare4All & the Democratic Primaries

By MATTHEW HOLT

Since Saturday’s Nevada primaries, confusion seems to be reigning about how Bernie Sanders seems to be winning. Time (and not a lot more of it) will tell who actually ends up as the Democratic nominee. But the progressive side (Bernie + Warren) is doing much better than the moderate side (Biden/Butt-edge-edge/Klobuchar) expected, while we wait to see how the  Republican side of the Democratic primary (Bloomberg) does in an actual vote. The key here is the main policy differential between the two sides, Medicare For All.

Don’t get too hung up in the details of the individual plans, especially as revealing said details may have hurt Elizabeth Warren. But do remember that there is one big difference between Sanders/Warren and the moderates. It comes down to whether everyone is in the same state-run single payer system (a modified and expanded version of Medicare) or whether the private employer system is left as it is, with expanded access to something that looks like Medicare (the public option) for everyone else. Note that no Democrat wants to stand pat on Obamacare “as is”. Everyone is way to the left of what Obama ran on in 2008 (or at least what he settled for in early 2009).

Why has this changed? Well there’s been a decade of horror stories. I’m not talking about the BS anti-Obamacare stories from people forced to give up their junk insurance, I’m talking about people with insurance being bankrupted or put through horrendous experiences, like this mother who was put through the ringer by various insurers when her 1 year old son was killed and husband injured in a road accident. Or this health tech CEO, who was an MD & JD and had to put $62,000 on his American Express card to get surgery

About 3 years ago as the dust was clearing from the Obamacare implementation, the impact of this started showing up in the polls.Continue reading…

Off the Couch, Onto the Stage: My First, Only and Not-So-Great Presidential Debate

DETROIT, MICHIGAN – JULY 31: Democratic presidential candidate former Vice President Joe Biden (C) speaks while Sen. Kamala Harris (D-CA) (R) and Sen. Cory Booker (D-NJ) listen during the Democratic Presidential Debate at the Fox Theatre July 31,
GETTY IMAGES

By MICHAEL MILLENSON

I could’ve been Kamala Harris, Joe Biden and Marianne Williamson all rolled into one. That’s how I might have handled my first, only, and not-so-great presidential debate. 

No, I wasn’t actually running for president. But I was involved in the campaign of someone who was: Barack Obama. In September, 2008, the campaign asked me to serve as a surrogate in a debate with John McCain’s health care adviser when one of Obama’s close advisers – as opposed to me, who’d met the candidate once at a campaign event – couldn’t make it. 

As a policy wonk and politics junkie, I was ecstatic. Entering the debate, I was confident. Afterwards, metaphorically dusting the dirt off my clothing and checking for cuts and bruises, I was chastened. 

Getting off the couch and onto the stage, even a small one, is tougher than it looks. Watching the cluster of Democratic presidential candidates go at it on health care, I scoffed and sneered along with other experts at their obfuscations and oversimplifications. (More on that in a moment.)  But I also sympathized. 

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Doctors Will Vote With Their Patients

By MIKE MAGEE, MD

As Robert Muller’s testimony before Congress made clear, we owe President Trump a debt of gratitude on two counts. First, his unlawful and predatory actions have clearly exposed the fault lines in our still young Democracy. As the Founders well realized, the road would be rocky on our way to “a more perfect union”, and checks and balances would, sooner or later, be counter-checked and thrown out of balance.

On the second count, Trump has most effectively revealed weaknesses that are neither structural nor easily repaired with the wave of the wand. Those weaknesses are cultural and deeply embedded in a portion of our citizenry. The weakness he has so easily exposed is within us. It is reflected in our stubborn embrace of prejudice, our tolerance of family separations at the border, our penchant for violence and romanticism of firearms, our suspicion of “good government”, and –unlike any other developed nation – our historic desire to withhold access to health services to our fellow Americans.

In the dust-up that followed the New York Times publication of Ross Douthat’s May 16, 2017 article, “The 25th Amendment Solution for Removing Trump”, Dahlia Lithwick wrote in SLATE, “Donald Trump isn’t the disease that plagues modern America, he’s the symptom. Let’s stop calling it a disability and call it what it is: What we are now.”

Recently a long-time health advocate from California told me she did not believe that the majority of doctors would support a universal health care system in some form due to their conservative bend. I disagreed.

It is true that, to become a physician involves significant investment of time and effort, and deferring a decade worth of earnings to pursue a training program that, at times, resembles war-zone conditions can create an ultra-focus on future earnings. But it is also true that these individuals, increasingly salaried and employed within organizations struggling to improve their collective performance, deliver (most of the time) three critical virtues in our society.

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Is “Medicare For All (Who Want it)” Enough?

By MIKE MAGEE

In the 2nd night of the Democratic Primary debate on June 27, 2019, Pete Buttigieg was asked whether he supported Medicare-For-All. He responded, “I support Medicare for all who want it.” 

In doing so, he side-stepped the controversial debate over shifts of power from states to the federal government, and trusted that logic would eventually prevail over a collusive Medical-Industrial Complex with an iron lock grip on a system that deals everyone imaginable in on the sickness profitability curve – except the patient.

On July 30, 1965, President Lyndon B. Johnson signed into law “Medicare,” a national insurance plan for all Americans over 65. He did so in front of former President Truman, who 20 years earlier had proposed a national health plan for all Americans, and for his trouble was labeled by the AMA as the future father of “socialized medicine.”

For Truman, there was a double irony that day in 1965. First of all, the signing was occurring at around the same time as our neighbor to the north was signing their own national health plan, also called “Medicare”, but their’s covered all Canadian citizens, not just the elderly.

The second incongruity was that Truman was fully aware that in 1945, as he was being tarred and feathered as unpatriotic by taxpayers for having the gall to suggest that health care was a human right, those very same citizens were unknowingly funding the creation of national health plans as democracy stabilizers in our two primary vanquished enemies – Germany and Japan – as part of the US taxpayer funded Marshall Plan.

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