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You are here: Home / Archives for Healthcare / World's Best Healthcare (If You Can Afford It)

World's Best Healthcare (If You Can Afford It)

The Coming Apocalypse

by Tom Levenson|  November 20, 20205:58 pm| 210 Comments

This post is in: COVID-19 Coronavirus, Open Threads, Republican Stupidity, World's Best Healthcare (If You Can Afford It)

Ed Yong, who has done really excellent work throughout the pandemic, has a tragic, terrifying piece up at The Atlantic just now, “The Hospitals Know What’s Coming.”

The story focuses on one institution, the University of Nebraska Medical Center in Omaha. It’s a major center of excellence, and as Yong reports was uniquely well-placed to deal with an epidemic:

After the SARS outbreak of 2003, its staff began specifically preparing for emerging infections. The center has the nation’s only federal quarantine facility and its largest biocontainment unit, which cared for airlifted Ebola patients in 2014. They had detailed pandemic plans. They ran drills. Ron Klain, who was President Obama’s “Ebola czar” and will be Joe Biden’s chief of staff in the White House, once told me that UNMC is “arguably the best in the country” at handling dangerous and unusual diseases.

But, as Yong meticulously reports, no amount of preparation can overcome a broad-based failure of basic public health measures.

In the past two weeks, the hospital had to convert an entire building into a COVID-19 tower, from the top down. It now has 10 COVID-19 units, each taking up an entire hospital floor. Three of the units provide intensive care to the very sickest people, several of whom die every day. One unit solely provides “comfort care” to COVID-19 patients who are certain to die. “We’ve never had to do anything like this,” Angela Hewlett, the infectious-disease specialist who directs the hospital’s COVID-19 team, told me. “We are on an absolutely catastrophic path.”

The Coming Apocalypse 1

 

That’s just from the top of the story. Read the whole thing–really. There are well-told human stories throughout, and my admiration for and sense of obligation to everyone working on the healthcare front lines of this have ratcheted way up from already high levels.

 

But the incidents and anecdotes are in service of the larger point, which is tragic and utterly infuriating. The conscious and willful failure of leadership that has persuaded so many people to ignore the risk has created the conditions for utter disaster. When–and it doesn’t appear to be an “if”–the disease exceeds hospital systems’ capacity the death toll will accelerate.
This will be bad everywhere, but worse in the places that are now hardest hit: the more rural states with fewer major hospitals to draw upon.
While cities like New York or Boston have many big hospitals that can care for advanced strokes, failing hearts that need mechanical support, and transplanted organs, “in this region, we’re it,” [critical care Dr. Dan] Johnson says. “We provide care that can’t be provided at any other hospital for a 200-mile radius. We’re going to need to decide if we continue to offer that care, or if we admit every single COVID-19 patient who comes through our door.”
Yong concludes his story with the same truth David Anderson keeps drumming into our thick skulls:
 It takes several days for infected people to show symptoms, a dozen more for newly diagnosed cases to wend their way to hospitals, and even more for the sickest of patients to die. These lags mean that the pandemic’s near-term future is always set, baked in by the choices of the past. It means that Ricketts is already too late to stop whatever UNMC will face in the coming weeks (but not too late to spare the hospital further grief next month). It means that some of the people who get infected over Thanksgiving will struggle to enter packed hospitals by the middle of December, and be in the ground by Christmas.
This is what makes this piece both a sober, meticulously reported and heart breaking story, and a call to action. It’s too late to deal with what’s heading at us, what will happen in the latter half of December and beyond remains subject to our choices, good or bad.
.
On that happy note…open thread.
.
Image: Gustave Doré, Jesus healing the sick, before 1883.

The Coming ApocalypsePost + Comments (210)

Friday Evening Open Thread: World’s Best Healthcare (If You Can Afford It)

by Anne Laurie|  October 2, 20206:42 pm| 260 Comments

This post is in: COVID-19 Coronavirus, Open Threads, World's Best Healthcare (If You Can Afford It)

Good thing for him the Oval Office Occupant is on the Gold tier of the public dole…

President Trump has a fever, per a source; and is fatigued and taking an experimental antibody cocktail, per a letter from his physician.

— Jake Tapper (@jaketapper) October 2, 2020

I don’t want him to die (at least not until November 3rd), but the Goddess of Consequences knows he’s earned whatever he’s due to endure.

Also, it looks like the “President’s” physician doesn’t run his own twitter account:

I know we've all become inured to this stuff, but sentiments like these would be much more reassuring from someone who knew how to spell the basic concepts involved. "Asymptotic" is a math term, not virology, and "comorbities" doesn't mean anything. https://t.co/G7hs05bCpm

— David Roberts (@drvox) October 2, 2020

show full post on front page

Instead of listening to Dr. Fauci, @realDonaldTrump went to Jared.🤦‍♀️#TrumpCovid #coronavirus #COVID19 pic.twitter.com/CDF2XgPF19

— Dr. Dena Grayson (@DrDenaGrayson) October 2, 2020

I don’t want the President to get seriously ill because it’s dangerously destabilizing for the country. I aspire to wishing him good health, despite him being historically destructive and evil, but truthfully I struggle with it.

— DebatHat (@Popehat) October 2, 2020

President Woodrow Wilson was afflicted by a massive stroke at the White House 101 years ago today: pic.twitter.com/p7jCZVTOSx

— Michael Beschloss (@BeschlossDC) October 2, 2020

“I don’t wear masks like him," Trump said of Biden during the debate. “Every time you see him, he’s got a mask. He could be speaking 200 feet away from me, and he shows up with the biggest mask I’ve ever seen” https://t.co/Ea0JU36RLm

— The Hollywood Reporter (@THR) October 2, 2020

==========

Trump has tested positive for covid, and now is a good time to practice what I learned as a adult. If you can’t say anything nice, write it down so you don’t forget and tell it to a friend you trust and laugh your ass off.

— John Cole (@Johngcole) October 2, 2020

this is a real dogma-who-finally-caught-the-karma situation

— Matt Haughey ?? (@mathowie) October 2, 2020

this is like pinochet falling out of a helicopter

— kilgore trout, $750 (@KT_So_It_Goes) October 2, 2020

Looks like science voted early.

— The Hoarse Whisperer (@TheRealHoarse) October 2, 2020

October surprise writers studied Chekhov.

— Schooley (@Rschooley) October 2, 2020

i would recommend psalm 109:8 https://t.co/VfRBe5BoDU

— reverend s. pumpkins (@Theophite) October 2, 2020


“Let his days be few, and let another take his office.”

This is one of those crowd-pleasing plot twists you could see coming a mile away, but I’m glad the writers went through with it.

— The Rude Pundit (@rudepundit) October 2, 2020

JUST IN: Putin says that Trump's innate stamina, high spirits and optimism will help him overcome coronavirus

— The Spectator Index (@spectatorindex) October 2, 2020

The good news is this going to be your most liked tweet of all time. https://t.co/4lEXbDcGBG

— Joe Stapleton (@Stapes) October 2, 2020

It is what it is. pic.twitter.com/xfyZLraLz4

— Brian King (@bkbkbk) October 2, 2020

Trump: “I wish I didn’t have to do the next debate” pic.twitter.com/pNDGb6v4vM

— Immaculate Homosexual 🏳️‍🌈🙄 (@SJGrunewald) October 2, 2020

at this rate, we're going to have to break into the strategic thoughts and prayers reserve before the end of the day.

pictured: https://t.co/IhLvCdCFiF pic.twitter.com/EX9XOoZGfO

— GETFUCKINGMADABOUTITmachine (@golikehellmachi) October 2, 2020

Friday Evening Open Thread: World’s Best Healthcare (If You Can Afford It)Post + Comments (260)

The President Announced He’s Signing an Executive Order To Cover Pre-Existing Conditions: If You Think It’s a Joke, You’ve Missed the Point!!

by Adam L Silverman|  August 8, 202012:59 pm| 111 Comments

This post is in: 2020 Elections, America, Domestic Politics, Healthcare, Information Warfare, Open Threads, Politics, Silverman on Security, World's Best Healthcare (If You Can Afford It)

During his press conference yesterday at his golf club, the President announced he’d be signing s series of executive orders (EOs) over the next several weeks. Almost all of these are actions that are outside his authority to take. One in particular, however, has drawn a lot of derision.

#BREAKING: President Trump announces executive order on pre-existing conditions: "I'll be pursuing a major executive order requiring health insurance companies to cover pre-existing conditions for all of its customers." pic.twitter.com/iOQH5kKILg

— The Hill (@thehill) August 8, 2020

It was then trumpeted by several surrogates in both the administration and the campaign:

Huge news just now – @realDonaldTrump announces upcoming EO to cover pre-existing conditions. Big, big, big news.

— Jason Miller (@JasonMillerinDC) August 7, 2020

THIS. IS. LEADERSHIP.@realDonaldTrump just announced that he’s going to sign an upcoming Executive Order to cover pre-existing conditions.

— J. Hogan Gidley (@JHoganGidley) August 8, 2020

The response have ranged from the humorous to the fully sarcastic:

Next up, Donald to announce he’ll extend voting rights to POC… https://t.co/BVzEj8AYl5

— David Cay Johnston (@DavidCayJ) August 8, 2020

You like this? Wait until I tell you what Barack Obama did!

— Janet Johnson (@JJohnsonLaw) August 8, 2020

BREAKING: Trump writes memo about thing that Obama already made law 10 years ago.

— The Hoarse Whisperer (@HoarseWisperer) August 8, 2020

The ACA literally is still the law: right now. It remains the law of the land.

Do I really have to explain basic law to you? https://t.co/TzKfs2tSsn

— Bradley P. Moss (@BradMossEsq) August 8, 2020

This is not a joke, nor should it be treated as one. If you think it is a joke, you’ve missed the point. This, like so many other things I keep pointing out here, is a type of influence operation. What most Americans, even those of us who are hyper-vigilant when it comes to political news and information about health insurance because we’ve got Dave Anderson keeping us informed here every day, either don’t know or don’t remember is that THERE ARE A LOT OF HEALTH INSURANCE PLANS THAT WERE PITCHED AT BOTH TRUMP SUPPORTERS, LOW INFORMATION AMERICANS, AND LESS AFFLUENT AMERICANS THAT DO NOT COVER PRE-EXISTING CONDITIONS!!!!!!!

And the reason that these health care plans exist is because Republican elected officials complained about them not existing from the time the Affordable Care Act, now doing business as ObamaCare, passed. They had a screwy version of them in their nebulous replace plan that they were allegedly going to pass after they passed repeal, which would then, supposedly, force them to actually introduce something that could be called a replacement bill. And they exist because the President signed an executive order allowing for them when the Republican efforts to repeal and replace the ACA failed in 2017.

NOTE: Trump expanded health plans that *exclude coverage for pre-existing conditions*

They are called "short-term" plans but Trump allowed them to be extended for years.

United Healthcare notes these plans *do not have coverage requirements* pic.twitter.com/AzP3aJPVDY

— Steven Dennis (@StevenTDennis) August 8, 2020

Trump has signed an executive order encouraging cheap insurance plans that aren't subject to Obamacare rules: https://t.co/UzzyqJUVYV

— MarketWatch (@MarketWatch) October 12, 2017

President Donald Trump signed an executive order Thursday directing federal agencies to consider expanding health-insurance coverage in low-cost plans that are not subject to Affordable Care Act rules, a move that could raise costs for sicker people.

The order is designed to provide what the White House calls “alternatives” to plans offered through Obamacare markets. It comes after the implosion last month of Republicans’ latest attempt to dismantle President Barack Obama’s signature health-care law, a chief policy goal that Trump and GOP lawmakers campaigned on.

Speaking before signing the order at a White House ceremony, Trump said consumers “will have so many options.”

“People will have great, great health care,” he added.

Everyone who is making fun of the President’s announcement or his administration, campaign, and media surrogates doing victory laps about this on social media because they think it is a joke since it is already the law because of the Affordable Care Act need to sober up because they have missed the point. It is not a joke, it is a psychological operation aimed by the President, his administration, his campaign, and his surrogates, included Republican elected officials at Americans (emphasis mine):

Psychological operations (PSYOP) are planned operations to convey selected information and indicators to foreign audiences to influence the emotions, motives, objective reasoning, and ultimately the behavior of foreign governments, organizations, groups, and individuals.

The real objective of this executive order is not to ensure that insurance plans cover people with pre-existing conditions. Rather, the objective is to convince Republicans and conservatives who have hated the ACA/Obamacare, especially those that don’t know what is in it because they don’t want to because it is Obama’s plan. It is also targeted at less affluent and lower information Americans who have internalized the misinformation and agitprop about the ACA/Obamacare that Republican elected and appointed officials and conservative elites and notables have been pushing through conservative news, digital news, and social media for a decade and, as a result, actually believe that any plan that they could purchase through the ACA/Obamacare is both prohibitively expensive and does not actually cover anything because the policies are full of loopholes! And who were gullible enough to then buy one of the short term plans created by the President 17 October 2017 EO. This is the target audience. The better informed ones don’t care that the Administration is supporting the Republican Attorneys General’s lawsuit trying to have the entire ACA struck down, which would actually remove the pre-existing condition protections in the law for everyone in the US not on one of these short term plans. And the low information ones simply don’t know. What they know of current political events, including what is going on with health insurance, is either very little or is filtered through their local news, where Sinclair has an overwhelming influence and impact, or their or their families’ and friends’ social media, which means it is highly influence by Fox News, OANN, Breitbart, Gateway Pundit, the Daily Caller, and dozens more purveyors of misinformation, disinformation, and agitprop.

This is NOT A JOKE! It is an influence operation intended to further solidify a base that the President’s campaign leadership is worried might get shaky, the larger Republican party and conservative movement, which is a bit wobbly right now, and less affluent and low information Americans, especially low information voters, who will see or hear or read this and think the President has done something good for them.

That’s not the joke, that’s the point.

Open thread!

The President Announced He’s Signing an Executive Order To Cover Pre-Existing Conditions: If You Think It’s a Joke, You’ve Missed the Point!!Post + Comments (111)

So About That Third Party Spoilers Thing… The Libertarian Presidential Candidate And A Possibly Rabid Bat Edition

by Adam L Silverman|  August 7, 202011:13 pm| 104 Comments

This post is in: 2020 Elections, America, Domestic Politics, Faunasphere, Free Markets Solve Everything, Glibertarianism, Healthcare, Humorous, Nature, Nature & Respite, Open Threads, Politics, Show Us on the Doll Where the Invisible Hand Touched You, World's Best Healthcare (If You Can Afford It)

The 2020 Libertarian Party presidential nominee has been bitten by a possibly rabid bat.

— Jim Antle (@jimantle) August 8, 2020

I will not be able to attend the campaign rally tomorrow morning. I will be getting a rabies vaccine as a precaution after having been bitten by a bat near the start of this campaign tour! I have every intention of participating in the FLAME march and I will deliver remarks at…

— Jo Jorgensen (@Jorgensen4POTUS) August 8, 2020

What effect might his have on Ms. Jorgenson’s views on the US healthcare system? Well let’s just say kvetching was involved!

Not with the health care system we have now!

And I'm not stopped…I'm just pausing for a few hours.

— Jo Jorgensen (@Jorgensen4POTUS) August 8, 2020

Or maybe we should have a free market in which doctors could travel to the patient outside of a hospital or their offices.

— Jo Jorgensen (@Jorgensen4POTUS) August 8, 2020

There is, as of 11:10 PM EDT, no word on the condition of the bat and whether it has contracted anything serious or life threatening from coming into contact with Ms. Jorgenson.

Open thread!

Obligatory:

So About That Third Party Spoilers Thing… The Libertarian Presidential Candidate And A Possibly Rabid Bat EditionPost + Comments (104)

Republicans–and Republicanism–Kill Americans…Pandemic Update

by Tom Levenson|  June 6, 20202:17 pm| 32 Comments

This post is in: Healthcare, Open Threads, Republican Stupidity, World's Best Healthcare (If You Can Afford It)

One of the benefits of throwing a few bucks at Charles Pierce at Esquire is getting on the list for his weekly email. This week it featured an interview with Ken Starnes, a physician working along a rural stretch of the  Arkansas-Missouri border.

Republicans--and Republicanism--Kill Americans...Pandemic Update

Starnes’ experience provides a natural way to observe what happens when insane ideological commitments trump obvious public policy wins.  He sees and accesses hospitals in both states. His patients come from the same demographic in both states.  There is only one key difference between them: Arkansas came up with a Rube Goldberg way to implement Obamacare’s Medicaid expansion, while the people he sees from the Misery side of line are governed by GOPsters so doctrinaire that they refused the Black-President-tainted free money rather than deliver care to their citizens.

Stearns:

…there is a big difference between the way I treat people in Arkansas and the way people I treat in Missouri because of that. Here in Arkansas, I could probably get you to follow up with somebody, or you’re on your medicines. I was in medical school when they expanded Medicaid, and all of a sudden you have people coming in who were bad asthmatics, who had not had inhalers for years. Or diabetics who had not been on medicine for years. And the numbers turned out that these people were getting better health outcomes in Arkansas.

In Missouri, they have not done that—take the free money as you said—and the health outcomes are different. When I’m working in the emergency department, a lot of what I’m looking for is, I may not have to put this guy in the hospital, but what am I gonna do with this? If he’s not sick enough to come in, but this can’t be ignored. If I can’t get you in for a follow-up with a primary-care doctor because you don’t have insurance, or you do, but there’s not one available to you, I can’t really fix your problem. I’m just going to wait for it to get worse and for you to come back and see me. That’s the frustrating part.

Republican AGs are suing to eliminate the ACA altogether, including, obviously, the Medicaid expansion. The Trump administration supports that effort.  If they win, Missouri will be the model for the US. The Supremes will hear the case in October. I hope (and expect) that Biden and Democrats all the way down the ticket will be ready to go with the appropriate message when that happens. (Remember–whatever folks think they think about Obamacare, that other thing, the ACA, and specific benefits like having health care at all, remain popular to very popular.)

But what about the GOP Obamacare replacement plan, you ask?* That has remained consistent since 2010, at least. It’s only virtue is that it is simple:

Die sooner.

Which looks way too damn likely is what’s about to happen in a bunch of places that for ideological reasons have neither extended the reach of their health care systems nor taken seriously elementary public health techniques in the face of a pandemic.

This thread: it is as open as Trump wants his convention to be.

*You don’t…because you know better. But roll with me.

Image: John Constable, The Hay Wain, 1821.

Republicans–and Republicanism–Kill Americans…Pandemic UpdatePost + Comments (32)

Repubs in Disarray! Open Thread: The Hydroxy– Y’Know

by Anne Laurie|  May 19, 202010:04 am| 60 Comments

This post is in: COVID-19 Coronavirus, Open Threads, Repubs in Disarray!, Trumpery, World's Best Healthcare (If You Can Afford It), Riveted By The Sociological Significance Of It All

How to hydroxychloroquine pic.twitter.com/yMObDCFGXS

— Sarah Cooper (@sarahcpr) May 19, 2020

Look on my works, ye mortals, and despair!

Trump says he is taking hydroxychloroquine, a drug FDA has cautioned about using for COVID-19. He started "a couple weeks ago"
"I think it's good. I've heard a lot good stories. And if it's not good, I'll tell you right, I'm not going to get hurt by it" https://t.co/Nj065CIsxp pic.twitter.com/eFPC0g1Vns

— CBS News (@CBSNews) May 18, 2020

Trump says he has evidence that the experimental treatment works: "Here's my evidence: I get a lot of positive calls about it."

— Vivian Salama (@vmsalama) May 18, 2020

Granpa started talking like this, you’d take away his car keys & checkbook. Even the Media Observers are beginning to doubt the ‘long con’ theory:

"He says he's taking it. He could have had a ham sandwich for lunch and it was really tuna fish. We don't know." @edokeefe on POTUS disclosure that he's been taking hydroxychloroquine.

— Christina Ruffini (@EenaRuffini) May 18, 2020

Trump really outflanking Dems on poisoning yourself.

— Tentin Quarantino (@agraybee) May 18, 2020

Maybe it's time to circle back to when Trump made an emergency unplanned detour to Walter Reed.

— Tentin Quarantino (@agraybee) May 18, 2020

Trump isn’t taking hydroxychloroquine. The question is why exactly is he saying he is?

— Dana Houle (@DanaHoule) May 18, 2020

He lies about everything, but its also entirely possible he actually thinks he is taking hydroxychloroquine and his doctor is lying to him.

— Elsworth Amasa (@wfrolik) May 18, 2020

show full post on front page

?? This statement – over three hours in the making – does not say the President was prescribed hydroxyhloruqine or that he is actually taking it and makes no mention of other medicines – zinc and Azithromycin – President said he is taking. @CBSNews https://t.co/zpry05qSrH

— Paula Reid (@PaulaReidCBS) May 19, 2020

as much as I want to believe trump has talked his doctor into feeding him what’s probably poison we all know they’re just giving him a baby aspirin https://t.co/BlkmG3s6st

— kilgore trout, lizard king (@KT_So_It_Goes) May 19, 2020

frankly I would like him to gobble it by the fistful. purely for science.

— kilgore trout, lizard king (@KT_So_It_Goes) May 19, 2020

like testing the fire retarding properties of gasoline on a tire fire https://t.co/VIDxmgVvZS

— kilgore trout, lizard king (@KT_So_It_Goes) May 18, 2020

Oh hell yeah let's get straight to the "not taking hydroxychloroquine is for cowards" phase of this. pic.twitter.com/4S0VLJoJQj

— Adrenochrome Harvester (@ClenchedFisk) May 18, 2020

I don’t think it’s hilarious or trivial or a distraction. Look, he’s either taking a drug that he shouldn’t or he’s lying about it. In the middle of the worst pandemic in the 100 years. With 90 thousand dead. Everyone is too “savvy” nowadays. This is completely insane.

— Brian Schatz (@brianschatz) May 18, 2020

Repubs in Disarray! Open Thread: The Hydroxy– Y’KnowPost + Comments (60)

Monday Morning Open Thread: Murphy the Trickster God Help Us All

by Anne Laurie|  May 18, 20205:59 am| 281 Comments

This post is in: COVID-19 Coronavirus, Open Threads, Trumpery, World's Best Healthcare (If You Can Afford It)

AZAR: The coronavirus results for the US could've been vastly worse

TAPPER: It's worse here than anywhere else

A: When you look at mortality rates, that's simply not correct

T: I'm looking at number of dead bodies

A: The US population has significant unhealthy comorbidities pic.twitter.com/z1NYoHj7Sp

— Aaron Rupar (@atrupar) May 17, 2020

I think it is time to name all current and future scandals after Trump instead of Nixon, given the hitherto uncharted depths of depravity this administration has plumbed. So "-a-lago" should be the new suffix instead of "gate." https://t.co/ioUQX5VfcV

— Aviel Roshwald (@RoshwaldAviel) May 15, 2020

Coronavirus-a-lago? Covid-19-a-lago?…

Rounding up to the nearest hundred, Trump rallies averaged 4400 people in 2016.

The death toll from Covid-19 is equal to 20 Trump rallies. https://t.co/oQtEEXVvKd

— Zeddy (@Zeddary) May 17, 2020

Send in the spinmeisters!

Yeah, this makes a lot more sense than ramping up their response to the pandemic. ?? https://t.co/ohx9FwcfPs

— Daily Trix (@DailyTrix) May 17, 2020

Hey, if I thought I might have to flee to Moscow by the end of the year, I’d want to make sure they had plenty of working ventilators there first too. https://t.co/8SblqZcnoX

— Mig Greengard (@chessninja) May 17, 2020

Speaking of the Official Trump Tax Residence, could we line every possible entry route with ‘Miss Me Yet?’ Obama billboards? (The rest of us sure don’t need the reminder, but it would irk the living daylights out of Lord Smallgloves… )

Barack Obama: “More than anything, this pandemic has fully, finally torn back the curtain on the idea that so many of the folks in charge know what they’re doing. A lot of them aren’t even pretending to be in charge.” https://t.co/2YhOHwg2hv

— Philip Rucker (@PhilipRucker) May 16, 2020

Monday Morning Open Thread: Murphy the Trickster God Help Us AllPost + Comments (281)

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