HEALTH CARE: The Republicans are so Shakespearian

To be “hoist with one’s own petard,” is Shakespeare’s way of saying “To be undone by one’s own schemes.”  It fits the Republican attempts to come up with a replacement for Obamacare.   It makes me so happy.  Probably not in the long run, but for the moment.

It is a wonderful illustration of how different it is to actually try to create something as opposed to trashing something else.   All I’ve heard for seven years is how bad Obamacare is and how they would repeal and replace it.   Well, mostly repeal, they didn’t get around to figuring out what to replace it with.  It was easy to seem like they knew how do to it, until they actually got the chance, much to their surprise I’d say.

But that was their big promise, so they stuck themselves in the butt with it.

Obamacare needs a lot of fixing, but both House and Senate Republican plans don’t fix much of anything except give back more money to the rich and, more important for the moment, they don’t satisfy enough party Congressmen to get anything passed.

That’s because the Republican party has come to stand for little more than grabbing power and holding on tight.  Of course, there are exceptions.  Ohio governor John Kasich being one, but so few as not to matter in the whole picture.   I think the Republican party lost its identity during the G. W. Bush years and all they could salvage was to become the Un-Obama party.  Anyone willing to trash Obama was welcome.  Donald Trump come on down (Do you recall how the other Republican contenders vilified him in the primaries?  They seem unable to.)

Agreeing on doing something concrete is a whole different story as I learned in my 20s when joining an amazing group of high school students who had started their own school, dissatisfied with the public schools.  I was one of the designated teachers, but the school was truly free in that I couldn’t demand anything of students.  I could only try to persuade them.   It was frustrating but taught me much about humans working together.

The relevance here is that the kids and teachers at this school could all agree on the many things wrong with public schools, but when it came to agreeing on what we would do and how we would operate each day, we could not agree on much.

And that is the Republican managed Congress right now.   To call it “controlled” is an overstatement.  The party, once known for its discipline as compared with the Democrat’s comparable anarchy, can’t even control itself.

Maybe the Republican inability to pass a replacement plan will lead to the two parties actually making some improvements in Obamacare.   It would actually make both parties look better.  Stranger things have happened.

Like Donald Trump became president.

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THE TRUMP SHOW CONTINUES: The Second Republican Debate

Donald Trump’s unique achievement has been to turn politics into entertainment by being the most entertaining of the candidates.  Tonight figures to be another big show.  If it is, I think the Donald’s numbers are safe.   Trump’s support will not go down until his fans have become tired of his shtick, just as fans of any popular TV show drop off over time.  The novelty loses its magic.  The tension now lies in our not knowing how long he can keep the show going.

The curiosity for me is which other candidate or candidates jump up their poll numbers tonight and how they do it.

If I were in a position to ask the Donald a question, I’d ask him to explain what he meant by saying he was an “entertainer”  in response to criticism for his comment about Carly Fiorina (“Would you vote for this face?”)  Is he implying that an entertainer should be judged differently than a politician?

I think he revealed much with that comment, surprisingly so, like an actor in a movie who gives an aside to the audience and then returns to character.   He and the character are not one and the same.   Trump’s authenticity isn’t as authentic as it seems.

I think many of his fans see the actor in Trump, but it doesn’t matter as long as they like the script.

But enough of that……   To go beyond the entertainment factor, how should we judge these candidates as presidential timber?  According to conservative columnist Jennifer Rubin there are seven things to look for in candidates who are not ready to be president .

Though I seldom agree with her on other topics, like her estimation of Obama (“feckless”), I think she’s an astute critic of her own party.  It might be interesting to read the list below and guess who she might be referring to and then go to her column for elaboration and her suggested culprits:

  1. If you plead on a major issue that it is a hypothetical ….. you are not ready for prime time.
  2. If you say you will have “advisers for that” in reference to major policy decisions or a basic understanding of the world, you are not ready for prime time.
  3. If you delight in creating chaos, you are not ready for prime time.
  4. If you make a martyr out of a government employee who refuses to do her job in compliance with the law (common law, statute or constitutional decision), you are not ready for prime time.
  5. If you declare you are in favor of a constitutional amendment to address some issue, you are not ready for prime time.
  6. If you attack the questioner or the question, you are not ready for prime time.
  7. If you promise to “abolish the IRS,” build a wall along the entire Mexican (or Canadian) border, get rid of the National Security Agency (instead only gather information on known terrorists) or start a trade war with China, you are not ready for prime time.

A HAPPY NEW YEAR? I HAVE NO IDEA…..

Twas the day before New Year’s and despite wracking my mind, no upbeat year’s end message can I find.   However, I do have a  web site I want to share with you, The Fiscal Times brought to my attention by a reader who sent me a link while saying:   “It is this crap that drives me crazy, and adds further evidence that there really isn’t any difference between the parties after the rhetoric dies.”

He is referring to the 1600 page budget bill Congress passed before heading home for the holidays, which included many late-addition “surprises” hardly anyone noticed before the bill was passed.  The article linked here points out five of them that are head shakers for honest folk whether on the left or right.

The article isn’t long, so rather than me summarize the points I’d rather add a couple of points of my own.  First, despite the outrageous way this bill was passed, I am glad they passed it.  The alternative was to go into next year without a budget and a Republican controlled Congress, including libertarians who seem quite willing to continue to treat the “full faith and credit of the United States” as if it were a pin ball game.

They are so focused upon smaller government they seem not to have noticed the Chinese economy just surpassed ours in size this year and that China has taken various steps to develop currency exchanges that do not hinge upon the American dollar.  Nothing the Chinese would like more than for us to offer further evidence to the world that we have an increasingly unworkable order.

So, I’m glad that budget was passed despite it’s ugly underbelly.

Here is my other point.   While I have run across The Fiscal Times before, I never took a good look at it.  Since I liked that article I began exploring other pieces on the The Fiscal Times web site and found them interesting and not obviously partisan like so many other sites.  In their Statement of Purpose, they claim to be non-partisan, and so far I believe them.

If you do check it out, let me know what you think by replying using the comment link at the end of  all that stuff below.  If you like the site, think of it as a late Christmas (holiday) present.

If not, you can think of me as the Grinch.

THE EBOLA SCARE: When Common Sense is Nonsense

I wrote about the Ebola “crisis” only about two weeks ago, but now it seems like ancient history.   Here’s a history question:  Regarding Ebola, do you know the significance of Nov 7?   That was the final day for those who had had any contact with Thomas Eric Duncan, who died of Ebola in Dallas,  to show signs of Ebola.   I assume no one did.   Otherwise we’d hear all about it.  That’s really good news, but now Ebola stateside is a distant memory and news that isn’t bad isn’t really news, with the rare exception of great news, like astronauts landing on the moon or VE Day, the end of the European front of WW II.

In retrospect, some of the Ebola scare was good, in that it pressed hospitals around the nation to actually think through the question:  What do we do if an Ebola patient walks in through our doors?  In a previous post, I referred to the “Dallas debacle”, but most hospitals would have reacted in the same chaotic way.   If anyone had come in off the street with Ebola to a hospital before I haven’t heard of it.   Ebola cases get shipped here to one of our specialist facilities. They just don’t appear out of nowhere. At least hadn’t.

Surely, that question must have been raised by medical staff in hospitals here and there throughout the country, but in typical bureaucratic fashion, that got lost in the shuffle. The changes needed would have cost money and staff time, perhaps a lot, and the likelihood of it happening must have seemed small, so …

With that one case in Dallas the likelihood suddenly seemed huge. With many Americans thinking it was only “common sense” to make everyone who traveled from those afflicted west African countries remain in 21 day quarantine.   Well, common sense to a point maybe, but when it came to doing that with health workers who had volunteered to go to Africa, it was just plain wrong headed.   As President Obama said, those medical volunteers should be treated as heroes.  Instead they tended to be treated like criminals.

Centuries ago common sense  supported the notion that the sun revolved around the earth because when we looked at the sky we could see the sun moving.   That’s not a fair analogy, but while common sense has valuel, the evolution of science has come in contrast to so-called common sense. i. e. common sense is often misleading, such as in the case of eye witnesses of crimes who used to be thought of as providing great evidence until studies showed different eyes can see events differently.   Thank God for the discovery of DNA.

The problem with the “common sense” angle prized by politicians like the governors of New Jersey and New York, is that an abundance of caution would likely dissuade medical volunteers to go to West Africa where the real problem, the biggest danger to us all in the future, needs to be eradicated.   It is “penny wise and pound foolish,” to apply an old expression.

Common sense was actually head-in-the-sand thinking, but popular with the people, so certain politicians had to slop it up like pigs at a trough.   According to polls 70% of Americans thought it a good idea.   I wonder how many of those polled were libertarian leaning with a strong belief in reducing governmental meddling.

…..except when each of them gets scared enough to demand more meddling.  That’s only common sense.

Here’s to a Republican Senate Victory Tomorrow.

I have so many thoughts and questions on world events jammed together in my little mind that  I feel mentally constipated.   I need to relieve myself of some of them or my head will burst, but where to begin the flow?

I’m not up to tackling the ISIS crisis, Ebola or even the Ukraine (remember when that was the big attention grabber ?   Still, a near civil war brewing there in the western part with Putin playing his games, but it is a tired story, not quite hot enough at the moment to attract our public attention.)

Let’s look at the Senate race which  is mildly interesting to me because I watch enough cable news to be ensnared into viewing the event like a horse race or football game and the “two teams” seem close enough to expect a good match tomorrow, even though the pundits are leaning towards a Republican victory.

Unlike those pundits, I don’t take it very seriously as it seems to me which ever party holds the Senate reins (which is like riding a bucking bronco), the familiar gridlock will continue.   At the moment, I like the idea of a Republican victory simply because it should make for a more interesting next  two years, as they would be in a position to actually develop shared legislation in both Houses.   That would tie them down to their ideas instead of allowing them the luxury of a constant chorus of we’d do it better than Obama.

O. K. show us what you got.

I don’t think they’ve got much, frankly, and it is so much easier to agree in criticisms of Obama and the Democrats than actually agreeing among themselves on something specific to do.   Really, do you think Ted Cruz could agree on much with anyone other than possibly his clone?  That the Republican party can’t even govern itself might be revealed prior to the 2016 election and give the Democrats real governing power then, both Houses and the presidency, assuming typhoon Hilary doesn’t run out of wind  by then through over exposure.

Of course, from a liberal perspective there are negatives if the Republicans win the Senate (they already control the House).  For one, President Obama would likely have even less chance to accomplish much of anything the next two years, but how would that be so different than the last two?

Also, if a supreme court judge or two needs replacing over these next two years, for Obama to find  someone who could get nominated and not add to the conservative majority of the court might be so hard, we’d have an eight (or less?) member court for awhile.   And of course, with the Republicans controlling the committee chairs, Senate investigations of the Obama regime would multiply like dandy lions in an Illinois summer, vying for TV time with fellow House Republican Darrell Issa’s ongoing contemporary version of judgement at Nuremburg when it comes to all things Obama.

Maybe this all wouldn’t be so good for the country, but it figures to me more interesting to follow than two more years of largely the same boring political theater.   I say:  Let’s have some new boring political theater.

My attitude reminds me of something the romantic English poet John Keats wrote centuries ago.  “What shocks the virtuous philosopher, delights the chameleon poet.”

I’m feeling poetic today.  And a little less constipated now.

EBOLA IN THE U. S.: An Abundance of Caution Can Prompt Excessive Fear

No doubt you’ve heard that an Ebola case has developed in New York City, that of Dr.  Craig Spencer, who had worked with Ebola victims in Africa.  Of course, that has prompted another media frenzy (“first Ebola case reported in New York!”) that is supposed to calm our nerves but makes us more nervous (think of the teeming million of potential victims).

But not me.   So far, here is what the Ebola crisis has added up to in this country, one Ebola death of a man who came to the U. S. with the disease and two infections of nurses who treated him after he had full blown symptoms, and they did so in a hospital that was not prepared to deal with a surprise visit of that virus (which seemed true of most of our hospitals at the time).

The good news is that was a wake up call.

From articles I’ve read, training for dealing with a walk in Ebola case has sky rocketed since then, with Belleview Hospital where Spencer has been treated, an excellent example.  In my previous post, I pointed out that only four hospitals were considered specialists in dealing with an Ebola case, but prompted by the Dallas debacle Belleview seems to have upped it s preparedness enough to become a “designated Ebola Center”.

I have read about three Maryland hospitals  that have attained the same status, and are “listed as second options for the treatment of Ebola patients who are unable to go to one of the federal health facilities.”   I suspect a number of hospitals in other states have followed suit.

To me, that is the big news as to what is going on with Ebola, not a doctor who has been monitoring himself twice daily and finds he has a fever (100.3, not the 103 initially reported) and is taken into Belleview for treatment immediately.    From what I can tell, his chances of infecting anyone prior to having that fever are virtually nil (note, despite even his having a fever no one close to Thomas Eric Duncan in Dallas, including his fiancee, caught Ebola and all are now cleared of quarantine).

The problem is that with each case of Ebola we go into maximum response mode with quarantines and watch lists of anyone who might have had some contact with the victim, implying a sense of wide spread danger when really it is the hospital workers who deal with vomit and diarrhea who are much, much, much, much more likely than anyone else to catch the virus.  The doctors who wind up on TV say as much, or at least imply it.

The reason they don’t stress it more adamantly is that no matter how unlikely, it is theoretically possible the disease could spread through casual contact, so they tout the value of an “abundance of caution”, while simultaneously producing an excess of fear fueled by the media’s always implying they will share special insights and news just after the next commercial, which is seldom more than a rehash of what they have repeatedly covered.

There is an element of c.y.a. in all of this, of course, as a doctor who criticized all the attention paid to the wrong things would be crucified if someone did happen to get Ebola in a surprising way.   So, from this self-protective angle too, better to show an excessive amount of caution.

Ashoka Mukpo, a free lancer from  NBC and another who caught Ebola in Africa and is now cured, is no doctor, but I think he got to the nub of this issue better than most doctors in a recent tweet:  “People get Ebola by being around very very sick people.  Not people who felt a little funny and then became symptomatic later that night.”

Again, the only two people who have caught Ebola in this country fit that bill.

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(1)  The national CDC offers a guideline for the possible transmission of the Ebola virus, located here.    If you read the page you can see how it is conceivable that someone could catch Ebola from touching the same surface as did an Ebola victim, but from what I can tell that victim would have had full blown symptoms for this to possibly happen.

By the way, some of the fear regarding Dr. Spencer’s case stems from that initial report that he had a temperature of 103 when contacting the hospital, implying that he might have had a temperature well before that.   Now it seems it was 100.3, a big difference because by all reports the chances of contracting the virus get much greater as symptoms worsen.

EBOLA in the U. S.: What is Most Worrisome?

Move over ISIS, you are being scooped by the U. S. Ebola problem today.  It is not a crisis, but it may have the makings.

Most of the cable news this morning has been focused on the fact that Amber Vinson, a second nurse from Texas Health Presbyterian. has contracted Ebola.   The first was Nina Pham.

Worrisome is that Vinson was allowed to fly back to Dallas following a trip to Cleveland despite her reporting to the CDC that she had a fever of 99.5.  She was told not to worry about it because their guideline is 100.4.

Ah….  shouldn’t it matter that she had treated Thomas Eric Duncan, the Ebola patient who died in Dallas?  Rules are made to be broken in special cases.

It sounds like they will lower that bar now, but it is one more reason to be nervous as to the preparedness of  our health care system for handling Ebola cases.   Texas Health has issued a statement that they followed CDC procedures and staff had the recommended protective gear in treating Duncan, but that seems the product of a legal team and nurses there report differently, one very publicly on TV this morning.   Basically, when confronted with an Ebola case, the response was chaotic.

But here’s what’s most worrisome to me.   We have only four hospitals that are expert at handling infectious diseases like Ebola, one of them Emory where Vinson now resides.  More importantly, they are estimated at being able to handle only 19 patients max. 

As described in Time:

“There are four hospitals in the U.S. with special isolation units designed to contain biohazards like Ebola. In addition to Emory, they are the National Institutes of Health Clinical Center, in Bethesda, Md., a hospital at the University of Nebraska in Omaha and St. Patrick Hospital in Missoula, Mt. The facilities in Atlanta and Omaha have successfully treated Americans infected with Ebola overseas without any healthcare workers contracting the virus.

Though transporting future cases to these facilities may be prudent, they have limited beds: only 19 between them, according to CNN. Exclusively using specialized hospitals to treat Ebola is only an option so long as the number of cases in the U.S. remains extremely low.”

From what I’ve heard on TV from experts, we could easily have over thirty cases break out (and that seems a total guess to me) and I don’t know if that includes 3,000 military in West Africa, some of whom seem bound to contract the disease.

And it seems we are only completely confident that we can handle 20 or so.  I would worry less if I believed that we are doing whatever it takes to expand that capacity as quickly as possible.

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P. S. – After writing the above I saw Rachel Madow on TV focus on the same issue of all too few beds available for Ebola patients, but her count is even less:  She says nine beds in those four best facilities, four of which are now in use.   Whatever the exact count it seems way too few.