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Who's In Charge During the Ebola Crisis?
Lasrick writes: Epidemics test the leadership skills of politicians and medical infrastructures, which is clear as this article goes through the different ways West African countries have dealt with the Ebola crisis. Now that fears are spreading about a U.S. outbreak (highly unlikely, as this article points out), it may be time to look at the U.S. medical infrastructure, which, of course, in many ways is far superior to those West African countries where the virus has spread. But there is an interesting twist to how disease outbreaks are handled in the U.S.: "The U.S. Constitution—written approximately 100 years before the germ theory of disease was proven by French chemist Louis Pasteur and German physician Robert Koch — places responsibility for public health squarely on the shoulders of local and state political leaders ... one could argue that the United States is hobbled by an outdated constitution in responding to epidemics. State and local jurisdictions vary tremendously in their public health capabilities."
It's whoever has the most guns! In case of a tie, hand sanitizer and lysol can be used as a tie breaker.
"general welfare" as part of the spending power section is all that congress
needs to craft well considered laws.
Federal agencies could be funded to establish top level technical resources.
States could then move forward.
Emergencies open doors as well....
As scary as Ebola is it may not qualify as an emergency we have
common problems from influenza, food poisoning, pneumonia that
kill more...
However congress could declare Ebola in Africa and others problems
as a health risk to the US and fund emergency actions.
My gut reaction is if citizens were to take personal responsibility
and act on all the common influenza, food handling, common cold
basic sanitation programs Ebola would vanish only to be found in
footnotes referencing a small number of individuals and hospitals in
the US. Sadly Africa is still behind the eight ball in this disaster.
Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn't. Mark Twain.
Who's in charge?
WHO's in charge.
In the US, the people in charge are still the health insurance companies. They will call the shots during this situation just as they have for decades (including during the writing of the 2010 "health care reform" bill). They will dictate who gets which care, and who gets to die in which ways. The 26 year old nurse in TX has probably already had her policy cancelled for a pre-existing condition (ie, she was alive and hence had the potential to be infected with ebola in her hazardous occupation).
Just wait until the insurance companies quietly release their 2014 profit reports in another year or two and we see how handsomely we rewarded their top executives for this.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
The USA has handled many epidemics in the past. The experience of Western Samoa vs. American Samoa during the Spanish Flu epidemic is an interesting example. The TL;DR: version: Western Samoa decided they couldn't stopping the importation of plantation laborers, and as a result 20-25% of the population died. American Samoa self-quarantined, and nobody died.
One of the core problems today is that the CDC has lost focus, and instead of controlling infectious disease, they spend money things like playground safety, workplace accidents, guns, and birth defects. And then there was the NIH grant to study why gay men are often thin and lesbians are often obese.
We don't need to change the Constitution, just the spending and research priorities of a bunch of bureaucracies.
Q: What does the "B." in Benoit B. Mandelbrot stand for? A: Benoit B. Mandelbrot
Ebola is in charge during an Ebola crisis.
There has been one case of Ebola transmitted in the U.S. Isn't it a wee bit early to be writing an epitaph for the Constitution? Especially since none of that crap was part of TFA?
TFA's commentary on patient zero being sent home with a bottle of antibiotics (for a virus, of course) was spot on though. That's what happens when you insist on running healthcare as a business.
That's what trial by jury is for.
Nope. SCOTUS says "Can't have; not yours."
http://apps.americanbar.org/litigation/committees/adr/articles/winter2013-032713-federal-arbitration-act.html
the U.S. Supreme Court sent a clear message to all state courts that the Federal Arbitration Act precludes any interference with arbitration proceedings based upon valid arbitration agreements, even if those proceedings seek to enforce a contract provision that violates state law
You no longer deserve a day in court even if the health insurance contract is prima-facie illegal. There is good reason that more people with life-threatening illnesses are appealing to the court of public opinion for their fights with the insurance companies...
Focus all the worlds efforts on the people there
Yep, the world has no shortage of people wanting to take a one-way trip to ebolaland.
If I have been able to see further than others, it is because I bought a pair of binoculars.
Yep. Where I work, we train first responders, mayors, governors and all sorts of people regarding their roles in an emergency.
The states have their roles, the cities and county health departments and leadership have theirs, as do the hospitals, etc, and the CDC and others at the federal level.
What we don't need us a mandate that everything has to be done through a federal agency, maybe via ebola.healthcare.gov.
One interesting drill that covers not only infectious disease but also riot is the zombie drill. In the drill, their is a microbe that turns people into zombies. Healthcare workers practice inoculating a lot of people in a hurry, while treating those already infected. City managers and the like practice communications with FEMA,CDC, and other agencies to get the needed information and resources, public information officials stand in front of our TV cameras and practice getting the most important information out in a clear manner, etc. Instructors watch everything via one-way mirrors and record all phone calls, then review the students' performance.
Now, several Republican members of Congress demand that the President immediately designate an "Ebola Czar". The hypocrisy is extreme. On Oct 4, 2014, Rep. Kingston told the Washington Examiner: "Rep. Jack Kingston, R-Ga., said Saturday that while he "hate[s] to invoke the term 'czar,'" President Obama needs one to combat the spread of the deadly Ebola virus."
Meanwhile, Sen. Richard Burr (R-NC) issued a statement (flash required) on Oct 3, 2014 that criticized the President:
To be clear, when Kingston, Burr (and Sen. John McCain, R-AZ, and others) urges fast action to put someone in charge, he can't mean confirming someone through the Senate, which takes months or even more than a year.
Final related note: The position of US Surgeon General has limited powers and would not be the supreme leader on Ebola. Still, it would not hurt to have someone in the job, and that person can play a key role communicating with the public. However, the US has no confirmed, permanent Surgeon General because the NRA is blocking the Senate confirmation of President Obama's nominee, Dr. Vivek Murthy. He is an MD and an MBA. He practices and teaches at Brigham and Women's Hospital and teaches at Harvard Medical School. He cofounded a clinical trials company, and an HIV education organization. But he supports an assault weapons ban and tweeted that he thinks guns are a health care issue. So the NRA's opposition means his nomination will never come to a vote. It is dead. Even if one disagrees with Dr. Murthy's position on guns, he has no power over guns whatsoever, and it's reasonable that a President get his people if they are more or less qualified and mainstream (not hacks or crazy radicals). Republicans are right to seek smaller government in some places. But to just throw the monkey wrench in the gears of government for political gain is not constructive. It's just politics.
from the commentary linked in the summary:
"Single-payer." Like the VA. Because unaccountable, lying government officials and patients dying while on fake waiting lists are exactly what we need during an ebola epidemic.
And Obamacare. Because of Obamacare I can not afford medical care. My premiums are about 3x before Obamacare. My deductible is $5,000.00. I am taxed $300.00/month on my health insurance because I am employed at a small company which can not purchase the plan directly from an insurer. (Obamacare revokes the tax exemption for employer-subsidized health insurance.) I am buying the least-expensive plan mandated by Obamacare to avoid the penalty and paying about $1,300.00 per month in insurance and taxes. I had a shoulder injury, went to an in-network doctor and had to pay for the entire visit, treatment and the physical therapy myself.
To summarize, now, because of Obamacare, I am required by law to pay $1,300.00 per month for health insurance and taxes at a minimum and on top of that I have to pay for my own medical expenses. Because of Obamacare, unless I am absolutely certain that I am dying I will not be going anywhere near a health care provider. By both making the patients poorer with higher insurance premiums and by raising the cost of treatment with higher deductibles Obamacare has created a massive financial disincentive to seeing medical care during an epidemic. And then also there is the decreased access to health care because of shrinking provide networks.
In addition to advocating for evidently broken and corrupt systems, the author wants to re-write the Constitution. You know, that document which guarantees citizens rights. What could possibly go wrong?
Ceci n'est pas une signature.
You' ll be modded down, but it really is this fucking simple.
You know, the US Constitution was written explicitly to prevent tyranny. When you start bumping up against its limits and grouching that you need more power, and this damned document won't let you, this means you're on the wrong side.
When the editorial pages of the New York Times express admiration for tyrants abroad and your fundraisers openly state that the executive needs more power (what, being the President of the United States isn't enough power, WTF) then you have a problem and you need to go through and re-think your entire worldview, starting from base principles. Either that, or We The People need to introduce you dictatorial fuckheads to hemp rope and cottonwood trees.
Shutting down free speech with violence isn't fighting fascism. It IS fascism!
We've had many epidemics in the US. We've had scarlet fever, tuberculosis, cholera, typhus, polio, dengue, malaria, leprosy, influenza named after various places and creatures... the list is endless.
The problem is the CDC lost focus. With a relative lack of communicable diseases for going on five decades, like all bureaucracies with not enough to do they started expanding their portfolio to include lots of things you wouldn't think belong under "disease control" and took their eye off the ball. Now that we have a bona fide health threat all they know how to do is hold press conferences telling us not to worry.
The one thing the CDC doesn't need is more power and money. They already have broad emergency powers, and if they have enough money to do gun control studies and lesbian weight gain studies they already have too much money.
As a side note, the director would be a lot easier to support if he wasn't obviously lying when he says there's nothing to worry about. We're not children, buddy, so don't treat us like children. Obviously this strain of Ebola is quite a bit more contagious than earlier strains, and it falls in about the middle of the lethality range normal for that disease (20%-80%). We should be restricting travel from affected countries, and anyone coming in from those countries should be quarantined for 21 days.
Comment removed based on user account deletion
One state doing the wrong thing + free travel = nation-wide epidemic. That seems pretty obvious. If the chance for one state to get it wrong is just 2%, then the chance of a nationwide epidemic is 1-(1-0.02)^50 = 64%.
And as usual, the thinker who came up with the parent post couldn't get their nonsense argument even grammatically correct ("Ebola can be transmitted by airborne infection...")
We know where leadership by an anti-intellectual "strongman" who scapegoats minorities and likes boisterous rallies goes
>"one could argue that the United States is hobbled by an outdated constitution in responding to epidemics. State and local jurisdictions vary tremendously in their public health capabilities."
One could also argue that this is EXACTLY the way it is supposed to be. USA States are SUPPOSED to have control over most of what happens in their area and not be puppets to a huge, inefficient, out-of-touch, expensive, slow, borderline fascist, federal government overloard.
Someone is taking you for a ride. That's not even approaching what I'm paying, $600/month, and this is for a plan *far* from being the least-expensive plan for mandated coverage: %100 coverage ( $0 deductible for in-plan doctors ), and an expenditure account. I'd suggest trying to find out who's lying to you. The average price of a "bronze" plan across states for someone in their 40's is like, $350/mo.. and a platinum plan is like, $500. If your premiums really are that high, the "lying" may be somewhere less obvious. Research to see if your state did something stupid with the implementations that screwed it's citizens, and direct complaints there.
"I am taxed $300.00/month on my health insurance because I am employed at a small company which can not purchase the plan directly from an insurer" I'm not even sure what this is saying. This was removed for all businesses, not just small businesses. All employees are now taxed on the income that used to be "pre-tax" income used to buy health insurance. If a business is somehow hiding the cost of health insurance for it's employees and not reporting it as income, that's illegal AKAIK.
In any case, trying to wrap that into the "cost of your insurance" as an extra $300/mo seems pretty disingenuous to me.
Somebody on Fox is *asking* for Fema camps now.
I am not making this up.
Need Mercedes parts ?
from the commentary linked in the summary:
"Single-payer." Like the VA. Because unaccountable, lying government officials and patients dying while on fake waiting lists are exactly what we need during an ebola epidemic.
I have read studies published by the VA on the outcomes of people treated at different VA hospitals for conditions like prostate cancer colorectal cancer, and I've talked to VA doctors. The VA has some of the best outcomes in the world. They did some of the major studies in cardiology to find out what works and what doesn't work, and every cardiologist in the world follows the recommendations of the VA studies. If I had cancer or a heart attack, I would be confident in any major VA hospital. (Although like all health care providers, they do have problems in rural areas.)
The reason they had that problem with waiting list fraud (which is unexcusable) is that their managers gave them politically-mandated targets for appointments, without giving them the money that they needed to hire more doctors to meet those targets. (Would you have predicted any problems with that?) That's what corporate-style management by financial incentives gets you. Now they're giving them more money to hire doctors.
But it doesn't affect their main purpose, which is to save the lives and health of veterans, many of whom have service-related injuries. In rehabilitation medicine, they've been doing a great job since at least WWII. I know a lot of veterans in their 70s and 80s who go to the VA and are very happy with it. You're seeing a doctor who is on salary and trying to treat you with the best possible medicine, not a doctor who gets 10 minutes to see you and gets paid for the procedures he does on you, even if they do more harm than good.
And Obamacare. Because of Obamacare I can not afford medical care. My premiums are about 3x before Obamacare. My deductible is $5,000.00. I am taxed $300.00/month on my health insurance because I am employed at a small company which can not purchase the plan directly from an insurer. (Obamacare revokes the tax exemption for employer-subsidized health insurance.) I am buying the least-expensive plan mandated by Obamacare to avoid the penalty and paying about $1,300.00 per month in insurance and taxes. I had a shoulder injury, went to an in-network doctor and had to pay for the entire visit, treatment and the physical therapy myself.
To summarize, now, because of Obamacare, I am required by law to pay $1,300.00 per month for health insurance and taxes at a minimum and on top of that I have to pay for my own medical expenses. Because of Obamacare, unless I am absolutely certain that I am dying I will not be going anywhere near a health care provider. By both making the patients poorer with higher insurance premiums and by raising the cost of treatment with higher deductibles Obamacare has created a massive financial disincentive to seeing medical care during an epidemic. And then also there is the decreased access to health care because of shrinking provide networks.
In addition to advocating for evidently broken and corrupt systems, the author wants to re-write the Constitution. You know, that document which guarantees citizens rights. What could possibly go wrong?
I am no fan of Obama or Obamacare, which was designed on a Republican model (Romneycare) and on a proposal put out by the Heritage Foundation, which now denies it.
And how do you like those free-market insurance company bureaucracies? Good thing you don't have to deal with government bureaucracies like Medicare.
The big problem with Obamacare is that, instead of expanding Medicare, as the progressives wanted, it gives the insurance companies about 30% of your health care premium, and that's the main reason why i
Ebola is in charge - nobody controls Ebola right now.
The only way to come to terms with the disease is isolation. It is the black plague of our time.
Involving politicians into this means that there will be petty bickering all the time while the disease spreads.
If builders built buildings the way programmers wrote programs, then the first woodpecker would destroy civilization.
Where is "there"? The whole of Africa?
Are you proposing that you can create an impermeable land and sea border for the whole of Africa? A border that can be maintained in the face of the breakdown of multiple societies due to the combination of Ebola, other current and very severe problems in these countries eg Boko Haram, malaria, etc, and the economic embargo you're effectively imposing through the border?
Yeah, well, let us know how that works out for ya.
Essentially, the OP is militating for a centralized dictator to deal with the emergency. "You never let a serious crisis go to waste. And what I mean by that it's an opportunity to do things you think you could not do before." Thus spake Rahm Emanuel. The tradition extends from Sulla to Napoleon to every petty Don, triad leader, or military dictator of our own era.
In fact, when stuff gets real, there will be no lack of opportunists seizing all infrastructurally available power to respond to the crisis. The best process known for dealing with the pre-crisis stage is the democratic process. It is sub-optimal for any given threat, but has the merit of being a tolerable living condition which is capable of responding to the broad range of threats which arise in the ordinary course of events.
-I like my women like I like my tea: green-
and making under $150k/yr wouldn't trade it for private insurance. And we all go single payer at 65 unless we're making 10 times that. While I'm on the subject, I've never met a Canadian or Britain who would trade their health care for ours.
And what world do you live in where Obamacare is single payer? It isn't even close. It's an awful compromise created when the insurance companies spent half a billion dollars in _one_ year flooding every possible media channel with stories of death panels for Grandma (who, ironically, is already on Medicare, a single payer system). It's the best we can get with the current political system and folks like yourself with an irrational fear of a system that works great everywhere else in the world.
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