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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 one could argue that the United States is hobbled by an outdated constitution in responding to epidemics.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."
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
The 26 year old nurse in TX has probably already had her policy cancelled for a pre-existing condition
Ah, good old "probably". A sure indicator that the poster hasn't bothered to actually research what he's claiming, but rather is just making something up that would support his pet conspiracy theory, if it were true.
I don't care if it's 90,000 hectares. That lake was not my doing.
is just making something up that would support his pet conspiracy theory, if it were true.
If you haven't been fucked by your insurance company yet, just wait until you're a bit older. I can guarantee you it will happen, it is only a matter of when and how badly. This is not a conspiracy theory, this is a guarantee. They hold all the cards and they set the rules of the game; you can't win or even hope to break even.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
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.
"general welfare" as part of the spending power section is all that congress needs to craft well considered laws.
Not true. The historical record very clearly shows that the "general welfare" clause was a restrictive clause, not a permissive one.
The point is that any Federal law which is otherwise Constitutional also has to be "for the general welfare", as opposed to for the welfare of just one, or a few, or some subgroup of the populace.
The General Welfare clause does NOT grant license for the Federal government to exceed the powers enumerated in the Constitution. Period. It grants no new power at all, in fact. It does the opposite. It restricts all Federal laws to be for the good of everybody. That was its whole purpose.
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...
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.
You're insane. The insurance companies are at the end of the line here. Things are going to happen way too fast for insurance companies to change their policies, treatments are going to be medically necessary, the only question is whether the extra costs entailed by the infection precautions are going can be charged back to the patient's insurance (likely with a subsequent hissy fit about actually paying it).
No one is going to call Aetna and say 'can we treat Ms. Doe for potential Ebola exposure?' - that's not the way the system works. This sort of thing is something insurance companies hate - fast moving problems that can't rationally be refused. And hospitals are already on the hook for uninsured patients due to the EMTALA laws.
Faster! Faster! Faster would be better!
You do realize that one thing that the ACA (aka Obamacare) does is take the teeth out of pre existing clauses, do you not? Or are you too busy ranting and raving to actually look at the real world?
Faster! Faster! Faster would be better!
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 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!
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.
The USA is seeing a resurgence of formerly conquered diseases because of the anti-vaccination movement.
Whooping cough, diphtheria, measles, mumps, and rubella are all making a comeback.
Stopping Ebola in the USA is trivial compared to stopping the repeated outbreaks of diseases we already have vaccines for.
[Fuck Beta]
o0t!
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
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-