While much attention is appropriately focused on the horrific and brutal attacks by Pakistan’s Taliban on secular political parties as the country approaches elections in its first-ever transition from one civilian government to another, we have news today of a sad triumph by the Taliban as a child in North Waziristan has been diagnosed with polio after the Taliban successfully shut down polio immunizations there last summer.
Health workers are on the cusp of making polio the second disease after smallpox to be completely eradicated from the planet. The latest plan forecasts eradication by 2018, but a huge barrier is that conservative Islamic groups view Western vaccination programs as attempts to sterilize Muslims. In addition, the participation by Dr. Shakeel Afridi in a bogus vaccination program set up by the CIA to obtain DNA samples from Osama bin Laden’s compound added fresh fuel to the belief that vaccination programs also are used to spy on Muslims. Just under a month ago, a policeman protecting workers administering polio vaccine was shot and killed:
The latest attack took place in the afternoon in the Par Hoti neighborhood of the Mardan district in Khyber-Pakhtunkhwa Province. The policemen, Raj Wali and Mohammad Ishfaq, were accompanying two female workers on the second day of a three-day anti-polio drive, said Wajid Ali, a local police official.
The policemen were standing guard in the street as the health workers administered drops inside a house when an unidentified gunman, who appeared to be in his early 20s, walked up to them and opened fire. Mr. Wali was killed and Mr. Ishfaq was wounded, Mr. Ali said in a telephone interview. The gunman escaped.
That killing followed the deaths of eight vaccine workers last December and the violence has led to a significant interruption in the distribution of the vaccine:
In December, at least eight people engaged in polio vaccinations were shot dead in Karachi and the north-west, and in January and February two police officers were killed in similar attacks.
The UN said last month that some 240,000 children have missed vaccinations since July in parts of Pakistan’s tribal region, the main sanctuary for Islamic militants, because of security concerns.
And it is from the tribal area of Waziristan where we have today’s sad news of a child being diagnosed with polio:
A child has contracted polio for the first time in Pakistan’s militant-infested tribal belt since the Taliban banned vaccinations a year ago, a UN official said Monday.
“The new case has been detected in North Waziristan where we had been denied access in June last year,” the World Health Organization’s (WHO) senior coordinator for polio eradication in Pakistan, Elias Durry, told AFP.
Durry fears that this case is not likely to be isolated:
“We are worried because this new case comes as an example of a bigger impending outbreak of disease in the region,” the WHO official said.
In addition to making vaccination drives shorter and lower profile while working closely with security, the executive summary (pdf) for the new polio eradication plan has a key step of outreach to religious groups:
4. Religious leaders’ advocacy: markedly step up advocacy by international, national and local Islamic leaders to build ownership and solidarity for polio eradication across the Islamic world, including for the protection ofchildren against polio, the sanctity of health workers and the neutrality of health services.
Unfortunately, I don’t see an open call in the plan for bringing about an end to intelligence agencies undertaking new vaccination ruses, although “the neutrality of health services” would seem to touch on it. Meanwhile, Afridi has started a hunger strike in a desperate attempt to keep his name in the headlines.
The American Bear
Sunshine/Lollipops
“Seriously, if we believe a 14 year old is too immature to know how to take a pill, do we really think she’s adult enough to handle an unwanted pregnancy?
“The truth is that the age restriction is completely arbitrary, tied only to our puritanical comfort levels. And listen, I get it; I think it’s fair to say that most people are uncomfortable with the idea of a 14 year old having sex. But here’s the thing - access to Plan B isn’t about keeping a 14 year old from having sex - by the time she gets to the pharmacy, that ship has sailed - it’s about keeping a 14 year old who has already had sex from getting pregnant. And despite what urban legend (or past embarrassing FDA memos) may tell you, making emergency contraception more available is not more likely to make young teens have sex - it will just make them less likely to end up pregnant.
“We can’t let our discomfort with teen sex trump young people’s right to sexual and reproductive health and we can’t continue to let politics trump science. If we care about young women’s health and bodily autonomy and integrity, we’ll drop all age restrictions from emergency contraception. Anything less isn’t just illogical - it’s immoral.”
— “Hey, FDA: Drop the Plan B Age Restriction,” my latest at The Nation (via jessicavalenti)
› Obama Administration Continues Blocking Access to Emergency Contraception | Kate Sheppard
On Wednesday night, President Barack Obama’s administration indicated that is challenging an April court decision that would make emergency contraception available to everyone without a prescription. The announcement means that, after a decade of fighting between reproductive rights advocates and the Food and Drug Administration over this issue, there’s still no resolution.
In 2011, the FDA approved Plan B One-Step, one of the most common forms of emergency contraception, for purchase over-the-counter for all women. But the Department of Health and Human Services overruled the FDA, instead making it available without a prescription only to women ages 17 and older. Reproductive rights groups sued, and on April 5, Federal District Court Judge Edward R. Korman issued a scathing decision that said that the administration’s policy was “was politically motivated, scientifically unjustified, and contrary to agency precedent.” His ruling directed HHS and the FDA to make emergency contraception available to all by May 5.
On Wednesday evening, however, the Department of Justice announced that it is appealing Korman’s ruling. “The Court’s Order interferes with and thereby undermines the regulatory procedures governing FDA’s drug approval process,” said the DOJ in a statement.
The DOJ statement is misleading. The FDA actually approved Plan B for women of all ages in 2011. Then HHS interfered.
The appeal comes a day after the FDA announced that it has approved the sale of Plan B One-Step to women ages 15-and-over without a prescription. In its announcement, the FDA claimed that decision “is independent of” the lawsuit and “is not intended to address the judge’s ruling.” However, as Washington Post’s Sarah Kliff reports, the DOJ’s appeal uses the FDA’s decision to make its case:
The Justice Department, in fact, relied on that new decision to argue that none of the federal case’s plaintiffs — who are 15 or older — would be harmed by a court decision to delay Korman’s ruling from taking effect.
“The approval has the effect of ensuring that all of the plaintiffs in this case (including the youngest of them) now have access without a prescription and without significant point-of-sale restrictions to at least one form of emergency contraceptive containing levonorgestrel,” the Justice Department argued, referring to the active ingredient in Plan B.
The judge’s ruling clearly stated that Plan B should be available to everyone without a prescription and without government-issued ID. The Obama administration is not complying with that order. This doesn’t sound like the same Obama who, just last week, said in a speech to Planned Parenthood that he is a president “who is going to be right there with you, fighting every step of the way” on reproductive rights.
The administration’s latest position seems to be that lowering the age to 15 is a compromise. Yes, it is two years younger than the previous limit, and the FDA’s new guidelines would also mean Plan B is now available on the shelf and not only during pharmacy hours. But it still means that women will need to have some manner of government-issued ID to obtain it. Not every woman has that sort of ID—especially 15- and 16-year-olds that can’t yet drive and don’t have a passport, or simply don’t want to have a cashier know their names.
The Center for Reproductive Rights, which filed the lawsuit challenging the restrictions, said on Thursday that they will continue to press for universal access. “We are deeply disappointed,” CRR president Nancy Northup said in a call with reporters, pledging to “continue the battle in court to remove these arbitrary restrictions.”
› Beyond Obamacare: How A Single Payer System Can Save Health Care in the U.S. | Dave Dvorak, M.D.
The ACA of 2010, known widely as Obamacare, is expected to extend coverage to 32 million more Americans. But it accomplishes this goal primarily by expanding the current fragmented, inefficient system and maintaining the central role of the private insurance industry in providing coverage. As a result, the ACA is expected to do little to rein in health care spending. Furthermore, it will fall far short of achieving universal coverage, as tens of millions of Americans will remain uninsured after its full implementation.
The central feature of a single-payer health care system would be one health plan that covers all citizens, regardless of their employment status, age, income or health status. Having a public fund that pays for care would slash administrative inefficiencies and eliminate profit-taking by the private insurance industry.
Under a single-payer system, the way society pays for health care would change, but the market-based health care delivery system would remain. Physicians and hospitals would continue to compete with one another based on service, quality of care and reputation. The chief difference is that they would bill a single entity for their services, rather than numerous insurers.
Individuals would benefit immensely by having continuous coverage that is decoupled from their employment. This would alleviate “job lock,” in which people remain in undesirable employment situations in order to maintain coverage. In a single-payer system, individuals could choose to see any provider, in contrast to the current system in which choice is restricted to those who are in-network. Deductibles and copays would be minimal or eliminated, removing cost as a barrier to obtaining needed care.
A single-payer system would be funded through savings on administrative costs, along with modest taxes that would replace the premiums and out-of-pocket expenses currently paid by individuals and businesses. The cost savings to individuals, businesses and government would be considerable. The nonpartisan U.S. General Accounting Office concluded that single- payer health care would save the United States nearly $400 billion per year, enough to cover all of the uninsured.
Physician support for a simplified, universal health care system is robust and growing. A 2008 survey published in Annals of Internal Medicine found that 59 percent of physicians supported a national health insurance system—up from 49 percent in 2002. Physicians for a National Health Program, a national organization advocating for single-payer reform, reports a membership of 18,000. …
Recognizing the implausibility of achieving single-payer reform at the national level in the current political climate, many single-payer advocates have turned their attention to state-level reform. The ACA provides for “state innovation waivers” to be granted beginning in 2017, allowing states to implement creative plans they believe would work best for them. With this in mind, organized single-payer movements have taken root in states as varied as Colorado, Hawaii, Illinois, New York, California, Oregon and Vermont. Vermont’s governor and Legislature passed a law in 2011 setting the path for the state to move toward single payer.
… With nearly 50 million uninsured people in the United States and skyrocketing health costs, the need for profound reform of our health system could not be more clear. The ACA is a start, but it will fall far short of achieving universal coverage, and it allows unsustainable spending growth to continue. Single-payer health care would eliminate administrative waste and inefficiency, thereby creating an opportunity to achieve truly universal, cost-effective health care.
The belated conservative reaction to the Gosnell case is a classic example of the bait-and-switch at the heart of the increasing proliferation of abortion regulations. Anti-choicers talk a great deal about the relatively tiny number of medically unnecessary post-viability abortions—which Roe v. Wade explicitly allows to be banned and are already illegal—in order to pass regulations that apply at every stage of pregnancy. The most common of these regulations—prohibitions on public funding for abortion, waiting periods, parental-involvement laws, mandatory ultrasounds, and the targeted regulation of abortion providers—are not merely irrelevant, but counterproductive. All of these legal burdens make obtaining a safe first-trimester abortion more difficult. Although the Gosnell case will be used by opponents of reproductive freedom to advocate for more arbitrary regulations, to argue that a single doctor performing already illegal post-viability abortions means that we should make safe pre-viability abortions less accessible is self-refuting nonsense. As Carmon puts it, women kept going to Gosnell’s clinic ‘because they felt they had no alternative.’ That alternative is clinics where even poor women can obtain safe first-trimester abortions in a timely manner, without having to navigate a blizzard of regulatory impediments with the sole purpose of inhibiting access to abortion.
Five Lessons from the Gosnell Abortion-Clinic Controversy (via dendroica)
(via dendroica)
› ObamaCare Clusterfuck: Virginia bans abortion coverage on health exchanges | Lambert Strether
Of course, all this was fully predictable when Obama incorporated the Hyde Amendment into ObamaCare by executive order.
Previously, the pill required a prescription for girls aged 16 or under. In 2011, Health and Human Services secretary Kathleen Sebelius made a controversial move, blocking an FDA recommendation that the pill be available over-the-counter to anyone.
(via robotmonastery)
Today, when the acquisition of wealth, quickly and in large amounts, is admired above any other human endeavor, every medical emergency or catastrophic illness is seen as an opportunity for some to enrich themselves beyond their wildest dreams. It’s no wonder that our healthcare is so much more expensive than that of every other developed country in the world, where the costs are not only much lower, but people also live longer than we do. Unlike us, other countries have the peculiar notion that profit has no place in any situation in which the basic decencies that human beings owe to one another ought to be the first consideration, and for that reason regulate the cost of lifesaving drugs and operations. In other words, they are less greedy than we are and far more humane.
Health Care: The New American Sadism
ObamaCare Clusterfuck
A new series by Lambert Strether at Corrente. Enjoy!
White House delays small business coverage, citing “operational challenges”
Low wage workers “screwed” (Salon’s word)
Insurers get to cherry pick 2014 renewals
The way out is single payer experiments by the states
CO pushes single payer citizen initiative
Is Joe Klein truly the most stupid member of the political class?
Yay for the entrenchment of the private insurance model as pretend-universal healthcare!
As Lambert says at the end of the 2nd linked piece:
Of course, with single payer these problems don’t arise. Lower Medicare eligibility age to zero and boom! You’re done. Well, over-simplifying, but the right idea. The political class, because they are owned and they suck, thinks people want choices in health insurance. They don’t. They want choices in health care. Doctors can do that. Abolish the health insurance companies, and all their complex rental extraction schemes, and make health care a right that’s paid for with a single payer, and all the “operational challenges” go away.
› The VA is Severly Backlogged, and It May Be Costing Lives
Military veterans experience “excessive wait time” for medical care, leading to higher incidences of preventable hospitalizations and death, according to a scientific research council.
Drawing on the findings of recent government and scholarly studies, a report issued this week by the Institute of Medicine paints a picture of a healthcare system that is understaffed, undertrained, and inaccessible.
Davies’s report is full of good stuff. It points out that while targets and political attention to MRSA and Clostridium difficile have paid off, bigger problems are being caused by gram negative organisms. They live in our guts, where they exchange antibiotic resistance genes with abandon. Even worse, all the obvious weaknesses in bacteria that can be attacked by antibiotics have already been targeted. So the development of new drugs is very difficult. And antibiotics are not good business for Big Pharma, because they cure patients quickly, unlike blood pressure pills and all the other drugs that are taken for life. Davies’s recommendation that antibiotic resistance should be put in the national risk register is very reasonable. It could even be said that there is a better case for it to be there than an influenza pandemic, which tops the current list, because our ability to prevent flu by vaccines and antivirals, and the outcomes of treatment, are improving all the time, whereas for antibiotic resistance a pessimistic policy is the only prudent one.
The Antibiotics Problem
Arkansas Enacts Strictest Abortion Law In The Country
Arkansas has just enacted the most extreme abortion law in the country - barring abortion at 12 weeks.
Despite the Governor’s veto, both chambers of the legislature voted to override, making it illegal to have an abortion after 12 weeks - still in the first trimester and only shortly after most women will have learned they are pregnant. This ban is two months earlier than any other state in the country. And it comes soon after the legislature banned abortion after 20 weeks.
Certain politicians in Arkansas don’t seem to care that this law is unconstitutional. Nor do they care that this law strips women of their ability to make deeply personal reproductive health decisions.
The Supreme Court’s Roe v. Wade decision affirmed the right to a safe & legal abortion. However, opponents of abortion in Arkansas disregard this ruling in their effort to both remove the right that Roe affords women and to force the Supreme Court to reconsider the constitutionality of abortion. These bans in Arkansas are one more step in their strategy to make all abortions completely illegal.
(via randomactsofchaos)
Food companies have known for decades that salt, sugar and fat are not good for us in the quantities Americans consume them. But every year, people are swayed to ingest about twice the recommended amount of salt and fat — and an estimated 70 pounds of sugar. We speak with New York Times reporter Michael Moss about how in his new book, “Salt Sugar Fat: How the Food Giants Hooked Us.” In a multi-year investigation, Moss explores deep inside the laboratories where food scientists calculate the “bliss point” of sugary drinks or the “mouth feel” of fat, and use advanced technology to make it irresistible and addictive. As a result of this $1 trillion-a-year industry, one-in-three adults, and one-in-five children, are now clinically obese.
And don’t miss the follow-up: Pandora’s Lunchbox: Pulling Back the Curtain on How Processed Food Took Over the American Meal
› How the ‘For Profit’ Health Care System Ignores the Hippocratic Oath. | Corrente
A majority of medical schools recite the Modern Hippocratic Oath either at entrance to, or graduation from medical school. Although this oath is in no way binding, those of us who use physician’s services trust them to adhere to the principals that they once professed to embrace.
I could analyze each part of the Oath, but I would like to focus on this paragraph:
“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”
This paragraph has no basis in the real world of the “For Profit” medical system in the U.S. Here is a quick story to illustrate.
My diabetic older brother died in 2009 at the age of 47, due to his having no medical insurance. Somehow he got a bacterial infection in his foot that had it been left untreated would have rapidly spread through his body and killed him. Doctors said, had he waited another hour, he most likely would have lost his leg. As it was, he had 1/3 of his right foot amputated.
Four operations, seven days in the hospital and numerous follow-up visits later, you can imagine the hundreds of thousands of dollars in bills that accrued. While the hospital used money set aside in an endowment to cover the hospital costs, the doctors were another story. Their bills were nearly $200,000.
With no medical insurance, although both he and his wife worked, there was no way for them to pay these bills. Now insulin dependent and unable to work, he had to file for bankruptcy. It’s the same story for thousands of Americans every week. Unable to get the physical, emotional and occupational therapy he needed to adjust to the new limitations, I believe he simply gave up. He died in his sleep one week after the bankruptcy was finalized. My Sister-in-law is still struggling to recover from having her life decimated.
[…] What kind of a society creates doctors that save a life and then are willing to allow that life to be financially and psychologically ruined due to the inability to pay. It’s like taking out a prisoner’s appendix so you can execute him later. Then there’s the irony that those doctors never did get any of that money. Universal health care for all could have eliminated the suffering my brother’s, and so many other’s, suffering.
Doctor’s are the ones who should be out front demanding that money not be the determining factor for access to the medical system. Not in America.
“Today’s Financial Times has has a front-page piece (“US business hits out at ‘Obamacare’ costs”) confirming the central point of the McKinsey survey: for many employers, it will be much cheaper to pay the penalties than cover full-time workers, and cut the hours for others so they fall under the definition of full-time and then don’t have to be covered. Retailers and fast-food chains are the most likely to do that, but there’s no reason that many other employers wouldn’t join in.
David Dillon, CEO of Kroger, put it succinctly: “If you look through the economics of the penalty the companies pay versus the cost to provide coverage, the penalty’s too low, or the cost of coverage is too high.” The penalty for not covering a worker is $2,000 a year — less than half the cost of covering a single worker ($4,664, according to the Kaiser Family Foundation), and less than a fifth the cost of covering a family ($11,429). Uncovered employees will be forced to buy coverage on the new insurance exchanges — with a government subsidy if their income is low enough— or pay the penalty themselves.”
