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Tuesday, October 14, 2014

Judy Stone: I have practiced Infectious Diseases and Infection Control for 30+ years, primarily in a number of community hospitals, and offer a different perspective here, based on these experiences. Some of us suspect the Dallas patient was not admitted in part because he was uninsured. He was inexplicably and irrationally sent home with antibiotics for a presumed viral infection, even though he should have been considered an obvious risk. We need a health care system that cares for all, even for those without insurance, without causing them to delay seeking care until they are seriously ill, perhaps infecting others in the process (e.g., tuberculosis, more commonly). And we need to take the politics out of funding for public health and research. And we need to take the politics out of funding for public health and research. read more

Thursday, October 09, 2014

Public Safety Officer Ben Hall of Emmett Township, Michigan, pulled a car over for a traffic violation, while on patrol last Saturday. As the officer spoke with the driver, he noticed that a child was in the back of the vehicle without a car seat. The child's mom, Alexis DeLorenzo, explained that she couldn't afford one. Instead of ticketing DeLorenzo, the officer met her at a nearby Walmart and bought her a new car seat. read more

Tuesday, October 07, 2014

The Hammond (IN) police broke a car window and used a Taser on a passenger during a September traffic stop, according to a video recorded by a family member of the driver. According to a federal lawsuit against the police department, the officers acted "intentionally with malice, willfulness, and reckless indifference to the rights and safety of plaintiffs." Police pulled Lisa Mahone over for not wearing a seatbelt. They asked Mahone and her friend Jamal Jones, who was sitting in the passenger seat, for identification. Mahone handed over her license and Jones explained to the officers that he was ticketed for driving without registration and didn't have his license. Jones claims that the officer drew his gun when Jones went to retrieve his ticket. After calling for backup, they asked Jones to get out of the car because they feared for their safety. Jones said he would not get out "because he feared the officers would harm him." The rest is on the video. read more

Two NYPD officers are under criminal investigation after punching and bashing a 16-year-old suspect in the face with a gun despite the teen raising his hands to surrender, according to a video obtained by DNAinfo New York. The officers from the 79th Precinct are now targets of a criminal investigation conducted by the NYPD's Internal Affairs Bureau and Brooklyn District Attorney Kenneth Thompson. "What's depicted on this video is troubling and warrants a thorough investigation," Thompson said. read more

Friday, October 03, 2014

The separation of church and state doesn't mean "the government cannot favor religion over non-religion," Supreme Court Justice Antonin Scalia argued during a speech at Colorado Christian University on Wednesday. "I think the main fight is to dissuade Americans from what the secularists are trying to persuade them to be true: that the separation of church and state means that the government cannot favor religion over non-religion," the Reagan-appointed jurist told the crowd of about 400 people. "We do Him [God] honor in our pledge of allegiance, in all our public ceremonies," the conservative Catholic justice continued. "There's nothing wrong with that. It is in the best of American traditions, and don't let anybody tell you otherwise. I think we have to fight that tendency of the secularists to impose it on all of us through the Constitution." read more


It's truly appalling how little educated people understand about the real impact of taxation upon US citizens. As mentioned above, it's not the dollar amount that is important, it's the percentage of wealth paid in taxes that truly tells the story of it's real impact upon each taxpayer.

There never has been a time, nor will there ever be a time that the poorer quintiles of society will not pay a higher percentage of their wealth to taxation than do the wealthier quintiles and it is because of one simple, inescapable fact: The poorer spend all (or the vast majority) of their money on consumption and the wealthier always spend markedly smaller percentages of their wealth at any given time. Virtually every dollar spent is subject to additional myriad taxes beyond income taxes, depending upon where and how it's spent, while the wealthier not only invest substantial amounts of their wealth on investments, their returns are taxed at lower rates than workers are forced to pay on their own labor and their losses are deducted against current or future wealth taxation obligations. So again - as a percentage of wealth/income - the poorer always pay a significantly higher percentage to taxes than do the wealthier.

The 47% figure is largely irrelevant as an indicator of anything but the innate inequality our current economy fosters through the redistributive priorities of our federal and state governments. And the vast majority of non-income taxes are yokingly regressive because every taxpayer pays the same amount on the same dollars spent, even though any calculation tells you that it impacts the poorer far more than it scratches the wealthier taxpayers. Common sense tells one that any flat tax scheme will place a higher burden upon the poorer than it will the wealthier because the poorer have fewer dollars to begin with to live on. Lastly, those making less than $105k annually pay payroll taxes on 100% of their income while those making over that amount pay no more than those at the threshold amount, so again, advantage wealthy.

At some point one has to ask whether it makes more sense to decrease the spending power of the majority in order to alleviate a perceived burden upon the wealthier when much of said wealth comes from the consumption choices of the very people who are demonized for the misperception of not paying their fair shares.

Republicans were effectively shut out of the process from April of 2009 until it was signed in March 2010.

The Dems had the numbers to go it alone and that's exactly what they did. Now, for better or worse, they own this law. All of it.


Why do you continue to say something that is 100% FALSE?

This is how Senator John McCain saw the process play out:

I would like to make sure that my colleagues and especially those who were not here in 2009 understand that there are many of us who are opposed to Obamacare, as it's called, the Affordable Care Act, and the opposition that we mounted in 2009, it's a matter of record that, to start with, the Senate Finance Committee considered the Affordable Care Act over several weeks and approved the bill on October 13 of 2009.

At that time, members of the Finance Committee submitted 564 amendments, 135 amendments were considered, 79 roll call votes taken, 41 amendments were adopted. Then the Senate Health, Education, Labor and Pensions Committee approved the Affordable Care Act by 13-10 after a month-long debate. 500 amendments were considered, more than 160 Republican amendments WERE accepted.

And then it came to the floor of the Senate, and the Affordable Care Act was on the floor for 25 straight days, including weekends between Thanksgiving and Christmas of 2009. 506 amendments were filed, 228 of which were Republican. 34 roll call votes were held. Most roll call votes resulted in party-line votes, including a motion which I had to commit the bill to the Finance Committee for a rewrite....

But the fact is that this legislation was hard-fought, it was a legislative process, I didn't like the end of it, but I'm proud of the effort that we made and, frankly, the other side of the aisle allowed that debate to take place. And again, we finally finished up on December 24 of 2009 at 7:05 a.m.


Here is a prima facia example of how and why the Texas voter ID law is unconstitutional:

Texan Eric Kennie has voted in every single general election since his 18th birthday -- his parents raised him to understand the importance of the right to vote for African Americans like himself. Yet Kennie will not be voting in next week's election. He can't, thanks to Texas's new voter ID law.

The details of the ordeal Kennie faced in order to exercise his right to vote is chronicled in a must-read piece by the Guardian‘s Ed Pilkington. Because Kennie doesn't drive, he doesn't have a driver's license. That not only means that he lacks one of the few forms of ID Texas will accept at the polls, it also means that he has no easy way to bring himself to the government office that issues IDs to people in his position. Instead, he spent four hours per round trip, transferring to three different buses along the way. When he arrived, he had to wait up to three hours before he would be seen by someone who could issue him an ID.

Except that he was not issued an ID. On one of his trips, Keenie was told that he needed a copy of his birth certificate in order to obtain the ID. To get that certificate, he had to take another multi-bus trip to an entirely different government office. He also had to pay a $23 dollar fee.

To put that fee into perspective, Keenie earns his living by "foraging in people's garbage to collect cans, bottles and metal for recycling," according to Pilkington. The $23 fee is more than he earns in a typical day. It should also be noted that making an otherwise eligible voter's right to vote contingent upon their ability to pay a fee is unconstitutional. The 24th Amendment provides that "[t]he right of citizens of the United States to vote in any primary or other election for President or Vice President, for electors for President or Vice President, or for Senator or Representative in Congress, shall not be denied or abridged by the United States or any State by reason of failure to pay any poll tax or other tax."

Yet, even though Keenie ultimately decided to give up more than a full day's pay in order to exercise his most fundamental right as a citizen, he soon learned that even that was not enough. The birth certificate listed his name as "Eric Caruthers" -- Caruthers is his mother's maiden name -- and that meant he still couldn't get an ID because the name on the birth certificate did not match the name he registered to vote under.

Voter ID's defenders often justify these laws by claiming that they are necessary to thwart voter fraud. Yet, as Justice Ruth Bader Ginsburg recently explained, "there were only two in-person voter fraud cases prosecuted to conviction in Texas" between 2002 and 2011. So in-person voter fraud, the only kind deterred by voter ID, is virtually non-existent.

Eric Keenie, by contrast, is very real. thinkprogress.org

The officer, Darren Wilson, has told the authorities that during the scuffle, Mr. Brown reached for the gun. It was fired twice in the car, according to forensics tests performed by the Federal Bureau of Investigation. The first bullet struck Mr. Brown in the arm; the second bullet missed.

The forensics tests showed Mr. Brown's blood on the gun, as well as on the interior door panel and on Officer Wilson's uniform. Officer Wilson told the authorities that Mr. Brown had punched and scratched him repeatedly, leaving swelling on his face and cuts on his neck. www.nytimes.com

I wrote this on 09/06, long before the above information was confirmed:
Here is what I've always thought: Officer Wilson was scared for his life the moment Brown didn't cower to his immediate commands. Wilson bounced his door off Brown, got further pissed and grabbed at him through the open window. As Wilson did this, it probably dawned on him that as he was trying to pull Brown toward him that he was also making it possible for Brown to potentially reach his weapon, and this really freaked Wilson. It's also possible that Brown saw Wilson go for his gun and realized that he'd shoot him right there if he raised it up, so in theory, Brown may have been trying to keep Wilson from leveling the gun, not trying to take it from him. The trajectory of the 1st stray bullet might answer these questions based on where it was found. Browns palm- print on the top of the gun's barrel - or fingerprints on the side facing downward - might support such a theory of events.

Instead of confirmation bias, it's simply confirmation that Brown was shot in the arm from the FRONT during the encounter in the vehicle. What you've forever failed to consider is that what Wilson thinks was happening doesn't have to be what happened because Wilson can never speak to Brown's intent at that moment. The forensics of the struggle will tell us how it occurred, but they cannot account for what either man thought the other was doing. Obviously, Wilson believed Brown had criminal intent and was committing a crime against him, but if Wilson indeed was the instigator in grabbing Brown and pulling him into the SUV, then he initiated the dangerous scenario, not Brown, and it's possible Brown thought the struggle was for his own life. And as it turned out, if he thought this, he was right.

You have me confused with TonyRoma.


No, he doesn't. Everyone knows who and what you are:

Here is what I've always thought: Officer Wilson was scared for his life the moment Brown didn't cower to his immediate commands. Wilson bounced his door off Brown, got further pissed and grabbed at him through the open window. As Wilson did this, it probably dawned on him that as he was trying to pull Brown toward him that he was also making it possible for Brown to potentially reach his weapon, and this really freaked Wilson. It's also possible that Brown saw Wilson go for his gun and realized that he'd shoot him right there if he raised it up, so in theory, Brown may have been trying to keep Wilson from leveling the gun, not trying to take it from him. The trajectory of the 1st stray bullet might answer these questions based on where it was found. Browns palm- print on the top of the gun's barrel - or fingerprints on the side facing downward - might support such a theory of events.

Ultimately, Brown fought off Wilson, broke free then ran away. Wilson followed him and opened fire still fueled by adrenaline and fear. Brown was grazed from behind, stopped, turned around and gave up. He raised his hands and began to surrender to Wilson. In Wilson's mind he saw this large man headed toward him and fired away while still backing up out of fear.

I've never thought that Wilson intended to kill Brown or did so out of blind racism or bigotry. Wilson was a victim of his own fears and the living manifestation of them by Brown's visage and Wilson's mental interpretation of what had just transpired. In his mind, only a criminal would have done what Brown did and that thought dictated his resultant actions.

However, Wilson's fear and belief's should not protect him from being charged criminally because fear is not a reasonable basis for taking someone else's life when they are both surrendering and unarmed regardless of what you believe they did or might have done.

POSTED BY TONYROMA AT 2014-09-06 03:52 PM |

Exactly what bias was I showing here, that it might be more relevant to consider the human reactions of the actual participants, both under an immediate stress neither one was anticipating, more than to nitpick and critique the remembrances and reliabilities of myriad eyewitnesses?

One hospital I am familiar with has Powered Air Purifying respirators (PAPRs), purchased with bioterrorism preparedness grants, but neither stethoscopes nor other dedicated equipment for isolation rooms. So nurses and docs gown up to go in the room of a patient with a "superbug" but take their stethoscopes into the room and then on to other patients, perhaps remembering to wipe it down first.

The problems with controlling Ebola cases in the United States is not that we can't care for people well, or with good infection control. We absolutely can. But the Dallas case abundantly illustrates some of the problems in caring for anyone with a communicable illness, whether a antibiotic resistant organism (aka "superbug) like carbapenem resistant enterobacter (CRE), measles or Ebola.

It's fine to have policies for isolation and employee health. Administrators love that, and it looks great when JCAHO (Joint Commission on Accreditation) comes around. The problem is that we need training, practice, and the ability to demonstrate our infection control skills. I have made this plea repeatedly for helping to control superbugs, to no avail. I have suggested that each year or two we practice our skills using Glo-Germ, which will readily show if we make an error. For example, I suspect that I contaminate something as I try to balance and take off shoe covers. It's not easy. Unsurprisingly, now US nurses are saying they are unprepared for caring for Ebola patients.

In previous epidemics, especially during the SARS outbreak in 2003, removing personal protective equipment (PPE) was the most dangerous and health care workers (HCW) reported insufficient training. As Médecins Sans Frontières (MSF, or Doctors Without Borders) has demonstrated, HCW can be much safer by having a second HCW guide them through the removal process.

We don't need high tech to control Ebola. This has been demonstrated repeatedly. In the 1995 Kikwit oubreak, we learned that transmission was not airborne and that the epidemic could be controlled with very basic personal protective equipment. PAPRs and HazMat suits may, in fact, be more of a risk, given they complicate care. Clearly, we need basic education and a buddy system like this, not just for physicians and nurses, but for EMTs, housekeeping, radiology techs, etc. -- everyone who might come in contact with infectious patients or their secretions.


Could this new patient's exposure been due to removing her own protective gear where fluid attached to it at some point tending to the deceased infected patient?

I'm not going to spend time looking up the health related reasons studies like you mention get funded, but Congress has the responsibility of making sure the money is spent wisely, and they obviously are doing a bad job of it under any measure. If strange projects are being funded and they don't have a significant health-related rationale behind the research, then we've likely identified another inside grab by politically-connected interests.

It's ALWAYS politics Andrea, and it doesn't matter which side is which. They all play the game. The difference is I know the game is rigged and the only way for important projects to be funded is through the public trough, especially when there won't be a huge financial bonus at the user-end by private corporate interests.

We need to stop using the omnipresent fact - that there is graft and corruption throughout the process and there will never be a truly pristine system - from keeping us what is needed to insure both a healthier and safer public through the governments we have in place to protect and serve us, the collection of all taxpayers who pay our own way as the cost of citizenship. If this threat doesn't make you see how each and all of us are interconnected by the very way we live our lives then you're not paying attention.

There is a very real, and very important "public interest", and money isn't going to buy a cure or vaccine when there isn't one to be sold. Germs aren't usually racist and don't discriminate by class. That should be frightening to everyone when the reality hits that the health conditions of the poorer may determine the very lives of some of the privileged.

We need to approve a strong Surgeon General like Dr. Vivek Murthy, and not have appointments like his be derailed by the NRA and their politicians. NIH's budget was reduced by $446 million from 2010 to 2014, and subjected to inappropriate politically motivated interference in its decision making. The CDC's discretionary funding was cut by $585 million during this same period. Shockingly, annual funding for the CDC's public health preparedness and response efforts were $1 billion lower for 2013 fiscal year than for 2002. These funding decreases have resulted in more than 45,700 job losses at state and local health departments since 2008. Again, it is not just the Ebola that is a looming threat. We need to worry about vaccine-preventable but neglected infections like influenza, measles, and whooping cough; the serious emerging viral infections in the US like Enterovirus-D68, chikungunya and dengue, as well as overseas MERS and bird flus, and natural disasters.

Appeals such as this one didn't just materialize after Ebola broke out in Africa. There is a reason Congress is charged with passing federal budgets based upon the needs of the bureaucracy it funds. Slashing budgets without first prioritizing specified spending leads to inevitabilities like the ones we're facing as infectious diseases threaten our populations. Many people understood the need to make sure the poorest of our citizens have timely access to healthcare services precisely because these people will wait to the last possible second to seek care that they cannot afford, potentially infecting friends, families and anyone unfortunate enough to have contact with them as infectious disease incubates and worsens.

Maybe this will wake up many who feel as a society we cannot afford to provide healthcare access to every citizen. Karma has a way of showing the ignorant and selfish the error of their ways in excruciatingly painful and much more costly ways.

I'm an epidemiologist with Los Angeles County Public Health Department, and I worked there all through the Bush years, and have worked closely with CDC throughout my career.

I just want to inform your reporting on the trend of public health spending during those years. Bush sent a LOT of money to public health departments. A LOT. There was the push to vaccinate every person against smallpox (remember that?) and there were other foolish vaccination-type initiatives as well.

But most of the money they threw at us was bioterrorism money. And I do mean they threw it at us. We had so much bioterrorism money (BT) that most large health departments (which are largely local animals -- city-run or county-run) formed whole sections in their departments, fully staffed and rolling in money such that the staff couldn't even spend fast enough.

And this for a problem that didn't exist, of course. There was no bioterrorism. But we did use the money wisely, on emergency planning and resourcing. Every public health worker was trained in emergency management. Our public health lab was expanded and highly improved. And of course as you know, California has earthquakes, so we broadened the emergency management training protocols to include natural disasters, which are infinitely more likely than a massive bioterrorism attack, I'm sure every sane person would agree.

That massive public health response to the Bird Flu in 2009? That was due to the expansive program of emergency management across the US almost entirely funded by bioterrorism money. So ultimately the money didn't go to waste.

Unfortunately, much of the money for more routine public health measures was either cut or turned over to ideologues. I could enumerate the insanity, but it's not relevant here. I do give Bush credit, however, for saving millions of lives in Africa with his malaria and HIV initiatives there.

Of course, the severe recession and the sequester and all the rest put severe strain on local health departments these past years, as we all know. We are just now starting to recover the lost staff and the lost capability. I am, however, completely confident that our local health system is fully prepared in the event of an outbreak. Our ACD and public health nurses and investigators are first rate. talkingpointsmemo.com


St. Louis police did not release much information overnight about Myers or formally identify him, but the St. Louis Post-Dispatch is reporting that the teen was set to stand trial next month for unlawful use of a weapon.

Myer's family, however, is contending that he was unarmed and had been "Tased" by the officer prior to being shot.

Dotson had initially declined to provide information on Myers, but, while still refusing to identify him, then said that he was "no stranger to law enforcement" on Thursday, according to the Post-Dispatch.

The newspaper reported that Myers was set to stand trial in November on charges of unlawful use of a weapon and resisting arrest. As a condition of bail, he was supposed to be under house arrest and wearing an ankle bracelet. Nothing in his file suggested that he has previously broken the rules of his house arrest, according to the Post-Dispatch.

Myers' family said that he had been unarmed and leaving a convenience store after buying a sandwich when he was caught up in a police chase that didn't involve him, according to the newspaper, based on the family's own discussions with witnesses.

"My nephew was coming out of a store from purchasing a sandwich. Security was supposedly searching for someone else. They Tased him," Jackie Williams, his uncle, said. "I don't know how this happened, but they went off and shot him 16 times. That's outright murder."

The police told the Post-Dispatch that the officer did not have a Taser, in response to the comments from Myers's family. talkingpointsmemo.com

This is going to be fairly cut-and-dried as it regards the discrepancy in the narratives. Either he was tased or he wasn't. Either he will show up on the store video unrelated to the outside chase or he'll be shown with the other suspects. The key is to divulge the important information as soon as it's available.

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