Gentle Reader – The next months and years in our United States will be fraught. How so many of our people could have been convinced to vote for a fraud, a charlatan, a self-described abuser of women, a man who encourages torture and war-crimes, encourages violence upon dissenters, is a question that will consume gallons of ink and reams of paper (or 1s and 0s). There will be much blame to pass around; indeed analysis has already begun.
In this Section – Issues of our Time and Destiny – we will discuss what went wrong and how we can correct the wrongs. I have some thoughts in this and will post them as well as the thoughts of others. Please comment and criticize if you wish.
By the way, the title of this page, Issues of our Time and Destiny, is from a poem of one of the victims of the first 9/11, Victor Jara, a crime in which we were complicit and for which we have never accounted. A bit of a problem when we only look forward and never back.
34. Gentle Readers – a few words (837 to be exact) on the Graham-Cassidy Bill. Yet another transparent attempt to strip access to health care from the American People and cut taxes to the rich.
The Graham-Cassidy Bill: Yet another Attempt to Remove Health Care from Americans and Cut Taxes for the Rich
It had been my intention to write a multi-part series on Health Systems as a way to lead into further discussion about the direction our health system should take. There are also issues related to women’s health, the opiate crisis, mental health services (or their lack), and the role of the “unsung” in the history of medicine and science (who amongst you remembers Bernard Fantus ? More on him later).
But not today. Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) and their minions are trying to repeal the Patient Protection and Affordable Care Act (ACA), replacing it with legislation that will harm many of us. If you think I am overstating the issue and being excitable, read on. I will not reiterate here the pluses and minuses of the ACA, you may read the several pieces written by me as well as others on that issue. Here, I will “simply” point out the destruction that will be caused by this new attempt to strip health care from the American people…..more follows
33. Here is the 5 part series on the Health System of the United States and its’ “peer systems”. We CAN do better than this, and not through the Graham-Cassidy bill.
The Health System of the United States of America – Can We Do Better than This ? A Five Part Series
“There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not?”
Those over a certain age will remember this phrase from then Presidential-candidate Robert Kennedy’s 1968 speech. I use it here purposefully, to begin a series on health systems and health. We hear repeatedly – I’ve said this – that our system is inadequate, expensive, unresponsive; a Rube Goldberg system that results in high-cost and poor outcomes. This price is not just in dollars: it is lives lost, potential wasted, opportunities destroyed.
I have been extremely critical of the so-called “Repeal and Replace” or “Just Replace” process that Representative Ryan, Senator McConnell and Mr. Trump attempted to institute; that it unwound is a plus for our citizens. This does not mean that what we have in the Affordable Care Act (ACA) is optimal, or even just ok. Thus, I dream of what could be and say: Why not?…..more follows
32. Gentle Reader – The piece for the column to be published 6 August, 2017=====================
The Collapse of “Repeal and Replace” and “Just Repeal” – Was There Ever a Plan ?
Now we know. Despite eight years calling for repeal of the Affordable Care Act (ACA) Messers McConnell (R-KY), Ryan (R-WI) and colleagues had no plan, actually no clue, of what to do. This is unsurprising. The ACA is an amalgam of conservative, originally Republican, proposals that were finally operationalized by President Obama…….more follows—————————————————————————————–https://ajlayon.com/2017/08/04/the-collapse-of-repeal-and-replace-and-just-repeal-was-there-ever-a-plan31. Gentle Reader – The Introduction to the new twice monthly column in the regional press. All pieces will be placed here as well.
INTRODUCTION TO NFTSH
Welcome to the new column on healthcare and health policy. I use this initial space to explain who I am, how I got here, and what you can expect if you walk this path with me every other Sunday.
As the poet says:
I am a man from across the ocean, who has come to stay with you, who speaks a different language, and who walks on different legs.
In a way, that’s me. We are immigrants from the Middle East; my father and his brothers were Navy and Army during WW II – dad on the USS Yorktown – mom a Coast Guard’s Woman. My brother and sisters all dreamed – and achieved – the American Dream. Our three children are adults in service to humanity……more follows
———————————————————————–https://ajlayon.com/2017/07/16/notes-from-the-s…e-regional-press/——————————————————————————————30. Gentle Reader – Another piece whose title says it all. The case of Charlie Gard and our continuously shrinking President’s intervention in the affairs of the British National Health System and a Family’s tragedy.
This Man Has No Sense of Irony
In Britain this morning, there is an 11-month old child named Charlie Gard with a genetic disease that condemns him to death. The disorder, Mitochondrial DNA Depletion Syndrome (MDS), is a group of disorders caused by abnormalities in various genes that result in mitochondrial failure. The mitochondria, you may remember, exist in all the cells in our bodies and produce the energy we need to live; without them we die…….more follows
—————————————————————-29. The piece says it all. I think I am running out of words.
Why has the Senate Kept Us in the Dark about the AHCA ?
he House of Representatives passed the American Health Care Act of 2017 (House Resolution 1628) on 4 May 2017. While the Senate is in the process of re-writing this legislation, it is being done completely in secrecy. Democrats, Independents and even Republicans are being kept in the dark. When Republican Senators are asked about even the broad outlines of the bill, their response is: We don’t know. Because they don’t know……more follows
————————————————————————-28. I have nothing more to say than what is said in the piece.
Maybe Death Isn’t All That Bad: Trump’s Budget Proposal Slashes Spending by $3.6 Trillion Over 10 years – Guess Who Pays ?
The “oil spot” theory of counter-insurgency asserts, in brief, that if we take an area and make it safe for the population, the effect of this improved safety would spread beyond the confines of the area made safe(er), kind of like an oil spot spreads. Not being a counter-insurgency expert, I can’t be sure I have this exactly right, nor that it actually works – Viet Nam, Afghanistan and Iraq come quickly to mind – but you get the point.This oil spot analogy may work in life as well; at least in my life as I am living it now. I am thinking, specifically, about death.
—————————————————————————27. Gentle Readers – this was published this morning in the Daily Item, the paper for this area of Pennsylvania. I grant that it is not measured and without passion. But then, if you have read anything I have written, you will know that the facts are correct, but there is always passion.———————Today the Republicans and their President presented the “idea” they have to repeal and replace the Affordable Care Act (ACA), also known to many as ObamaCare.To be perfectly transparent, I must point out that while I read the actual legislation and generally supported it, I found too many insurance company give-aways were included. The single-payer option, which would have driven costs down in a major way while focusing our quality efforts, was not allowed to see the light of day. Obama and his collaborators made the calculation that if they tried to have a single-payer option – that is, one among many – the entire plan would fail. So, they chose, instead, a complex system of Exchanges, Subsidies, Medicaid expansion and regulation to get where they wanted to go.https://ajlayon.wordpress.com/2017/03/10/repealing-the-affordable-care-act-be-afraid————————————————————-26. Gentle Reader – We are in for a rather wild ride, and I don’t mean that in the most pleasant or interesting way. The new administration – or should I say anti-administration since Trump has appointed government haters to his cabinet, from the Secretary of Education to the Director of Management and Budget, to say nothing of his Breitbart Chief of Staff – having come to power on the strength of lies, will soon betray the people who voted for him. Indeed, the very Cabinet members I refer to is the beginning of this betrayal, not just to his voters, but to our planet, but more on that later.In classes I teach, a complex issue will come up with no obvious way to perform analysis. I often remind my students that they should at least start the analysis by finding some part of the problem of which they have knowledge, and working from there. This does not, of course, guarantee final successful analysis of the entire problem, but it does provide a start point. In the same way, we will deal with this President-elect and what are likely to be the contours of his policies. And we will do this by studying, in the detail available, his plans for health care.Some years ago, after reading the legislation that produces the Patient Protection and Affordable Care Act (ACA) – yes, I ACTUALLY read it, the first 600 pages which dealt with acute care; I didn’t read the last several hundred dealing with chronic care, although I probably should have as the issue of chronic care becomes more and more important in our health system………https://ajlayon.wordpress.com/2016/12/18/healthcare-under-trump25. Gentle Reader – Much is written about the bravery and heroism of our men and women in uniform. Even I, one who doesn’t wear uniforms or accept top-down discipline easily, think much about these accolades are right. Much, not all. There are horrors, crimes, carried out by our men and women in the military, and all too often, there is no justice when these illegitimate acts are discovered.When the leaders of our country refer to, essentially, anyone in uniform as a hero, it is unseemly; a uniform doesn’t make you a hero, words uttered or actions performed in a dangerous setting make the hero. Sometimes, a hero is born merely by living her or his life: one of my heroes are single mothers who do the best they can every day to provide for and raise her child; the teacher – much abused in our culture and profoundly disrespected by many (see Trump’s selection for Secretary of Education if you have doubt) – are another of my heroes. I should point out that three women I love are teachers, so I might be somewhat biased here.None of this, however, should suggest that military men and women aren’t or can’t be heroic. The story below details the unique heroism – real heroism – of three men of my generation. Hugh Thompson, Larry Colburn and Glenn Andreotta, young men flying one of the United States’ armed helicopters in Viet Nam, confronted abuses and crimes by their fellow soldiers and acted.By their actions, these three men – now all dead – have earned the right to be called heroes. These three are my heroes.—————————————-
Larry Colburn, Who Helped Stop My Lai Massacre, Dies at 67
Larry Colburn, who became an 18-year-old American hero when he intervened with two comrades to halt the massacre of unarmed Vietnamese civilians by United States soldiers in 1968, elevating an innocuous hamlet named My Lai into a watchword for the horrors of war, died on Tuesday at his home in Canton, Ga. He was 67.
24. Gentle Reader – Let us now say goodbye to what we thought we knew about how our Government worked. Infrastructure spending – goodby. Health care (ACA, Medicare, Medicaid) – adios. Educational assistance – adieu.The rich will make out like – well – bandits.This is what thumbing our nose to the elites – without thinking, without analysis – gets us. An elite thug, blending crony capitalism with fascism.
Analysis of Trump’s Tax Plan Shows Big Cuts in Taxes, Federal Revenue
Updated Dec. 22, 2015 8:34 p.m. ET
Donald Trump’s tax plan would cut federal revenue by $9.5 trillion over a decade and boost the after-tax incomes of the wealthiest households by an average of more than $1.3 million a year, according to an analysis released Tuesday.
The Republican presidential candidate’s proposal would lower income tax rates and exempt millions of low-income households, requiring significant new borrowing or unprecedented spending cuts beyond anything Mr. Trump has detailed in his campaign.
Mr. Trump’s plan, first released in September, would eliminate 22% of federal revenue over 10 years, radically shrinking the government, according to the Tax Policy Center, a nonpartisan project of the Brookings Institution and the Urban Institute.
23. Gentle Reader – It is this setup for the next 4 years – a tax cut that removes somewhere between $ 5 and $ 9 trillion from the Federal Treasury, most going to the wealthiest 1% – that sets the stage for cuts in Medicare, Medicaid, educational assistance, Social Security (?), everything. A renewed or revised Accountable Care Act ? Forget it, you 20-million who were helped by the attempt – this first step – at a national health care scheme. We will be lucky to have anything except the dried husks of empty promises.And the tax-cuts of this charlatan will result in a TAX INCREASE for the the unsung heroes of our country: low-income and single parent families.Cuts to everything, that is, except for our bloated military. A military that this President-elect will use to our detriment when his economic plans and promises are ship-wrecked on the reefs of reality. At that point, he and his cabal of criminals will be in search of an enemy to make war upon.The most likely victims are middle- and low-income families.—————————————————–
Expert warn that more than eight million low-income and single-parent families will face sharp tax increases under Donald Trump, exacerbating income inequality.
Under Donald Trump’s proposed tax plan, the most wealthy Americans will receive an average annual tax cut of $215,000.
President Donald Trump is set to give America’s richest 1% an average annual tax cut of $214,000 when he takes office, while more than eight million families with children are expected to suffer financially under his proposed tax plan.
22. Gentle Reader – the attempt to “normalize” these bigots and racists has begun. Remember, the violence these people are capable of perpetrating upon us will always start with words; indeed the words have begun. They are not normal; this is not a normal time.
Donald Trump, Stephen Bannon and how bigotry became a cool new trend
There is no journalism course that prepares students for the advent of a bigot in high office. How does one address the president-elect of the United States and his associates when they have clearly made racist, sexist or antisemitic statements? It is a protocol of tact and diplomacy that has not recently been tested in the western world. But some in the media have not risen to the challenge, choosing instead to treat the office and status with a respect that has been voided by its occupants.
21. Gentle Reader – In the context of the previous piece, this may be the place where the war begins. When the President-elect’s economic plans fail, when he is reviled by the very people who voted for him, when his tax cutting is revealed for what it is – a $ 3.5 to $ 5.5 trillion hole in our budget with the proceeds going to the richest 1% of the US population – this man and his minions of hate will be looking for scapegoats, for new enemies to divert our attention.
This may be – although we should all hope I am wrong – where that diversion occurs.
20.Gentle Reader – This is frightening enough, yet not written to frighten. Rather to steel one’s mind as to the work we have to do to salvage our world from the likes of Trump, Erdogan, Putin, Dutarte, al Asad, Netanyahu, and others. The question is: Do we have the ability to work together, or will the end come first ?
The combination of automation, complexity and climate change is dangerous in ways we haven’t even begun to grasp.
By George Monbiot, published in the Guardian 23rd November 2016
Wave the magic wand and the problem goes away. Those pesky pollution laws, carbon caps and clean power plans: swish them away and the golden age of blue-collar employment will return. This is Donald Trump’s promise, in his video message on Monday, in which he claimed that unleashing coal and fracking will create “many millions of high-paid jobs”. He will tear down everything to make it come true.
19. Gentle Reader – This, I fear is what happens when we “look forward, not back”, as President Obama so generously stated at the beginning of his first term. But by not dealing with the criminality that was perpetrated by our largest banks and bankers, by holding no-one accountable, our President Obama sent a message that there are no consequences of criminal behavior if you are rich or powerful enough; to our detriment.
There are many facets to the populist, anti-establishment anger that swept Donald J. Trump into the White House in Tuesday’s election. A crucial element fueling the rage, in my view, was this: Not one high-ranking executive at a major financial firm was held to account for the crisis of 2008.
18. Gentle Reader – Adrian says what I have been thinking better than I. How could we ? Stay home ? Not vote ? Carp about Hilary’s flaws ? Complain about her changing positions ? (don’t serious people change their positions when faced with new facts ?). How could we let her and ourselves down by not standing by her, and in so doing, allow a racist, KKK and American Nazi-supported, woman hating and abusing, would-be-torturer thug and his minions into the office of the President ?
This will be a bad four years, a bad generation. Yes, generation. The men – and they are likely to be men – that this President-elect puts into the Supreme Court will color our lives for a generation.
I’m about to piss y’all off. I might even lose some friends because of this. If you’re too much of a (grab ’em by the) pussy to handle it or tired of angry rants, maybe you should stop reading now because I’m going in on all of us. It’s been a week since the election and I’ve had some time to weep, rage, drink a bottle of wine, gather my thoughts, eat lots of carbs, weep again and drink two more bottles of wine, but still I have not yet been able to come to peace with the worst thing that has happened to this country since they made a standalone movie for Catwoman. But maybe bitching to you, my friends, my fellow progressives, may help bring some solace and help us understand where we went wrong so we can come together and kumbaya or whatever.
17. Gentle Reader – Is this what our fellow citizens who voted for the President-elect wanted ? If not, speak up. Words have power, my friends. The President-elect’s words are there for all to see.
‘You Deserve to Be Gassed’: Hate Crimes Skyrocket After Trump’s Win
U.S. Election 2016 – Haaretz – Israel News
Debra Nussbaum Cohen Nov 13, 2016 4:35 PM
NEW YORK – In the days since Donald Trump won the American election, as many 250 reports of hate crimes were filed with the Southern Poverty Law Center, it says — roughly the amount they receive in a typical five or six month period.
16. Gentle Reader – A Trump failure might doom our country, perhaps even our world. Yet I am unsure that success will be any better. How can I wish success to a man who wants to evict 11 million people from our country ? How do I wish success on a man who says he will order our soldiers, sailors, and marines to torture ? In what world do I wish success for a man who believes – and insists he will – commit war crimes by killing the families of those we believe are terrorists ? How can I wish success to a man who brags about his sexual predations ? And anyway, how could I face my daughter, Maria, and my granddaughters – Marianna, Sloane, Harry – if I wished him well in these things ?
My parents are 1st generation Lebanese, both sets of their parents came over to the US about the time WW I began. My mother’s parents came through Ellis Island, the “legal way”; my dad’s parents entered through Canada and then simply crossed the border into the State of North Dakota. My paternal grandfather became an active participant in the populist movement in North Dakota. During WW II, my dad was a sailor on the USS Yorktown; my mom a Coast Guard’s Woman. My son is a former Marine.
My son asked me to help with the Military Medical Corps so, even though I am not the person who follows orders or enters into a disciplined body of people with ease, I complied with my son’s request. I signed up for the (first) Army and then Navy Medical Corps. If my son needed better care, so did his buddies and if they deserved it, so did our enemies. After all, I am a physician; we take care of all who seek our aid.
My Navy packet is in its last stages of either acceptance or rejection ( I am a bit older than they prefer but have pretty good trauma and burn skills). If they were to have said “Yes”, I would have gone.
I am pulling the packet. I cannot serve under a commander in chief who has said he would order torture. The reasons I walk with little spring in my step these days are the following: not only do I fear the President-elect’s behavior, his policies on a woman’s right to control her body, climate change, and so forth. No, not only that.
I wanted to serve my people more than I have done in the last 35 years; I was to have been a Navy physician. And now, because I will not serve a man who would have us torture, commit war crimes, I cannot.
15. Gentle Reader – I don’t know Professor Tuttle, but I wish I did. If I met her, I would address her as “sister”.
A fine piece, detailing the concerns many of us have after the election of a man fulfilling the definition of a fascist, and appointing people to positions of power in a way that does nothing to limit that concern.
Astrophysicist. Mom. Lunatic. Bionic Woman. Heavily salting the garden path of ignorance. Disobedient and Uncontrollable. Armed with wrenches and a dream.
14 November, 2016
We are not ok.
Note: This has been removed by the AAS from the Committee for the Status of the Women in Astronomy. It has been replaced with a modified version. I (ST) was told it was an unacceptable “legal and reputational risk” to them.
13. Gentle Reader – Dissent is as American as our Republic. The very Republican Party that spent 8 years blocking every program President Obama attempted to put into place is in no position to be telling us to “just pull together”.
The President-elect has given voice to some rather terrifying positions, from banning an entire religion, to anti-Semitism, through support for torture, to violence against women.
Does ANYONE need wonder why there are protests in the streets ?
And to my fellow citizens who are in the streets, a word. Peaceful protest is the way. And remember, it is easier to take to the streets than to build a movement. We must do the latter, as well.
In the Trump era it is the movement that Sanders was part of coalescing that becomes key in building a resistance with a positive vision. One of the weaknesses of the Sanders message was its failure to unify matters of class with race and gender. This is about telling the right story about the United States. It is also a matter of tapping into significant social movements—Occupy; immigrant rights; LGBT, environmental justice; Black Lives Matter. This is where hope lies.
6. Gentle Reader – The first, by no means last, profound disappointment we will see with the election of this man.
Three items are particularly poignant:
1. Carrier Executives have said too bad so sad, we’re leaving;
2. The increase in salaries for working people OCCURRED UNDER THE PARTY OF ROOSEVELT. THE ONE WE JUST REMOVED. There were none under the Party of the Rich – er, Republicans.
3. In this article, one of the workers interviewed comments that Hilary has “never worked a day in her life”. What a profound lack of understanding of what it takes to study, to study The Law. And then to vote for a man who has done more harm to workers than we can imagine.
Can Trump Save Their Jobs ? They’re Counting on it
3. Gentle Reader – The next months in our United States will be fraught. How many of our people could have been convinced to vote for a fraud, a charlatan, a self-described abuser of women is a question that will consume gallons of ink and reams of paper (or 1s and 0s). There will be much blame to pass around; indeed analysis has already begun.
In this Section – Issues of our Time and Destiny – we will discuss what went wrong and how we can correct the wrongs. I have some thoughts in this and will post them as well as the thoughts of others. Please comment and criticize if you wish.
By the way, the section title, Issues of our Time and Destiny, is from a poem of one of the victims of the first 9/11, Victor Jara.
2. Gentle Reader – this thoughtful piece is from the Washinton Post. Authored by Steven Pearlstein, a WaPo business and economics writer, he is also Robinson Professor of Public Affairs at George Mason University.
Some data before you go on to the article:
UNDER OBAMACARE –
1. 129 million of us – including about 19 million children – with pre-existing conditions are protected from denial of coverage and reduced benefits;
2. 105 million citizens have benefitted from annual caps on out of pocket spending;
3. Prior to this year’s (2016) open enrollment period, 16 million uninsured have gained coverage;
4. Another 14 million of us – in addition to the above 16 million – have received coverage through Medicaid since Obamacare’s first open enrollment in 2013;
5. Tax credits have helped 7.8 million Americans, who otherwise couldn’t have afforded it, buy insurance in the Health Insurance Marketplaces;
6. 5.7 million young adults gained coverage under Obamacare because they could stay on their parent’s health plans until age 26.
All of this is real. All of this shows the positive power of government intervention.
All of this is at risk now.
There are consequences to our choices.
Repeal Obamacare ? Not Quite So Easy….Unless You’re Peddling Hokum
1. Gentle Reader – it may be me, my own flawed character or even lack of “pedigree”, but I’ve thought for years that way too much attention is given the brainiacs on the East Coast. Here is a beautiful and haunting piece by our own Gary Fincke, the Charles B. Degenstein Professor of English and Creative Writing at Susquehanna University.
Would that we paid attention to more like him.
Nov 12, 2016
For the last two days, I’ve tried to put the best face on the election results. There’s no point in ranting. There’s little to be gained by accusing others of being racist or misogynist or just plain stupid for voting for Trump even though, despite the claim that working-class America elected him, I know that in the working-class neighborhood in which I grew up, Trump would have been dismissed as a “pig” or worse.