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  • Archive for the 'Health Care' Category

    Reopening — I (Practice)

    Posted by Jay Manifold on 17th August 2020 (All posts by )

    For most Americans, the great day of realization of the seriousness of the COVID-19 threat—or more precisely, the seriousness of the official reaction to it—was Thursday, March 12th, when they woke to the news that the previous evening, the National Basketball Association had postponed an OKC Thunder-Utah Jazz game after a player’s test result came back positive, and then quickly canceled the remainder of the season. I was less concerned with the NBA, but coincidentally, also on Thursday the 12th, was informed that a certain institution of higher education that we all know and love was moving to remote learning for undergraduate and graduate classes for its entire Spring Quarter of 2020. Simultaneously, nearly all students were ordered to plan to vacate their on-campus housing by 5 PM CDT on Sunday, March 22nd.

    I had also just returned home from a severely truncated trip to Italy which had gotten no farther than New York City. Had the Italy leg been undertaken, I would have been on one of the last flights out of that country before it was locked down entirely, and would have been a strong candidate for two weeks of quarantine upon arrival in the US. I was therefore necessarily concerned with pandemic response, and on the day after my return home, sent an e-mail to several leaders and volunteers in my church with a general offer of expertise and recommendations to pursue several of the items discussed below, especially a communications plan.

    Read the rest of this entry »

    Posted in Christianity, Civil Society, COVID-19, Current Events, Health Care, Management, Personal Narrative, Religion, Society, USA | 8 Comments »

    What is going on with China right now ?

    Posted by Michael Kennedy on 12th May 2020 (All posts by )

    China was admitted into the World Trade Organization in 2001 with the understanding that they would participate in free trade and to international norms.

    Until the 1970s, China’s economy was managed by the communist government and was kept closed from other economies. Together with political reforms, China in the early 1980s began to open its economy and signed a number of regional trade agreements. China gained observer status with GATT and from 1986, began working towards joining that organization. China aimed to be included as a WTO founding member (which would validate it as a world economic power) but this attempt was thwarted because the United States, European countries, and Japan requested that China first reform various tariff policies, including tariff reductions, open markets and industrial policies.

    That has not happened. China has followed a mercantilist trade policy, stealing intellectual property, requiring companies selling to the Chinese to share ownership with often corrupt entities owned by the Peoples Liberation Army and relatives of regime principals.

    Mercantilism is a policy that is designed to maximize the exports and minimize the imports for an economy. It promotes imperialism, tariffs and subsidies on traded goods to achieve that goal. These policies aim to reduce a possible current account deficit or reach a current account surplus. Mercantilism includes an economic policy aimed at accumulating monetary reserves through a positive balance of trade, especially of finished goods. Historically, such policies frequently led to war and also motivated colonial expansion.[1] Mercantilist theory varies in sophistication from one writer to another and has evolved over time.

    America has been largely passive in tolerating this behavior until Donald Trump became president. Some of this passivity may reflect Chinese influence with US politicians.

    While it may seem politics as usual in Washington today, some are alarmed.

    “Nobody in the 1980s would have represented the Russian government. And now you find so many lobbying for the Chinese government,” said Frank Wolf, a retired U.S. representative from Virginia who long served as the co-chairman of the Tom Lantos Human Rights Commission. “I served in Congress for 34 years. I find it shocking.”

    Read the rest of this entry »

    Posted in China, COVID-19, Health Care, Markets and Trading | 47 Comments »

    Risk Register

    Posted by Jay Manifold on 18th April 2020 (All posts by )

    There are, of course, many items that could be placed in a risk register for our ongoing management of COVID-19. I find myself drawn to those categorizable as, or perhaps triggered by, human perception and behavior. By way of limiting the scope of this post to reasonable attention spans, here are my current top 3: Read the rest of this entry »

    Posted in Big Government, Business, Capitalism, China, Civil Society, COVID-19, Current Events, Health Care, Human Behavior, International Affairs, Law Enforcement, Markets and Trading, Predictions, Religion, Society, Statistics, USA | 21 Comments »

    SARS-CoV2/COVID-19 Update, Easter 2020 edition

    Posted by Trent Telenko on 12th April 2020 (All posts by )

    There are lots of hopeful reports — despite the USA COVID-19 infections being over 1/2 million and the total deaths of over 20,000 people — that the pandemic will soon be “Over.”

    This is fantasy thinking at best.  SARS-CoV2/COVID-19 won’t be over, until it is over, for YEARS.

    “Over” being defined as world wide mass vaccinations to the tune of 70% of humanity or human herd immunity.  Assuming such a thing is possible, which it may not be, given this recent report from the UK Daily Mail on post SARS-CoV2/COVID-19 infection immunity —

    Blow to Britain’s hopes for coronavirus antibody testing as study finds a THIRD of recovered patients have barely-detectable evidence they have had the virus already

    .

    – Nearly third of patients have very low levels of antibodies, Chinese study found
    – Antibodies not detected at all in 10 people, raising fears they could be reinfected
    – Explains why UK Government repeatedly delayed rolling them out to the public

    .

    https://www.dailymail.co.uk/news/article-8203725/Antibodies-prove-difficult-detect-Chinese-coronavirus-survivors.html

    .

    Related studies:
    Wu F et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. medRxiv 2020.03.30.20047365; doi: https://doi.org/10.1101/2020.03.30.20047365

    .

    and

    .

    Zhao J et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019, Clinical Infectious Diseases, , ciaa344, https://doi.org/10.1093/cid/ciaa344
    total by July 1st 51,197

    Or this South Korean story on coronavirus “reactivation” —

    South Korea reports recovered coronavirus patients testing positive again
    APRIL 10, 2020
    Josh Smith, Sangmi Cha

    .

    https://www.reuters.com/article/us-health-coronavirus-southkorea-idUSKCN21S15X?utm_campaign=trueAnthem%3A+Trending+Content&utm_medium=trueAnthem&utm_source=facebook

    The issue with most COVID-19 tests, like the ones mentioned in South Korea, is they detect SARS-CoV2 RNA. They do not detect whether the viral particles are active or not. The issue here is whether these people are shedding active viral particles that can re-infect people.  We don’t know if that is the case here from the story text.  Given how infectious it is.  This coronavirus will tell us in due course.

    There are some viral diseases like Herpes that hide inside your body and reactivate to make you infectious. We do not know enough about the SARs-CoV2 virus to say whether that is the case here.

    If the SARS-CoV2 virus is like Herpes in that once contracted, it never goes away and flares infectious several times a year.

    And there is no herd immunity for some people no matter how often they are infected.

    Then we will need multiple, cheap,  out-patient style “cure-treatments” as well as multiple vaccines, based on co-morbidities, and possibly to account for racial differences like sickle cell blood mutations, as SARS-CoV2 may well be more a blood disease than a respiratory infection in terms of it’s killing mechanism.

    See:

    COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism

    https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

    There is not enough reliable data, d*mn it!

    Until we get to “Over,” our old economic world of Just-In-Time, Sole Source anywhere, but especially in China, is dead without replacement.

    The world is in the same position as Germany was from August 1944 – April 1945 or  Japan from August 1944 until August 1945 versus the Allied strategic bombing campaign.  We have entered the world of  End Run Production as world wide supply chains grind to a halt from various fiddly bits of intermediate parts running out without replacement.  The on-and-off hotspots world wide of COVID-19 at different times and places in the world economy is no different than WW2 strategic bombing in terms of causing random damage to the economic life support.

    See also  “End Run Production” here from this one volume WW2 history book The Great Crusade:

    https://books.google.com/books?id=5L-bwPZK7PQC&pg=PA420&lpg=PA420&dq=%22End+Run+Production%22&source=bl&ots=kc30FQflCj&sig=ACfU3U2kmF-kTPo0Tgr2A9_ESPKpEQAEOg&hl=en&sa=X&ved=2ahUKEwjfpurOnOPoAhUKA6wKHemwBMcQ6AEwAHoECC4QKQ#v=onepage&q=%22End%20Run%20Production%22&f=false

    Be it automobiles, self propelled construction equipment, jets, power plants or the latest electronic gadget, anything that has thousands of parts sourced world wide with lots of Chinese cheap/disposable sub-component content anywhere in the supply chain simply won’t be produced for the next 18 months to three years.

    This “random damage to the economic life support” effect is amplified by the unwillingness of Western private industry to invest in building the capitol equipment to produced those intermediate parts.  Because of the threat of China coming back with predatory pricing — using bought politicians to cover for them — means those parts won’t be built without massive cost plus contract government buy out of the investment risk like happened in the USA in the 1942 WW2 mobilization.

    The story of  one American n95 mask manufacturer’s experience with the Obama Administration in 2009 with the Swine flu is a case in point.  The n95 mask is a 50 cent item where China pays 2 cents a mask for labor versus 10 cents a mask for American labor.  When the American manufacturer geared up to replace Chinese mask production.  China came back on-line and the Obama Administration refused to keep buying the American mask producer’s 8 cents more expensive mask when the Chinese masks were available.

    Unlike almost 80 years ago, current Western and particularly American politicians are too corrupt to go too massive cost plus contract government buy out this private investment risk.  Mainly because these political elites  can’t be bothered to figure out their 10% cut.  Instead we are getting more “fiscal stimulus” AKA boondoggles that the elites will saddle the rest of us with high interest payments on huge public debts.

    It will take local small to mid-sized business to get the American economy going during the COVID-19 pandemic via making products and services that don’t use the intermediate products China threatens with when the pandemic ends.

    My read on what comes next economically is local/distributed production with limited capitol investment that is multi-product capable.  The name for that is additive manufacturing, AKA 3D Printing. Here are a couple of examples:

    1. The idea of 3D Printed Sand Casting Molds For Automobile Production

    voxeljet enters alliance to industrialize core tooling production using 3D printing

    2. And the replacement of physical inventory with 3D printers, print media and electronic drawings:
    Such “Make or buy” decisions have always been the key decision of any business.  The issue here is that middle men wholesalers and in-house warehousing holding cheap Chinese-sourced  intermediate parts are both set to go the way of the Doe-Doe Bird in a 3D/AM manufacturing dominated world.
    .
    Distributed production in multiple localities with 3D/AM vendors for limited runs of existing intermediate products to keep production lines going.  Or the re-engineering intermediate products so one 3D/AM print replaces multiple intermediate products for the same reason, will be the stuff of future Masters of Business Administration (MBA) papers describing this imminent change over.

    .

    But, like developing SARS-CoV2/COVID-19 vaccines, this new locally distributed manufacturing economy will take time.  The possible opening of the American economy in May 2020 will not bring the old economy of December 2019 back.

    .

    That economy is dead.  It cannot, will not, come back.

    .

    We will have to dance with both the sickness from SARS-CoV2/COVID-19 and the widening End Run Production product shortages that the death of the globalist  just-in-time, sole source in China economic model causes for years.

    .

    And this is a hard reality, not a fantasy, we must all face.

    Posted in America 3.0, Business, Capitalism, China, Civil Society, COVID-19, Culture, Current Events, Deep Thoughts, Entrepreneurship, Germany, Health Care, Human Behavior, International Affairs, Medicine, Miscellaneous, Politics, Public Finance, Science, Systems Analysis, Taxes, Tradeoffs, Uncategorized, USA | 64 Comments »

    In Medias Res

    Posted by Jay Manifold on 4th April 2020 (All posts by )

    What I’ve got so far:

    1. Everything’s on the table. The likelihood that your preexisting ideology or priorities are an entirely adequate match to what this situation truly requires of us is close to nil. “In a time of drastic change it is the learners who inherit the future. The learned usually find themselves equipped to live in a world that no longer exists.” ― Eric Hoffer
    2. That said, your life experience will give you insights. Privilege your experience over your ideology and nominal priorities.
    3. All disasters are local. Concentrate on your meaningfully immediate environment, which in this case will be the local market for medical resources. For most of the US, that will be our MSA. For those outside an MSA (metropolitan or micropolitan) that will be their county; and for some it will be the group of counties that feed into the one hospital in the region.
    4. Deprioritize pandemic news from outside your local area. There are people in the massive NY/NJ/MA outbreak that I worry about, but what happens there will only modestly resemble what happens in the KC MSA, not least because of the difference in population density, which can approach 20x.
    5. Mitigate or avoid your own risk (including the risk you pose to others) by both following the hygiene advice we’ve all heard and minimizing your physical interaction with anyone outside your immediate household. Internalize R₀ = b × k × d, where R₀ is the reproduction number of the virus, b is the probability of infection given contact with an infectious person, k is the contact rate, and d is the infectious duration. While the nominal R₀ of COVID-19 is ~3, your personal R₀ can be driven to < 1 by your own behavior.
    6. The general form of the challenge confronting us is abrupt wide variation in formerly relatively constant phenomena. In Talebian terms, we have migrated from “mediocristan” to “extremistan.” The multiplicative nature of a novel viral pandemic, especially by comparison to the relatively predictable seasonality of influenza viruses, has a thick-tailed (power law) probability structure and complex payoffs (notoriously ranging from large numbers of nearly asymptomatic cases to abruptly life-threatening “cytokine storm” reactions). For detail, see The Fourth Quadrant: A Map of the Limits of Statistics.
    7. So we find ourselves at serious risk of running out of ventilators, ICU beds, and even hospital beds generally, to say nothing of supplies (but see “all disasters are local,” above), raising the prospect of significant second-order mortality among those unable to obtain adequate care for entirely unrelated illnesses and injuries.
    8. In this connection, many prior customs, techniques, tools, and materials are being revealed as highly dysfunctional and, if all goes sufficiently well, will be swept into the dustbin of history. The bad news for me is that my earlier fears about easily-bottlenecked processes have been realized. But we may look forward to significant adaptation, including deregulation of medical services.
    9. Similarly, a large number of purported fixes and remedies will fail. Folk remedies, in particular, seem likely to be disastrous, and this blog’s audience needs no persuasion that attempts at central planning will fail thanks to the Hayekian local knowledge problem. In that connection, and to quote something I wrote a few years back: “John Gilmore famously said that ‘the Net interprets censorship as damage and routes around it.’ The future adaptation of representative democracies will depend on our capability, as individuals, to interpret endemic institutional dysfunctionality as damage and route around it.”
    10. The relatively vulnerable are closer to the center of the network: affluent, living in high-density major cities, well-traveled, extroverted, socially active, with large numbers of regular contacts (even if mostly in a “bubble” as per Murray’s notorious quiz). But some are the alienated and defiant who reject risk avoidance or even risk mitigation tactics (or attempt folk remedies instead), ordinarily associated with …
    11. The relatively invulnerable, who are at or near the edge of the network: impoverished, living in rural or low-density metro areas, untraveled, introverted, socially isolated, rarely in face-to-face contact with others. Many of these people have mental health issues and associated substance abuse problems. But the relatively invulnerable are also the intelligent and conscientious who promptly adopt appropriate risk management strategies.
    12. The post-pandemic preferences of the relatively invulnerable will have massive economic and cultural effects. I expect a reasonably quick partial recovery from the economic shutdown, but full recovery may take several years. Many of the “third places” which have done well over the last few decades will not regain their patronage, and as of early April 2020, we can only guess which ones. Fond hopes of some of my co-religionists aside for a sudden revival, I believe church attendance and involvement will be well down in the aftermath, and will not significantly grow until the next “Awakening,” which per Strauss and Howe should occur at mid-century. Until then, believers will be culturally marginalized and congregations will be smaller—but comprised of relatively fervent, active members.
    13. Geopolitical risks are heightened, especially US-China tensions, and if Xenakis’ “58-year hypothesis” holds, this very year will see an echo of the Cuban Missile Crisis.
    14. The most important output of this process—and it is a process, with inputs, providers, outputs, recipients, etc—will be a collective lessons-learned database, comprised of both tacit and explicit knowledge, and somehow transmitted to future generations.

    Posted in America 3.0, Big Government, Business, China, Christianity, Civil Society, COVID-19, Culture, Current Events, Economics & Finance, Health Care, Human Behavior, International Affairs, Libertarianism, Military Affairs, Organizational Analysis, Predictions, Religion, Society, Systems Analysis, USA | 34 Comments »

    A Corona Virus Timeline.

    Posted by Michael Kennedy on 1st April 2020 (All posts by )

    It is now becoming a theme on the left that Trump was not quick enough to recognize the coming epidemic.

    For that reason, I think it valuable to keep a record of the time line.

    Here is the January 12, 2020 WHO report on the virus epidemic in China.

    The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. The market was closed on 1 January 2020. At this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission. The Chinese authorities continue their work of intensive surveillance and follow up measures, as well as further epidemiological investigations.

    Here is the January 30, 2020 report by WHO on the epidemic in China.

    The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.

    The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success.

    Trump stopped incoming flights from China on January 31, 2020.

    Read the rest of this entry »

    Posted in Big Government, Bioethics, China, Civil Liberties, Current Events, Health Care | 36 Comments »

    Positive Stores about Covid-19

    Posted by Dan from Madison on 26th March 2020 (All posts by )

    Amid all of the doom and gloom that the press is all too eager to peddle upon you for eyeballs and clicks, I present a few promising stories about the latest Chinese virus to infect our shores.

    Approximate timelines on medications/vaccines to combat the virus.
    Canadian scientists have successfully isolated the virus, an essential step in getting a vaccine ready for testing.
    A welcome side effect of the virus is that as people have sheltered, pollution has plummeted.
    A University of Minnesota doctor has gone MacGyver in creating a ventilator.
    The total number of people recovered has recently surpassed one hundred thousand.
    Projections of death totals could be orders of magnitude too high.
    Apple may start re-opening stores in China soon.

    There are many, many more good stories about the event if you care to test out your Google-fu.

    Also, some anecdotal items. It appears that people in general are helping one another, remaining calm for the most part, and doing the right things. If there were hospitals with people stranded in hallways or on floors we would have seen those photos/video by now so I am assuming that **at this point** they are handling the influx of patients just fine. My stores locally are fully stocked with all items, save some canned foods like tomato sauce, and of course paper products. I assume those will be available sooner rather than later.

    Discuss as you wish.

    Posted in China, COVID-19, Health Care, Human Behavior | 12 Comments »

    Sh*t Just Got Real

    Posted by Sgt. Mom on 14th March 2020 (All posts by )

    I had been half-expecting that San Antonio would cancel or delay the yearly Fiesta; this was made official Friday morning: put off the celebrations until November. Fiesta San Antonio was originally focused on Sam Houston’s victory at San Jacinto – which took place in April of 1836. (Lot of other events being cancelled as well.) Since Wednesday, I had been getting emails from various companies who I do business with, at least enough business for them to have my email: Costco, Sam’s, Petco, Frost Bank, the Alamo Drafthouse Cinema, the Texas author’s group (who have put off the Wimberly book event from June until November)the senior center in Bulverde who hosts a fall craft fair, Lowe’s and Home Depot – I think. All had pretty much the same message: “Aware of the Covid-19 thing, taking every precaution – deep-cleaning, sanitizing, encouraging sick employees to stay home, those who can to work remotely, concern but doing what we can, customers encouraged to wash hands, self-quarantine if feeling ill …” I wonder now if there wasn’t a degree of coordination going on, or if all the corporate public relations departments simultaneously came to the same conclusion. Reasoning? I rather thought the city and the Fiesta Commission would have to do something of the sort, after reading of Disneyland closing, and the LDS temporarily suspending meetings at every level. Read the rest of this entry »

    Posted in Americas, Civil Society, COVID-19, Current Events, Health Care, Media, Personal Narrative | 47 Comments »

    SARS-CoV2/COVID-19 Update 3 March 2020

    Posted by Trent Telenko on 3rd March 2020 (All posts by )

    This will be a short update. Issues covered will be on COVID-19 spread, World Headlines, COVID-19 medical developments regards PPE & the role of building contamination in spreading disease in Japan, and the social media and videos COVID-19 tracking source section.
     
    Top line, There are currently 92,138 confirmed COVID-19 cases worldwide, including 3,134 fatalities as of the 3 March 2020 at 5:51 a.m. ET time hack on the BNO News corona virus traking site (https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/) There are 70(+) and growing nations including China plus three “Chinese special administrative regions” (Macao, Hong Kong and Taiwan) that have reported COVID-19 infections. China, Taiwan, Hong Kong, Japan, Thailand, Singapore, Italy, Iran, Germany, R.O.K. and the USA all appear to have local, or endemic, spread of the disease.
    The reality of personal protective equipment shortages in the USA because we outsourced most such production to China.

    The reality of personal protective equipment shortages in the USA because we outsourced most such production to China and many regional medical systems sent a lot of our existing medical PPE to China in January 2020 per the request of the CDC.

     
    World Headline Summary (As of late evening 3/2/2020):
     
    o US death toll climbs to 6; all in WA, which has 18 cases
    o 2 new cases confirmed in Tampa Bay
    o 1st case reported in New Hampshire
    o Hubei reports 114 new cases, 31 new deaths
    o Santa Clara County confirms 2 more cases, bringing county total to 9
    o Gottlieb warns US cases likely in ‘low thousands’
    o Illinois announces 4th case
    o Boris Johnson: “A very significant expansion” of the virus is “clearly in the cards”
    o Italian death toll climbs 18 to 52 while total cases surpasses 2,000
    o BMW tells 150 to quarantine after Munich employee infected
    o Algeria total hits 5
    o Senegal becomes 2nd sub-Saharan country to confirm virus
    o WHO’s Tedros: Virus is “common enemy” of humanity so don’t focus on blame
    o Jordan reports first two cases
    o French death toll revised to 3, total cases climb to 191
    o Tunisia reports first case
    o UK total climbs to 40
    o OECD warns global growth could fall by half
    o Indonesia reports first cases
    o “Progress is being made” toward a vaccine
    o Cuomo says NY expects more cases
    o India confirms 2 more cases
    o ‘Official’ Iran death toll hits 66
    o EU confirms 38 deaths across 18 members
    o First cases confirmed in Fla.
    o 2 Amazon employees test positive in Milan
    o Virus now in 8 US states: Washington, California, Illinois, Rhode Island, New York, Florida, Oregon and New Hampshire
    o San Antonio virus patient re-hospitalized after testing positive
    o China warns it could face ‘locust invasion’
     
    COVID-19 MEDICAL DEVELOPMENTS
     
    This article is very much worth reading in full, printing out a copy, highlighting and carrying around. I’ll excerpt a couple of sections from it below the title and link:
     
    Unmasked: Experts explain necessary respiratory protection for COVID-19
    by Stephanie Soucheray
    CIDRAP News, Feb 13, 2020
     
     

    Read the rest of this entry »

    Posted in Big Government, Civil Liberties, Civil Society, COVID-19, Current Events, Health Care, Human Behavior, Miscellaneous, USA | 41 Comments »

    SARS-CoV2/COVID-19 Update 29 Feb 2020

    Posted by Trent Telenko on 29th February 2020 (All posts by )

    The themes of this update will be on issues of

    – COVID-19 spread,
    – World Headlines,
    – US Good News,
    – US Mixed News,
    – A sample of US Relevant Coronavirus Stories,
    – Medical Information of the Day,
    – The SARS-CoV2 Virus and it’s COVID-19 infection ARE NOT THE FLU
    – The On-Going Just-in-time, Sole Source in China Supply -Chain Crisis, and
    – The social media and videos COVID-19 tracking source section.

    Top line, There are currently 85,996 confirmed COVID-19 cases worldwide, including 2,942 fatalities as of the 29 February 2020 at 2:46 p.m. ET time hack on the BNO News corona virus tracking site (https://bnonews.com/index.p…/…/the-latest-coronavirus-cases/) There are 59 and growing nations including China plus three “Chinese special administrative regions” (Macao, Hong Kong and Taiwan) that have reported COVID-19 infections. China, Taiwan, Hong Kong, Japan, Thailand, Singapore, Italy, Iran, Germany and R.O.K. all appear to have local, or endemic, spread of the disease.

    The US may currently have endemic spread as the CDC has confirmed 62 cases of coronavirus in the US (and there late breaking news of a COVID-19 death in Washington State and the slimming of a senior care facility in Kirkland). These include 44 people who were aboard the Diamond Princess cruise ship, three people repatriated from China and 15 US cases.

    Spread inside the US cases include:
    California: 9
    Massachusetts: 1
    Washington state: 1
    Arizona : 1
    Illinois: 2
    Wisconsin: 1

    World Headline Summary:

    o Health authorities in Texas and Oregon report 12 new coronavirus cases in US
    o US coronavirus case total hits 63, 2nd case ‘of unknown origin’ confirmed
    o US issues travel advisory for Italy
    o Italy says first case discovered in Lazio
    o China, SK release nightly figures
    o Google says employee who visited Zurich office has coronavirus
    o France confirms 57 cases
    o Italy reports 3 deaths in Lombardy; nat’l toll now 21; total cases 821
    o Google employee tests positive for coronavirus after visiting Zurich office
    o British man becomes 6th ‘Diamond Princess’ passenger to die
    o Two Japanese dogs tested positive for coronavirus
    o Mulvaney says school closures, transit disruptions may happen in US
    o Dr. Tedros said Friday that there’s no evidence of ‘community outbreak’
    o Mexico confirms 1st virus case [More below]
    o Fauci warns virus could take ‘two years’ to develop
    o Kudlow says “no higher priority” than the “health of the American people
    o Toronto confirms another case
    o WHO says 20 vaccines in development
    o St. Louis Fed’s Bullard pours cold water on market hopes
    o Netherlands confirms 2 more
    o United cuts flights to Japan
    o Advisor to CDC says shortage of tests in US creating a “bottleneck”
    o Nigeria confirms first case in sub-saharan africa
    o South Korea reports more than 1,000 new cases in under 48 hours
    o Italy cases surpass 700
    o WHO says virus will ‘soon be in all countries’

    Read the rest of this entry »

    Posted in Americas, Business, China, Civil Society, COVID-19, Ebola, Health Care, History, Miscellaneous, USA | 44 Comments »

    SARS-CoV2/COVID-19 Evening Update 2-25-2020: The Pandemic Hide the Name & Blame Games

    Posted by Trent Telenko on 25th February 2020 (All posts by )

    The themes of this update will be on issues of COVID-19 spread, World Headlines, border closings, the CDC news conference, developments with fomite spread, how American Public Health institutions build a liablity law suit proof diagnostic test and how that limits tests for community spread and a new recommended COVID-19 sites, social media and videos section.
     
    Top line, There are currently 80,420 confirmed COVID-19 cases worldwide, including 2,710 fatalities as of the 24 February 2020 at 5:24 p.m. ET time hack on the BNO News corona virus tracking site (https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/) There are 39 nations including China plus three “Chinese special administrative regions” (Macao, Hong Kong and Taiwan) that have reported COVID-19 infections. China, Taiwan, Hong Kong, Japan, Thailand, Singapore, Italy, Iran and R.O.K. all appear to have local, or endemic, spread of the disease. Italy has spawned further spread in Spain proper, it’s Canary Islands possession, Austria, Germany, and possibly Croatia. And now Brazil in South America and Algeria reporting a case signals North West Africa have added two new regions to the Pandemic spread list. The virus has spread from Asia to Europe, North America, Australia and Africa.
     
    All of the above meets the pre-COVID-19 WHO standard for a “Pandemic” that requiring endemic spread in multiple nations in multiple WHO regions. However, the WHO just decided that it was time to retire the term “Pandemic” because…something…[insert reasons here]. The WHO statement for doing so was a master piece of unintelligible double talk that boils down to “Lets not scare the “Normies” and set off more “Run, Hide & Hoard” panics like seized Italy, ROK and Singapore in the last few days. Meanwhile the WHO is cheering-on China’s “Hospice-Prison system for the infected” Quarantine as a “Model” in aiding China’s restarting the World economy.
    ITALY COVID-19 Confirmed Cases and Deaths 25 Feb 2020

    ITALY COVID-19 Confirmed Cases and Deaths 25 Feb 2020

     
    World Headline Summary
    o WHO warns the rest of the world “is not ready for the virus to spread…”
    o CDC warns Americans “should prepare for possible community spread” of virus.
    o San Francisco Mayor declares state of emergency
    o Later, CDC says pandemic not a question of it, but when
    o Brazil may have South America’s first coronavirus case
    o Germany confirms 2nd case on Tuesday, brings total to 17
    o Italy cases spike to 322; deaths hit 10
    o Japan’s Shiseido tells 8k employees to work from home
    o Trump Economic Advisor Kudlow tries to jawbone stock markets higher
    o HHS Sec. Azar warns US lacks stockpiles of masks
    o Italy Hotel in Lockdown After First Coronavirus Case in Liguria
    o Algeria confirms 1st case
    o First case in Switzerland
    o Kuwait halts all flights to Singapore and Japan
    o Iran confirms 95 cases, 15 deaths
    o First case in Austria
    o Spain reports 7 cases in under 24 hours, including in Madrid, Canary Islands, Barcelona
    o Iran Deputy Health Minister infected with Covid-19
    Pandemic Border Closures
    Turkey, Iraq, Kuwait, Afghanistan, Pakistan, Turkmenistan, Georgia, Armenia, and UAE blocked border crossings by Iranians.
    Russia, North Korea and Vietnam are blocking border crossings from China
    Austria and Switzerlan are blocking border crossings from Italy.
    El Salvador on Tuesday announced it would prevent entry of people from Italy and South Korea.
     

    Read the rest of this entry »

    Posted in Big Government, Bioethics, China, Civil Liberties, Civil Society, COVID-19, Current Events, Economics & Finance, Health Care, Iran, Medicine, Middle East, Miscellaneous, National Security, North America, Politics, USA | 28 Comments »

    COVID-19/SARS-CoV2 Update 2-23-2020 — When the “New Versailles Class” Meets Reality Without Privilege

    Posted by Trent Telenko on 23rd February 2020 (All posts by )

    The themes of this update will be on issues of COVID-19 spread, testing, public health institutional credibility, some e-mails evaluating the CDC and our elites, and my personal analysis of same after the top line infection numbers and headlines.

    The SARS-CoV2 virus and it’s COVID-19 virgin fields infection seems to have a top line R(0) of between three and 6.7 — that is one person infects near seven people on average — because there are repeated “super spreader” events where one person slimed an institution with a lot of close contact and then the fomite contamination of that institutional setting causes everyone present to get the disease. Examples thus far include the Diamond Princess Cruise ship, a pair of prisons in China, and multiple hospitals in China and now South Korea. The rate of growth of the COVID-19 pandemic is such that we will be fighting it on a very large scale in a few weeks (no more than 10) in every nation world wide with the public and private medical institutions, societal resources, and people we have right now, with all their flaws. And not what we wish they were, but will never have. There simply isn’t going to be time and energy for blame games when issues of daily survival break upon us all.

    Top line, there are currently 78,986 confirmed COVID-19 cases worldwide, including 2,468 fatalities as of 23 February 2020 at 11:52 a.m. ET on the BNO News corona virus traking site (https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/) China, Taiwan Hong Kong, Japan, Thailand, Singapore, Italy, and Iran all appear to have local, or endemic, spread of the disease. See multiple charts attached and headline summary

    Bar Chart of World COVID-19 Infections as of 23 Feb 2020

    Bar Chart of World COVID-19 Infections as of 23 Feb 2020

    Bar Chart of World Qide COVID-19 Infections Without China and the Diamond Princess Cruise Liner

    Bar Chart of World Wide COVID-19 Infections Without China and the Diamond Princess Cruise Liner

    World Headline Summary:

    o Italy confirms 3rd death and cancels last 2 days of carnivale in Venice as cases soar above 100
    o 4 more cases confirmed in UK
    o 200 Israelis quarantined
    o Japan confirms more cases
    o Japanese Emperor expresses hope for Tokyo Games (fat chance)
    o ROK Gov’t total cases above 600
    o Trump says US has everything ‘under control’ as he asks Congress for more money (I call B.S. below)
    o EU’s Gentiloni says he has ‘full confidence’ In Italian health officials
    o Turkey, Pakistan close borders with Iran as confirmed cases soar
    o Global Times (Chinese Gov’t news source) says virus may not have originated at Hunan seafood market
    o Axios reports shortages of 150 essential drugs likely. (Most source in China)

    Read the rest of this entry »

    Posted in Big Government, Civil Liberties, Civil Society, COVID-19, Current Events, Health Care, Iran, Medicine, Middle East, Miscellaneous, National Security, Uncategorized, USA | 42 Comments »

    COVID-19 Update, Morning 2-21-2020 — Living & Dying from China’s Biological Chernobyl

    Posted by Trent Telenko on 21st February 2020 (All posts by )

    Wednesday the world got the worst possible news about COVID-19 from China, and it explained all the strange things China was hiding since this disease first appeared. We are in the midst of China’ Biological Chernobyl. But first, the numbers. As of 20 February 2020 at 7:04 p.m. ET there were 76,192 confirmed COVID-19 cases worldwide, including 2,245 fatalities. China 74,988 cases, 2,234 fatalities and International 1,205 cases, 11 fatalities.  See the latest disease numbers here:

    https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/

    A quiet Chinese announcement Wednesday has changed the world.
    It appears that COVID-19 is an airborne bug in some very common medical situations.  This was why China was keeping the CDC and WHO experts out of China.  It is also why they had such heavy casualties with medical workers.  You need a PPE-4 level independent oxygen supply to entubate a COVID-19 pneumonia sufferer.
    “Airborne transmission” has a very specific medical-technical definition.  See the figure below.
    This graphic explains the technical definition of airborne transmission.

    This graphic explains the technical definition of airborne transmission. (Peak Prosperity video screen capture)

    See this, the opening sentence of which is the technical description of “Airborne Transmission” —
    China admits aerosol infection possible in coronavirus outbreak

    KYODO NEWS – Feb 20, 2020 – 13:14

    .
    KYODO NEWS – Feb 20, 2020 – 13:14 | WorldAll

    China’s health authorities have admitted that people may contract the pneumonia-causing COVID-19 coronavirus by inhaling small virus-containing particles floating in the air, or so-called aerosol infection.

    .

    Updated diagnostic and treatment guidelines published Wednesday say a person can be infected if they are “exposed to a high concentration of aerosol in a relatively closed environment for a long time.

    .

    This is the sixth edition of the guidelines for treating patients of the new virus in China. The guidelines posit that the main routes of transmission are “droplets from the respiratory system” and “close contact.”

    .

    Previous versions of the guidelines said the possibility of aerosol infection had yet to be clearly established.

    .

    Aerosol infection is said to be prone to occur during medical procedures, such as when inserting a tube into the windpipe to ensure an open airway.

    And airborne transmission beyond the narrow medical procedures have been confirmed in South Korea. ROK public health officials tracked a single asymptomatic church lady to a Christian mega-church service of a 1,000 people.  Below is the result:

    Steve Lookner
    @lookner
    544 members of South Korea’s Shinchonji Daegu church have virus symptoms(This is the church with dozens of new cases in the past 2 days)https://twitter.com/lookner/status/1230698482207313920
    China also announced a prison had 200 prisoners and seven guards get COVID-19 last night. Essentially any institutional situation with poor/unfiltered circulation will see mass COVID-19 infection.
    And it gets worse.  How much worse?  This much worse:
    The Fight Plan of China's Biological Chernobyl

    The Fight Plan of China’s Biological Chernobyl — 60,000 airline flights with poor air circulation where up to 12 million souls (assuming 200 unique people per plane flight) were exposed to an airborne transmitted SARS-CoV2 virus.

    WELCOME TO THE WORSE CASE SCENARIO

    The heart of the issue for 2019-nCoV is that it is a virgin fields epidemic. Everyone who hasn’t got it, will get it, absent a genetic gift or  vaccine…and there will be no vaccine for a year, assuming this coronavirus is amenable to a vaccine.

    This is compounded by the issue that the COVID-19 coronavirus infection takes a very low SARS-Cov2 viral load for the initial infection…

    …and that low viral load initial infection takes a very, very, very, long time to manifest as either positive test result or as
    “symptoms.”

    Additionally, four of five people that test positive for COVID-19 have either no or very minor symptoms while being infection spreaders.
    Case in point is the South Korean church-lady who seems to have given COVID-19 infections to 544 people either by giving out communion or singing.

    The infection rate right now is over 20% for the souls aboard Diamond Princess and it will take at least 24 days from their last
    exposure to be detectable in new cases.  The chaos and ineffectivness of the Japanese quarantine was such that every passenger, crewman or Japanese health ministry body on the Diamond Princess were likely exposed to infection causing viral loads right up to and through the flights back to their home countries.

    There is now no chance stopping COVID-19, short of a vaccine, because China’s Communist Party allowed those 12 million exposed souls to travel the world.

    COVID-19 is not just a flu.  It is 20 times deadlier (2% death rate) with an intact medical system and 50 time deadlier (5% death rate) in a collapsed medical system.  And every medical system in the world will collapse under the weight of SARS-CoV2 infections.

    Buckle up.  This will be a rough ride.

    -End-

    Posted in Big Government, Civil Society, COVID-19, Current Events, Health Care, Miscellaneous | 26 Comments »

    COVID-19 Update, Morning 2-19-2020

    Posted by Trent Telenko on 19th February 2020 (All posts by )

    This update is going to be a horror show of numbers involving “super spreaders” and public health incompetence in and around the Diamond Princess cruise ship. As of this mornings’s writing time hack, there are currently 75,129 confirmed COVID-19 cases worldwide, including 2,007 fatalities. China: TOTAL 74,130 2,002 12,017 serious 13,818 recovered 6,242 suspected. (No one believed these numbers except the Who and CDC) Everywhere else: 999 cases, 5 deaths, 39 serious/critical

    Next — the COVID-19 infection numbers from the Diamond Princess are horrific.

    See:

    Tracking coronavirus: Map, data and timeline

    “Japan: The 542 people from the “Diamond Princess” cruise ship are listed separately and they are not included in the Japanese government’s official count. Fourteen of them are Americans whose test results came in while they were being evacuated from the ship. 246 were _asymptomatic_.”

    Given 246 of 542 infected are asymptomatic…we are looking at a 45% of no-symptom super-spreader rate.

    Note: the following additional “Diamond Princess” information culled from four US newspapers over at the Free Republic forum’s “Corona Virus Live—mostly Thread. 2/18-2/19”

    https://www.freerepublic.com/focus/f-chat/3817559/posts?q=1&;page=151

    In one flight of the Diamond Princess returnees. “…the original 14 tested have become 19 due to inflight testing, or 18 pending and 1 CDC confirmed.

    .

    The flight to Travis, CA had 7, and picked up 3 inflight – all asymptomatic

    .

    The Flight to Lackland, TX had 7, and picked up 2 inflight – all but one asymptomatic

    .

    So that’s 14+3+2

    .

    It was reported that Texas sent 6 to Omaha; however Omaha said they received 13. One requiring hospitalization but stable, and the rest asymptomatic. All are awaiting final CDC confirmation.

    .

    Of the 7 in Calif, 2 were transferred to QotV – one asymptomatic received CDC confirmation of positive today; one with mild symptoms is still awaiting CDC.

    Third — More super spreader evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China

    “In this effort to evacuate 126 people from Wuhan to Frankfurt, a symptom-based screening process was ineffective in detecting SARS-CoV-2 infection in 2 persons who later were found to have evidence of SARS-CoV-2 in a throat swab. We discovered that shedding of potentially infectious virus may occur in persons who have no fever and no signs or only minor signs of infection.”

    https://www.nejm.org/doi/full/10.1056/NEJMc2001899

    Read the rest of this entry »

    Posted in Big Government, China, Civil Society, COVID-19, Current Events, Health Care, Japan, Miscellaneous, USA | 20 Comments »

    COVID-19 Update 2-17-2020

    Posted by Trent Telenko on 17th February 2020 (All posts by )

    As of this morning’s time hack, world wide there are now 1,770 dead and 71,223 infected by COVID-19. Community spread is underway in Singapore (see chart), Taiwan and Japan. The USA thinks it might be on-going in the USA. Both Japan and the USA refuse to state this, but actions being taken argue otherwise.  Two horrid COVID-19 infection reports from Chinese news sources — the Taiwan News is reporting re-infection with COVID-19 is causing heart failure and South China Morning Post is reporting 34 and 94 day from exposure to infection super spreaders.  Recovered from COVID-19 infection Ontario couple are still testing positive for coronavirus. Finally,  COVID-19 fomit** contamination of Chinese money and survival of corona-virus in high heat & humidity are also in the update.

    31 Dec 2019 to 16 Feb 2020 COVID-19 Bar chart

    31 Dec 2019 to 16 Feb 2020 COVID-19 Infection Level Bar Chart

    Number of COVID-19 Infections outside China as of Feb 16, 2020

    Number of COVID-19 Infections outside China as of Feb 16, 2020

    Singapore COVID-19 Infection Status 15 Feb 2020

    Singapore COVID-19 Infection Status 15 Feb 2020

    Read the rest of this entry »

    Posted in Big Government, Civil Liberties, Civil Society, COVID-19, Culture, Current Events, Health Care, Human Behavior, International Affairs, Miscellaneous, National Security, Politics, USA | 23 Comments »

    COVID-19 Update Morning 2-14-2020

    Posted by Trent Telenko on 14th February 2020 (All posts by )

    There are currently 65,213 confirmed COVID-19 cases worldwide, including 1,486 fatalities. Of which 4,823 new cases and 116 new deaths were reported in Hubei province, China.
    .
    There are several trends in this update, as well as the headline summary. First Community spreading of COVID-19 is now established in Hong Kong (attached graphic), Japan and Singapore.
    COVID-19 in Hong Kong

    COVID-19 in Hong Kong

    .
    Second, the shut down of China as an economic power seems near complete. See the JP Morgan coal for electricity usage and the Goldman Sachs economic projection charts attached to this post. The JP Morgan chart shows that while traditionally daily coal consumption – the primary commodity used to keep China electrified – rebounds in the days following the Lunar New Year collapse when China hibernates for one week. This is not the case this now. There hasn’t been even a modest increase, indicating that so far there hasn’t been a return to work.
    .
    2020 Chinese Coal/Electrical Consumption

    2020 Chinese Coal/Electrical Consumption

    .
    Short Form — Lack of Chinese coal use/electric power generation indicates the scale of Chinese industries that are shut down…AKA near total.
    .
    And the “Just-In-Time/Sole-Source in China” world-wide, Multi-national corporation, economic shut down virus is gathering a huge economic momentum. Nissan has shut down auto production in addition to South Korea’s Hyundai for lack of Chinese parts. Rumor has it that Ford has the same issue — as their heater coils in their autos are sole sourced in China — and will soon shut down auto production.  Anything cheap or disposable in the world economy is sourced in China, and the Chinese economy is now off-line for the foreseeable future.
    Near Term Economic Projections for China

    Near Term Economic Projections for China

    .
    Third, China is again playing games with COVID-19 numbers and particularly the announced deaths to keep the death rate at 2.1%, saying deaths were “double counted”?!? (See JP Morgan graphic).
    .
    Dodgy Chinese COVID-19 Infection Numbers

    Dodgy Chinese COVID-19 Infection Numbers

    .
     This has been ‘officially noticed’ by the White House.
    .
    See:
    White House does not have ‘high confidence’ in China’s coronavirus information, official says
    .
    .
    Fourth, American COVID-19 are now officially 15 with a case in San Antonio, Texas from a Wuhan evacuation flight and no deaths. I say “officially” as there possible COVID-19 death in Boise, ID. See:
    .
    .
    The possible COVID-19 victim was a 71-year-old man found dead on Feb 9 in an advanced state of decomposition. He returned from China Feb 5. The initial testing came up negative, but additional tests are being run. The cause of death has not been released.
    .
    An idea of what “Community spreading” in Singapore means can be seen in the following report:
    .
    “Singapore Casino employee confirmed with COVID-19; symptomatic Feb 5, hospitalized Feb 9
    On February 13, 2020, the Central Epidemic Command Center (CECC) pointed out that the confirmed case of coronavirus disease 2019 (COVID-19) in Singapore announced on February 11 is an employee at the casino in Resorts World Sentosa Casino. The employee developed symptoms on February 5 and was hospitalized in isolation on February 9. Travelers who visited the casino during the communicable period (February 4-9) are advised to call 1922, put on a face mask and seek immediate medical attention as instructed if suspected symptoms develop within 2 weeks. Moreover, such travelers should inform the physician of any relevant travel history when seeking medical attention.”
    .

    .

    World Headline Summary:
    .
    o China says 1,716 medical workers have been infected
    o Singapore reports largest daily jump in cases amid increased human-to-human transmission
    o Hong Kong reports 3 new cases
    o Hubei’s new party boss orders quarantine tightened
    o President Xi touts new “biosecurity law”
    o Hong Kong Disney land offers space for quarantine
    o Chinese company says blood plasma of recovered patients useful in combating the virus
    o US mulling new travel restrictions

    -end-

    Posted in China, Civil Society, COVID-19, Current Events, Economics & Finance, Energy & Power Generation, Health Care, Medicine, Politics, Urban Issues, USA | 59 Comments »

    How to Think About 2019-nCov

    Posted by Jay Manifold on 8th February 2020 (All posts by )

    In the wake of Ebola, NVD-68, and Zika, we should have all learned our lesson by now. We haven’t. This is 2020—Iowans took a week to count the votes of 5% of their population, and an elderly white Northeastern president is principally opposed by a gaggle of downright ancient white Northeasterners. There aren’t any quick fixes for emergent idiocies like those, but a few simple heuristics will go a long way toward avoiding panic over coronavirus.

    Read the rest of this entry »

    Posted in Aviation, Business, China, COVID-19, Current Events, Health Care, International Affairs, Markets and Trading, Predictions, Society, Transportation, USA | 45 Comments »

    Bafflement

    Posted by Sgt. Mom on 23rd May 2019 (All posts by )

    Speaking as one who formerly identified as a feminist, of the reasonable ‘small-f’ variety, when it meant equal opportunity for education, employment, the same pay for doing the same job, and equal consideration when it came to things like credit, I have always been baffled by how the raving ‘Capital-F’ feminists chose abortion as the hill to die on. I was also baffled by the rabid male-hating by influential Capitol-F feminists like Andrea Dworkin.
    (Ladies, the male of our species may have their moments, and a very, very, very few of them are creatures which any sensible woman should run screaming, or at least murmuring a polite excuse and expeditiously leaving the room … but the rest of them are very nice, if occasionally a bit eccentric in their hobbies and inability to load the dishwasher and remember where they left the toilet seat. They fix things – I rather adore men who can fix things. It’s an endearing quality, as far as I am concerned. They are also stronger than us, and they willingly kill large bugs and spiders.) Read the rest of this entry »

    Posted in Civil Society, Conservatism, Current Events, Diversions, Feminism, Health Care, Society | 51 Comments »

    A Modest Proposal

    Posted by Jonathan on 12th April 2019 (All posts by )

    New ‘Medicare for All’ Bill Would Kick 181 Million Off Private Insurance

    Now might be a good time for new federal legislation requiring all members of Congress to use only Medicaid for their own non-emergency medical care. The plan’s features could include:

    -Doctors assigned randomly from a list of the Medicaid providers in each member’s district.

    -Penalties (fines? misdemeanor/felony? the posting of the member’s name in an online ledger?) for going outside of this system for treatment without prior approval.

    -Prior approval to require a unanimous vote by a panel of citizens selected randomly from a list of the registered voters in each member’s district.

    Of course this legislation would have no chance of passage. Its purpose would be to make Congressional single-payer advocates explain why they should be exempt from it, and then why the rest of us should be be subjected to their hare-brained socialized-medicine schemes.

    Make them live by their own rules, as a great man once said.

    Posted in Big Government, Health Care, Leftism, Medicine, Politics | 9 Comments »

    Some thoughts on what health care reform could look like.

    Posted by Michael Kennedy on 1st April 2019 (All posts by )

    I have previously posted some articles on the French healthcare system, which is the best in Europe.

    Here is an article on the French system.

    The French citizen or resident joins Caisse Nationale d’Assurance Maladie deTravailleurs Salariés (CNAMTS)—health insurance organisation for salaried workers. That covers about 80% of the population now and it pays 80% (often more like 70%) of a fee schedule for the doctor visit although specialists are allowed to charge more. French doctors are divided for payment and fee schedule purposes into three “sectors” after 1980. Sector 1 doctors agreed to abide by the fee schedule established in 1960, modified for inflation and technological changes. They are mostly primary care doctors although some had waivers from the fee schedule prior to 1971 because they were more experienced or had great reputations. Few are still practicing. Sector 2 doctors could set their own fees but reimbursement was still determined by the fee schedule. These two categories correspond roughly to Medicare assignment in the US. If you accept assignment, you agree to accept Medicare payment as the full payment (or 80% of it plus the Medi-Gap payment).

    The French have private insurance that acts like US “Medi-Gap” polices but for all.

    It seems unlikely to me that Democrats would accept a health plan that allowed balance billing, which is the only way to control costs, short of pure rationing. The French basically provide a fee schedule that is the same for everyone but which allows doctors to charge more if the patient is willing to pay. For example, I called the office of a new internist last week to schedule an appointment. The clerk required that I submit all my insurance information, not my health status, and the doctor would decide if he would see me. If he is that busy, perhaps he could justify charging more.

    Here is another article from that series explaining the French system.

    French primary care physicians are paid less than American but medical school in France does not require a college degree and is free. I suspect that system might be more attractive in the US than many realize.

    Unfortunately, such a radical reform is unlikely. There are other options under consideration.

    Read the rest of this entry »

    Posted in Big Government, Health Care, Medicine | 19 Comments »

    Russia to healthcare in one day. What now ?

    Posted by Michael Kennedy on 30th March 2019 (All posts by )

    Last Friday, the Mueller report was submitted to the DOJ. Monday, left wing media saw ratings collapse.

    What next ? Why Healthcare, of course.

    Obamacare, which is a form of expanded Medicaid, costs too much and provides too little care (high deductibles) unless you are a Medicaid recipient. It was designed to shift costs to the insured from the poor. It also was a gift to certain sectors of the healthcare industry. Ted Kennedy criticized healthcare as a “cottage industry” with lots of independent doctors doing their own thing as small businesspeople. That is why doctors have traditionally been conservative. Obamacare changed that. Healthcare is now an industry with doctors mostly on salary and controlled by administrators.

    I talked to a young ophthalmologist last week, who had treated a mild eye disorder. He told me he moved to Tucson to work at U of Arizona medical center, which used to be called “UMC” by everybody in Arizona. He explained that the UMC administrators had gotten deeply into debt installing a new “Electronic Health Record” system and sold the UMC to Banner Health. This is a chain that runs the former UMC and has seen an exodus of university faculty physicians. Even my barber noticed. He told me several weeks ago that his surgeon, who had operated on him, got tired of constantly being told he only had 15 minutes to see each patient and left for the VA. The ophthalmologist was disappointed as he had looked forward to working at the academic center.

    Traditionally, administrators hated doctors. We made their lives more difficult by advocating for patients. I once told an administrator that if the hospital did not reduce the markup on pacemakers, I would testify for the patient if they sued him for the balance of the bill. They didn’t like it but knew I could go elsewhere,and take my patients there. If I had been an employee, I would not have that choice. Several years ago, I explained how we started a trauma center in our hospital. Since then, the hospital has been sold to a non-profit run by nuns. The surgical group that ran the trauma center for 35 years was fired two years ago. They had declined to sell the group to the hospital. They were replaced by six female surgeons no one had ever heard of and who had never applied for privileges at the hospital or been evaluated by the Surgery Department. No one knew anything about them except one member of this new group had applied for a job at the trauma group and been turned down.

    There were a few comments about some less satisfactory results on trauma cases but that has quickly gotten quiet.

    Read the rest of this entry »

    Posted in Big Government, Health Care, Medicine | 2 Comments »

    The Revenge of John McCain.

    Posted by Michael Kennedy on 1st December 2018 (All posts by )

    John McCain Was elected to Congress in 1982 and elected to the Senate in 1986 taking the seat previously held by Barry Goldwater. In 1989, he was involved in the “Keating Five Scandal.

    The five senators—Alan Cranston (Democrat of California), Dennis DeConcini (Democrat of Arizona), John Glenn (Democrat of Ohio), John McCain (Republican of Arizona), and Donald W. Riegle, Jr. (Democrat of Michigan)—were accused of improperly intervening in 1987 on behalf of Charles H. Keating, Jr., Chairman of the Lincoln Savings and Loan Association, which was the target of a regulatory investigation by the Federal Home Loan Bank Board (FHLBB). The FHLBB subsequently backed off taking action against Lincoln.

    The late 1980s were the era of the Savings and Loan scandals.

    The Federal Home Loan Bank Act of 1932 created the S&L system to promote homeownership for the working class. The S&Ls paid lower-than-average interest rates on deposits. In return, they offered lower-than-average mortgage rates. S&Ls couldn’t lend money for commercial real estate, business expansion, or education. They didn’t even provide checking accounts.

    In 1934, Congress created the FSLIC to insure the S&L deposits. It provided the same protection that the Federal Deposit Insurance Corporation does for commercial banks. By 1980, the FSLIC insured 4,000 S&Ls with total assets of $604 billion. State-sponsored insurance programs insured 590 S&Ls with assets of $12.2 billion.

    Inflation in the late 1970s and early 1980s led to pressure on Savings and Loan institutions that had been lending money at 6% to home buyers but savers were demanding higher interest rates to compensate for inflation. The S&Ls were caught in the “Borrow high and Lend low” vise that led to their demise.

    My review of Nicole Gelinas’ book on the 2008 economic crisis includes some discussion of the 1986 problems.

    The story of the 2008 collapse begins in 1984 with the rescue of the Continental Illinois Bank. Here began the “too big to fail” story. Two things happened here that led to the crisis. One was the decision to bail out all depositors, including those whose deposits exceeded the FDIC maximum. Secondly, the FDIC guaranteed the bond holders, as well. Thus began the problem of moral hazard. Another feature of this story was the role of Penn Square Bank, which had gone under two years earlier in the wake of the oil price collapse, which devastated many of its poorly collateralized loans in the oil industry. Both banks had been caught seeking higher returns through risky investments. Penn Square, however, had been allowed to collapse. Continental was rescued and that began a trend that the author lays out in detail through most of the rest of the book.

    The 1986 crisis and the 1989 scandal affected McCain deeply. He was a freshman Senator and was probably included in the group for two reasons. First he was the only Republican and Second, Keating, a Phoenix developer, was a constituent. McCain was humiliated and his ego was as big as all outdoors.

    His reaction to his humiliation was once of the worst pieces of legislation in the 20th century, The McCain-Feingold Act.

    In 1995, Senators John McCain (R-AZ) and Russ Feingold (D-WI) jointly published an op-ed calling for campaign finance reform, and began working on their own bill. In 1998, the Senate voted on the bill, but the bill failed to meet the 60 vote threshold to defeat a filibuster. All 45 Senate Democrats and 6 Senate Republicans voted to invoke cloture, but the remaining 49 Republicans voted against invoking cloture. This effectively killed the bill for the remainder of the 105th Congress.

    McCain, still in his “Maverick mode and still running on ego, persisted.

    Read the rest of this entry »

    Posted in Big Government, Elections, Health Care, Personal Narrative, Politics | 19 Comments »

    Where is health care going ?

    Posted by Michael Kennedy on 28th August 2018 (All posts by )

    UPDATE: A new analysis of Obamacare’s role in the conversion of American Medicine to an industry with corporate ethics.

    The health system is now like a cocaine junkie hooked on federal payments.

    This addiction explains why the insurance companies are lobbying furiously for these funds alongside their new found friends at left-wing interest groups like Center for American Progress. The irony of this alliance is that the left-wing allies the insurers have united with hate insurance companies and want to abolish them. The insurance lobby is selling rope to their hangman.

    Hospital groups, the American Medical Association, the AARP and groups like them are on board too. They are joined by the Catholic Bishops and groups like the American Heart Association and the American Lung Association. (If you are donating money to any of these groups you might want to think again.) This multi-billion dollar health industrial complex has only one solution to every Obamacare crack-up: more regulation and more tax dollars.I practiced during what is more and more seen as a golden age of medical care. Certainly the poor had problems with access. Still, most got adequate care, either through Medicaid after 1965, or from public hospitals, many of which were wrecked by Medicaid rules and by the flood of illegal aliens the past 40 years.

    Obamacare destroyed, probably on purpose, the healthcare system we had. It had been referred to by Teddy Kennedy, the saint of the Democrats Party as “a cottage industry.” As far as primary care was concerned, he was correct. What we have now is industrial type medicine for primary care and many primary care doctors are quitting.

    So why is there waning interest in being a physician? A recent report from the Association of American Medical Colleges projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.

    There appear to be two main factors driving this anticipated doctor drought: First, young people are becoming less interested in pursuing medical careers with the rise of STEM jobs, a shift that Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency based in Dallas, has noticed.

    “There are definitely fewer people going to [med school] and more going into careers like engineering,” Fowler told NBC News.

    There are several reasons, I think. I have talked to younger physicians and have yet to find one that enjoys his or her practice if they are in primary care. That applies to both men and women. Women are now 60% of medical students. This has contributed to the doctor shortage as they tend to work fewer hours than male physicians.

    A long analysis of physician incomes shows that 22% of females report part time work vs 12% of males.

    Physicians are the most highly regulated profession on earth. The Electronic Health Record has been made mandatory for those treating Medicare patients and it has contributed a lot to the dissatisfaction of physicians.

    THE MOUNTING BUREAUCRACY
    This “bottleneck effect” doesn’t usually sour grads on staying the course, Fowler finds, but he does see plenty of doctors in the later stages of their careers hang up their stethoscopes earlier than expected. Some cite electronic health records (EHRs) as part of the reason — especially old school doctors who don’t pride themselves on their computer skills. New research by Stanford Medicine, conducted by The Harris Poll, found that 59 percent think EHRs “need a complete overhaul;” while 40 percent see “more challenges with EHRs than benefits.”

    If I remember my arithmetic, that adds up to 99% unhappy with the EHR.

    Most primary care physicians I know are on salary, employed by a hospital or a corporate firm. They are require to crank out the office visits and are held to a tight schedule that does not allow much personal relationships with patients. The job satisfaction that was once a big part of a medical career is gone.

    Posted in Health Care, Medicine, Obama, Politics | 43 Comments »

    Retrotech, Revitalized

    Posted by David Foster on 24th August 2018 (All posts by )

    A triple-expansion steam engine, which was used for water pumping in Phillipsburg NJ, has been restored to operating condition thanks to a small group of dedicated volunteers.  The engine, which pumped 6 millions gallons per day to a reservoir 265 feet above its level, was built in 1913 and was in continuous operation until 1969, when it was put into standby status (the pumping duties having been taken over by electric pumps) and finally removed from service in 1982.  Here’s a video of its final run in 1982, which has turned out to not be so final.

    The boilers have not yet been restored; test runs were done using a portable commercial rent-a-boiler as the steam source.  The team intends to restore one of the boilers as well in the future.

    When people think about the vast improvements in health and lifespan over the past century and a half, attention tends to be focused on antibiotics, better medical care, x-ray and scanning equipment, etc.  Public water systems, enabled initially by waterwheels and especially by engines like this one, played an important role as well.

    The restoration team has a Facebook page, here.

    See also my posts 301 Years of Steam Power and 175 Years of Transatlantic Steam.

    Posted in Energy & Power Generation, Health Care, History, Tech | 7 Comments »

    CON Does Seem Like an Appropriate Acronym

    Posted by David Foster on 5th August 2018 (All posts by )

    Thirty-five states and the District of Columbia currently impose certificate-of-need (CON) restrictions on the provision of healthcare. These rules require providers to first seek permission before they may open or expand their practices or purchase certain devices or new technologies. The applicant must prove that the community “needs” the new or expanded service, and existing providers are invited to challenge a would-be competitor’s application.

    …from a Mercatus article on healthcare “Certificates of Need”, linked by The Advice Goddess.

    In most other industries, collusion of providers in order to keep supply down–and, hence, prices up–is considered an antitrust violation and can carry heavy civil and criminal penalties.

    Does anyone see any legitimate public-policy rationale for the requirement for the CONs in healthcare?

    Posted in Big Government, Business, Health Care | 20 Comments »