Psyche, Science, and Society

Laurie Penny: A New York spider gave me an insight into US private healthcare

Laurie Penny came to the US to cover Occupy Wall Street. Instead she got spider bights and a first-class lesson in what it means to be among the 99% in America, worrying how you’re going to pay for that unexpected medical bill:

A New York spider gave me an insight into US private healthcare
Occupy Wall Street is right – a rash of bites showed me how private healthcare keeps Americans cowed and compliant

By Laurie Penny

It started with a spider. Someone with a taste for narrative justice might call it retribution, but there’s really no moral correlation between the wisdom of absconding with a relative stranger after a party and waking up the next morning in Brooklyn with a rash of poisonous bites on your arm. When the angels of sexual continence want to punish you, they send crabs not spiders.

I assumed, at first, that the maddeningly itchy marks were the work of common-or-flophouse New York bedbugs, but 12 hours later, with my right arm swollen to the width and purplish colour of a prize turnip, my friend identified the hallmarks of the brown recluse spider, and uttered words I had hoped never to hear on this side of the Atlantic: “You should really get that checked out by a doctor.”

I first came to New York to write about the emerging social justice movements associated with Occupy Wall Street. Through my conversations with the protesters in Zucotti Park, I began to understand how profoundly the stranglehold of American private healthcare keeps ordinary people cowed and compliant in the land of the notionally free.

It’s not just the 59 million Americans living without health insurance and unable to access treatment for everyday maladies without crippling expense. It’s the millions more who dare not risk a dispute with their boss for fear of losing their medical cover, who expect to remortgage their homes in old age to meet the costs of failing health, or who live in fear of bankruptcy should they develop a chronic condition or have an accident.

The notion of a society that sanctions companies to profit from sickness feels barbaric enough, without then forcing ordinary people to choose between medical treatment and the financial future of their families. President Obama’s attempt to reform the system in 2009 roundly failed to remove healthcare as a source of perennial anxiety for most American citizens, or to lighten the dead hand of the market on medical provision in the US.

Socialised healthcare is in my blood but, unfortunately last Wednesday, so was a hefty dose of spider venom and several billion extra bacteria – the unfriendly sort that make an infected limb sweat and swell like a rotten root vegetable. I had travel insurance, but no idea if it stretched to the snacking habits of urban arachnids. So I uttered the words familiar to any uninsured or precariously insured American: “I’ll just wait for a little bit and see if it gets better.”

Had I waited another 24 hours, I might have lost my arm. By the time I was persuaded to go to the emergency response unit at Beth Israel hospital I could no longer move the limb, which was developing worrying purple track-marks. The triage nurse sent me straight through to ER, where I was given a bunk next to a groaning man in his mid-30s who, like me, had been so worried about the cost of treatment that he had allowed an infection to spread, in this case from a rotten tooth. He was already missing several teeth. He told me he was a postal worker with no health insurance, and that he wouldn’t have come for treatment had his girlfriend not driven him to hospital when he collapsed with a fever.

Compared to the accident and emergency unit at my local London hospital, the waiting period was civilised; it was a mere hour before a stern-looking registrar arrived to take my money. He explained the covering clauses of my travel insurance and showed me where to sign on several complicated forms. When I explained I was unable to do so because my arm wasn’t working, he gave me a look that suggested I’d have had to find a way to sign even if I’d come in with all four limbs off. I signed with my left hand.

After that, the service was exceptional. I was whisked off to intensive care for intravenous antibiotics. I was put in a quiet bed near a window, with no cracks or mildew in the walls, and brought cool water and a clean towel. And when, in the middle of the night, I went into near-fatal anaphylactic shock, the staff’s reaction was swift and efficient. I felt, in other words like a valued customer. But it also meant that, at 2am and thousands of miles from home, I was already wondering how I would afford the prescription for all the antibiotics I needed.

This is the difference that social medicine makes to the fabric and quality of life in a civilised country. When I finally wobbled out of the shiny lobby of the Beth Israel, clutching a bag of drugs, follow-up advice and complimentary hospital toiletries, I understood what it really means to be without means in America. Those who are wealthy enough to afford decent healthcare have their needs met in relative luxury, while those who are poor live in fear of getting ill, worrying that one misadventure might leave you with yet more debts to pay off.

No amount of fresh towels and edible breakfasts can make up for the feeling that your health is less important than the capacity of your chequebook. Which is why children and pensioners are still standing in Manhattan’s financial district with placards telling the world they cannot afford healthcare, as police patrol the perimeter. And why, when I got out of hospital, I went straight back down to Liberty Plaza to stand with them.

 

December 5th, 2011

Johns Hopkins emulates Tuskegee Syphilis Study

The Tuskegee Syphilis Study was one of those formative events that triggered the modern era of research protections. But these protections aren’t working when it comes to poor minority families.

In shades of Tuskegee, word comes of a study conduced at Johns Hopkins in which families with African-American children may have been deliberately induced to move into lead-tainted public housing so the lead levels in the children could be assessed. Families of those showing elevated lead levels were never told and were never offered treatment.

The fact that this study could be conducted at a major university is further evidence that the system of research protections is broken. These protections often appear to be protections only for the researchers and institutions, not those subject to the research, who apparently are considered expendable. Dr. Gary W. Goldstein, the head of the institute where the research was conducted said the

“research was conducted in the best interest of all of the children enrolled.”

Evidently, in his view, poisoning young children with lead and keeping knowledge of their poisoning from them is in the “best interests” of poor African-American children. We need have no doubt that “Dr.” Goldstein would never consider such treatment appropriate for his children or the children from his social circle.

One wonders how this study got funded and how it got approved. The “Informed Consent Form,” which would better be called a “Disinformation Form,” lists no risks of participating in the study. Nor does it list any procedures should participating children be found to have elevated lead levels, as happened to some of the children.

Here’s a New York Times account:

Racial Bias Seen in Study of Lead Dust and Children

By Timothy Williams

A class-action lawsuit was filed Thursday against a prominent Baltimore medical institute, accusing it of knowingly exposing black children as young as a year old to lead poisoning in the 1990s as part of a study exploring the hazards of lead paint.

Lawyers for the plaintiffs say that more than 100 children were endangered by high levels of lead dust in their homes despite assurances from the Kennedy Krieger Institute that the houses were “lead safe.”

The institute, a research and patient care facility for children that is affiliated with Johns Hopkins University, periodically tested the children’s blood to determine lead levels.

But, the lawsuit said, Kennedy Krieger provided no medical treatment to the children, who ranged in age from 12 months to 5 years old. Lead exposure was a significant cause of permanent neurological injuries in some of the children, according to the suit. Johns Hopkins, which approved the study, is not a defendant in the lawsuit.

“Children were enticed into living in lead-tainted housing and subjected to a research program which intentionally exposed them to lead poisoning in order for the extent of the contamination of these children’s blood to be used by scientific researchers to assess the success of lead paint or lead dust abatement measures,” said the suit, filed in state court in Baltimore. “Nothing about the research was designed to treat the subject children for lead poisoning.”

Dr. Gary W. Goldstein, president and chief executive of the Kennedy Krieger Institute, said in a statement on Thursday that the “research was conducted in the best interest of all of the children enrolled.”

“Baltimore city had the highest lead poisoning rates in the country, and more children were admitted to our hospital for lead poisoning than for any other condition,” he said. “With no state or federal laws to regulate housing and protect the children of Baltimore, a practical way to clean up lead needed to be found so that homes, communities, and children could be safeguarded.”

“Over all, the blood lead levels of most children residing in the study homes stayed constant or went down,” the statement read, “even though in a few cases, they rose.”

The lead paint study, which started in 1993 and continued for six years, was designed to determine how well various levels of lead abatement would reduce lead in the blood of young children. The buildings where the study was carried out were generally in poor neighborhoods of Baltimore. Litigation surrounding the research has gone on for more than a decade, and in 2001 the Maryland Court of Appeals compared the study to the Tuskegee syphilis experiment, which withheld medical treatment for African-American men with syphilis.

According to the lawsuit, Kennedy Krieger helped landlords get public financing for lead abatements and helped select families with young children to rent apartments where lead dust problems had been only partly eliminated so that the children’s blood could be measured for lead over a two-year period, according to the lawsuit.

“What they would do was to improve the lead hazard from what it was but not improve it to code,” said Thomas F. Yost Jr., one of the lawyers who filed the suit.

Mr. Yost said that although parents signed consent forms, the contracts failed to provide “a complete and clear explanation” about the research, which aimed to measure “the extent to which the children’s blood was being contaminated.”

David Armstrong, the father of the lead plaintiff in the lawsuit, David Armstrong Jr., said that after his son, age 3, was tested for high levels of lead in 1993, he went to a Kennedy Krieger clinic for help. The father said the family was provided state-subsidized housing by Kennedy Krieger and was told they would be part of a two-year research project. Mr. Armstrong said he was not told that his son was being introduced to elevated levels of lead paint dust.

Mr. Armstrong said blood was collected from his son for two years, but that no one told him the lead levels had increased. After the two-year mark passed, Mr. Armstrong said he continued to live in the two-bedroom apartment but did not hear from Kennedy Krieger.

During those two years, he said his son, now 20 years old, received no medical treatment for lead. Later, when Mr. Armstrong took his son to a pediatrician, the doctor detected blood lead levels two and a half to three times higher than they had been before the family moved into the apartment.

“I thought they had cleaned everything and it would be a safe place,” Mr. Armstrong said. “They said it was ‘lead safe.’ ”

 

September 26th, 2011

Raging Grannies: Stop! In the Name of Health, Don’t Cut My Medicare

July 31st, 2011

Medicare vs. private insurance costs

Paul Krugman calls attention to this figure showing Medicare costs vs. private insurance:

Source.

Seeing this figure, wouldn’t everyone think that replacing Medicare with private insurance was just the thing for cost saving?

June 13th, 2011

As physicians become workers they start thinking like workers

e The New York Times has an interesting article on how physicians’ attitudes, interests, and politics are changing as the profession moves towards becoming more female and more likely to be (high paid) workers rather than self-employed business people. As they report, doctors are now less concerned about tort reform and insurance reimbursement and more concerned about healthcare access and public health. This change could presage an important change in healthcare politics in the country, as physicians come to identify with other workers, not other business people.

As Physicians’ Jobs Change, So Do Their Politics

By Gardiner Harris

AUGUSTA, Me. — With Republicans in complete control of Maine’s state government for the first time since 1962, State Senator Lois A. Snowe-Mello offered a bill in February to limit doctors’ liability that she was sure the powerful doctors’ lobby would cheer. Instead, it asked her to shelve the measure.

“It was like a slap in the face,” said Ms. Snowe-Mello, who describes herself as a conservative Republican. “The doctors in this state are increasingly going left.”

Doctors were once overwhelmingly male and usually owned their own practices. They generally favored lower taxes and regularly fought lawyers to restrict patient lawsuits. Ronald Reagan came to national political prominence in part by railing against “socialized medicine” on doctors’ behalf.

But doctors are changing. They are abandoning their own practices and taking salaried jobs in hospitals, particularly in the North, but increasingly in the South as well. Half of all younger doctors are women, and that share is likely to grow.

There are no national surveys that track doctors’ political leanings, but as more doctors move from business owner to shift worker, their historic alliance with the Republican Party is weakening from Maine as well as South Dakota, Arizona and Oregon, according to doctors’ advocates in those and other states.

That change could have a profound effect on the nation’s health care debate. Indeed, after opposing almost every major health overhaul proposal for nearly a century, the American Medical Association supported President Obama’s legislation last year because the new law would provide health insurance to the vast majority of the nation’s uninsured, improve competition and choice in insurance, and promote prevention and wellness, the group said.

Because so many doctors are no longer in business for themselves, many of the issues that were once priorities for doctors’ groups, like insurance reimbursement, have been displaced by public health and safety concerns, including mandatory seat belt use and chemicals in baby products.

Even the issue of liability, while still important to the A.M.A. and many of its state affiliates, is losing some of its unifying power because malpractice insurance is generally provided when doctors join hospital staffs.

“It was a comfortable fit 30 years ago representing physicians and being an active Republican,” said Gordon H. Smith, executive vice president of the Maine Medical Association. “The fit is considerably less comfortable today.”

Mr. Smith, 59, should know. The child of a prominent Republican family, he canvassed for Barry Goldwater in 1964, led the state’s Youth for Nixon and College Republicans chapters, served on the Republican National Committee and proudly called himself a Reagan Republican — one reason he got the job in 1979 representing the state’s doctors’ group.

But doctors in Maine have abandoned the ownership of practices en masse, and their politics and points of view have shifted dramatically. The Maine doctors’ group once opposed health insurance mandates because they increase costs to employers, but it now supports them, despite Republican opposition, because they help patients.

Three years ago, Mr. Smith found himself leading an effort to preserve a beverage tax — a position anathema to his old allies at the Maine State Chamber of Commerce and the Republican Party but supported by doctors because it paid for a health program. The doctors lost by a wide margin, and the tax was overturned.

Mr. Smith still goes to the State Capitol wearing gray suits, black wingtips and a gold name badge, but he increasingly finds himself among allies far more casually dressed, including the liberal Maine People’s Alliance and labor groups. And while he still greets old Republican friends — he is a lobbyist, after all — he spends much of his time strategizing with Democrats.

Representative Sharon Anglin Treat, a powerful Democrat who was first elected in 1990, said that she and Mr. Smith were once bitter foes. “But Gordon’s become like a consumer activist,” she said with a big smile. “I’ve seen him more times in the last few years than I can count.”

Dr. Nancy Cummings, a 51-year-old orthopedic surgeon in Farmington, is the kind of doctor who has changed Mr. Smith’s life. She trained at Harvard, but after her first son was born she began rethinking 18-hour workdays. “My husband used to drive my son to the hospital so that I could nurse him,” she said. “I decided that I really wanted to be a good surgeon, but also wanted to raise healthy, well-adjusted kids I would actually see.”

So she went to work for a hospital, sees health care as a universal right and believes profit-making businesses should have no role in either insuring people or providing their care. She said she was involved with the Maine Medical Association, for the most part, to increase patients’ access to care.

Dr. Lee Thibodeau, 59, a neurosurgeon from Portland, still calls himself a conservative but says he has changed, too. He used to pay nearly $85,000 a year for malpractice insurance and was among the most politically active doctors in the state on the issue of liability. Then, in 2006, he sold his practice, took a job with a local health care system, stopped paying the insurance premiums and ended his advocacy on the issue.

“It’s not my priority anymore,” Dr. Thibodeau said. “I think Gordon and I are now fighting for all of the same things, and that’s to optimize the patient experience.”

Many of Mr. Smith’s counterparts in other states told similar stories of change.

“When I came here, it was an old boys’ club of conservative Republicans,” said Joanne K. Bryson, the executive director of the Oregon Medical Association since 2004.

Now her group now lobbies for public health issues that it long ignored, like insurance coverage for people with disabilities.

Even in Texas, where three-quarters of doctors said last year that they opposed the new health law, doctors who did not have their own practices were twice as likely as those who owned a practice to support the overhaul, as were female doctors.

Dr. Cecil B. Wilson, the president of the A.M.A., said that changes in doctors’ practice-ownership status do not necessarily lead to changes in their politics. And some leaders of state medical associations predicted that the changes would be fleeting.

Dr. Kevin S. Flanigan, a former president of the Maine Medical Association, described himself as “very conservative” and said he was fighting to bring the group “back to where I think it belongs.” Dr. Flanigan was recently forced to close his own practice, and he now works for a company with hundreds of urgent-care centers. He said that in his experience, conservatives prefer owning their own businesses.

“People who are conservative by nature are not going to go into the profession,” he said, “because medicine is not about running your own shop anymore.”

May 30th, 2011

Why is US healthcare so expensive?

May 14th, 2011

Guantanamo docs fail to document torture; independent scrutiny needed

As one of very few health professionals who has viewed Guantanamo detainee health files as a consultant to defense and habeas attorneys, I was not at all surprised by the findings of a new paper in PLOS Medicine by Vincent Iacopino and Stephen N. Xenakis: Neglect of Medical Evidence of Torture in Guantánamo Bay: A Case Series. Iacopino and Xenakis report on their examination of the medical records and reports by independent medical and psychological consultants on nine Guantanamo prisoners. They find that, despite strong evidence that the prisoners were subjected to torture, the health professionals examining and treating them made no attempt to determine if the prisoners had been abused and failed in their ethical (and military) duty to document and report torture and ill treatment.

The findings of this study demonstrate that allegations by these nine detainees of torture were corroborated by forensic evaluations by non-governmental medical experts and that DoD medical and mental health providers at GTMO failed to document physical and/or psychological evidence of intentional harm.

In each case we reviewed, detainees alleged forms of abuse that are highly consistent with torture as defined by the UN Convention Against Torture as well as the more restrictive US definition of torture that was operational at the time [12]. In one case, unclassified interrogation plans and interrogation summaries provided precise corroboration of the methods of torture and ill treatment that the detainee alleged.

….

The medical evaluations in this case series revealed evidence of severe physical and severe and prolonged psychological pain as stipulated in the Bybee definition of torture. But, according to the Bybee definition of torture, even if the requisite pain thresholds had been exceeded, the infliction of such pain had to be the interrogator’s “precise objective” to constitute torture.

….

The medical doctors and mental health personnel who treated the detainees at GTMO failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to “personality disorders” and “routine stressors of confinement.” Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment.

The documentation of torture and ill treatment in medicolegal evaluations conducted by non-governmental medical experts indicates that each of the detainees continues to experience severe, long-term and debilitating psychological symptoms that are likely to persist for many years, and possibly a lifetime.

The Defense Department has issued a response to Iacopino and Xenakis which, in its failure to even mention their main charges can be taken as an official confirmation that Guantanamo health professionals do no investigate or document the terrible abuses suffered by many prisoners there:

DoD personnel working in detention facilities operate under a high level of scrutiny and consistently provide the most humane and safe care and custody of individuals under their control. The Joint Medical Group is committed to providing unconditional appropriate comprehensive medical care to all detainees regardless of their disciplinary status, cooperation, or participation in a hunger strike. The healthcare provided to the detainees being held at Guantanamo Bay rivals that provided in any community in the United States. Detainees receive timely, compassionate, quality healthcare and have regular access to primary care and specialist physicians. The care provided to detainees is comparable to that afforded our active duty service members. All medical procedures performed are justified and meet accepted standards of care. A detainee is provided medical care and treatment based solely on his need for such care and the level and type of treatment is dependent on the accepted medical standard of care for the condition being treated. Diagnosis of such conditions and medical care and treatment for them are not affected in any way by a detainee’s cooperation, or lack thereof, during an interrogation session. Similarly, medical care is not provided or withheld based on a detainee’s compliance or noncompliance with detention camp rules or on his refusal to end a hunger strike. Medical decisions and treatment are not withheld as a form of punishment. Additionally, the medical staff has no involvement in discipline decisions made by detention personnel.

This DoD reesponse also neatly elides the Iacopino and Xenakis claims in another way in that it is written in the present tense and thus only applies to current practices. Yet Iacopino and Xenakis, by their methodology of examining medical records, are talking about past practices. The DoD “response” makes no claims whatsoever recording the appropriateness of past practices. It thus seems likely that some of those practices were indefensible, even by Defense Department spokespeople not usually noted for their truthfulness.

The Iacopino and Xenakis findings are entirely consistent with my experience reading medical files on one Guantanamo prisoner on whom I consulted. Despite claims that he had been subjected to abuse, and mental health symptoms consistent with abuse, there was no indication in the hundreds of pages I read that any health professional had made any attempt to find out if he had been abused or to document possible abuse. Rather, the mental heath staff seemed only interested in whether the prisoner might make a suicide attempt. Beyond that, his obvious anguish appeared to be of no interest to the psychologists and other mental health staff.

Further, the Guantanamo medical unit and the Obama Justice Department fought tooth and nail to prevent any independent examination of these records, much less of the prisoner himself. The prisoner’s attorneys requested, and the habeas judge ordered, that the records be made available for examination by an independent psychologist, me, to determine if there was a possibility that mental health issues might interfere with the prisoner’s ability to cooperate with his attorneys. The Guantanamo medical staff filed a declaration denying any need for independent evaluation. And the Justice Department appealed every step. First they opposed any access to records as too burdensome. Then they appealed access to more than the past few month’s records. They appeared to objected to any scrutiny on principle, which in itself in a sign of inadequate transparency at Guantanamo and is the exact opposite of what should occur in an institution run by a democratic government. We cannot take the word of officials at an institution absent meaningful independent scrutiny that abuses and ethical lapses were, or are, absent.

The Iacopino and Xenakis paper contributes to existing evidence, including the questionable use of anti-malarial drugs, that Guantanamo healthcare was often problematic and deserves independent scrutiny. While the Bush and Obama administrations have made every effort to keep those records secret, health professionals should challenge that secrecy. We should demand that Guantanamo medical records be opened, with prisoner consent, to independent inspection. Further, all detainees desiring it should be able to receive independent medical evaluations.

Additionally, independent of the issues of possible abuse, the complete medical records of released prisoners should be made available to those prisoners and/or their current health providers. To suppress medical records for years of a person’s life is unethical as it interferes with released individuals’ ability to obtain required care in the present and the future. Health professionals from all disciplines should make clear that denial of access to their records by released prisoners is in simply unacceptable.

May 1st, 2011

Medical care in Latin america sought for Guantanamo prisoners

A story I missed from last month demonstrating the lengths to which the government went to keep Guantanamo prisoners out of the US:

WikiLeaks cable casts doubt on Guantanamo medical care

By Carol Rosenberg | McClatchy Newspapers

WASHINGTON — The Bush administration was so intent on keeping Guantanamo detainees off U.S. soil and away from U.S. courts that it secretly tried to negotiate deals with Latin American countries to provide “life-saving” medical procedures rather than fly ill terrorist suspects to the U.S. for treatment, a recently released State Department cable shows.
The U.S. offered to transport, guard and pay for medical procedures for any captive the Pentagon couldn’t treat at the U.S. Navy base in southeast Cuba, according to the cable, which was made public by the WikiLeaks website. One by one, Costa Rica, the Dominican Republic, Panama and Mexico declined.
The secret effort is spelled out in a Sept. 17, 2007, cable from then assistant secretary of state Thomas Shannon to the U.S. embassies in those four countries. Shannon is now the U.S. ambassador in Brazil.
At the time, the Defense Department was holding about 330 captives at Guantanamo, not quite twice the number that are there today. They included alleged 9/11 mastermind Khalid Sheik Mohammed and two other men whom the CIA waterboarded at its secret prison sites.
The cable, which was posted on the WikiLeaks website March 14, draws back the curtain on contingency planning at Guantanamo, but also contradicts something the prison camp’s hospital staff has been telling visitors for years — that the U.S. can dispatch any specialist necessary to make sure the captives in Cuba get first-class treatment.
“Detainees receive state-of-the-art medical care at Guantanamo for routine, and many non-routine, medical problems. There are, however, limits to the care that DOD can provide at Guantanamo,” Shannon said in the cable, referring to the Department of Defense.
The cable didn’t give examples of those limits. But it sought partner countries to commit to a “standby arrangement” to provide “life-saving procedures” on a “humanitarian basis.”
It’s unclear what prompted the effort. The cable said then Deputy Secretary of State John Negroponte had approved making the request at the behest of then Deputy Defense Secretary Gordon England, who at the time oversaw Guantanamo operations.
Negroponte said Wednesday that he had “no recollection” of the request but that it would have been unrealistic to expect the Latin American nations to agree to it, “because anything to do with Guantanamo was always so politically controversial for any of these countries.” England didn’t respond to a request for comment.
Earlier that year, a captive had managed to commit suicide, according to the military, inside a maximum-security lockup. Two medical emergencies also tested Guantanamo’s medical services in 2006: Two captives overdosed on other prisoners’ drugs they’d secretly hoarded, and then three men were found hanged in their common cellblock before dawn one Saturday.
In 2007, lawyers for Guantanamo’s eldest detainee, former U.S. resident Saifullah Paracha, who Pentagon officials said was a key al Qaida insider, also challenged the military’s plans to conduct a heart catheterization procedure at the base.
Paracha, now 63 and still suffering from a chronic heart condition, wanted to be taken to the U.S. or his native Pakistan for the catheterization. He refused to undergo the procedure at the base, even after the Pentagon airlifted a surgical suite and special equipment to the base to undertake the procedure.
The U.S. Supreme Court refused to consider Paracha’s request that he be brought to a U.S. hospital rather than have the experts brought to him.
“Where do they treat soldiers with heart problems?” said Zachary Katznelson, who at the time was part of Paracha’s pro-bono legal team. “They get them out of Guantanamo as soon as possible. They take them to a real cardiac care unit. It’s already risky enough.”
The WikiLeaks cable “clearly indicates that everything we were telling the courts, everything that Saifullah was telling us, was true,” Katznelson said. “Guantanamo did not have the facilities to adequately treat Saifullah on the island.”
The cable also makes clear that the driving force behind seeking the arrangements was the fear that detainees would use a medical emergency to exercise their legal rights.
The cable said that emergency medical treatment on American soil presented “serious risks” to the U.S. government, or USG.
“Admitting particular detainees might lead litigants to argue that U.S. courts should order the USG to admit other, more dangerous, detainees,” the cable said. “These concerns are unique to the United States and are not something that third countries face.”
A State Department official said the U.S. was never able to arrange for emergency medical treatment elsewhere. But a Pentagon spokeswoman argued such a deal wasn’t really necessary.
U.S. captives in Cuba “receive the highest quality medical care, the same caliber as that received by our own service members,” Army Lt. Col. Tanya Bradsher said.
“Medical emergencies are handled on a case-by-case basis to identify the most effective means of providing appropriate medical treatment to the detainee at Guantanamo,” she said. “This may include bringing in outside medical capabilities should the need arise.”
Those outside specialists have included cardiologists and a spinal surgeon. Colonoscopies are done more or less routinely.
Today, there’s an added complication: Congress forbids the Defense Department to use taxpayer money to transport Guantanamo captives to the U.S.
(Rosenberg reports for the Miami Herald.)

April 27th, 2011

Poll: Far more people support comprehensive healthcare reform than oppose it

As Democrats cower in fear of the Tea Party attacks on healthcare reform, a new AP poll finds that most discontent with the bill passed last year is because it didn’t go far enough:

A new AP poll finds that Americans who think the law should have done more outnumber those who think the government should stay out of health care by 2-to-1.

[...]

The poll found that about four in 10 adults think the new law did not go far enough to change the health care system, regardless of whether they support the law, oppose it or remain neutral. On the other side, about one in five say they oppose the law because they think the federal government should not be involved in health care at all.

The AP poll was conducted by Stanford University with the Robert Wood Johnson Foundation. Overall, 30 percent favored the legislation, while 40 percent opposed it, and another 30 percent remained neutral.

Those numbers are no endorsement for President Obama’s plan, but the survey also found a deep-seated desire for change that could pose a problem for Republicans. Only 25 percent in the poll said minimal tinkering would suffice for the health care system.

[...]

Republicans “are going to have to contend with the 75 percent who want substantial changes in the system,” said Stanford political science professor Jon Krosnick, who directed the university’s participation.

September 27th, 2010

Obama surrenders healthcare refor to Wellpoint executive

David Sirota reports that Obama has appointed an insurance company executive to run healthcare reform. Appointing industry executives to run the government agencies that regulate them? That used to be so Bush! But Obama is eagerly catching up.

Sirota sums up the implications:

Clearly, this is a telling indictment of the health care law itself, strongly suggesting that it was constructed by the Obama administration — as some progressives argued — as a massive taxpayer-financed giveaway to private insurers like WellPoint. And let’s be honest: In investment terms, Fowler has been a jackpot for the health industry. The industry maximized her public policy experience for their own uses when they plucked her out of the Senate. Then, having lined her pockets, they deposited her first into a key Senate committee to write the new health care law that they will operate under, and now into the administration that will implement said law. Any bets on how much Fowler will make when WellPoint (or another health insurer) inevitably rehires her in a few years?

July 15th, 2010