Here Comes The Dark Money

Dark Money Here comes the money – into the Nevada District 4 Congressional race:

“Crossroads GPS, a conservative group, said Tuesday it has bought $820,000 worth of TV time for ads to start airing today and run through Election Day on Nov. 4. A source familiar with the ad buy said it is aimed at Horsford, who represents the 4th Congressional District.

Paul Lindsay, communications director for Crossroads GPS, confirmed the group’s eleventh-hour spending plans for the campaign, which could be a game-changer, but offered no details.

“We have placed a buy in the Las Vegas media market and have an important message to communicate,” Lindsay said.” [LVRJ]

And what might the “important message” be? It’s that Representative Horsford is in the same political party as the President of the United States.  Horsford, the ads explain, supports the Affordable Care Act.  Yes, that’s the law which restrains some of the more egregious practices of health insurance corporations, requires that comprehensive insurance cover flu vaccinations, and autism screening, and makes shopping for private health care plans more convenient.   Then there’s the almost an outright lie.

The Affordable Care Act cut Medicare.” This prevarication has been one of the pillars of Republican opposition to the Affordable Care Act.  Those “cuts” actually: (1) Close the do-nut hole in Medicare Part D prescription coverage until the ‘hole’ is eliminated in 2020; (2) Expands existing coverage for senior citizens; (3) Supports initiatives to support care coordination; (4) Does not reduce benefits from Medicare Advantage (the private option to Medicare); (5) Reduces payments to Medicare Advantage rewarding those providers who improve the quality of their coverage, bringing payouts in line with other areas of Medicare; (6) Helps protect the Medicare trust fund.  [OFacts]

The “cuts” were made to over-payments to Medicare Advantage providers which were higher than payments made to Medicare providers – in essence supplying the private Medicare option with a public corporate subsidy. “Your” Medicare (Advantage) benefits weren’t cut!  What was cut were unjustifiable taxpayer subsidies to private health insurance corporations.   And, maybe we should be reminded that those same “cuts” about which Rove’s Dark Money ads are caterwauling, are the same “cuts” which appear in  Representative Paul Ryan’s budget plans?

Someone doesn’t like “cuts” made to the public funds available to private health care insurance corporations.  Who might that be? We’ll not know because Crossroads is a Dark Money 501 (c) 4 which doesn’t have to reveal the names of its donors. [IBT]  There’s nothing grass-roots about Rove’s organization which takes advantage of the decision in Citizens United to cover the tracks of mega-donors.

“The large donations may renew questions from Sunlight and others about whether Crossroads GPS should be able to file as a nonprofit “social welfare” group under the tax code, allowing it to avoid disclosing donor names. According to IRS regulations, the group’s “primary purpose” cannot be influencing elections, but the group can spend up to half of its money on political campaigning.” [WaPo] (emphasis added)

This goes toward explaining why the GOP was so anxious to attack the IRS for “politicizing” 501 (c) organization decisions?  There are legitimate questions about the “social welfare” activities of organizations like Crossroads GPS, and someone didn’t want those questions answered.

Republicans may see an opening in Nevada District 4 and are willing to unleash the Dark Side Money into the breach. We can hope that the constituent services, and the person campaign style of incumbent Representative Stephen Horsford can overcome the money accreting to the Tea Party Radical campaign of challenger Cresent “Segregation” Hardy.  [NVProg]

Early voting has started, and the GOP base is out in force – as usual – Every. Vote. Counts. GOTV.

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Fear mongering is hazardous to our health

Halloween Mask Finally, a headline making some sense: “Washoe health official: Worry about the flu not Ebola.”

“(Washoe County Health Officer) Dick said the “media barrage and sensationalism has frightened people,” emphasizing that medical responders are the ones who need to be trained and prepared.

“We are straining resources across my agency and the hospitals are ramping up and getting prepared for the training and drilling,” Dick said. “The community can help by getting a flu shot and not showing up at the emergency rooms with flu-like symptoms.”

That’s right – FLU – good old fashioned influenza.  And, no, we don’t have exact figures on the numbers of people in the United States who succumb to influenza each year because (1) the states aren’t required to report such cases in individuals over the age of 18; (2) the disease isn’t noted on death certificates very often; and (3) death may result from associated illnesses such as bacterial pneumonia well after the flu infection. [CDC] The CDC can offer some context, and report from 2012 studies that there are about 1,532 deaths from influenza a year, and that about 45.2% of youngsters 6 months to 17 years old have gotten a flu shot, while only about 26.3% of adults 18-49 have done so.  Adults 50-64 have a better rate, at 42.7%, and those over 65 have a 66.5% vaccination rate.  [CDC]

If these figures say anything, it’s that we’re less likely to get flu from those little Germ Bags who crawl on carpeting or share the contents of soda pop cans with alarming alacrity than we are from the “adults” in the room – except for Granny, who’s on Medicare and gets her flu shot without a hassle.

And here’s the part where the Affordable Care Act comes into play.

If a family enrolled in a new health care insurance plan on or after September 23, 2010 the plan will be required to cover recommended vaccinations without charging a deductible, copayment, or coinsurance.  This means FLU shots.  [HHS]

The CDC provides a schedule of vaccinations adults should receive, which is available in almost any format from PDF to an app for your Smartphone.  Because of the Affordable Care Act, influenza, tetanus, etc. vaccinations must be covered in comprehensive health insurance plans. Now, does anyone want to discuss “repealing the Affordable Care Act?”

And here’s the part wherein pure stupidity comes into play.

There were school closings and/or panics in Texas, Ohio, and Maine… because “Ebola.” [NYT] [Denver]  It seems a teacher from beautiful downtown Strong, Maine (Google that one) went to a conference in Dallas, Texas and has been asked to take a 21 day paid leave of absence. Let’s review. The immediate family of the man who died from the disease in Dallas has been cleared, having passed the time limit without infection – so a teacher who attended a conference across town is on leave?

There are continuous calls for a travel ban with west Africa. Which goes nowhere toward explaining why a musical group from Kenya (EAST Africa!) had a U.S. performance cancelled. Actually, the travel ban blather says more about the intrinsic American problem locating anything or anyone on a map than about a sentient reaction to a world health problem.

We’re going to stop flights from Freetown, Sierra Leone? What flights from Freetown?  The flights go through Casablanca (Morocco) and Brussels (Belgium) [VSL.org] Or, stop flights to and from Monrovia, Liberia?  Flights from Monrovia, Liberia to New York make stops in Casablanca, Montreal, Paris, and  Madrid [TripAdv]  A “flight ban” makes absolutely no sense – unless it’s being advocated that we stop flights from Brussels, Casablanca, Montreal, Paris, and Madrid.

What we could do instead of getting all panicky?

#1. Provide funding for the CDC and the National Institutes of Health to conduct research into the Ebola disease (and others) and increase funding for programs which improve local and state emergency preparedness, for both natural and man-made disasters.

#2. Stop worrying about who the “czar” is …and start worrying about when the Senate of the U.S. might confirm the next Surgeon General. 

#3. Provide funding for medical relief activities in countries such as Liberia, Guinea, and Sierra Leone, which will help curb the disease in place.

#4. Get a flu shot and don’t run to the ER with the sniffles.

#5. Vote for candidates who promise to do numbers 1-3.

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Halloween Shocker

Laxalt Or, perhaps not.  The Laxalt Family pulls the plug on support for Adam Laxalt’s candidacy for Attorney General.  [Las Vegas Sun]

It has to hurt when it comes from the family?

“It is our belief that Ross Miller’s documented history of pulling himself up by his own bootstraps and establishing a well-respected career in law and public service while still maintaining a strong sense of family and community constitute the critical characteristics needed for Nevada’s highest legal office.”

Once again we’re treated to the spectacle of the Nevada Republican Party unable to keep the members of the Old Guard aligned with the Tea Party influx of fringe characters from the radical right.   There are Nevada Republicans who aren’t pleased with the antics of the Bundy Family, and who aren’t in ideological lock step with the pseudo-libertarian radicals.  There are Nevada Republicans for whom vote suppression is not a recipe for winning hearts, minds, and votes.  However, it will be a struggle for them to take their party back from the reactionaries and radicals who have provided candidates in some of the last elections.  They are afraid of some of their own, meaning independents and Democrats should be equally alarmed.

Happy Halloween?

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The Halloween Campaign Season

Halloween House It’s always great fun when Halloween and Mid Term Elections converge.   Or, as comedian Jon Stewart puts it, “We’ve got nothing to fear, but fear itself, so we’re going with fear.”   If I were really getting into the spirit of the campaign/Halloween season I’d put the Halloween candy up on the roof, take down the ladder and lock it up in the shed, and then tell the kiddies that if they are patient, hard working, diligent, and patriotic some day the candy will trickle down to their eager little mitts.

However, since I’m definitely not a Republican, the candy will stay on the porch where everyone gets a shot at it.   So, what’s scary this season?

Halloween Pumpkin

It’s three pumpkin scary that there are still a large number of voters who are clinging to the failed and long debunked hoax that what is good for Wall Street is necessarily good for Main Street.   Wall Street, and the financialists therein,  love the witches brew of mergers and acquisitions – whether the companies involved are actually improved or gutted – and tales of layoffs, off-shoring, and other devices to reduce costs and improve “shareholder value.”  Anything which reduces the expenses is received with joy, such as not paying their share of taxes by using accounting tricks and the ever popular Inversions.  

So, when faced with the probability that they might have to contribute their fair share or face their responsibilities, the corporate shills resort to dragging out their well rehearsed talking points – taxes cost jobs, the wealthy create jobs, taxes make us less ‘competitive,’ and regulations are a burden.  These lines are just so much mush in the core of an over-ripe pumpkin.

The good folks on Main Street and Elm Street are left holding the bag, every time a multi-national corporation plays games with the tax system Main Street and Elm Street have to foot the bills for roads, infrastructure, education, national defense, and health services.  

Halloween Pumpkin

Another three scary pumpkins for a political system so cynical that cheating is required to win.  There’s NO epidemic of voter impersonation fraud in this country.  An analysis of 2,068 cases of fraud in the entire nation since 2000 revealed that there were only 10 cases of voter impersonation fraud. There are approximately 146,000,000 registered voters in this country.  Do the arithmetic.  Your calculation should result in an answer of 6.84e-8.  (If that “e-8” is throwing you, just remember to move the decimal point place 8 places to the left.)

However, that infinitesimally small number hasn’t stopped candidates from advocating Photo ID laws, the purpose of which  is to reduce the number of the elderly, the young, the ethnic minorities, and the women at the polling stations.   We even have our very own Vote Suppressionist running to be the chief election officer (Secretary of State) in Nevada.  Voting suppression bills are enacted because voters buy into the fear-mongering about fraud, and the utterly illogical personalization talking point, “Would you want your vote to be canceled out by a fraud?”   The answer, of course, is “no,” but the odds against this actually happening are literally astronomical.

Halloween Pumpkin

It’s also three pumpkins scary we have media outlets which cater to the least attractive  human characteristics – like, fear and what it does to otherwise rational beings.   Yes, what the Islamic State proposes to do in Iraq and Syria is serious stuff, but remember the odds of being killed in a terrorist attack are 1:20,000,000.   The terrorists would no doubt like to get us sufficiently agitated so that we’d agree to send troops to their region, which would make it ever so much easier to kill Americans. 

And yes, the Ebola virus is a nasty little bug. However, it tends to thrive in places where medical facilities are both rare and not well regulated.  It seems to prefer places with inadequate sanitation infrastructure.  Thus far that does not describe the public health systems in North America and western Europe.  What should concern us more than the incidents are questions about how our privatized health care delivery services are to regulated in order to prevent outbreaks of any infectious disease.

There is an old bit of business advice which says, “You can’t control what you don’t own.”  We can apply the adage to public health care facilities.  Government standards can be enforced in public facilities, whereas under the current system of corporate health care standards come in the form of guidelines – the implementation of which may not be as uniform as we’d like. One relatively recent report says that public hospitals declined by 27% in major suburban areas from 1996 to 2002, and by 16% in major cities.  [AmMedNews]  Are standards of accreditation strong enough to maintain a level of health care practices in which the environment is safe for both the patients and the medical staff?  This question leads to our next set of pumpkins.

Halloween Pumpkin There ought to be three scary pumpkins awarded to the advocates of de-regulation.  The exploiters, polluters, and “shareholder value” advocates have been beating drums about “burdensome regulations” since the corporate interests organized their campaigns to repeal any law which impinged on their profits.  For example, since January 2011 the House of Representatives have voted 297 times to weaken public health and environmental protections. [CWA]  

Though the Enron Debacle seems a distant memory from 2002, the Republicans are still trying to repeal the Sarbanes-Oxley Act which sought to curb the abuses that allowed the scam to spread through the financial sector.  Opponents of financial regulation are still calling for the Act’s amendment or outright repeal in spite of the benefits stemming from its enforcement.   The Dodd Frank Act, enacted in the wake of yet more financial sector abuse, and the cavorting in the Wall Street Casino leading to the Housing Bubble disaster,  passed its 4th anniversary with more calls from the GOP to repeal it.

It would be remiss not to mention the REINS Act again.  This bit of legislation from the House is a de-regulator’s wet dream, and everyone else’s nightmare.  Congress would have to approve any and every regulation set forth by any agency of the federal government – environmental, financial, and (compliments of the Smith Amendment) public health. [See H.R. 367] Representative Jason T. Smith (R-MO8) offered amendment #450 which included all regulations under the Affordable Care Act.  This is as good a time as any to see what Representative Smith’s amendment would do in terms of hospital regulations.

Section 3025 of the ACA outlined a “readmission reduction program” which penalizes hospitals which have readmission rates higher than acceptable.  The idea was to get hospitals to use Best Practices (pdf) to reduce the readmission rate for cardiac patients, those who were at risk of being readmitted because of a lack of resources, and those who might show signs of infections after initial hospitalization.   Now, imagine the members of the House of Representatives “de-regulating” hospitals which have high readmission rates by refusing to approve the CMS standards.   That’s more money in the coffers of the 81% of Alabama hospitals which have been penalized; 82% of the hospitals in Arkansas which have been penalized; 89% of the hospitals in Illinois which have been penalized; and the 153 hospitals in Texas (out of 322) which have been penalized. [Kaiser]

Want to get scared again?  There’s credible research suggesting that hospital acquired infections affect the readmission rate [AmMedNews] and hence the regulations from Section 3025 relate to hospital sanitation practices and the prevention of hospital acquired infections.  Now, grab the remote and try to find a cable news channel that isn’t overloading the airwaves about Ebola. Quiver again, while thinking that Representative Smith’s little amendment could remove the incentive for corporately owned hospitals to literally clean up their acts.

Halloween Pumpkin

Instead of being fearful, let’s enjoy the Halloween season with thoughts of increasing the minimum wage and adding about $22 billion to our gross domestic product. [TP]  Or, we could think about further reducing our dependence on foreign oil by encouraging more solar power research, and ending the $4 billion annual subsidy paid by taxpayers to highly profitable Giant Oil Companies.  Or, we could think of reducing the burden on college students by allowing them to renegotiate or refinance student loans.  We could start by insuring students aren’t required to repay more than 10% of their annual income. [WH] We could improve the Voting Right Act and insure that everyone, in every state has an equal opportunity to cast his or her ballot.  We could enact legislation to require equal pay for equal work, improving family financial situations across the country.  We could employ people in our construction sector by starting to work on our infrastructure issues – our airports, dams, bridges, water lines, wastewater facilities, and  levees could all use some work.  [ASCE]  We could enact reasonable gun safety legislation.  And we could enact legislation to insure there’s no discrimination of any kind in American commerce.

The scary part is that none of these things will get started, much less accomplished, with Republicans sowing fear and discomfort – belaboring spooky apparitions like “Benghazzziiiii,” or “IRSssssss,” or “ISISssssss,” or other specters, wraiths, and spirits.   It’s Halloween after all, and  those are manufactured phantoms, nor more material than the costumes available at any big box store.   Instead of focusing on the Spooks of October, we ought to be enthusiastic about the opportunities in November, such as electing people to state and national offices who aren’t afraid of their own shadows.

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Filed under Economy, financial regulation, Health Care, Iraq, terrorism, Vote Suppression, Voting

The Realtors Are Coming: Nevada’s Question Three

The Realtors Against Question 3, related to the Alliance for Property Protection Rights, related to the National Association of Realtors, related to Nevada Data Mine LLC, would like for me to vote “no” on Nevada’s ballot Question 3.  Oh hark! The fear mongering begins. Today’s mail includes my second mailer from their offices at 760 Margrave Drive, Reno, and it tells me:

Thousands of Nevadans would lose their jobs. Employers would have to pay the tax on total revenue, even if they have no profits and are losing money.”  Really?

Here’s the real Question 3: Shall the Nevada Revised Statutes be amended to create a 2% tax to be imposed on a margin of the gross revenue of entities doing business in Nevada whose total revenue for any taxable year exceeds $1 million, with the proceeds of the tax going to the State Distributive School Account to be apportioned among Nevada’s school districts and charter schools?

So, some firm doing more than $1 million worth of business in this state might be “profit-less, or losing money?”  That isn’t a tax problem – it’s a lousy management issue.  If the firm’s total revenue exceeds $1 million, and the taxable margin is determined by taking the lesser of (a) 70% of the entity’s total revenue; or (b) the entity’s total revenue minus the cost of goods sold or the amount of compensation paid to its owners and employees – then if a 2% margin tax would put the outfit out of business I think we could reasonably expect the enterprise is already doomed.  But wait, the second item is pure doom and gloom:

It would devastate future job growth in the state. This would be one of the largest tax increases in Nevada’s history, making us less competitive with neighboring states like California.”  Devastate?

This is nothing more than the superannuated argument that lower taxes mean more economic growth.   So, let’s look at our neighboring state.  California was looking at a $60 billion budget deficit when the Housing Bubble/Wall Street Fiasco exploded, by using a combination of budget cuts and tax increases it had a budget surplus as of 2013. [USAT] In 2012 California’s GDP growth was 3.5%.  As of 2013 it improved by another 2%. [BEA] Nevada’s rate YOY 2012-2013? 1.0%.  Thus much for the anti-tax argument.  And, while we’re at it – just once could some organization NOT employ the hyperbolic “Biggest Most Gigantic Extra Colossal Humongous Tax Increase Ever” ploy? That’s getting even more hirsute than the anti-tax argument.

The Legislature would be able to divert funds to anything, not just education. It’s a blank check for politicians with no oversight or accountability.”  Obviously,  we DO need to put more money into our educational programs because these people can’t read.

What part of “with the proceeds of the tax going to the State Distributive School Account to be apportioned among Nevada’s school districts and charter schools” isn’t comprehensible?  Granted the vocabulary is about at the 12th grade level, but this shouldn’t be an obstacle to people used to reading real estate contracts?   But, there’s more:

Increased costs would be passed on to your family. All of us would soon pay more for healthcare, food, clothing, gas, water, and housing.” Oh please!

All business expenses are passed along the economic food chain. They always have been.  Imagine becoming worked up into a lather because the price of cocoa has increased to a three year high?  Merciful Heavens, it’s up to $3,185 a ton.  [WSJ]  This cost will surely be passed along to candy bar consumers! Oh, the horror.  However, how much more might we be paying if employees had to find private education, or private security, or private fire protection services, or pay for toll roads… Get the picture?  At it’s core, the APPR argument says that any and all pass-along expenses are bad for us, without, of course, offering any substantiation for the assumption.  It’s more logical to argue that the economic benefits of better public educational services are at least commensurate with any pass-along expenses we might incur as consumers.   We do know from both statistical and experiential information that better schools = higher property values for homeowners; [DukeEdu]  just as better police and fire protection contribute to the value of residential property.

And, this leads us to wonder – why are real estate interests so dead set against a business margin tax increase?

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Filed under Nevada economy, Nevada politics, nevada taxation

Republicans are a Public Health Hazard

 

Health Hazard

Just Saying… Nevada early voting begins on October 18, 2014. Register, and vote.

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Filed under health, Health Care

A Virus Could Ask Better Questions?

TV Set 1 I get the part wherein cable news needs ratings to sell advertising, although exactly how much revenue can be accumulated from purveyors of unregulated supplements, interesting but not likely remunerative litigation, and vehicle insurance is beyond me.  So, the coverage of the ebola outbreak in western Africa isn’t surprising – it’s the Lost Airplane of the Day.  What is alarming is the lack of substance, and I’m thinking of the CNN broadcast in which a novelist is foisted off on the public as an expert on viral transmission.   Amid all the hysteria, we’re missing some important points.

What is the state of our medical research? What happened to our “stable research support trajectory? Instead of being entertained by the musings of a science fiction novelist, perhaps we could be hearing more from medical experts?  Say, from the National Institutes of Health?

“Dr. Francis Collins, the head of the National Institutes of Health, said that a decade of stagnant spending has “slowed down” research on all items, including vaccinations for infectious diseases. As a result, he said, the international community has been left playing catch-up on a potentially avoidable humanitarian catastrophe.

“NIH has been working on Ebola vaccines since 2001. It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,'” Collins told The Huffington Post on Friday. “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”  [HuffPo]

Why is the National Institutes of Health purchasing power down 23% from ten years ago? Or,  why does the following situation hold in terms of funding for research into infectious diseases?

“In fiscal year 2004, the agency’s budget was $28.03 billion. In FY 2013, it was $29.31 billion — barely a change, even before adjusting for inflation. The situation is even more pronounced at the National Institute of Allergy and Infectious Diseases, a subdivision of NIH, where the budget has fallen from $4.30 billion in FY 2004 to $4.25 billion in FY 2013.” [HuffPo]

We’ve endured a “ten year slide in research support,” meaning that we’ve not invested enough since 2004 to keep on track to provide pharmaceuticals and other research related to diseases such as that caused by the Ebola virus. Could it be that in the last ten years there has been a steady drum beat of opposition to federal funding … for almost anything? 

Our very own Representative Mark Amodei (R-NV2) announced back in January 2013 that federal spending was out of control, and Congress “hasn’t had the courage to fix it.”  In December 2013 he was pleased as punch with the Budget Act which cut federal funding, saying:

“This two year agreement moves us away from government by crisis and continuing resolutions, where so much of the status quo persists, and back to a legislative framework for reforming federal spending. It cuts the budget deficit by $23 billion without raising taxes at a time when the Senate wanted to increase spending by $1 trillion. It is 100 percent in line with the Budget Control Act deficit reduction numbers and does not end the sequester cuts, but replaces upfront, across-the-board cuts with targeted savings that are both larger and produce additional deficit reduction over the long term. The agreement is also $83 billion below the original Ryan Budget (2010) target for FY 2014.”

His current official website tells us:

“As a fiscal conservative, I believe that our nation’s deficit is out of control. We now borrow 42 cents for every dollar we spend. The bloated federal government spends some of that money on frivolous projects that benefit only a select group of special interests and other needless expenses.”

Now, in light of that ten year slide in appropriations for the National Institutes of Health, and the loss of the “stable research support trajectory,” can Representative Amodei still justify the reduction in NIH funding?  It isn’t like the NIH didn’t advertise what was going to happen under the terms of the budget act Representative Amodei was applauding:

“On March 1, 2013, as required by statute, President Obama signed an order initiating sequestration. The sequestration requires NIH to cut 5 percent or $1.55 billion of its fiscal year (FY) 2013 budget. NIH must apply the cut evenly across all programs, projects, and activities (PPAs), which are primarily NIH institutes and centers. This means every area of medical research will be affected.” [NIH]  (emphasis added)

Yes, “every area of medical research will be affected,” and that included the National Institute for Allergy and Infectious Diseases, a subdivision of the National Institutes of Health.   Remember that Government Shutdown in October 2013?  Not only did clinical trials get shut down at the CDC, but so did the processing of laboratory samples. [MedNewsToday]   All this makes a sentient person wonder how much more “reforming the budget” we can stand?

What is the status of our prevention and control capacity?  There’s a penchant on the right to try to attach the “sequester” to the President as if the budget he signed hadn’t been enacted by the Congress in 2013.  For those functioning in the real world,  it’s no secret that the Congress slashed funding for the CDC emergency preparedness program. [Vox]  Again, the CDC announced well in advance what the sequester cuts would do.

About $195 million was cut from “emerging and zoonotic infectious diseases,” another $19 million was cut from “public health scientific services,” also cut was $18 million from “global health” categories, and another $98 million from “public health preparedness and response” programs.  [CDC pdf]

$160 million less would be available in funding to on the ground public health in the United States, “a system already strained by state and local budget cuts.”  A further $33 million was cut from “state and local preparedness ability to respond to natural and man-made disasters.” [CDC pdf]

Do we have an institutional structure in place to enforce CDC guidelines on public health matters?   The CDC has issued guidelines for EMT responders in the wake of Ebola illness, now we have to ask, how are the guidelines to be implemented?  How are CDC guidelines to be implemented in hospital settings?   What the CDC issues are recommendations – what the privately owned hospitals actually DO is up to the administration and leadership in those hospitals.  And, now we get to the part where the people at ground zero are involved. 

The California Nurses Association surveyed its members and found that some were working in hospitals lacking “necessary protective equipment, such as HAZMAT suits, face shields, and fluid resistant suits and gowns.” Some also reported inadequate training on how to deal with Ebola, for example being given a video to watch without any hands-on, personal, training or rehearsals.  [CNA]

Obviously, those attending to patients with Ebola or SARS would need to use “Full Barrier” personal protective equipment, so the next obvious question should be – Does each local hospital, especially those in metropolitan areas served by international transportation hubs, have the Full Barrier PPEs, and have those who need them been trained in their use? And this state of affairs leads to yet another question.

What level of de-regulation in health care can we tolerate in order to provide the best public health services?    The NIH can research, and the CDC may recommend to their collective hearts content – but if the House of Representatives had its way every regulation would be scrutinized by Congress to see if it impinged in any way on the profitability of the health care provider.

When the House passed the REINS Act in 2013 language was added to require Congressional approval on health care related rules, in an amendment sponsored by Rep. Jason Smith (R-MO). [Hill]  Representative Amodei (R-NV2) and Heck (R-NV3) both voted in favor of the REINS Act, including as it did, the provision requiring Congressional approval of health care related regulations.  [vote 445]  Representative Titus (D-NV1) had the common sense to vote nay.  Worse still, for those who believe that hospitals should be required to act with some uniformity during a public health crisis, both Representatives Amodei and Heck voted in favor of the Smith Amendment. [vote 438]  Again, Representative Titus had the foresight to vote nay.

Not to put too fine a point to it, but Representatives Heck and Amodei voted in favor of a provision which would prevent the implementation of standards for isolation care and personal protective equipment/training if the hospitals could show that such regulations diminished their profitability.  Not only did Representative Amodei vote in favor of the Smith Amendment, and vote in favor of the REINS Act, he was one of the 164 co-sponsors.  The bill was sent to the Senate wherein it was, thankfully, buried in the files of the Committee on Homeland Security and Governmental Affairs.

In the instance of H.R. 367 (113th) nothing could be a better example of putting profits before people, especially considering the attachment of the Smith Amendment.

Our media would serve us far better if we were to be given background information on how our government and health care institutions could better protect us from – Ebola, MERS, SARS, Norovirus, drug resistant strains of bacteria, etc. and how funding priorities relate to national, state, and local preparedness.   It would beat listening to a novelist, a pundit, or some lady with a Ouija Board.

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Filed under Amodei, Congress, conservatism, health, Health Care, worker safety