Just Saying… Nevada early voting begins on October 18, 2014. Register, and vote.
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.
The minimum wage in Nevada is $7.25 per hour if the employer sponsors group health insurance policies, or $8.25 if health insurance is not part of the compensation package. This doesn’t mean a person will automatically receive those wages because some employers are taking advantage of loopholes in current statutes [LVRJ] There are other elements which are the subject of FAQs on the Labor Commissioner’s web site.
However, the bottom line is still that the minimum wage in Nevada is not a living wage. The point is driven home in the realm of fast food operations, and there is talk of a bill in the upcoming session of the state legislature to raise the minimum wage to $15.00 per hour. Because minimum wage levels are a topic inserted in the state constitution, the raise would have to pass in two sessions and go to the voters. [LVRJ] The second important point is that Nevada job growth is showing in sectors which employ a high number of minimum wage workers – in the sector we are pleased to call “leisure and hospitality.”
Obviously, there’s ample evidence from the charts above to support the contention that if employers pay sub-living level wages, then the state and local governments must make up the difference in the form of social safety net programs. In short, the taxpayers are subsidizing the businesses.
But, but, but… Spare me the noble story of How I Started Mowing Lawns in the 7th Grade And Worked Up To…. Only about 7% of the low wage work force in this country is composed of teenagers. This means 93% of low wage workers are adults. Women make up about 60% of the low wage work force, and a growing number of low wage workers are men. [LWW]
But, but, but… granted that wages are low in retail and fast food sectors but this is insufficient to raise the minimum for everyone… yes, fast food work considered nationally makes up about 5% of low wage employment. However, we’re forgetting about data entry operators, bank tellers, child care workers, teachers’ aides, home health care providers, maids, cooks, porters, cashiers, pharmacy assistants, parking lot attendants, ambulance drivers, dry-cleaning workers, hotel receptionists, and a plethora of other low wage occupations. The median annual wage for a home health care provider is $26,170; for a bank teller $24,940; for a grocery cashier about $21,370. None of these jobs would get a person with a family of four above the federal poverty line.
But, but, but… if we raise the minimum wage that will actually destroy jobs… this bit of mythology has been around since time out of mind. It’s purely theoretical, rising from the minds of well paid lobbyists from the United State Chamber of Commerce, and at least five academic studies have debunked it:
“A significant body of academic research has found that raising the minimum wage does not result in job losses even during hard economic times. There are at least five different academic studies focusing on increases to the minimum wage—including increases ranging from 7 percent to 12.3 percent made during periods of high unemployment—that find an increase in the minimum wage has no significant effect on employment levels. The results are likely because the boost in demand and reduction in turnover provided by a minimum wage counteracts the higher wage costs.
Similarly, a simple analysis of increases to the minimum wage on the state level, even during periods of state unemployment rates above 8 percent, shows that the minimum wage does not kill jobs. Indeed the states in our simple analysis had job growth slightly above the national average. [...]
All the studies came to the same conclusion—that raising the minimum wage had no effect on employment.” [emphasis in original] [TProg]
But, but, but … think of the Mom and Pop store… which we would except for the fact that 2/3rds of low wage workers don’t work at the corner bodega. 2/3rds of our low wage workers labor for large corporations. For example, WalMart has seen profits grow by 23% since the Recession, Yum! Brands by 45%, and McDonalds by a hefty 130%, with help from U.S. taxpayers supporting their personnel. [TP] From the April 15th edition of Forbes we learn that WalMart workers cost U.S. taxpayers approximately $6.2 billion in public assistance. One certainly wouldn’t want to disparage the efforts of the Walton’s to create a successful business – but on the other hand there’s no reason to give the ultra-rich family gifts from the taxpayers. McDonald’s cost the U.S. taxpayers some $1.2 billion in public assistance. [HuffPo] A billion here, a billion there, and soon, as the late Senator Everett Dirksen opined, it starts to add up to real money. That would be real money Mom and Pop are paying in taxation to support their competition.
And then there’s the concept – repeated to the point of redundancy – that increasing wages increases aggregate demand, and increased demand produces increased sales, and increased sales yield increased profits – for any business, large or small.
We should be asking Nevada politicians who are out seeking our votes this season: Do you support raising the minimum wage in Nevada to $15.00 per hour? If what comes back is a “No” qualified by the standard talking points – it’s just kids, or it’s just a few jobs, or it’ll kill employment – then the politician in question is simply regurgitating the corporate line, the big corporate line. The big corporate lie.
We’re waiting for Yes.
Some couples got married in Las Vegas, NV yesterday, a headline which now joins “Dog bites man,” and “Spring Flowers Bloom” in the archives of conspicuous banality. The question in Nevada shifted from “could it ever happen?” to “will it happen?” to “how come it has taken so long?” [more from Ralston]
Conservatives who are still uncomfortable with the idea of letting a relatively small number of homosexual citizens in the state take on the joys and obligations of marriage may not take much comfort in the thought that part of their message over the last 30 years has been received: Government should not intrude on our private lives. And, when we’re talking about truly private matters – who can argue with that?
It’s never been a simple matter to claim religious authority in the public sphere. It’s especially difficult in a country in which initial religious practice ranged from the Brownists in Plymouth – marriage was an invention of man without scriptural authority, to Catholics in Maryland – marriage was a sacrament. [CJPH] However, it’s also never been a simple matter to avoid entangling religious beliefs and political ideologies – witness the Rovian formula welding Patriotism and Christianity for the benefit of the Republican Party.
The result has been a right wing conglomeration of the fiscal ultra-conservative (Grover Norquist) added to the religious ultra-conservative (Patriot Pastors) mixed with the military/financial interests (Koch Brothers, Wall Street). At some point the seams start ripping.
Small But Not Too Small?
It’s impossible to have “small government” if the government is tasked with supervising individual sexual behaviors. It’s impossible to have “small government” if the government is charged with executing statutes on family matters and women’s individual healthcare decisions.
It’s impossible to have “small government” while maintaining a military budget of at least $682 billion – as large as the combined military budgets of the next ten highest national budgets combined. [WaPo] And, it’s impossible to have “small government” if we also want to secure fiscal and economic stability. We tried ‘de-regulation’ and what we got was Enron and Lehman Brothers – and the worst economic disaster since the Great Depression of the 1930s.
Now the frazzle shows up in the religious realm. It’s now impossible to anchor a political ideology on a floating buoy – public opinion has moved remarkably on same sex marriages in the last decade. What was a useful wedge issue in 2004 has become something to avoid in 2014. Witness the palaver over Blundermeister John Boehner’s decision to campaign on behalf of a gay Republican in California? [TDB]
No majority is ever permanent. No radical ideology is ever secure.
First Republican candidate for Attorney General, Adam Laxalt, told me he wanted my vote because he’s a native Nevadan, “ready to serve,” making much of his stint in the U.S. Navy – thank you for your service sir. BUT it escapes me exactly how prosecution of terrorists in military courts prepares a person for administering the Bureau of Consumer Protection, Consumer Complaints, Insurance Fraud, Medicaid Fraud Control Unit, Mortgage Fraud Unit, resolution of questions regarding the application of the Open Meeting Law, Worker’s Compensation Fraud, and Special Prosecutions. Nor does this explain to me how Mr. Laxalt is ready to participate in the Advisory Commission on the Administration of Justice, the Attorney General’s Substance Abuse Working Group, the Committee on Domestic Violence, the Nevada Board of Examiners, the Nevada Council on Domestic Violence, the Nevada Information Technology Board, the Nevada Supreme Court Commission on Statewide Juvenile Justice Reform, and the Nevada Open Meeting Law Task Force.
And, then there’s that not so little matter of having some really dismal evaluations from one’s own law firm. Rather than demonstrate he did not earn the sobriquet “Train Wreck,” Mr. Laxalt is outraged his opponent could be the source of the leaked evaluations – which Mr. Miller is not. That would be a denigration of Mr. Jon Ralston’s skills as an investigative journalist – Ralston got them, Ralston shared them. [NVProg] Even a layman can figure out “promotion to counsel” doesn’t equate to “promotion to partner.” There’s little left but the whining that Evil Doers have sabotaged his campaign? Most of the time using the Victimization excuse merely serves to remind voters that those who are good at making excuses are rarely good at much else.
“Adam is running for Attorney General to protect the safety of Nevada’s families, to preserve the liberty of Nevada’s citizens and businesses and to stand up for Nevadans against federal government overreach.” [Laxalt]
And for this he gets the endorsement of none other than the most infamous Word Salad Shooter the conservatives have to offer – Sarah Palin.
“While most of the focus leading into 2014 elections has been on the country’s life and death fight for our future with a conservative majority serving in the U.S. Senate, there are other offices we need to count on to put a stop to the liberal Obama agenda. In individual states, good Attorney Generals have led the legal fight against Obamacare, to protect religious liberties and states’ right, and to uphold other imperative core Constitutional principles. Here are four conservative Attorney General candidates I’m supporting. They will continue the fight for all of us!”
OK, sometimes I do get into “Comma Queen Mode,” but “death fight for our future with a conservative majority…” says to me the fight is with the conservative majority, which as a progressive is something with which I could agree. This, in turn, reminds me that Mr. Laxalt told me he wanted to “stop Obamacare.” Translation: Mr. Laxalt would like to repeal the health care insurance reforms enacted in the Affordable Care Act.
Seriously? He doesn’t want Nevadans to have any recourse if an insurance corporation rescinds a policy because the person made a legitimate mistake in the medical history portion of an application? Forgot you had measles in 1972? He wants policies for women to automatically be more expensive than those for men? He wants to kick the kids off family policies before age 25? He wants to allow insurance companies to sell junk “life time limit” policies? He wants to tell new entrepreneurs they can’t go to an insurance exchange (market) and pick out a policy from Anthem, Nevada Health Care Co-Op, Health Plan of Nevada, or Saint Mary’s [SSE] that fits his needs and finances? Perhaps Mr. Laxalt hasn’t yet figured out that Obamacare isn’t a thing. There’s are no government issued insurance policies. There are only markets (state and federal) where people who do not have employer sponsored insurance policies can find affordable plans to purchase. If candidate Laxalt hasn’t figured this out, perhaps there is a reason those evaluations weren’t stellar?
Speaking of families, there’s the gay marriage issue on which Mr. Laxalt has made his opposition clear, in spite of advice from Governor Sandoval and AG Masto. There is something to be said for following the news:
“Case law over the last year and a half has completely turned our argument upside down,” Masto told the Reno Gazette-Journal on Tuesday. Gov. Brian Sandoval, a Republican and former federal judge, also said the state’s ban is “no longer defensible” in court and told the Gazette-Journal on Tuesday that he looked at the case “as a judge and a lawyer” and agrees with Masto.” [LVSun]
Indeed, the case law is changing, and in light of the recent refusal of the Supreme Court to take same sex marriage cases Mr. Laxalt continues to say he will “enforce the law” whatever that might be – a far cry from his adamant opposition to LGBT rights in 2010. [RGJ] We might say, given Mr. Laxalt’s Navy experience, that that ship has sailed.
There’s one other arrow in Mr. Laxalt’s quiver – Tough On Crime – he wants to keep women and children safe – and who doesn’t? However, Mr. Laxalt is not running for District Attorney. Or Sheriff. Or applying to be Chief of Police. Or, even running for a state legislative seat wherein crimes are defined and penalties assigned. He’s running to be an an administrator, and thus far his agenda is to fight anything Federal, fight anything that impinges on health insurance corporation profits, and fight anything that says members of the LGBT community should have equal rights. For some this agenda will be adequate, even acceptable. For others it’s an admission that he’s frozen in the politics of the past.
Indeed, those congealed into the Rovian politics of the Culture Wars will find our National Word Salad Shooter only too pleased to endorse them. The remainder of the electorate may see only the candidate’s imploring brown eyes, seeking our votes, and looking for all the world like a young beagle trying desperately to comprehend house-breaking instructions.
If It Bleeds It Leads – and I am getting really tired of cable and network news blathering on about The Next Great Scary Bacteria/Virus. First, let’s get some perspective – there are an estimated 316,148,990 people in the United States. [Census]
Remember the West Nile Virus? If memory serves, the media served up mosquito pictures on television screens and print versions ad nauseam not so many years ago. The largest number of cases occurred in 2003, at 9,862. There were a grand total of 39,557 cases of which only 1,668 were fatal, between 1999 and 2013. [CDC pdf] Do the arithmetic. Divide 39,557 by 316,148,990 on your handy plastic calculator. (Ans: 1.2521 e-4)
Remember SARS? The coronavirus showed up in 2003. Lord knows how many “travel alerts” there were, and how many were reported as major news stories. By April 2003 there were 115 suspected SARS cases in the U.S. reported from 29 states, there were no deaths reported. By the end of the year the World Health Organization reported 8,096 cases globally, leading to 774 deaths. In the United States there were 8 SARS infections documented by laboratory testing and an additional 19 probable cases. [CDC] Again, play with the arithmetic problem: Divide 115 by 316,148,990. What are the odds someone will contract SARS?
Now it’s Ebola! A virus which is relatively difficult to contract, but whose photograph graces the pages and screens, along with breathless speculation about how control this “ISIS of Viral Evil.” Thus far we have 1, repeat ONE, case reported in the United States. One case, one fatality. And that of a man who sought treatment, was turned away from a hospital in Dallas, TX – which has some explaining to do to his family – and so far that’s IT.
Yes, this is a nasty virus. It is also primarily running rampant in west Africa, a region generally ignored by the U.S. media even when uncivil wars are decimating the populations, but there’s a reason the medical professionals in the U.S. aren’t panicking like, say CNN, for Faux News, or some “billionaire with bad hair:”
“It’s important for us to remember here in the US that the likelihood of an outbreak due to bringing back two patients with Ebola virus disease is incredibly small, and that conditions here in the US and other developed nations are such that it is unlikely that such an outbreak, even in the unlikely event that it happened, would spread very far, given the differences in medical care, availability of resources, and differences in funeral practices. That’s not to say we shouldn’t be vigilant, but there is really nothing particularly unusual about Ebola virus other than the rapid onset and severity of the disease it causes.” [SciBMed]
Meanwhile — The CDC reports 11,068 firearm homicides, with a death per 100K of 3.6 [CDC] The last CDC report showed 39,518 suicides, of which 19,990 were completed with firearms; death per 100K at 12.7. [CDC] Now, if a virus had killed 31,058 people in a single year – that would be a story. However, we can’t consider the epidemic of gun violence as a public health problem because the GOP controlled House of Representatives refuses a meager $10 million for funding gun violence prevention research. The American Medical Association, the American Psychological Association, and the American Academy of Pediatrics begged for the research funding, but Republicans and the NRA said we simply need to “prosecute more people, not carry out more studies.” [ProPublica]
Meanwhile – Heart disease will kill 596,577 people in the United States, and another 73,831 will die from Diabetes. So, faced with this obvious public health problem, what did the U.S. Congress do? Republicans sponsored a bill to roll back school nutrition standards. [MMA] The implications are obvious, Republicans are favoring the food manufacturing interests over the advice of professional nutrition experts. Oh, and did we remember that the “School Nutrition Assoc.” receives most of its funding from companies which sell food to schools?
Meanwhile – What are we doing to cut the numbers of stroke victims (128,932)? Cancer victims (576,691)? Chronic respiratory disease victims (142,943)? Alzheimer’s victims (84,974)? Flu and Pneunomia (53,862)? Nephritis (45,591)? We cut the budget for the Centers for Disease Control.
“The agency’s budget in 2014 is $5.9 billion, compared to the $6.5 billion allotted in 2010. Last year’s budget deal delayed the across-the-board sequester cuts until fiscal 2016, but the law required the CDC to cut 5 percent, or more than $285 million, from its fiscal 2013 budget, the agency said.” [TheHill]
And while the right wing is screaming about how we’re not being kept safe from Ebola and ISIS, or Ebola and ISIS, or Ebola with ISIS, or ISIS with Ebola, what did the GOP House do to the funding for the agency tasked with securing public health?
The sequester resulted in a $195 million cut in 2013 to the National Center for Emerging and Zoonotic Infectious Diseases, which aims to prevent illness and death by a wide variety of infectious diseases, according to the CDC. A CDC report from earlier this year also noted its funding for public health preparedness and response activities was $1 billion lower in fiscal 2013 than in 2002. [TheHill]
However, all the statistics in the world won’t be as entertaining as Jon Stewart’s rendition of the Million Ways to Die in the U.S. DO click and enjoy!