HEALTH CARE/Joan Retsinas

Our Kaleidoscope-in-Chief: Below-the-Fold Havoc

The Buffoon-Candidate – gathering fans by ridiculing opponents – has morphed into the Kaleidoscope-President. Watch him. The Golfer-in-Chief morphs into the Warmonger-in-Chief, into the Aryan-in-Chief, into the Grand Feuder (alas, Sens. Sessions and McConnell – no friends of Caesar), then into the Friend-of-Putin (the one person our President hasn’t feuded with), next into the Pinocchio of truly great lies, then ricocheting into Ignoramus-in-Chief (Frederick Douglass is not alive, Mr. President), now into the Pardoner-in-Chief, and always the Twitterer-in-Chief.

The metamorphosis is dizzying. Three Democratic representatives have asked a Yale psychiatrist to convene a panel to probe the mindset of the Paranoid-in-Chief, a move that follows a bill (HR 1987) to establish a commission on presidential capacity.

On the healthcare front the news is alarming, but well-publicized. We know that this Administration wants to demolish, whatever the consequences, the signature achievement of his predecessor – even though demolition promises to leave millions of Americans without insurance, raise the premiums of those with insurance, and – a result anathema to conservatives – raise the deficit.

Below the fold, though, the news we don’t glom onto is also alarming.

Xenophobia reigns. We are upping the visa-hurdles for “international medical graduates.” Applicants are seeing waits of up to six months for processing, along with a higher rate of denials. The Association of American Medical Colleges recently joined with a slew of other health organizations to protest this administration’s travel bans.

Previous administrations tried to lure the world’s best and brightest into our laboratories, our hospitals, our universities. Those of us who want to see treatments, if not cures, for the diseases that bedevil us have not balked at the special visas issued to people who fill what is for us a brain-gap.

Simply stated: We don’t train enough native-born physicians. If we value brains over birthright, we must open our doors. But this administration has erected a litmus test of nationality: for him, and for the legions of Americans fearful of foreigners, ignorance has truly trumped smarts.

The judiciary – in this instance, the California Supreme Court — has befriended pharmaceutical companies. The case (Bristol-Myers Squibb Co. vs. Superior Court of California) revolved around Plavix, designed to prevent blood clots. In 1997 the FDA approved this drug. Over time some patients complained of side-effects. A group of plaintiffs (86 from California and 592 from 33 other states) banded together to sue Bristol Myers in California. The Court did not rule on the dangers of Plavix, but on the site of the suit: the plaintiffs who didn’t live in California could not sue there. The upshot: plaintiffs would have to take their cases to individual states – all 33 of them. Admittedly, savvy trial lawyers can and will shop for the best venues to try their cases; but in an era when patients buy drugs on-line – when patients themselves move from state to state – the ruling was a temporary win for pharmaceutical companies seeking to defray patient-lawsuits – and a hurdle for aggrieved patient-consumers.

This line-item was so small — $214 million for 81 five-year grants — that budget-cutters might have neglected it. But ideologues saw danger in the intent: school “health education” programs that discussed contraception. The United States’ teenage pregnancy rate is 22.3 per 1000, an 8% drop since 2014.

Presumably, optimistically, whatever this country was doing was working. Yet the solons who want to obliterate Planned Parenthood as well as family planning programs overseas took their axes to these grants, now slated to end two years earlier than expected. For Baltimore, where the teenage pregnancy rate is double that of Maryland, the axe translates to a $3.5 million cut. The ideologues’ victory may be Pyrrhic, if those teenage mothers, unemployed and uninsured, end up on their states’ Medicaid rolls (which the ideologues want to slash anyway). (Ariana Cha, “Big city health officials decry Trump administration’s cuts to teen pregnancy prevention,” Washington Post, August 9).

It is easy to fixate on the daily metamorphoses of this Kaleidoscopic Administration. We wonder, with trepidation, what the Chief will do, where he will go, what he will say – all the while overlooking the below-the-fold havoc.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, October 1, 2017

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