On October 11, prison organizer Dawn Brooks’s phone began ringing off the hook. Within three days, she received 50 calls. Colitha Bush, a Texas mother who had been released from federal prison under COVID measures in mid-September, was one of the callers. She had spent 14 days at a halfway house before being released to home confinement at her sister’s house. On October 12…
This post was originally published on Latest – Truthout.
Senate Majority Leader Chuck Schumer and a handful of other Democrats sent shockwaves across social media on Tuesday after apparently voting with Republicans to terminate the COVID-19 national emergency declared by former President Donald Trump in March 2020 as the virus shuttered the nation and much of the world. Schumer’s office later told reporters that his “yea” vote was mistakenly recorded — including on his own website — and his vote was actually a “nay.” Other top Democrats still voted with the GOP.
In a 61-37 vote, 11 Democrats joined 49 Republicans in voting for a joint resolution to bring the pandemic national emergency declaration to an end. Unless there were other “mistakes,” the Democrats voting with Republicans include Sen. Amy Klobuchar (Minnesota), Sen. Tim Kaine (Virginia) and others. Progressive observers were outraged, arguing the pandemic is far from over with winter threatening a surge in COVID cases along with other respiratory illnesses that could destabilize an already stressed health care system.
However, there appears to be some confusion not only over who voted for what, but also over two different declarations. Trump reluctantly declared a “national emergency” in March 2020 after the World Health Organization designated COVID a global pandemic, but an earlier order signed by Trump’s health czar at the Department of Health and Human Services declared a “public health emergency” in January 2020 as the virus threatened to sweep across the United States. Both declarations give the federal government emergency powers to intervene in state policy in order to meet urgent medical needs.
The Senate’s joint resolution would only affect the national emergency declared by Trump and was passed by simple majority under the Senate’s executive oversight rules. The Biden administration recently announced another 60-day extension of the public health emergency, which gives the federal government power to expand Medicaid coverage, nutrition assistance, and other benefits often provided by state governments for the duration of the pandemic.
The White House also said President Joe Biden would veto the Senate resolution to terminate the national emergency declaration, and House Democrats may choose to ignore the resolution for the remainder of their term in the majority. In a statement, the White House said the national emergency provides the federal government with authority ensure that “necessary supplies” are readily available as winter approaches and the health care system remains under stress. The order allows millions of people to receive free tests, treatments and vaccines through federal and state programs.
“Strengthened by the ongoing declaration of national emergency, the federal response to COVID19 continues to save lives, improve health outcomes, and support the American economy,” the White House Office of Management and Budget statement said, adding that terminating the national emergency “abruptly and prematurely would be a reckless and costly mistake.”
Last month, Biden extended the national emergency indefinitely before it will finally expire on March 1, 2023, according to Fierce Healthcare. The declaration allows for waivers that expanded the use of telehealth services and loosen regulations to allow for innovative public health programs, such as federally supported COVID testing sites.
The administration has also drawn authority from both emergency declarations to expand nutrition benefits for low-income families and to bolster programs such as Medicaid and Medicare to protect people from losing health coverage during a pandemic. Removing the public health emergency order in particular could open up federal pandemic efforts to challenges from conservative states.
Kansas Republican Sen. Roger Marshall introduced the joint resolution to terminate the national emergency declaration on Tuesday, citing a CBS interview with Biden in September, when the president said the “pandemic is over.” Some observers saw the statement as a gaffe after administration officials walked it back. On the Senate floor, Marshall argued that COVID cases, deaths and hospitalizations are down, and the administration is “manipulating” policy in order to “super-size” government power and enact a federal “spending spree.”
On the floor, Sen. Ron Wyden (D-Oregon) noted that it was the third time the Senate debated Marshall’s resolution and warned it was a “recipe for chaos” in the health care system as winter brings COVID, flu, and other viruses. The resolution would create “red tape” and make it harder to for federal agencies to keep waivers on the books that have kept hospitals staffed and supplied, and allowed for flexibility in programs such as Medicaid, which provides health coverage to millions of lower-income people.
“Congress ought to be looking here to support medical workers and protect our health care system from becoming totally overwhelmed by viruses,” Wyden said, adding the resolution was dead on arrival in the House. “The Marshall resolution and this broader Republican effort we have been hearing about on the floor to eliminate health care flexibilities does the opposite.”
However, leading Democrats, such as former presidential hopeful Amy Klobuchar of Minnesota, voted with Republicans to pass the resolution in the Senate. Press offices for both Senators Schumer and Klobuchar did not respond to several inquiries from Truthout.
The resolution is unlikely to be taken up by the House while Democrats remain in charge, but leading Democrats may be signaling to the Biden administration that it should start preparing for an “end” to the pandemic, or at least to the emergency powers granted to his administration. With a closely divided Senate and the GOP expected to have a slim House majority next year, the senators may be warning Biden that patience is limited among lawmakers and the public alike, and Congress is expected to fiercely debate the issue.
While the resolution did not address the January 2020 public health emergency order from the Department of Health and Human Services, that authorization will also likely be a target for Republicans. If the public health emergency order is revoked or expires in March, the administration’s pandemic powers would begin to unravel, including a requirement that states do not remove people from Medicaid rolls. If the public health order expires during the winter and GOP-led states begin dropping people from Medicaid, experts warn that struggling hospitals could face a financial and logistical disaster.
This post was originally published on Latest – Truthout.
Major medical groups say that the loss of federal abortion protections has diminished access to pregnancy care such as treatment for ectopic pregnancies and miscarriages. The groups are sounding the alarm that racial gaps in pregnancy-related deaths will be exacerbated, according to a new Senate report first shared with The 19th.
The analysis comes on the heels of preliminary data suggesting that in the first two months since the ruling in Dobbs v. Jackson Women’s Health Organization — a case that eliminated federal abortion rights and opened the door for states to ban abortions entirely — abortions fell by about 6 percent, or about 10,000 abortions, across the country. So far, abortion is entirely or almost entirely illegal in 13 states. In Georgia, it is banned for people after six weeks of pregnancy. Bans in other states, including North Dakota, Indiana and Ohio, are currently being blocked by courts. In Florida and Arizona, abortion is prohibited after 15 weeks of pregnancy.
The report was compiled by four Democratic senators: Elizabeth Warren of Massachusetts, Tammy Duckworth of Illinois, Mazie Hirono of Hawaii and Tina Smith of Minnesota. It contains responses to letters Warren sent to the American Medical Association, National Nurses United, the American Pharmacists Association, the American Hospital Association, and Physicians for Reproductive Health, asking them to track how the Supreme Court’s June 24 decision has affected access to pregnancy-related care. The report also cites a public letter from the American College of Obstetricians and Gynecologists.
All five organizations expressed concerns that these abortion bans would result in higher pregnancy-related death rates. Currently, federal data shows that Black and Indigenous pregnant people are two to three times more likely to die from pregnancy than White ones. That racial gap is likely to grow, medical groups fear.
“Restrictions on access to abortion and related care will worsen existing gaps in health disparities and outcomes,” a letter from the AMA read.
Even when state abortion bans have exceptions to save someone’s life or health, the language is often vague enough that physicians aren’t sure if the patient qualifies. Several groups raised concerns about the bans’ impact on people with dangerous health conditions. Already, many physicians in states with abortion bans are delaying treating ectopic pregnancies, which can quickly become fatal and are treated by terminating the pregnancy, until patients are on the verge of death.
Patients experiencing other potentially life-threatening health concerns such as hemorrhaging, preeclampsia and intrauterine infections are now facing similar risks, the medical groups told the senators.
Ohio’s six-week abortion ban required doctors to meet with a pregnant person “at least 24 hours prior to the performance or inducement of the abortion.” Since a spontaneous miscarriage is treated with the same medications as an abortion, the state’s Cleveland Clinic Emergency Department interpreted that stipulation as applying to pregnancy loss treatment as well. (Ohio’s six-week abortion ban is currently blocked by state courts.)
Medical providers are “being forced to wait to intervene until their patient’s condition worsens because of uncertainty around what is ‘sick enough’ to qualify for an exception,” according to the letter from Physicians for Reproductive Health.
The AMA also singled out other concerns for patients experiencing spontaneous miscarriages, making it harder to access the appropriate treatment. Ahead of the Dobbs decision, many physicians and reproductive health advocates expressed concern that abortion bans might create a chillling effect, discouraging medical providers from prescribing the pills — mifepristone and misoprostol — or making them harder to find.
That now appears to be happening. Specifically, many doctors are reporting difficulties finding mifepristone for patients who experience miscarriage. While miscarriages can be managed using just misoprostol, the medication regimen is far more effective when both drugs are available.
“Limiting access to mifepristone has serious consequences for treatment of these conditions,” the AMA said.
The report also found that as more people travel out of state for abortions, wait times have grown substantially at clinics in states where abortion remains legal. In New Mexico, which saw a 12 percent increase in abortions between June and August of this year, wait times at most clinics are now at least three weeks. That can be enough to push someone into a subsequent trimester, requiring more advanced care and potentially an abortion that takes two days instead of one.
It’s not clear how many more states will enact and enforce abortion prohibitions. Currently, eight state bans are being blocked by courts. Lawmakers in other states, including Nebraska and Florida, are expected to pursue harsher abortion restrictions in the coming year, though it’s an open question as to how many will pass.
Sen. Lindsey Graham, a Republican from South Carolina, introduced a bill earlier this fall that would ban most abortions after 15 weeks. The bill currently does not have the votes to pass, and other Republican senators were quick to distance themselves from the proposal. But it’s not clear if such a ban might gain more traction if Republicans took control of Congress.
If enacted, such a law could have stark consequences, all of the medical groups warned.
“The effects of this type of federal abortion ban would be devastating to the health and well-being of individuals and families across the country,” ACOG wrote.
Among the consequences, per National Nurses United: “severe symptoms, illness, and even death.”
This post was originally published on Latest – Truthout.
Crystal Muñoz was four months pregnant when federal agents knocked on her door. They assured the Texas mother that she wasn’t in any trouble; they just wanted to know about a map she had drawn for some people two years earlier. Little did she know that talking with them would lead to a 20-year prison sentence — and delivering her baby with her wrist and ankle cuffed to a hospital bed.
Federal agents arrested Muñoz for conspiracy to distribute marijuana. The courts allowed her to stay at home with her husband and months-old daughter until the end of her trial. When a jury convicted her in October 2007, she was sent to the Ector County Detention Center to await sentencing. By then, she was in her last trimester.
“It was horrible to be in there at all,” Muñoz told Truthout, “but to be pregnant [in that jail] was super-awful.”
She recalled being handcuffed and shackled — with cuffs around her wrists and ankles — when she was brought to an outside hospital for prenatal visits. Depending on the officer, she might also have a metal chain wrapped around her waist.
Each day brought the same meal — beans, cornbread and bologna, even though lunch meats can cause listeria in pregnant people and result in serious illness for fetuses. Muñoz requested extra fruits and vegetables to no avail. The jail did not supply prenatal vitamins. Her husband attempted to navigate the jail bureaucracy to bring her a bottle, but despite his efforts, the vitamins never reached her.
The American College of Obstetricians and Gynecologists states that pregnant people should drink eight to twelve cups of water each day, but Muñoz recalled that meals were the only times that the jail provided drinking water. Otherwise, women would have to drink water from the bathroom sink, the same sink where people brushed their teeth, washed their hands and washed their panties. “And it’s right by the toilet,” Muñoz added.
Not wanting to risk bacteria, Muñoz hid empty potato chip and snack bags, filled them with ice, then drank the contents.
The day after Christmas, Muñoz went into labor. She was brought to the hospital, where officers secured her left wrist and left ankle to the bed posts. Although the attending doctor ordered the officers to remove the restraints, they did so slowly — first freeing Munoz’s ankle and, when she began birthing her baby, her wrist.
“I was super-healthy, so she came out super-healthy,” Muñoz said, recalling that her baby was the same size as her first daughter. But if she had had a more difficult pregnancy, or preexisting health conditions, her pregnancy and birth might have been much worse.
Now, federal lawmakers are seeking to improve pregnancy care in the federal prison system.
In October, Senators Amy Klobuchar (D-Minnesota) and Susan Collins (R-Maine) introduced the Protecting the Health and Wellness of Babies and Pregnant Women in Custody Act. Rep. Karen Bass (D-California) introduced a similar House bill in March.
The legislation bans restraints during pregnancy, a prohibition already enacted by the 2018 First Step Act. It also prohibits placing pregnant people in solitary confinement during their third trimester.
The bill also directs the Bureau of Prisons, which oversees all federal prisons, to provide regular access to water and bathrooms, nutritionally adequate diets, prenatal vitamins as well as information about parental rights and lactation. These protections would only apply to pregnant people in federal jails and prisons.
Carolyn Sufrin is a medical anthropologist, OB-GYN and an assistant professor at Johns Hopkins University School of Medicine. She is also the founder of the organization Advocacy and Research on Reproductive Wellness of Incarcerated People (AARWIP), which researches reproductive health care behind bars. During a 12-month period between 2016 and 2017, ARRWIP found that approximately 4 percent of people entering state and federal prisons and 3 percent of people entering jails were pregnant.
“The vast majority of pregnant people who are incarcerated are not in the federal system,” Sufrin told Truthout. During ARRWIP’s 12-month data collection, there were 172 pregnant people in federal women’s prisons, comprising 0.3 percent of the federal women’s prison population. Since then, those numbers have not increased significantly.
In addition to prohibiting shackling during pregnancy, the 2018 First Step Act instituted data collection on pregnancy and pregnancy outcomes in federal prisons. In 2019, federal authorities reported that 180 pregnant people had been incarcerated in federal facilities that year. Ninety-four gave birth while incarcerated. Federal authorities reported one instance of handcuffing a pregnant person, allegedly for disruptive behavior.
The following year, as COVID-19 began spreading across the country, 91 pregnant people were incarcerated in federal facilities. Thirty-nine were released before giving birth; of the 52 who remained, 50 had live births, one had a stillbirth and there was one maternal death. There were no reports of restraints of pregnant people.
Many states do not collect or report pregnancies or pregnancy outcomes in their prisons or jails. The new federal bill would alleviate that black hole by directing the Bureau of Justice Statistics, which collects and publishes data about incarcerated people in the United States, to include information about pregnancy, pregnancy-related care and the use of solitary confinement during pregnancy.
The bill comes too late to help Muñoz, who was granted clemency by then-President Donald Trump and reunited with her now-teenage daughters in February 2020.
But even for future people who are pregnant behind bars, legislation doesn’t necessarily ensure that prison or jail officials will follow the new measures. In 2009, formerly incarcerated mothers and their allies succeeded in passing legislation in New York to end shackling during labor, delivery and postpartum recovery. But despite the law, as late as 2014, prison officials continued to clap pregnant people in handcuffs, leg irons and belly chains when transporting them to outside medical visits — and even restrained them in the hospital hours after they had given birth.
In 2018, Maryland passed a law requiring jails and prisons not only to have written policies to address pregnancy and child placement, but to provide incarcerated people with these policies. In 2019, the state also passed a law prohibiting jails and prisons from placing pregnant people in solitary confinement.
Kimberly Haven, the executive director of Reproductive Justice Inside, helped draft both bills and has been monitoring implementation. She noted that in July 2021, two years after the prohibition of solitary confinement for pregnant people, Jazmin Valentine was placed in solitary after being arrested on an alleged probation violation. She gave birth alone in her jail cell after jail staff and nurses ignored her pleas for help, telling her over the course of six hours that she was merely withdrawing from drugs, not in labor.
“The reason we wrote this bill was just for this reason,” Haven told Truthout. “We came to them [Maryland’s jails and prisons], offered our trainings and training materials, and we were rebuffed.”
While the federal bill allows for the use of restraints or solitary confinement under extreme circumstances, it requires federal jails and prisons to review their use every few hours and report any such use.
But, noted Sufrin, “those [reporting requirements] are after the fact. There are no mandatory sets of health care standards or system of oversight or accountability to entice jails and prisons to follow the standards.”
Ultimately, said Sufrin, the solution to inadequate and terrible pregnancy and postpartum care “is not to incarcerate pregnant people in the first place and to invest in access to adequate pregnancy and postpartum care in the community.” But, she added, “that’s going to take a long time. We need some mandatory standards and systems of oversight and accountability.”
This post was originally published on Latest – Truthout.
On Wednesday, Kentucky’s Democratic governor announced a plan to expand the state’s Medicaid program to include dental, vision and hearing care for adults.
Gov. Andy Beshear’s plan to expand the services available under Medicaid in Kentucky will impact around 900,000 adults enrolled in the program. New benefits will go into effect on January 1, 2023.
Medicaid is a joint state- and federally-funded program that provides medical coverage to individuals and families with low incomes across the U.S. In Kentucky, a single adult is only eligible for the program if they earn less than $18,075 per year; for families of four, adults are eligible if the household income is below $36,908.
The changes will allow low-income adults in the state to access necessary care that was previously out of reach. (Children in the state are already eligible for dental, vision and hearing care if they receive Medicaid.)
Beshear assured residents that the changes won’t have a major effect on state spending, pointing out that Kentucky already has a healthy Medicaid budget and that federal funding will pay for most of the costs associated with expanding coverage.
Federal dollars will account for 90 percent of the expansion, which will cost an estimated $36 million annually. Kentucky will cover the remaining 10 percent of yearly costs, which amount to around $3.6 million per year — equivalent to approximately 8.5 percent of the state’s total government spending in fiscal year 2022.
“It will have no significant impact on Kentucky’s budget. It will require no changes to our budget in this next session,” Beshear said. “In other words, it is easily affordable, which means we absolutely should do it.”
Beshear touted the changes as being beneficial to workers across Kentucky.
“If you can’t see, it’s really hard to work,” Beshear said. “If you can’t hear the instructions that you’re getting, it’s really hard to work. If you have massive dental problems that are creating major pain or other complications, it’s really hard to work.”
Beshear’s announcement was praised by analysts in the state.
“This is a big deal!” tweeted Dustin Pugel of the Kentucky Center for Economic Policy. “Kentucky Medicaid has long offered vision and dental, but they offered scant services — for example you could get an eye exam, but not glasses. And it has never offered hearing benefits. Good on [the Cabinet for Health and Family Services] for implementing these long-overdue benefits.”
In what advocates call a “grotesque display of corporate profiteering,” the health insurance giant formerly known as Anthem reported making $2.3 billion in net profit off its policyholders over the past three months as analysts predict a dramatic spike in the cost of health insurance premiums in 2023.
Elevance Health, the largest for-profit company within the Blue Cross Blue Shield Association, surpassed Wall Street expectations on Wednesday and reported nearly $40 billion in revenue during the third quarter of 2022. Returns to shareholders increased by 7 percent, generating $1.6 billion in profits for investors. Elevance provides health coverage for 118 million people across multiple states.
Elevance claims its profits are the result of offering more service to more customers. However, health care activists who help patients fight for coverage from their insurance providers say a chunk of this profit undoubtably comes from denying insurance claims from sick people who cannot afford proper care otherwise. Denying claims, they say, is a “regular business practice” for squeezing out extra profits. Insurers know the vast majority of patients do not exercise their right to appeal when claims are denied and are often unsure how to do so.
“Part of this money is made denying claims,” said Aija Nemer-Aanerud, Health Care For All campaign director at People’s Action, in an interview. “How many surgeries, medications and doctor visits would $2.3 billion amount to if we didn’t live under a for-profit system set up to advance the interests of greedy corporations instead of actually care for people?”
A spokesperson for Elevance did not respond to an email requesting internal data that would show whether the company is turning profits by denying health insurance claims, but organizers have gathered horror stories from patients across the country. The six largest private health care insurers enjoyed a combined $41 billion in profits in 2021, and in 2020, private insurers denied more than 42 million in-network claims from patients covered by Affordable Care Act (ACA) marketplace plans, according to People’s Action and the Kaiser Family Foundation.
Thanks to federal transparency requirements tied to ACA subsidies, we know that means nearly one in five claims under ACA marketplace plans were denied by private insurers in 2020. This figure only includes federally subsidized ACA plans, not the private plans provided by employers that many people have. Eleana Molise, a neighborhood organizer with ONE Northside in Chicago, said one in seven of all medical claims are estimated to be denied nationally.
“This especially affects Black and Brown people who are sold the worst insurance, and people in rural America, where you get fewer or no health care providers, or they are ‘out-of-network,’ meaning you get stuck with the bill,” Molise said in a livestream Tuesday with health care advocates, impacted patients and Sen. Bernie Sanders (I-Vermont).
“A rational health care system is a system that guarantees health care for all as a human right, and it is s system that is cost effective, a system that is comprehensive … it is not a system designed to make private health insurance companies huge profits,” Sanders said, repeating his call for universal public health insurance known as Medicare for All.
Private health insurers will often refuse to pay for medical care under the rules baked into insurance plans — deductibles must be met, doctors must be within the insurer’s network, and any drugs prescribed must be on the insurer’s approved list of medications.
However, advocates report that people are often stuck with massive bills for medical care that is rightfully covered under their plans, forcing them to pay out-of-pocket or challenge the insurer under complicated and frustrating appeals processes handled by the company itself.
“The wolf is guarding the henhouse,” said Ken Whittaker, executive director of the social justice group Michigan United. “They know most people don’t know you can appeal your claim, and less than 1 percent appeal claims when they are denied … and that’s more money for CEOs and Wall Street investors.”
While it’s unclear just how much profit is raised by denying insurance claims, advocates say the industry’s behavior leaves little doubt that private insurers are gouging patients and public health care programs. For example, an Elevance CEO took home $17 million in salary and bonuses in 2020, the same year Elevance and other Blue Cross Blue Shield companies agreed to pay a $2.67 billion settlement in a major antitrust case filed on behalf of policyholders.
A recent New York Times investigation found that private insurance companies exploited Medicare Advantage, which provides private health coverage for people 65 and older but is paid for by the federal government, to rake in billions of dollars from taxpayers. The majority of large insurers sent the government inflated bills, and Elevance and other companies face federal lawsuits for elaborate schemes to inflate profits. As The Times notes:
Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.
Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.
Medical bills that the insurance company refuses to pay after an emergency room visit or a major illness are the most common form of claim denial, Nemer-Aanerud said, but millions of uninsured and underinsured people are unable to afford basic preventative care that would help them stay healthy long-term — and keep costs down for everyone else. Coverage of lifesaving treatments and prescriptions are also denied by insurers, often the result of secret kick-back agreements made with pharmaceutical companies that drive up drug prices and determine which medications are covered for patients.
Callie Gibson, whose husband Mark Hall was denied access to proper medication for a chronic digestive disease, said the issue is affecting her family right now, but health coverage denial can happen to any of us. Hall was on medication that worked for years, but after switching from Medicaid to a private employer’s plan through Cigna Health, he was forced to switch to a biosimilar despite an appeal from his doctor. Even after taking higher doses, the new drug does not adequately control digestive bleeding and other painful symptoms, preventing Hall from living his daily life.
“Because ultimately, the insurance companies don’t care about you as an individual,” Gibson said during the livestream with Sanders, reflecting on the couple’s experience with Cigna. “They care about their shareholders, the people who are making money off this company, and they are not going to take action as long as they are continue to make money, and until we hold them accountable for what they are doing.”
The Health Care For All campaign is helping people fight for their claims through the appeals process, and anyone who has been denied health coverage is encouraged to contact the campaign.
This post was originally published on Latest – Truthout.
The multibillion-dollar National Football League (NFL) is locked in an extremely divisive controversy that can only be solved with a simple, but controversial, sandlot solution — a flag stuck in the back of the quarterback’s pants… and then of all ball carriers and receivers.
Though the solution may seem silly to those with no interest in or tolerance for professional football, the problem cuts to the core of a significant health and labor issue facing NFL athletes.
Much of the progress toward understanding the seriousness of the concussion problem has come from the football players’ union, the NFL Players Association (NFLPA), and from an organization of former players including retired running back Ken Jenkins.
“We’ve come a long way since I played,” says Jenkins, who retired in 1987. “You were supposed to be able to shake off a little stinger or dinger or a small concussion or a bell rung. That was expected back then. And, if you didn’t … it was almost like, ‘Well, he’s not tough.’ Now we know that a concussion can cause problems down the road and even lead to death. It has opened our eyes and created a cascade of safety measures to be put in place that have helped our game, especially for the youth coming up.”
Pioneered by former Colts player John Mackey in the 1970s, the NFLPA struggled long and hard against the billionaire owners who still view “their” players as dispensable employees. Over the decades, led later by former player Gene Upshaw and attorney Ed Garvey, the union faced almost impossible odds, fighting through brutal battles over pay, working conditions, free agency and collusion, and more. Gradually, the union built immense clout through organizing.
But perhaps the union’s biggest fight has centered on the discovery that many players have been suffering a previously undiagnosed form of brain damage called chronic traumatic encephalopathy (CTE). First identified by a Nigerian-born coroner in Pittsburgh, Bennett Omalu, the problem surfaced with the death of former Pittsburgh Steelers and Kansas City Chiefs superstar center Mike Webster.
Webster played from 1974 to 1990, entering the Pro Football Hall of Fame with a reputation for violent outbursts. Eventually Webster came to live with depression and mental illness, struggling with drug addiction and exhibiting erratic behaviors. At age 50, he died suddenly. According to The Atlantic, while the hospital report said Webster had died at Allegheny General Hospital from a heart attack, he also “suffered from ‘depression secondary to post-concussion syndrome,’ suggesting the syndrome was a contributory factor to his death, thus making it accidental.”
When Omalu used his personal funds to examine Webster’s brain tissue, he discovered a previously unknown syndrome of cell damage caused by the repeated trauma that is at the core of tackle football. Soon, with NFLPA support, the syndrome was confirmed in other dead and dying retired players.
Like the tobacco industry denying a connection between cigarettes and lung cancer, or the nuclear power industry whitewashing the dangers of atomic radiation, the NFL and its super-rich owners went into deep denial. They viciously attacked Omalu and his supporters, vehemently denying their immensely profitable sport could cause any lasting harm.
But the NFLPA took Omalu’s findings into the public mainstream. The union gradually organized retired players and their families — many of who continue to struggle with players’ high rates of depression, domestic violence and suicide. Ultimately, the union sued the NFL on behalf of its stricken veterans and their too-often abused spouses and children. A preliminary 2013 court settlement of $765 million opened the door to a long series of legal battles.
The union has also battled the league over funding for medical studies. Meanwhile, the 2015 film, Concussion, starring Will Smith and focused on Omalu and his research brought a new level of public attention to the situation. After Junior Seau, another beloved Hall of Famer, committed suicide at 43, medical researchers found that his brain exhibited “cellular changes consistent with CTE.” The findings deeply impacted public opinion.
The NFL and other major sports leagues have long been criticized by legendary consumer advocate Ralph Nader, among others. Much of his critique has focused on the ability of professional teams’ wealthy owners to gouge the public for huge sums of money to build enormous stadiums that only benefit the rich. But Nader has also skewered contact sports like hockey and football for promoting and marketing the brutal physical contact that results in CTE and other serious injuries.
In recent years, controversies have erupted over “race-based adjustments in dementia testing that critics said made it difficult for Black retirees to qualify for awards in the $1 billion settlement of concussion claims,” the Associated Press reported. The testing procedures, which the NFL agreed to end in 2021, had caused complex conflicts within the players’ union.
But the union and the league are continuing to battle over the brain damage issue. It’s been generally assumed that football is the United States’ most popular sport, in large part because its most loyal viewers love the violence itself. Promoted in part by the macho rantings of Donald Trump, who once owned a non-NFL professional football team (and the contract of running back Herschel Walker, the GOP’s far right candidate for Senate from Georgia), harm done to players has been considered “part of the game.”
The current uproar stems from two seemingly opposite situations — the disturbing concussive damage done to a young Miami Dolphins’ quarterback, and an overly protective penalty called in favor of an aging veteran QB.
The more serious side of the controversy surrounds Tua Tagovailoa, Miami’s 24-year-old star passer. In successive games Tagovailoa suffered head injuries that may have permanently threatened his health.
Under intense pressure from the players’ union and public advocates like Nader, the NFL has instituted some protocols to protect its most valuable assets: its star quarterbacks. Rules now in place, about how badly QBs can be hit by defensive players, and when quarterbacks must be substituted out after suffering obvious trauma, have somewhat mitigated risks. But the protocols are deeply flawed and seriously contradictory.
Tagovailoa was slammed to the ground on September 25, 2022, and experienced a concussion. But the Dolphins claimed he’d suffered a “back injury” and put him back in. Then, on September 29, 2022, he suffered yet another serious hit. According to People: “While lying on the field, Tagovailoa’s raised his hands and arms above him and appeared to be unable to control their movement, and medical assistance was called. Tagovailoa remained motionless on the field for around 10 minutes before being carried out in a stretcher.”
Despite the obvious trauma, Tagovailoa was allowed to play the next week and was hit yet again in ways too devastating to ignore. Commentators have voiced outrage that the life and future health of a player in his twenties could be so cavalierly risked for a mere ball game.
Ironically, when Tagovailoa was made to sit out the next game, his replacement — Teddy Bridgewater — was himself on the very first play hit too hard to continue. Miami’s third-string passer then led the team — which had been streaking — to an abysmal defeat.
The futures of Tagovailoa, Bridgewater and the Dolphins themselves are now all up in the air. The angry, divisive and often confusing debate about when concussed QBs should play and when they should be pulled has no clear resolution.
But the flip side of the debate reared its ugly hammered head in a marquee game between the Tampa Bay Buccaneers and Atlanta Falcons when legendary Buccaneers quarterback Tom Brady was sacked. The hit was routine and showed no signs of excess within the league’s protocols. Brady appeared uninjured.
But as one of the NFL’s all-time leading passers, Brady had license to jump up and down with theatrical complaints. The referees granted him a very dubious penalty, which probably decided the game in the Bucs’ favor.
In response, one of U.S. sports’ most popular commentators, Stephen A. Smith, made what could be a definitive suggestion. While expressing his outrage at Brady’s antics, he argued that a flag should be stuck in the back of the quarterback’s pants… and then of all ball carriers and pass receivers. Instead of letting these key players get smashed and thrown to the ground by massive pass rushers, the flag could merely be pulled, ending the play. The extreme violence and tangible damage suffered in this pivotal part of any football game would thus be avoided.
The suggestion to use flags in professional football may have been first discussed in public as a “serious cultural issue” 10 days prior by four former players on this writer’s weekly Green Grassroots Emergency Protection Zoom call and Progressive Radio Network’s “Solartopia” radio show.
“He [Tagovailoa] had a concussion from four days earlier and they let him play,” said former player Dan Sheehan. “It was just bizarre.”
The suggestion to use a cloth strip to be pulled and thrown to the ground is a throwback to “flag football,” the sandlot version of the sport played by millions of amateurs in parks throughout the country. In this more pacific version of the game, there’s no tackling. Each play ends with the ball carrier’s flag — rather than the players themselves — being thrown to the ground.
Such a version of the game is of course viewed as “wimpy” by Trumpian fans, most of whom have never played the sport
themselves, but who pay the big bucks to see hired gladiators (most of them Black) smashing each other’s brains to oblivion on the field.
For all the focus on rules surrounding quarterbacks, the essence of the game at all positions remains embedded in its violence, with the expectation of injury being virtually universal.
In the long run, going to flags — and not just for quarterbacks — may be the game’s only hope.
While European “football” — what people in the U.S. know as soccer — has grown exponentially, tackle football in the U.S. is tanking among young people. A new study suggests that half of adults in the U.S. disagree with the idea that tackle football is an “appropriate sport for kids to play.” Fearing injuries, lawsuits and a spreading revulsion against violence, high schools and colleges around the country are dropping the sport altogether.
As early as 2003, a major orthopedic study showed as many as 350,000 high school football players were being injured every year. And while the NFL gorges on high ratings and gargantuan profits, it cannot continue without a constant flow of young players.
For the league, a good quarterback is vital to the game’s allure. Tagovailoa has a multimillion-dollar four-year contract. The Kansas City Chiefs’ quarterback Patrick Mahomes recently signed a long-term deal for a half-billion dollars.
As we have seen in Miami, a team led by a mediocre quarterback is barely worth watching, even for the game’s most devoted fans. The quality of the NFL’s “product” is degraded every time a star QB is forced to sit out a game.
In the short term, protecting the quarterback, runners and pass catchers with a flag protocol rather than murky, hard-to-define concussive protocols should be — forgive the pun — a no-brainer.
The violence lovers will whine that the sport is going “wimpy.” But in the long term, the whole game must be overhauled and made less brutal. The grotesque parade of seriously harmed young stars being carted off the field is not sustainable. For the NFL, there can be no greater threat than the wise decision of young athletes to choose other sports.
Will making professional football less violent affect American culture? Realistically, it’s hard to think otherwise.
Football is the nation’s premier spectator sport, watched weekly by tens of millions. The Super Bowl is the most watched annual sporting event in the world.
A packed weekend of often horrifying blood sport can do the American psyche no good. Taming it down to the beautiful nonviolent ballet it really should be could constitute a great leap forward for the nation’s cultural mindset, and for the health of its athletes.
We won’t know for sure until we try. But common sense should tell us that when it comes to tackle football, flags are the better option.
Please write me directly via solartopia@gmail.com to help make it happen.
This post was originally published on Latest – Truthout.
New research unveiled Monday estimates that around 1.3 million U.S. adults with diabetes either skipped entire insulin doses, took less than needed, or put off purchases of the medicine over the past year due to its high cost, a striking indictment of a healthcare system that allows profit-seeking pharmaceutical companies to drive up prices at will.
The authors of the new study, published in the Annals of Internal Medicine, analyzed data from the 2021 National Health Interview Survey, examining a sample representative of 1.4 million U.S. adults with type 1 diabetes and 5.8 million with type 2 diabetes.
The results indicate that 16.5% of all adult insulin users across the U.S. rationed insulin in some way in the past year, with rationing more common among those with type 1 diabetes than type 2.
“Universal access to insulin, without cost barriers, is urgently needed,” Adam Gaffney, an ICU doctor at the Cambridge Health Alliance and the lead author of the study, told NBC News. “We have allowed pharmaceutical companies to set the agenda, and that is coming at the cost to our patients.”
Gaffney, an outspoken advocate of Medicare for All, said he has personally “cared for patients who have life-threatening complications of diabetes because they couldn’t afford this life-saving drug.”
BREAKING: We found 1,300,000 Americans with diabetes ration insulin due to cost.
Those without insurance had the highest rates of rationing at 30%.
This isn’t some awful phenomenon. This is a policy failure.https://t.co/SG5ntSDApe
— Public Citizen (@Public_Citizen) October 17, 2022
The high price of insulin has long been a scandal in the U.S., where the list costs of the cheap-to-produce medicine are often up to 10 times higher than in other countries.
Sen. Bernie Sanders (I-Vt.) has famously led caravans of people with diabetes into neighboring Canada to spotlight the shocking price of insulin in the U.S., which does little to regulate the pharmaceutical industry’s price-setting power.
One recent report by Human Rights Watch (HRW) described insulin access in the U.S. as “a privilege that many cannot afford,” noting that “soaring medicine prices and inadequate health insurance coverage can result in unaffordable out-of-pocket costs that undermine the right to health, drive people into financial distress and debt, and disproportionately impact people who are socially and economically marginalized, reinforcing existing forms of structural discrimination.”
The new study, co-authored by David Himmelstein and Steffie Woolhandler, echoed those findings, pointing out that people without health insurance “had the highest rate of rationing… followed by those with private insurance.” People on Medicaid and Medicare reported the lowest rate of insulin rationing.
“Several factors likely underlie our findings,” the authors note. “Insulin prices in the United States are far higher than in other nations. Moreover, pharmaceutical firms have increased insulin prices year upon year, even for products that remain unchanged.”
According to public data spotlighted by HRW, Eli Lilly has hiked the list price of the commonly used insulin product Humalog by an inflation-adjusted 680% since it started selling the drug in 1996.
Gaffney, Himmelstein, and Woolhandler note that the recently enacted Inflation Reduction Act includes a provision limiting insulin copays to $35 per month for those on Medicare, a change that “may improve insulin access for seniors, who experienced substantial rationing in our study.”
But they lament that Senate Republicans stripped out an insulin copay cap for those with private insurance.
“Further reform,” the trio writes, “could improve access to insulin for all Americans.”
In July, California Gov. Gavin Newsom announced that the state would soon move to produce its own insulin in an effort to provide a lower-cost alternative to Big Pharma’s products.
At the national level, HRW has called on Congress to “consider legislation to provide insulin to all insulin-dependent individuals in the country free-of-cost.”
“People who need insulin shouldn’t have to break the bank just to survive,” said Matt McConnell, economic justice and rights researcher at HRW, “but in the U.S. they often do.”
In an early August press conference, Florida Gov. Ron DeSantis delivered a shocking announcement: He was abruptly suspending Andrew Warren, the elected chief prosecutor for Hillsborough County (Tampa) and an outspoken critic of the governor. Warren, who was given no warning, was escorted from his office by an armed deputy.
In an accompanying executive order, DeSantis accused Warren of “incompetence and willful defiance of his duties.” Although county prosecutors in Florida are elected and do not answer to the governor, DeSantis pointed to a statute in the Florida State Constitution that allows a governor to suspend elected officials “for reasons of misfeasance, malfeasance, neglect of duty, drunkenness, incompetence, permanent inability to perform official duties, or commission of a felony.” Historically, this power has almost exclusively been used to remove officials charged with felonies.
To support his claims, the governor pointed to two joint statements signed by Warren and other prosecutors around the country: a June 2022 pledge not to use their offices’ “limited resources” to prosecute those who seek or provide abortion care, and a 2021 pledge not to criminalize transgender people or gender-affirming health care. DeSantis also noted a policy Warren implemented against bringing charges in cases that stem from police stops of pedestrians and cyclists; this was intended to end the high number of “biking while Black” bike-stop charges in Tampa.
All three of Warren’s opinions cited by DeSantis — his support for access to legal abortion, the right to gender-affirming care and reducing unnecessary and racist policing — stand in direct opposition to the governor’s political goals. The two public officials have clashed over these and other issues repeatedly over the past several years.
After removing Warren from his elected office, DeSantis immediately appointed Susan Lopez as his replacement, a conservative Hillsborough County judge and member of the Federalist Society, a conservative legal organization that believes in a literal interpretation of the U.S. Constitution, and whose membership includes all six Republicans on the Supreme Court. Lopez has already repealed some of Warren’s reforms, including the bike-stop policy.
But Warren is not going down without a fight. In an ongoing federal lawsuit seeking his reinstatement, he argues that his suspension violates his First Amendment rights and oversteps the powers granted to DeSantis under the Florida Constitution. The current suit has since been limited to the First Amendment question, which is within the realm of federal court. A trial is set for November 29.
In his complaint, Warren points out that DeSantis has not identified a single case that he declined to prosecute: His office had not received any cases regarding abortion, and Florida does not currently criminalize transgender medical care.
Warren also argues that his removal violates the will of Tampa voters who elected him in 2016 and 2020. These voters were further disenfranchised when his replacement was handpicked by DeSantis, who lost Hillsborough County by a nine-point margin in the last gubernatorial election.
“If DeSantis can arbitrarily suspend an elected official without one shred of evidence they have done anything wrong, how far will he go to punish anyone else who disagrees with him?” Warren wrote in an op-ed in the Tampa Bay Times. “This abuse of power should shock every business owner, teacher, doctor, public servant — and every voter.”
So far, Warren has already received one favorable ruling: When DeSantis moved for dismissal, arguing that First Amendment protections do not apply, U.S. District Judge Robert L. Hinkle disagreed, allowing the case to move forward.
Meanwhile, the Florida State Senate, which is responsible for deciding whether to reinstate or permanently remove suspended officials, has halted hearings regarding Warren’s case, citing the ongoing lawsuit.
“It’s a very unusual case. And it’s a problematic case,” Bruce Green, director of the Louis Stein Center for Law and Ethics at Fordham University School of Law, told Truthout. Green is a lead signatory on one of several amicus briefs filed in support of Warren. Green’s brief was signed by 115 legal scholars whose work focuses on legal ethics, professional responsibility and criminal procedure.
“The concern is that prosecutors are going to have trouble, at least in Florida, exercising the independent, professional judgment and discretion that they were elected to exercise,” said Green. “Because they have a governor who is looking over their shoulder, and is potentially going to remove them from office if he doesn’t like the way they’re making decisions. And it certainly chills them from being candid with their electorates and with the public about how they view things.”
The brief warns that Warren’s suspension “runs counter to professional standards of conduct … usurps the will and power of the electorate, and eviscerates the carefully crafted separation of powers erected in the Florida Constitution.”
Another amicus brief in support of Warren was filed by a group of scholars of the Florida State Constitution. They note the dangerous precedent that Warren’s removal could set for voting rights if allowed to stand, warning: “If Governors were permitted to suspend State Attorneys because of their prosecutorial priorities and replace them with attorneys whose priorities mirror their own, Florida’s electoral process for the office of State Attorney — and potentially all elected state officers — would be virtually meaningless.”
That brief’s signatories include members of a committee that approved revisions to the state constitution in 1997-1998, including the constitutional statute DeSantis used to justify the suspension. They note that none of DeSantis’s claims meet the legal definition of “neglect of duty” or “incompetence.”
In fact, Warren argues his competency and fulfillment of duty had nothing to do with his suspension. Instead, he has repeatedly accused DeSantis of removing him as an attention-grabbing, partisan performance. In a statement, the ousted prosecutor wrote: “Today’s political stunt is an illegal overreach that continues a dangerous pattern by Ron DeSantis of using his office to further his own political ambition.”
In an interview with Bolts magazine, Florida Rep. Anna Eskamani, a Democrat, agreed, calling Warren’s suspension “a fascist approach to governing, if you can even call it governing.”
The evening before the suspension, DeSantis’s press secretary, Christina Pushaw, teased the announcement in a tweet, suggesting that the real intent was to stir up controversy: “MAJOR announcement tomorrow morning from @GovRonDeSantis. Prepare for the liberal media meltdown of the year. Everyone get some rest tonight.”
In recent years, Warren has increasingly criticized or attempted to mitigate DeSantis’s policies at the local level.
In 2017, for example, Floridians overwhelmingly passed a ballot initiative that restored voting rights to most people convicted of felonies after completion of their sentence. The following year, the governor signed a bill harshly limiting the initiative’s scope by requiring people to pay all court fines and fees before voting. (DeSantis is currently going even further by prosecuting Florida citizens for accidentally voting before they were eligible.) In 2019, Warren’s office responded by setting up a process to help residents apply to have their debts waived for voting purposes.
Then in March and April 2020, Warren started to bring a case against an evangelical pastor who was defying social distancing rules to hold crowded megachurch services in Tampa. DeSantis intervened by abruptly adding an exception for church services in the statewide “safer-at-home order,” which superseded any local orders. Warren criticized the action as “weak and spineless.”
And in 2021, Warren spoke out against DeSantis’s so-called “anti-rioting bill,” which created a new, broad, vague definition of rioting that could more easily be used to punish nonviolent participants. The bill denied bail for people arrested at a “riot,” gave drivers civil immunity for running over protesters, and made it more difficult for cities to reduce police funding. In response, Warren said the law “tears a couple corners off the Constitution.” The bill has also been criticized by the United Nations. (Although DeSantis signed the bill into law in August 2021, a federal judge halted major parts, including the rioting definition, earlier this year, as a lawsuit is ongoing.)
A recent article in the Orlando Sentinel pointed out yet another indication that Warren’s suspension was politically motivated: Elected sheriffs throughout the state have pledged not to enforce gun control measures, without receiving any criticism from DeSantis — let alone suspensions for “neglect of duty.”
And Warren’s ouster fits with DeSantis’s history of punishing people who disagree with his politics.
Just weeks after Warren’s suspension, DeSantis suspended and replaced four school board members from Broward County, the sixth-largest school district in the nation and the second-largest in Florida.
In this instance, DeSantis was responding to the results of a grand jury investigation he had initiated into school safety issues following the 2018 Parkland shooting at Marjory Stoneman Douglas High School. The grand jury recommended that the school board members be removed for “incompetence and neglect of duty.” But instead of allowing the vacated seats to go up for general election, DeSantis once again took the opportunity to replace the ousted members, all of whom were Democratic women, with four Republican men of his own choosing.
DeSantis has gone after others who disagree with him. In April, he and GOP legislators punished Disney for speaking out against the state’s “Don’t Say Gay” law banning discussion of sexual orientation or gender identity in schools. His department of health also suspended an Orange County health officer in January after he sent an email encouraging his staff to get vaccinated.
And back in 2019, DeSantis suspended Broward County Sheriff Scott Israel, a Democrat, for the failings of his deputies in responding to the Parkland school shooting. Although a special master appointed by the State Senate concluded there was not enough evidence to support Israel’s suspension, the Republican-controlled State Senate confirmed his removal anyway.
Since taking office in 2016, Warren implemented policies that decreased the number of children tried as adults, gave judges more flexibility to waive excessive fines and fees, established mental health courts and created a Conviction Integrity Unit that has overturned at least 18 wrongful convictions.
After a 2016 Department of Justice investigation found that Black people made up 26 percent of the Tampa population and 73 percent of cyclists stopped by Tampa police, Warren’s office stopped bringing charges for offenses that resulted from non-criminal bike and pedestrian stops (such as “resisting without violence” charges).
These policies seem to have been popular in Hillsborough County; Warren easily beat his challenger for reelection in 2020.
But The Marshall Project outlined a concerning trend earlier this year, noting that “from Virginia to Missouri to Texas, conservatives have backed bills allowing the state to take over cases local district attorneys choose not to pursue, undermining the ability of elected prosecutors to carry out reforms that led voters to support them in the first place.”
By removing Warren directly, DeSantis has taken this attack to a new level. His appointed replacement, Susan Lopez, immediately began rolling back Warren’s reforms, including the bike-stop policy. She also reversed his decision to not pursue the death penalty in a pending murder case.
For now, Warren’s chances of reinstatement hang on the federal lawsuit. Other chief prosecutors and elected officials throughout Florida will be watching closely.
“Governors do not have the authority to disregard the autonomy and independence of prosecutors, nor are they entitled to undermine the will of the voters,” argued dozens of dozens of former judges and law enforcement officials, including three retired Florida Supreme Court justices, in yet another amicus brief in support of Warren’s lawsuit.
“Allowing governors to do so would upset the careful balance of roles and responsibilities delegated to local as well as state actors by state constitution, delegitimize our justice system, and erode public confidence in the operation of government and the integrity of the election process.”
This post was originally published on Latest – Truthout.
Updated: Sheikh Abduljalil Al-Muqdad is a prominent 64-year-old Bahraini religious cleric and political opposition leader and activist. He has been serving a life sentence at Jau Prison since 2011 following his warrantless and violent arrest in relation to pro-democracy demonstrations in the country. During his detention, he has been subjected to torture, religion-based insults, enforced disappearance, an unfair trial, reprisal, and medical neglect. On 16 November 2023, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion concerning four elderly Bahraini opposition leaders, including Sheikh Al-Muqdad, concluding that their detention was arbitrary and calling for their immediate and unconditional release, as well as a thorough and independent investigation into the violations of their rights.
On 27 March 2011, security officers who did not identify themselves raided Sheikh Al-Muqdad’s house at 3:00 A.M., raising their weapons at him. They took him from his room, threatened him, and tied his hands behind his back in the hall of the house while they searched it. The officers did not present arrest or search warrants. Next, they took him outside barefoot despite the pain in his left foot due to an injury. Sheikh Al-Muqdad was placed in the car, blindfolded, and taken to an unknown location.
When he was taken out of the car, he was slapped, and then officers interrogated him late into the night. In the morning, they brought him to Al-Qurain Prison. He was not permitted to contact a lawyer and was only allowed to call his family for new clothes.
At the prison and during interrogation, officers brutally tortured Sheikh Al-Muqdad. They beat him, insulted him, put him on the ground, and whipped him with a leather belt or a sole after pouring water on him. One of the officers forced him to open his mouth, spat in it, and forced him to swallow. These violations continued at the Military Prosecution, where officers blindfolded him and punched him in the head. Sheikh Al-Muqdad informed the investigator at the Military Prosecution that he was subjected to torture outside the room and asked him to write that in his file and present it to the doctor; however, the investigator did not do so. He was then transferred to the National Security Agency, where officers also verbally abused him, blindfolded and sexually assaulted him, and insulted him, his family, and his religious sect.
On 22 June 2011, the National Safety Court sentenced Sheikh Al-Muqdad to life imprisonment for attempting to overthrow the regime. Both the military and civilian Courts of Appeal upheld the sentence on 28 September 2011 and 4 September 2012, respectively.
During imprisonment, officers continued their abuse, mainly through intentional medical negligence. Sheikh Al-Muqdad, still suffering from pain in his leg, has also been forced to endure back pain and has not received serious treatment or obtained an accurate diagnosis despite constant demands. Furthermore, he has suffered from severe and persistent headaches, which also have gone untreated.
In June 2022, after being denied headache treatment for four years, the Jau Prison administration took Sheikh Al-Muqdad to two appointments; however, he was denied seeing the doctor after arriving at the hospital under the pretexts of “the code has changed” and “you don’t have an appointment.”
In September 2022, Sheikh Al-Muqdad was transferred to an ophthalmologist appointment at an external medical facility to treat cataracts in his eyes. He was transferred into a small vehicle that was not equipped with air conditioning despite the extremely high temperature at the time. Consequently, he suffered from a headache, had difficulty breathing, and was on the verge of losing consciousness.
On 27 September 2022, Sheikh Al-Muqdad was due to be transferred again from Jau Prison for an external medical appointment to treat his headache, dizziness, and poor eyesight. However, just before the appointment, an officer informed him that a doctor would not be present. Consequently, Sheikh Al-Muqdad refused to go to the appointment. Officers told him that he had to sign a statement declaring that he was rejecting medical treatment, which Sheikh Al-Muqdad refused to do. His refusal was met with an aggressive response from some officers, who verbally assaulted him; approximately 4 to 5 officers attempted to beat him but were stopped by other officers. A phone call for Sheikh Al-Muqdad detailing the incident was published the following day on social media platforms. At the beginning of the call, an officer tried to interrupt it and stop Sheikh Al-Muqdad’s testimony. In this recording, Sheikh Al-Muqdad said to the officer who tried to interrupt his call “You are prohibiting me from talking about my medical situation! I’m talking about something else I’m talking about my medical treatment”. At the end of the same recording, it could be heard when Sheikh Al-Muqdad said “Notice, my brother here is prohibiting me from talking!” before the officer ended the call.
When this incident was publicized, with supporters inside and outside the prison expressing solidarity with Sheikh Al-Muqdad, authorities sought revenge against him instead of launching impartial investigations to hold the officers accountable. Sheikh Al-Muqdad was taken to the Public Prosecution Office (PPO) to be questioned. A wooden board he usually sleeps on to alleviate pain was also taken away as a form of reprisal. Additionally, the prison administration took retaliatory measures against political prisoners who protested in solidarity with Sheikh Al-Muqdad, depriving them of contact and family visits and reducing the time allowed outside their cells from 90 minutes to 45 minutes a day.
On 29 September 2022, the PPO requested an investigation based on a complaint from the Syrian officer involved in the incident, Ali Farhan and summoned Sheikh Al-Muqdad for questioning as the assailant rather than the victim. The PPO and Ombudsman subsequently fabricated a case against Sheikh Al-Muqdad, accusing him of assaulting and provoking the office.
Sheikh Al-Muqdad’s denial of medical treatment has worsened after this incident. On 9 November 2022, he underwent an eye examination, and despite having paid for the glasses from his personal account, they were not provided to him. Three weeks prior to that, he had a medical appointment outside the prison, but he was taken there in handcuffs and leg shackles despite the swelling in his feet. They placed him in the car, but when they approached the gate, they abruptly told him to get out and returned him to his cell.
On 5 April 2023, Sheikh Al-Muqdad was denied his scheduled hospital appointment, prompting him to stage a sit-in in the prison yard, where he raised a banner demanding medical treatment.
Between 16 and 20 August 2023, prominent Bahraini detained opposition figures and leaders, including Sheikh Al-Muqdad, conducted a hunger strike in solidarity with political prisoners who were also on hunger strike.
On 16 November 2023, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion on four elderly Bahraini opposition leaders, including Sheikh Al-Muqdad, determining their detention to be arbitrary. The Working Group urged the Bahraini government to immediately and unconditionally release all four opposition figures, conduct a comprehensive and independent investigation into the violations of their rights, and hold the perpetrators accountable.
The medical neglect policy practiced against Sheikh Al-Muqdad is still ongoing, despite his deteriorating health condition.
The warrantless arrest, torture, enforced disappearance, religious-based insults, unfair trial, reprisal, and medical negligence against opposition leader and religious cleric Sheikh Abduljalil Al-Muqdad constitute clear violations of the Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment (CAT), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social and Cultural Rights (ICESCR), to which Bahrain is a party. Moreover, the violations he faced during his imprisonment, particularly medical negligence, constitute a breach of the United Nations Standard Minimum Rules for the Treatment of Prisoners, known as the Nelson Mandela Rules.
Americans for Democracy & Human Rights in Bahrain (ADHRB) calls on the Bahraini authorities to respond to the request of the UN Working Group on Arbitrary Detention opinion, by immediately and unconditionally releasing Sheikh Al-Muqdad, who was arbitrarily detained due to his peaceful activism, and all other political prisoners. ADHRB also urges the Bahraini government to investigate allegations of arbitrary arrest, torture, enforced disappearance, religious-based insults, reprisal, and medical negligence and hold perpetrators accountable. ADHRB further calls on the Bahraini government to compensate Sheikh Al-Muqdad for the violations he suffered, including serious medical negligence. ADHRB warns of Sheikh Al-Muqdad’s seriously deteriorating health condition resulting from years of medical neglect and urges the Jau Prison administration to urgently provide him with appropriate and necessary medical care, holding it responsible for any further deterioration in his health, given that he is over 64 years old. Finally, ADHRB calls on the international community to advocate further for Sheikh Al-Muqdad’s immediate and unconditional release and to call for the urgent provision of appropriate and necessary medical care for him and other elderly opposition leaders.
The post Profile in Persecution: Sheikh Abduljalil Radhi Maki (Al-Muqdad) appeared first on Americans for Democracy & Human Rights in Bahrain.
This post was originally published on Americans for Democracy & Human Rights in Bahrain.
Racial inequities are emerging in the vaccination and treatment of monkeypox, just as we saw with COVID. In recent weeks, roughly 25 percent of new monkeypox cases have occurred among white patients. Yet more than 33 percent of monkeypox vaccines have gone to white patients (as of September 27).
Financial and logistical barriers to monkeypox care can disproportionately affect patients of color. In New York City, appointments for monkeypox treatment and vaccination, distributed on a first-come, first-serve basis, have disproportionately gone to wealthy, white individuals who have better access to the health care system. The first vaccines were doled out in Chelsea, a mostly white neighborhood, during the middle of the workday on Thursday. Even when vaccines began to be distributed in Harlem (a neighborhood that is 82 percent non-white), appointments appeared to go largely to white residents from outside the community, leaving community members frustrated.
Such disparities mirror larger trends in society. Across specialties, physicians disproportionately spend their time seeing white patients, despite patients of color, on average, having higher medical needs. Due to the legacy of slavery, Indigenous genocide, xenophobic immigration regulations and centuries of racist economic policies, patients of color are more likely to be under- or uninsured, and in general, have lower incomes. Patients of color are also more likely to experience difficulties accessing transportation, or taking paid time off work to access appointments. The latter is particularly important for individuals with monkeypox, which requires prolonged isolation, and whose painful lesions can inhibit the ability to work.
We need explicitly anti-racist policies to repair these harms. Medicare for All would eliminate financial barriers to health care, and in doing so, help address the racial inequities highlighted by the monkeypox pandemic.
Medicare for All would establish a “single-payer” system, in which all U.S. residents would receive health insurance. All U.S. residents would have access to medications, doctor appointments and hospitalizations with low or no copayments. Undocumented individuals could be covered under the current House bill, as to be determined by the U.S. Secretary of Health and Human Services.
Studies show that Medicare for All would have saved 340,000 lives so far during the COVID pandemic, primarily by eliminating financial barriers to care, while saving billions of dollars annually. It’s a rare “free lunch” in economic policy, because savings under a single-payer system far outstrip the costs of expanding coverage. The U.S. spends nearly a third of all health care dollars on administration, approximately $800 billion annually, primarily coming in the form of private health insurance company overhead and profits. Medicare’s fee-for-service plan, in contrast, has 2.4 percent overhead.
Medicare for All could address racial disparities in monkeypox access by making all services free of charge, disproportionately benefiting racial and ethnic minorities. Most Americans would see their incomes rise, not only because premiums and copayments would fall to near zero, but because for the majority of Americans with employer-sponsored insurance, the potential salary that is currently tied up in insurance subsidies would be freed up.
Taken together, these financial boons could disproportionately benefit people of color who are more likely to delay health care because of cost. It’s notable that in the Veterans Health Administration, a single-payer health care system, many racial disparities in health outcomes are mitigated or absent.
When diseases like monkeypox disproportionately affect communities of color, the financial impact on hospital systems is not equal, reproducing structural racism. In general, hospitals primarily serving patients of color earn fewer profits, since these patients are disproportionately uninsured or covered by public insurance, which reimburses less than private insurance. This codifies a perverse financial system in which white lives are more valued than the lives of people of color.
Over the past few decades, this has also led to an arms race among health care systems, which invest in lucrative projects to attract privately insured (disproportionately white) patients, driving up the cost of care for all in the process. Meanwhile, clinics that serve people of color remain underfunded.
It doesn’t have to be this way. Medicare for All would establish a financing system called “global budgeting” that could allocate resources based on need, similar to how we currently finance fire departments. It’s a common-sense approach that aligns dollars with need. Safety net and rural hospitals, which are currently closing at record rates, would see boosts in revenue, and unnecessary or wasteful spending would be curtailed. This would be a boon for clinics which focus on lower reimbursing areas, like primary care, mental health, and yes, infectious diseases.
The early days of the monkeypox pandemic have been plagued by supply chain and logistical challenges. Vaccines remain scarce and maldistributed. Contact tracing and testing have been challenging. Medicare for All wouldn’t, in and of itself, fix all of these problems, but it would enable a national electronic medical record, mitigating logistical hurdles that result from our byzantine, multi-payer health system.
For example, in 2020, Taiwan’s lauded initial response to COVID would not have been possible without its single-payer system and national health insurance database, which streamlined contact tracing and communication.
There will be more pandemics after monkeypox and COVID-19. Narrow, disease-specific measures, such as those passed in 2020 making COVID hospitalizations free, expire with time, serving only as Band-Aids. Other incremental reforms are politically attractive, but mathematically infeasible, as they do not come with the administrative savings of a single-payer system.
There is a saying in medicine that the United States does not have a “health care system,” we have a “sick care” system. Among wealthy nations, the U.S. stands out for its uniquely reactive, profit-driven system which is disinterested in prevention. The monkeypox pandemic makes this all the more clear, and also sheds a light on structural racism in our health care system. By advocating for Medicare for All, we can build a better system, fundamentally reoriented to justice and public health, one that prioritizes people over profits and takes a necessary step toward confronting racial inequities in our society.
This post was originally published on Latest – Truthout.
When most of us think of mental health care, we think of seeing a therapist once per week. But at Kaiser Permanente facilities in California and Hawaii, clinicians — including psychologists, clinical social workers, marriage and family therapists, and addiction medicine counselors — say their patients routinely wait months between appointments. Not only that: There’s no limit to the number of patients that can be assigned to one therapist.
“You’re expected to follow anybody you have seen in the last two years. At times, the number of people I have seen in the last two years has been up to 600,” Sabrina Chaumette, a Kaiser therapist in Oakland, told Truthout.
Since July 2021, Kaiser mental health clinicians in California, who are members of the National Union of Healthcare Workers (NUHW), have attempted to use contract negotiations to demand the resources they need to provide better care for their patients. But workers say management has been unwilling to budge on changes necessary to reduce their unmanageable workloads and reverse understaffing, so on August 15 — nearly 14 months after their first bargaining session — over 2,000 Kaiser therapists in California went on strike. Nearing two months, it is the longest mental health strike in history. And on August 29, 57 of their colleagues in Hawaii, also NUHW members, joined them.
Kaiser is the largest nonprofit HMO in the United States, operating in eight states and the District of Columbia. It’s the largest health insurance plan in California, with more than half the market share, and the second-largest in Hawaii. However, despite reporting an $8.1 billion profit in 2021, Kaiser staffs only one full-time-equivalent mental health clinician for every 2,600 members in Northern California and just one therapist for every 5,500 patients in Hawaii, according to NUHW. Union members say this flies in the face of Kaiser’s key marketing promise: That by offering health insurance plans and operating hospitals and other facilities under one umbrella, patients receive better and more integrated care.
“I call it the glitter cloud,” Rachel Kaya, a Kaiser therapist in Hawaii, told Truthout. “They put out into the world how they promote mental health care, how they help people thrive, and how they do fair labor bargaining. But in my field, we talk a lot about the difference between talking the talk and walking the walk.” Unlike their colleagues in California, whose contract expired, Kaiser therapists in Hawaii are still without a first contract four years after joining NUHW.
“A strike is an absolute last resort. We have made numerous efforts to compel our employer to shift our model of care to reduce dangerous delays in terms of wait times that our patients face,” Ilana Marcucci-Morris, a Kaiser therapist in California and bargaining committee member, told Truthout. According to Marcucci-Morris, the union’s last contract cycle nearly ended in a strike over the same issues, but members ultimately accepted an offer from Kaiser when it agreed to form a committee, with equal participation between union members and management, that would make recommendations on how Kaiser could improve its model of care. After that committee met for over a year and made its final presentation, “Kaiser cherry-picked one or two pieces that they liked and then dumped the rest,” said Marcucci-Morris. Before walking out, NUHW members in Northern California accepted Kaiser’s financial terms. They’re not striking over their own compensation or benefits.
“Our patients are waiting three months in between appointments and flooding the emergency room because they’re in crisis, or paying out of pocket to go outside Kaiser. That extreme moral injury is the crux of our strike,” said Marcucci-Morris. We want our patients to get better and we need the resources to help them do that.” Kaya agrees. “I just want to be really clear that the reason why we are on strike is not a financial issue,” she said. “It is absolutely a social justice issue. Kaiser being a multibillion-dollar company, yet choosing to underfund mental health care in these communities, is wrong. The entire community pays the price when we underfund mental health care.”
Marcucci-Morris likens the Kaiser model, where there is no limit on the number of patients a therapist can be expected to take on, to “a house where you have a front door that’s wide open but no windows, no side door, or back door.” In addition to forcing clinicians to work many hours of overtime on non-patient-facing work like completing and reviewing notes and connecting with other members of a patient’s care team, union members say this approach actually compels them to break the law. In addition to recently strengthened federal law, California has some of the strongest mental health parity laws in the nation. SB 221, enacted in 2021, requires that mental health and substance use patients be offered return appointments within 10 business days, unless the treating therapist determines that a longer wait time is appropriate. If an appointment with an in-network provider is not available, insurers and HMOs are obligated to arrange for outside care at no additional cost to the patient. NUHW members say state regulatory bodies have been slow to enforce the new law, and that Kaiser was noncompliant even before their strike.
“Our current contract compels therapists to break mental health parity laws on the state and federal level,” said Marcucci-Morris. When she went on strike on August 15, said Chaumette, her next available intake appointment was in mid-November.
Barbara McDonald is a single parent to two daughters with mental health challenges. McDonald told Truthout that getting her younger daughter an appropriate diagnosis within the Kaiser system took so long that she was forced to pay out of pocket to go outside Kaiser. Once her daughter did have a diagnosis of borderline personality disorder, the only treatment she was offered within Kaiser was a series of classes — which were then canceled. After her daughter was hospitalized multiple times for self-harm, McDonald paid out of pocket again to get her the treatment she needed outside of Kaiser. All told, she has spent around $50,000. “I don’t think my daughter would be alive if I hadn’t been able to provide outside care for her,” she said. “And I’m still digging myself out of a financial hole because of that.”
“My older daughter said, ‘Do I have to cut my throat to get a therapy appointment?’ She sees her sister only getting care if she escalates and hurts herself. That must feel really scary, that nobody cares unless you’re hurting yourself or threatening yourself,” said McDonald.
Chaumette said that in her experience, it’s often patients with less severe symptoms who do manage to get a referral for covered care outside the Kaiser system. “If I’m seeing somebody with depression and they’re having a difficult time getting out of bed, dressing, bathing, eating, they’re not going to have the energy to be on the phone with Kaiser fighting for an outside referral. This system disproportionately hurts the people with more severe symptoms,” she said. Kaiser also encourages therapists to keep more severe cases in-house, purportedly to better manage care for those patients, and because they might be rejected by therapists in private practice. But Kaiser’s mental health providers are so overwhelmed that McDonald questions the safety of that approach. “Even though Kaiser is dispensing my daughter’s medication, they don’t have anybody following up with her. She can go six months between meetings with her psychiatrist,” McDonald said. “That’s just dangerous.”
In California, Kaiser contracts with Medi-Cal, the state’s Medicaid program, and its failures to deliver timely care disproportionately affect people who can’t afford to go outside the system. “Any marginalized community that has been unused to advocating for itself is not going to fight the system to give them a referral to an outside provider,” said Chaumette.
These untenable conditions have therapists leaving Kaiser in droves, according to NUHW. Between June 2021 and May 2022, said the union, 668 California clinicians left Kaiser — nearly double the 335 clinicians who left the previous year. In a survey conducted by NUHW, 85 percent of those clinicians said they had an unsustainable workload, and 76 percent said their inability to “treat patients in line with standards of care and medical necessity” influenced their decision to leave.
In California, NUHW members are asking for several key changes: Up to an additional 30 minutes per day to perform indirect patient care tasks such as returning phone calls and emails from patients and communicating with other members of a patient’s care team; the ability for clinicians to stop taking new patients when they have no available appointments for new patients within two weeks; a ratio of one appointment for a new patient to every six appointments with current patients; and a requirement that Kaiser hire enough staff to comply with federal and state law. The only concession Kaiser management has offered, according to Marcucci-Morris, is an increase in indirect patient care time of just 12 minutes per day, applying to generalist therapists only, which would exclude a majority of the union. Representatives for Kaiser Permenente did not return a request for comment.
In May, the National Committee for Quality Assurance, an independent nonprofit organization that accredits health plans, placed Kaiser under “corrective action” because of its violations of national mental health standards. Two California state agencies are also investigating Kaiser’s failures to follow state mental health parity law, though those investigations are not expected to conclude until next year. “I’d like to see them hit them with fines big enough to get their attention and to make it worth it for them to turn this around, because clearly they’re only interested in the money they make,” said McDonald. “Or if they’re not going to provide mental health care, then they should just say that rather than pretending they do.”
In Hawaii, NUHW filed a complaint in November 2021 with the Department of Commerce and Consumer Affairs regarding Kaiser’s failure to address serious patient care problems. In its formal response in December, Kaiser pledged to hire 44 additional therapists. According to NUHW, the number of full-time Kaiser clinicians in Hawaii has actually decreased from 51 to 48 since then.
Chaumette says that, because of its poor practices, Kaiser faces a reputational crisis among therapists. “They are never going to be able to hire enough therapists to treat all these patients, because nobody wants to work for Kaiser,” she said. “Our reputation in the community among therapists is bad. When I tell people I work for Kaiser, their first response is, ‘You don’t do therapy.’ I think this strike has increased my reputation within our community of therapists. We’re doing advocacy in ways I’ve never done before as a therapist.”
Though roughly half of the clinicians who went on strike in California have returned to work out of financial necessity, Marcucci-Morris said support for the strike remains high — in a recent vote, 85.9 percent of union members still supported the strike. “It’s important to note what a union is. We are a collection of workers. This is not one or two people telling us what to do,” she said.
According to Marcucci-Morris, therapists who have gone back to work informed the union that Kaiser is still booking appointments for patients with therapists who are out on strike, then canceling and rescheduling them. “If Kaiser felt following the law was a priority, they’d follow our proposal,” she said. “We’re ready to negotiate around the clock to get an agreement.”
British dockworkers join the podcast to talk about ongoing strikes in Liverpool and Felixstowe.
In the wake of the Supreme Court’s decision to overturn Roe vs. Wade, strict new abortion laws went into effect in more than a dozen states. Since then, women have reported being denied care for miscarriages, ectopic pregnancies, fatal fetal anomalies and unforseen crises, like premature rupture of membranes.
We are a nonprofit, nonpartisan, investigative news organization that wants to better understand how these laws are affecting the most intimate of health care decisions between patients and providers. Lawmakers who support the restrictions say the measures include exceptions to address life-threatening emergencies, and, in some cases, rape and incest. But many medical providers say the laws are not clear enough to account for all of the dangers that could arise during pregnancy.
These are significant policy changes and, as reporters, we are interested in learning about how they are experienced by real people. We know there are a lot of strong feelings about this issue, but we’re not looking for opinions. We’re looking for examples and insights. We are especially interested in hearing from caregivers or lawyers who work in the continuum of medical care.
If you’re in a state that tightly restricts abortion, we’d like to know more about your experiences and observations. If you are pregnant or are planning to become pregnant, what are your questions about how your state’s new laws affect your options or care? Have you had a medical conversation about what falls under the definition of “emergency” or a health threat under your state’s law? Contact us using the form below.
This post was originally published on Articles and Investigations – ProPublica.
New survey data released Monday shows just 12% of Americans think healthcare in the United States is handled “extremely” or “very” well, further evidence of the deep unpopularity of a profit-driven system that has left roughly 30 million without insurance coverage and contributed to the country’s stunning decline in life expectancy.
The new Associated Press/NORC Center for Public Affairs Research poll finds that 56% of the U.S. public believe healthcare in general is handled “not too well” or “not at all well,” while 32% believe healthcare is handled “somewhat well.”
In all, just 1 in 10 Americans feel the U.S. healthcare system as a whole and healthcare for older adults are handled well or extremely well.
“The poll reveals that public satisfaction with the U.S. healthcare system is remarkably low, with fewer than half of Americans saying it is generally handled well,” AP notes. “The poll shows an overwhelming majority of Americans, nearly 8 in 10, say they are at least moderately concerned about getting access to quality healthcare when they need it.”
The survey results will come as no surprise to those who have attempted to navigate the byzantine U.S. healthcare system to obtain basic care, which often comes at such prohibitively high costs that millions each year are forced to skip treatments to avoid financial ruin as insurance giants and pharmaceutical companies rake in huge profits.
The AP/NORC findings, based on interviews with 1,505 U.S. adults between July 28 and August 1, 2022, show that just 6% feel prescription drug costs are handled well or extremely well in the U.S., where pharmaceutical firms have broad authority to set prices as they please.
As for potential solutions to the country’s longstanding healthcare crises, the new poll shows that “about two-thirds of adults think it is the federal government’s responsibility to make sure all Americans have healthcare coverage, with adults ages 18 to 49 more likely than those over 50 to hold that view.”
“The percentage of people who believe healthcare coverage is a government responsibility has risen in recent years, ticking up from 57% in 2019 and 62% in 2017,” AP notes.
More specifically, the survey shows just 40% for a “single-payer healthcare system that would require Americans to get their health insurance from a government plan.” Depending on how the question is framed and phrased, single-payer — more commonly called Medicare for All — has polled as high as 70% support.
According to the AP-NORC survey, 58% “say they favor a government health insurance plan that anyone can purchase” — a public option.
Recent research shows that a Medicare for All system of the kind proposed in new legislation introduced by Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.) could have prevented hundreds of thousands of Covid-19 deaths in the U.S. over the past two years.
“In the richest country in the world, no one should die or go into debt just because they don’t have access to healthcare,” Jayapal, the chair of the Congressional Progressive Caucus, tweeted last week. “We need Medicare for All now.”
This post was originally published on Latest – Truthout.
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For nearly three decades, long before the fall of Roe v. Wade, the blond brick Building for Women in Duluth, Minnesota, has been a destination for patients traveling from other states to get an abortion. They have come from places where abortions were legal but clinics were scarce and from states where restrictive laws have narrowed windows of opportunity.
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For many residents of northern and central Wisconsin, and the Upper Peninsula of Michigan, it was faster to head west toward the Minnesota border than to go southeast to clinics in Milwaukee, Green Bay or Madison. Over the years, thousands of pregnant people climbed the stairs of the Building for Women to get abortions at WE Health Clinic, on the second floor.
Treating travelers from other states is nothing new for WE Health or the other abortion providers around the state, but Minnesota’s role as a so-called abortion access island is. The state’s neighbors have either banned abortion, are poised to do so or have severely restricted the procedure.
Data kept by Minnesota shows that white people make up a larger share of those who travel from another state for an abortion than those who seek abortions in state, raising questions about whether certain groups — particularly people of color — will be able to make the trip.
The Building for Women is home to the WE Health Clinic. (Jenn Ackerman, special to ProPublica)According to the state’s data, Minnesota residents seeking abortions are a fairly diverse group. From 2018 through 2021, on average, 31% of patients were Black, 9% were Hispanic, 8% were Asian and 2% were American Indian; an additional 6% were recorded as “other.” White patients accounted for 44%.
But among those coming from out of state, people of color made up a much smaller percentage on average of the patient population. White people made up 75% of out-of-state patients.
Experts say some of the disparity results from the fact that the states bordering Minnesota are predominantly white, particularly in the rural areas adjacent to the state. But this also describes Minnesota’s population. So at least some of the difference could be tied to access to transportation or money to travel.
“Minnesota is going to become a haven state, but for what percentage of people that actually need our services?” said Paulina Briggs, WE Health Clinic’s laboratory manager and patient educator. “That’s a huge thing.”
Paulina Briggs, WE Health Clinic’s laboratory manager and patient educator, said the facility was prepared for the estimated rise in out-of-state patients. (Jenn Ackerman, special to ProPublica)When Roe was overturned in June, the small staff at WE Health Clinic was dismayed but not surprised. In fact, it was prepared to meet the estimated 10% to 25% increase in out-of-state patients.
“We’ve anticipated this for a long time,” Briggs said. “So it’s not like sudden news to us.”
While the clinicians in Duluth may have been prepared for the end of Roe, something much more unexpected happened 2 1/2 weeks later, when a district court judge delivered a surprise ruling that expanded abortion access in the state. Ruling in Doe v. Minnesota, the judge threw out measures that included a mandatory 24-hour waiting period before abortions, two-parent consent for minors and a requirement that physicians discuss medical risks and alternatives to abortion with patients. He also tossed out a requirement that only doctors were allowed to provide abortion care, including by telemedicine, and that after the first trimester, the care had to take place in a hospital.
In contrast to the tearful scenes that played out in many clinics after Roe fell, in Minnesota that Monday morning, abortion providers and their support staff celebrated. Laurie Casey, the executive director of WE Health, was behind her long, crowded desk, doing paperwork when she first got news.
“It’s like, ‘Oh my God, is this real?’” she said. “Something good happened?”
Briggs said: “I think I audibly cheered. Like: ‘Yeah. Hell yeah.’”
Laurie Casey, the executive director of WE Health. She and her staff celebrated a surprise ruling that expanded abortion access in the state. (Jenn Ackerman, special to ProPublica)Lawyers for the plaintiffs in the Minnesota case, which was filed in 2019, had expected to go to trial at the end of August. Instead, the judge granted abortion supporters a big victory, leaving intact two measures: a requirement that abortion providers collect and report data on their patients to the state, and a law that dictates the rules for disposing of fetal remains.
Minnesota Attorney General Keith Ellison, whose office represented the state in the lawsuit, announced that he would not appeal the court’s decision. Ellison also pledged that he would not prosecute abortion-seekers from other states and wouldn’t cooperate with extradition orders from outside jurisdictions.
Minnesota Gov. Tim Walz signed an executive order making similar promises.
Both officials have made abortion access central tenets of their reelection campaigns.
In these early days of a post-Roe reality, it’s not yet clear who will need these protections, though the data can provide clues.
States track demographic data on abortion differently; according to the Centers for Disease Control and Prevention, more than two dozen publicly report the race and ethnicity of patients. Minnesota is the only access island state in the Midwest that releases those numbers; the state also separates that data into resident and nonresident figures.
Illinois is projected to accept far more out-of-state patients than Minnesota, but its health department does not release statistics about the race and ethnicity of abortion patients. Kansas allows abortion up to 22 weeks, protects the right to abortion in its Constitution and reports one of the highest rates of out-of-state patients in the country, at nearly 50% and second only to Washington, D.C. But Kansas’ state health department does not combine where patients are from with demographic data.
From 2008 to 2021, 13,256 patients who live outside Minnesota received abortion care there, an average of about 950 people a year, according to the state health department. Among that population, the racial and ethnic breakdown of patients has held fairly steady.
A number of factors play into the lack of diversity, said Asha Hassan, a graduate researcher at the Center for Antiracism Research for Health Equity at the University of Minnesota.
“There’s the obvious one that might be coming to mind, which is the effects of the way structural racism and poverty are interwoven,” Hassan said.
The bridge between Duluth and Superior, Wisconsin, often crossed by out-of-state pregnant people seeking abortion care in Minnesota. (Jenn Ackerman, special to ProPublica)Caitlin Knowles Myers, a professor at Middlebury College in Vermont who studies the economics of abortion, added, “Obviously resources like ability to take time off, ability to get and pay for child care, etc., etc. — that obviously prevents poor women from making a trip.”
Then there is the cost of the procedure itself. In Minnesota, residents can use state medical assistance funds to pay for an abortion under certain circumstances; out-of-state residents cannot. According to Our Justice, a nonprofit that provides financial assistance for abortion care and travel to Minnesota, in-clinic abortion services can cost $400 to $2,000, depending on the gestational age of the pregnancy. A locally based telemedicine service and mobile clinic called Just the Pill charges $350 for abortion medication.
Shayla Walker, executive director of Our Justice, said her organization helps people work through the kinds of barriers to travel that pregnant people of color face every day. Undocumented patients, for instance, may not have a driver’s license or other form of identification, meaning that flying from states like Texas or Oklahoma is out of the question.
Of the out-of-state patients who come to Minnesota, residents from neighboring Wisconsin make up the vast majority. And like Minnesota and its neighboring states, Wisconsin is predominantly white: 80.4% of residents identified as such in the 2020 U.S. Census.
From 2008 to 2021, an average of 690 patients from Wisconsin received abortion care in Minnesota each year. The proportion of Wisconsinites has dropped over the years — in 2008, 80% of out-of-state abortion patients reported that they lived in Wisconsin, compared with 63% by 2021. Over that same period, South Dakota residents ticked up from 4% to 16%, and Iowa patients rose from 2% to 6%.
According to Myers, the lack of abortion providers in western and central Wisconsin likely drives the traffic across the border to Minnesota. These parts of the state are largely rural and mostly white. Wisconsin’s more diverse urban centers are concentrated in the southern and eastern parts of the state, much closer to the Illinois border.
“A lot of them are likely to end up heading south to the Chicago area,” Myers said. “The Chicago area also has a lot of providers and likely a lot of capacity. And the question for Minnesota is, if the Chicago area ends up unable to absorb an enormous influx of patients heading their way from all directions, then you would expect to see patients spilling over into Minneapolis.”
Leaders of the Options Fund, which provides financial help to pregnant people in rural central and western Wisconsin who are seeking abortions, said the majority of the money they provide is for care that takes place in Minnesota.
“Certainly it’s not that people of color don’t exist, of course,” said the group’s vice president, who spoke on the condition of anonymity out of concern for her safety. “But I think generally, the more rural we get, the more white it’s going to be.”
Of course, the data from Minnesota is backward-looking, from years when abortion was still legal, though restricted or sometimes difficult to access, in surrounding states. There are certain to be shifts in where patients travel from, most obviously North Dakota, where the state’s lone abortion clinic moved from Fargo to its Minnesota sister city of Moorhead, just across the border. And as reproductive rights supporters across the country respond to the end of Roe, abortion funds have reported huge increases in their donations, which may bring travel and abortion care in Minnesota within the grasp of more low-income pregnant people and people of color.
The first week after the Doe v. Minnesota decision, WE Health Clinic’s patients felt the impact. Casey said she was able to tell a mother that her minor daughter could receive an abortion without the permission of her long-absent father or from a judge. Briggs was able to schedule a next-day abortion, which would have been illegal before the judge’s decision.
A medical abortion kit from WE Health Clinic includes mifepristone and misoprostol as well as a home pregnancy test, lip balm, candy and other items. (Jenn Ackerman, special to ProPublica)At some point, a clinic worker went through intake folders and pulled out all the forms certifying that “state mandated information” had been provided to patients. They were fed into the office shredder.
Tossing out their scripts, canceling the physician phone calls 24 hours in advance, no longer going down to the county courthouse to ask judges to grant their minor patients special permission to have an abortion — all of this will save the WE Health Clinic workers hours every week.
Beyond that, the court ruling — which abortion opponents are seeking to have overturned — has the potential to increase the number of providers, as advanced clinicians like nurse practitioners and some classifications of midwives may now be able to get training, and eventually provide abortion care and telemedicine.
This pivotal moment for abortion care in Minnesota and the country at large comes at a moment of major transition for WE Health as well. Casey is looking at retirement in the coming year, which means much of the work of adapting the clinic to serve patients in a post-Roe world will fall to her staff, including Briggs.
Briggs started working at the clinic six years ago, when she was just 21. She wanted to do this work after receiving her own abortion at WE Health as a college student, an experience she found at once “nonchalant” and “empowering.”
She is troubled by the disparities in who might be able to make it across the borders and climb the stairs of the Building for Women, to receive the kind of life-changing care that she did. Just keeping the doors open does not mean the care will be equitable.
Haru Coryne contributed data analysis.
This post was originally published on Articles and Investigations – ProPublica.
Some advocates of a publicly funded universal health care system have predicted that its creation is inevitable because of the “death spiral” of insurance costs. This term refers to the fact that as costs of insurance rise, fewer people can afford it, leading to a new round of rising premiums and out-of-pocket costs. If this cycle were allowed to continue indefinitely, it would be only a matter of time before the medical insurance industry priced its product out of existence.
In a rational world, this simple fact would lead Congress to do what every other industrialized nation has done; create a publicly funded system of universal health care either through a government-run system such as Medicare for All, or through a tightly regulated system of non-profit insurers that offer a defined benefit package specified by the government, as in Germany.
The post The Stealth Plan For Medicare For All appeared first on PopularResistance.Org.
COVID-19 cases persist all over the world, causing special concern in regions where vaccination rates are low due to inequities in access to vaccines. As the pandemic continues, analyses of the global response continue to point out the dangers of the predominant multi-stakeholder driven campaigns. One of the latest in line of such analyses is a report published by Transnational Institute and Friends of the Earth International in July. It zooms into how transnational corporations (TNCs) seized the opportunity to gain more power over international institutions and expand markets during the COVID-19 pandemic.
During the launch of the report, Lauren Paremoer from the People’s Health Movement underlined that the capture of the multilateral system by TNCs and private philanthropies was already underway before the pandemic, but the extraordinary circumstances led to an unanticipated expansion.
The post Inequities In Access To COVID-19 Medical Products Continue appeared first on PopularResistance.Org.
This post was originally published on PopularResistance.Org.
On July 30 activists marched and rallied in Washington, DC, calling for a more humane healthcare system. Physician and Left Voice member Mike Pappas spoke at the rally about how capitalism and health aren’t compatible. Below is the text from his speech.
Hi, everyone. My name is Mike, and I’m a healthcare worker in New York City. I work at the nation’s first overdose-prevention center and at a psychedelic-medicine clinic. Before this, I worked in both a federally qualified health center and a hospital in New York. I’m also a member of Left Voice, a revolutionary socialist group with a publication that is part of an international network of news sites.
To start out — and this should be no surprise to anyone — but just in case, I’m going to be really blunt and make things real clear: our healthcare system is a piece of shit that doesn’t remotely foster health or well-being.
The post Fighting For Healthcare Means Fighting For Socialism appeared first on PopularResistance.Org.
Once upon a time there was a company called 3M. You might recall that name because everybody loved them when they made a billion face masks during the pandemic. Remember at the beginning everybody was like, “Where are we gonna get enough face masks?! We need roughly a quadrillion and the entire US only has… seven. What are we gonna do?”
So people were wearing all kinds of weird shit on their faces. And then a few companies like 3M said, “We got it. We’re national heroes. We’re like the dudes who landed on the moon.” And I was like, “No you aren’t! You’re fuckin’ making a boatload of cash. You’re not sacrificing your life, running into enemy fire with a knife between your teeth. No, you saw that you could make a trillion dollars by pumping out face masks. Stop acting like you cured polio with a third grade chemistry set.
The post Major Mask Maker 3M Found To Have Harmed 200,000 Troops appeared first on PopularResistance.Org.
Nearly 17,000 monkeypox infections have now been reported across 75 countries, and the World Health Organization declared the spread of monkeypox a global emergency. Meanwhile, the U.S. has stopped short of declaring a public health emergency even with nearly 3,000 cases reported in 44 states. New York alone has reported 900 cases of monkeypox, with rollout of the vaccine inhibited by short supply. We speak to Joe Osmundson, professor of microbiology at New York University, about the queerphobic myths about the viral spread, the global inequity of vaccine distribution and more. “This should have been an easy virus to contain,” says Osmundson. “The immense frustration in our community has been watching hundreds of people get sick, not because they’re having sex, not because of their queer identity, but because they’ve wanted to get vaccinated and those vaccines have not been available.” Osmundson also describes how he helped a friend get treatment for monkeypox. His new book is Virology: Essays for the Living, the Dead, and the Small Things in Between.
This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: There have now been more than 17,000 cases of monkeypox infections in at least 75 countries, including the United States. Monkeypox isn’t fatal, but it can cause fever, rashes and extremely painful lesions. It’s most often spread through close, intimate physical contact. On Saturday, for the second time in two years, the World Health Organization declared a global emergency to address the spread. The last time, it was for COVID-19; this time, for monkeypox. This is WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
TEDROS ADHANOM GHEBREYESUS: WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region, where we assess the risk is high. There is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment. So, in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations. For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern. …
Stigma and discrimination can be as dangerous as any virus. In addition to our recommendations to countries, I’m also calling on civil society organizations, including those with experience in working with people living with HIV, to work with us on fighting stigma and discrimination. But with the tools we have right now, we can stop transmission and bring this outbreak under control.
AMY GOODMAN: Here in the United States, the Centers for Disease Control and Prevention has reported more than 2,800 cases of monkeypox so far across 44 states, with the largest outbreaks in New York, California, Illinois, Florida, D.C. and Georgia. The White House has not declared a public health emergency, that could bolster the U.S. response to the monkeypox outbreak. White House COVID response coordinator Dr. Ashish Jha said, quote, “It’s an ongoing, but a very active conversation at HHS.” That’s the Department of Health and Human Services.
For more, we’re joined by Joe Osmundson, professor of microbiology at New York University, scientist, activist, author of the new book Virology: Essays for the Living, the Dead, and the Small Things in Between. He’s featured in a new piece in The New Yorker headlined “The Agony of an Early Case of Monkeypox.”
The piece begins, quote, “On the evening before Juneteenth, Joseph Osmundson, one of my best friends and a microbiologist at N.Y.U., texted me: ‘We think Andy has monkeypox.’ Two nights earlier, our friend Andy, as I’ll call him, had spent hours hunched over in an emergency room with excruciating rectal pain, only to be refused testing. It was his third try in five days. Andy’s anal sores were internal; for patients to qualify for testing, C.D.C. guidelines required the appearance of lesions on the skin. Osmundson needed help.”
Well, Professor Joe Osmundson, that’s the opening paragraph of the piece in The New Yorker. Tell us where you went from there. And in the process, explain what monkeypox is.
JOE OSMUNDSON: Yeah. I’ll actually start with the second part. Monkeypox is not a new virus. And this is sort of why our community has been so frustrated by the lack of urgency to get us the tools we need to care for ourselves and each other and to prevent this virus. It was discovered in 1958 in animals and was shown in 1970 to exist in humans. It’s a virus that’s related to smallpox. You mentioned earlier that it’s not deadly. It’s not very often deadly, but in this outbreak so far this year, there have been five deaths, all of them in the endemic region between Congo and Nigeria. It’s a virus that is similar to smallpox but less dangerous. But it causes pockmarks all over the body, high fever. The lesions can be in the throat or on the mouth, inside the anus and rectum. They are excruciatingly painful. And the course of infection typically lasts two to four weeks. And during this time, patients are asked to fully isolate.
So, again, it’s a pretty miserable virus, although it’s not very often deadly. The frustration has been that because it’s so closely related to smallpox, we actually, prior to this sort of explosion of monkeypox outside of the endemic region — we have FDA-approved tests, we have FDA-approved medications that are likely to help ease suffering, and, most importantly, we have vaccinations that can prevent infection. So we have all of the tools, and yet all of these tools have been exceedingly difficult to access, even for someone like Andy, who has a Ph.D., has friends who are working on the response. I mean, it took direct phone calls to contacts in the New York City Department of Health and in the federal government to get him tested. And then, once he was tested and presumed positive, it took another few days to get him access to TPOXX, which is, again, an FDA-approved medication that we thought would help. Once he did get TPOXX, he went, in 24 hours, from being in the most pain of his life to the pain easing. And within five or six days, all of his lesions had healed, and he was cleared to leave isolation.
So, the good news is we have the tools both to prevent infections and to ease suffering. The immense frustration in our community has been watching hundreds of people get sick, not because they’re having sex, not because of their queer identity, but because they’ve wanted to get vaccinated and those vaccines have not been available.
AMY GOODMAN: I mean, we’re here in Chelsea, New York, and this is where people lined up around the block to get vaccines, but there simply weren’t enough.
JOE OSMUNDSON: That’s right. And that, you know, the rollout in New York, has gotten a lot of criticism. And, you know, the New York City Department of Health didn’t reach out to community partners prior to that. They just wanted to get shots into arms prior to Pride weekend. They’ve been listening to us about how that didn’t go well, and they are trying to do better. They are reaching out to more community-based organizations. They’re trying to have more vaccine equity in nonwhite, less affluent communities than the Chelsea community. But, you know, they are incredibly limited. You cannot have equity when vaccine is so scarce. It’s just not possible.
AMY GOODMAN: I wanted to turn to the protest that occurred last Thursday here in New York. ACT UP New York organized an emergency march against monkeypox and government failure in New York City. This is Cecilia Gentili, founder of Transgender Equity Consulting, speaking at the rally.
CECILIA GENTILI: Sex workers are again being forced to the impossible situation of choosing between prioritizing their health or having enough money to survive. Sounds familiar. Yes. The same [beep] happened a couple of months ago with COVID. What did the government do? Almost nothing. What is the government doing now? Almost nothing. I am so tired of getting almost nothing from the federal government.
AMY GOODMAN: Professor Joe Osmundson, if you can say what needs to happen? I mean, this weekend, you have Congressman Adam Schiff demanding that more be done. You have Ashish Jha on the weekend news shows saying they haven’t decided whether to make the — call this a national emergency in the U.S. And if it were called an emergency, what would that unleash?
JOE OSMUNDSON: Yeah, it would just increase the amount of funding and tools available. There’s a couple of things going on here. One is the scientific response, the biomedical response, that is absolutely lacking. There is no urgency. This should have been an easy virus to contain. Unlike COVID, unlike many other emerging threats, we have all of the tools. They are in a stockpile. The point of that stockpile is that it’s meant to be there to respond to an emergency. Here we have an emergency, and the stockpile has not been activated. We found out that vaccine sits in the stockpile in such a way that it can’t actually get into people’s bodies. And vaccine in a freezer is useless. So, we need resources to mobilize the national stockpile that we have to help us, to keep us safe, to treat us when we’re ill.
But we also know — look, COVID is — you know, a lot of us, by now, have done COVID isolation, 10 days, even five days. It is incredibly difficult. It is costly. Sometimes you miss out on work. Sometimes you have to get a hotel to isolate in. It is really difficult to do. Here we have an isolation with monkeypox that is two to six weeks. That is incredibly disruptive for people’s lives. We’ve been having to crowdfund to get people the money that they need to take time off work. We need emergency funds and hotel rooms so people can properly isolate to prevent the spread. And none of that, none of those funds and resources have been coming from any level of government.
In addition, there are essential scientific questions: Is the virus present in semen? Can we develop new tests that don’t require a skin lesion? Can we test saliva during the early-on flu-like illness? These are obvious questions. And without the proper funding, it will take too long to answer them. The ideal is we get these scientific questions answered as rapidly as possible; instead of skin lesion tests, we have really good saliva tests; if you think you have monkeypox, you can go in, get a saliva test in your flu-like illness, get TPOXX immediately, and maybe you don’t even get an outbreak of skin lesions, or if you do, you suffer much less, and you’re much less likely to spread the virus. And just, I mean, the vaccine is the most ridiculous thing. There are people who wanted to get vaccine, and now instead of getting vaccine, they have monkeypox.
AMY GOODMAN: Professor Osmundson, this whole controversy over whether to call this a sexually transmitted disease — you can also get it just in close breathing contact, isn’t that right?
JOE OSMUNDSON: That’s right. It’s a very tricky, you know, question. And there are obviously STIs that don’t require sex to transmit them, like herpes. But I’m really worried. We’re already seeing this pushback of, “Oh, if monkeypox is an STI, why are we seeing it in children?” — sort of, again, doing the groomer thing, implying that queer people are having sex with children. This is incredibly, incredibly dangerous.
This is a virus that commonly spreads throughout households when it’s in households. It is on sheets. It’s on towels. It’s on clothes. And we need to be aware of those nonsexual modes of transmission, so that if it pops up in a wrestling team or a massage parlor or a Broadway show where someone is handling costumes all the time, we actually — that’s on our radar, and we can diagnose it in those places and prevent spread there. I think it’s a little bit myopic to be so focused on sex and the queer community. WeAs Monkeypox Spreads, US Vaccine Access Is Pitifully Inadequate need to be curious and open to the many places this virus may spread.
AMY GOODMAN: Finally, Professor Osmundson, let’s talk about the issue of global equity. There is a severe lack of vaccine here in the United States, but multiply that many times over. Talk about the rest of the world.
JOE OSMUNDSON: This was a choice. This international outbreak was a choice. The United States government let 28 million doses of the modern smallpox vaccine, JYNNEOS, expire and get binned from the national stockpile, as opposed to being used in the endemic regions, from Congo to Nigeria, where people commonly are getting monkeypox. I was on a webinar with the head of the Nigerian CDC, who laughed when I asked, “What countermeasures do you have? Do you have vaccine? Do you have treatment?” They have nothing. If in Nigeria, where there’s been an ongoing outbreak of human-to-human spread of monkeypox since 2017, if they had countermeasures there to care for this painful infection there, it’s likely that we may have prevented the international spread of this virus.
Infectious diseases show us that borders are meaningless. Viruses will spread because people interact around the world. It is our obligation to care for human suffering everywhere, not just because it will prevent us from potentially getting sick, but because human suffering is human suffering. So there is absolutely an issue with countermeasures, including vaccine and treatment globally. And capitalism does not set us up well to care for everybody. It is not a way to make a profit. But in our increasingly warming and increasingly interconnected world, we are going to see more of these crises. This is not a viral crisis; this is a crisis of late capitalism.
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AMY GOODMAN: Joe Osmundson, I want to thank you for being with us, professor of microbiology at New York University, scientist, activist, author of the new book Virology: Essays for the Living, the Dead, and the Small Things in Between. We’ll also link to that piece in The New Yorker that features Professor Osmundson.
When we come back, we speak with California Congressmember Ro Khanna about his efforts to address the ongoing infant formula crisis impacting working-class families and parents of color, to stop the price gouging. Stay with us.
This post was originally published on Latest – Truthout.
The U.S. pharmaceutical industry exercised its virtually unlimited pricing power to hike costs for patients again this month as Senate Democrats made progress toward a limited deal to regulate out-of-control prescription drug prices, which are forcing millions of people to ration their medication or go without it entirely.
A new analysis released Wednesday by Patients for Affordable Drugs estimates that pharmaceutical companies in the U.S. have raised drug prices 1,186 times so far this year, further padding their bottom lines while intensifying the already overwhelming cost burden for patients.
Patients for Affordable Drugs found that between June 24 and July 5, pharmaceutical companies increased prices for 133 products. Pfizer, for instance, hiked the cost of its leukemia medication Besponsa again this month, bringing its per-vial price tag to $21,056.
“This is Pfizer’s fourth hike on the cancer drug during the Covid-19 pandemic — even as the company enjoys record-shattering profits from its vaccine,” the analysis notes.
The patient group also spotlighted Amgen’s price hikes for its autoimmune disease drug Enbrel. The California-based firm’s price increases for the medication have exceeded even the record-high U.S. inflation rate.
Amgen’s two price hikes for Enbrel this year alone are particularly brazen given that the company has faced recent congressional scrutiny over its business practices.
“Americans are struggling with record inflation and the continued challenges of a pandemic,” David Mitchell, the founder of Patients for Affordable Drugs, said in a statement. “Yet Big Pharma continues to raise drug prices with no regard for the health and financial well-being of Americans.”
Mitchell, a patient with incurable blood cancer whose drugs come with an annual list price of more than $900,000, argued that the pharmaceutical industry’s “latest price hikes demonstrate again why the Senate must stand up for the American people and pass the comprehensive drug pricing reforms in the reconciliation package.”
“These reforms are overwhelmingly supported by Republicans, Democrats, and independents alike, and the votes are there to pass the package immediately,” said Mitchell. “We must put an end to drug corporations’ unfettered ability to dictate prices at the expense of patients.”
Earlier this month, Senate Democrats unveiled 190 pages of legislative text containing their plan to require Medicare to negotiate the prices of a small subset of prescription drugs directly with pharmaceutical companies. The proposal also includes other measures to limit costs, such as a $2,000-a-year cap on out-of-pocket prescription drug payments for Medicare Part D enrollees.
But as The American Prospect’s David Dayen noted earlier this month in a detailed look at the plan — which has predictably drawn opposition from the pharmaceutical industry — the legislation’s scope is highly restricted.
“In earlier versions of the bill, the negotiated prices would have been accessible to all insurance payers,” Dayen observed. “But in this bill, the prices are only available to Medicare recipients. Part B (for drugs given at hospitals) and Part D (the Medicare prescription drug benefit) drugs that Medicare spends high amounts on are eligible.”
“The drugs eligible for negotiation also have to be at least 7 to 11 years beyond their approval stage, meaning that there’s still an exclusivity buffer where newer drugs can charge whatever they want,” he continued. “Since no drug can get a negotiated price at launch, this is likely to lead to higher launch prices.”
Launch prices are already in the stratosphere: Research published last month showed that nearly half of all new brand-name prescription drugs launched in the U.S. in 2020 and 2021 had an initial price tag of $150,000 or more per year.
Ashley Suder, a patient in Morgantown, West Virginia who takes GSK’s Benlysta to manage her lupus, said that she’s had to spend “her entire paycheck” on her medications. That experience is all-too-common in the U.S., where patients spend far more on prescription drugs than their counterparts in other rich countries.
Accounting for the latest price hikes, Benlysta now carries a monthly price tag of $4,282.
“Without this drug, my immune system attacks my healthy tissue, resulting in painful inflammation that damages my skin, joints, blood vessels, and brain,” Suder said. “With the price increasing again, I worry about how I’ll make ends meet while still affording my drugs.”
This post was originally published on Latest – Truthout.
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This story was co-published with ARD German TV.
In the year since the United States blocked Mexicans from entering the country to sell their blood, the two global pharmaceutical companies that operate the largest number of plasma clinics along the border say they have seen a sharp drop in supply.
In a suit challenging the ban, the companies acknowledged for the first time the extent to which Mexicans visiting the U.S. on short-term visas contribute to the world’s supply of blood plasma. In court filings, the companies revealed that up to 10% of the blood plasma collected in the U.S. — millions of liters a year — came from Mexicans who crossed the border with visas that allow brief visits for business and tourism.
The legal challenge by Spain-based Grifols and CSL of Australia relates to an announcement last June that U.S. Customs and Border Protection doesn’t permit Mexican citizens to cross into the U.S. on temporary visas to sell their blood plasma. The suit was initially dismissed by a federal judge but reinstated by the U.S. Court of Appeals for the D.C. Circuit. The drug companies’ lawyers have said in court filings that the sharp reduction in Mexicans selling blood to the border clinics is contributing to a worldwide shortage of plasma and is “precipitating a worldwide public-health crisis that is costing patients dearly.”
ProPublica, ARD German TV and Searchlight Mexico reported in 2019 that thousands of Mexicans were crossing the border to donate blood as often as twice a week, earning as much as $400 per month. Selling blood has been illegal in Mexico since 1987.
Many countries place strict limits on blood donations — Germany, for example, allows a maximum of 60 donations per year with intensive checkups before every fifth donation. But the Food and Drug Administration doesn’t require comparable donor checkups and allows people visiting American clinics to sell their blood twice a week, or up to 104 times a year.
The limits that other countries set on blood donations have made the U.S. one of the world’s leading exporters of blood. In 2020, U.S. facilities collected 38.2 million liters of plasma for the production of medicine, accounting for approximately 60% of such blood plasma collected worldwide.
Until now, it has been unclear how much of the U.S. blood plasma supply came from Mexican citizens, and pharmaceutical companies had downplayed border clinics’ role in meeting demand for plasma. Grifols noted in 2019 that “more than 93% of the centers [are] at a far distance from the border between the U.S. and Mexico.”
But in its recent court filings, Grifols stressed the importance of the border clinics. A statement from a company executive disclosed that at the company’s Texas centers alone, there were “approximately 30,000 Mexican nationals donating and supplying over 600,000 liters of plasma [a year].” He describes Mexican donors as “loyal and selfless in their commitment to donating plasma.”
According to a filing by Grifols and CSL, the 24 border centers run by Grifols alone account for an “annual economic impact of well over $150 million” and represent approximately 1,000 jobs.
The trade organization for the pharmaceutical companies, the Plasma Protein Therapeutics Association, has similarly reframed its arguments on the issue. In a 2019 statement, the association urged reporters not to attach any significance to “donation centers that happen to fall within areas states define as border zones.” It said then that it had no estimate of how much blood was being bought at the border or whether the amount was disproportionate when compared to the rest of the country.
But a recent court filing by the association said there are 52 plasma centers in the border zone, and “the average center along the border collects higher than average (31% more) plasma than the average center nationwide.”
Some of those donation centers were set up just steps away from the U.S.-Mexico border. Their location, court papers make clear, was part of a strategic effort to bring in Mexican donors: A memorandum written by the companies’ lawyers acknowledged that the centers were located to “facilitate” donations made by Mexican nationals, and that Grifols and CSL “have also spent ‘several million dollars in the last several years’ on advertising to encourage Mexican citizens to donate plasma in exchange for payment at the centers located along the border.” The memorandum did not specify if the ads were published in Mexico, but advertising for paid plasma donations is illegal in Mexico.
The Mexican nationals selling their blood previously entered the U.S. on what are known as B-1 or B-2 visas, documents that allow visitors to shop, do business or visit tourist sites. U.S. Customs and Border Protection had long viewed the practice of selling blood as a “gray area,” with some officials allowing short-term visitors to go to the centers while others did not. In 2021, about a year and a half after we published our 2019 story, the Border Patrol issued internal guidance that barred short-term visa holders from selling blood.
CSL and Grifols challenged that action, asserting that for 30 years, CBP had “largely allowed B-1/B-2 visa holders from Mexico to enter this country for the purpose of donating their plasma at collection centers that provide a payment to donors.” The CPB disagreed. Matthew Davies, a supervisory border security officer, told the court that selling plasma for compensation had never been a permissible activity.
On June 14, 2021, CBP sent out “clarifying guidance” that selling plasma on a visitor visa was not allowed. The announcement created chaos at the border centers. Two days later, Grifols wrote — and later deleted — a post on its Spanish-language Facebook page that said, “We are replying to the hundreds of messages asking when people with a visa can come back to donate. For the moment, the response is, you can’t.” An angry reply stated “Now, we’re no longer heroes who are saving lives. They just used us.”
Since then, donations at border centers have dropped dramatically. The pharmaceutical companies told the court that a survey of 12 centers in Texas found a 20% to 90% decline. “One particularly large center, which normally collects 5000+ donations per week, has decreased to a level closer to 200,” said the plasma association president, Amy Efantis.
Some previous donors interviewed by ProPublica said they would welcome a court ruling that set clear rules for people crossing the border to sell their blood. Genesis, a 23-year-old student from Ciudad Juárez, said she had worried about losing her visa when she entered the United States for her regular visits to the border clinics.
A current manager of a plasma collection center at the border, who asked not to be named because of the ongoing court case, said that he had to lay off about two-thirds of his employees and cut the center’s hours. “It would be good if they allowed [Mexicans] to donate again,” he said. “People are depending on this, on both sides.”
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This post was originally published on Articles and Investigations – ProPublica.
Gov. Gavin Newsom announced on Thursday that California is going to begin making its own insulin, in an effort to expand access and ensure that the people who need the drug can still afford it.
“California is going to make its own insulin. Nothing, nothing epitomizes market failures more than the cost of insulin,” Newsom said in his announcement, adding that some patients have to spend $300 to $500 per vial, which typically only last a patient about 30 days.
The state will allocate $100 million to produce the drug “at a cheaper price, close to at cost, and to make it available to all,” he said. Half of the money will go toward opening and staffing a manufacturing facility in the state and the other will cover costs of developing the product. Newsom has also been working on plans to potentially lower prices of other prescription drugs in the state.
“In California, we know people should not go into debt to receive life-saving medication,” Newsom said. The governor’s office says that the plan will cut the cost of insulin in half, if not more.
People in the U.S. pay more for insulin than people in any other wealthy country — often paying between 5 to 10 times more than what people in other countries do, research has found. With such high costs for common types of insulin, some people with diabetes have been organizing caravans to travel to Canada in order to obtain the medication for a fraction of the cost.
A recent survey by CharityRx found that a whopping four out of five patients have taken on credit card debt in order to afford insulin, taking on an average of $9,000 per patient. Additionally, 83 percent of respondents said they’ve feared not being able to pay for basic necessities like clothes, food and rent due to the cost of their insulin.
The high costs of insulin have had dangerous consequences. Yale University researchers found that one in four diabetes patients who visited the Yale Diabetes Center in 2017 said that they were skipping or skimping on doses of insulin because of the cost of the drug — which led to poorer health outcomes for those patients. Further, about a third of these patients didn’t discuss their underuse of the drug, which could have caused additional health problems.
CharityRx’s findings were even more drastic. The survey found that 38 percent of respondents said that they have had to stay at the hospital for more than a day due to problems caused by insulin rationing, while 33 percent said that rationing has caused them to get sick with other health issues.
Likely partially a result of high insulin prices, diabetes is a leading cause of death in the U.S. In both 2020 and 2021, over 100,000 Americans died due to diabetes, and the illness was the seventh highest cause of death in 2019. Meanwhile, the average price of insulin increased 11 percent every year between 2001 and 2011, research has found, making the condition the most costly chronic condition in the U.S., according to American Action Forum; in the U.S., one in four dollars spent on health care is spent on people with diabetes.
Democrats in Congress have been pushing to lower the cost of insulin. In March, the House passed a bill that would place a cap on prices of insulin to $35 a month or 25 percent of insurance plans’ prices, whichever is lower.
Over the past year, Democrats have also been working on plans to lower drug prices in general. Senate Majority Leader Chuck Schumer (D-New York) released a plan this week that would allow Medicare to negotiate drug prices for the most expensive drugs, though the plan excludes the insulin price cap, unlike the drug price negotiation plan introduced by House Democrats last year.
This post was originally published on Latest – Truthout.
Quickly delivering donated organs to patients waiting for a transplant is a matter of life and death. Yet transportation errors are leading to delays in surgeries, putting patients in danger and making some organs unusable. This week, we look at weaknesses in the nation’s system for transporting organs and solutions for making it work better.
More than any other organ, donated kidneys are put on commercial flights so they can get to waiting patients. In collaboration with Kaiser Health News, we look at the system for transporting kidneys and how a lack of tracking and accountability can result in waylaid or misplaced kidneys.
We then look at the broader issues affecting organ procurement in the U.S. with Jennifer Erickson, who worked at the White House Office of Science and Technology Policy under the Obama administration. She says one of the system’s weaknesses is that not enough organs are recovered from deceased people – not nearly as many as there could be.
We end with an audio postcard about honor walks, a new ritual that hospitals are adopting to honor the gift of life that dying people are giving to patients who will receive their organs. We follow the story of one young man who was killed in a car accident.
This episode originally was broadcast Feb. 8, 2020.
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Since the end of Roe v. Wade, numerous European political leaders have lamented the decision. British Prime Minister Boris Johnson labeled the Dobbs decision a “big step backwards,” and French President Emmanuel Macron said abortion “must be protected,” as his country prepared to place a nationwide right to abortion in its constitution.
In response, conservatives have cried hypocrisy, both to deflect criticism and to cast doubt on European institutions in general. “Many of the leaders who criticized the United States for the decision have laws that are either comparable to the Mississippi law at the center of Dobbs v. Jackson Women’s Health, which outlawed abortion past the 15th week of pregnancy,” Charles Hilu writes at National Review. “Americans should be very skeptical of the opinions of leaders across the pond.”
But this is not true on multiple levels. Though there are some moderate restrictions on abortion access in most European countries (and strict ones in a few), in practice almost all of Europe had far greater access to all aspects of reproductive freedom than Americans did even before Roe was overturned, and vastly greater freedom now.
The post Europeans Have Far More Reproductive Freedom Than Americans appeared first on PopularResistance.Org.
This post was originally published on PopularResistance.Org.
Following last week’s Supreme Court ruling that struck down federal protections for abortion rights, major companies, including a number of Silicon Valley giants, publicly broadcast their intention to assist their workers in traveling out of state to obtain an abortion. Meta, Apple, Disney, Dick’s Sporting Goods and Condé Nast were among them, the New York Times noted, joining companies that had made similar pledges in May, when a leaked memo revealed that the Court would overturn Roe v. Wade. These companies include Reddit, Tesla, Microsoft, Starbucks, Yelp, Airbnb, Netflix, Patagonia, DoorDash, JPMorgan Chase, Levi Strauss & Co. and PayPal, the Times reports.
The post The Fresh Hell of Depending on Your Employer for Abortion Access appeared first on PopularResistance.Org.
This post was originally published on PopularResistance.Org.
Prime Minister Jacinda Ardern called the US Supreme Court’s decision to overturn Roe v Wade “incredibly upsetting” as New Zealand politicians reacted to the controversial ruling.
Millions of American women have lost the constitutional right to abortion, after the 50-year-old Roe v Wade decision protecting the right to an abortion was overturned yesterday.
Ardern said in a statement that the decision was a loss for women everywhere.
“Watching the removal of a woman’s fundamental right to make decisions over their own body is incredibly upsetting,” she said.
“Here in New Zealand we recently legislated to decriminalise abortion and treat it as a health rather than criminal issue.
“That change was grounded in the fundamental belief that it’s a woman’s right to choose. People are absolutely entitled to have deeply held convictions on this issue. But those personal beliefs should never rob another from making their own decisions.
“To see that principle now lost in the United States feels like a loss for women everywhere.
‘We need progress … not move backwards’
“When there are so many issues to tackle, so many challenges that face woman and girls, we need progress, not to fight the same fights and move backwards.”
New Zealand decriminalised abortion in 2020.
National Party leader Christopher Luxon previously has said he is against abortion personally, but is not interested in changing New Zealand law.
In a statement last night, he reaffirmed that, saying that abortion laws “laws will not be relitigated or revisited under a future National government”.
Roe v Wade is an issue for the American people who have a different set of constitutional arrangements than us. NZ’s abortion laws were voted on and ultimately settled in the last parliament. These laws will not be relitigated or revisited under a future National government.
— Christopher Luxon (@chrisluxonmp) June 25, 2022
Foreign Affairs Minister Nanaia Mahuta tweeted that it was “draconian” and does not support womens’ right to choose.
The US Supreme Courts overturning of Roe v. Wade Is draconian and does not support the right of women to choice. How can this happen?
— Nanaia Mahuta (@NanaiaMahuta) June 24, 2022
Green Party MP Chlöe Swarbrick blasted the decision, expressing “solidarity with Americans fighting for restoration of their rights to healthcare.”
Prohibiting abortions doesn’t stop abortions. It prevents safe, regulated abortions. It prevents access for those without the resources to travel to areas where abortion is legal.
Solidarity with Americans fighting for restoration of their rights to healthcare.
— Chlöe Swarbrick (@_chloeswarbrick) June 24, 2022
ACT leader David Seymour said that “It may be that this is just returning the question to a state one, but half the states are going back a century in just a few days.”
What’s happening, Twitter? Great question. It may be that this is just returning the question to a State one, but half the States are going back a century in just a few days. pic.twitter.com/BFM0U0wFNB
— David Seymour (@dbseymour) June 24, 2022
Seymour, who supported New Zealand’s Abortion Legislation Bill to decriminalise abortion, said he was deeply concerned for the rights of American women and the future of US politics.
“I think that this will bring about a political earthquake in America. And this is a time when New Zealand really needs America to be focused on trade and security, rather than re-litigating battles of the 1950s.”
‘We cannot be complacent’
Green Party MP Jan Logie did not expect the decision would encourage people to push for changes to the abortion laws in New Zealand.
Logie said she was grateful New Zealand decriminalised abortion in 2020.
“We’ve seen a result of that an increasing number of New Zealanders who recognise the importance of reproductive justice. But this tells us also that we cannot be complacent.”
Logie said she feared the decision would increase the rate of unsafe abortions in the US.
Family Life International’s Michelle Kaufman said she wanted New Zealand’s abortion laws to change.
“I hope one day that we will see an end to abortion, that people will see that it’s the unthinkable choice, that there are better ways.”
Kaufman said abortion was violence and that it did not solve problems.
This article is republished under a community partnership agreement with RNZ.
This post was originally published on Asia Pacific Report.