Thoughts of a retired physician

  I read two articles in the New York Times this week about hospital groups that appear to have put profits over patients even though they are nonprofit entities. One is Providence and the other is Bon Secours Mercy Health. I have long been a proponent for universal health care as opposed to the profit-driven fragmented “system” we have in the United States. What is perhaps surprising is that the two hospital groups the Times explored are nonprofits . The quest for dollars by the medical industry in the U.S. knows no genuine boundaries. A table and two graphs for context. The source is World Health Systems Facts . First a table comparing developed countries national health systems: Lots of numbers but the United States has the highest total health spending as % of GDP, among other data. How about healthcare spending per capita?  Well, the United States spends more per capita than the other developed nations in this comparison sample. But what counts is outcomes, right? Check out

Covid-19 has NOT disappeared. The trend for cases, hospitalizations, and deaths from Covid has been downward but today’s New York Times tracking page shows (as of 17 September 2022) a 7-day average for the U.S. of 62,037 cases (down 29% over 14 days), 32,168 hospitalizations (down 12% over 14 days), and 465 deaths (down 6% over 14 days). The cases have been declining since late May. Sadly, vaccination rates have not materially improved. For all ages in the U.S., 68% have been fully vaccinated (2 doses) but only 33% have received a booster. The numbers for those older than 65 are somewhat better: 92% are fully vaccinated and 65% have been boosted.  The head of WHO said on 14 September “We have never been in a better position to end the pandemic. We are not there, but the end is in sight.” As an infectious disease physician and epidemiologist, I will simply say I am hopeful but prefer to keep my powder dry. At the moment, there do not appear to be new variants emerging that would cause

  Twenty-one years ago I sat at our morning report at JTF-CS, then located at Fort Monroe, Virginia. Our J2 (intelligence) burst into the room to announce that an airplane had just hit the World Trade Center. Our CO ordered him to get more info and he came back to tell us another plane had hit the second tower. The event changed world events in an instant and reverberates to this day. Let us remember it and also remember that we were united then. 9/11 was a foreign foe. Now the foe is internal fascism. I hope we are able to overcome the domestic threat that faces our democracy.

  This is the Sunday of the 2022 Labor Day weekend. The labor movement is once again stirring after going into the doldrums starting in the late 1970s. A few thoughts came to mind as I opened my laptop today. The first is that what we see today in the United States has been built over the centuries by the working men and women of this country. While some praise the work of the (primarily) men who provided the capital for business, we must never forget that we would not have what we see today without the workers. From the early canals like the Erie to the railroads that opened this vast country to commerce in the late 18th and early 20th centuries and the steel and petroleum industries that led to the automotive industry , names like Clinton, Vanderbilt, Carnegie, Rockefeller, and Ford readily come to mind. As with military history, this is remembering the generals and forgetting the soldiers.  The labor movement’s histor y is long in our country. It is checkered with many episode