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

  Here at MonteCedro, Margan and I conduct a biweekly session on current events for our residents. The format is a presentation of the subject for which either M or I prepare a slide presentation, followed by a discussion on the topic. With the state of the world, we have had no shortage of topics to discuss. We ask the audience what they are interested in for the following session. They asked for a critical race theory (CRT) discussion, and it’s my turn in the box in 2 days. When I began reading up on CRT, I realized how little I knew about what it really is. My heart initially sank but I started reading and accumulating references. I never want to be at the worst end of the Dunning-Kruger effect: I’m somewhere just beyond the “Valley of Despair” on the steep “Slope of Enlightenment” (you never want to be at the Peak of “Mount Stupid”).  Here is a little of what I have figured out with some of the references I found that may help others grappling with this issue. First and foremost, C

  This past week, I saw the obituaries for Pete Carril in the newspapers. When I was a student, Mr. Carril was the basketball coach at Reading High in Reading, PA. Home games were always a thrill because he coached great teams at RHS before moving on to college coaching, first at Lehigh University and then for 29 years at Princeton, where he is credited with creating March Madness as the name for the NCAA finals. I want to comment on his teaching my high school civics class, not basketball. I was a college prep student at Reading High. Every student had to take a civics course prior to graduation and Mr. Carril was my teacher. I remember many discussions in his class about how the government was structured, how it came to be that way, why understanding its working was important to our democracy, and why being an informed voter was important. The 17-year-old me took this in and I think it has stuck with me ever since. Margan and I have been members of the League of Women Voters since

  On 14 August 1935, President Franklin D. Roosevelt signed the Social Security Act into law. I shared Heather Cox Richardson’s story this morning of the driving force behind it, FDR’s Secretary of Labor, Frances Perkins. She was the first female Cabinet Secretary and millions of Americans remain in her debt (and Roosevelt’s) for ensuring a social welfare net for seniors and others. The 1930s were dire times for our country and much of the world with depression and the rise of fascism; we survived and the liberal world order and democracy that followed lasted for over 30 years. America had a robust middle class for the first time in its history. We know, of course, that this did not last. The neoliberals, enthralled with unfettered capitalism and profits as the apex of life, came to the fore in the 1980s with Ronald Reagan and Margaret Thatcher. The policies of the New Deal were anathema and have been eroded piece by piece over the past 40 years. Now the party of Donald Trump wants to