Category: Health Care
Tulane School of Medicine put on probation by accrediting agency after bias complaints

https://www.nola.com/news/healthcare_hospitals/article_1336e91e-df46-11eb-840c-bffb5f2379ea.html

Tulane School of Medicine put on probation by accrediting agency after bias complaints

 

    • JUL 7, 2021 – 12:09 PM

 

The Tulane University School of Medicine graduate medical program, which trains newly-minted doctors during their residencies at hospitals across New Orleans, was put on probation by a national oversight panel last week.

The panel did not state the reason for probation. But the rare step was taken after allegations of racial and gender discrimination erupted within the institution earlier this year. Tulane drew national attention after the dismissal of Dr. Princess Dennar, a Black female doctor, four months after she filed a discrimination lawsuit against the school.

Dr. Princess Dennar, a specialist in internal medicine and pediatrics at LCMC Health and Tulane Medical School.

The Accreditation Council for Graduate Medical Education, or ACGME, notified Tulane of its decision on July 2.

Tulane is one of six medical training institutions currently on probation out of 865 regulated by the ACGME. Although the university’s 37 programs and fellowships employing nearly 500 physicians-in-training remain accredited, the institution-wide probation suggests the panel is concerned about the training program as a whole and its oversight of trainees.

“A status of probationary accreditation is conferred when it is determined that a sponsoring institution or program has failed to demonstrate substantial compliance with the applicable requirements,” said ACGME representative Susan White in an emailed statement.

The statement said the ACGME became aware of public reports of racial bias and discrimination in February of this year. Complaints began years before that.

After Tulane suspended a Black female doctor, medical community erupts with racism, bias claims

In April of 2018, seven Black female residents filed a formal discrimination complaint to the ACGME about what they alleged were unfair, time-intensive rotations that interfered with completing their program requirements.

Dennar filed a complaint at the same time, alleging that her authority over the combined internal medicine and pediatrics program she ran had been taken away. A few months before, another resident had lodged a similar complaint.

After a site visit triggered by those complaints, the accrediting agency noted several violations, including that Dennar did not have the agency to run her own program and residents were working more than 80 hours per week. In addition, it found that Dr. Jeffrey Wiese, then the head of the school’s internal medicine residency and current associate dean, had a conflict of interest in overseeing both his and Dennar’s programs. The ACGME did not find evidence of discrimination or bias during the site visit, but said it “could not be excluded.”

The probationary status was conferred after two more site visits in April 2021 following the uproar over Dennar’s dismissal. The ACGME does not disclose details of investigations, but said Tulane “is welcome to share information as it sees fit,” according to White.

Citing confidentiality, Tulane officials declined to say why it had been put on probation. A letter to medical residents from Dr. Lee Hamm, the dean of the medical school, said the “clear message from the ACGME” was to “improve the oversight” of programs and improve “learning and working environments, including enhancing equity, diversity and inclusion.”

The letter outlined several steps Tulane is taking to address the unnamed findings of the investigation, including reducing residents’ workloads, establishing a professionalism task force, hiring more staff for programs, retaining the services of the Norton Rose Fulbright law firm to conduct an evaluation of the programs, and hiring Sensei Change Associates, a management consulting firm.

After COVID, some Louisiana patients get diabetes diagnosis: ‘We should be concerned’

Graduating residency from an accredited institution is required for new doctors to practice on their own. When a training institution is stripped of accreditation, residents must find other positions in their specialty.

In addition to the entire institution’s probationary status, the ophthalmology program is on probation and the internal medicine and neurology programs are on warning status, the step before probation, according to the ACGME.

Some residents who felt their residency rocked during the controversy following Dennar’s dismissal see the probationary status is a good thing.

“The powers that be, now they’re on thin ice,” said a fourth-year resident who did not want to be named. “Tulane is a little too big to fail in regards to medical education. This will put them over the fire.”

But for prospective students, the probation status, which could take years to resolve, weighs heavily on their decision to apply for a Tulane residency.

“This throws a wrench into the thinking process,” said Russell Ledet, a fourth-year medical student at Tulane who was hoping to start a child psychiatry residency next year in his hometown of New Orleans. “Everything in me wants to stay here. Obviously, there is some hesitancy to go into residency programs that are on probation.”

Though Dennar remains the medical director of a clinic at University Medical Center and an assistant professor of internal medicine and pediatrics at Tulane, she declined a condition-based offer for reinstatement from the school, instead proposing a different set of conditions, which Tulane did not entertain. She no longer teaches or supervises residents, many of whom were attracted to Tulane because of its track record caring for a diverse patient population.

Dennar’s lawsuit against Tulane University is ongoing. A trial date has been set for Jan. 24, 2022.

In a prepared statement, Dennar called the probationary status “a positive step toward addressing concerns raised by myself and others about racism, sexism and retaliation at Tulane University.”

The ACGME has scheduled another review for Jan. 2022. If the institution’s status remains probationary at that review, the school will have one more chance to improve at an additional review. At that time, if the school does not get removed from probation, the accreditation will be withdrawn.

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ATI Workers are on the picket lines again—health care is at the heart of the struggle
worker | June 21, 2021 | 7:18 pm | Health Care, Single Payer 676 | Comments closed

In 2015 Allegheny Technologies, Inc. locked out USW workers in Brackenridge, PA and other locations.  Those workers and then USW President Leo Gerard told the story of that battle to maintain health benefits in the documentary “Off the Table.”

History repeats itself as ATI workers are again courageously walking the line in a similar health care fight.  The updated 20 minute documentary is here.  An updated union single payer resolution is here.  Now more than ever, unions and workers must win national single payer health care.

Striking ATI Steelworkers Hold the Line for Premium-Free Health Insurance

June 14, 2021 / Peter Knowlton

Steelworkers Local 1357 strikers and supporters pose for a photo in front of cars carrying replacement workers. Workers at nine ATI plants across the country have been on strike since March 30. Photo: Dan Brush

Across the country, steelworkers at nine plants of Allegheny Technologies, Inc. have been on strike for the last 11 weeks.

They want raises; to stop contracting out; to secure full funding of their retirement benefits; and to beat back management’s efforts to introduce health insurance premiums and a second tier of coverage for younger workers.

The Steelworkers union (USW) accuses ATI of unfair labor practices including bad faith bargaining, and of holding retiree benefits hostage for contract concessions.

ATI, which is headquartered in Pittsburgh, makes steel used in aerospace and defense, oil and gas, chemical processes, and electrical energy generation.

Five years ago ATI locked workers out for seven months, demanding major concessions on wages, pensions, and health insurance. Workers fought off the bulk of those demands, though the company was able to shed future liability for the pension by replacing it with a 401(k) for anyone hired after 2015—a huge cost shift to workers that makes a decent retirement at age 65 unlikely for new hires.

There were 2,200 workers at 12 unionized sites back then. There are 1,300 at nine sites this time around.

Most of the shops are in areas still reeling from the deindustrialization of the ’80s and ’90s. Five are in western Pennsylvania: Canton Township, Brackenridge, Latrobe, Natrona Heights, and Vandergrift. The others are in Louisville, Ohio; Lockport, New York; East Hartford, Connecticut; and New Bedford, Massachusetts, where 60 members are on strike.

Read more:

https://labornotes.org/2021/06/striking-ati-steelworkers-hold-line-premium-free-health-insurance

Peter Knowlton is the retired general president of the United Electrical Workers (UE).

Pledge your solidarity with ATI workers.

Distributed by:

Kay Tillow, Coordinator

All Unions Committee for Single Payer Health Care

P. O. Box 17595

Louisville, KY 40217

(502) 636 1551

http://unionsforsinglepayer.org

06/21/2021

Africa/Global: Decolonizing Medical Technology
worker | May 18, 2021 | 8:06 pm | Africa, Health Care | Comments closed

Africa/Global: Decolonizing Medical Technology

AfricaFocus Bulletin
May 17, 2021 (2021-05-17)
(Reposted from sources cited below)

Editor’s Note

“A continent of 1.2 billion people should not have to import 99% of its vaccines. But that is the tragic reality for Africa. Fixing the lack of home-grown manufacturing capacity has become a top priority for Africa’s policymakers. Last week, 40,000 people, including researchers, business leaders and members of civil-society groups, joined heads of state for a two-day online summit designed to share the latest developments and kick-start fresh thinking on how to bring vaccine manufacturing to Africa.” – Nature magazine editorial, April 21, 2021

Covid-19 has revealed the urgency of reducing the inequality in global access to vaccines, prompting a wide-ranging and ongoing debate about what must be done about what many are calling “vaccine apartheid.” But, as stressed in this summit convened by the Africa CDC and the African Union, the issue goes beyond any single disease, to the need to plan for future pandemics and address the inequities in capacity in both research and manufacture of vaccines.

This is already the case for malaria. A new vaccine with over 70% of efficacy was first reported earlier this month. African and world leaders and health officials are increasingly focused on the possibility of accelerating the fight against this deadly disease, which in 2019 caused over 84,440 deaths world-wide. Ninety-seven percent of those deaths were in sub-Saharan Africa. So while global campaigns under the slogan of “Malaria Must Die” continue, it is clear that the initiative for action must come from Africa.

Even once vaccines are available, there will remain formidable problems of manufacturing and distribution. On April 13, African leaders pledged to increase the share of vaccines manufactured in Africa from 1% to 60% by 2040. It will not be easy.

This AfricaFocus Bulletin includes (1) key links on the current status of the fight against malaria, (2) an open letter to international funders from African researchers, reposted here in full with permission from Nature magazine; and (3) excerpts from a news story and an editorial in Nature magazine on the urgency of development of vaccine capacity in Africa.

For previous AfricaFocus Bulletins on health, visit

http://www.africafocus.org/intro-health.php

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Two additional notes about this Bulletin

1. Unlike many if not most readers of AfricaFocus, including my wife, I have never had malaria, despite a total of more than five years spent in areas of the continent where the disease is endemic. But my awareness of the disease began long before I first traveled to Africa. My father, Dr. David Minter, served as a malaria control officer in the South Pacific during World War II, where in the early years the disease caused more casualties among U.S. troops than the Japanese military. Atabrine, DDT, and education of the troops brought the toll down significantly.

Unlike many wartime assignments, his posting to this position made good sense, as he had several years of experience in treating malaria in the 1930s in Mississippi, where malaria was endemic before the war.

His colleague in the South Pacific in this effort, Filipino physician Dr. Francisco Dy, who later served as the World Health Organization regional coordinator for the Western Pacific, became a life-long friend of my parents.

2. With this Bulletin, I am including a short embedded video featuring the Kanneh-Mason family cover of Bob Marley’s Redemption Song. I may make this a regular feature of the Bulletin, featuring short music videos that do not take up extra bandwidth in the email. The idea came from the editors of Quartz Africa, who often end their weekly email with a note saying “written while listening to.”

I am not good enough at multi-tasking to listen while I write. But I do find it necessary to take short breaks from writing to listen and watch short music videos. That is essential for the spirit, particularly when one is writing about subjects which more often feature grim realities than hope for change. The videos I will choose for inclusion are not linked to the specific theme of the Bulletin. But they definitely illustrate the visions of the resilience and hope needed both by Africa and the world.

I hope some of you enjoy them. If you don’t, it’s easy not to watch. They aren’t set to auto-play.

++++++++++++++++++++++end editor’s note+++++++++++++++++

Recent news and background on malaria

 

https://theconversation.com/new-malaria-vaccine-proves-highly-effective-and-covid-shows-how-quickly-it-could-be-deployed-159585

https://qz.com/africa/2005934/africa-can-avoid-covid-19-vaccine-missteps-with-malaria-vaccine/

https://www.who.int/news-room/fact-sheets/detail/malaria

https://www.cdc.gov/malaria/about/distribution.html

https://allafrica.com/malaria/

https://allafrica.com/stories/202105040682.html
Meeting of African Leaders Malaria Alliance

https://malariamustdie.com/
World campaign against malaria, headlined by David Beckham

*******************************************************

Open letter to international funders of science and development in Africa

April 15, 2021

Nature Medicine, April 15, 2021

https://www.nature.com/articles/s41591-021-01307-8

From Ngozi A. Erondu? ?1,2;, Ifeyinwa Aniebo 1,3,4; Catherine Kyobutungi 5; Janet Midega1, 6; Emelda Okiro 7; and Fredros Okumu 1,8.

1 Aspen Institute, Washington, DC, USA; 2 O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA; 3 Health Strategy and Delivery Foundation, Lagos, Nigeria; 4 Harvard T.H. Chan School of Public Health, Baltimore, MD, USA;

5 African Population Health Research Center, Nairobi, Kenya; 6 Wellcome Trust, London, UK; 7 KEMRI Wellcome Trust Research Programme, Nairobi, Kenya; 8 Ifakara Health Institute, Dar es Salaam, Tanzania. Contact email for authors: ngozierondu@gmail.com

To the Editor—Recently there was an announcement1 of a US$30 million grant awarded to the nonprofit health organization PATH by the US government’s President’s Malaria Initiative (PMI). The grant funded a consortium of seven institutions in the USA, the UK and Australia to support African countries in the improved use of data for decision-making in malaria control and elimination.

Not one African institution was named in the press release. The past year has been full of calls from staff and collaborators of various public-health entities for equality and inclusion, so one might imagine that such a partnership to support Africa should be led from Africa by African scientists, partnering with Western institutions where appropriate, especially where capacity has been demonstrated.

We write this letter to the major international funders of science and development in Africa as African scientists, policy analysts, public-health practitioners and academics with a shared mission of improving the health and wellbeing of communities in our continent and beyond. We represent a diverse group of institutions and communities dedicated to achieving the United Nations’ Sustainable Development Goals and to establishing a more equitable world.

Our work is informed by lived experiences and accumulated local knowledge of diseases such as malaria, AIDS, diarrhea, meningitis and polio, which have plagued millions of our families and friends for ages. We are therefore grateful that organizations that fund international health research have long been part of the international efforts to rid the world of these illnesses and their associated inequities. We believe the reason these organizations are financing global health and development is that they share in our dreams and aspirations.

We also believe, just like you, the decision-makers at these major funding organizations, that all humans, regardless of where they are located, are equal, even if opportunities are not. We recognize multiple injustices that have been perpetuated through historical practices, often without due consideration of their negative consequences. The current political climate has amplified the global call to ‘decolonize global health’, a more overt stance against what public-health practitioners in both high-income countries and low-income countries have known all along: that the predominant global health architecture and its business model enable ‘western’ institutions to gain more than, and sometimes at the expense of, the people and institutions in the countries where the actual problems are.

As the ‘decolonize global health’ movement has demonstrated, dismantling structures that perpetuate unequal power over knowledge and influence must support the quest for justice and equality. Global health institutions, especially funding organizations, must therefore examine their own internal policies and practices that impede progress toward justice and equality for populations that they intend to help. We write this letter as a collective, hoping to accelerate, and in some cases initiate, a process toward real fairness. We believe that there are many issues with this specific consortium focused on malaria, including the fact that there are strong African institutions with excellent capabilities this area, including some already actively engaged on the ground, such as the KEMRI Wellcome Trust Information for Malaria (INFORM) initiative that began in 2014 (http://inform-malaria.org/).

International funding, such as that from the President’s Malaria Initiative, has substantially advanced the goal of improving people’s health and wellbeing in Africa and beyond. However, funding models such as that of the PATH-led initiative are among the reasons that after several decades and billions of dollars spent, the control of diseases such as malaria is still heavily donor dependent, This type of funding has also contributed a model of implementation that puts the delivery of several health interventions directly in the hands of Western non-governmental organizations, which further diminishes the capacities and ownership of national programs to deliver to their populations and ultimately leads to weak health systems and a lack of sufficient local capacity. Decisions about such major funding initiatives should be made in consultation with in-country scientists and researchers involved in this work, alongside ministries of health and national malaria-control programs, to augment national priority research efforts. Such efforts have the best chance of success if they are run by local research agencies and institutions that can work closely with governments and are well positioned to support decision-makers in integrating data into local policies and strategies.

The new ‘high burden to high impact’ initiative from the World health Organization rightly recognizes the need for such vital work to be country-owned and country-led to reignite the pace of progress in the global fight against malaria and to increase the likelihood of success in eliminating malaria. Omitting African institutions from leadership roles and relegating them to recipients of ‘capacity strengthening’ ignores the agency these institutions have, their existing capacity, the value of their lived experience and their permanence and close proximity to policy-makers.

In 2017, the USA, UK and Canada collectively spent US$ 1.1 billion on malaria development aid, which includes research funding. When the Institute of Health Metrics and Evaluation data-visualization tool is used (https://vizhub.healthdata.org/fgh/), it appears that once global fund contributions are removed, 81% of funding was used to support institutions in the funding country and 18% went to non-governmental organizations (probably based in high-income countries)—that leaves just 1% of malaria funding available to local in-country research institutions. We recognize that the current funding structures create an imbalance of power and a monopoly that favors Western institutions and is derived in part from the perpetuation of inequities in access to funding with policies that lock out African institutions. These structural inequities must be examined, and they must end.

We know that several decision-makers of these organizations recognize the limitations of the model that you have woefully applied to the issue of which we speak. The New Partnerships Initiative from the US Agency for International Development (https://www.usaid.gov/npi) and the Alliance for Accelerating Excellence in Science in Africa (https://www.aasciences.africa/aesa) are good examples of funding local institutions for impact. The latter is shifting its center of gravity by ensuring its funding is provided directly to African scientists and institutions, which in turn empowers and enables them to shape their research agenda and to conduct research relevant to the continent. But we argue that these are the exceptions. For long-term progress, true partnerships and stronger collaborations, you, the funders, are responsible for totally transforming this model. We believe that in the same way we have to apply innovation in our work to fight diseases, innovation can be applied to the design of sustainable funding models with local researchers and organizations at their center.

We are asking that all major international funders of science and development in Africa commit to finding and implementing short-term and long-term changes to these models with consideration of the points we have listed above and with further consultation with reputable Africa-based institutions and scientists. There is a way to create equitable and dignified partnerships and to defeat the diseases that threaten everyone. We who authored this Correspondence are few, but we are committed to assisting any organization that is willing to make a substantial change.

https://doi.org/10.1038/s41591-021-01307-8

References

1. PATH. https://www.path.org/media-center/path-announces-pmi-inform-malaria-operational-research-project/ (10 February 2021).

2. World Health Organization & RBM Partnership to End Malaria. High burden to high impact: a targeted malaria response (WHO, 2019).

Author contributions

All authors were involved in the original drafting, reviewing, and editing of this letter and gave final approval of the version to be published. This letter is signed in an individual capacity. The views and opinions expressed do not necessarily reflect that of any organization they (the authors) are associated with or employed by.

************************************************************

How COVID spurred Africa to plot a vaccines revolution

For decades, Africa has imported 99% of its vaccines. Now the continent’s leaders want to bring manufacturing home.

Nature magazine, April 21, 2021

https://www.nature.com/articles/d41586-021-01048-1

[excerpt from full news story available at link above]

Prompted by the pandemic, Africa’s leaders are on a path to ramp up capacity in vaccine manufacturing and boost the continent’s regulatory bodies for medicines. On 13 April, they pledged to increase the share of vaccines manufactured in Africa from 1% to 60% by 2040. This includes building factories and bolstering capacity in research and development.

The COVID-19 pandemic has left Africa woefully short of vaccines, according to John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), based in Addis Ababa. The ambitious move represents an important step in boosting Africa’s capacity in public health, he added.

Nkengasong was speaking at a 2-day vaccines summit on 12 and 13 April, co-organized by Africa CDC and the African Union, and attended by 40,000 delegates. Also taking part were heads of state and leaders from research, business, civil society and finance.

“We have been humbled, all of us, by this pandemic,” said Abdoulaye Diouf Sarr, Senegal’s minister of health and welfare. The 1% figure “boggles the mind”, added virologist Salim Abdool Karim, formerly a science adviser to South Africa’s government.

. . .

In the next pandemic, will Africa make its own vaccines?

The AU meeting ended on an upbeat note, with delegates talking of “tipping points”, “now-or-never moments” and “global goodwill” to enable Africa to finally create its own vaccines industry. Progress will need political commitment, long-term finance and regional cooperation, said Patrick Tippoo, executive director of the African Vaccine Manufacturers’ Initiative, a group of vaccine manufacturers and research institutes.

The foundational problem, Tippoo added, is that the continent’s leaders have lacked the vision to recognize the centrality of local vaccine manufacturing in health-care policy.

The lack of manufacturing and weak regulation will require long-term governmental support if they are to be overcome, said Solomon Quaynor, a vice-president at the African Development Bank Group. Without such support, he warned the meeting’s delegates, “there will be no vaccine manufacturing in Africa”.

But momentum is on the side of new beginnings. “In the final analysis, the onus is on us as Africa. I do know we can do the job,” said Ngozi Okonjo-Iweala, Nigeria’s former finance minister and now director-general of the World Trade Organization.

*************************************************************

Africa’s vaccines revolution must have research at its core

It’s an injustice that Africa has to import 99% of its vaccines. COVID has sparked a push for change — and researchers have a crucial role.

Nature magazine, April 21, 2021

https://www.nature.com/articles/d41586-021-01038-3

[excerpt from full editorial available at link above]

A continent of 1.2 billion people should not have to import 99% of its vaccines. But that is the tragic reality for Africa. Fixing the lack of home-grown manufacturing capacity has become a top priority for Africa’s policymakers. Last week, 40,000 people, including researchers, business leaders and members of civil-society groups, joined heads of state for a two-day online summit designed to share the latest developments and kick-start fresh thinking on how to bring vaccine manufacturing to Africa.

For more than a century, vaccine research and development (R&D) and manufacturing have been concentrated in Europe, India and the United States. Amid a raging pandemic, one result of this is that people in low- and middle-income countries might have to wait until the end of 2023 before they can be vaccinated against COVID-19. This is simply unacceptable.

Delegates at last week’s summit vowed to accelerate plans to boost the continent’s vaccine manufacturing, research and regulatory capacity. They endorsed a proposal for 60% of Africa’s routinely used vaccines to be made in Africa within 20 years, and agreements were signed with international organizations representing companies and donor agencies. But achieving this goal will need some hard conversations in the weeks and months ahead.

One such conversation must be on the need for sustained and long-term investment, especially in domestic R&D, as a vaccines industry cannot be created without this. In spite of the best efforts of researchers such as the late Calestous Juma, who founded the African Centre for Technology Studies in Nairobi, most governments, for a variety of reasons, pushed back against the idea that domestic R&D is of long- term value. It needed a pandemic to persuade Africa’s leaders to be convinced of the case for bigger investments. That is to be welcomed — but it will need more than warm words at a conference to provide assurance that the plans being hatched will come to fruition.

There will also need to be hard conversations with donor countries, their pharmaceutical companies, and funders and researchers — essentially, all those currently involved in supplying Africa with vaccines. If the goal is now African self-sufficiency in what some call the vaccine ‘value chain’, then international partnerships with the continent’s institutions will require a different approach. A partnership in which the objective is to empower the continent’s own researchers and businesses will need to be different from existing partnerships, in which the objective is to supply Africa with vaccines. Some international companies might regard African self- sufficiency as a long-term risk to their business; some might fear a loss of influence. Firms and researchers from outside Africa shouldn’t take this view if they agree that a genuine partnership of equals is in everyone’s interests. Vaccines are essential to public health. And public health is essential to strong economies.

. . .

The world’s researchers have created, and continue to create, innovative vaccines. But it is now time to grow and share this knowledge with colleagues in under-served regions, especially in Africa. Their intervention in Africa’s vaccine-manufacturing ambitions might well be too late to make a difference during the present pandemic, but it will almost certainly help to ensure that the continent’s people are much better protected during the next.

Redemption Song (Arr. Kanneh-Mason)

312,283 views

There are many other versions of this song available on-line.

Three that I particularly like are

https://www.youtube.com/watch?v=JhtZ5SyGHFU – with Bob Marley

https://www.youtube.com/watch?v=ZncWCgN-zms – with Angelique Kidjo

https://www.youtube.com/watch?v=55s3T7VRQSc – Playing for Change with Stephen Marley

AfricaFocus Bulletin is an independent electronic publication providing reposted commentary and analysis on African issues, with a particular focus on U.S. and international policies. AfricaFocus Bulletin is edited by William Minter. For an archive of previous Bulletins, see http://www.africafocus.org,

Current links to books on AfricaFocus go to the non-profit bookshop.org, which supports independent bookshores and also provides commissions to affiliates such as AfricaFocus.

AfricaFocus Bulletin can be reached at africafocus@igc.org. Please write to this address to suggest material for inclusion. For more information about reposted material, please contact directly the original source mentioned. To subscribe to receive future bulletins by email, click here.

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under
worker | March 12, 2021 | 8:00 pm | Health Care, Mental Health | Comments closed

https://www.rt.com/op-ed/517862-caitlin-johnstone-mental-health/

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under
Are you psychologically unable to keep up with the harsh pace demanded of you by capitalism just to survive? Join the gang: we’re all depressed because we’re stuck in dead-end jobs that simply turn millionaires into billionaires.

How many of people’s mental health diagnoses are really just them struggling to function in a capitalist system that is amoral, destructive, overwhelming, overbearing, unsatisfying, and bereft of meaning?

It’s surely one of the most under-examined questions in the field of modern psychology. People in general and researchers in particular all too rarely think to take a step back from the data they are looking at and consider the large-scale framework within which that data is materializing, and to consider whether there’s anything about that particular framework which is giving rise to the particular data sets they are seeing.

How many of the mental health diagnoses given out are really just people not coping well under capitalism? It’s worth looking into. How many people end up consulting with mental health professionals because they find themselves psychologically unable to keep up with the frenetic corporate pace that’s demanded of them in order to “earn a living”? Or earlier on as children because they are unable to successfully navigate the capitalism boot camp known as school? How many people are given diagnoses, and corresponding bottles of pills, simply because they can’t march to the beat of the capitalist drum?

Beyond that, how many people are pushed into mental illness by the madness of our current system? How many people suffer from very real depression or anxiety arising from the pressure to keep churning out pieces of future landfill in meaningless jobs which serve no purpose other than to turn millionaires into billionaires? How many people simply collapse under the weight of financial insecurity, food insecurity, housing insecurity, employment and insurance insecurity, combined with the effects of  desperate attempts to self-medicate the stress?

How many of these stressors are exacerbated by being psychologically pummelled with mass media propaganda day in and day out, artificially twisting your mind into the belief that this is all normal, and that if you can’t keep up, you’re the problem? Telling you that it’s fine and normal for there to be billionaires and empty investment properties while you struggle to keep a roof over your head? Telling you it’s fine and normal for wealth and resources to go toward murdering strangers overseas while you’re forced to choose between medicine and groceries?

And by the capitalism propaganda known as advertising? How is our psychological health affected by a nonstop barrage of corporate messaging informing us that we are deficient, and that there are things we lack which we must obtain in order to become whole? That we’re not beautiful enough, not skinny enough, not fashionable enough, not affluent enough, that we don’t own enough of the top-line items which only the well-off can afford?

I’d venture to say this all has a major impact on our minds. You can have anxiety without being poor, but you can’t be poor without having anxiety. Our competition-based model uses the stress of potential homelessness and death to keep all the slaves turning the gears of the machine, and that stress is now interwoven into the very fabric of our society. It’s so pervasive you have to take a step back just to see it all.

So how best to respond to this depressing situation? How best to avoid drowning in the tar pit of a soulless, nihilistic political and economic paradigm? How to find meaning under a meaningless system which squeezes your psychological wellbeing in order to power its batteries?

Well, that question is much easier to answer. You find meaning under a meaningless system by working to destroy that system.

Do whatever you need to survive, up to and including taking psychiatric medications if you need to, and with whatever remaining time and energy you have left, throw sand in the gears of the machine. Do whatever you can to upset the status quo. Engage in activism. Join a union. Start a union. Start a podcast. Start a Twitter account. Above all, work to spread awareness of what’s really going on in our world, because that’s the weakest point in the machine’s armor right now.

The loose transnational alliance of plutocrats and government agencies which comprises our real government works so hard to manufacture consent because they require the consent of the governed in order to rule; we greatly outnumber them and we can oust their rule if enough of us decide we don’t consent to it anymore. In a western society which must try to at least appear to support free speech, the best front on which to attack such a power structure is on the front of information.

They can’t kill and imprison us all, so if we all awaken to how oppressed we are and to who has been oppressing us, we can use the power of our numbers to kick them out and replace them with a healthier model. The job of the propagandists is to prevent this from happening. The job of you and me is to make it happen.

So help wake people up to the injustices of our system, as many people as you can by whatever means you have access to. Wake them up to the abuses of capitalism. To the abuses of imperialism. To the abuses of mass media propaganda. Learn as much as you can about the madness of our current system, and share what you have learned with as many people as possible.

All positive changes in human behavior arise from an increasing awareness of the underlying dynamics which give rise to them, whether you’re talking about the psychological dynamics underlying the addictive or compulsive behaviors of an individual or the power dynamics underlying the murderous and oppressive behaviors of a globe-spanning empire. If you are looking for meaning, you will find it in the spreading of that awareness.

We absolutely do have the ability to move away from this misery-generating competition-based model that is choking us all to death and replace it with one in which we collaborate with each other and with our ecosystem toward health, beauty, truth, and thriving. If there is meaning to be found in our world, it lies in that direction.

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

Private equity ownership is killing people at nursing homes
worker | March 4, 2021 | 9:34 pm | Health Care | Comments closed

Investor-owned, for-profit health care facilities—hospitals, nursing homes, dialysis centers–cause unnecessary suffering and death.  The point is made well by Dylan Scott in the article below where he reports on the findings of a recent study by the National Bureau of Economic Research. 

Representative Pramila Jayapal is preparing to re-introduce her national single payer legislation, Improved Medicare for All, in the new congress.  Please write or call her, to encourage her to include in the legislation, a ban on investor-owned, for-profit facilities and conversion of them to maintain these resources for health care. She can be reached at 2346 Rayburn House Office Building, Washington. DC 20515, @RepJayapal, Phone: 202-225-3106, or email her at https://jayapal.house.gov/contact/

 

Private equity ownership is killing people at nursing homes

A new study describes the human toll of private equity firms buying up nursing homes.

By Dylan Scott@dylanlscottdylan.scott@vox.com Feb 22, 2021

When private equity firms acquire nursing homes, patients start to die more often, according to a new working paper published by the National Bureau of Economic Research.

Private equity acquisitions of nursing homes is a pressing topic: Total private equity investment in nursing homes exploded, going from $5 billion in 2000 to more than $100 billion in 2018. Many nursing homes have long been run on a for-profit basis. But private equity firms, which generally take on debt to buy a company and then put that debt on the newly acquired company’s books, have purchased a mix of large chains and independent facilities — making it easier to isolate the specific effect of private equity acquisitions, rather than just a profit motive, on patient welfare.

Researchers from Penn, NYU, and the University of Chicago studied Medicare data that covers more than 18,000 nursing home facilities, about 1,700 of which were bought by private equity from 2000 to 2017.

Their findings are sobering.

The researchers studied patients who stayed at a skilled nursing facility after an acute episode at a hospital, looking at deaths that fell within the 90-day period after they left the nursing home. They found that going to a private equity-owned nursing home increased mortality for patients by 10 percent against the overall average.

Or to put it another way: “This estimate implies about 20,150 Medicare lives lost due to [private equity] ownership of nursing homes during our sample period” of 12 years, the authors — Atul Gupta, Sabrina Howell, Constantine Yannelis, and Abhinav Gupta — wrote. That’s more than 1,000 deaths every year, on average.

What accounts for such a significant loss of life when private equity takes over a nursing home? The researchers advance a few possible explanations.

For one, they note, the increased mortality is concentrated among patients who are relatively healthier. As counterintuitive as that may sound, there may be a good reason for it: Sicker patients have more regimented treatment that will be adhered to no matter who owns the facility, whereas healthier people may be more susceptible by the changes made under private equity ownership.

Those changes include a reduction in staffing, which prior research has found is the most important factor in quality of care. Overall staffing shrinks by 1.4 percent, the study found, but more directly, private equity acquisitions lead to cuts in the number of hours that front-line nurses spend per day providing basic services to patients. Those services, such as bed turning or infection prevention, aren’t medically intensive, but they can be critical to health outcomes.

“The loss of front-line staff is most problematic for older but relatively less sick patients, who drive the mortality result,” the authors wrote.

The study also detected a 50 percent increase in the use of antipsychotic drugs for nursing home patients under private equity, which may be intended to offset the loss in nursing hours. But that introduces its own problems for patients, because antipsychotics are known to be associated with higher mortality in elderly people.

The combination of fewer nurses and more antipsychotic drugs could explain a significant portion of the disconcerting mortality effect measured by the study. Private equity firms were also found to spend more money on things not related to patient care in order to make money — such as monitoring fees to medical alert companies owned by the same firm — which drains still more resources away from patients.

“These results, along with the decline in nurse availability, suggest a systematic shift in operating costs away from patient care,” the authors concluded.

The researchers make a point in their opening to stipulate that private equity may prove successful in other industries. But, they warn, it may be dangerous in health care, where the profit motive of private firms and the welfare of patients may not be aligned:

For example, patients cannot accurately assess provider quality, they typically do not pay for services directly, and a web of government agencies act as both payers and regulators. These features weaken the natural ability of a market to align firm incentives with consumer welfare and could mean that high-powered incentives to maximize profits have detrimental implications for consumer welfare.

This finding is likely to draw a lot of attention, as David Grabowski, a Harvard Medical School professor who studies long-term care, told me. (He said he found the result to be plausible, though he would need more time to unpack the research data in full.) Private equity has already faced scrutiny for surprise medical billing and acquisitions of physician practices.

This study of nursing homes lays down a marker in the research literature: private equity leads to worse care. For patients, it’s a matter of life and death.

https://www.vox.com/policy-and-politics/22295461/nursing-home-deaths-private-equity-firms

 

_______________

Distributed by:

Kay Tillow, Coordinator

All Unions Committee for Single Payer Health Care
P. O. Box 17595
Louisville, KY 40217
(502) 636 1551

Email: nursenpo@aol.com
http://unionsforsinglepayer.org
https://www.facebook.com/unionsforsinglepayer

March 4, 2021

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens
worker | March 4, 2021 | 9:28 pm | COVID-19, Health Care, Local/State | Comments closed

https://www.rt.com/op-ed/517130-shelter-food-failure-prison-state/

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens

Helen Buyniski
Helen Buyniski

is an American journalist and political commentator at RT. Follow her on Twitter @velocirapture23 and on Telegram

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens
Though marketed as ‘the shining city on the hill’ envied by all other nations, America is rapidly proving to its own inhabitants and the world that not only can it not keep its own people safe – it can barely keep them alive.

Between the Covid-19 pandemic and the disastrous economic fallout engendered by government responses to that outbreak, the US has proven itself shockingly incapable of actually functioning in any way its peers might consider “normal.” Whether it’s keeping the lights on in American households, providing healthcare that cures rather than kills, educating children, or merely standing out of the way while residents try to build a life for themselves, Washington has demonstrated a profound, almost malignant ineptitude at the simplest tasks, so much that one might ask if it actually wants to perform them at all.

Dozens of Texas residents perished amid the massive snowstorm that seized the state last month. The storm knocked out the electric grid and left over 4 million residents with neither heat nor light. The state’s electricity vendors added insult to injury by slapping customers with absurdly high electric bills (some over $10,000) as the utility’s money-grubbing equivalent of “surge pricing” kicked in – all in a state where energy can literally be pulled out of the ground.

ALSO ON RT.COMTexas freeze exposes cold, dark heart of America in which EVERYTHING is now politicalTexas is only one state, though – surely the rest of the country can’t be so horrifically incompetent when it comes to something as basic as electricity? But oh no, out West, there’s always California bidding to fail bigger and better. The Golden State’s own power supplier PSE&G was sued for starting the wildfires that destroyed entire neighborhoods in 2017 and 2018. Indeed, PSE&G has been blamed for more than 1,500 fires since 2014 alone and is in the process of declaring bankruptcy after being sued by over 70,000 of its victims, including the entire city of Paradise. It’s so inept when it comes to not burning down the state that for years it has shut off power – often for extended periods – during the summer, lest its equipment trigger still more wildfires.

OK, but surely such travesties are rare? It’s not like the US government just goes around displacing people from their land deliberately? Yet Georgia man Tim Leslie is living through that Kafkaesque nightmare of his own right now after having bought a plot of land in Polk County to homestead and raise animals with his family. Because they haven’t built their house yet, they’re (legally) living out of a trailer on that land – or were, until the police forced them to abandon their animals and move to a proper RV park. It’s difficult to imagine a community so free of crime that it wouldn’t have benefited from the cops finding something else to do during the hours spent harassing the Leslie family, but victimizing law-abiding citizens is much easier than going after criminals.

Policing – once the pride and joy of the world’s largest prison state – has itself deteriorated rapidly. New York City endured a major surge in crime thanks to the shutdown, while cops who might have been able to stop it were ignominiously tasked with guarding Mayor Bill de Blasio’s virtue-signaling “Black Lives Matter” mural or (somewhat schizophrenically) detailed to clobber the odd BLM protester. The NYPD even punished its own officers for public display of Trump fandom while real crimes went ignored and unpunished. (New York also released hundreds of supposedly low-level convicts last year “because Covid,” only for the public to learn they were guilty of much more serious offenses, with many ending up right back in the clink after committing further crimes. It’s an ominous state of affairs indeed for the country with the most prison inmates per capita in the world, and those numbers are almost guaranteed to further explode thanks to law enforcement’s new fixation on “domestic terrorists” – a group defined so broadly as to include anyone who’s expressed opinions outside the ever-narrowing mainstream.

Maybe the US is just focusing its efforts on combating the Covid-19 pandemic? Americans may spend more on healthcare than any other first-world country, but it wasn’t getting much for its money even before Covid. When the pandemic hit, all hell broke loose in many states, and when hospitals were barred from seeing ‘normal’ patients for lucrative procedures, they instead turned to ventilating anything that moved in order to get reimbursed by the government – even though 88 percent of those intubated died. Governors didn’t beg for lifesaving treatments – indeed, they banned some. Instead, they pleaded for ventilators, all while shunting Covid-infected patients into nursing homes where they would go on to decimate the helpless population.

If this is how the US treats its sick, what about its children? Despite some scientists confirming vanishingly few kids are falling ill, major teachers’ unions refuse to return to the classroom, never mind how poorly most children have been shown to learn over a distance model. In some areas, the shutdown of schools revealed a problem the US had been covering up for a while – the need to feed the millions of destitute children who rely on their schools not just for learning, but for free meals their families can’t afford. At the same time, these kids’ parents spent hours lined up in the cold for free groceries from the nearest food bank, and millions remain out of work or severely underemployed, many dangling on the verge of eviction. Sorely-needed stimulus checks never arrived for many, whose only recourse now is to claim the check on their taxes in the hope of maybe getting reimbursed later.

Most of these problems could be solved with some smart policies and a fraction of the infusion of cash that has already gone out to large corporations. But there’s wars to fight, and no evidence the ruling class wants its domestic problems fixed anyway. Instead, it seems to take sadistic pleasure in gaslighting Americans to within an inch of their sanity, insisting the rest of the world wants to be just like us. After all, it’s not like we can fly there to check.

 

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

Games People Play
worker | February 7, 2021 | 7:25 pm | Health Care | Comments closed

Games People Play

– from Greg Godels is available at:
http://zzs-blg.blogspot.com/

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Facing joblessness, eviction, foreclosure, and a broken, ineffective health care system unable to deliver hundreds of thousands of US citizens from a death sentence, the public needs more than an entertaining, sensationalist narrativeTo read more, please go to: http://zzs-blg.blogspot.com/2021/02/games-people-play.html