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Corporate Journalists are Blind to a Big COVID Lesson

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Ted Rall

Episode 24.5 - Literary Scandals 201 - Fax Machines, Man — The Bookstore

           One of my complaints about mainstream media is that they recruit reporters from inside the establishment—Ivy League colleges, expensive graduate journalism programs, rival outlets with similar hiring practices. Some staffs develop admirable levels of gender and racial diversity. But they all come from the same elite class. Rich kids believe in the system and they accept its basic assumptions.

            On New Year’s Day a reporter (UPenn and Oxford, of course) published a solid piece for The Washington Post about an important issue, how America’s “fractured healthcare system” hurts our response to COVID-19. Seeking to answer the question of why the pandemic is still going on after the miraculously rapid development and distribution of vaccines, the Post identified organizational shortcomings as part of the problem, citing the need for “improvements on the delivery side.” She quoted an expert who called for “increasing staffing and funding for local health departments, many of which have been running on a shoestring. Officials in some local health departments still transfer data by fax.” Both true. I’ve been asked to fax my records recently.

            But.

            Nowhere in the Post piece was there any mention of what the United States is missing that most other countries in the  world are not: a unified national healthcare system like the United Kingdom’s NHS.

            I’m not talking here about fully-socialized medicine or a single-payer Medicare For All system like the one championed by Bernie Sanders, although I strongly believe Americans need and deserve one. This isn’t about who pays for healthcare (though it should obviously be covered 100% by the government).

It’s about data integration.

In the same way that law-enforcement agencies across the country can access criminal records from other jurisdictions via the FBI’s National Data Exchange system, public-health officials need access to a real-time, constantly-updated source of every report of disease whether it’s known or novel, the visit was paid for in cash by the patient or covered by insurance, or it was diagnosed by a country doctor, walk-in urgent-care center or a giant urban hospital system.

A fully-integrated national healthcare database would be a powerful side benefit of a national healthcare system like Medicare For All. But how likely is Bernie Sanders’ pet project to cross the mind of a writer who graduated from UPenn and Oxford and has a gold health insurance plan provided by her employer, who is Jeff Bezos?

Here in America, the nation’s top epidemiologists at the Centers for Disease Control are flying blind, relying on algorithmic models that estimate what’s going on rather than providing accurate, precise situational awareness.

I tested positive for COVID-19 on December 30. I notified my doctor’s office on January 1 but due to the holiday didn’t hear back until January 3. Will New York City authorities and/or the CDC be notified about my case and, if so, when?

Several friends and friends of friends also tested positive during the Omicron surge using home tests. Many, probably most, didn’t tell their doctor. You have to assume that official numbers for Omicron have been significantly underreported.

If we had a national healthcare system instead of a medical Wild West in which the ailing are jostling against each other fighting over $24 testing kits like shoppers rushing into Best Buy on Black Friday, testing would be handled through clinics and doctor’s offices in coordination with the federal government—which would instantly compile the results.

A national healthcare database could include “visualization tools to graphically depict associations between people, places, things, and events either on a link-analysis chart or on a map. For ongoing investigations, the subscription and notification feature automatically notifies analysts if other users are searching for the same criteria or if a new record concerning their investigation is added to the system… [allowing] analysts to work with other analysts across the nation in a collaborative environment that instantly and securely shares pertinent information.”

I lifted that last quote from an FBI description of their police database. Crime, by the way, kills a small fraction of the number of Americans who die from disease.

HIPAA regulations governing patient records would need to be modified by Congress, but consider the potentially lifesaving benefits even when there is no longer a pandemic. Medical errors are the third leading cause of death in the United States.

Decentralized recordkeeping is a public-health disaster. If you live in Wyoming, there is no good reason that your healthcare records shouldn’t be accessible to first responders driving the ambulance that responds to a call that you collapsed and are unconscious at a mall in Florida. As soon as you are identified—something that could be facilitated by a national healthcare ID card that you carry in your wallet or as an app on your smartphone—EMS workers could use your patient history to identify chronic problems. They could avoid a medication to which you might be allergic or feel confident in administering one thanks to the knowledge that you are not.

I didn’t go to UPenn and Oxford. As an independent writer, I pay my own health insurance. I am reminded of America’s crappy healthcare system every time I pay my ACA bill and every time I cough up a co-pay. Newspapers like the Post may or may not need me. But they definitely need people like me if they want to relate to the readers they’re trying to serve.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of a new graphic novel about a journalist gone bad, “The Stringer.” Order one today. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

 

Big Tech Is Killing People

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Ted Rall

The Wall Street Journal has published “the Facebook papers,” which revealed that Facebook and other big technology companies have been more than willing to monetize disinformation and misinformation, even when it needs to people’s deaths. Legacy media is laughing, but they should look at themselves too.

New DMZ Podcast: The Debt Ceiling Debate Triggers an Existential Discussion About Consumerism and Facebook Kids

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Ted Rall
From the left, political cartoonist Ted Rall discusses the dysfunctional political climate that gave us the ridiculous debt ceiling crisis with, from the right, political cartoonist Scott Stantis. Revelations in the Wall Street Journal about Facebook internal research and the company’s attempt to appeal to young children sparks a soulful discussion about everything from getting rid of your local cashier to self-driving cars.
 

Revolution via Zoom

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Ted Rall

Cops without masks. Cops too. Agitate for Black Lives Matter from the safety of your home.

We Need a Centralized Medical System Too

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Ted Rall

Is there a central database for medical records in the U.S.? - Quora

The coronavirus pandemic has laid bare two fundamental flaws in the American healthcare system.

Number one: There’s a reason that other rich countries treat healthcare as a taxpayer-financed social program. Employer-based health insurance was stupid pre-COVID-19 because our economy was already steadily transitioning from traditional full-time W-2 jobs to self-employment, freelance and gig work. The virus has exposed the insanity of this arrangement. Millions of people have been fired over the last two months; now they find themselves uninsured during a global health emergency. The unemployed theoretically face fines for the crime of no longer being able to afford to buy private healthcare.

The second inherent flaw in the U.S. approach is that it’s for profit. Greed creates an inherent incentive against paying for preventative and emergency care. Even people who are desperately ill with chronic conditions see 24% of legitimate claims denied.

When your insurance company issues a denial, they don’t merely pocket that payment. They also add to future profits. Even if you’re insured, the hassle of knowing that you might get hit by a surprise bill for uncovered/out-of-network charges makes you more likely to stay home rather than to risk seeing a doctor or filling a prescription and going broke. “Visits to primary care providers made by adults under the age of 65…dropped by nearly 25% from 2008 to 2016” due to routine denials by insurers, reports NPR.

Denials also create a societal effect: news stories about patients with insurance receiving bills for thousands of dollars after being treated for COVID-19, even just to be tested, prompt people to stay away from hospitals and try to ride out the disease at home. Some of those people die.

There’s another, third structural problem exposed by the pandemic—but it’s not receiving attention from public policy experts or the media. I’m talking about America’s lack of a centralized healthcare system.

A centralized healthcare system has nothing to do with who pays the doctor. A centralized system can be fully socialized, government-subsidized or fully for-profit. In such a scheme all patient records are stored in a central online database accessible to physicians, pharmacists and other caregivers regardless of where you are when you need care. If you fall ill while you’re on a trip away from home, the admitting nurse at a walk-in clinic or hospital has instantaneous access to your complete medical history.

The current system is primitive. Data is not transferable between doctors or medical systems without a patient’s directive, which inexplicably is often required by the obsolete technology of sending a fax. That assumes the sick person is sharp enough to remember which of his previous doctors did what when. And that’s it’s not a weekend or national holiday or a Wednesday, when some doctors like to golf.

Unless a patient happens to be wearing a medical alert bracelet, there is currently no way to determine whether an unconscious victim is allergic to a drug, has a chronic illness or that there’s a treatment regimen proven to be more effective for them. Even if the patient is alert and conscious, a new doctor may ignore her request for a specific medication in favor of cookie-cutter one-size-fits-all treatment.

A few months ago I developed the classic symptoms of what we now know to be COVID-19. I live in New York. I succumbed while on business in LA. Trying in vain to fight off a relentless dry cough, difficulty breathing and day after day of brutal aches and fever, I visited a CVS walk-in clinic. I have a long history of respiratory illnesses: asthma, bronchitis, pneumonia, swine flu. I requested a third- or fourth-generation antibiotic since I knew from experience that I would inevitably decline with anything less. “We do not treat viral infections with antibiotics,” the nurse, a charmless Pete Buttigieg type, pompously declaimed. I pointed out that viral lung infections usually have a bacterial component that should be treated with antibiotics.

This would not have been a issue back home in New York, where both my general practitioner and my pulmonologist know my medical history. Either doctor would have prescribed a strong antibiotic and a codeine-based cough syrup.

Because I happened to be in LA, I left CVS empty-handed.

I declined.

It got to the point that I couldn’t walk 100 feet without pausing to catch my breath.  I felt like I was going to die.

I called my doctor back in New York. She called in a prescription to the same CVS. It helped arrest my decline. But I wasn’t getting better.

I visited a different walk-in clinic, in West Hollywood. It was a better experience. They tested me for flu (negative), X-rayed me (diagnosis was early stage- pneumonia) and put me on a nebulizer. I began a slow recovery.

A centralized system would have been more efficient. The CVS nurse would have seen my history of non-response to treatment devoid of strong antibiotics. He also might have taken note of my pulmonologist’s effective use of a nebulizer to treat previous bouts of bronchitis and pneumonia. I might have been prescribed the proper medication and treatment as much as a week sooner.

COVID-19 almost certainly would have been detected in the United States sooner if we had a centralized medical system. “One example of a persistent challenge in the early detection of health security threats is the lack of national, web-based databases that link suspected cases of illness with laboratory confirmation. This leaves countries vulnerable, as they cannot accurately and quickly identify the presence of pathogens to minimize the spread of disease,” according to the U.S. Centers for Disease Control. Algorithms can automatically scan massive volumes of information for signs of novel infectious diseases, help identify potential problems and focus responses where they are needed most.

How many people’s lives could have been saved if lockdown procedures had begun earlier? If public health officials had seen the coronavirus coming back in December—or November—they might have been able to protect vulnerable populations and avoid a devastating economic shutdown.

There are substantial privacy considerations. No one wants a hacker to find out that they had an STD or an employer to learn about documented evidence of substance abuse. Keeping a centralized healthcare system secure would have to be a top priority. On the other hand, there is no inherent shame in any kind of illness. In a nightmare scenario in which medical records were to somehow become public, no one would have anything to hide or any reason to look down on anyone else.

We can’t pretend to be a first world country until we join the rest of the world by abolishing corporate for-profit healthcare and decouple insurance benefits from employment. But reform without centralization would be incomplete.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of the biography “Bernie,” updated and expanded for 2020. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

SYNDICATED COLUMN: Ban Drones

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Ted Rall

Image result for sky full of drones           Ban drones.

Why not?

We have succumbed, in recent years, to technological passivity, the assumption that there’s nothing we can (or should) do about what an older generation used to call “progress.” But that’s not true.

War goes on, yet most of the world’s nations came together to ban landmines. Mines, humanity decided, were a horror we could no longer live with because their murderous potential remained long after the frontlines moved elsewhere, even after hostilities ceased, and mostly hurt civilians. Similarly, chemical weapons were banned after mustard gas scarred the World War I generation.

Here in the United States, societal consensus supports bans of hollow-point bullets that explode inside the body (they’re currently banned by the military), high-capacity magazines for guns, the bump stocks that came to our attention after the mass shooting at a country music festival in Las Vegas, and semi-automatic assault rifles.

Weapons aren’t the only tech to which society simply responds: “Hell no. Just. No.” Human cloning has prompted calls for bans by those who believe we shouldn’t plow ahead without better understanding the potential downsides. Alcohol and cigarettes are banned for children. Lots of drugs are banned. Banning products is a well-established societal and political prerogative.

Drones should be banned too: military drones as well as recreational ones. We already have a substantial body of evidence that they are dangerous. Potential advantages, on the other side, seem relatively modest. They’re cool. I’ve played with them.

No one has sat down to consider, in a careful measured way, the pros and cons of unmanned aerial vehicles. Where, as our skies are about to turn into the Wild West, are the Congressional hearings and expert opinions?

If you stop to think about it, selling drones to any yahoo with $400 is a recipe for chaos. Launched from the roof of a Manhattan apartment building, a pervert’s drone can peep through windows. A terrorist, or merely a doofus, can fly one into the blades of a low-flying helicopter or into the engine or windshield of a plane approaching the airport. And they will. It’s only a matter of time.

The terrorism potential became evident in 2015 when a guy accidentally flew his Phantom drone onto the White House lawn. Loading one with explosives is easy. Or a gun—a father and son affixed a pistol to a drone and fired it remotely in the woods of Connecticut.

I’m even less sanguine about corporate and institutional applications. Whether it’s Uber and NASA’s announcement that they plan to launch flying taxis in Los Angeles or Amazon’s imminent fleet of delivery drones, I’m not sure I want to live long enough to hear buzzing drones where birds are supposed to sing, or see some dude’s dinner pass overhead. Maybe a sane compromise is possible, like limiting the gadgets to flight paths above major roadways. Why can’t we figure that out now, before the inevitable technological growing pains (aka deaths and injuries and overall crapitude)?

While it’s easy to imagine how drones can improve our lives—they have already found missing hikers in the wilderness, for example—it is impossible to overstate how creepy it would be to put them into the hands of law enforcement. Obama attorney general Eric Holder said in 2013, and no legal expert challenged him, that the feds have the right to launch military drone strikes against American citizens on U.S. soil. California cops used one to track a rogue LAPD officer a few years ago. Local law enforcement drones could catch speeders, scan for expired vehicle registration and inspection stickers (stationary devices already do) and use thermal imaging devices to conduct warrantless searches. And there will come a day, not in the distant future, when the same Cleveland police department that shot 12-year-old Tamir Rice to death for the crime of playing while black will type commands into an iPad that controls an armed drone that blows up more innocent civilians.

This is serious, major dystopian horror-show crap. Can’t we stop it before it starts?

Overseas, and thus far from the decreasingly vigilant eyes of our increasingly establishmentarian journalists, the Trump Administration is expanding the military drone assassination program Obama expanded after inheriting it from Bush. Formerly focused on killing young men and whoever happens to be nearby in South Asian zones like Pakistan, where studies show that 98% of the thousands of victims were innocent, the drone killers are ramping up in new places like Africa.

“The number of American strikes against Islamist militants last year tripled in Yemen and doubled in Somalia from the figure a year before,” reports The New York Times. “Last month, an armed drone flown from a second base in Niger killed a Qaeda leader in southern Libya for the first time, signaling a possible expansion of strikes there.”

Like the innately disconcerting notion of letting local-yokel cops run wild with facial-recognition-enabled autopiloted self-guided missile drones, it is impossible to overstate how self-defeating America’s drone program has been to U.S. interests. Unlike here, where the nearly daily attacks barely rate a mention in the news, people in other countries and especially in the Muslim world are well aware of the fact that the vast majority of victims are innocent civilians, including many women and children. (Even the “guilty” men who die aren’t threats to the U.S., but rather to the corrupt local governments we supply with arms.) Local populations in cities where drones patrol the skies are jittery and resentful. Many have PTSD.

True, drones eliminate harm to American soldiers. But we operate them in macho cultures that prize honor and courage. Our unwillingness to risk our sons and daughters in ground combat makes us look not just like aggressors, but cowards worthy only of contempt. In a war for hearts and minds, drones are propaganda suicide.
We’ve begun a new arms race. When a foreign country or non-state actor attacks us with drones, who will listen when we complain?

Even in the short run, drone killings don’t work. “Eliminating jihadi military leaders through drone operations could temporarily disorganize insurgent groups,” Jean-Hervé Jezequel, deputy director of the International Crisis Group told the Times. “But eventually the void could also lead to the rise of new and younger leaders who are likely to engage into more violent and spectacular operations to assert their leadership.”

A drone ban doesn’t have to be forever. But it should last long enough for us to figure out, as Donald Trump used to say on the campaign trail, what the hell is going on.

(Ted Rall (Twitter: @tedrall), the editorial cartoonist and columnist, is the author of “Francis: The People’s Pope.” You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

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