Harmful American Health Care Act - Republicans undermine seniors

Published in the Bangor Daily News- published in  Bangor Maine Thursday, June 1, 2017

AHCA bad for seniors- Letter to the BDN editor

The American Health Care Act, deeply flawed legislation, will hurt millions of Americans and their families. 

According to the Congressional Budget Office report, an estimated 23 million people will lose their health coverage by 2026 if this bill passes.

When one considers what the American Health Care Act would mean for Maine, you can see why this bill should not be enacted.

First, the bill would allow insurance companies to charge higher premiums for people with pre-existing health conditions. According to AARP, there are 123,155 Mainers between ages 50 and 64 living with a pre-existing condition. For many, the new premiums would be unaffordable.

Second, the bill heavily penalizes older Americans in this same age group. Once again, it is the insurance companies who come out on top because they will be allowed to charge five times what others pay for the exact same coverage. According to the budget office, premiums for a 64-year-old earning $26,500 a year would increase from $1,700 to $13,700 in 2026. Let’s call this what it is: An age tax.

In addition, the bill reduces Medicare funding, which would put us on the road to turning Medicare into a voucher system. The bill would also slash Medicaid by over $800 billion, ultimately harming those who are most at-risk.

This bill is neither about health nor about care. Please call Sen. Susan Collins today and urge her to oppose the American Health Care Act.

Roberta Downey Bangor Maine

Oklahoma "Tulsa News" Letter to Editor - Trump cuts Medicaid

Donald Trump promised he would NOT cut Medicaid, Medicare or Social Security. But he lied.

Oklahomans can't afford cuts to Medicaid

By Kevin Taubman, M.D., Tulsa Oklahoma
May 28, 2017
On May 7, 2015, then-candidate Donald Trump said he was "the first and only potential GOP candidate to state there will be no cuts to Social Security, Medicare and Medicaid.”

Just two years later, President Trump is proposing a budget that would cut more than $800 million and eliminate Medicaid eligibility for more than 10 million Americans.

While we are sadly well-versed in politicians failing to keep their campaign promises, seldom have we seen a broken vow with such disastrous consequences for Oklahoma patients. More than 20 percent of Oklahomans receive basic healthcare services through Medicaid. Nearly 60 percent of Oklahoma babies have their prenatal and delivery costs covered by Medicaid. This draconian budget proposal would place the healthcare of thousands of our fellow citizens at risk.

Are there savings to be had in the Medicaid system? Perhaps. Are there reforms needed to the Medicaid components of the Affordable Care Act? Probably. But this (Trump) budget proposal does none of those, choosing instead to simply cut off thousands of our state’s most vulnerable citizens from the healthcare they need.

We urge our congressional delegation to reject Trump’s budget proposal and pass a budget that achieves meaningful reforms while preserving the safety net that protects so many Oklahomans.

Editor’s note: Taubman is president of the Oklahoma State Medical Association.

Nursing opinion and vaccinations

TED talk: 

Nurses need to reclaim their roots in public health.

Why I changed my mind on vaccinations! by Dani Stringer

By RNL Editors | 05/11/2017- from Sigma Theta news

For pediatric nurse practitioner Dani Stringer, presenting a TED talk was a dream come true.

Dani Stringer, MSN, CPNP, PMHS, always wanted to give a TEDx talk but was still shocked, and felt immensely humbled, when Grand Canyon University asked her to present her views on vaccination.

“In addition to explaining why I left vaccine-hesitancy behind and now advocate for immunizations, I explored the critical need for people to depolarize the vaccine debate by communicating with kindness," Stringer says. 

“This is a topic that has been very personal for me for several years. Both with KidNurse [her website] and in practice, I've seen that parents have a dire need to better understand vaccines.”

By now, you’ve undoubtedly seen the mass media coverage about the measles outbreak in the United States. With nearly 200 measles cases confirmed just in the first few months of 2015 and rapidly continuing to spread throughout the country, epidemiologists and public health experts predict these outbreaks are not going away. In fact, at this rate, we are expected to surpass the number of cases seen in 2014.

That is incredibly substantial when you consider that the number of measles cases in 2014 marked a 20-year high. Did you catch that? Twenty-year high. America hasn’t seen this many cases of the measles for decades.

Now that Disneyland, that iconic symbol of childhood paradise and happiness, has been tainted by vaccine-preventable infectious disease, a firestorm of controversy has erupted. Everything from national news stories to your Facebook newsfeed has likely been inundated with measles information, opinions, and, all too often, overly passionate arguments.

National decline of herd immunity

As a pediatric nurse practitioner and author of the blog KidNurse.org, I have been following and even breaking news on the measles outbreak. When a local Arizona pediatrician shared his thoughts in a letter after his immune-compromised daughter with leukemia and his infant son were exposed to measles by a simple visit to urgent care, I published it in my blog. 

At the time, millions saw the story, and I had to work around the clock just to keep my site from crashing. Measles outbreaks have become the quintessential example of why vaccines are so important in combatting—and reversing—our national decline of herd immunity. The world is watching and waiting, and I have been watching and waiting as well.

As one who daily takes care of young children in an Arizona outpatient clinic, I held my breath as I read the notification from our county department of health stating that measles had been confirmed in Arizona. 

As a matter of fact, with the massive outbreak in California, I knew it was only a matter of time to hear about infections in Arizona, but it was disheartening, nonetheless. And it hit way too close to home when I received a fax message that one of my patients, too young to be vaccinated, had been exposed to the measles. Because the infant’s older brother has cystic fibrosis, it was especially concerning.

I immediately called the child’s mom and described the extremely contagious nature of measles and the typical quarantine process, explaining why she would have to cancel her child’s birthday party and keep him inside the house for 21 days. As frustrating as it is for any parent to receive that news, what’s worse is constantly waiting for the other shoe to drop and thinking that every runny nose may develop into a life-threatening disease. That’s information no healthcare provider wants to give a parent.

The next day at work, I couldn’t help but feel gloomy when I posted signs, as instructed by the public health department, on the door of our clinic, warning parents of the outbreak and providing quarantine precautions. It reminded me of what I had read about steps taken by the federal government back in the 1920s, when quarantine notices were nailed on the doors of infected homes. Were we really going through this again?

Where I’m coming from

As knowledgeable about vaccines as I now consider myself to be, I wasn't always that way. When I was younger, I was swept up into vaccine skepticism as well, and that experience gives me a different perspective on the vaccine debate than most healthcare providers have.

It’s true; I used to be part of the anti-vaccination movement. As a child, I received every vaccine recommended. But, as time progressed and my parents had more children, they were misled by the rising doubt about the harm versus benefits of vaccines, and confusion set in. By the time my third and fourth siblings were born in the 1990s, they received very few vaccinations. Why would my highly educated parents make such a decision? Well, in part, because of the decline in infectious diseases.

The glory of vaccine efficacy in dramatically reducing—if not eliminating entirely—global, deadly diseases has fallen prey to its own success. Like my mom and dad, many parents are no longer intensely motivated to vaccinate children the way our grandparents were. It’s simply human nature. Nothing illustrates this better than a Gallup poll taken back in May 1954, in the midst of the national polio crisis when thousands of children became paralyzed from that horrible disease. The poll found that more Americans knew about the field trial of Jonas Salk’s polio vaccine than knew the full name of Dwight David Eisenhower, the U.S. president at the time. Viewed against the background of the current and very vocal anti-vaccine movement, this survey is especially astonishing.

In the words of Paul A. Offit, MD, a leading infectious disease physician and vaccine advocate, “Once you’ve scared them, it’s hard to un-scare them.” When parents become afraid, whether from facts or myths, it’s difficult to fully leave that fear behind. However, fearing vaccines more than deadly diseases is incredibly misguided.

My journey

As knowledgeable about vaccines as I now consider myself to be, I wasn’t always that way. … It’s true; I used to be part of the anti-vaccination movement.

Because of the anti-vaccine views I had been exposed to as a child, I had to go on a journey to understand this for myself. In becoming a nurse, I studied and explored the science and research behind vaccines, and later, working in the trenches further opened my eyes. When you hear the gasping of a 1-month-old fighting pertussis and witness a desperate mother crying by the child’s bedside, you never forget it. When you work with a child who has lost his arms and legs from meningitis, you always remember. When you hospitalize a limp toddler for severe dehydration from rotavirus, you learn. When you hear that a newborn died in your county shortly after birth because her mom just had a case of varicella, you mourn. But most of all, when you work with little children suffering—and sometimes dying—from terrible diseases that are preventable, you change. I changed.

I believe vaccines are safe, effective, and absolutely the best defense we—individuals and communities—have against infectious diseases. As a pediatric nurse practitioner, I’ve vaccinated thousands of children, and I spend time each day educating parents about the importance of vaccines. Vaccinations are crucial for public health.

My parents were not alone in their anti-vaccine beliefs. Many parents and caregivers are still making the decision not to vaccinate. As nurses, we must address the importance of immunizations in our daily practice. My participation in the vaccine debate has taught me several important lessons.

Nurse voices vital to public health

First and foremost, when nurses speak, people listen. 

Pediatric Nurse Practioner

Year after year, the public ranks nurses as the most trusted professionals. Many nurses freely advocate for the health of their patients but sometimes fail to advocate effectively on health issues to the public. When I started writing about children’s health on my blog, I thought my mom and a few friends would read it—if I was lucky. To my extreme surprise, more than 2 million people have visited Kid Nurse since I started writing the blog. People are desperate for health information from experienced, trustworthy healthcare professionals, and nurses need to fill that gap.

Secondly, when it comes to discussing vaccinations, nurses must figuratively take off their white coats. We need to communicate with care and personal understanding to make ourselves as approachable as possible. The debate about immunization is emotionally driven and fueled by fear. As nurses, we need to use our empathy skills to understand where people are coming from before presenting the science and research that supports vaccines. To get to the heart of the matter, we need to first ask people about their fears and concerns.

Finally, I fully believe it’s time for nurses to reclaim our roots in public health. 

Vaccinations, nursing, and public health are inseparable. 

Public health in America would never have been established the way it is today without the devotion and dedication of public health nurses. Lillian Wald transformed New York City in 1893 with the creation of the Henry Street Nurses’ Settlementorganization. By 1933, this public health organization served more than 100,000 people who, otherwise, would not have had access to healthcare.

Nurses have the same opportunity today, and advocating for vaccines is a foundational aspect of this mission. As daunting as the vaccine debate and the measles outbreak may be, nurses play a critical, irreplaceable role. It’s time to find our voices and join the conversation.

Dani Stringer, MSN, CPNP, PMHS, is a pediatric nurse practitioner in Arizona. When she isn’t seeing lots of little patients in the office, she spends her time blogging at www.kidnurse.org with the goal of bringing public awareness to children’s health.

Editor's note: Dani Stringer passed her pediatric nurse practitioner certification exam in January 2011 at the age of 18. At that time, she was the youngest nurse practitioner in the United States. 

Can Jarod Kushner advise Donald Trump about Memorial Day?

Jarod Kushner is Donald Trump's son in law and, supposedly, his adviser. It's a mystery, therefore, why Kushner couldn't advise Donald Trump about what a US President is supposed to do and say on Memorial Day.  Is it possible that the "back channel" of secret communication discussed between the White House and Russia was so that Jarod could have a private place where someone could advise him about what to "advise" his father in law? 

Convoluted logic, to be sure, but at least it postulates a reason for such clandestine shenanigans. 

Nevertheless, patriotic ceremonies like those held on Memorial Day, hold no purpose for Donald Trump, unless they are an adulation to himself. In spite of losing the popular vote in the 2016 presidential election, Donald Trump continues to believe he is the center of the universe.  Unfortunately, Donald Trump has abdicated his responsibilities as the American President, choosing instead, to create a new paradigm for "leadership by ego". In other words, rather than pleasing the people he leads, they have become the flocks who mush pay him homage.

This has been strikingly obvious on Memorial Day in 2017, when the nation tributes all veterans, especially remembering those who have died.  Donald Trump is not a veteran, so the ceremonies are, clearly, never about him. Therefore, he just goes thru robotic motions because his advisers have tried to convince him to at least pretend he cares about the people who are honored on Memorial Day, even if he isn't the focus of the attention.

Coincidentally, on Memorial Day 2017, there happens to be a mourning for two American martyrs, resulting from a terrible incident on a train, in Portland Oregon. Two brave men are dead, killed while trying to defend a Muslim who was attacked by a crazed murderer, with a knife, on a train. Unbelievably, the defenders of the victim of the attack were, themselves, killed. Donald Trump has not personally responded to this tragedy. (Somebody posted on the @POTUS "Twitter" handle.) 

In facr, Trump's silence was especially hypocritical, in spite of the fact that it was about a week or so ago when he was the center of attention in a group of flowing Saudi Arabian sheikhs. He played to the media by participating in a saber dance, handling a glowing orb and accepting an award from the nation where 14 of the 19 September 11, 2001 terrorists held passports. 

But, there was no mention of the two men killed while defending a Muslim in Portland Oregon, less that two weeks after the made for TV Saudi performance in Riyadh.

After public criticism was expresed about this glaring omission, some unidentified Donald Trump social media surrogate took to the @POTUS handle on Twitter, to post a response. It was not posted from the @realDonaldTrump handle, the one used for personal messages to his minions, but obviously by a person with the ability to write complete sentances. In fact, @realDonaldTrump only "tweets" about himself. He hardly ever "tweets" about others unless doing so reflects equally positively on himself.  

This is what @POTUS surrogate, a White Hosue social media guru, posted:

@POTUS "The violent attacks in Portland on Friday are unacceptable. The victims were standing up to hate and intolerance. Our prayers are w/ them."

In my opinion, the above "tweet" is unacceptable.  First of all, Donald Trump doesn't pray, because, frankly, he doesn't know how to do it.  Secondly, the statement is two complete sentances and Donald Trump is incapable of articulating dual thoughts in 140 characters.

Moreover, the @POTUS "tweet" was posted only following intense criticism and not with genuine concern for the horrendous situation that caused the deaths of two innocent people,who were trying to do what was right.

It's entirely possible the reason Donald Trump waited too long to comment on the Portland Oregon tragedy was because he has a difficult time understanding the the concept of "doing what's right".  

Indeed, a man who must be reminded by his immigrant wife to cover his heart with his hand during the playing of the Star Spangled Banner, obviously can't understand the right response to a tragic killing of innocent men, in Portland Oregon.

Instead of a rogue "tweet" Jarod Kushner could have at least posted a picture on the @POTUS handle taken of this grave in Arlington Cemetery:

In my own Memorial Day message, in response to @POTUS, the 140 characters I will post include a tribute to the names of the two men who were killed in Oregon.   #RickyJohnBest #TaliesinMyrddinNamkaiMeche and I will hashtag #JarodKushner and use the @realDonaldTrump handle

There's no need to set up a secret back channel communication with me for this purpose. Instead, I'm glad to offer my services to do what's right.  I was raised that way.

Here's why Donald Trump foreign trip was a "foul to right field"

“The times in which we could completely depend on others are on the way out,” she Chancellor Merkel, according to German newspaper Welt. “I’ve experienced that in the last few days.”

Although Donald Trump has typically engaged in self aggrandizement about his failed foreign trip to Saudi Arabia, Isreal, Rome, Europe and Sicily, the facts don't support his declared theory abut the effort being a baseball "home run". In fact, the baseball analogy only works if the evaluation will award the effort as "long foul ball hit to right field".

Here's why Donald Trump's foreign trip failed- it was a foul ball.  

First of all, Donald Trump looked absolutely ridiculous walking in the center of a group of huddled flowing Saudi Arabian sheikhs. After years of mocking Muslims, the appearance of Donald Trump at the center of their flowing attention just didn't pass the straight face test. "Strike one!", for optics.  Black suit amidst sheikhs just didn't work for me. Trump's Saudi effort didn't look genuine on either side of the international equation. Obviously, Donald Trump wants Saudi money and he's willing to sell his soul to get it. 

I hope these ugly photographs don't find their way into New York City's, September 11 Museum.

By the way, that gaudy medallion given to Donald Trump by the Saudi's, created for some "trumped up" ceremonial reason, would not look good in a Presidential history museum. Rather, it looks like the award belongs on an ebay clearance sale.

Second, Donald Trump did not make friends with Pope Francis. 

Rather, he simply visited with the Holy Pontiff. (Pictures said a thousand words.) I don't believe I heard "gracie" or "gracias", in Trump's response to receiving a signed copy of "Laudato Si", about the care of our common environmental home; it was a valuable copy given to Trump, from the Pope's own hands,. This is a beautifully written encyclical, easily understood in any of the languages where translations are available: "...now cries out to us because of the harm we have inflicted on her - earth - by our irresponsible use and abuse of the goods with which God has endowed her. We have come to see ourselves as her lords and masters, entitled to plunder her at will...".

Like nouveau "American Gothic" rather than a Papal audience.

Third- Melania Trump's amazing and now historic hand slap. Hmmm. Not much more to say about that message.  In other words, "this isn't going well, is it?"

In fact, from the Melania shove to the hobnobbing with sheikhs, no single Trump moment from the foreign trip stood out as inspiring or even plausible.  Melania obviously didn't want her husband to touch her; but the sheikhs were all over the man.

Nevertheless, the ultimate strike against the Donald Trump failed foreign trip was summarized by German Chancellor Angela Merkel  
Following the Group of Seven (G7) summit in Sicily, German Chancellor Angela Merkel said that Europeans can no longer rely on the United States.

The G7 summit included representatives from the United States, Canada, France, Germany, Italy, Japan, the United Kingdom and the European Union. Leaders met to discuss the world economy, foreign policy, climate change and other global issues, and it ended with all countries reaffirming the Paris agreement on climate change—with the exception of the United States.

In its final communique from the summit, the leaders were forced to admit this fact, saying that “the United States of America is in the process of reviewing its policies on climate change and on the Paris Agreement and thus is not in a position to join the consensus on these topics.” (Remembering how Donald Trump did not say "grazie" to the gift given to him by Pope Francis.)

“The entire discussion about climate was very difficult,” Angela Merkel said yesterday, “if not to say very dissatisfying.”

Merkel further echoed those sentiments today before an election rally in Munich, Germany. “The times in which we could completely depend on others are on the way out,” she said, according to German newspaper Welt. 

“I’ve experienced that in the last few days,” said Merkel.

Or, to put another way, in the words of former President George W. Bush (POTUS 43), said after Trump's awful inauguration speech, "Tha't's some weird shit...."

Or, in baseball analogy- the trip was a foul ball on a 3-2 count.

American - French politics- those who ignore history are doomed to repeat

Mais vous  savez ce qu'on dit : Ceux qui ignorent l'histoire sont condamnés à la revivre.

(A concept most often attributed to huge massacres and wars, in particular The Holocaust.)

Emmanual Macron's French History Lesson for Donald Trump

By Adam Gopnik in The New Yorker

The first meeting between Donald Trump and Emmanuel Macron, at what was billed as a “lengthy lunch,” during the NATO summit in Brussels, Belgium—complete with veal filet, chocolate mousse (though no reports yet on whether Trump demanded his usual double share of dessert), and a super-strong competitive handshake—is a reminder that the French Presidential election resembled its American counterpart in every way but one. Well, two, counting the result. In France, as in America, the election pitted an extreme right-wing nationalist against a moderate technocratic liberal, but in France the leaders of the “Republican” right recognized the extreme nationalist right as a threat to democratic values and, after one round of voting, supported Macron, a man of the center-left who had served in a Socialist government. 

In the USA, (unfortunately) the leaders of the Republican Party made the opposite choice.

That difference made all the difference. 

Vive la différence

The space between the conservative, François Fillon, the defeated right-wing candidate, and Macron is, in ideological terms, every bit as large as the space between, say, Marco Rubio and Hillary Clinton. 

Donald Trump probably thinks "Molière" is an exotic French resort; but French President Macron can quote from the playwright's popular opening lines.

But Fillon understood that a Marine Le Pen in power would be a threat to the nation’s constitutional structure. The irony was that the French, with their (mostly unearned) reputation for craven surrender and opportunism, held fast to their deepest principles, while mainstream American rightists discarded theirs.

The reasons for this seem rooted, above all, in collective experience—in history. The French right has an institutional memory of the Vichy government, of the nineteen-forties, and of what collaboration between the honorable and the dishonorable right cost the country. It also understands the meaning of Charles de Gaulle’s example. The right still knows him as the man who, despite belonging, ideologically, to the most reactionary part of the right, grasped the essential difference between patriotism and nationalism, and insisted that no decent Frenchman could collaborate with evil, even if that collaboration put him in league against many of his lifelong enemies. The notion, put forward by some American conservatives, that Le Pen was de Gaulle’s heir is absurd: the French learned from Vichy that you can’t make a deal with the devil, even if the deal that the devil promises is to keep some other devil out. In this country, a “French”-style unequivocal denunciation of Trump by Republicans would have had an essential effect in an election that was decided, after all, by a handful of votes in a few states, and was clearly won, in the popular vote, by moderates.

As it is, Trump’s contempt for truth, law, democratic tradition, and what was once called “the good opinion of mankind” is on display every day. So much so that the one consolation has become the frequency of his scandals. Interfering with an F.B.I. investigation for personal political reasons is the sort of thing that led to Richard Nixon’s fall, but we are so engulfed by each revelation that the last outrage hardly registers with its proper force. (So here we are, debating Trump’s next choice to head the F.B.I., even when we should still be aghast at what he did to the last one.)

This week, though, no one should, under the pressure of Trumpism, sentimentalize Macron, or underrate his difficulties. It is wonderful to have a President who knows the opening lines of Molière plays by heart (and he plays the piano), but France has had erudite, and literary leaders before, such as François Mitterrand, and brilliant technocratic centrists, too, such as Valéry Giscard D’Estaing. Unfortunately, they have not been wholly successful in solving the country’s predicaments. 

Macron operates without a strong political base on the left or the right, and when, as is bound to happen, his policy proposals provoke demonstrations in the streets, he will somehow have to find more backbone to stand up for reform than any previous French President has found. At the same time, he has to stand up against the still-powerful right-wing nationalists. It’s a tall order for a master politician, and so far Macron has shown himself only to be a lucky one. 

Yet it’s hard not to envy France a little, too. How bad can it be? That was, invariably, the question that reasonable conservatives asked before, and even just after, Trump’s election. They believed that people were exaggerating Trump’s personal flaws and underestimating the power of the Party and the constitutional structures to contain and moderate him. They also thought that he would at least help move the country toward what they happened to view as desirable goals: reshaping President Barack Obama’s too-timid foreign policy, or confronting Islamist extremism more robustly, or simply treating government-controlled national health insurance as the abomination that conservatives honestly believe it to be. The other side insisted that people were wildly underestimating Trump’s pathology, and failing to learn the lessons of how nationalist autocrats and tyrants take over countries.

The other side, the “alarmists” in this case, have proved to be right. Yet the challenge remains for the left to avoid falling prey to tribal habits, as the right did. You see this risk in the insistence, surprisingly widespread, that there is no real point in resisting Trump, since the Republicans in Congress are complicit in his program. Mike Pence would be more dangerous to liberal causes, this argument runs, because he shares the Republicans’ beliefs and brings none of the chaos. Trump is almost better than Pence because he is more nakedly unfit for the office.
That is a Vichy-style mistake in itself. Democracies die when they can no longer distinguish between honest opponents of another ideological kind and toxic enemies who come from far outside all normal values. The Republican Party has functioned, by and large, within the constraints of liberal democracy. There are many obvious exceptions—the issue of the legality of government-sponsored torture, during the George W. Bush Administration, is but one key instance from recent years. 

Yet, it’s a legitimate reproach to liberals that, by maximizing Bush’s violation of the norms, as substantial as they were, they helped make it difficult to distinguish adequately between the Bushes and the Trumps of the world. We can, perhaps, blame the Bushes, as well, for failing to distinguish themselves adequately from Trump. Muttering under your breath, “That was some weird shit,” as George W. Bush is said to have done at the Inauguration, is not as significant as it would have been to say it before the election, when the weirdness and the darkness were already visible.

What’s needed against Trump now is what has been found in France—not an ideologically narrow, politically focussed opposition but the widest possible coalition of people who genuinely value the tenets of democracy, meaning no more than the passionate desire to settle differences by debate and argument, rather than by power and cruelty and clan. Broadening the opposition may help return us to the saner side of life. 

It might be a lesson we can learn from the French, who learned their lesson from history. 

(MaineWriter- Donald Trump doesn't know anything about Molière , never mind being able to quote from any of the French playwright's dialogues. Instead, he probably thinks Molière is a French resort, like Mar-a-lago.) 

Cincinnati Inquirer letters to editor- Health Care

Two interesting "letters to the editor" responding to the House Republican health care plan, published in the Cincinnati Enquirer:

What is hard for me to understand is, Republicans are against abortion and yet they are overjoyed about not taking care of people with pre-existing medical conditions.

Also, what happens when the child that can't be aborted has a pre-existing condition?

Pre-conditions will cause people to die. Some of those have children. I have a friend that has cancer and has a 14-year-old. What happens to that child?

I had voted for Brad Wenstrup. But, as soon as I knew he had voted yes for this bill (AHCA), I immediately called his office and told whoever answered that he will never have my vote again.

From: Day Lemming, Hyde Park

And another letter:

It's time for US to get serious about health care

The folly surrounding the passage of the recent House bill (ACHA) on health care shows that maintaining the current partisanship only postpones a real solution to our health care needs in the United States. We can learn from many other countries how government at the national level supports and treats the health care of its citizens.

I would like to see the Cincinnati Enquirer highlight in a series the general outlines of health care in Canada, England, France, Germany, Russia, Japan, China and others.

We would like the Enquirer to compare the best of these systems with the House Bill 676 for a single-payer system in the United States. (!- Yes!)

Perhaps by some working knowledge of how other systems benefit their populations, we can begin to put our people first in providing the best care for our citizens. It's time health care gets the same attention as the defense of our country. Healthy citizens are the bedrock of our great nation.

From: Elaine Berninger, Cleves

Maine needs new gubernatorial leadership

Democrat Adam Cote to run for governor in Maine as a political outsider and military leader.  

He said, "I learned leadership through 20 years as a soldier in places like Bosnia, Iraq and Afghanistan and 16 years in the private sector, as both a small businessman and a renewable energy attorney.”

Indeed, we support Adam Cote for Maine's new governor.

"There's an opportunity for Maine to reclaim "Dirigo", the state's "I lead" mission. 

Adam Cote is the candidate who can fulfill the state's motto.

In fact, the right candidate who will put Maine and the nation's governor's on to the path to a progressive renaissance is the Sanford native, Major Adam Cote, who is a war veteran and public policy leader. In the gubernatorial campaign launched by Major Adam Cote, the state of Maine has leadership potential to revive our international stature as a progressive state; plus forge a strong alliance with our international shared heritage with Canada, and the state's industrious Franco-American culture.

This is what Adam Cote believes about healthcare:

"For many Americans, and many Mainers, ObamaCare was the first step in providing health care for those who weren’t fortunate enough to have it.  (But)...Now, President Trump is trying to take us backward with his own health care plan."

In fact, we found out just how far backward the TrumpCare (AHCA) would take Americans, with the release of the the Congressional Budget Office (CBO) score. 

A jaw-dropping 23 million Americans, 101,000 of those Mainers, would lose healthcare coverage under the bill. 

It will hit rural Mainers, who make up over 60 percent of the population, and Mainers with pre-existing conditions especially hard. Scarily, 548,200 Mainers with pre-existing conditions are at risk of losing their coverage, including 61,200 children.

Mainers should not have to choose between health insurance and affording basic needs. And they won’t have to if enough of us speak up and tell the Senate to vote down this Republican bill.
TrumpCare leaves a lot up to each of the states, which means that the governor of Maine will play a huge role in health care. And Governor LePage has already kept thousands of Mainers from being able to access coverage by not setting up a health care exchange like most other states.

Look, ObamaCare isn’t perfect, but Democrats in Congress have been working to fix it. They’ve just introduced new legislation that would give Mainers the option to buy health insurance from the same exchange as Congress members. That would help Mainers in rural areas who have a limited number of plans to choose from.

While President Trump and Governor LePage are actively working to limit the availability of affordable health care, I know what is at stake and am ready to fight for all Mainers to have access.

When Adam Cote filed his paperwork to run for the office of Governor of Maine, he said he wants to “turn the page from the dead-end politics of division.”

Manchester England tragedy affects nursing

Nurses are among all of those who extend our heartfelt sympathy to the people affected by the tragic loss of life, caused by a suicide bomber in Manchester England.

"I don’t want to think about who did it. I want to focus on the good I saw and was part of on Monday night," Manchester nurse Joe O'Brien.

Among the victims are those who treated the injured and received the mortalities.  

'I still feel raw': nurse tells of treating Manchester bombing victims

Joe O’Brien is a senior sister (a nurse) in the surgical department of Stepping Hill hospital in Stockport, where six of the 59 injured in the Manchester bombingwere treated.

She says, "On Monday, I worked from 8am until 6pm as a surgery sister at Stepping Hill hospital in Stockport. I was in bed that night listening to BBC Radio Four when I heard the words ‘Manchester’ and ‘incident’. I immediately thought about Declan, my son, a student who lives in central Manchester. I shot downstairs, spoke to my husband Sean. We rang Declan and established that he was OK, then I rang work and went in."

When she got there at 1.30am, there were ambulances outside which had brought in six of the 59 casualties from the arena. 

They were stabilised in the A&E unit and brought to the surgical department where she worked. They all had lower limb injuries with foreign bodies – shrapnel injuries. Metal bolts and nuts, some an inch wide, had gone into them. They had caused real damage and left big holes in people. Shrapnel is like a large bullethole. It just destroys anything it goes through – arteries, bones, nerves, the lot.

"I’ve been in operating theatres since 1988 and it’s the most upsetting thing I’ve ever seen", she reported to The Guardian.

The Guardian is a British daily newspaper.

"My patient was a lovely, lovely lady who had been in the foyer of the arena when the bomb went off. She had extensive, horrendous injuries caused by the shrapnel, including broken bones and tissue damage. She was in theatre from 3am until about 6.30am. I talked to her just before she went to sleep for the operation and she was just holding my hand and saying ‘Thank you, thank you’. She was in a very bad way but was still smiling and saying thank you. That showed real humanity; I thought that was amazing."

At least four of the six patients needed surgery. Usually only one of the hospital's 18 theatres is open overnight for emergencies. But on Monday, surgery was going on simultaneously in three of them, staffed by teams including about 25 other colleagues who, like her,  had just come in to help – surgeons, anaesthetists, nurses, theatre technicians, radiologists to read X-rays and hospital managers – everyone.

Surgeons took the bolts and nuts out of patients and repaired the damage they had caused. One woman with abdominal shrapnel damage who arrived at 4am ended up in theatre for 12 hours.

The atmosphere in the surgical department overnight was very calm and focused but also very emotional. 

"I found it emotional partly because of my lovely lady patient, who didn’t deserve what happened to her; I’ll always remember her smiling. And emotional also because one of the doctors I worked with overnight had actually been at the arena when the bomb exploded, waiting to pick up his daughter from the concert. He didn’t even mention that though. I don’t know how he found the strength to come into work and work all night after getting his daughter home, and after being at the scene of such horror, but he did. I said to him, ‘You’re fantastic.’ But he just said: ‘I’m not fantastic; it’s what we do.’"

"Strangely, it was only when the police told us to bag up the clothes belonging to the casualties and also the shrapnel – not to clean the bolts and nuts, because they would need them for evidence – that I realised something awful had happened. That brought home the enormity of it."

"I’m still feeling very raw and emotional. I finally finished at 9.30 on Tuesday morning and I cried when I got home. On the BBC news a lady was appealing for help to find her daughter and that reminded me of how I felt when I woke up and panicked about my son in Manchester. I cuddled up with my black labrador, called Shadow, on the floor and had a good cry."

"A terrible thing happened, and there’s no explanation for it. But I don’t want to think about who did it. I want to focus on the good I saw and was part of on Monday night. We should focus on the love and warmth people displayed after the bomb, and on those who helped those affected, like the homeless guys who gave people directions after the bomb, and not on those who do things like this."

Lt. General Flynn betrayed the United States

:"Lock Him Up!"  Those prophetic words were wrongly directed towards Secretary Hillary Clinton but now they are rightly being used to demand accountability from Lt. General Flynn, for his unpatriotic behavior and Russian collusion 

Democrats: New documents show Lt General Flynn lied to investigators about Russian trips

CNN-A new letter from the leading Democrat on the House oversight committee, Rep. Elijah Cummings, reveals new information about former national security adviser, Michael Flynn and what he told investigators about his ties to foreign governments when he was interviewed about his security clearance.

According to the Report of Investigation, which Cummings refers to in his letter to committee Chairman Jason Chaffetz, Flynn made false statements to investigators about who funded his foreign trips, including a 2015 trip to Russia where Flynn was paid roughly $45,000 to speak at an event in Moscow. According to the letter released Monday by Democrats on the committee, Flynn claimed that his trips were funded by "US companies."

The report stated that Flynn said he "had not received any benefit from a foreign country."

Flynn also claimed to investigators he had no substantial contacts with foreign government officials, saying he only had "insubstantial contact." Flynn was shown sitting next to Russian President Vladimir Putin at the 2015 dinner.

The committee Democrats say Chaffetz must subpoena documents from the White House to determine what the White House was told about these foreign contacts and trips.

"We need to know what the President, Vice President, White House Counsel, and other top officials knew about General Flynn ---- and when they knew it," Cummings writes in the letter.

The request comes after a blockbuster New York Times report that Flynn's lawyer had informed the Trump transition team weeks ahead of the inauguration that Flynn was under investigation for allegedly working for the Turkish government during the 2016 presidential campaign.

The letter also comes the same day that Flynn said he would not comply with a Senate intelligence committee subpoena for information and will invoke the Fifth Amendment.

In the letter, Cummings accuses Chaffetz of defying the interests of the investigation by not subpoenaing the records. Time is ticking as Chaffetz is expected to step down as a member of Congress on June 30.

"In refusing our requests for a subpoena, you have made the same argument as President Trump -- that you believe the White House bears no responsibility for vetting General Flynn for the position of National Security Advisor because he received his latest security clearance renewal under the Obama Administration in early 2016," the letter goes on.

The oversight committee had previously sent a bipartisan request to the White House that it wanted any information into how the Trump transition team vetted Flynn as well as any communication White House officials may have had about Flynn's alleged connects to foreign nationals.

It's impossible to understand how Lt. General Flynn could have made the decision to communicate with Russia after he studied US Army intelligence. His unpatriotic action seems to have been directed.  In myopinion, Flynn was following orders from the Tump campaign to communication with Russia. 

As a result, it's high time to lock him up! #Seriously!

Scientists revolt- use real data to count people

When it comes to counting the number of people in a crowd, it's always a good idea to start with the number of persons at "1" and continue with additional digits, until all are included in the final tally. In reality, it makes no sense to claim a crowd size, without the verification of having somebody who does a "count". Obviously, some crowds are too large to count; but other attendance indicators can be counted, like checking to see if all parking lots are full to capacity or by issuing numbered tickets to events.  

Empty seats at inauguration of Donald Trump January 20, 2017- evidence of low crowd size.

Unfortunately, Donald Trump made up the numbers about his inaugural crowd size. Among his first executive orders as POTUS was to randomly declare that his inauguration crowds were huge. Nevertheless, even people who can't count have the ability to see when the event photographs showed empty seats. Rather than admit to the pictures of empty seats, Donald Trump ordered the Park Service to remove the evidence from social media. 

In other words, the first executive order Donald Trump gave after his inauguration was to tamper with evidence.  There's no way he serendipitously made up that kind of judgement. In fact, it's probably so routine for Trump to change facts in his favor, that he didn't even consider how he might be wrong. Moreover, in his selfish corporate world, nobody dared to tell Trump otherwise, until the media forced the issue. (Classic, "Emperor has no clothes".)

Thankfully, scientists are rightly obsessed about speaking "facts to power", in spite of protracted efforts by revisionist Donald Trump and right wing extremists.

Scientists, reported in "Mother Jones" evaluated the
Anti-Trump "Science Protesters". They finally released their thoroughly fact-checked crowd estimates. (By Rebecca Leber)

When protesters descended on Washington, DC, last month for the March for Science, they carried signs that were straight-to-the point: "What do we want? Evidence-based science. When do we want it? After Peer Review." And unlike the Donald Trump administration they were protesting, organizers were careful to apply scientific rigor to how they calculated the number of people who participated in the march.

As a result, it took organizers an unusually long time—three weeks—to come up with their estimate for how many people took part in the April 22 marches in Washington and 600 other cities worldwide. In a blog post published Monday, organizers approximated that nearly 1.1 million people had protested around the world, with the largest marches taking place in DC (100,000), San Francisco (50,000), Los Angeles (50,000), Chicago (60,000), and Boston (70,000).

Their patience was a marked contrast to how President Donald Trump handled his inauguration crowd size. Trump spent his first weekend as president insisting that far more people attended his swearing-in than were actually there and attacking anyone who disagreed. Trump told the CIA on that Saturday that he drew "a million-and-a-half people." In his first address to reporters as White House press secretary, Sean Spicer angrily claimed, "That was the largest audience to witness an inauguration, period." Photographs proved these assertions to be untrue, but the White House didn't budge. Trump aide Kellyanne Conway even coined the term "alternative facts"—a phrase widely derided by the pro-science marchers—when she was defending the White House's claim that Trump drew a larger crowd than President Barack Obama had in 2009.

March for Science organizers decided to take their time tabulating their crowds after volunteer Kate Gage suggested that they should "science the shit out of the numbers"—which Gage said was meant neither as a reference to Trump's crowds debate nor to Matt Damon's character in the movie The Martian. 

"We really wanted to emphasize that it was a march about science and data and evidence," explained Gage, a former policy adviser in the White House's International Science and Technology office during the Obama administration. Scientific rigor was critical, she said, because the march "was organized by scientists, in a way and a scale we haven't seen before."

Crowd counting is an inexact science, and the volunteers who organized the marches acknowledge the shortcomings of their methodological choices. The DC march was particularly challenging, said Kishore Hari, the DC march coordinator (and a co-host of our Inquiring Minds podcast), because the National Park Service doesn't release crowd estimates and the rainy weather that day prevented the use of satellite imagery. In the end, comparing crowd density to the area's known capacity, they estimated 100,000 attendees.

While the DC march count had its limitations, the other marches used a variety of methods. Most marches used hand counts, but for larger, moving groups, hand counts can be prone to error, so organizers had to rely on other methods. Rufus Cochran, an engineer and co-chair of the Indianapolis march, spent a few nights reading about different methodologies. Here's the approach they settled on in Indianapolis, as described in a blog post on the March for Science's website:

At the beginning of their event, pictures of the square were taken with reference landmarks visible. Using this and other pictures, the organizers estimated a fairly consistent density across the square. The organizers then drew an outline of the area using MapChecking.com and combined that with state crowd density still data from Professor Keith Still, a crowd estimation scientist. They settled on a likely density of 2 and 3 people per m2 resulting in an attendance calculation of just under 10,000. Given that more people arrived after this picture was taken and there were people at the periphery beyond the borders of area, this estimate is likely conservative.

"Researching and building on existing technologies is very important," Cochran told me. "A lot of the methodology is people making best-educated guesses." He said his aim was to use "a methodology that is transparent and repeatable."

Keith Still, a crowd size scientist who provided estimates for the Inauguration and Women's March, says that the methods used by the March for Science organizers were acceptable. "Crowd counting has been around for a long time, we don't use a static process as it is fraught with inaccuracies," he said in an email, noting that some methods for determining density are crude and highly variable. "Without images, it would be difficult to assess the accuracy of the crowd count in the March for Science, but the information on the blog is reasonable. By that I mean, the figures are typical of this sort of event (and not over inflated)."

(MaineWriter:  I can predict this. When Donald Trump is impeached, the crowd size and the television ratings for the vote will exceed all the numbers thrown around about the inauguration.)

Salem Witches object - they own copyright to Witch Hunt

Salem Witch Trails of 1692-93

Donald Trump has violated yet another law. His claim about being the victim of a "Witch Hunt" is now challenged by the Salem Massachusetts Congressman, who represents the place where the original atrocities occured.  In other words, Donald Trump had no license to use the copyrighted term "Witch Hunt". In fact, Trump isn't the subject of a Witch Hunt, because the practice of hunting witches ended in about 1693, and current witches don't take kindly to infringment on their copyrighted era.

Salem MA Congressman Representative Seth Moulton has taken issue with Donald Trump's claim that he is the victim of the single greatest witch hunt in American history.

Moreover, Donald Trump was insensitive to the original victims when he declared himself the victim of a Witch Hunt. He should have checked with the surviving families of the original victims before infringing on their intellectual property rights. May the original victims, all of them unjustly executed without objective due process, rest in peace.

This is a list of people associated with the Salem witch trials, a series of hearings and prosecutions of people accused of witchcraft in colonial Massachusetts between February 1692 and May 1693. The trials resulted in the executions of twenty people, most of them women (one man is on this unfortunate list):

Bridget Bishop (née Playfer; executed June 10, 1692)
Rebecca Nurse (née Towne; July 19, 1692)
Sarah Good (formerly Poole, née Solart; July 19, 1692)
Elizabeth Howe (née Jackson; July 19, 1692)
Susannah Martin (née North; July 19, 1692)
Sarah Wildes (née Averill; July 19, 1692)
George Burroughs (August 19, 1692)
George Jacobs, Sr. (August 19, 1692)
Martha Carrier (née Allen; August 19, 1692)
John Proctor (August 19, 1692)
John Willard (August 19, 1692)
Martha Corey (September 22, 1692; wife of Giles Corey)
Mary Eastey (née Towne; September 22, 1692)
Mary Parker (née Ayer; September 22, 1692)
Alice Parker (September 22, 1692)
Ann Pudeator (September 22, 1692)
Wilmot Redd (September 22, 1692)
Margaret Scott (September 22, 1692)
Samuel Wardwell, Sr. (September 22, 1692)

Donald Trump said at a news conference, whining about the Russian investigation, "The entire thing has been a witch hunt and there is no collusion between certainly myself and my campaign - but I can always speak for myself - and the Russians. Zero," he told the news conference. (HELLO?  Donald Trump also speaks for the Russians?  OMG!)  Regardless of what Donald Trump claims about being the victim of a Witch Hunt, he obviously has not given credit to those who made this copyright claim possible.  

Perhaps Donald Trump will apologize to the real Witch Hunt victims families and give a reparations to the Salem Witch Museum. 

Psychiatric assessment essential - King Lear syndrome

King Lear Syndrome

Donald Trump and his descent into madness.

It makes no sense for Donald Trump to exhibit erratic behavior and mental illness symptoms of paranoia (I've been treated badly!), without demanding an evaluation from a psychiatrist.

Shakespeare was a magnificent writer, poet and playright. In light of 21st century news, he is now a prophet. 

President Trump’s King Lear Moment- by Anna North published in The New York Times

Donald Trump is looking a bit like King Lear these days.

In the wake of reports that he shared classified intelligence with Russian officials and allegations that he asked James Comey to stop the investigation into Michael Flynn, the president’s mood “has become sour and dark, and he has turned against most of his aides — even his son-in-law, Jared Kushner — describing them in a fury as ‘incompetent,’” Glenn Thrush and Maggie Haberman reported at The Times.

On Wednesday, he told United States Coast Guard Academy graduates, “No politician in history, and I say this with great surety, has been treated worse or more unfairly.” (MaineWriter- "paranoia!)

It’s not hard to imagine President Trump railing against the heavens, orange pate standing in for Lear’s “white head,” proclaiming himself “a man more sinn’d against than sinning.” 

Even the language of news reports has a Learian feel: “President Donald Trump, amid his own swirling controversies”; “the maelstrom raged around the staff”; “the tempest in Washington.”

Of course, Mr. Trump’s storm, unlike Lear’s, is of his own creation. And he doesn’t have Lear’s way with words — or, perhaps, he has a different one.
On Tuesday morning, he tweeted, “I have been asking Director Comey & others, from the beginning of my administration, to find the LEAKERS in the intelligence community,” then trailed off with an ominous ellipsis. His only tweets since then have been anodyne (?) (MaineWriter- Oh, please Ann, use words people understand! "anodyne" IOW, not likely to provoke dissent or offense); 

Recent Tweets appear to be inoffensive, often deliberately so.or at least anodyne for President Trump: a link to a story about industrial production and a video of his speech welcoming President Recep Tayyip Erdogan of Turkey.

His aides must be relieved. “We are hoping the president doesn’t tweet,” one told Politico on Tuesday night. “Fingers crossed.”

During their break from doing Twitter damage control, Mr. Trump’s staff has been busy preparing him for his first trip official abroad. They are giving him lots of charts, graphs and photos and inserting his name at regular intervals in briefing materials “because he keeps reading if he’s mentioned,” according to a Reuters report.

Meanwhile, NATO is telling heads of state to keep their remarks at a May 25 summit under four minutes to accommodate the president’s attention span, according to Foreign Policy. “It’s like they’re preparing to deal with a child — someone with a short attention span and mood who has no knowledge of NATO, no interest in in-depth policy issues, nothing,” a source with a short attention span and mood who has no knowledge of NATO, no interest in in-depth policy issues, nothing,” a source with knowledge of the preparations told Foreign Policy.

At this point, regardless of what happens with Mr. Comey, the Russians and anything else that comes out of the White House in the next few days, it’s hard to see how Mr. Trump can function as the president. Reports cast him as someone who cannot be trusted to perform the core duties of his office. 

Before the Inauguration, some speculated that Mr. Trump might operate as a head of state, flying around the world and meeting dignitaries while leaving the day-to-day workings of government to his vice president. It now appears he cannot even manage that: Mr. Thrush and Ms. Haberman report that some of his advisers “fear leaving him alone in meetings with foreign leaders out of concern he might speak out of turn.”

Calls for impeachment have begun, but they will only gain traction if enough Republicans decide to back them. In the meantime, what does the country do with a president who can’t do his job?

The president is unlike King Lear in many respects, but in this perhaps most of all: He seems to lack a Cordelia who will speak to him honestly. (MaineWriter: Poor Cordelia paid a price for her honesty.) 

Instead, Mr. Trump has been Regan and Goneriled all the way to the presidency, flattered and coddled by his advisers, the Republican establishment and his family to the point where flattery and coddling are useless and no amount of careful management can keep him from revealing state secrets and then bragging about it on Twitter.

It’s not clear whether someone who refuses to lie, flatter or curry favor would have much influence with Mr. Trump, so surrounded is he by people willing to do all of those things. But someone like that, especially from within the Republican Party, could have a great influence on the country right now. Without such voices, we’re all at the mercy of the storm.
 

Anna North (@annanorthtweets) is a writer and editor in The Times opinion section.

Donald Trump may have created a new psychiatric diagnosis, first described by William Shakespeare, called "King Lear Syndrome".