American Elephants


The Indian Health Service is Just as Bad, or Worse, than the VA by The Elephant's Child

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As long as I’m beating up the Obama Administration for their unbelievably dreadful performance on health care — at the Veterans Administration we have found needless patient suffering, fatal delays in medical treatment, and retaliation against whistleblowers — they are as well the shameful traits of the Indian Health Service.

Part of the Department of Health and Human Services, the Indian Health Service is required by treaty to deliver health care to Native Americans around the country, with more than two million depending on this federal agency. Unfortunately, it appears to be failing. Tribal members have told the Senate Committee on Indian Affairs about alarming conditions at hospitals run by the IHS. During the committee’s investigation, which began last summer, we have heard accounts of nurses unable to administer basic drugs, broken emergency-resuscitation equipment, unsanitary medical facilities, and seriously ill children being misdiagnosed. …

The situation has gotten so bad that inspectors from the Centers for Medicare and Medicaid Services have issued multiple Statements of Deficiencies over the past few years identifying four IHS hospitals in the Great Plains that are putting patients in “immediate jeopardy.” Our investigators have found evidence that the IHS, like the VA, maintains a culture of cronyism and corruption. Many staff members collect government paychecks without fear of accountability.

Tribal Leaders have contacted the Department of Health and Human Services specifically identifying underperforming supervisors and upper-level management who deserve to be fired. There is no sign that these people have been terminated. Instead employees who perform poorly are transferred to other facilities and in some cases even get raises and  promotions with work files that show no records of bad performance. Nice work if you can get it.

According to HHS, Indian Health Service funding has expanded by 43% since 2008, so more money is not a solution. What’s required seems to be a culture change at the agency from leadership in D.C. down to local hospitals. Some hospitals in the Great Plains area actually had money left over at the end of the fiscal year — but made the choice not to spend it on patient care.

When an administration consistently shows that politics and the next election trump duty and responsibility, and the Constitution is just an old tired document, those attitudes seep through the whole administration, and you get a Navy Commander surrendering boats to the Iranians because he believed that Obama’s Iran Deal was so important to the President, you get sexually-confused bathrooms, a military open to transsexuals, women in combat roles, and an administration unable to say “Islamic terrorism” because the words might offend, though it might also kill a lot of Americans.

Contrary to the hard Left who believe all things are better done and controlled  by the best and brightest in the federal government, there are few things that the federal government actually does well. There are a lot of things that must be done by a federal government, but most are better left to the states which are more directly responsible to their citizens. Health care is just one of them.

ObamaCare is slowly falling apart, Medicaid is a disaster, we have read of way too many failings of the Veterans Administration health care, and now the Indian Health Service, required by treaty to deliver health care to Native Americans around the country has more than two million depending on that service.

Free Markets, Free People and lots of competition — works every time. Presented with challenges and the opportunity to be free of meddling bureaucrats, ideas for better care pop up and little miracles happen all over.



“Compassion” is what the Hard Left Thinks They’re All About, Except When They’re Not. by The Elephant's Child

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The headline at National Review for an article by Wesley J. Smith reads “Keeping Patient Alive Can Be ‘Non-beneficial Treatment.'”

The medical bureaucrats and technocrats are changing the meaning of definitions and terms to permit health care rationing and coerced withdrawal of care.

This is the “futile care” controversy, sometimes called “inappropriate care,” or in my parlance, “futile care theory.”

The idea is that when a doctor or bioethics committee believes the patient’s life not worth sustaining based on their values about quality of life or cost, wanted treatment — even that requested in an advance directive — can be unilaterally refused.

Futile care is akin to a restaurant posting a sign stating, “We reserve the right to refuse service.”

The International Journal for Quality in Healthcare is doing the hard Left’s politically correct trick of changing the language to fit their desired goal. The goal is essentially to get rid of expensive treatments for those whose illness is not expected to result in improvement in quality of life. In such cases the technocrats, bureaucrats, hospitalists and other doctors and bioethicists will decide if it is “non-beneficial treatment (NBT).” Keeping the patient alive because the patient wants to be kept alive has no part in the discussion. The bureaucrats are redefining the core purpose of medicine. And of course there will be an acronym to further disguise what they’re up to.

You have perhaps noticed that one state after another is attempting to pass “Assisted Suicide” laws. They usually succeed by suggesting that you, old and feeble, and suffering from dreadful pain, with no hope might want to end your misery by getting your doctor to kill you. That will help get rid of some whose expectations don’t involve improvement in their quality of life, but adding on a bunch of bureaucrats to make those decisions brings back memories of Logan’s Run, or Solyunt Green. They don’t make movies like that anymore —uncomfortably close to reality, not the politically correct party line.

Anyone who isn’t frightened by the prospect of technocrats, bureaucrats, hospitalists and other doctors, and bioethicists — strangers to the patient — deciding that continuing to live is non-beneficial hasn’t thought the question through.

In Britain, the National Health Service (NHS) has been accused of denying elderly patients food and water to help them die more quickly, but the NHS is socialized medicine.



Obama is Dismantling Medicare by The Elephant's Child

Modern medicine has been a blessing for seniors. Before Medicare, old folks ended up in nursing homes or in wheelchairs with crippling illnesses. Now more seniors are able to get hip and knee replacements, cataract operations and heart procedures to spare them some of the worst parts of aging. And they are living longer. The American Journal of Public Health reported that a man turning 65 can expect to live 5 years longer than he would have in 1970.

The Obama administration has, as usual with the left, included lots of unnecessary goodies in order to get people to sign up with ObamaCare and Medicare. And with Medicare, they carefully eliminated many of the features that controlled costs and encouraged older folks to use it more carefully.  The so-called “donut hole” was designed as an incentive for seniors to use cheaper generic drugs instead of name-brands when they were equivalent.  It worked very successfully. Obama eliminated that.

Medicare has always faced the problem of the sheer numbers of retiring baby boomers, which has meant trouble for Medicare finances. Under the guise of “reform,” President Obama is dooming seniors to disability, needless pain and shortening their lives.

Hillary, economically clueless, is proposing to open Medicare to people in their 50s, so younger, healthier people would be competing with seniors for resources. Brilliant.

Obama, under the pretense of “reform,” is issuing a 962 page of new Medicare regulations. The reforms will make it harder for seniors to get joint replacements. New payment rules will shortchange doctors, discouraging them from accepting Medicare in the first place — which is already a problem. Hospitals will get bonuses for spending less on each senior patient, despite having higher death and infection rates. Seeing Medicare patients will be a money loser.

Because of new regulations on how doctors treat patients (the feds know better than the doctors) doctors spend time completing reports for the government. They spend their time with the patient glued to a computer screen instead of interacting with patients.

“Doctors who want to provide individualized care” will have to “either opt out of Medicare or simply not comply,” explains Richard Amerling, past president of the American Association of Physicians and Surgeons.

Obama’s rules are “far too complex and burdensome to be workable for most physicians,” warns John Halamka, a Harvard medical professor.

The new rules also make seeing Medicare patients a money loser. Annual fee increases for doctors are capped at a fraction of 1 percent — even though rents and other costs go up every year.

No wonder nine out of 10 solo practitioners admit they’ll avoid Medicare patients — right when 10,000 new baby boomers are joining each day.

Old folks with cancer will be in trouble. Doctors administering chemotherapy are getting a pay cut and told to choose the cheapest drug, regardless of what medication is best for the patient. Seniors needing knee and hip replacements likely to need rehab may have to settle for painkillers instead.

The administration claims the rules reward quality instead of quantity, but that’s a lie. Betsy McCaughey says that five of the hospitals who had the worst scores on patient outcomes — who get more infections and die sooner from heart problems and pneumonia than at other hospitals — have all gotten bonuses from Medicare because they are low spenders.

Remember the 2012 campaign when Obama accused Republicans or plotting to “end Medicare as we know it” and a video depicted a Republican pushing Granny’s wheelchair off a cliff?  Nasty and false claims, but now the Democrats are pushing America’s seniors off a cliff indeed.

Obama has made several remarks indicating that medical care is more important  for the young, who have more years ahead of them, than having expense wasted on the old, who could depend on pain killers instead. It would be a lot less offensive if he were not at the same time wanting to insure the votes of young women by promising free contraceptives to all, although they cost so little  few would have a hard time paying.

In a free competitive market, competition brings prices down, and the promise of profit makes people have new ideas, and take the risk to make them work. The Left despises the free market, and wants ever more control. They believe that they have the best ideas and they just need to be put to work. And if they aren’t working, new and more regulation will fix things. It’s a war of Individualism versus Collectivism — or Freedom versus Socialism. Perhaps you have noticed that they are starving in Venezuela and being killed in food riots. And their hospitals have no medicine, no antibiotics and no pain pills either.



Ideology Overrides Common Sense And Law. by The Elephant's Child

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Donald Trump got a lot of support from his announced plan to build a “Great Big Wall and make Mexico pay for it.” The commentariat reacted immediately with cries of racism and xenophobia, (the fear of anything new or different), but in fact, countries all over the world are reacting to migrants with new fences or walls. Turkey’s new Syrian border fence will have a smart tower every 1,000 feet featuring “a three-language alarm system and automate firing systems” supported by zeppelin drones.

Israel’s Separation Barrier with the West Bank has been hotly debated. There is a Moroccan Wall in the Western Sahara. The Great Wall of Jordan (costs half a billion dollars), and Kenya has an anti-terror wall on its Somalia border.

Saudi Arabia is building a 600 mile “Great Wall” to protect against border infiltrators from Iraq that begin with sand berms, twin chain link fences with razor wire 100m apart separated by concertina fence, then 40 watchtowers equipped with radar and daylight cameras, command-and-control centers, 38 separate communication towers and 32 military response stations. They are serious, but ISIS regards the capture of Saudi Arabia home to the”Two Holy Mosques” of Mecca and Medina, as a key goal.

Many of the EU states are erecting border fences, but those who consider the nation-state to be a fiction, and who sneer at border fences as attempting to keep the barbarians out, note that “barbarians can be defined however the wall -builders desire.” Technology is dismissed as a leftover Cold War trend. An essay from UPI suggests since the advent of the War on Terror, border barriers have been framed as a state’s response to terrorist acts, but are a distorted mirror image of terrorist intentions. Building a wall is easier for a more authoritarian state, and part of a policy framework that includes state-sanctioned repression. But then Evelyn Gordon reports at Commentary about the 13 year-old Israeli-American who was murdered in her bed this morning, stabbed to death by a Palestinian teenager.

I would submit that people are by nature tribal. The Middle East is deeply divided by tribes who all seem to be fighting each other. People who share a language, a background and customs are apt to stick together. America was settled by tribes or groups who settled together, the British in new England, the Dutch in New Amsterdam, the Germans in Germantown, members of  religious sects came together. Many were despised when they first arrived, but assimilated, integrated and intermarried — and then they formed new tribes, barn builders,  quilters, musicians and horse breeders and so on and on.

Victor Davis Hanson wrote recently  that “The history of nations is mostly characterized by ethnic and racial uniformity, not diversity.”

Most national boundaries reflected linguistic, religious, and ethnic homogeneity. Until the late 20th century, diversity was considered a liability, not a strength. …

Many societies created words to highlight their own racial purity. At times, “Volk” in German and “Raza” in Spanish (and “Razza” in Italian) meant more than just shared language, residence, or culture; those words also included a racial essence. Even today, it would be hard for someone Japanese to be fully accepted as a Mexican citizen, or for a native-born Mexican to migrate and become a Japanese citizen …

America is history’s exception. It began as a republic founded by European migrants. Like the homogenous citizens of most other nations, they were likely on a trajectory to incorporate racial sameness as the mark of citizenship. But the ultimate logic of America’s unique Constitution was different. So the United States steadily evolved to define Americans by their shared values, not by their superficial appearance. Eventually, anyone who was willing to give up his prior identity and assume a new American persona became American.

Consider the agenda of the Obama administration. Diversity is to be enforced, including forcing suburbs to accept people from the inner city, and forcing people from the inner city to relocate to unfamiliar suburbs. Refugees are to be planted in communities across the country. Idaho just got 7 refugees with active Tuberculosis (TB), following seven other states who have reported active TB among refugees resettled in their states. Of 4,650 refugees resettled in Idaho between 2011 and 2015 — 896 tested positive for latent TB infection. TB is a very serious disease. It had been nearly eradicated. And TB is just one of the diseases that Obama is quite deliberately spreading around the country in the name of ideology.

Illegal alien unaccompanied children have been sent to every state, including Alaska and Hawaii.  Attempting to reach some ideological goal by forcing diversity of race and ethnicity in the name of achieving “equality” goes against the natural inclinations of the people involved — to solve a solely political goal of the administration. A goal that seems to be mostly about making themselves feel noble and important, because it certainly has nothing to do with the people and what they want.



Senate Democrats Block Zika Virus Funding by The Elephant's Child

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Most of the news about the Zika Virus is bad. Babies are born with malformed brains, adults who suffer the progressive paralysis of Guillaine-Barré syndrome, Americans diagnosed after travel to the topics, active transmission of the disease in U.S. territories, but primarily because of regulatory requirements no vaccine is likely to become available before the end of the decade.

The FDA is “blocking real progress on a vital tool to control the Aedes aegypti mosquitoes that carry and transmit Zika and the viruses that cause dengue fever, chikungunya and yellow fever.”

Using genetic engineering techniques, the British company Oxitec (a subsidiary of American-owned Intrexon) has created male Aedes aegypti mosquitoes with a specific mutation that causes them to need a certain chemical (the antibiotic tetracycline) to survive. Without it, they die—and their offspring die before reaching maturity. Releasing the males over several months causes a marked reduction in the mosquito population. Because male mosquitoes don’t bite, they present no health risk, and, because their progeny die, no genetically engineered mosquitoes persist in the environment.

Turf battle: the USDA’s Animal and Plant Health Inspection Service, which has the authority and expertise to oversee genetically engineered insects vs. the USDA (budgetary concerns and anti-genetic engineering among senior USDA people) who sent it over to the FDA which is unqualified to review the mosquito and unwilling to move it along. If all this sounds nuts, it is.

Brain damage in Zika babies is far worse than doctors expected. The virus attacks lobes of the fetal brain that control thought, vision and movement.

The Senate voted to approve a $1.1 billion bill to fight Zika by a 52 to 48 margin, with funds to go to help develop a vaccine. (Not enough to get the bill to the floor). It was slightly less than what Obama requested, but his budget request earmarked over half a billion for Zika programs in other countries and shortchanged public health here at home. (ObamaCare has a 2 billion slush fund for public health).

Harry Reid called the bill “nothing more than a goodie bag for the fringes of the Republican Party” and said they had no choice but to block it. Their real complaint was that Planned Parenthood wouldn’t be able to get a portion of the funds directed to public health departments and hospitals that are reimbursed by public health. Sen. Bill Nelson (D-FL) claimed that the Republican bill “limits access to birth control services needed to help curb the spread of the virus and prevent terrible birth defects.”

The Democrat’s idea was that the mainstream press would blame the GOP for the bill’s demise, but even the liberal media wouldn’t buy this mess of pottage. The headlines for CNN, NBC, CBS and even the NY Times were uniformly something in the line of “Senate Democrats block Zika funding.”

Scientists are getting closer to understanding how Zika causes Microcephaly, but they’re not there yet. The Senate’s stupid move makes it impossible for Congress to send legislation to the president before July 4. This means the bill is dead, and a new bill will have to be written and submitted. Both chambers are back in session for just one week before leaving for summer vacation July 15 and not returning till after Sept 5.



My Very First Broken Bone! by The Elephant's Child

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This is the first time, despite my advanced age, that I have ever had a broken bone. Right foot, 5th metatarsal, spiral fracture. I get a fancy ski boot with all sorts of Velcro and canvas and buckles that I apparently have to wear for months and months. It lets me walk on my injured foot, which makes life easier. No cast, for which I am grateful.

I didn’t even break a bone when my horse pitched me off trying to show off her ability as a cutting horse. She was pretty good. I wasn’t all that much as a cutting horse rider.



Sorry about the Erratic Blogging. by The Elephant's Child

Sorry about the light blogging. Dramatic version: I fell down the stairs and broke my foot. Reality: It was just the last step, and I thought it was just a sprain, but it is indeed broken, painful, puffy, and bright purple.

I shall write as soon as possible, cranky as ever, and there’s a remarkable amount to be cranky about.




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