Obamacare A Huge Success Despite Easily Debunked Conservative Claims

The exchanges set up under the Affordable Care Act open tomorrow. While there were initially problems when the exchanges opened last year, these were quickly fixed, allowing millions to obtain health care coverage, including those who previously could not obtain coverage due to preexisting conditions or cost. A Gallup poll found that most people who obtained coverage through the exchanges last year were satisfied:

Over seven in 10 Americans who bought new health insurance policies through the government exchanges earlier this year rate the quality of their healthcare and their healthcare coverage as “excellent” or “good.” These positive evaluations are generally similar to the reviews that all insured Americans give to their health insurance.

These findings are consistent with previous polls showing how people benefited from Obamacare.

Insurance coverage has been made more affordable by the exchanges, with eighty-three percent of enrollees qualifying for subsidies last year. Those who qualified payed an average of $82 per month in premiums. Those obtaining Silver plans paid an average of $69 per month.

Three was some sticker shock on the part of many who did not realize that they qualify for subsidies along with those of us who do not qualify for subsidies. While we pay the full premiums, the coverage is far better than was available on the individual market in the past, including guarantees that we cannot lose our coverage if we get sick and caps on maximum annual out of pocket expenses. Some people, especially those who were not familiar with the individual insurance market were expecting lower premiums. Despite conservative claims that Obamacare is a right wing take over of health care, the insurance is sold through private companies and their rates have always been high, and frequently increased by double digit amounts annually.

Conservatives also complain about the deductibles, especially on the plans with lower premiums. These plans have higher deductibles and a lower premium, with Medical Savings Accounts available to help with these out of pocket expenses. Plans on the individual market have typically had higher deductibles than employer plans. The attacks from conservatives regarding this are also rather hypocritical as conservatives have long been advocating high deductible plans paired with MSA’s as a way to reduce costs. Now that they have what they advocated, they are suddenly complaining. I guess we shouldn’t be surprised as many other components of Obamacare have long been advocated by conservatives, including the individual mandate and selling insurance through exchanges.

While there may be higher deductibles, there are also total caps on out of pocket costs which we did not have before. The Affordable Care Act has eliminated the old maximums on coverage. Republicans never mention this, but these factors could result in lower out of pocket costs for many, along with eliminating the risk of bankruptcy for those with expensive diseases who outspend their coverage. All plans cover preventative services with no deductible. Some plans now being sold will provide some other forms of coverage before the deductible is met, including office calls and prescriptions.

While premiums in 2014 were consistent with previous premiums, instead of seeing double digit increases in 2015 most people are seeing comparable rates due to the increased number of insurance companies offering coverage and the larger risk pool as more people have coverage. Many people will even see lower insurance rates:

In preliminary but encouraging news for consumers and taxpayers, insurance filings show that average premiums will decline slightly next year in 16 major cities for a benchmark Obamacare plan.

Prices for a benchmark “silver” or mid-priced plan sold through the health law’s online marketplaces aren’t all moving in the same direction, however, a report from the Kaiser Family Foundation (KFF) shows. (Kaiser Health News is an editorially independent program of the foundation.) In Nashville, the premium will rise 8.7 percent, the largest increase in the study, while in Denver it will fall 15.6 percent, the largest decrease.

But overall the results, based on available filings, don’t show the double-digit percentage increases that some have anticipated for the second year of marketplace operation. On average, rates will drop 0.8 percent in the areas studied.

Opponents of the Affordable Care Act have spread a wide variety of lies about the plan. Although these lies have repeatedly been debunked, Republicans continue to repeat them.

The latest attack from dishonest opponents of the plan has been to repeat irrelevant quotes from Jonathan Gruber, an economist who worked on Mitt Romney’s plan and also made economic projections on the impact of the Affordable Care Act. He is not a part of the Obama administration, and is not the “architect” of the plan as conservatives claim. Nor did he have a role in the writing or the promotion of the legislation. His comments that the American people were stupid do not reflect the views of anyone other than himself. His claims of a lack of transparency are incorrect, with the law having been written in open hearings and with the various versions having been posted on line.  The two items he brought up, the penalties for not obtaining coverage, and the transfer of wealth from the healthy to the sick, were both openly discussed prior to the passage of the law. Besides, all insurance has always represented a transfer of wealth from those who purchase insurance and do not require the benefits to those who do require insurance benefits. Apparently many conservatives fail to understand how insurance works.

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Despite Solyndra, Energy Loan Program Now Making A Profit

Before Republicans became obsessed with Benghazi, and now putting far more significance on Jonathan Gruber’s comments on the Affordable Care Act than, as I explained earlier in the week,  there actually is, they loved to scream about Solyndra. Solyndra was granted loan guarantees under a program which was started under George Bush and expanded in Obama’s stimulus program. Never mind that the entire stimulus package was highly successful.  All they cared about was that Solyndra went under. The decision to invest in risky  energy companies which could advance clean energy in the United States is now paying off.  NPR’s Morning Edition reports that the energy loan program is now making a profit.

In 2011, solar panel company Solyndra defaulted on a $535 million loan guaranteed by the Department of Energy. The agency had a few other high-profile bankruptcies, too — electric car company Fisker and solar company Abound among them. But now that loan program has started turning a profit.

Overall, the agency has loaned $34.2 billion to a variety of businesses, under a program designed to speed up development of clean-energy technology. Companies have defaulted on $780 million of that — a loss rate of 2.28 percent. The agency also has collected $810 million in interest payments, putting the program $30 million in the black.

When Congress created the loan program under the Energy Policy Act of 2005, it was never designed to be a moneymaker. In fact, Congress imagined there would be losses and set aside $10 billion to cover them…

Conservatives who saw a scandal in the Solyndra loan guarantees appear not to understand how the economy works. Some companies are going to succeed and some are going to fail. The loan program did not stay away from risky investments, and this has sometimes paid off:

The Energy Department actively monitors all the companies in its portfolio for potential default risks, “and when there are warning flags, then the disbursements are suspended — possibly ended,” Moniz says.

But he says the Energy Department doesn’t want to go too far in the direction of only lending to safe investments. “We have to be careful that we don’t walk away from risk, because otherwise we’re not really going to advance the marketplace,” he says.

Moniz points to a small company called Beacon Power as an example. It got an Energy Department loan, went bankrupt and defaulted on about $14 million in debt. Today the company is back in business, providing a valuable service to electricity grids and repaying the rest of its loan.

The United States has now accepted new challenges in light of the major breakthrough on climate change reached this week with China:

The deal jointly announced in Beijing by President Obama and China’s president, Xi Jinping, to limit greenhouse gases well beyond their earlier pledges is both a major diplomatic breakthrough and — assuming both sides can carry out their promises — an enormously positive step in the uncertain battle against climate change.

It will be interesting to see if any of the companies which received loan guarantees through the Department of Energy are instrumental in enabling the United States to carry out these promises.

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Why The Republicans Won Despite Being Wrong On The Issues, Revisited

Paul Krugman discussed how the Republicans won in the midterm elections despite being wrong about pretty much everything. Kurt Eichenwald has more in Vanity Fair looking at many of the things conservatives were wrong about over  the past thirty years. Although the list is far from complete, I’d suggest checking out the full article for the specifics. Topics covered include:

  • Tax cuts pay for themselves
  • Deregulating the Thrift Industry Will Save It
  • Iraq I: The Tilt
  • Giving Iranian Moderates Weapons Will Help America
  • Raising Taxes Will Cause a Recession
  • Abolishing Some Bank Regulations Will Help the Economy
  • The U.S.–led Bombing of Yugoslavia Would Be a Disaster
  • Bin Laden Was a Front for Iraq
  • Iraq 2: W.M.D.s and a Short, Inexpensive War
  • Obamacare

Many people have given different ideas regarding the other part of the question as to how the Republicans won. Fivethirtyeight.com looked at one issue  from polling data in Iowa. They found that, “White voters in Iowa without a college degree have shifted away from the Democratic Party.”

Loss of white working class votes has been a problem for Democrats for several election cycles, and was most pronounced in the 2012 elections. It will be interesting to see if there is any reduction in this trend when Barack Obama is no longer on the ticket. This is certainly not exclusively an issue based upon a black president. The Republicans have depended upon the southern strategy since the 1960’s, using this in the south along with provoking racial fears to gain the votes of less educated white voters in the north.

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Navy SEAL Describes How Osama bin Laden Died As A Coward

Robert O’Neill, reportedly the Navy SEAL who shot Osama bin Laden, was interviewed by CNN and had some comments on how bin Laden died. Gawker summarizes:

In a previously unreleased audio interview aired last night on CNN, O’Neill told freelance journalist Alex Quade that he had used details of bin Laden’s death to bring closure to the families of 9/11 victims, saying:

“[O]ne thing I tell them is ‘All right, Osama bin Laden died like a pussy. That’s all I’m telling you. Just so you know. He died afraid. And he knew that we were there to kill him.'”

“You can quote me on this bullshit,” said O’Neill.

Bin Laden’s alleged killer also told Quade that SEAL Team Six was sent after the Al Qaeda leader “because they wanted him dead” and that “it doesn’t matter anymore if I am ‘The Shooter.'”

“I don’t give a fuck,” said O’Neill. “We got him. We brought him out and we lived.”

Mediaite also describes how he “used details of the terrorist mastermind’s death to provide comfort to 9/11 families.”

He also will be interviewed on Fox. Does that mean that Fox viewers actually believe that bin Laden was killed under Obama? There really are conservatives who deny this, seeing yet another conspiracy theory in the reports of his death. After all, as MisterConservative said, we never saw the body, and Benghazi!

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Why The Republicans Won Despite Being Wrong On All The Issues

Paul Krugman points out that the Republicans, despite winning the midterm elections on Tuesday, were wrong on everything:

First, there’s economic policy. According to conservative dogma, which denounces any regulation of the sacred pursuit of profit, the financial crisis of 2008 — brought on by runaway financial institutions — shouldn’t have been possible. But Republicans chose not to rethink their views even slightly. They invented an imaginary history in which the government was somehow responsible for the irresponsibility of private lenders, while fighting any and all policies that might limit the damage. In 2009, when an ailing economy desperately needed aid, John Boehner, soon to become the speaker of the House, declared: “It’s time for government to tighten their belts.”

So here we are, with years of experience to examine, and the lessons of that experience couldn’t be clearer. Predictions that deficit spending would lead to soaring interest rates, that easy money would lead to runaway inflation and debase the dollar, have been wrong again and again. Governments that did what Mr. Boehner urged, slashing spending in the face of depressed economies, have presided over Depression-level economic slumps. And the attempts of Republican governors to prove that cutting taxes on the wealthy is a magic growth elixir have failed with flying colors.

In short, the story of conservative economics these past six years and more has been one of intellectual debacle — made worse by the striking inability of many on the right to admit error under any circumstances.

Then there’s health reform, where Republicans were very clear about what was supposed to happen: minimal enrollments, more people losing insurance than gaining it, soaring costs. Reality, so far, has begged to differ, delivering above-predicted sign-ups, a sharp drop in the number of Americans without health insurance, premiums well below expectations, and a sharp slowdown in overall health spending.

And we shouldn’t forget the most important wrongness of all, on climate change. As late as 2008, some Republicans were willing to admit that the problem is real, and even advocate serious policies to limit emissions — Senator John McCain proposed a cap-and-trade system similar to Democratic proposals. But these days the party is dominated by climate denialists, and to some extent by conspiracy theorists who insist that the whole issue is a hoax concocted by a cabal of left-wing scientists. Now these people will be in a position to block action for years to come, quite possibly pushing us past the point of no return.

He then went on to look at why they won, expressing views similar to what I had written about the election earlier in the week:

Part of the answer is that leading Republicans managed to mask their true positions. Perhaps most notably, Senator Mitch McConnell, the incoming majority leader, managed to convey the completely false impression that Kentucky could retain its impressive gains in health coverage even if Obamacare were repealed.

But the biggest secret of the Republican triumph surely lies in the discovery that obstructionism bordering on sabotage is a winning political strategy. From Day 1 of the Obama administration, Mr. McConnell and his colleagues have done everything they could to undermine effective policy, in particular blocking every effort to do the obvious thing — boost infrastructure spending — in a time of low interest rates and high unemployment.

This was, it turned out, bad for America but good for Republicans. Most voters don’t know much about policy details, nor do they understand the legislative process. So all they saw was that the man in the White House wasn’t delivering prosperity — and they punished his party.

This was their strategy, literally beginning on Day 1, if not earlier. A Frontline documentary described what the Republicans planned:

On the night of Barack Obama’s inauguration, a group of top GOP luminaries quietly gathered in a Washington steakhouse to lick their wounds and ultimately create the outline of a plan for how to deal with the incoming administration.

“The room was filled. It was a who’s who of ranking members who had at one point been committee chairmen, or in the majority, who now wondered out loud whether they were in the permanent minority,” Frank Luntz, who organized the event, told FRONTLINE.

Among them were Senate power brokers Jim DeMint, Jon Kyl and Tom Coburn, and conservative congressmen Eric Cantor, Kevin McCarthy and Paul Ryan.

After three hours of strategizing, they decided they needed to fight Obama on everything. The new president had no idea what the Republicans were planning.

Of course we cannot just criticize the Republicans. The Democrats were at fault when six years later they still had no effective response to this Republican strategy, and were afraid to stand up for their accomplishments. Being right doesn’t do any good politically if they were afraid to explain this to the voters. Democratic candidates ran away from Obama and his policies and then were shocked when the Obama voters didn’t come out to vote for them. As Peter Beinhart wrote, the Democrats cannot keep playing not to lose:

This fall, Democrats ran like they were afraid of losing. Consider the issues that most Democrats think really matter: Climate change, which a United Nations report just warned will have “severe, pervasive and irreversible impacts” across the globe. The expansion of Medicaid, so millions of poor families have health coverage. Our immoral and incoherent immigration system. Our epidemic of gun violence, which produces a mini-Sandy Hook every few weeks. The rigging of America’s political and economic system by the 1 percent.

For the most part, Democratic candidates shied away from these issues because they were too controversial. Instead they stuck to topics that were safe, familiar, and broadly popular: the minimum wage, outsourcing, and the “war on women.” The result, for the most part, was homogenized, inauthentic, forgettable campaigns. Think about the Democrats who ran in contested seats Tuesday night: Grimes, Nunn, Hagan, Pryor, Hagan, Shaheen, Landrieu, Braley, Udall, Begich, Warner. During the entire campaign, did a single one of them have what Joe Klein once called a “Turnip Day moment”—a bold, spontaneous outbreak of genuine conviction? Did a single one unfetter himself or herself from the consultants and take a political risk to support something he or she passionately believed was right?

…We saw the consequences on Tuesday. According to exit polls, voters under 30 constituted only 13 percent of the electorate, down from 19 percent in 2012. In Florida, the Latino share of the electorate dropped from 17 to 13 percent. In North Carolina, the African-American share dropped from 23 to 21 percent.

By positioning himself as a moderate, he may have missed a chance to gin up more enthusiasm within the state’s expanding Democratic base, earning fewer votes in such deep-blue communities as Arlington County and Alexandria than left-of-Warner Gov. Terry McAuliffe (D) did a year ago.

All of it has left some to wonder whether Warner would have won bigger if he had eschewed the middle and embraced the left, and whether the winning path for moderates that Warner forged during his own bid for governor 13 years ago is becoming extinct.

“I think if you look at the returns around the country . . . it raises questions about just how successful the bipartisanship brand really is,” Rep. Gerald E. Connolly (D-Va.) said Tuesday after easily winning a fourth term in Northern Virginia’s 11th Congressional District by talking about women’s rights, immigration reform and climate change — and less about working with Republicans.

Here’s a similar take on what the Democrats did wrong: “They were so focused on independents that they forgot they had a base. They left their base behind. They became Republican-lite.”

That opinion came from Rob Collins, the executive director of the National Republican Senatorial Committee. He also said Democrats “sidelined their best messenger” by running away from Obama, and for not talking about the economy. Republicans might be wrong virtually all the time lately when it comes to governing, but quite often they are smarter than Democrats with regards to politics.

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Republicans Beat Something With Nothing Other Than Negativity And Fear

Ronald Reagan couldn’t save the Senate for the Republicans in his 6th year. While the closeness of the polls left hope until the end, realistically the Democrats were not in a situation to defy history. There were two tends which the Democrats could not overcome. When people are unhappy, they look at the president regardless of who is actually to blame. Running a campaign based upon negativity was a winning formula for Republicans. Democrats were further hampered by the older and whiter electorate in midterm elections as once again large portions of the Democratic base stayed home for a midterm.

Republicans won by avoiding discussion of what they would do in power, beating something (Obama) with nothing. Americans who vote for Republicans to retake control of the Senate out of concern about current problems are as delusional as Russians who want the return of Stalinsim. It makes no sense to trust the party which created the economic downturn with fixing it, and Americans certainly do not want the Republican social or militarist agenda. The party which opposes most government action (other than imposing the agenda of the religious right, foolish military action, or rigging the system to transfer wealth to the ultra-wealthy) is hardly likely to propose real solutions to problems.  Polling on issues generally shows a majority favoring Democratic views but that does not help in elections where Republicans concentrate on distorting the views of their opponents and  hiding their own views.

That said, I am disappointed (as usual) in the Democrats as a political party. Yes, all the fundamentals were against them. So they took the cowardly way out, running away from not only Obama but from principles. If they ran a campaign based upon their accomplishments and the problems with GOP principles they very well still might have lost in this atmosphere, but at least their campaign would have meant something. Plus, considering how close the polls were, just maybe they could have won some more seats.

Of course that isn’t something that can be done in the last few months of a campaign. It requires a change in attitude and behavior of the party every year, acting as if it was a perpetual battle of ideas–as Republicans do even though they run on bad ideas. When Democrats run from their own record and fail to speak out on the issues, they leave themselves wide open to being defined by their opponents.

The Republicans were successful in hiding their most extreme views. They did receive some help from a friendly media in this regard as many of the most extreme statements from Republicans such as  Joni Ernst received too little attention. When Mitch McConnell tried to make his desire to repeal Obamacare more popular by claiming the people of Kentucky would still have their popular exchange, the media concentrated far more on the less important refusal of Alison Lundergan Grimes to say whether she voted for Obama. When liberals spoke out on this, the media did begin to pay more attention to McConnell’s gaffe, showing there is benefit to serious discussion of the issues by liberals. If only Democratic candidates had the courage to do this too.

External events helped the Republicans. Widespread opposition to Congressional Republicans over the threat of a government shutdown of October 2013 was forgotten after the initial failed roll out of the exchanges, even if this was quickly fixed. Republicans gained further by promoting exaggerated fears of ISIS and Ebola.

The Republicans avoided saying what they would do while running, but now will be under closer scrutiny. Republicans decided upon a strategy of opposing everything Obama does, including if he promoted policies previously favored by Republicans, from before he took office. Now that they control Congress, this might no longer be their best strategy. Many Republicans will mistakenly see this election result as a mandate and try to move even further to the right. Some must be intelligent enough to realize that Republican victories with the midterm electorate will not translate into victories with the younger and minority voters who turn out in greater numbers for general elections. While it is hard to see the two parties work together on many of the big issues such as climate change, there might be some pragmatic legislation which both McConnell and Obama could agree on, considering Obama’s long-standing willingness to compromise with Republicans.

McConnell is attempting to portray a more moderate image, but even if this is his personal desire he still has to deal with the far right wing of his own party. He might even find that he cannot pass legislation without Democratic cross over support. It remains to be seen whether McConnell will pass legislation which doesn’t beg for a Democratic filibuster or presidential veto, especially if Tea Party Republicans push through amendments to legislation to attempt to repeal Obamacare or restrict access to contraception. The Tea Party wing is least likely to realize that this election does not signify agreement by American voters with their goals. An example of this was seen with the failure of Personhood measures even in red states. Republicans won midterm elections but their policies remain opposed by a majority of Americans.

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Quote of the Day: David Letterman On Obama’s Popularity

“This is what happens when we have the midterm elections. The Republicans, of course, have turned against Obama, and the Democrats have also turned against Obama. That’s a lonely, lonely gig being president, ladies and gentlemen.

“Take a look at this: gas under $3 a gallon — under $3 a gallon. Unemployment under 6%, whoever thought? Stock market breaking records every day. No wonder the guy is so unpopular.” –David Letterman

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Kaci Hickox Is A Hero–Now On Two Counts

Kaci Hickox is a hero. First for volunteering to help treat Ebola patients, as eradicating Ebola in West Africa is the only way to handle this disease. She became a hero again for standing up to unjust restrictions upon her civil liberties upon returning home and supporting the concept of making political decisions based upon science and reason as opposed to giving in to public hysteria.

It was Hickox’s protests which forced Governors Christie and Cuomo to back away from guidelines policies which were both unnecessary and counterproductive. Some state governments are still going beyond the extremely cautious CDC guidelines with policies such as home quarantine of individuals who show no sign of the disease for twenty-one days. We know that this is unnecessary based both upon our knowledge of how the Ebola virus is transmitted and based upon our experience to date.  Ebola is not contagious early in the disease and is not transmitted by casual contact. While highly contagious when people are having symptoms such as projectile vomiting and uncontrolled diarrhea, those who do not have symptoms are not contagious. People with Ebola do not yet pose a danger of spreading the disease when they initially reach the CDC’s threshold of a fever of 101.4 degrees, and they certainly are not contagious before reaching this point.

We have seen one patient in Texas be released in error by an Emergency Room and return to the community. We have seen a nurse later revealed to be infected with Ebola fly with a low grade fever. We have had a doctor traveling around a city as densely populated as New York City just prior to meeting criteria for isolation. Not a single person has contracted Ebola due to contact with these individuals. That is the nature of the disease.

Kaci Hickox, well aware of the science, has stated she plans to fight the involuntary home quarantine being imposed:

“I will go to court to attain my freedom,” Hickox told “Good Morning America” today via Skype from her hometown of Fort Kent, Maine. “I have been completely asymptomatic since I’ve been here. I feel absolutely great.”

One of her attorney’s explained her legal position:

New York civil rights lawyer Norman Siegel, said she would contest any potential court order requiring her quarantine at home.

“The conditions that the state of Maine is now requiring Kaci to comply with are unconstitutional and illegal and there is no justification for the state of Maine to infringe on her liberty,” he said.

Hickox will abide by daily monitoring, as recommended the by updated guidelines released Monday by the federal Centers for Disease Control and Prevention, Hyman said. She has been in regular contact with state health officials, Siegel said.

U.S. CDC Director Tom Frieden called for isolation of people at the highest risk for Ebola infection but said most medical workers returning from the three African nations at the center of the epidemic — Sierra Leone, Liberia and Guinea — would require daily monitoring without isolation.

The new guidelines recommend considering isolation only for individuals exposed to Ebola who show symptoms. Those with no signs of illness should be monitored for 21 days after the last potential exposure, with symptom-free individuals at the highest risk subject to “restricted movement within the community” and no travel on public transportation, according to the guidelines…

“She understands the nature of the disease, she treated it,” Hyman said. “She understands the nature of the risk.”

The American Civil Liberties Union has posted an article on the over-reaction to Ebola coming from some politicians, in contrast to the more rational guidelines proposed by the Center for Disease Control and the Obama administration:

One over-reaction to the disease that has emerged is a proposal for a blanket travel ban from the affected countries in West Africa. Public health experts say that such bans are not necessary, would not be effective, and would be a poor use of resources. Worse still, experts say they would most likely make matters worse by further isolating the countries where the outbreak is taking place, worsening the situation in those countries and therefore the threat to the United States. Travel bans “hinder relief and response efforts risking further international spread,” as the World Health Organization warned. Experts say such bans would also inevitably drive travelers underground, making it difficult to retrace the path of a disease when a case does appear.

Proposals to close the border to all travelers from affected nations are not a scientifically and medically legitimate exercise of government power and therefore would be arbitrary and discriminatory whether applied to citizens or non-citizens.

Now, of course, we are also seeing the questionable use of quarantine powers in some states. Medical experts have opposed such steps given that Ebola is not transmissible until after a fever begins and is not a highly transmissible disease generally, and given that individuals have strong incentives to carefully monitor themselves. Doctors Without Borders, for example, has condemned these quarantines as a threat to its battle against the disease in Africa. It cites the effect the quarantines will have in deterring doctors and nurses from taking the already remarkably brave step of entering the fight against the disease—and in stigmatizing them when they do. In short such quarantines threaten to weaken the most effective weapon we have in stopping the disease at its source. (It’s also shameful to treat returning health care workers, who have put their own lives at risk to help others, as anything less than heroes.)

Where individuals cooperate with the authorities in allowing close monitoring of their health and other reasonable precautions, the imposition of quarantines on those without symptoms appears to be driven by politics rather than science, and therefore raises serious civil liberties concerns.

While some political leaders have acted out of fear, Obama Administration officials deserve praise for largely sticking to science and not caving in to some of the fear mongering that is swirling around them. The White House has prioritized medicine over politics. It has resisted calls for travel bans, tried to persuade the governors of New Jersey and New York to reconsider their quarantines, and has largely followed the advice of public health experts in the recommendations that they have made. The Administration has also taken helpful steps such as expediting emergency FDA authorization for the use of new machines for rapid detection of the Ebola virus—which could allow detection of the disease before symptoms appear.

In fact, the Obama Administration has a history of good policy on communicable diseases. As we described in a 2009 white paper on that year’s H1N1 flu scare, the Administration acted calmly and appropriately in response to that epidemic, and overall, President Obama has turned away from his predecessor’s military/law enforcement approach to fighting disease, which we criticized in detail in our 2008 report on pandemic preparedness.

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Arguing Against Counterproductive Hysteria Over Ebola

While the outbreak of Ebola began in West Africa about ten months ago, we have now had only nine patients with Ebola in this country. Most were brought in for treatment after contracting it elsewhere. One is currently undergoing treatment. One died. All the rest have recovered. There have been zero cases of transmission in the general population but two nurses have become infected while treating the patient who died.

There is a remarkable amount of hysteria in this country for a disease which has had so little actual impact. Some of this is natural fear, seeing how less developed nations have been affected, and some is due to hysteria being generated by Republican politicians for political gain. Unfortunately the proposals made by Republicans would be counterproductive, making it harder to treat Ebola at its source. Eliminating Ebola in West Africa is the only way to eliminate the problem and prevent further spread.

This is also turning out to be a learning experience, at least for those who respect science and are willing to consider the facts. In terms of treatment, hospitals around the country have learned from the mistakes made in Texas, and these are not likley to be repeated.

In terms of the political reaction, there are many sources which are trying to counter the over-reaction with reason. As we have seen on so many issues, some will pay attention to the facts, and others won’t.

The New England Journal of Medicine has released their editorial for next week’s issue, which includes a repetition of how Ebola is transmitted and the dangers of over-reaction:

The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We understand their motivation for this policy — to protect the citizens of their states from contracting this often-fatal illness. This approach, however, is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal. The governors’ action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial.

Health care professionals treating patients with this illness have learned that transmission arises from contact with bodily fluids of a person who is symptomatic — that is, has a fever, vomiting, diarrhea, and malaise. We have very strong reason to believe that transmission occurs when the viral load in bodily fluids is high, on the order of millions of virions per microliter. This recognition has led to the dictum that an asymptomatic person is not contagious; field experience in West Africa has shown that conclusion to be valid. Therefore, an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious. Furthermore, we now know that fever precedes the contagious stage, allowing workers who are unknowingly infected to identify themselves before they become a threat to their community. This understanding is based on more than clinical observation: the sensitive blood polymerase-chain-reaction (PCR) test for Ebola is often negative on the day when fever or other symptoms begin and only becomes reliably positive 2 to 3 days after symptom onset. This point is supported by the fact that of the nurses caring for Thomas Eric Duncan, the man who died from Ebola virus disease in Texas in October, only those who cared for him at the end of his life, when the number of virions he was shedding was likely to be very high, became infected. Notably, Duncan’s family members who were living in the same household for days as he was at the start of his illness did not become infected…

The American College of Physicians has made the same argument:

The American College of Physicians is strongly concerned about the approach being taken by some state health departments to impose strict, mandatory quarantines for all physicians, nurses, and other health professionals returning from West Africa, regardless of whether they are showing symptoms of Ebola virus infection. ACP agrees that physicians and other health professionals must take the necessary precautions to ensure the safety of others and prevent the spread of infection. However, the College maintains that mandatory quarantines for asymptomatic physicians, nurses and other clinicians, who have been involved in the treatment of Ebola patients, whether in the United States or abroad, are not supported by accepted evidence on the most effective means to control spread of this infectious disease. Instead, such mandatory quarantines may do more harm than good by creating additional barriers to effective treatment of patients with Ebola and impede global efforts to contain and ultimately prevent further spread of the disease…

Some newspapers, such as The New York Times, have repeated these arguments for a larger audience:

The Dangers of Quarantines

Ebola Policies Made in Panic Cause More Damage

… two ambitious governors — Chris Christie of New Jersey and Andrew Cuomo of New York — fed panic by imposing a new policy of mandatory quarantines for all health care workers returning from the Ebola-stricken countries of West Africa through John F. Kennedy and Newark Liberty international airports. There is absolutely no public health justification for mandatory quarantines…

Lost in this grandstanding was one essential point. The danger to the public in New York in the case of Dr. Craig Spencer, who had worked in Guinea for Doctors Without Borders, was close to nonexistent. Health experts are virtually unanimous in declaring that people infected with the virus do not become contagious until after they develop a fever or other symptoms, such as diarrhea, vomiting, or severe headaches, at which time they need to be hospitalized and taken out of circulation.

Health care workers like Dr. Spencer know that it is in their interest to ensure that — if symptoms do arise — they get care quickly to improve their chances of survival and to reduce the risk of infecting their friends and families. Dr. Spencer reported his temperature promptly when it was a low-grade fever of a 100.3 degrees and was rushed to Bellevue Hospital Center for isolation and treatment while his fiancée and two friends were put into voluntary isolation…

The problem with a mandatory quarantine, even if done at home, is that it can discourage heath care workers from volunteering to fight the virus at its source in West Africa. Doctors Without Borders, the nongovernmental organization that has led the battle there, typically sends its workers on arduous four- to six-week assignments. The risk of being quarantined for another 21 days upon return has already prompted some people to reduce their length of time in the field and may discourage others from volunteering in the first place…

Fortunately the response has been more rational at the federal than state level, including the statement from Barack Obama earlier today, pointing out that “If we don’t have robust international response in West Africa, then we are actually endangering ourselves here back home.”

President Obama pledged support for health care and aid workers in West Africa Tuesday, saying new rules for monitoring them for Ebola once they return to the United States would be “sensible and based on science.”

Obama gave brief remarks on the federal response to the disease after speaking with U.S. aid workers on the front lines of battling Ebola in West Africa.

“They’re doing God’s work over there, and they’re doing that to keep us safe, and I want to make sure that every policy we put in place is supportive of their efforts. Because if they are successful, then we’re not going to have to worry about Ebola here at home.”

Besides being counterproductive, there are civil liberties concerns when the government forcibly quarantines people who do not have the disease or who are not contagious.

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Not Hearing Anything Lately From Republicans About Their Frivolous Suit Against Obama

Remember a few months ago when John Bohner was talking about filing a ridiculous law suit against Barack Obama? Politico points out that, despite the Republican hype, we haven’t heard anything about this suit recently:

House Speaker John Boehner came out swinging hard last June when he announced that his chamber would take President Barack Obama to court. The suit, charging that the president grossly exceeded his constitutional authority by failing to implement portions of the Obamacare law, was billed as an election-season rallying point for aggrieved Republicans. But days before the midterms the House’s legal guns seem to have fallen silent.

Lawyers close to the process said they originally expected the legal challenge to be filed in September but now they don’t expect any action before the elections.

Some attribute the delay to electoral politics — suggesting that Republicans were worried it could rile up the Democratic base — though the GOP is mum on why the suit has yet to be filed.

Whatever the reason, the delay means the core of the suit could effectively be moot before the Obama administration even has to respond to it in court. The case was expected to center on an employer mandate provision that Obama twice delayed but is now set to kick in for many employers on Jan. 1.

Bloomberg says the suit might be more trouble than it is worth for the Republicans:

Part of the problem may lie in the troubled history of the suit. In mid-September, the GOP’s law firm dropped the case over “political pressure,” according to a Republican aide speaking to Politico. That same week, the Seventh Circuit Court of Appeals tossed out a lawsuit similar to the House’s from the Association of American Physicians and Surgeons.

Politically, the lawsuit presents catch-22s for the GOP. First, the party has to choose between upsetting conservatives (some of whom support impeachment) by not suing the president or bewildering the rest of the country by suing the president.

A July CNN/ORC poll found that 65 percent of Americans don’t think the president should be impeached, 57 percent don’t support the lawsuit, and less than half of respondents thought Obama has gone too far with his executive orders. Fifty-six percent of conservatives were in favor of the impeachment, compared to 26 percent of moderates.

The lawsuit was a compromise, but appeasement didn’t really work. The pro-impeachment conservative wing of the party has been given voice by Sarah Palin, who told Breitbart News that “you don’t bring a lawsuit to a gunfight.”

Second, if Boehner had gone through with suing the president before the midterm elections, it might have help Democrats fundraise and motivate the liberal base even more than it already had. The Democratic Congressional Campaign Committee made $7.6 million in the month after the suit was announced, including $2.1 million in one weekend off emails warning of impeachment.

Plus Republicans might be embarrassed if small businessmen realize that the Republican Party is pursuing a lawsuit which seeks to punish Obama for trying to make conversion to the Affordable Care Act easier for small business, as many small business owners had requested. This hardly sounds like where the Republicans should draw the line in the sand against what they claim is tyranny from the Obama administration. Of course they had to settle for this suit as they couldn’t find anything of substance with which to pursue this absurd claim.

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