Emergency rooms push Medicaid patients out more often than privately-insured people

By Nicole Wetsman

Before 1986, emergency rooms in the United States routinely turned patients away at the door if they didn’t have insurance. In fact, it was legal to do so. The Emergency Medical Treatment and Active Labor Act (EMTALA), passed that year, looked to stop that practice: The law mandated that hospitals screen and stabilize any patient, regardless of their ability to pay.

While the law has helped cut down on overt refusal of care, gaps in emergency room access persist, according to research published this week in the Journal of the American Medical Association. Uninsured patients or those on Medicaid who come to the emergency department with pulmonary conditions like pneumonia or asthma are more likely to be transferred to another hospital than patients on private insurance, the study found. They are also more likely to be discharged directly from the emergency department than patients with private insurance.

[ ... ]

The new study also found that patients without insurance or with Medicaid had nearly half the rate of admission after an emergency department evaluation than patients with private insurance. “That was definitely surprising,” Venkatesh says. Prior research has shown that uninsured patients are more likely to be discharged from the emergency department—uninsured patients with brain injuries or other types of trauma, for example, were less likely to be admitted. The pulmonary conditions examined in this study, though, have standard assessments that guide decision making around hospital admission, which the study authors note makes this particular gap stand out.

[ ... ]

Donald Trump just made it easier for Senate Republicans to dump him

[ ... ]

When it comes to the GOP we’re talking about a bunch of corrupt wishy-washy cowards, of course. But they’ve spent the past week voting against Trump in increasing numbers, because they’re getting the sense that his criminal scandals are going to take him down, and they don’t want to go down with him.

[ ... ]

It was four last week, and now it’s twelve, so it could be even higher by the time this comes back for a veto override vote. If and when it does reach twenty, it’s time for Trump to panic. If twenty Senate Republicans are willing to vote to kill Trump’s wall fantasy, then they’re probably willing to vote to remove him from office if they conclude that it’s what’s selfishly best for their own Senate reelection chances.

In other words, with these weakling Senate Republicans now holding Donald Trump’s fate in their quivering hands, it would be really smart of Trump to try to make nice with them, and to throw them a bone. After all, they’re more likely to keep him around longer if they think they can get a bit more usefulness out of him.

So what did Donald Trump do in furtherance of this goal? He launched a vicious Twitter attack today on the late John McCain. Someone mentioned McCain on Fox News, and Trump was watching, and he just couldn’t help himself. Trump has attacked McCain before and gotten away with it, but that was back when he still had leverage over the Republican Party. These days it’s the opposite. Trump needs the GOP Senate’s help to survive, and now he’s attacking the patron saint of the GOP Senate.

[ ... ]

Republicans seem to mock gun violence victims by wearing pearls as they testify

A group of male Republican lawmakers in New Hampshire have come under criticism for a stunt that gun control advocates say was demeaning to victims of gun violence: donning pearl necklaces to apparently mock those testifying in front of them.
NRA: the 'growing storm' challenging group's legendary clout and power
Read more

In a hearing in the New Hampshire house of representatives on Tuesday for a bill that would make it easier to restrict access to guns for people who pose an immediate threat to themselves or others, a number of Republican male legislators turned up wearing pearls.

Advocates from the group Moms Demand Action for Gun Sense in America said the message being conveyed was clear: opponents of gun violence were “clutching their pearls”.

“It really is shameful to behave that way when your constituents are being brave enough to share their stories,” Shannon Watts, founder of the group told the Washington Post.

It's not just AOC and Rashida Tlaib ...

https://www.dailymail.co.uk/news/article-6762869/Anti-Muslim-poster-comparing-Rep-Omar-9-11-West-Virginia-state-capitol-draws-outrage.html

Shocking poster linking congresswoman Ilhan Omar to 9/11 sparks outrage in the West Virginia statehouse on the same day the sergeant at arms resigns for saying 'all Muslims are terrorists'

A poster displayed on Friday in the rotunda of the West Virginia capitol featured an image of the 9/11 attack on the Twin Towers juxtaposed with Rep. Omar

The captions read '"Never forget" - you said' over the burning buildings and 'I am the proof you have forgotten' over the image of the Minnesota representative

Rep. Omar responded that it was 'no wonder' she was on a 'hitlist of a domestic terrorist' with the West Virginia GOP displaying such anti-Muslim rhetoric

Democrats in West Virginia became heated after the display went up and were further infuriated by a sergeant at arms who allegedly made bigoted remarks



https://twitter.com/wvdemocrats/status/1101558033656762368

Also reported in WaPo:
Poster linking Rep. Ilhan Omar to 9/11 sparks outrage, injuries in W.Va. state Capitol

https://twitter.com/IlhanMN/status/1101614278585536512

https://twitter.com/pushkinforhouse/status/1101532563020148737

Congresswoman Lucy McBath Delivers Weekly Democratic Address

February 22, 2019

Washington, D.C. – Congresswoman Lucy McBath of Georgia delivered the Weekly Democratic Address. In this week’s address, the Congresswoman shared her family’s tragic story of gun violence and explained the work she and House Democrats are doing to pass commonsense gun safety legislation, beginning next week with H.R. 8, the Bipartisan Background Checks Act. Video and audio of the Weekly Democratic Address can be downloaded here.

Below is a full transcript of the address:

“Hi, I’m Congresswoman Lucy McBath and I’m proud to represent Georgia’s 6th Congressional District.

“There have never been more women or people of color in Congress and I’m honored to be a part of this historic freshman class. I proudly serve on both the Judiciary and Education [and] Labor Committees.

“This coming week, H.R.8 the Bipartisan Background Checks Act of 2019 will come to Floor of the House for a vote. This historic, bipartisan gun violence prevention legislation was introduced by Mike Thompson and was co-sponsored by myself and many of my colleagues. The bill will ensure background checks for all gun sales, including unlicensed gun dealers.

“As many of you may know, gun violence is an issue that is deeply personal for me. In 2012, my son Jordan Davis was shot and killed by a man who opened fire on a car of unarmed teenagers at a gas station in Jacksonville, Florida. My son Jordan was 17 years old. Jordan would have turned 24 this past weekend.

“After my son’s death, I dedicated my life to advocating for commonsense gun safety solutions. But, it was the shooting at Marjory Stoneman Douglas High School in Parkland, Florida last year that finally motivated me to run for Congress.

“The pain of losing a child to gun violence never ends. It is that pain which drives my work to prevent gun violence.

“These stories are vitally important as we work to pass commonsense gun safety legislation to keep families like ours from experiencing the horror and the heartbreak brought on by gun violence.

“The overwhelming, bipartisan support for universal background checks symbolizes the power of advocacy and the incredible power of the survivors, family members and students who have shared their stories as they advocate for commonsense gun safety solutions and demand that we act to address gun violence.

“House Democrats are taking action to make sure our communities and our nation are safer.

“We need commonsense legislation to prevent gun violence and ensure that mothers and fathers have one less reason to worry. This gives students one less thing to fear when they walk into school. Most importantly, it makes our communities and our nation a safer place to live.

“Thank you.”

Judge doesn’t throw Roger Stone in jail, instead hands him an even worse punishment

Judge Amy Berman Jackson decided not to revoke Roger Stone’s bail today and send him to jail. But she instead handed Stone what, for him, is an even worse punishment: she’s made him irrelevant for the rest of his life.

[ ... ]

This means that Roger Stone, ever the publicity hound, is now irrelevant. No more provocative Instagram posts. No more interviews. No more Infowars appearances. He’s finished. He can still go home and go out to dinner and such, but we all know his nature, and he’ll quickly incriminate himself in a manner which will ensure his conviction. He’ll also quickly violate this full gag order, meaning he’ll go to jail. This is Roger Stone’s worst nightmare.

[ I missed Stacey Abrams' speech. Found the transcript of the planned speech on the Speaker's web site ]

Former Georgia State House Minority Leader Stacey Abrams’ Democratic Response To President Trump’s State Of The Union


February 6, 2019

As Prepared for Delivery

Good evening, my fellow Americans. I’m Stacey Abrams, and I am honored to join the conversation about the state of our union. Growing up, my family went back and forth between lower middle class and working poor.

Yet, even when they came home weary and bone-tired, my parents found a way to show us all who we could be. My librarian mother taught us to love learning. My father, a shipyard worker, put in overtime and extra shifts; and they made sure we volunteered to help others. Later, they both became United Methodist ministers, an expression of the faith that guides us.

These were our family values – faith, service, education and responsibility.

Now, we only had one car, so sometimes my dad had to hitchhike and walk long stretches during the 30 mile trip home from the shipyards. One rainy night, Mom got worried. We piled in the car and went out looking for him – and eventually found Dad making his way along the road, soaked and shivering in his shirtsleeves. When he got in the car, Mom asked if he’d left his coat at work. He explained he’d given it to a homeless man he’d met on the highway. When we asked why he’d given away his only jacket, Dad turned to us and said, “I knew when I left that man, he’d still be alone. But I could give him my coat, because I knew you were coming for me.”

Our power and strength as Americans lives in our hard work and our belief in more. My family understood firsthand that while success is not guaranteed, we live in a nation where opportunity is possible. But we do not succeed alone – in these United States, when times are tough, we can persevere because our friends and neighbors will come for us. Our first responders will come for us.

[ ... more at link above ]

Don't know if this is the right forum for this.

Just got home from the hospital last night. Thought I had gallbladder troubles, next thing I know the clinic calls for an ambulance, I'm taken to a nearby hospital, people swarm all over me and they're telling me I had / am having a major heart attack. Stripped on the table, thin blanket, wheeled into 'cath lab' or 'cardiac lab' and a doctor runs something partway up my right arm, stops, then runs something up from the groin area while I'm shivering and equipment and people surround me at the edge of my vision. Got a stent for an artery that had 100% blockage.

I was told it didn't take very long at all, but it felt like a long time while I was shivering. Spent Sat., Sun., and most of Mon. laying around tethered by cables to a monitor thingy that didn't like me. It had an evil streak -- it would let me start to doze and then beep about one of the leads losing a signal. Found out on the last afternoon that it was the lead that measured respiration. It had pulled loose sometime Sunday and I had just stuck it back on one of the stick-on pegs that were scattered all over my torso. It was trying to read my respiration from a peg on my hip.

The folks at the hospital kept telling me to take it easy for a while, no matter how I felt, to avoid popping open either of the arteries the doc ran his wire (or whatever) through, so I'll post this and go fall over for a while. Have to take some stupid medicine twice a day for forever now. Still can't wrap my head around the fact I had a heart attack.

Might be a while before getting back to this.

*****

EDIT TO ADD:

Wow, folks! I am overwhelmed by your response! Thank you, thank you, thank you.

I don't get emotional, usually, but I'm typing through tears right now. Never expected such a response. Thank you, every one! Will try to answer individually as I can sit and type more.

I posted just in case someone else out there has symptoms that do not match television and movies, you know, the scene where the old person clutches the chest, grimaces and falls over. Nothing like that happened to me.

Shortly after breakfast Friday morning, I felt queasy around the abdomen. This was followed by a pinching sensation under each arm at the bundle of muscle at the front of each armpit, extending a little into the pectoral muscles. Think of how your arm feels if you hang it over a car window that's not quite all the way down. That came and went over several hours. Late Friday afternoon, my son tried to convince me to go to a clinic, urgent care facility or hospital E.R. I'm stubborn.

By late Friday night, I was miserable, but still convinced it was gallbladder problems. It was the most miserable night I've ever had. The queasiness (never so much as I would call nausea) stayed about the same, the pain in the front of the armpits came and went, then there was a feeling sort of like indigestion that appeared. At one point, my sternum was sensitive from top to bottom. I squirmed and moaned and tried various positions to get some relief, and started taking aspirin -- 81mg tablets at the rate of 1 per hour. That didn't do much so I doubled it to 2 per hour. This allowed me to cat-nap a few times through the night, for 15 to 30 minutes at a time. Each dosage of the little aspirins was taken with a glass of water, which meant a lot of trips to the bathroom.

Both dogs stayed close by the couch I was writhing on. At one point I tried lying face down on my bed to get some relief. When I got up, the little dog (65 lb) was staring at me from his bed across the hall. The big one (250 lb) was at the other end of the hall, aimed my way.

Here's a gross detail that may or may not be significant. I had to defecate 4 times Friday, the last time felt like fire. I've been as regular and often as sunrise for as many years as I can remember.

Saturday morning took forever to arrive. I called my son as soon as I thought he might be awake, to ask if that urgent care place would be open yet. I was convinced by this time that my gallbladder was dead from a stone cutting off circulation. When my son started presenting me with choices of facilities, I just asked him, "Will you take over?" He did, and hauled me to a reputable clinic about 30 miles away. Because of symptoms and family history, we were both still convinced it was a bad gallbladder.

After waiting about half an hour, I was called back. A lady took all my info and I sat waiting for a doctor. An old cotton-top fellow about my age or a little more came in and asked more questions, some of them the same as the lady had asked, so I asked him if he'd talked to her. He said, "Yes, but there are things here that worry me." He then ordered an EKG. Lady came in and stuck on those cold adhesive-backed electrodes and ran the wire leads to them. She tore off the printed paper, went out of the room and came back with the doctor on her heels. As she unhooked me, he said, "We've called an ambulance. You're having a heart attack."

They pretty much ignored any argument I tried to make from that point. They did ask my son which hospital he preferred. He asked the lady with the EKG and followed her recommendation.

Everybody tried to make a big deal out of how many of those 81mg tablets I took -- 25 in a little over 12 hours -- but I was within the maximum recommended dosage for the time period.

At 11:31 am, the ambulance headed out from the clinic. At 11:44, they were checking for blockages at the hospital. At about 1 pm, they wheeled me to my room.

( Right arm and hand aching some. Going to stop a while. Thanks again, folks, for sympathetic ears and support! )

*****
EDIT 2: I can't answer 'em all! Thanks again for the encouragement!

I have been smoking for 50 years. Quitting is NOT easy. All the time I was tied to that monitoring equipment, 15 cigarettes and my lighter were in a pocket in my jeans just 10 feet from my bed, in a plastic "patient belongings" bag. My typical intake of coffee per day is around a gallon (not an exaggeration), with 25 to 35 home-rolled cigarettes. Before breakfast, I would usually smoke 5 cigarettes and drink 4 cups of coffee. That would also finish off each day before bed. Each meal would be followed by 2 to 4 cigarettes and 4 cups of coffee. In between it would drop to 1 or 2 cigs and 1 or 2 cups of coffee per hour.

I did not drink any coffee in the hospital for fear it would make the cigarette cravings worse. I've tried to quit "cold turkey" many times in the past and always failed, smoking more on the rebound. This time, I have goals (that I'm exceeding) and some strong incentives. My wife drinks more coffee and smokes more, but has said she will quit if I do. We will get there.

One of the worst emotional aspects of this comes from the knowledge that my son had to travel from the clinic to the hospital while wondering if I was going to still be alive when he got there. He wasn't allowed to ride in the ambulance, because time was "critical".

[ Eric Levitz, the author of the article, has some good arguments with links to his sources. I'm not posting this as flame-bait but rather in hopes of getting some enlightenment by discussion here. ]

Biden and Beto Boosted GOP Candidates in 2018. That’s Disqualifying.

By Eric Levitz
Jan 23, 2019

George Will has been a reactionary for longer than Beto O’Rourke has been alive. Will was an adviser to Ronald Reagan’s 1980 campaign, climate change denier, and fierce opponent of Social Security. His hatred of progressivism is so deep and comprehensive, he may be the only nationally syndicated columnist who has called for the abolition of both the minimum wage and denim pants.

But last summer, Will advised his readers to “vote against the GOP this November” — no matter where they lived.

[ ... ]

Will was not the only lifelong conservative to render this verdict. Max Boot, a neoconservative intellectual who once decried Brown v. Board of Education as an attack on the Constitution — and opposition to the Iraq War as mindless isolationism — wrote in October 2018, “Vote against all Republicans. Every single one.”

Joe Biden and Beto O’Rourke refused to endorse this advice.

[ ... ]

By boosting Hurd, and spurning Ortiz Jones, O’Rourke did not put “country before party”; he put himself before both.

[ ... ]

Biden declined to endorse the Democratic candidate Matt Longjohn in his race to oust Upton from Congress. Instead, “uncle Joe” vouched not only for Upton’s bipartisan credentials, but painted him as a champion of the sick and infirm — despite the fact that the Michigan Republican played a lead role in trying to pass legislation that would have thrown 20 million Americans off of health insurance.

Upton ultimately won his race by less than 5 percentage points.

[ ... ]

Bipartisan overtures will never persuade congressional Republicans to vote against the interests of fossil fuel companies, or back dramatic expansions in public health insurance, or dismantle election laws that give their coalition wildly disproportionate power. Only a unified, Democratic government — that is willing to ruthlessly prioritize ideological goals over bipartisan comity — will have any chance of overcoming our legislative system’s copious veto points, and passing anything resembling a proportionate response to our nation’s climate, health-care, and democratic crises into law.

[ ... ]

[ Much more at the link (title above). Lots of supporting links within the article. ]

His views are straight out of the 'free market' book of lies. The mythical self-regulating free market works only if all consumers are fully informed, presumably by magic. One need look no further than the tobacco industry to see how consumers cannot become fully informed in the face of concentrated power, greed, and wealth, and in fact are deliberately misinformed in the quest to further concentrate same.

Consumers must rely on the power they wield collectively through government because individually we are overwhelmed by large business. Deregulation should be done only where the particular regulation is found to be worse than its absence. Unregulated business leads to the barbarianism of the beginning of the Industrial Age.

Multi-national corporations are not elected to govern, yet they have the power to alter government. If society is to be shaped for people, then the people must constrain the ravenous beast of their own industry.