“We’re telling you that no one should be out here because it’s dangerous, but we’re sending you out there and we’re not giving out any masks.” --- The bus driver, who declined to be named for fear of losing her job, is one of hundreds of thousands of Brooklynites still working essential jobs, even as the borough is hit hard by the coronavirus. Twenty-eight percent of New York City’s essential workers live in Brooklyn — the most in any borough — and the vast majority of them are people of color. In Brooklyn, the number of deaths outpaced those in Queens on Sunday. Brooklyn has more than 2,606 confirmed COVID-19 deaths and 865 “probable” COVID-19 deaths, according to NYC data released April 19.

Mitigation can buy us time, but only suppression can get us to where we need to be. --- All of the difficult actions we are taking now to flatten the curve aren’t just intended to slow the rate of infection to levels the health-care system can manage. They’re also meant to buy us time. They give us the space to create what we need to make a real difference. […] Some Americans are in denial, and others are feeling despair. Both sentiments are understandable. We all have a choice to make. We can look at the coming fire and let it burn. We can hunker down, and hope to wait it out—or we can work together to get through it with as little damage as possible. This country has faced massive threats before and risen to the challenge; we can do it again. We just need to decide to make it happen. […] All of the difficult actions we are taking now to flatten the curve aren’t just intended to slow the rate of infection to levels the health-care system can manage. They’re also meant to buy us time. They give us the space to create what we need to make a real difference.

Why helping people victimized by forces outside their control is a good idea. --- The only villain is an impersonal natural force; everyone with a face is a victim, an Us to be tended. In the face of a virus, only the conventionally feminine approach of mutual care is useful. That leaves the lens through which the authoritarian sees the world (domination and submission) blind, and the tools available to him (scapegoating, exclusion, retribution, violence) impotent. There is no one to punish, no one to make suffer. Without that, the authoritarian is scarcely able to process the threat as a threat at all. A threat without an Other is like a wavelength of light that is invisible to him. […] Trump, his administration, and his coalition are in politics to help friends and destroy enemies. All they know is zero-sum competition, domination, and submission — and with no one to dominate, no one upon whom they can impose ritual cruelty to appease the bloodlust of their base, they are ... adrift. They simply aren’t confident, or competent, in expressing, organizing, and administering care. Many thousands of lives will likely be lost as a result. […] All across America, millions of people live in precarity, one step ahead of financial ruin, with lives that can be upended overnight by a health or employment twist entirely outside of their control. Metaphorically speaking, this country is full of viruses — poverty, poor health care, inequality, systemic discrimination, loneliness, and isolation — that infect innocent victims every day by the thousands. Those victims deserve care as well, and not churlish, moralistic, “means-tested” care. Just care, enough to get by and to live a life of dignity.

Some candidates use Medicare-for-all to establish themselves as bold progressives or moderate pragmatists. The Trump administration uses it as a point of attack. But voters don’t know what it actually means, and none of the candidates explain it. --- Making national health insurance a reality would mean redesigning the country’s health care payment infrastructure. It would involve going from a diffuse network that includes private insurers for those who can afford it and public services for a limited number of those who can’t into a single government-administered system. The role of insurance companies would be vastly reduced. By one estimate, as many 2 million people who are paid to process insurance claims or argue about them would lose their jobs. Would people get to keep their doctors? Unclear. Would prescription drug costs decrease? Uncertain. Would wait times increase? Unknown. Copays? No, depending on the plan. Increase in taxes? Almost certainly, but again, it depends.

Total costs are lower under single-payer systems for several reasons. One is that administrative costs average only about 2 percent of total expenses under a single-payer program like Medicare, less than one-sixth the corresponding percentage for many private insurers. Single-payer systems also spend virtually nothing on competitive advertising, which can account for more than 15 percent of total expenses for private insurers. The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers. In 2012, for example, the average cost of coronary bypass surgery was more than $73,000 in the United States but less than $23,000 in France.

Perhaps we need to ask our patients how they would design their ideal emergency department. Has anyone thought to do that? I know they would like caring, kind, compassionate staff. Staff who are not carrying serious emotional damage with them to work and back every day. It would be good for all of us to get this right. And soon.

Given the importance of medicine, I feel that it would be useful to clarify this issue. I will explain clearly, and with evidence, why it is that universal healthcare of any sort would be better than the current system in every significant way. If you find yourself disagreeing with this assertion, I ask that you read on before replying, as all conceivable objections will be addressed and resolved.

If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.

Which is all to say that, yes, this election matters more than most. It matters more politically because the party in power will likely see their agenda affirmed by a cyclical recovery. But it matters more to actual people because the Affordable Care Act is poised to reshape American health care in two years. A vote for Obama is a vote for the law to take effect and for 30 million Americans to get health insurance they won’t get otherwise. A vote for Romney is a vote for the law — and its spending and its taxes — to be repealed. There are few elections in which the stakes are so clear.

Governor Romney has repeatedly promised that on his first day in office he will work to repeal Obamacare. Insurance companies will again be free to deny my family coverage for whatever reasons they see fit. The Ryan budget which Governor Romney plans to enact as president includes enormous cuts to Medicaid. A vote for the Romney/Ryan ticket is a vote to completely destroy the financial security and medical safety of my child and family. If you are planning on voting for him I’m sure that you are doing it for other reasons but these will be the consequences of that decision. You may not like hearing it but it’s the truth. A vote for Romney/Ryan is a vote that will hurt hardworking Americans like me and my family.

2,546 votes and 863 comments so far on Reddit

“Eventually, the country will have to confront the deficit we have, rather than the deficit we imagine. The one we imagine is a deficit caused by waste, fraud, abuse, foreign aid, oil industry subsidies and vague out-of-control spending. The one we have is caused by the world’s highest health costs (by far), the world’s largest military (by far), a Social Security program built when most people died by 70 — and to pay for it all, the lowest tax rates in decades. “To put it in budgetary terms, the deficit we imagine comes largely from discretionary spending. The one we have comes partly from discretionary spending but mostly from everything else: tax rates, Medicare, Medicaid and Social Security.”

"Your Guide to Quackery, Health Fraud, and Intelligent Decisions"

"Atul Gawande gave the commencement speech at Stanford’s School of Medicine last week. Here is what he told the graduating class." On the need for building interconnected systems of care in medicine, rather than a hodgepodge of specialists not communicating with each other.

The four most common types of healthcare that really work and don't really work and how ours is a jumble of parts of all four and all the proposals are pretty shitty.