More good news about Obamacare: No pre-existing conditions clause

May 31, 2012

More:


ObamaCare: Making stuff up to complain about

April 17, 2012

Collected on Facebook, April 16, 2012:

Panel truck complains that President and Senators are exempt from ObamaCare

It even offers a page and line -- page 114, line 22. But that page has nothing to do with what the caption on the truck says.

Here’s the text from H.R. 3200, the Affordable Care Act, on page 114.  Where’s the language this guy complains about?

17 ‘‘(b) LIMITATIONS ON USE OF DATA.—Nothing in this
18 section shall be construed to permit the use of information
19 collected under this section in a manner that would ad
20 versely affect any individual.
21 ‘‘(c) PROTECTION OF DATA.—The Secretary shall en
22 sure (through the promulgation of regulations or otherwise)
23 that all data collected pursuant to subsection (a) are—
24 ‘‘(1) used and disclosed in a manner that meets
25 the HIPAA* privacy and security law (as defined in

[continuing to page 115]

1 section 3009(a)(2) of the Public Health Service Act),
2 including any privacy or security standard adopted
3 under section 3004 of such Act; and
4 ‘‘(2) protected from all inappropriate internal
5 use by any entity that collects, stores, or receives the
6 data, including use of such data in determinations of
7 eligibility (or continued eligibility) in health plans,
8 and from other inappropriate uses, as defined by the
9 Secretary.

That GPO version of the bill is searchable in .pdf form — searching for “Congress” I find no reference to any part that exempts Congress.  Searching for “exemption,” I find no mention of any exemption from any provision that applies to Congress or the President.

So, what are the anti-ObamaCare fanatics really concerned about?  Is there language in the bill that exempts either Congress or the President, from any provision?

Some guy is so obsessed with hatred for President Obama and health care reform that he paints the offending part on his truck.  But he gets the law wrong.

Dear Reader, what am I missing?  Can you explain?

I wonder if the guy is into tattoos.

_____________

*  HIPAA is The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104-191, 110 Stat. 1936, enacted August 21, 1996)

_____________

PPS:  Here’s the text of H. R. 3590, the number of the bill that finally passed.  I can’t find any more light there, either.

_____________

Update: In comments, blueollie refers us to a Forbes blog article that both reveals the truth of the matter — Congress and the President get no special treatment — and the origins of the hoax.

So, here’s the real deal –As things currently stand, Members of Congress and their staff, until 2014, will continue to participate in the Federal Employees Health Benefits Program (FEHBP). This program, considered among the best in the nation, allows federal employees- including Members of Congress and their staff- to choose from a wide range of health plans and select the one that best suits their needs. Note that the current plan is neither ‘government’ insurance, ‘free’ insurance nor any other sort of sweet deal that the public has been led to believe is the case. The federal employee’s program involves private insurance policies with premiums, deductibles, co-pays, etc.

Here’s the surprise – come 2014, when the lion’s share of the ACA provisions come on line, Members of Congress and their staff will be required to buy their health insurance on an exchange. In fact, their choices will be even more limited than our own. While it is expected that some 24 million people will elect to purchase their health care policy on a state run exchange, we are not required by law to do so. Members of Congress and their staff, however, must buy their insurance in this way.

There you have it.  That guy, whoever he is, had his truck painted erroneously.  We hope he doesn’t have a close relationship with the tattoo parlor.

_____________

So many hoaxes relating to Barack Obama; do you think there’s a shop somewhere with a dozen people sitting around dreaming up these hoaxes?  What else explains the sheer number of Obama-related hoaxes?


More good news about the Affordable Care Act (Obamacare): CBO says it will save money

March 22, 2012
President Barack Obama's signature on the heal...

President Barack Obama's signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. CBO projections in March 2012 indicate savings under the bill will increase beyond earlier projections, offsetting increased costs from continuing economics woes. (Photo credit: Wikipedia)

Remember, without the Affordable Care Act, the U.S. was experiencing health care cost inflation of about 15%annually.

You might not know it if you read conservative blogs, watch Fox News, or listen to the Republican candidates for president — all of whom seem to have their fact panties on wrong — but the Congressional Budget Office (CBO) projects the bill will reduce federal spending, still, even after accounting for recent changes in law and changes in the economy that will increase costs of the bill’s provisions.

Yeah, Obamacare saves money.

The new law will  not eliminate the problem of people not having insurance coverage to guarantee access to health care, a sad result of Republican efforts to cut the bill’s effectiveness.  But it’s a great first step to making America better, healthier, and economically more sound.  Here’s the blog post from the CBO discussing the bill, and CBO’s continuing studies of the effects of the law:

CBO Releases Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act

March 13, 2012

In preparing the March 2012 baseline budget projections, CBO and the staff of the Joint Committee on Taxation (JCT) have updated estimates of the budgetary effects of the health insurance coverage provisions of the Affordable Care Act (ACA)—the health care legislation enacted in March 2010. Those provisions:

  • Establish a mandate for most legal residents of the United States to obtain health insurance;
  • Create insurance “exchanges” through which certain individuals and families may receive federal subsidies to substantially reduce the cost of purchasing health insurance;
  • Significantly expand eligibility for Medicaid;
  • Impose an excise tax on certain health insurance plans with relatively high premiums;
  • Establish penalties on certain employers who do not provide minimum health benefits to their employees; and
  • Make other changes to prior law.

The most recent previous estimate of those effects was prepared in March 2011. For more details on the insurance coverage provisions of the ACA, you can see CBO’s cost estimate for the health care legislation, which was issued in March 2010.

The Estimated Net Cost of the Insurance Coverage Provisions Is Smaller Than Estimated in March 2011

CBO and JCT now estimate that the insurance coverage provisions of the ACA will have a net cost of just under $1.1 trillion over the 2012-2021 period-about $50 billion less than the agencies’ March 2011 estimate for that 10-year period. (For comparison with previous estimates, these numbers cover the 2012-2021 period; estimates including 2022 can be found below.)

The net costs–specifically the combined effects on federal revenues and mandatory spending–reflect:

  • Gross additional costs of $1.5 trillion for Medicaid, the Children’s Health Insurance Program (CHIP), tax credits and other subsidies for the purchase of health insurance through the newly established exchanges and related costs, and tax credits for small employers,
  • Offset in part by about $0.4 trillion in receipts from penalty payments, the new excise tax on high-premium insurance plans, and other budgetary effects (mostly increases in tax revenues).

Those amounts do not encompass all of the budgetary impacts of the ACA. They do not include federal administrative costs, which will be subject to future appropriation action. Also, they do not include the effects of the many other provisions of the law, including some that will cause significant reductions in Medicare spending relative to that under prior law and others that will generate added tax revenues relative those under prior law.

CBO and JCT have previously estimated that the ACA will, on net, reduce budget deficits over the 2012-2021 period; that estimate of the overall budgetary impact of the ACA has not been updated.

Gross Costs Are Higher, but Offsetting Budgetary Effects Are Also Higher

The current estimate of the gross costs of the coverage provisions—$1,496 billion through 2021—is about $50 billion higher than last year’s projection; however, the other budgetary effects of those provisions, which partially offset those gross costs, also have increased in CBO’s and JCT’s estimates—to $413 billion—leading to the small decrease in the net 10-year tally.

Over the 10-year period from 2012 through 2021, enactment of the coverage provisions of the ACA was projected last March to increase federal deficits by $1,131 billion, whereas the March 2012 estimate indicates that those provisions will increase deficits by $1,083 billion.

The net cost was boosted by:

  • An additional $168 billion in estimated costs for Medicaid and CHIP, and
  • $8 billion less in estimated revenues from the excise tax on certain high-premium health insurance plans.

But those increases were more than offset by a reduction of:

  • $97 billion in the projected costs for the tax credits and other subsidies for health insurance provided through the exchanges and related spending
  • $20 billion in the projected costs for tax credits for small employers, and
  • $107 billion in deficits from the projected revenue effects of changes in taxable compensation and penalty payments and from other small changes in estimated spending.

The Revisions in Estimates Reflect Legislative, Economic, and Technical Changes

The major sources for the differences between the March 2011 and March 2012 projections are the following:

  • New Legislation. Several laws were enacted during the past year that changed the estimated budgetary effects of the insurance coverage provisions of the ACA.
  • Changes in the Economic Outlook. The March 2012 baseline incorporates CBO’s macroeconomic forecast published in January 2012, which reflects a slower recovery when compared with the forecast published in January 2011 (which was used in producing the March 2011 baseline).
  • Technical Changes. The March 2012 baseline incorporates updated projections of the growth in private health insurance premiums, reflecting slower growth than the previous projections. In addition, CBO and JCT made a number of other technical changes in their estimating procedures.

The Number of the Nonelderly Uninsured Is Higher Than Previously Estimated

CBO and JCT’s projections of health insurance coverage have changed since last March. Fewer people are now expected to obtain health insurance coverage from their employer or in insurance exchanges; more are now expected to obtain coverage from Medicaid or CHIP or from nongroup or other sources. More are expected to be uninsured. The extent of the change in insurance coverage varies from year to year.

Compared with prior law, the ACA is now estimated by CBO and JCT to reduce the number of nonelderly people without health insurance coverage by 30 million to 33 million in 2016 and subsequent years, leaving 26 million to 27 million nonelderly residents uninsured in those years (see Table 3 at the end of the report). The share of legal nonelderly residents with insurance is projected to rise from 82 percent in 2012 to 93 percent in 2016 and subsequent years. That share rose to 95 percent in CBO and JCT’s previous estimate.

According to the current estimates, from 2016 on, between 20 million and 23 million people will receive coverage through the new insurance exchanges, and 16 million to 17 million additional people will be enrolled in Medicaid and CHIP as a result of ACA. Also, 3 million to 5 million fewer people will have coverage through an employer compared with the number under prior law

Estimates Through Fiscal Year 2022

This report also presents estimates through fiscal year 2022, because the baseline projection period now extends through that additional year. The ACA’s provisions related to insurance coverage are now projected to have a net cost of $1,252 billion over the 2012-2022 period; that amount represents a gross cost to the federal government of $1,762 billion, offset in part by $510 billion in receipts and other budgetary effects (primarily revenues from penalties and other sources).

The addition of 2022 to the projection period has the effect of increasing the costs of the coverage provisions of the ACA relative to those projected in March 2011 for the 2012-2021 period because that change adds a year in which the expansion of eligibility for Medicaid and subsidies for health insurance purchased through the exchanges will be in effect. CBO and JCT have not estimated the budgetary effects in 2022 of the other provisions of the ACA; over the 2012-2021 period, those other provisions were previously estimated to reduce budget deficits.

If we could get another stimulus program to goose the economy into quicker recovery, the cost savings would likely grow much faster.  What conservative budget chopper wouldn’t prefer that solution?

Barack Obama signing the Patient Protection an...

Barack Obama signing the Patient Protection and Affordable Care Act at the White House Español: Barack Obama firmando la Ley de Protección al Paciente y Cuidado de Salud Asequible en la Casa Blanca (Photo credit: Wikipedia)

How did your favorite media outlets report the CBO cost projections?

More, Resources (with help from Zemanta and WordPress):


Good news about health care in the U.S.: The case for Obama’s health care reforms

March 7, 2012

Here’s a preview of another piece of television that many Republicans hope you will not bother to see, a piece that explains exactly how and why the health care reforms championed by President Obama will help you and millions of others:

Program: U.S. Health Care: The Good News

Episode: The Good News in American Medicine

Journalist T.R. Reid examines communities in America where top-notch medical care is available at reasonable costs and, in some instances, can be accessed by almost all residents. Included: Mesa County, Colo.; Seattle; Everest, Wash.; Hanover, N.H. In Mesa County, for instance, doctors, hospitals and insurers place an emphasis on prevention; and a program that offers pre-natal care to poor women has proved popular.

T. R. Reid’s report started airing on PBS stations in mid-February.  If you haven’t seen it, go to this site to view the entire production.

More, resources (suggested by PBS, mostly):


DDT news: Ethio Sun reports, “Ethiopia and Botswana in banned DDT pesticide deal”

January 12, 2012

How many hoax claims of Steven Milloy, Roger Bate and other DDT advocates are exposed in this one news story?

Somebody count.  The story reveals

  1. African nations still use DDT.
  2. There’s a lot of DDT in Africa to be used.
  3. Some nations don’t use DDT due to fear of health effects on people; they appear to have weighed the alternatives, and found better ways to fight malaria without DDT.
  4. DDT is cheap in Africa (US$4.50/kilogram).
  5. Despite the U.S. ban on DDT use on U.S. crops, some nations in Africa kept using DDT (the article misstates the case for a worldwide ban — there has never been a worldwide ban).
  6. DDT use is not assumed in Africa to be a great way to fight malaria.

I don’t mean to suggest EthioSun as a sterling source of information; but it’s not difficult to find stories like this with frequency, out of Africa.  Each of them refutes the case for more DDT, so that there really is no good case to be made for more DDT, anywhere.

Ethiopia and Botswana in banned DDT pesticide deal

Posted By On Thursday, January 12, 2012 06:32 AM.

Ethiopia is set to export about 15 tonnes of the banned pesticide, DDT, to Botswana, it has been revealed.

This follows a recent suspension on the use of the pesticide by the Horn of Africa nation, which cited adverse effects of human health and the environment as reasons for the decision.

Adami Tulu Pesticide, a state owned company has huge stocks of DDT, which it will reportedly sell to Botswana at US$4.50 per kilogramme.

It is estimated the company has 450 tonnes of DDT in stock.

The US led a worldwide ban on the use of DDT as a pesticide in 1972 following reports of adverse side effects on humans.

However, Ethiopia along with a few other countries continued the use of DDT in the fight against malaria.

Activists have demanded that the ban be lifted, in order to allow the use DDT in the elimination of malaria, especially in developing countries.

More than half of the estimated 80 million people in Ethiopia are said to be at risk of contracting malaria.

According to the World Health Organisation some countries still use DDT to fight malaria.

The disease killed over half a million people worldwide last year, most of them in Africa.

There was no immediate confirmation from Botswana about the planned export.

Steve Milloy, Roger Bate, Richard Tren, Henry I. Miller and others hoax us when they say DDT can save mankind, or even help save mankind.  See also Tim Lambert’s takedown of Goklany’s post.


Scalia and Thomas: Neither is Caesar’s wife

November 18, 2011

It sure looks like a breach of ethics, but James Oliphant writes in the Los Angeles Times that there is no formal rule prohibiting a sitting Supreme Court justice from hobnobbing with a law firm set to argue a gargantuan case in a few months.

The day the Supreme Court gathered behind closed doors to consider the politically divisive question of whether it would hear a challenge to President Obama’s healthcare law, two of its justices, Antonin Scalia and Clarence Thomas, were feted at a dinner sponsored by the law firm that will argue the case before the high court.

The occasion was last Thursday, when all nine justices met for a conference to pore over the petitions for review. One of the cases at issue was a suit brought by 26 states challenging the sweeping healthcare overhaul passed by Congress last year, a law that has been a rallying cry for conservative activists nationwide.

The justices agreed to hear the suit; indeed, a landmark 5 1/2-hour argument is expected in March, and the outcome is likely to further roil the 2012 presidential race, which will be in full swing by the time the court’s decision is released.

The lawyer who will stand before the court and argue that the law should be thrown out is likely to be Paul Clement, who served as U.S. solicitor general during the George W. Bush administration.

Clement’s law firm, Bancroft PLLC, was one of almost two dozen firms that helped sponsor the annual dinner of the Federalist Society, a longstanding group dedicated to advocating conservative legal principles. Another firm that sponsored the dinner, Jones Day, represents one of the trade associations that challenged the law, the National Federation of Independent Business.

Another sponsor was pharmaceutical giant Pfizer Inc, which has an enormous financial stake in the outcome of the litigation. The dinner was held at a Washington hotel hours after the court’s conference over the case. In attendance was, among others, Mitch McConnell, the Senate’s top Republican and an avowed opponent of the healthcare law.

The featured guests at the dinner? Scalia and Thomas.

One wishes for some of the usual journalistic “balancing,” with someone to note who among the crowd represents the opposite side in the case, and someone else to note that the dinner had a lot of other sponsors.  But one might get uneasy thinking that the usual journalistic balancing can’t be mustered here, and that Scalia and Thomas just don’t care about appearances of ethical violations, if they can get away with it.

Lower court judges have clear ethical guidance on the issue, counseling against such appearances:

It’s nothing new: The two justices have been attending Federalist Society events for years. And it’s nothing that runs afoul of ethics rules. In fact, justices are exempt from the Code of Conduct that governs the actions of lower federal judges.

If they were, they arguably fell under code’s Canon 4C, which states,A judge may attend fund-raising events of law-related and other organizations although the judge may not be a speaker, a guest of honor, or featured on the program of such an event.“

Those rules do not apply to the nine people who sit on the nation’s highest court.

In those few times I lunched with Thomas and worked with him, when he staffed environmental issues for Indiana’s Missouri’s Sen. John Danforth, I found him an agreeable lunch companion and smart, but a great idealogue.  Had I known then what we all know now, I would have paid closer attention, asked different and sharper  questions, and kept notes.  And I might have dropped a few hints about history, and Caesar’s wife.  Supreme Court justices should consider themselves wedded to the American republic, and act accordingly.

What do you think, Dear Reader?  Was this a violation of ethics, even if not required by the rules that apply to Supreme Court justices?


A cure for the ills caused by air pollution: Vitamin D in milk

October 29, 2011

Air pollution texts often made the note, but I’ve not seen it talked about much recently:  Air pollution in the U.S. (and England) was so bad in the first years of the 20th century that it actually shut out the sun, and an epidemic of rickets followed.

FSA photo of child in Jefferson, Texas, with rickets - Library of Congress

Child with rickets, son of relief client near Jefferson, Texas. This child has never talked though he is two years old. He has never received any medical attention. Lee, Russell, 1903-1986, photographer. CREATED/PUBLISHED 1939 Mar. More information about the FSA/OWI Collection is available at http://hdl.loc.gov/loc.pnp/pp.fsaowi; CALL NUMBER LC-USF34- 032719-D REPRODUCTION NUMBER LC-USF34-032719-D DLC (b&w film neg.)

Public health officials, clever devils, discovered a form of vitamin D that prevented rickets.  It turns out that humans manufacture vitamin D from cholesterol, using ultraviolet B from the sun.  So, when the sun was smokily eclipsed, rickets proliferated.

In an era when technical and legal tools were inadequate to clean up the air pollution, physicians, nutritionists and researchers struck on the idea of supplementing food with vitamin D — and that is how we come to have vitamin D-fortified milk today, and a lot less rickets.

I was happy to find a publication at the National Institutes of Health that relates this history, at least in part, “Solar Ultraviolet Radiation and Vitamin D:  A Historical Perspective,” by Kumaravel Rajakumar, MD, Susan L. Greenspan, MD, Stephen B. Thomas, PhD, and Michael F. Holick, MD, PhD, in American Journal of Public Health, October 2007, Vol 97, No. 10.

At the dawn of the 20th century, the expansive industrialization and urban migration in the major cities of western Europe and the northern United States set the stage for the high prevalence of rickets among infants residing in those polluted and “sunless” cities. Overcrowded living conditions in the big-city slums and tenements and the sunlight deprivation precipitated by atmospheric pollution from smoke and smog were responsible for a rickets epidemic.  Increased ozone concentration from industrial pollution and the haze and clouds from atmospheric pollution compromise vitamin D production by absorbing the UV-B photons essential for its synthesis.

*          *          *          *          *

Edwards Park states, “But for rickets vitamin D would not have been discovered. Its discovery was the secret to rickets; its use is essentially the therapy of that disease.” The discovery of vitamin D led to the eradication of the epidemic rickets of the early 20th century. Pioneering advances were made in the understanding of vitamin D and rickets from 1915 to 1935. The discovery of the synthesis of vitamin D by the irradiation of foods was the “jewel in the crown” of vitamin D discoveries. This discovery was a catalyst for the public health triumph against rickets. It became feasible to fortify and enrich milk and other foods with vitamin D to ensure that the general population was likely to consume sufficient vitamin D.

It’s a good article with detailed history of rickets, the search to find what turned out to be vitamin D, and the use of nutritional supplements to eradicate a nasty, crippling disease in children.  Happy to see it online.

Some of our greatest triumphs in science, technology and public health are too little known.  I am working on the history of technology and science, and particularly its wedding with social progressivism in the Progressive Age, part of a project I was fortunate to stumble into in the Dallas Independent School District funded by a Teaching American History Grant from the U.S. Department of Education.  Sadly, Republicans in Congress insisted on cutting those grants to improve teaching with greater emphasis on original sources and original documents.

More Americans, more American school kids, should know about the triumphs of public health and science.  Maybe highlighting some of those advances here can help another teacher somewhere else.

 


Avoid death panels; let them all die

September 17, 2011

It’s horrifyingly ironic if you think about it:  Republicans opposed expanding access to the health care system with a false claim that the Democratic plan included rationing of health care in a “death panels” clause.  Completely untrue.  The bill barely passed.

But did you see what happened last week at the Republican Party’s event featuring their candidates for president?  Here a citizen responds to the Republicans:

In their silence, Republicans appear to support rolling back current health care, foregoing “death panels” as not harsh enough, and moving on to “let ‘em all die.”

Tip of the old scrub brush to MoveOn.org.


Sideshow of DDT and malaria

August 23, 2011

Not exactly a DDT/Malaria carnival.  Just enough for a sideshow.

First, the controversy over use of DDT in Uganda continues, even as DDT is applied daily there.  This demonstrates that DDT remains freely available for use in Africa.  It also demonstrates that Africans are not clamoring for more DDT.

Uganda offers a key proving ground for the propaganda campaign against environmentalists, against scientist, against medical care officials, and for DDT.  Though malaria plagues Uganda today and has done so for the past 200 years at least, it was not a target of the World Health Organization’s (WHO) campaign to eradicate malaria in the 1950s and 1960s, because the nation lacked the governmental structures to mount an effective campaign.  DDT was used to temporarily knock down mosquito populations, so that medical care could be improved quickly and malaria cured among humans.  Then, when the mosquitoes came roaring back as they always do with DDT, there would be no pool of the disease in humans from which the mosquitoes could get infected.  End of malaria problem.

Plus, for a too-long period of time, Uganda was ruled by the brutal dictator Idi Amin.  No serious anti-malaria campaigns could be conducted there, then.

Uganda today exports cotton and tobacco.  Cotton and tobacco interests claim they cannot allow any DDT use, because, they claim, European Union rules would then require that the tobacco and cotton imports be banned from Europe.  I can’t find any rules that require such a ban, and there are precious few incidents that suggest trace DDT residues would be a problem, but this idea contributes to the political turmoil in Uganda.  Businessmen there sued to stop the use of even the small amounts of DDT used for indoor residual spraying (IRS) in modern campaigns.  They lost.  DDT use continues in Uganda, with no evidence that more DDT would help a whit.

Malaria campaign posters from World War II, South Pacific - Mother Jones compilation

Much of the anti-malaria campaign aimed at soldiers, to convince them to use Atabrine, a preventive drug, or to use nets, or just to stay covered up at night, to prevent mosquito bites. Mother Jones compilation of posters and photos.

Second, the website for Mother Jones magazine includes a wonderful 12-slide presentation on DDT in history.  Malaria took out U.S. troops more effectively than the Japanese in some assaults in World War II.  DDT appeared to be a truly great miracle when it was used on some South Pacific islands.  Particularly interesting are the posters trying to get soldiers to help prevent the disease, some done by the World War II-ubiquitous Dr. Seuss.  Good history, there.  Warning:  Portrayals of Japanese are racist by post-War standards.

Third, a new book takes a look at the modern campaigns against malaria, those that use tactics other than DDT.  These campaigns have produced good results, leading some to hope for control of malaria, and leading Bill Gates, one of the biggest investors in anti-malaria campaigns, to kindle hopes of malaria eradication again.  Here is the New York Times  review of  Alex Perry’s Lifeblood: How to Change the World One Dead Mosquito at a Time (PublicAffairs, $25.99).   Perry is chief Africa correspondent for Time Magazine.

This little gem of a book heartens the reader by showing how eagerly an array of American billionaires, including Bill Gates and the New Jersey investor Ray Chambers (the book’s protagonist), are using concepts of efficient management to improve the rest of the world. “Lifeblood” nominally chronicles the global effort to eradicate malaria, but it is really about changes that Mr. Chambers, Mr. Gates and others are bringing to the chronically mismanaged system of foreign aid, especially in Africa.

These three snippets of reporting, snapshots of the worldwide war on malaria, all diverge dramatically from the usual false claims we see that, but for ‘environmentalist’s unholy and unjust war on DDT,’ millions or billions of African children could have been saved from death by malaria.

The real stories are more complex, less strident, and ultimately more hopeful.


Anecdotal evidence: Malaria spreads to Tanzania highlands, warming climate blamed

April 16, 2011

Here’s one story that critics of science and scientists who study global warming will try to avoid mentioning:  Malaria’s spread in Tanzania appears to be due to deforestation plus a warming climate that altered historic rainfall patterns.

It’s anecdotal evidence, partly.  The case reinforces the point Al Gore made in An Inconvenient Truth, that climate change can smooth the path for the spread of diseases like malaria.

Via AllAfrica.com, from The Citizen in Dar es Salaam (Sunday Citizen News):

Malaria Threatens Nation’s Highlands

Felix Mwakyembe, 6 March 2011

Opinion

Mbeya — Tanzania’s southern highlanders have long worried about pneumonia and other respiratory illnesses brought on by the cool, wet weather. But as climate change contributes to warmer temperatures in the region, residents are facing a new health threat: malaria.

In Rungwe, a highland district in the south-western Mbeya region bordering Malawi and Zambia, malaria is fast replacing coughs, fever and pneumonia as the most serious local health problem. The change has taken by surprise the region’s residents, who live over 1,000 metres (3,200 feet) above sea level and outside Tanzania’s traditional malarial zones.

Ms Asha Nsasu, 32, of Isebe village, had no idea she had contracted malaria when she was sent to Makandana District Hospital in late December. “I felt weak. I thought it was pneumonia,” Nsasu said. “Then they told me it was malaria.”

In 2009, health centres in Rungwe district reported 100,966 malaria cases, a jump of 25 per cent from 2006, hospital records show.

Malaria is now the biggest public health threat facing Rungwe district, which lies about 940 kilometres (590 miles) southwest of Dar es Salaam, according to the Tukuyu Medical Research Centre, part of the National Institute for Medical Research. One third of outpatients visiting the hospital were diagnosed with the mosquito-borne illness in 2007, according to records from that year, making it the most common disease for outpatients.

Most highland areas in Tanzania are experiencing a growing burden of malaria cases, officials at the Tukuyu Centre said. Climatic changes brought on in part by local environmental degradation are contributing to the growing prevalence of malaria in the district, said Mr Gideon Ndawala, Rungwe district’s malaria coordinator.

“People have cleared the forests, rain has decreased, temperatures have risen,” Mr Ndawala said in an interview. “(When) I first reported on the district in 1983, it was very cold and it rained throughout the year except from mid-September to early November. The weather was not favourable for mosquito breeding,” he said.

Now, however, temperatures are higher and rain more erratic, he said, and mosquito populations – which thrive on warmer temperatures and breed in pools of stagnant water – are on the rise. Worst hit by the surge in malaria are Tukuyu district town, Ikuti, Rungwe Mission and Ilolo, according to district health officials.

Half a century ago, these traditionally cool areas saw no mosquitoes and did not register any malaria cases, but now the weather is warmer, said Mr Ambakisye Mwakatobe, a 76-year-old man from Bulyaga village in Rungwe.

“In the past, we never saw mosquito nets here. I saw a net for the first time at the age of 20, when I joined Butimba Teachers College in 1957,” he said, in an interview at his village home.

Mzee Mwakatobe said cases of malaria began to appear several decades ago but residents did not relate them to warming temperatures, believing the mosquitoes instead were arriving on buses from lower regions.

“It was in the 1970s when we started getting malaria here. I thought it was the buses from Kyela and Usangu that brought mosquitoes,” he admitted. But “the weather also started to change in those years,” he said.

A half-century ago, “it was very cold here and it rained throughout the year. Three things were compulsory: a sweater, pullover or heavy jacket; an umbrella or raincoat; and gumboots,” he added. “There was frost all day long and cars had to put their lights on.

“But today things have changed,” he said. “Look, now we even put on light shirts. There is no need for sweaters, gumboots or umbrellas.”

Scientists agree that the changing weather is feeding into Rungwe’s worsening malaria problem.

“Up until 1960, districts like Rungwe, Mbeya, Mufindi, Njombe, Makete and Iringa in the southern highland regions were malaria free. Today is quite different – malaria prevalence is high,” said Mr Akili Kalinga, a research scientist at Tukuyu Medical Research Centre.

Malaria accounts for 30 per cent of the burden of disease in Tanzania and is a huge drain on productivity, according to a report produced by research scientists for the Sixth Africa Malaria Day in 2006. In response to the rising malaria caseload, the government is taking steps to stem the disease’s expansion.

Measures include public health education in newly vulnerable districts on home cleanliness and water storage, how to eliminate the places of still water where mosquitoes live and breed, and the use of mosquito nets and fumigation, said Dr Sungwa Ndagabwene, Rungwe’s medical officer.

“The government is taking serious measures to fight malaria. We started with a ‘mosquito nets for all’ campaign – saying every person should sleep under bed nets,” Mr Ndagabwene said.

The government also has begun spraying the inside of homes with insecticide, first in the Kagera Region and now throughout the Lake zone, near Lake Victoria, he said. It plans to expand the spraying programme, which has helped cut malaria transmission in Zanzibar, to the rest of the Tanzania’s malaria-affected regions.

Such spraying programmes aim to kill mosquitoes that land on the inside walls of homes. Spraying can protect homes for between four to ten months depending on the insecticide, according to the World Health Organisation (WHO).

WHO has approved 12 insecticides it considers safe for such spraying programmes, including DDT – a controversial endocrine disruptor that has proved one of the most effective ways to control mosquito populations but that has also been linked to environmental damage and health problems including cancer.

Mr Ndagabwene said spraying the chemical only indoors limited its environmental impact. WHO officials have said they believe the benefits of using the pesticide outweigh its risks. The Stockholm Convention bans the use of DDT but exempts countries that choose to use the chemical to control malaria.

Tanzania is one of the world’s worst malaria-affected countries, recording 14 to 18 million clinical cases annually and 60,000 deaths, 80 per cent of them in children under five years old, according to a 2010 malaria reduction plan put together by USAID.

Children under five and pregnant women are most affected by the disease, official health figures show. (AlertNet)

The author is a freelance writer based in Dar es Salaam

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Texas House votes to maim education, cripple health care, send the aged off to ice floes

April 4, 2011

Where anyone can find an ice floe in Texas is a powerful question, but the search will be on to find some soon, if the budget approved by the Texas House of Representatives cannot be fixed.

Texas House Democrats sent out a notice shortly after the vote, explaining some of the cuts:

An hour ago, Texas House Republicans forced through some of the most destructive budget cuts in Texas history.  On a party line vote, 101 House Republicans trampled on the priorities of regular, middle-class Texas families. [1]

Tonight, Republicans voted to:

  • Eliminate 335,000 Texas jobs in both the public and private sectors, threatening our fragile economic recovery [2]
  • Lay off up to 100,000 teachers and school support workers, crowding dozens of kids into unruly classrooms [3]
  • Kick 100,000 kids out of full day Pre-Kindergarten [4]
  • Close half of the state’s nursing homes, leaving thousands of seniors with no place to go [5]
  • Create a ripple effect that will force local governments like cities, counties and local school districts to raise taxes [6]
  • Cut off access to financial aid for thousands of graduating high school seniors [7], while forcing up college tuition through cuts. [8]

They didn’t have to cut this deeply into the priorities set by most Texas families.  They chose to make the deepest cuts public education since the creation of our school finance system in 1949. [9]

For months, Republicans have been yelling “Cuts! Cuts!” and they have ignored the thousands of office visits, letters, emails and phone calls of average Texans protesting these hurtful cuts.

Democrats offered plenty of creative solutions that would keep schools open, spare nursing homes from closing, and keep our promise to graduating seniors who have worked hard for a chance to earn a college education. Republicans shot them down one by one in favor of deeper cuts.
Anybody can swing an axe and slash budgets across the board.  Texas needs people who can lead, set priorities, and protect those priorities.

Remember, Republicans chose to make these cuts. Help us hold them accountable for costing jobs, hurting families, and for choosing to sacrifice the future of too many Texas kids.

Sincerely,

Cliff Walker
Texas HDCC

  1. http://www.capitol.state.tx.us/BillLookup/History.aspx?LegSess=82R&Bill=HB1
  2. http://www.beaumontenterprise.com/news/article/Budget-cuts-could-slash-hundreds-of-thousands-of-1291051.php
  3. http://www.kvue.com/home/117522288.html
  4. http://www.newschannel10.com/Global/story.asp?S=14368977
  5. http://www.reporternews.com/news/2011/mar/09/democrats-cuts-will-hit-homes/?print=1
  6. http://www.star-telegram.com/2011/03/08/2906285/unfunded-mandates-from-the-texas.html
  7. http://blog.mysanantonio.com/texas-politics/2011/03/house-budget-writers-ok-bill-that-would-trim-23-billion/
  8. http://www.newswest9.com/Global/story.asp?S=14310923
  9. http://www.businessweek.com/ap/financialnews/D9MBC0PG1.htm

Fewer teachers when more are needed, bigger classrooms when smaller classrooms are needed, less health care in the state with the largest uninsured population of any state, the highest proportion of uninsured people.

Cleaver prop from YourProps.com

Texas Republicans chose the meat cleaver over the scalpel to try to balance Gov. Rick Perry's $27 billion deficit. Many cuts appear targeted to do the most damage possible to education and other "liberal" state functions. Cleaver prop from YourProps.com

Prisons, highways, state parks, and other programs suffered serious cuts, too.

Had a foreign power done this to Texas, it would be considered an act of war.  How will Texas citizens respond?

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“I Have Sex” — students speak out against ideological attack on Planned Parenthood

March 20, 2011

Here’s something to think about, from students at Wesleyan College:

The film’s producers on Facebook.

Tip of the old scrub brush to Dana Goldstein, Lady Wonk.


Radiation dose comparison charts from XKCD

March 20, 2011

No, there’s no humor in this thing — just good, solid information.

XKCD put together a chart that shows in geometric terms how various radiation doses work. With a tip of the pen to Bob Parks, the chart notes that cell phones don’t count here because cell phones don’t put out ionizing radiation, the type that causes cancer, but just radio waves.

The chart won’t be easy to read here — click on the image and go to the XKCD site for a bigger, more readable image:

Radiation Dose Chart from XKCD

Radiation Dose Chart from XKCD

It’s a good, clear graphic in its full size.  Go see.


WHO, DDT and the Persistent Organic Pesticides Treaty: Historic view from the inside

March 19, 2011

Rollback Malaria (RBM) was established in 1998 in part to reinvigorate the worldwide fight against malaria, and in part to facilitate the negotiations for what became the Stockholm Convention, the Persistent Organic Pesticides Treaty of 2001.

World Malaria Day, April 25, 2011

Remember: World Malaria Day, April 25, 2011

That’s about the time the ungodly assault on WHO and Rachel Carson started, by hysterical DDT advocates.  We now know that Roger Bate, Richard Tren, Donald Roberts and their comrades in pens are stuck in that 1998 fight.

Here’s a short account, from RBM, about just what happened:

The DDT Controversy

In 1999 the RBM Secretariat was called upon to help resolve a controversy emerging from intergovernmental negotiations to establish an international environmental treaty. At the centre of this controversy was DDT, former hero of the malaria eradication campaign and current totemic villain of the environmental movement. The treaty being negotiated was intended to eliminate the production and use of twelve persistent organic pollutants. DDT, still used for malaria control in over 20 countries, was included among ‘the dirty dozen’ chemicals slated for elimination, eliciting a strong reaction from public health activists and malaria specialists who claimed that its elimination would result in unacceptable increases in malaria morbidity and mortality. Environmental specialists and others claimed that environmentally friendly alternatives to DDT, although more expensive, could easily be deployed to guard against such a negative impact.

The controversy over the role of DDT in malaria vector control and the dangers posed to the environment escalated and attracted considerable media attention. The controversy was perpetuated in part because of a relatively weak evidence base on the human toxicity of DDT, the cost-effectiveness of proposed alternatives, and the probable impact of public health use of DDT (compared to agricultural use) on the environment. Resolution was also hampered by the relative lack of public health expertise among the Intergovernmental Negotiating Committee delegates, who were primarily active in the fields of foreign and environmental policy.

The challenges presented to the RBM Secretariat in responding to the controversy were many and varied. They included: evaluation of the evidence base and the drafting of policy guidance (a WHO normative role); a major communications effort; and the establishment of new cross-sectoral partnerships and working relationships. In the process, RBM formed new and highly effective ‘partnerships’ or ‘working relations’ with the United Nations Environment Programme (UNEP), the US Environmental Protection Agency, the environmental policy apparatus of core RBM partners, as well as a variety of health and environmental NGOs. RBM conducted country and informal expert consultations and convened and chaired a special working group on DDT which was able to establish a position on the use of the insecticide in public health and the process for evaluating and moving to alternatives. The weight of WHO’s technical authority contributed greatly toward establishing the credibility of the working group. Information about the treaty negotiations and the WHO position on DDT was disseminated to health specialists via the WHO regional networks and to treaty focal points via UNEP.

The RBM Secretariat led the WHO delegation to all meetings of the Intergovernmental Negotiating Committee and prepared information and media events for each, supporting the participation of health/malaria specialists from a number of countries. The RBM Secretariat also served as the media focal point on malaria and DDT and provided interviews and information to all major media, as well as presentations to professional meetings and interest groups.

RBM’s objectives throughout this process were:

  • to establish consensus on the present and future role of DDT and alternatives in malaria control;
  • to encourage greater involvement of public health specialists in country-level discussions about the treaty and in country delegations to the negotiating sessions;
  • to provide information to negotiators and others that would reduce controversy and result in a win-win situation for public health and the environment (in which the longer term goal of DDT elimination is achieved through strengthened, more robust malaria control);
  • to benefit from the media attention to inform the public about malaria; and
  • to mobilize resources to support malaria control from outside the health sector.

All of these objectives have been met and the final treaty, known as the ‘Stockholm Convention on Persistent Organic Pollutants’ provides for the continued public health use of DDT and international assistance for the development and implementation of alternatives.

Resources to support the initial work of the RBM Secretariat were provided by environmental agencies/offices. In addition, the Pan American Health Organization (PAHO) and the WHO Regional Office for the Americas (AMRO) and most recently the WHO Regional Office for Africa (AFRO) have been awarded project development grants from the Global Environment Facility (GEF) to promote regional efforts to strengthen malaria control and reduce reliance on DDT.

From Final Report of the External Evaluation of RBM, Roll Back Malaria to Date, Chapter 2, page 15 (circa 2001).


A fungus to fight malaria?

February 24, 2011

From a report in The Scientist Daily today:

Researchers have engineered transgenic fungi that drill into mosquitoes and kill the malaria parasite inside — the first tool of its kind — a February 25, 2011 study in Science reported.

Used in conjunction with traditional insecticide methods against mosquitoes, experts say this bioinsecticide has the potential to greatly improve malaria eradication efforts.

Mosquito infected with pathogenic fungus Metarhizium
Image: Courtesy of Raymond St. Leger

“This is a great example of trying to be innovative and use novel ways to look at this problem,” said Matt Thomas, a disease ecologist at Penn State who was not involved in the research. “It’s a move outside the existing insecticide paradigm, which has dominated parasite and vector control for 40-50 years.”

Read more: Fungus fights malaria? – The Scientist – Magazine of the Life Sciences http://www.the-scientist.com/news/display/58028/#ixzz1EuapNz8Z
Difficulties in developing this solution for use in the field promise no quick results.  Testing remains to be done on the process — and then there is the issue of how to infect the proper species of mosquito in the field.  Additionally, since this process involves genetic modification, there will be a raft of government approvals to contend with before deploying it, if it ever is deployed.

Unfortunately, putting the new technique into action may not be an easy task. “There are already difficult challenges in taking forward biopesticide technology,” said Thomas. “Now we’re adding in the additional regulatory and ethical issues around genetically modified organisms. It’s not a hurdle we should just dismiss as unimportant.”

Researchers at several different places pursue very different routes to help ease malaria — not one of them involving an increase in DDT use.
More:
  • Original article in Science:
    W. Fang et al., “Development of Transgenic Fungi That Kill Human Malaria Parasites in Mosquitoes,” Science 311: 1074-77 


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