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Closed Hospitals Leave Rural Patients ‘Stranded’ as Coronavirus Spreads

Map of where the nearest hospital is more than 30 minutes away.

Many red states chose to NOT expand Medicaid under the Affordable Care Act and one consequence has been the closure of many rural hospitals, leaving many rural residents with no nearby hospital.  In a medical emergency, having a hospital nearby is literally a matter of life and death - something I learned years ago when one of my children was stricken with bacterial meningitis.  We lived at the time about 5 minutes from a large hospital with a trauma center ER.  We had a positive result and full recovery.  Had the hospital been 30 minutes or more away, things would have been horrifically different. Now, with the Covid-19 pandemic still raging - cases are still rising in Virginia and many other states - many rural residents are finding a serious lack of hospital access.  The irony, of course is that many of these same areas support Republicans (usually because of GOP calls to racism and religious extremism) whose policies have exacerbated the lack of local hospitals. Talk about voting against one's own best interests! A piece in the New York Times looks at the predicament rural Americans are facing.  Here are highlights: 

Michael Nuzum had spent weeks fighting coronavirus-like symptoms — a wracking cough, terrible chills, an exhausting fever — before collapsing at his home in rural West Virginia.

Mr. Nuzum, a 54-year-old animal control worker, was already in cardiac arrest when the emergency workers arrived on April 3. That left them with a difficult decision: Should they transport their patient to the nearest hospital, 30 minutes away?

“There’s only so much one paramedic can do in the back of an ambulance,” said Michael Angelucci, who leads the Marion County rescue squad that cared for Mr. Nuzum. The two-person team that responded decided it couldn’t risk the long ride and instead tried to revive the patient at the scene. But the workers couldn’t save him.

Two weeks earlier, the options would have been different. Fairmont Regional Medical Center, just five minutes from Mr. Nuzum’s home, would still have been open. Mr. Angelucci, who is also a state representative, can’t help wondering if the hospital and its emergency room could have given the man a fighting chance.  “It’s incredibly frustrating that this entire community is stranded without a hospital,” he said.

Fairmont was one of three hospitals that have shut down in this corner of rural West Virginia and Ohio since September. They delivered hundreds of babies each year, treated car crash and gunshot victims, repaired hearts and knees and offered addiction treatment and psychiatric care.

They had been acquired by a for-profit company, Alecto Healthcare Services, beginning in 2014. Employees expected the new ownership to put the institutions on solid footing after years of financial struggle. Instead, decisions made by Alecto wound up undercutting patient care and undermining the hospitals’ finances, according to more than two dozen interviews with doctors, nurses, other staff members, government officials and patients, as well as a review of court records.

Finally, one after another, the three hospitals ceased operating. At the request of the governor, the West Virginia attorney general’s office is investigating the company’s decision to close them. The shutdowns . . . . have forced the region to fight a coronavirus outbreak with 530 fewer licensed hospital beds than it had a year ago. Across the United States, hospitals serving rural areas have spent decades trying to provide medical care and produce enough revenue to stay open. They have closed in increasing numbers in recent years as local populations have declined. About 170 rural hospitals have shut down since 2005. [F]or-profit hospitals are more likely to close than the others, one recent federal study showed. It found that for-profit facilities accounted for 11 percent of rural hospitals but 36 percent of closures among the group. Within the past year, rural hospitals have closed in Pennsylvania and Tennessee after selling to for-profit chains. Ms. Horwitz’s research found that for-profit rural hospitals were less likely to offer needed but unprofitable medical services, such as hospice and inpatient psychiatric care.

“The goal of the for-profit is to make money,” Ms. Horwitz said. “That doesn’t mean they’ll do anything to make a buck, but they have a different goal from nonprofits.”

Alecto’s hospitals generally serve low-income communities, with most patients covered by Medicare or Medicaid. In Marion County, for example, the population once served by Fairmont has higher-than-average smoking and obesity rates. The state also had the country’s highest rate of drug overdose deaths in 2018. West Virginia University’s health system, about 12 miles from Fairmont, plans to reopen part of the Fairmont hospital but will not be able to do so until late May.

For now, the three communities face a stretch of months where hospital beds could be scarce in the midst of a global pandemic. Jennifer Henderson Hayes, who was the chief pharmacist at East Ohio, now works at the remaining hospital in Wheeling.

She has already seen greater strain on the emergency room there. “You see people, potentially sick with Covid-19, waiting for eight or 12 hours just to be seen.”

For profit hospitals are a problem in my opinion.  Years ago when I worked for a law firm that represented a non-profit hospital system, administrators regularly complained that the for profit Humana hospital 20 minutes away would send uninsured patients by taxi to the non-profit hospital rather than treat them. 

Sunday Morning Male Beauty

Why Cocktail Hour Is Back

A French 75.

A piece in the New York Times looks at the revival of cocktail hour as many of us are working from home and/or seek a release from the subtle stress of living in a pandemic where you must treat everyone you meet as potentially contagious, wearing a mask and wiping down everything with sanitizer (routine real estate closings I do have a whole new underlying element of stress).   Meanwhile, as a piece in the Virginian Pilot notes, liquor sales in Virginia and other states have skyrocketed and there is a new focus on cocktails (beer sales have increased nowhere near as much as hard liquor). As the Times piece notes, cocktail hour meets a need: "we need the ritual; we have the time; and during lockdown, it’s 5 o’clock everywhere."  I think cocktail hour also meets another need for many, especially those of us of a certain age: nostalgia and a sense of a better time when things and life were more certain. In my youth I still recall cocktail hour at our summer home as my parents and relatives had cocktails on the front porch overlooking the lake discussing family things, reminiscing, and discussing politics (always a constant in my family).  Here are article highlights:

“Is it too early to drink?” A few weeks into our current disorientation, that line or some jokey variation of it began to appear with a certain frequency on Twitter, in texts I’d get, in Slack messages, in my head.

I would encounter it, too, during long calls with friends that now followed a distinct sequence . . . resolving, invariably, with a conversation about last night’s cocktail and the plan for this evening’s.

One friend recently posted a picture of David A. Embury’s classic primer, “The Fine Art of Mixing Drinks,’’ published in 1948, on his Facebook page with the caption: “Homework.’’ Another friend, Jimmy, was making Palomas with a grapefruit soda created by a Los Angeles bartender, which was now sold out on Amazon and at Target.

If you told me at Thanksgiving that in six months we would all be confined to our homes and facing shortages of toilet paper and a cactus-infused organic citrus beverage, I would have hugged you and smiled, and quietly called your psychopharmacologist to suggest adjustments.

[I]n New York and many other states, liquor stores were deemed essential retail businesses on the premise that our anxiety was going to require release. But there was a growing need as well for new rituals to replace the ones that had vanished from our lives — for a style of drinking that was neither rushed nor indiscriminate, presuming we were of sound health and blessed with the structural comforts. Gulping down a glass of wine from a screw-top bottle as you frantically heated leftovers because you got home late from work, again, was a habit it no longer seemed necessary to honor.

My friend Nelson and his wife have suddenly found themselves in a nightly cocktail routine. He recalled the sanctity of his parents’ cocktail hour, growing up in Palo Alto in the 1970s, and tracked its waning dignity in the years that followed. How could any of us have imagined that a pandemic would revive it? According to a 1958 New York Times article, the institutionalization of cocktail hour in American life can be dated precisely to Dec. 5, 1933, when the 21st Amendment made alcohol legal again. Cocktails “and the late-afternoon hour devoted to them,’’ the article explained, were a direct result of the Prohibition-era practice of disguising the flavor of bathtub gin and other spirits with fruit juices. It’s hard to say when it ended, but the tech boom was one assassin. In my own life, the need to punctuate the end of the day at a moment when time feels so static has left me looking for the exclamation points. On many days, I will make a drink that requires precise measurements, special equipment, effort, the boiling of water, the dissolving of sugar — order and the promise of a particular certainty. Perhaps some during this period will develop bad habits that require their own cures. I hope that is not the case. Five o’clock is now a lot closer to bed time than it used to be. And a single cocktail can feel like the best inoculation against dread.

Yes, the husband an I had cocktails last night - and will again this evening.

The Pandemic Has Shown That America is a Very Broken State

If nothing else, the Covid-19 pandemic is revealing that years of Republican policies - both under George W. Bush, while the GOP held the U.S. Senate and obstructed the Obama administration efforts, and now under the corrupt and incompetent regime of Der Trumpenführer - have left America a broken state.  Some might even argue a failed state.  Clearly, America is not the nation that won WWII and was the unrivaled leader of the world in the post-WWII era, leading in technology, manufacturing, science and a government infrastructure and economy that worked for a majority of Americans.  The GOP has long sought to bring back the Gilded Age of the late 1800's and pre-WWI era when the robber barons and incredible rich payed little in taxes while the rest of the citizenry struggled to get bay.  Under the Trump/Pence regime, much of this GOP agenda has been realized with huge tax cuts for the wealthy, the rolling back of health and safety regulations, and an economic system designed to benefit the wealthy first and foremost.  Now, the pandemic gripping the nation has pulled back the curtain and revealed the consequences of GOP policies.  A very long piece in The Atlantic looks at where America finds itself and the decision that must be made as to where the nation goes from here.  The following are article highlights: 

When the virus came here, it found a country with serious underlying conditions, and it exploited them ruthlessly. Chronic ills—a corrupt political class, a sclerotic bureaucracy, a heartless economy, a divided and distracted public—had gone untreated for years. We had learned to live, uncomfortably, with the symptoms. It took the scale and intimacy of a pandemic to expose their severity—to shock Americans with the recognition that we are in the high-risk category. 

The crisis demanded a response that was swift, rational, and collective. The United States reacted instead like Pakistan or Belarus—like a country with shoddy infrastructure and a dysfunctional government whose leaders were too corrupt or stupid to head off mass suffering. The administration squandered two irretrievable months to prepare. From [Trump] the president came willful blindness, scapegoating, boasts, and lies. From his mouthpieces, conspiracy theories and miracle cures. A few senators and corporate executives acted quickly—not to prevent the coming disaster, but to profit from it. When a government doctor tried to warn the public of the danger, the White House took the mic and politicized the message. Every morning in the endless month of March, Americans woke up to find themselves citizens of a failed state. With no national plan—no coherent instructions at all—families, schools, and offices were left to decide on their own whether to shut down and take shelter. When test kits, masks, gowns, and ventilators were found to be in desperately short supply, governors pleaded for them from the White House, which stalled, then called on private enterprise, which couldn’t deliver. States and cities were forced into bidding wars that left them prey to price gouging and corporate profiteering. Civilians took out their sewing machines to try to keep ill-equipped hospital workers healthy and their patients alive. Russia, Taiwan, and the United Nations sent humanitarian aid to the world’s richest power—a beggar nation in utter chaos. Donald Trump saw the crisis almost entirely in personal and political terms. Fearing for his reelection, he declared the coronavirus pandemic a war, and himself a wartime president. But the leader he brings to mind is Marshal Philippe Pétain, the French general who, in 1940, signed an armistice with Germany after its rout of French defenses, then formed the pro-Nazi Vichy regime. Like Pétain, Trump collaborated with the invader and abandoned his country to a prolonged disaster. And, like France in 1940, America in 2020 has stunned itself with a collapse that’s larger and deeper than one miserable leader.

[I]t should force a question that most Americans have never had to ask: Do we trust our leaders and one another enough to summon a collective response to a mortal threat? Are we still capable of self-government?

This is the third major crisis of the short 21st century. The first, on September 11, 2001, came when Americans were still living mentally in the previous century, and the memory of depression, world war, and cold war remained strong. On that day, people in the rural heartland did not see New York as an alien stew of immigrants and liberals that deserved its fate, but as a great American city that had taken a hit for the whole country.

Partisan politics and terrible policies, especially the Iraq War, erased the sense of national unity and fed a bitterness toward the political class that never really faded. The second crisis, in 2008, intensified it. At the top, the financial crash could almost be considered a success. Congress passed a bipartisan bailout bill that saved the financial system. Outgoing Bush-administration officials cooperated with incoming Obama administration officials. . . . . . All of the lasting pain was felt in the middle and at the bottom, by Americans who had taken on debt and lost their jobs, homes, and retirement savings. Many of them never recovered, and young people who came of age in the Great Recession are doomed to be poorer than their parents. Inequality—the fundamental, relentless force in American life since the late 1970s—grew worse. Social bonds had been under growing strain for several decades, and now they began to tear. The reforms of the Obama years, important as they were—in health care, financial regulation, green energy—had only palliative effects. The long recovery over the past decade enriched corporations and investors, lulled professionals, and left the working class further behind. The lasting effect of the slump was to increase polarization and to discredit authority, especially government’s. Trump came to power as the repudiation of the Republican establishment. But the conservative political class and the new leader soon reached an understanding. Whatever their differences on issues like trade and immigration, they shared a basic goal: to strip-mine public assets for the benefit of private interests. Republican politicians and donors who wanted government to do as little as possible for the common good could live happily with a regime that barely knew how to govern at all, and they made themselves Trump’s footmen. Like a wanton boy throwing matches in a parched field, Trump began to immolate what was left of national civic life. He never even pretended to be president of the whole country, but pitted us against one another along lines of race, sex, religion, citizenship, education, region, and—every day of his presidency—political party. His main tool of governance was to lie. A third of the country locked itself in a hall of mirrors that it believed to be reality; a third drove itself mad with the effort to hold on to the idea of knowable truth; and a third gave up even trying. Trump acquired a federal government crippled by years of right-wing ideological assault, politicization by both parties, and steady defunding. He set about finishing off the job and destroying the professional civil service. He drove out some of the most talented and experienced career officials, left essential positions unfilled, and installed loyalists as commissars over the cowed survivors, with one purpose: to serve his own interests. His major legislative accomplishment, one of the largest tax cuts in history, sent hundreds of billions of dollars to corporations and the rich. This was the American landscape that lay open to the virus: in prosperous cities, a class of globally connected desk workers dependent on a class of precarious and invisible service workers; in the countryside, decaying communities in revolt against the modern world; on social media, mutual hatred and endless vituperation among different camps; in the economy, even with full employment, a large and growing gap between triumphant capital and beleaguered labor; in Washington, an empty government led by a con man and his intellectually bankrupt party; around the country, a mood of cynical exhaustion, with no vision of a shared identity or future. If the pandemic really is a kind of war, it’s the first to be fought on this soil in a century and a half. Invasion and occupation expose a society’s fault lines, exaggerating what goes unnoticed or accepted in peacetime, clarifying essential truths, raising the smell of buried rot.
 The virus should have united Americans against a common threat. With different leadership, it might have. Instead, even as it spread from blue to red areas, attitudes broke down along familiar partisan lines. The virus also should have been a great leveler. You don’t have to be in the military or in debt to be a target—you just have to be human. But from the start, its effects have been skewed by the inequality that we’ve tolerated for so long. . . . . . ordinary people with fevers and chills had to wait in long and possibly infectious lines, only to be turned away because they weren’t actually suffocating. An internet joke proposed that the only way to find out whether you had the virus was to sneeze in a rich person’s face. [T]he rich had been allowed to buy their way out of military service and hoard gas masks. As the contagion has spread, its victims have been likely to be poor, black, and brown people. The gross inequality of our health-care system is evident in the sight of refrigerated trucks lined up outside public hospitals. We now have two categories of work: essential and nonessential. Who have the essential workers turned out to be? Mostly people in low-paying jobs that require their physical presence and put their health directly at risk: warehouse workers, shelf-stockers, Instacart shoppers, delivery drivers, municipal employees, hospital staffers, home health aides, long-haul truckers. Doctors and nurses are the pandemic’s combat heroes, but the supermarket cashier with her bottle of sanitizer and the UPS driver with his latex gloves are the supply and logistics troops who keep the frontline forces intact. In a smartphone economy that hides whole classes of human beings, we’re learning where our food and goods come from, who keeps us alive. The pandemic has also clarified the meaning of nonessential workers. One example is Kelly Loeffler, the Republican junior senator from Georgia, whose sole qualification for the empty seat that she was given in January is her immense wealth. Less than three weeks into the job, after a dire private briefing about the virus, she got even richer from the selling-off of stocks, then she accused Democrats of exaggerating the danger and gave her constituents false assurances that may well have gotten them killed. Loeffler’s impulses in public service are those of a dangerous parasite. The purest embodiment of political nihilism is not Trump himself but his son-in-law and senior adviser, Jared Kushner. In his short lifetime, Kushner has been fraudulently promoted as both a meritocrat and a populist. He was born into a moneyed real-estate family the month Ronald Reagan entered the Oval Office, in 1981—a princeling of the second Gilded Age. Despite Jared’s mediocre academic record, he was admitted to Harvard after his father, Charles, pledged a $2.5 million donation to the university. Father helped son with $10 million in loans for a start in the family business, then Jared continued his elite education at the law and business schools of NYU, where his father had contributed $3 million. [W]hen his father-in-law became president, Kushner quickly gained power in an administration that raised amateurism, nepotism, and corruption to governing principles. As long as he busied himself with Middle East peace, his feckless meddling didn’t matter to most Americans. But since he became an influential adviser to Trump on the coronavirus pandemic, the result has been mass death. To watch this pale, slim-suited dilettante breeze into the middle of a deadly crisis, dispensing business-school jargon to cloud the massive failure of his father-in-law’s administration, is to see the collapse of a whole approach to governing. It turns out that scientific experts and other civil servants are not traitorous members of a “deep state”—they’re essential workers, and marginalizing them in favor of ideologues and sycophants is a threat to the nation’s health. It turns out that “nimble” companies can’t prepare for a catastrophe or distribute lifesaving goods—only a competent federal government can do that. It turns out that everything has a cost, and years of attacking government, squeezing it dry and draining its morale, inflict a heavy cost that the public has to pay in lives. All the programs defunded, stockpiles depleted, and plans scrapped meant that we had become a second-rate nation. Then came the virus and this strange defeat. The fight to overcome the pandemic must also be a fight to recover the health of our country, and build it anew, or the hardship and grief we’re now enduring will never be redeemed. Under our current leadership, nothing will change. If 9/11 and 2008 wore out trust in the old political establishment, 2020 should kill off the idea that anti-politics is our salvation. But putting an end to this regime, so necessary and deserved, is only the beginning.

We’re faced with a choice that the crisis makes inescapably clear. We can stay hunkered down in self-isolation, fearing and shunning one another, letting our common bond wear away to nothing. Or we can use this pause in our normal lives to pay attention . . . We can learn from these dreadful days that stupidity and injustice are lethal; that, in a democracy, being a citizen is essential work; that the alternative to solidarity is death. After we’ve come out of hiding and taken off our masks, we should not forget what it was like to be alone.

More Saturday Male Beauty

Hopefully Trump Is Self-Destructing Before Our Eyes

The lies and insanity coming from Donald Trump's daily coronavirus briefings is so overwhelming that a number of Republican elected officials are whispering that the briefings need to stop.  Daily, Trump provides Joe Biden and other Democrats with material for future political ads that underscore his utter incompetence.  Trump's latest off the charts batshitery was to suggest that injecting humans with disinfectants would be a cure for Covid-19.  Yes, it would be a cure alright, the patient would be dead and the virus thus defeated. As the New York Times reports, both manufacturers of disinfectants and health officials have rushed to urge people to NOT follow Trump's suggestions: 

[Maryland's] Emergency Management Agency had to issue a warning that “under no circumstances” should any disinfectant be taken to treat the coronavirus. In Washington State, officials urged people not to consume laundry detergent capsules. Across the country on Friday, health professionals sounded the alarm.

Injecting bleach or highly concentrated rubbing alcohol “causes massive organ damage and the blood cells in the body to basically burst,” Dr. Diane P. Calello, the medical director of the New Jersey Poison Information and Education System, said in an interview. “It can definitely be a fatal event.”

Even the makers of Clorox and Lysol pleaded with Americans not to inject or ingest their products.

The frantic reaction was prompted by President Trump’s suggestion on Thursday at a White House briefing that an “injection inside” the human body with a disinfectant like bleach or isopropyl alcohol could help combat the virus.

One has to wonder when my Republican friends will finally admit that the elected a lunatic to the Oval Office.  Not a day goes by without numerous lies and falsehoods being disseminated by Trump.  It's so bad that CNN now has a daily piece that reviews the prior evening's falsehoods.  A column also in the Times speculates that Trump is self-destructing before our eyes (although probably not in the eyes of his knuckle dragging, racist base, some of whom may try Trump's suggested "cure").  Here are column highlights:

Tens of thousands of Americans die; what does the president do? Spreads bad information. Seeds false hope. Reinvents history, reimagines science, prattles on about his supposed heroism, bellyaches about his self-proclaimed martyrdom and savages anyone who questions his infallibility. In lieu of leadership, grandstanding. In place of empathy, a snit. And he’s going to get re-elected.

With that refrain we perform a spiritual prophylaxis. We prepare for despair. . . . We began to treat a verbal tic as inevitable truth.

It isn’t. While Trump may indeed be careening toward four more years, it’s at least as possible that he’s self-destructing before our eyes.

Maybe a toasty beam of sunlight is all that we need to wipe out the coronavirus? What if we just injected disinfectant into our veins? He floated both of those fantasies on Thursday, when he might as well have stepped up to the lectern in a tin foil hat. They’re the ramblings of a dejected, disoriented and increasingly desperate man.

As Katie Rogers and Annie Karni reported in The Times, [Trump] the president feels isolated and embattled and is panicked that he’ll lose to Joe Biden in November. That state of mind, they wrote, prompted his executive order to halt the issuing of green cards, which is precisely the kind of base-coddling measure that he resorts to “when things feel out of control.”

He can read the polls as well as the rest of us can, and they show that while he stands there nightly in the White House briefing room and blows kisses at himself, Americans aren’t blowing kisses back. A month ago there was much ado about a slight uptick in Trump’s job-approval numbers. But the real story was the slightness: Past presidents had experienced greater bumps during crises, when Americans tend to rally around their leader. For Trump there was no such rallying — just a grudging, incremental benefit of the doubt. A fleeting one, too. His uptick quickly took a downturn, reuniting him with his anemic norm. According to the polling average at FiveThirtyEight as of late Friday afternoon, 52.5 percent of Americans disapprove of his job performance. Only 43.4 percent approve. Other numbers tell an even scarier story for Trump. In all three of the battleground states that enabled his Electoral College victory three and a half years ago, he’s currently behind Biden — by 6.7 percentage points in Pennsylvania, 5.5 in Michigan and 2.7 in Wisconsin, according to the averaging of recent polls by RealClearPolitics. That website also puts him behind by 3.2 points in Florida, a state he won in 2016 and must win again. According to monthly polling by Gallup, the percentage of Americans who indicated satisfaction with the way things were going in the country plummeted to 30 percent in mid-April from 42 percent in mid-March. Only twice before in the past two decades has there been a one-month decline that precipitous.

Maybe this drop was less a referendum on Trump’s stewardship than a recognition of the coronavirus’s devastation. But maybe not: Surveys reveal that a significant majority of Americans believe that he acted too late to stem the virus’s spread. He’s also out of step with most Americans’ appraisal of what will and won’t be safe in the immediate future.

In a Washington Post-University of Maryland poll, 65 percent of Americans said it could take until June or later for gatherings of 10 people or more to be safe. And in a Yahoo News/YouGov poll, only 22 percent of Americans supported the protesters who have been demanding an end to their states’ restrictions, while 60 percent opposed them. President Trump has egged those protesters on.

Is he following some gut instinct or just flailing? I vote for the latter. Lately he has contradicted himself at a whole new pace and to a whole new degree, and he has undercut his own party’s talking points.

Republicans have developed a strategy to evade any responsibility for Trump’s response to the pandemic by blaming and demonizing China. “But there is a potential impediment to the G.O.P. plan — the leader of the party himself,” Martin and Haberman wrote, noting that Trump has “muddied Republican efforts to fault China” by continuing to curry favor with President Xi Jinping. Also, Trump’s most optimistic pronouncements about imminent deliverance from the current misery represent a bigger gamble than the many others he has taken. If he’s wrong, there’s not going to be any hiding it. If he’s reckless, the toll is Americans’ very lives. There’s incessant talk of how fervent his base is, but the many Americans appalled by him have a commensurate zeal. For every Sean Hannity, there’s a Rachel Maddow. For every Kellyanne Conway, a George Conway. She and her ilk may be wily in their defense of the president. He and his tribe are even better in their evisceration of him.

And what of the diaspora of refugees from the Trump administration: people like Rick Bright, the government scientist who says he was just stripped of his leading role in the search for a coronavirus vaccine because he wouldn’t parrot Trump’s cockamamie talking points? I predict that as November nears, more and more exiles will speak out, sharing alarming accounts of life inside the president’s hall of mirrors. Trump in turn will mutter about the “deep state,” but the phrase won’t fly when he’s left with such a shallow pool of charlatans around him — and when he’s making such a repellent fool of himself.

Don’t tell me that his nightly briefings are just a new version of the old stadium rallies; their backdrop of profound suffering makes them exponentially harder to stomach. Americans who take any comfort from them were Trump-drunk long ago. The unbesotted see and hear the president for what he is: a tone-deaf showman who regards everything, even a mountain of corpses, as a stage.

I sincerely hope the author is correct.

Saturday Morning Male Beauty

click image to enlarge

Trump Regime Moves to Scrap Protections for LGBT Healthcare Patients

Trump, Pence and HHS Secretary Azar.

With the Covid-19 pandemic raging one would think that the main focus of the Trump/Pence regime would be on insuring that all Americans have access to quality healthcare without any obstacles.  Sadly, that would be a false assumption.  As Politico is reporting the Trump/Pence regime is continuing on its quest to roll back Obama administration policies that protected LGBT individuals from discrimination and the refusal of medical services which in the LGBT context are part of Trump's efforts to impose the anti-LGBT license to discriminate laws  Trump's motivation for with such vile actions?  To maintain his support among evangelical Christians and Christofascists who cannot tolerate any regulations or policies that restrict their ability to mistreat those they deem "other" and who have a sick need to look down upon others in order to feel superior.  Here are highlights from Politico:

The Trump administration is moving to scrap an Obama-era policy that protected LGBTQ patients from discrimination, alarming health experts who warn that the regulatory rollback could harm vulnerable people during a pandemic.

The health department is close to finalizing its long-developing rewrite of Obamacare’s Section 1557 provision, which barred health care discrimination based on sex and gender identity. The administration’s final rule on Thursday was circulated at the Justice Department, a step toward publicly releasing the regulation in the coming days, said two people with knowledge of the pending rule. The White House on Friday morning also updated a regulatory dashboard to indicate that the rule was under review. Advocates fear that it would allow hospitals and health workers to more easily discriminate against patients based on their gender or sexual orientation.

The Obama administration moved to create its non-discrimination protections in response to advocates and health care experts who said that LGBTQ patients were being turned away from necessary care or intimidated from seeking it out. The broad rule also offered specific protections for transgender patients for the first time and extended protections for women who had abortions. But a federal judge in 2016 blocked those protections following a lawsuit from religious groups, and the Trump administration has steadily worked to weaken the rule before it could take full effect.

In last year's proposal, the health department also proposed changes that went further than simply rolling back the new Obama protections, moving to eliminate similar nondiscrimination protections for LGBTQ patients that were contained in other regulations.

"If the final rule is anything like the proposed rule, HHS is adopting changes that would be harmful in the best of times but that are especially cruel in the midst of a global pandemic that is disproportionately affecting vulnerable communities and exacerbating disparities,” said Katie Keith, a lawyer and Georgetown professor who’s tracked the rule.

The health department's top civil rights official also defended the administration's approach to vulnerable populations. “As we have shown in our recent efforts to protect persons from disability and age discrimination during the pandemic, HHS will vigorously enforce civil rights laws as passed by Congress, before, during, and after any rulemaking,” Roger Severino, the HHS civil rights chief, said in a statement. Severino was an active critic of the Obama-era non-discrimination rules before joining the administration. Any rule issued by the Trump administration on LGBTQ protections could be short-lived. The Supreme Court is set to rule on whether the Civil Rights Act protects LGBTQ workers, which could create a new regulatory framework and force health officials to swiftly return to the drawing board.

Given the Trump/Pence regime's anit-LGBT agenda - and that of the GOP in general, I find it dumbfounding that a small percentage of gays continue to call themselves Republicans. It makes about as much sense as a 1930's German Jew joining the Nazi Party.