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Joe BidenBiden knows fate of spending plan will show extent of his power – and define his legacy The president is about to embark on a legislative push with almost no room for errorLauren Gambino in Washington@ More
President Biden urged Americans to come forward to receive the Pfizer vaccine after it received FDA approval. The US Food and Drug Administration (FDA) is trying to finish its licensing process for the drug as soon as Monday.
The president spoke directly to Americans who have said they would wait to get vaccinated until one of the vaccines received full FDA approval. ‘It has now happened,’ Biden said. ‘The moment you’ve been waiting for is here. It’s time for you to go get your vaccination – and get it today’
Full FDA approval of Pfizer Covid shot will enable vaccine requirements More
RepublicansOklahoma Republicans: vaccine mandates like Nazi persecution of Jewish peoplePost on Facebook page features yellow Star of DavidVice-chairman calls post ‘beyond abhorrent’ A More
CoronavirusTennessee radio host doubted and mocked vaccines – now he has Covid
Phil Valentine’s family urges listeners to get the shot
Host sang ‘Vaxman’ Beatles parody and touted choice
Tennessee hospital grapples with Delta and vaccine hesitancy
Martin Pengelly in New York@ More
OpinionUS healthcareLike millions of Americans, I can never leave my spouse. I’ll lose my healthcareJessa CrispinMy access to doctors is tied to my husband – and his access is tied to his employer. Land of the free indeed Fri 23 Jul 2021 06.17 EDTLast modified on Fri 23 Jul 2021 07.03 EDTIt was around the second dose of fentanyl going into my IV bag that I stopped trying to control how much all of this was going to cost. I had been arguing with every decision the caregivers at the emergency room were making – “Is this Cat scan actually necessary or is there another diagnostic tool?” “Is there a cheaper version of this drug you’re giving me?” – and reminding them repeatedly that I was uninsured, but either the opioids in my bloodstream, or the exhaustion of trying to rest in a room next to a woman who, given the sounds she was making, was clearly transforming into a werewolf, forced me to surrender.Why is a 108-year-old resorting to GoFundMe to pay for home care? | Ross BarkanRead moreI walked out of there four years ago alive, yes. And, as the doctors and nurses kept reminding me, if I had waited another 48 hours to discover I didn’t actually have the magical ability to self-diagnose and self-treat serious problems with Google and herbs, I might have gone septic. But all said and done, I was also walking home to a $12,000 bill, which was approximately half of my annual income as a single woman.It took me several years of hardship, contributions from my friends and the assistance of the hospital’s charity program to pay off the $12,000.Then, last month, it started again. I was at home. I turned my head a little, the whole world started sliding away from me, and I crashed to the floor. I tried to crawl back into bed, insisting, “It’ll pass, it’ll pass.” My husband, on the other hand, was raised in a country with compulsory public health coverage, so his first instinct upon something weird happening isn’t to lie down for 48 hours and see if it goes away. He immediately started plotting the route to a hospital on his phone.I was back, but this time I was married. The whole hospital visit cost us $30, including the prescription. Everything was covered by his insurance. That’s when I realized I can never divorce my husband.The first emergency room visit might have been an anomaly – a freak health problem that the nurse explained as “sometimes these things happen”. The intense vertigo was the result of the deterioration of the condition of my ears. It has been a problem since childhood, one left in “let’s wait and see what happens” condition until a weird virus last year – yes, I was the big idiot who caught a debilitating non-coronavirus virus during a coronavirus pandemic – forced me to a doctor, who discovered significant hearing loss and structural damage that will require lifelong treatment and intervention.As a freelance writer who has tried and failed for years now to get a real job with real benefits, the costs of the surgeries and hearing aids and other treatments the doctor sketched out as part of my future would be suffocating. But almost all of it is covered by my husband’s insurance, making my health and ability to access healthcare dependent on his presence in my life.While I convalesced from the virus last year, I watched the discussion about health insurance take over the Democratic primary debates. I had little hope that the bright, sparkly Medicare for All plan championed by candidates like Bernie Sanders would be made reality. But still I despaired of the excuses other candidates made for why they did not support guaranteed coverage for all. It angered me to see Amy Klobuchar, Pete Buttigieg and the eventual winner, Joe Biden, defend their plans to largely maintain the status quo – a system in which employment and marriage determine access to healthcare – as though they were protecting our “freedom” to “choose” coverage that was right for us.The coercions built into American social welfare programs limit freedom, not preserve it. People who are not financially independent are forced to maintain ties with family members who might be abusive or violent unless they want to relinquish their housing, healthcare or other forms of support. And as outlined by Melinda Cooper’s Family Values: Between Neoliberalism and the New Social Conservatism, the dismantling of protections like food and financial aid in the 80s and 90s had the express purpose of increasing familial obligations in the name of “duty” and “responsibility”. Single parents seeking public support for their children’s wellbeing now had to first seek assistance through their partners, no matter how fraught or harmful those relationships might be. While politicians spoke of “strengthening families” and repairing the social fabric, one of the consequences of these policy changes was to limit the ability for people to make the basic decisions required to live the lives of their choosing, unless they had the money that in this country is our substitute for freedom.It’s not just unhealthy families we are stuck in: a Gallup poll revealed that one in six Americans stay in jobs they want to leave because they can’t afford to lose their health benefits. Politicians on both sides claim to support innovation and entrepreneurship, but the cost of healthcare is a huge barrier for many, and something that could be easily resolved with a public option. It’s almost as if we believe people who are sick, unlucky or not blessed by inherited resources deserve to have their choices constrained and stay trapped in perilous circumstances. (That last part is a joke. We Americans definitely believe this.)We have a Democrat-led Congress and a Democratic president, yet there is no public option or significant overhaul of our broken health insurance system on the horizon. As a result, when my husband got offered his dream job at an emerging non-profit startup, one so new that when the offer was made they could not yet offer health benefits, he hesitated. There would be a gap in coverage, of indeterminate length, and there was still that $12,000 emergency room visit in recent memory.In the end, simply by luck, the startup found a way to enroll employees in a health program that left us with only a one-month gap in coverage. I am lucky to be married to someone I like, who I am not afraid of, who I do not want to leave. This hasn’t always been the case for women in my family, or even myself in my 20s. For now, and for the foreseeable future, my access to doctors is tied to my partner, and his to his employer. Land of the free indeed.
Jessa Crispin is a Guardian US columnist
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A US public health expert has warned that though cases of Covid-19 are at their lowest rates for months and much of the country is returning to normal life, young Americans are still “a vulnerable host” for the coronavirus.Dr Richina Bicette, associate medical director at Baylor College of Medicine in Houston, told CNN children were now accounting for nearly 25% of US cases.“As adults get vaccinated and become more protected and immune,” she said, “the virus is still in the community looking for a vulnerable host and pediatric patients fit that description.”Children aged 12 and above are eligible to receive the Pfizer-BioNTech vaccine, one of three in US use. Federal authorities will this week debate extending vaccines to children aged 11 and under.Centers for Disease Control and Prevention (CDC) data shows that 52% of the US population over the age of 12 has had at least one vaccine dose and 42% is fully protected.The Biden administration wants 70% of US adults to have received at least one shot by 4 July. A range of incentives are being offered.Deaths in the US have slowed drastically, the toll a little under 590,000. But with virus variants causing problems as other countries reopen, experts have voiced concern over slowing rates of vaccination, particularly in Republican states.On Sunday the Republican governor of Mississippi, Tate Reeves, appeared on CNN’s State of the Union.Mississippi is 50th and last among states in vaccinations, with 30% of residents fully protected and 40.5% aged 12 and older having received at least one dose, according to the CDC. The states with the highest vaccination rates are Vermont (80.6% – with a Republican governor, Phil Scott), Hawaii (78.6%) and Massachusetts (76.8%).“I believe the vaccine works,” Reeves said. “I believe it’s safe. I believe it’s effective. I took my first dose in January, as did my wife, on TV live, and I have encouraged Mississippians to do the same.“But I also want to point out that President Biden’s goals for 4 July or otherwise are arbitrary to say the least.”Reeves said his focus was on providing “quality care” for people with Covid-19 – and trumpeted a steep decline in hospitalisations.“At our peak, we had 1,444 individuals in the hospital,” he said. “Today, we have 131. We’re down 90%. At our peak, we had 2,400 cases per day over a seven-day period. Over the last seven days, we have had barely 800 cases in total.“And so, for that entire year period, the goalpost was, let’s reduce the number of cases. And we have been successful at doing that. The question is, why?“We have had a million Mississippians that have gotten the vaccine, but we have also had 320,000 Mississippians that have tested positive for the virus. Many people believe that somewhere between four and five times more people have gotten the virus that have not tested [positive].“And so we have got probably a million or so Mississippians that have natural immunity. And because of that, there is very, very, very little virus in our state. But we’re still working to get the vaccine distributed, and hope we will continue to do so.”Asked if he was worried unvaccinated Mississippians could be “sitting ducks” to any surge involving a virus variant, Reeves avoided the question, complaining instead about political clashes with Biden officials.Host Jake Tapper changed tack, saying: “You seem to be arguing everybody should get vaccinated, and yet it’s not that big a deal that not everybody’s getting vaccinated. And those seem to be in conflict.”He then asked if Reeves would agree that Mississippians should go get vaccinated.“I would absolutely agree,” Reeves said. “I think that all Mississippians and all Americans should go get vaccinated, because I think it’s safe, I think it’s effective and I think it’s one way to continue to drive down the numbers.” More
When medical staff prepped Shawn Thierry for an emergency C-section, she knew something was very wrong. After an epidural, excruciating pain ran through her legs. Soon, she could barely breathe.“I felt like my heart was going to jump out of my chest and that I might die,” she said.She screamed for her doctor to put her under anesthesia – which happened to be the solution. The epidural, Thierry later found out, was given too high in her spine, causing a paralysis that inched toward her heart.“I was an attorney who had full private healthcare coverage and I almost died,” said Thierry, of the birth of her daughter in 2012. “I cannot imagine what the outcome would be for the thousands of other African American women without health insurance.”Years later, as a member of the Texas House, Thierry was “stunned” to learn of the state’s maternal mortality crisis.The US has the highest maternal death rate among similarly developed countries and is the only industrialized nation where such deaths are rising. But according to data from the federal Centers for Disease Control and Prevention, in Texas the maternal mortality rate is above the US average, at 18.5 deaths per 100,000 live births.Black women in the state are “disproportionately” affected, accounting for 11% of live births but 31% of maternal deaths. Wide racial and ethnic disparities exist nationally too.I was shocked that black mothers like myself are three times more likely to die than our white counterparts“I was shocked that black mothers like myself are three times more likely to die than our white counterparts,” said Thierry. “And no one in the legislature was really talking about it.”She has repeatedly filed legislation to combat the glaring problem. Her proposals included racial bias training for medical professionals and a bill to fix a “severe” maternal health data backlog by creating a centralized registry.They did not advance in 2019, or in the current legislative session which ends this weekend. Focused on restricting abortion rights, the male- and Republican-dominated state legislature has dragged its feet on maternal mortality.Health advocates were cautiously optimistic that in 2021 Texas lawmakers would at least usher through a proposal to extend Medicaid care to a year after birth.Lawmakers did take action. A proposal was sent to Governor Greg Abbott on Friday. But it stopped short of providing the full Medicaid expansion.‘A large racial disparity’A state maternal mortality and morbidity review committee found that out of pregnancy related deaths in Texas in 2013, about a third occurred 43 days to a year after the end of pregnancy. It also discovered that nearly 90% of such deaths were preventable. Among the leading underlying causes of death with the highest chance of preventability were infection, hemorrhage, preeclampsia and cardiovascular conditions.“It was really striking,” said Dr Amy Raines-Milenkov, a University of North Texas Health Science Center professor and member of the review committee. “We found that most of these deaths could have been prevented but the system is just not set up to prevent them. And we found a large racial disparity, which is a reflection of how we in society value women, especially African American women.”Since 2016, the committee’s No1 recommendation to help save lives has been to extend Medicaid coverage postpartum for low-income mothers to a year. Currently, Texas kicks new moms off Medicaid after 60 days, leading to delayed and less preventative care. The American Medical Association and the American College of Obstetricians and Gynecologists support longer postpartum care.“So many health problems can develop in this really sensitive time period, so it is critical that new moms have that full year of extended coverage,” said Raines-Milenkov. “To think new mothers can identify problems, get timely appointments and follow up with their doctors within just two months of having a baby is unrealistic. Anything less than 12 months is really insufficient.”The Biden administration recently initiated incentives for states to expand postpartum coverage to 12 months. Illinois was the first to have its extension approved and other states including Florida and Virginia hope to implement measures soon.Toni Rose, a Dallas representative, joined Thierry in filing HB 133, to do just that in Texas. The Republican-dominated House passed the bill with rare bipartisan approval and nearly 70 groups, from the Texas Medical Association to the rightwing Texas Public Policy Foundation, expressed support.When it comes to saving the lives of Texas mothers, ‘splitting the difference’ is not appropriateHowever, the ultra-conservative Texas Senate – which ushered through extremist anti-abortion bills in March – did not pass the bill until the final minutes of its session. Even then, the legislation was not what was proposed. Without explanation, Republican Lois Kolkhorst of Brenham reduced the year of coverage to six months.Rose called the legislation a “victory” but said it still “falls short”. Thierry expressed dismay.“The data is clear that women are still at risk of maternal mortalities and pregnancy related complications for up to one year postpartum,” she said. “While the six months negotiated by the Texas Senate is better than the status quo, many new mothers will still be deprived of quality healthcare at a time when they are most vulnerable.“Given that this is an issue in which I have both personal and professional experience, I am disappointed. When it comes to saving the lives of Texas mothers, ‘splitting the difference’ is not appropriate.”Marsha Jones, executive director of the Afiya Center, a Dallas group that supports Black women with reproductive healthcare, said the lack of substantial progress was partly a reflection of the legislature’s misplaced priorities and lack of diversity.The Texas legislature is comprised mostly of white males: 61% of lawmakers in the House and Senate are white, even though white Texans make up just 41% of the population. Women are vastly outnumbered by men.“Black women are dying at an alarming rate for reasons that could be prevented and our state leaders cut down the main proposal that a state-appointed committee recommended to help them – why would that even happen?” said Jones. “I think it’s because it’s so easy to dismiss Black women’s lives.”The legislature expended time and energy on restricting abortion access, including passing one of the most extreme bans in the country, which allows any citizen to sue an abortion provider, as well as a “trigger” bill that bans the procedure in the event Roe v Wade, the 1973 ruling which safeguards the right to abortion, is overturned by the US supreme court.Both measures were “top legislative priorities” for the Senate leader, Lt Gov Dan Patrick, who did not make maternal mortality a listed priority.“It seems the only time we want to stand up and care about a life is when it’s in the womb,” Rose told Republicans on the House floor in May.‘Women are obviously choosing a life’In an ideological quest to punish abortion affiliates, Republicans have decimated the Texas reproductive health safety net by blocking low-income Medicaid patients from receiving life-saving preventative care at Planned Parenthood, a move resulting in reduced access to contraception and increased rates of Medicaid births, according to the Texas Policy Evaluation Project.A recent study in the medical journal Contraception showed a correlation between high maternal mortality rates and states that pass abortion barriers.“We have a maternal health crisis and conservative legislators once again made anti-choice bills a priority,” said Thierry. “They fail to realize all the women threatened by maternal deaths are obviously choosing life – they shouldn’t have to do so in exchange for their own.”Lawmakers made no significant gains for Medicaid in general. Texas is home to the highest number of uninsured residents in the US as well as the highest percentage of uninsured women of childbearing age, but it has declined to expand Medicaid under the Affordable Care Act and Republicans blocked legislative efforts to help extend healthcare coverage for the working poor.Texas has one of the steepest Medicaid eligibility requirements in the US. Of 1.4 million Texans who would benefit from expanded Medicaid, 75% are people of color.“Once again, we are kicking the can down the road with many of these solutions,” said Thierry. “It’s absolutely imperative we continue to work on reducing maternal mortality. One death is too many, especially when it’s preventable.” More
By almost any measure, Joe Biden’s first 100 days have been hugely successful. Getting millions of Americans inoculated against Covid-19 and beginning to revive the economy are central to that success.Two-thirds of Americans support Biden’s $1.9tn stimulus plan, already enacted. His infrastructure and family plans, which he outlined on Wednesday night at a joint session of Congress, also have broad backing. The $6tn price tag for all this would make it the largest expansion of the federal government since Lyndon Johnson’s Great Society. But for most Americans, it doesn’t feel radical.Rather than bet it all on a single large-scale program such as universal healthcare – which Bill Clinton failed to accomplish and which Barack Obama turned into a target of Republican fearmongering – Biden has picked an array of popular initiatives, such as preschool, public community college, paid family and medical leave, home care and infrastructure repairs, which are harder to vilify.Economists talk about pent-up demand for private consumer goods, caused by the pandemic. Biden is responding to a pent-up demand for public goods. The demand has been there for years but the pandemic has starkly revealed it. Compared with workers in other developed nations, Americans enjoy few if any social benefits and safety nets. Biden is saying, in effect, it’s time we caught up.Even on the fraught issue of race, the contrast with Trump has strengthened Biden’s handBesides, it’s hard for Republicans to paint Biden as a radical. He doesn’t feel scary. He’s old, grandfatherly. He speaks haltingly. He’s humble. When he talks about the needs of average working people, it’s clear he knows them.Biden has also been helped by the contrast to his immediate predecessor – the most divisive and authoritarian personality to occupy the Oval Office in modern memory. Had Biden been elected directly after Obama, regardless of the pandemic and economic crisis, it’s unlikely he and his ambitious plans would seem so benign.In his address to Congress, Biden credited others for the achievements of his first 100 days. They had been accomplished “because of you”, he said, even giving a nod to Republicans. His predecessor was incapable of crediting anyone else for anything.Meanwhile, the Republican party, still captive to its Trumpian base, has no message or policies to counter Biden’s proposals. Donald Trump left it with little more than a list of grievances irrelevant to the practical needs of most Americans: that Trump would have been re-elected but for fraudulent votes and a “deep state” conspiracy, that Democrats are “socialists” and that the “left” is intent on taking away American freedoms.Biden has a razor-thin majority in Congress and must keep every Democratic senator in line if he is to get his plans enacted. But the vacuum on the right has allowed him to dominate the public conversation about his initiatives, which makes passage more likely.Trump is aiding Biden in other ways. Trump’s yawning budget deficits help normalize Biden’s. When Trump sent $1,200 stimulus checks to most Americans last year regardless of whether they had a job, he cleared the way for Biden to deliver generous jobless benefits.Trump’s giant $1.9tn tax cut for big corporations and the wealthy, none of which “trickled down”, make Biden’s proposals to increase taxes on corporations and the wealthy to pay for infrastructure and education seem even more reasonable.Trump’s fierce economic nationalism has made Biden’s “buy American” initiative appear innocent by comparison. Trump’s angry populism has allowed Biden to criticize Wall Street and support unions without causing a ripple.At the same time, Trumpian lawmakers’ refusal to concede the election and their efforts to suppress votes have alienated much of corporate America, pushing executives toward Biden by default.Even on the fraught issue of race, the contrast with Trump has strengthened Biden’s hand. Most Americans were so repulsed by Trump’s overt racism and overtures to white supremacists, especially after the police murder of George Floyd, that Biden’s initiatives to end police brutality and “root out systemic racism”, as he said on Wednesday night, seem appropriate correctives.The first 100 days of the Biden presidency were also the first 100 days of America without Trump, and the two cannot be separated.With any luck, Biden’s plans might prove to be the antidote to Trumpism – creating enough decent-paying working-class jobs, along with benefits such as childcare and free community college, as to forestall some of the rightwing dyspepsia that Trump whipped into a fury. More
