Questions to ponder on the coming administration

  1. Do we all agree the next administration will be that of Joseph R. Biden Jr. not donald j. trump?
  2. Do you believe the coming administration will improve healthcare in America, worsen healthcare in America, or keep it about the same?
  3. In what way(s) do you expect the next administration to be different from the current?
  4. In general, Brown (2007) tells us, bioethics has been politicized through three traditional lenses: liberalism, communitarianism, and republicanism. Brown finds “[t]he liberal emphasis on the irreducible plurality of values […] and the communitarian concern with the social dimensions of biotechnology” can be bettered further by the republican tradition “which emphasizes institutional mechanisms” that “enrich but [do] not dominate public deliberation” ensuring public accountability and contestability. Can you imagine other forms of bioethical politicization? Can you imagine a “better” form of politics?
  5. How do we “confront profound moral disagreement” we might have amongst ourselves, such as the ethical status of moral embryos and the positions we take w/r/t them? Put less pointedly, how do approximately 74 million Americans live knowing 80 million Americans disagree (sometimes vehemently! with them and vice versa?
  6. What does a just “public option” look like? How does it function? What does it fix? What comes after it?
  7. How/Shall we revise Obamacare?
  8. Does the upcoming U.S. Supreme Court decision regarding the Affordable Care Act have a moral dimension which ought to be considered along side its legal one(s)?
  9. A recent Executive Order on Lowering Drug Prices by Putting America First1 (issued on September 13, 2020(, it became “the policy of the United States that the Medicare program should not pay more for costly Part B or Part D prescription drugs or biological products than the most-favored-nation price [… –] the lowest price, after adjusting for volume and differences in national gross domestic product, for a pharmaceutical product that the drug manufacturer sells in a member country of the Organisation for Economic Co-operation and Development (OECD) that has a comparable per-capita gross domestic product.” Should the U.S. Federal Government retain this policy in future administrations?
  10. Will the United States ever have “universal healthcare”?
  11. Will reproductive rights be improved, be diminished, or remain about the same with the Biden administration as compared to the trump administration?
  12. Which U.S. administration has done the most to improve the overall health of Americans?
  13. Will Americans live longer over the next four years than they did previously?
  14. When will this pandemic end? How?
  15. How should/can we remember/honor/carry forward the quarter million dead Americans we have lost thus far and those we’ve still yet to lose?

1. Please note this comes from the Executive Order found here https://www.whitehouse.gov/presidential-actions/executive-order-lowering-drug-prices-putting-america-first-2/. This differs from one found at a related URL (found here https://www.whitehouse.gov/presidential-actions/executive-order-lowering-drug-prices-putting-america-first/). While substantively the same, the former omits this paragraph in the original justifying the need for the Order:

The need for affordable Medicare Part B drugs is particularly acute now, in the midst of the COVID-19 pandemic, which has led to historic levels of unemployment in the United States, including the loss of 1.2 million jobs among Americans age 65 or older between March and April of 2020.  The COVID-19 pandemic has also led to an increase in food prices, straining budgets for many of America’s seniors, particularly those who live on fixed incomes.  The economic disruptions caused by the COVID-19 pandemic only increase the burdens placed on America’s seniors and other Medicare Part B beneficiaries.


In the transcript

July 25, 2019, 9:03 – 9:33 a.m. EDT, Residence

– Congratulations on a great victory. We all watched from the United States and you did a terrific.job. The way you came from behind, somebody who wasn’t given much of a chance, and you ended up winning easily. It’s a fantastic achievement. Congratulations. –

– That’s a very good idea. I think your country is very happy about that. –

– Well it it’s very nice of you to say that. I will say that we do a lot for Ukraine. We spend a lot of effort and a lot of time. Much more than the European countries are doing and they should be helping you more than they are. Germany does almost nothing for you. All they do is talk and I think it’s something that you should really ask them about. When I was speaking to Angela Merkel she talks Ukraine, but she doesn’t do anything. A lot of the European countries are the same way so I think it’s something you want to look at but the United States has been very very good to Ukraine. I wouldn’t say that it’s reciprocal necessarily because things are happening that are not good but the United States has been very very good to Ukraine. –

– I would like you to do us a favor though because our country has been through a lot and Ukraine knows a lot about it. I would like you to find out what happened with this whole situation with Ukraine, they say Crowdstrike… I guess you have one of your wealthy people… The server, they say Ukraine has it. There are a lot of things that went on, the whole situation. I think you’re surrounding yourself with some of the same people. I would like to have the Attorney General call you or your people and I would like you to get to the bottom of it. As you say yesterday, that whole nonsense ended with a very poor performance by a man named Robert Mueller, an incompetent performance, but they say a lot of it started with Ukraine. Whatever you can do, it’s very important that you do it if that’s possible. – 

– Good because I heard you had a prosecutor who was very good and he was shut down and that’s really unfair. A lot of people are talking about that, the way they shut your very good prosecutor down and you had some very bad people involved. Mr. Giuliani is a highly respected man. He was the mayor of New York City, a great mayor, and I would like him to call you. I will ask him to call you along with the Attorney General. Rudy very much knows what’s happening and he is a very capable guy. If you could speak to him that would be great. The former ambassador from the United States, the woman, was bad news and the people she was dealing with in the Ukraine were bad news so I just want to let you know that. The other thing, There’s a lot of talk about Biden’s son, that Biden stopped the prosecution and a lot of people want to find out about that so whatever you can do with the Attorney General would be great. Biden went around bragging that he stopped the prosecution so if you can look into it… It sounds horrible to me. –

– Well, she’s going to go through some things. I will have Mr. Giuliani give you a call and I am also going to have Attorney General Barr call and we will get to the bottom of it. I’m sure you will figure it out. I heard the prosecutor was treated very badly and he was a very fair prosecutor so good luck with everything. Your economy is going to get better and better I predict. You have a lot of assets. It’s a great country. I have many Ukrainian friends, their [sic] incredible people. –

– Good. Well, thank you very much and I appreciate that. I will tell Rudy and Attorney General Barr to call. Thank you. Whenever you would like to come to the White House, feel free to call. Give us a date and we’ll work that out. I look forward to seeing you. –

– Okay, we can work that out. I look forward to seeing you in Washington and maybe in Poland because I think we are going to be there at that time. –

– Congratulations on a fantastic job you’ve done. The whole world was watching. I’m not sure it was so much of an upset but congratulations. –


CAUTION: A Memorandum of a Telephone Conversation (TELCON) is not a verbatim transcript of a discussion. The text in this document records the notes and recollections of Situation Room Duty Officers and NSC policy staff assigned to listen and memorialize the conversation in written form as the conversation takes place. A number of factors can affect the accuracy of the record, including poor telecommunications connections and variations in accent and/or interpretation. The word “inaudible” is used to identify portions of a conversation that the notetaker was unable to hear.

 


Children in America will miss 9 million vaccination doses in 2020

With all this talk of soon™-to-be-approved Covid vaccines and their extra half a percent of efficacy, we might miss data recently published by Blue Cross Blue Shield indicating a 26% decline in childhood vaccinations year over year in the United States. The current pandemic was cited as a common reason for missing routine medical care.

“The U.S. is on the precipice of a severe immunization crisis among children,” said the organization’s chief medical officer.

The total number of vaccination doses for measles, mumps & rubella (MMR), diptheria, tetanus & acellular pertussis (DTaP), and polio is estimated to be approximately 9 million. The shortfall will have follow on consequences, not least of which is reduced vaccination rates leading to diminished herd immunity. The fear lurking deeper beneath that: the reemergence of diseases once believed “eradicated”.

Global public health institutions (the CDC, the WHO, UNICEF, etc.) warn that action is needed to avert major waves of measles, polio, and whooping cough.

Please vaccinate your children.


Questions to ponder on democracy

  1. So how about that election, eh?
  2. For social primates such as human beings, there is always a balance to be struck between individual actions and outward effects, especially with regards to other human beings (i.e., our communities). Similarly, the influence of one’s community manifests in one’s acts. Chickens make eggs make chickens make eggs make… This can lead to cycles of health following the tides of the community. (We are, after all, all wearing a mask.) How can a community improve its health? 
  3. Can a community (legitimately) opt to decrease its own health? 
  4. Can you think of at least one way we could improve democracy in this country?
  5. Can you think of at least one way we could improve democracy in another country?
  6. Can you think of at least one good reason why we should improve democracy in this/another country?
  7. Why/Are we partial to democracy?
  8. Jennings posits that “To give a practice [of medicine] meaning is to locate it in relation to a broader scheme of society, history, and individual experience […] to see how it fits into the various patterns that people use to create order and structure in their lives”. Normalization and familiarization each facilitate integration. Can you think of an example in which a practice of medicine is best understood by the social/historical structures constraining an individual?
  9. Must bioethics strive toward liberalism? Put slightly differently, does “progress” require progressivism?
  10. Solomon and Jennings (2017) contend, “Increasingly, the United States’ cultural narrative has demeaned government as a paternalistic and overbearing “nanny state” or as wasteful and inefficient, and it has construed citizens as mere clients or consumers. This is a phenomenon sometimes described as “civic privatism.” Behind fake news, lack of transparency, and the generation of conflict seemingly for its own sake, there is an increasing cultural denigration of public service and governmental function.” Why/Do you think it is “increasingly” “popular” to disparage the U.S. Government?
  11. On average, do you think families make better medical decisions than individual actors? Conversely, could an individual always determine their course of treatment without reference to their family/community?
  12. Tucker et al. (2019) discuss “the problem of cognitive fixation on prior ideas” as a limiting effect of crowdsourcing. “[P]roviding an example or reference limits the diversity of ideas solicited. This concept is similar to groupthink, which occurs when a group of individuals converges on a single solution.” How can we ensure democratic/community-based solutions mitigate these effects?
  13. Would you be willing to kill/die to defend/spread democracy? Are there circumstances that would compel you? Would you participate in a draft? If called upon by your nation at this moment to serve in the military, would you?
  14. Have the American people elected their next leader of their Executive Branch of government?
  15. Has the internet made democracies around the world better, worse, or left them about the same?
  16. How should we confront profound disagreement?