Doctor and activist


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Tag: USA

One China or Two?

29 April 2021

The One China policy was basically the recognition of reality. Mainland Communist China won the revolution in 1949, and when China got its economic act together the world needed to trade with it as it was far more economically significant than Taiwan.


Chiang Kai-shek, the Kuomintang leader, was defeated by Mao Tse Tung and fled to the island that had previously been called Formosa, now Taiwan. He maintained the idea that he would lead a counter-revolution, so there was One China.  This counter-revolution became increasingly ridiculous with time, but was not abandoned.  The Communists claimed Taiwan and treat it as a rebel province, and they stated that there is One China and that the price of trading with them was to have Taiwan excluded from the UN and other international bodies. That has been the situation for many years, and almost all countries accepted the One China policy, and stopped recognising Taiwan, even if they traded with it.

By definition, if there is One China, who governs Taiwan is an internal Chinese matter. We may not like what China does in Hong Kong, with the Uighurs or in Taiwan, but it is the US that has accepted the One China policy for years. 

After WW2 at Bretton Woods it was assumed that free trade would allow countries that were competitive to rise, and those that were not competitive to fall. This was so that there would not be war over markets.  But the system that the West set up gave an advantage to countries with lower wages, and if they were smart enough to get the fruits of their labour rather than stay as colonies with foreigners owning their industries, they rose.  So China rose and is now a world power and the US are now seeking to intervene in Taiwan and re-create a two-China policy. One can hardly expect China to accept this massive loss of face. 

The assumption was that Taiwan would eventually solve its differences with mainland China peacefully.  After recent events in Hong Kong, this has become less likely in the short and medium term, but is still viable or even inevitable in the long term, which has always been China’s position.

China has done some sabre-rattling with flights over Taiwan and obviously the recent events in Hong Kong have made everyone nervous.

This article looks at the similarities of the Chinese way of doing business to capitalism.  It could be said that the model of an intelligent government cooperating with industry is more successful than a few large industries competing.  Competition works if there are many small producers competing in a market.  When there are a few oligopolies using trademarks or patents to make more money and not to share knowledge, the old adage that ‘private competition is the best way to run things’ starts to break down.  It may not just be cheaper wages that is allowing China to out-compete the US.

Starting a war because you are losing the peace seems a very unwise course of action. 

Australia has to stop being the US lapdog. We are not taking the right path.

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Trump Acquitted. Significance?

14 February 2021

President Trump was not impeached because it needs a two thirds majority of US Senators and the Democrats and Republicans have 50 each, with the Vice President having a casting vote.  So 13 Republicans would have had to vote for the impeachment, and only 7 did so. 57 to 43 was not two-thirds.

 Senate Republican Leader Mitch McConnell said that Trump could not be impeached as he was no longer President, but this was because the Senate delayed the debate while he was, so it looked like a convenient cop-out.  Whether it was ‘loyalty to the Republican party’ is a moot question. In practical terms, Trump has a lot of support at the grass roots of the Republican party, and if he directs his supporters to oppose a Senator’s pre-selection next time it will be likely to cost them their seat.  So they were willing to toe the line that the election was rigged, and now vote that Trump did not incite supporters to storm the Capitol. It is remarkable that they were in the Chamber when the Capital building was stormed, and the Senators were in physical danger, but now they decline to condemn Trump.

It is worth looking at the Republicans who did have the courage to cross the floor:

Mitt Romney of Utah was an Independent until 1993, and a Mormon.  He stood as the Republican Presidential Candidate against Barack Obama in 2012, and was elected to the Senate in 2019.  He is 73 now, but has probably a very strong base.

Bill Cassidy MD, aged 64 was a Democrat who changed to the Republicans in 2001.  He was the only Republican Senator who did not challenge the result of the 2020 Presidential election and was condemned by his Louisiana Republican party for this stance, even prior to his voting for Trump’s impeachment.  He was elected in 2020, so will face the voters again in 2024.

Susan Collins of Maine aged 68 was elected in 1996, and is the longest-serving Republican woman Senator, most recently re-elected in 2020.  She declined to support the bill to repeal Obama’s ‘Affordable Care Act’ and also declined to support the nomination of conservative judge Amy Barrett to the Supreme Court.

Lisa Murkowsi of Alaska aged 63 has been in the Senate since 1998, having followed her father into her seat but via a write-in vote, having been defeated in the pre-selection.  A survey showed her to be the second most liberal Republican Senator after Susan Collins.  She intends to run for a 4th term in 2022, but it has been tipped in Newsweek that Sarah Palin will stand against her in the next preselection.

Ben Sasse of Nebraska aged 48 has taken a strong stand against Trump and effectively bet his political career on what is currently not a popular stand in his State, though he paints himself as a strong conservative.

Richard Burr of North Carolina aged 65 surprised colleagues by voting against Trump. He was elected in 2005, but he had announced in 2016 that he would not seek a 4th term, so preselection is irrelevant for him.

Pat Toomey of Pennsylvania aged 59 was elected to the House of Representatives in 1998, then the Senate in 2011 and 2016, but has said that he would not stand again.

So it looks as if there are very few Senate Republicans who will put the national interest ahead of their own pre-selections and party loyalties. 

This is why we need the power returned to the people both in the USA and here. The interests of the political parties are not the same as the interests of the people.

https://abcnews.go.com/Politics/president-donald-trump-acquitted/story?id=75853994
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US Election Aftermath 8/1/21

All the commentators are saying that Trump has no case and that the US election was properly run and the result is correct.  No doubt they are right as far as they go.

But we might ask why people are so upset that they will storm the Capitol and make the US look like a tin pot third world rabble, where police line up to stop raging demonstrators and shoot a few.

Many years as a young child I went to the first version of ‘Around the World in 80 Days’ with my mother.   There is scene in that with a huge rally with banners, shouting, festivities and people squirting each other with hoses.  I asked my Mom, ‘What are they doing?’.  She replied, ‘They are having an election, son’.  I said, ‘That is not how you have elections’.  She said. ‘It’s how they do it over there’.

It has always stuck on my mind.  She regarded the US as not actually a civilised country.  At that time we watched Westerns where they had shoot outs and wars with the baddies a.k.a Indians.  Later she explained that they carried guns and had no health system for poor people.  When my parents retired they went on a trip to the USA and were held up at gunpoint at their motel in Los Angeles by men who needed money for drugs, which tended to prove her point.

This morning on  Radio National singer/songwriter Tori Amos told of how as an aspiring artist she played in bars and heard how the powers behind the throne arranged judicial appointments such that there was a court decision to allow unlimited money into political donations without the source of it being clear. 

Looking at the choices of president facing the US electors last time, there was Trump, the anti-Establishment TV reality host v. Hillary Clinton, an existing Establishment figure. The progressive voice of Bernie Sanders had been eliminated. This time there was Trump with his failed rhetoric and COVID non-policies against Biden, an existing Establishment figure.  Sanders had again been side-lined.  So, yes the count was correct, but how much use is this to the common person, whose job is no longer secure and whose income has not risen for decades? 

Inequality has been rising apace. Everyone may be aware of this, but some are more aware than others, some are much more affected than others, and some want to do much much more about it than others.

The vote count and procedures may be correct, but the system is not delivering a fair outcome.  Taking jobs from US workers to ones in China or elsewhere allows importers to make supernormal profits, and this process, which amounts to the undoing of colonialism where the raw materials came  from overseas and were processed in the First World will not be complete until all the world’s workers are equal.  In the meantime, the poor in the First World get a lot poorer and the rich, initially in the First World, but now elite as much by class as  by nationality, get richer (as Marx had predicted).

The Trump demonstrators are wrong about the election, but not so wrong if you talk about the system and their place in it.  Sanders may have had a solution, Trump never did.  The US elite have avoided confronting the issue so far, but it is still there, and will be ongoing.

Here is Bob Carr, ex-NSW Premier and ex- US Foreign Minister writing about how the problem will not go away.  He is less specific on why.

www.smh.com.au/world/north-america/capitol-chaos-is-just-the-first-act-the-republican-party-is-shattered-and-civility-is-not-coming-back-20210107-p56sdw.html

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US Health System and COVID-19 11/12/20

Here is an article about the US Health system and its response to COVID. Basically it seems that the US government is subsidising COVID treatments so that they are more lucrative than treatment of other diseases, so the private operators are filling their hospitals with COVID patients whether they need to be admitted or not, and non-COVID patients are excluded.

The other thing that is interesting is that there has been a huge growth in administrators since the 1970s. It has to be understood why private health systems are so inefficient. They have to keep individual insurance databases to keep track of premiums and churn as people change funds. When someone is treated they have to account for every band aid, visit, procedure or investigation, bill the patient and pay the practitioner. They have to market their product, compete for staff, and then figure out ways to avoid paying if possible.

Universal systems have everyone eligible, so do not need to worry about who is getting treated. No need to market the system, maintain many different churning databases, compete for doctors, keep accounts for every details of every treatment and bill and pay for them individually.

In terms of better health care there is no problem of adapting to whatever disease needs the most attention as the staff are motivated to do the most effective treatments, and there is no distortion of priorities to maximise profits.

The US health system is the least effective in the developed world in terms of delivering health care. but it is the most effective at its primary object- turning sickness into money.

No one has looked too closely at why the Australian system has been able to respond. Basically our public health system is State-based hospitals, which are still largely public and have doctors who could be re-directed to testing and vaccination. They can also change to do COVID if needed, and treat disease on their merit.

The private hospitals did very well out of the government subsidies here because they were emptied ready for a COVID influx that never came and they just pocketed the cash without much publicity for this from either themselves or the Government.

Australia has continued on its previous course, which is to starve Medicare and help the private system move towards a US system by stealth, and the COVID pandemic has so far not brought this to light. What is left of the public system has done well, helped by the fact that we are an island nation, so had some warning and could act to quarantine ourselves. The government was happy to take advice from the medical professionals because it had made such a mess of not taking advice from the firefighting professionals. But Medicare is still being quietly destroyed and we are moving to a US system of private medicine.

The government saves money on Medicare doing this, even though the system is much less efficient and much less equitable. But the key reason is not the savings on Medicare, it is the money to the Party coffers from the Private Health Industry (PHI), which is now much stronger with the changes John Howard did to the Aged Care system in 1997, which made it effectively a for-profit system, and the NDIS also a for-profit system, subsidised by the taxpayer through the Medicare levee, which was ironically not being used for health. (The discussion of the Aged Care system was in one of my posts last week).

The key thing to understand in the destruction of Medicare is that the rebate to doctors which was set at 85% of the AMA fee, so as to replace private medicine, has risen at half the inflation rate for 35 years and is now 46% of the AMA rate. Doctors are paid half what they were, so specialists mostly will not use it, and GPs who still bulk bill just do shorter visits.

Here is the article on the US response to COVID. Their prevention is also hopeless, as with such a poor welfare system the people cannot afford to stop work, and the story that it was a hoax was also promoted by President Trump. The obsession with ‘individual rights’ sits uneasily with the idea of staying home for the common good, and makes disinformation campaigns easier. People wanted to believe it was a hoax, because they could not afford to stop work anyway.

http://www.informationclearinghouse.info/55999.htm

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Medicine, Reality and the US vote 11/11/20

Doctors tend to assume that everyone knows certain things, particularly because everyone they meet usually does. They also tend to think that everyone knows the order of importance of what they know.

Many years ago as I started to campaign against tobacco, Henry Mayer, the first Professor of Political Economy in Sydney, who had a regular column in the SMH told me that the health people were invisible in the media on the tobacco issue. I said that this was ridiculous, it was the most studied subject in the history of medicine, with over 60,000 papers and growing daily. He pointed to a person called Tollison, who wrote in the non-medical media that was read by the business sector. There were no medical responses there. The mainstream also media had relatively little on tobacco, as tobacco advertising was one of the major sources of revenue.

So the harm of tobacco was known, but ignored, like the fact that you are going to die one day.

It came home to me, when I amputated the leg of a smoker for vascular disease. He had bad lungs and a bad heart. I said, ‘Look mate, if you keep smoking, you will lose the other leg.’

To my amazement he replied, ‘Look, all you doctors go on about smoking, but if it was as bad as you say it is, the government would do something about it’.

He had internalised the government’s non-action as being mute testimony to it not being a problem. Doctors are, after all a subculture that claims to have expertise in a certain area, as do engineers, educators, weather forecasters and many other groups. In tobacco, the Tobacco Industry, the Australian Hotels Association, Clubs and Pubs and the advertisers and sponsorship recipients fought like tigers to stop reasonable public health policy. They are probably still retarding it- there has not been a Quit campaign in Australia for over a decade.

Trump’s denial of the significance of COVID19 must have struck a chord with those who knew that in the absence of decent welfare system a lockdown would send them broke. They needed to believe that they could carry on, and he and his denial were their salvation. A lot of business interests supported them- they would go broke too.

So it was interesting that the health facts became politicised, and wearing a mask was as much a political statement as a medical one. Politics was not, and will not be in future a good basis for personal preventive heath decisions. So controlling the COVID epidemic in the US will be harder than here, where mainly apathy and complacency are in the way.

The figures that only 4% of people in the US changed their view on the dangers of COVID goes some way to explaining why Biden did not have a landslide. For many people, COVID was not an issue, Trump’s rhetoric was plausible if you did not fact-check, and the economy had been going OK prior to the epidemic.

SMH today:

Virus neglect didn’t infect Trump vote

Shaun Ratcliff

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Since the first person was diagnosed with COVID-19 in the US, more than 10 million cases have been confirmed and nearly a quarter of a million people with the virus have died.

Watching from afar, in a country where the coronavirus has been significantly less lethal, it is surprising the incumbent president did as well as he did.

While the pandemic probably did cost him votes, surveys we have run over the course of the year showed there are strong partisan effects on attitudes towards COVID-19, with supporters of Donald Trump mostly unconcerned about the risks from the virus, and getting less worried as the year went on.

These surveys were run in May and September. Both surveys consisted of responses from more than 1000 Americans.

In May, approximately 40 per cent of all Americans were very or extremely worried about the possibility they or a family member might catch the virus. Almost the exact same number were only a little or not at all worried. According to our data, this level of concern actually declined slightly between May and September.

This was largely a partisan affair. Respondents who said they were going to vote for Joe Biden retained a similar level of concern during this period, with 48 per cent very or extremely worried in May, and 50 per cent in September.

However, respondents who said they would vote for Trump were not very concerned about COVID-19 in May – about 19 per cent reported they were worried about it in the first survey and just 11 per cent of Trump voters reported this level of concern in the second survey.

The partisan differences, and the declining trend in Republican concern about COVID-19, are largely the product of the extremely polarised media and political environment in the US.

Trump voters are less trusting of information on COVID-19 from medical experts than Biden supporters, and between May and September a quarter of Republican voters became less likely to trust information from these experts.

This difference may, in part, stem from the media through which they obtain information. Those with the lowest levels of trust tended to rely upon more conservative cable and online news like Breitbart and Fox News, for instance, which have played down the risk posed by the pandemic.

Republicans who rely more on these conservative media outlets were more likely to have lower levels of trust in medical experts, even after controlling for demographic differences between Democrats and Republicans. They were also as likely to trust Donald Trump as medical experts for information on the coronavirus.

In this polarised environment, very few voters abandoned Trump between May and September (only about 4 per cent in our data), and hardly any shifted to support Biden.

Trump supporters tended to align their position on the coronavirus with their political allegiance. Relying more on media that downplayed the significance of the coronavirus, and taking cues from Republican leaders, they decided the pandemic was not a significant threat.

Our data indicates Biden was able to win over a small number of voters who supported neither candidate at the start of the year. It was enough to win in the end, but not enough to deliver the predicted landslide.

Shaun Ratcliff is a lecturer in political science at the United States Study Centre, University of Sydney.

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Truth in the COVID-19 Era: The USA

Some of us watch the COVID-19 statistics with fascination try to work out which policies will stop the march of the virus.  This has become all the more urgent as countries try to break the lockdown to restart their economies. The US has overtaken Western Europe (29 countries) in the number of cases by about […]

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Gun-Toting Protesters Invade Michigan Capitol Building

3 May 2020 Protesters, some armed with automatic weapons invaded the Michigan Capitol (State Parliament) to protest at the State Governor wanting to extend her lock-down powers. It is illegal to carry placards into the legislature, as they might damage the paintwork but open carrying of guns is legal in Michigan. Michigan is the 10th […]

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US Health System is worst to control COVID-19 Epidemic

30 April 2020The US health system which is largely private is poorly set up to handle a pandemic. It is set up to make money, so is not flexible when different equipment and procedures are needed. Added to this 12% of people have no health care insurance, so cannot get healthcare and of those insured, […]

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Bolivian Coup- another Leftist government overthrown 14/11/19

As I have posted before South American politics is about grass roots Leftist groups getting the people a better deal alternating with neo-liberal ones where mainly US interests extract the money, usually by supporting a right-wing dictator. The CIA supported coups in Argentina and Chile in the 1990s with huge loss of life and gross […]

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