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Pennsylvania Is Playing Politics with Drug Rationing

Pennsylvania Is Playing Politics with Drug Rationing

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"Never let a crisis go to waste," the old adage goes, and the coronavirus fiasco has demonstrated this principle in action more times than one can count. From declarations of veritable society-wide house arrest to crazed government spending and monetary policy, there has been no shortage of opportunistic actors working to live out their dreams of power and dominion over others that "normal" times would not allow. Another such instance of gleeful advantage taking has come to light in the form of the Pennsylvania Department of Health’s "Ethical Allocation Framework for Emerging Treatments of COVID-19" guideline, a document that barely conceals its authors’ desire to use the current fiasco as an opportunity to engage in their own schemes of egalitarian social engineering.

Just as a reminder of the kind of central planners we are dealing with, this is the same Pennsylvania Department of Health that decreed on May 12 that nursing homes "must continue to take new admissions, if appropriate beds are available, and a suspected or confirmed positive for COVID-19 is not a reason to deny admission." Months later, nearly 70 percent of coronavirus fatalities in the state have occurred in nursing homes.

Not being content with causing such a disaster, the state health department has issued guidance on how healthcare facilities should ration the limited supply of the new drug Remdesivir in the event that there are not enough doses to go around, but notes that the guidelines should apply to any scarce form of treatment. While certainly an unpleasant subject to address, it is true that in the face of scarcity the limited supply of Remdesivir or any other treatment will need to be rationed and that some kind of method of choosing will be needed. Scarcity is simply a fact of life that must be dealt with. However, because the distribution of Remdisivir has been taken over by the federal government, which distributes it to state governments, which in turn distribute it to healthcare providers, the process has unavoidably become political.

Putting all the jargon aside, the guideline is very clear about several points. First, it is not considered acceptable to distribute care via a random lottery, or on a first-come-first-served basis. Rather, healthcare providers must take into consideration "community-benefit" when rationing care and the department recommends the use of a weighted lottery system.

As you can see, the example lottery that the health department provides uses three different criteria to determine how a patient’s lottery chance is weighted: membership in a disadvantaged community, being an essential worker, and likelihood of death in the next year.

While the state’s determination of who is and who is not an essential worker is arbitrary and has been full of problems, one can at least see the logic behind such a consideration, as well as for those patients who are not likely to live much longer, although one must question where the state gets the authority to dictate such things to hospitals.

What raises the most concern is the idea that members of "disadvantaged communities" should be given a better chance at receiving treatment than others. According to the guidance, because "low-income communities and certain racial/ethnic minorities" are being disproportionately burdened by the coronavirus, the end goal of public health is served by benefitting some groups over others. According to the guidance, "the rationale is that a core goal of public health is to redress inequities that make health and safety less accessible to disadvantaged groups."

One might have thought that the main goal of public health was to save as many lives as possible. But instead, it seems that the state department of health considers the emergency room to be the perfect place to start "mitigating the structural inequities that cause certain communities to bear the greatest burden during the pandemic."

This formulation makes it unclear what the guidance means when it states that the first goal of the ethical framework is "to safeguard the public's health by allocating scarce treatments to maximize community benefit." Does community benefit mean saving as many lives as possible? Or is it some kind of grievance studies conception of equality where arriving at a more "equally distributed" survival rate based on race and socioeconomic status is the goal?

One can certainly argue that certain populations do not have very good access to healthcare resources, but it seems outrageous to think that the time to attempt to remedy such inequality is when triaging patients.

Similarly concerning is the way the guidance recommends that the treating physicians be removed from the rationing process and that it be left in the hands of hospital bureaucrats instead, effectively tying doctors' hands to treat their patients. Is this the kind of state-run healthcare that we have to look forward to in the future? Doctors as helpless as their patients as bureaucrats "assess" a patient’s social suitability to be worthy of treatment?

The guidance goes on to recommend some procedures for how membership in a "disadvantaged community" should be determined. After noting that both members of low-income communities and racial minorities have been adversely affected by the virus and therefore deserve an increased chance of receiving treatment, the racial component drops entirely from consideration in recommendations, no doubt because such discrimination would be highly illegal and result in a torrent of lawsuits against the state and any hospital foolish enough to try it. The guideline is explicit that "no one is excluded from access based on age, disability, religion, race, ethnicity, national origin, immigration status, gender, sexual orientation, or gender identity and to ensure that no one is denied access based on stereotypes, perceived quality of life, or judgments about a person's worth." However, one can’t help but think that if racial discrimination were not illegal the logic of this guidance would dictate that it be undertaken in the name of "equality."

What that list is lacking is a prohibition on discrimination based on socioeconomic status, which is the method the guidance suggests should be used for the purposes of weighing the lottery. Specifically, it recommends the use of the Area Deprivation Index, which is based on data from the 2015 American Community Survey. Hospitals would use the index’s Neighborhood Atlas to enter a patient’s address and determine if they are a disadvantaged community member.

One can’t help but feel that such a system is arbitrary to the extreme. When I entered my address into the Neighborhood Atlas I discovered that no one in my neighborhood would receive any weighted advantage if Remdisivir were needed. However, when I Google mapped the distance between my home and the nearest sector considered to be disadvantaged, I discovered that it was a mere two-minute drive away. Can anything based on something so arbitrary as five-year-old aggregated census block data be considered a useful tool for the fair rationing of treatment?

This entire scheme is just a taste of the ways medical care would be infected with politics if it were to be run by the government. In a system of socialized medicine would we see similar redistributionist schemes of rationing introduced? No doubt, many people of all political persuasions would view it as a fertile field for attempts at social engineering. Similarly, it is not hard to see politicians scheming to ensure that favored constituents and voting blocs have access to care at the expense of their opponent’s supporters, or that whole classes of people are purposefully and consciously disadvantaged based on whoever holds the keys to power at the moment.

The middle of a pandemic is no time for social engineering, but it is also not a time for state involvement in healthcare to begin with. That involvement has led to thousands of nursing home patients dying and has now led to a blatant redistributionist drug-rationing scheme. Further involvement is only going to make matters worse and continue to poison a crucial aspect of our lives with politics even more than it already is.

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Low Iron Levels In Blood Could Trigger Long COVID: Study

Low Iron Levels In Blood Could Trigger Long COVID: Study

Authored by Amie Dahnke via The Epoch Times (emphasis ours),

People with inadequate…

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Low Iron Levels In Blood Could Trigger Long COVID: Study

Authored by Amie Dahnke via The Epoch Times (emphasis ours),

People with inadequate iron levels in their blood due to a COVID-19 infection could be at greater risk of long COVID.

(Shutterstock)

A new study indicates that problems with iron levels in the bloodstream likely trigger chronic inflammation and other conditions associated with the post-COVID phenomenon. The findings, published on March 1 in Nature Immunology, could offer new ways to treat or prevent the condition.

Long COVID Patients Have Low Iron Levels

Researchers at the University of Cambridge pinpointed low iron as a potential link to long-COVID symptoms thanks to a study they initiated shortly after the start of the pandemic. They recruited people who tested positive for the virus to provide blood samples for analysis over a year, which allowed the researchers to look for post-infection changes in the blood. The researchers looked at 214 samples and found that 45 percent of patients reported symptoms of long COVID that lasted between three and 10 months.

In analyzing the blood samples, the research team noticed that people experiencing long COVID had low iron levels, contributing to anemia and low red blood cell production, just two weeks after they were diagnosed with COVID-19. This was true for patients regardless of age, sex, or the initial severity of their infection.

According to one of the study co-authors, the removal of iron from the bloodstream is a natural process and defense mechanism of the body.

But it can jeopardize a person’s recovery.

When the body has an infection, it responds by removing iron from the bloodstream. This protects us from potentially lethal bacteria that capture the iron in the bloodstream and grow rapidly. It’s an evolutionary response that redistributes iron in the body, and the blood plasma becomes an iron desert,” University of Oxford professor Hal Drakesmith said in a press release. “However, if this goes on for a long time, there is less iron for red blood cells, so oxygen is transported less efficiently affecting metabolism and energy production, and for white blood cells, which need iron to work properly. The protective mechanism ends up becoming a problem.”

The research team believes that consistently low iron levels could explain why individuals with long COVID continue to experience fatigue and difficulty exercising. As such, the researchers suggested iron supplementation to help regulate and prevent the often debilitating symptoms associated with long COVID.

It isn’t necessarily the case that individuals don’t have enough iron in their body, it’s just that it’s trapped in the wrong place,” Aimee Hanson, a postdoctoral researcher at the University of Cambridge who worked on the study, said in the press release. “What we need is a way to remobilize the iron and pull it back into the bloodstream, where it becomes more useful to the red blood cells.”

The research team pointed out that iron supplementation isn’t always straightforward. Achieving the right level of iron varies from person to person. Too much iron can cause stomach issues, ranging from constipation, nausea, and abdominal pain to gastritis and gastric lesions.

1 in 5 Still Affected by Long COVID

COVID-19 has affected nearly 40 percent of Americans, with one in five of those still suffering from symptoms of long COVID, according to the U.S. Centers for Disease Control and Prevention (CDC). Long COVID is marked by health issues that continue at least four weeks after an individual was initially diagnosed with COVID-19. Symptoms can last for days, weeks, months, or years and may include fatigue, cough or chest pain, headache, brain fog, depression or anxiety, digestive issues, and joint or muscle pain.

Tyler Durden Sat, 03/09/2024 - 12:50

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February Employment Situation

By Paul Gomme and Peter Rupert The establishment data from the BLS showed a 275,000 increase in payroll employment for February, outpacing the 230,000…

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By Paul Gomme and Peter Rupert

The establishment data from the BLS showed a 275,000 increase in payroll employment for February, outpacing the 230,000 average over the previous 12 months. The payroll data for January and December were revised down by a total of 167,000. The private sector added 223,000 new jobs, the largest gain since May of last year.

Temporary help services employment continues a steep decline after a sharp post-pandemic rise.

Average hours of work increased from 34.2 to 34.3. The increase, along with the 223,000 private employment increase led to a hefty increase in total hours of 5.6% at an annualized rate, also the largest increase since May of last year.

The establishment report, once again, beat “expectations;” the WSJ survey of economists was 198,000. Other than the downward revisions, mentioned above, another bit of negative news was a smallish increase in wage growth, from $34.52 to $34.57.

The household survey shows that the labor force increased 150,000, a drop in employment of 184,000 and an increase in the number of unemployed persons of 334,000. The labor force participation rate held steady at 62.5, the employment to population ratio decreased from 60.2 to 60.1 and the unemployment rate increased from 3.66 to 3.86. Remember that the unemployment rate is the number of unemployed relative to the labor force (the number employed plus the number unemployed). Consequently, the unemployment rate can go up if the number of unemployed rises holding fixed the labor force, or if the labor force shrinks holding the number unemployed unchanged. An increase in the unemployment rate is not necessarily a bad thing: it may reflect a strong labor market drawing “marginally attached” individuals from outside the labor force. Indeed, there was a 96,000 decline in those workers.

Earlier in the week, the BLS announced JOLTS (Job Openings and Labor Turnover Survey) data for January. There isn’t much to report here as the job openings changed little at 8.9 million, the number of hires and total separations were little changed at 5.7 million and 5.3 million, respectively.

As has been the case for the last couple of years, the number of job openings remains higher than the number of unemployed persons.

Also earlier in the week the BLS announced that productivity increased 3.2% in the 4th quarter with output rising 3.5% and hours of work rising 0.3%.

The bottom line is that the labor market continues its surprisingly (to some) strong performance, once again proving stronger than many had expected. This strength makes it difficult to justify any interest rate cuts soon, particularly given the recent inflation spike.

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Spread & Containment

Another beloved brewery files Chapter 11 bankruptcy

The beer industry has been devastated by covid, changing tastes, and maybe fallout from the Bud Light scandal.

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Before the covid pandemic, craft beer was having a moment. Most cities had multiple breweries and taprooms with some having so many that people put together the brewery version of a pub crawl.

It was a period where beer snobbery ruled the day and it was not uncommon to hear bar patrons discuss the makeup of the beer the beer they were drinking. This boom period always seemed destined for failure, or at least a retraction as many markets seemed to have more craft breweries than they could support.

Related: Fast-food chain closes more stores after Chapter 11 bankruptcy

The pandemic, however, hastened that downfall. Many of these local and regional craft breweries counted on in-person sales to drive their business. 

And while many had local and regional distribution, selling through a third party comes with much lower margins. Direct sales drove their business and the pandemic forced many breweries to shut down their taprooms during the period where social distancing rules were in effect.

During those months the breweries still had rent and employees to pay while little money was coming in. That led to a number of popular beermakers including San Francisco's nationally-known Anchor Brewing as well as many regional favorites including Chicago’s Metropolitan Brewing, New Jersey’s Flying Fish, Denver’s Joyride Brewing, Tampa’s Zydeco Brew Werks, and Cleveland’s Terrestrial Brewing filing bankruptcy.

Some of these brands hope to survive, but others, including Anchor Brewing, fell into Chapter 7 liquidation. Now, another domino has fallen as a popular regional brewery has filed for Chapter 11 bankruptcy protection.

Overall beer sales have fallen.

Image source: Shutterstock

Covid is not the only reason for brewery bankruptcies

While covid deserves some of the blame for brewery failures, it's not the only reason why so many have filed for bankruptcy protection. Overall beer sales have fallen driven by younger people embracing non-alcoholic cocktails, and the rise in popularity of non-beer alcoholic offerings,

Beer sales have fallen to their lowest levels since 1999 and some industry analysts

"Sales declined by more than 5% in the first nine months of the year, dragged down not only by the backlash and boycotts against Anheuser-Busch-owned Bud Light but the changing habits of younger drinkers," according to data from Beer Marketer’s Insights published by the New York Post.

Bud Light parent Anheuser Busch InBev (BUD) faced massive boycotts after it partnered with transgender social media influencer Dylan Mulvaney. It was a very small partnership but it led to a right-wing backlash spurred on by Kid Rock, who posted a video on social media where he chastised the company before shooting up cases of Bud Light with an automatic weapon.

Another brewery files Chapter 11 bankruptcy

Gizmo Brew Works, which does business under the name Roth Brewing Company LLC, filed for Chapter 11 bankruptcy protection on March 8. In its filing, the company checked the box that indicates that its debts are less than $7.5 million and it chooses to proceed under Subchapter V of Chapter 11. 

"Both small business and subchapter V cases are treated differently than a traditional chapter 11 case primarily due to accelerated deadlines and the speed with which the plan is confirmed," USCourts.gov explained. 

Roth Brewing/Gizmo Brew Works shared that it has 50-99 creditors and assets $100,000 and $500,000. The filing noted that the company does expect to have funds available for unsecured creditors. 

The popular brewery operates three taprooms and sells its beer to go at those locations.

"Join us at Gizmo Brew Works Craft Brewery and Taprooms located in Raleigh, Durham, and Chapel Hill, North Carolina. Find us for entertainment, live music, food trucks, beer specials, and most importantly, great-tasting craft beer by Gizmo Brew Works," the company shared on its website.

The company estimates that it has between $1 and $10 million in liabilities (a broad range as the bankruptcy form does not provide a space to be more specific).

Gizmo Brew Works/Roth Brewing did not share a reorganization or funding plan in its bankruptcy filing. An email request for comment sent through the company's contact page was not immediately returned.

 

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