The Politics of Self-Destruction: Racial Animus Continues to Fuel Medicaid Opposition.

Posted on | September 16, 2021 | 1 Comment

Mike Magee

If you like to see a political party self-destruct, you need only accompany the likes of Governors De Santis and Abbott, and failed California candidate Larry Elder who went down 2 to 1 in his states recall election this week. And If you would like to visit the meeting place of America’s two great contemporary pandemics –COVID-19 and structural racism – you need only walk down the historic Medicaid path and enter the dangling doors of its most vulnerable populations. 

The current pandemic is disproportionately killing and maiming Black and Brown Americans. This should come as no surprise to Medical Historians familiar with our Medicaid program. Prejudice and bias were baked in well before the signing of Medicaid and Medicare on July 30, 1965.

President Kennedy’s efforting on behalf of health coverage expansion met stiff resistance from the American Medical Association and Southern states in 1960. Part of their strategic pushback was the endorsement of a state-run and voluntary offering for the poor and disadvantaged called Kerr-Mills. Predictably, Southern states feigned support, and enrollment was largely non-existent. Only 3.3% of participants nationwide came from the 10-state Deep South “Black Belt.”

Based on this experience, when President Johnson resurrected health care as a “martyr’s cause” after the Kennedy assassination, he carefully built into Medicaid “comprehensive care and services to substantially all individuals who meet the plan’s eligibility standards” by 1977. But by 1972, after seven years of skirmishes, the provision disappeared.

Medicaid has always disproportionately served as a backstop for Black Americans. They are more likely to be financially eligible, and more likely to spend their final years in Nursing Homes funded by Medicaid dollars. They are also likely to die younger than white counterparts, have twice the rate of heart disease, high blood pressure and stroke. For younger Black women, lack of access to maternity care and mental health services places them at high risk. Their children are 500% more likely to die of asthma than white children.

Southern states, led by Republican governors, have also led the way in a decade long battle to collapse the Affordable Care Act, and most notably the 90% federally funded expansion of Medicaid services and eligibility which the Supreme Court deemed voluntary in a landmark 2012 decision. Until 2017, eighteen states stubbornly held ranks. But in the past three years six states (Idaho, Utah, Oklahoma, Nebraska, Maine and Missouri) have fallen in line after voter propositions passed in their states.

That leaves some 2 million vulnerable citizens without coverage that is readily available. Polls in those states show that 2/3rds of their citizens favor Medicaid expansion in opposition to their own governors – and that was before the pandemic. Even in red counties of red states, 1/3 of Republicans are polling in favor of Medicaid expansion.

When COVID-19 hit, Nursing Homes were at the epicenter. Thanks to the action of Republican governors and their opposition to vaccines, children are now also in the cross-hairs. The major Southern states resisting enrollment in Kerr-Mills in 1965 were Texas, Arkansas, Louisiana, Tennessee, Mississippi, Alabama, Florida, Georgia, South Carolina, and North Carolina. Today, eight of the twelve states resisting Medicaid are the same, and their hospitals have been overwhelmed for a second time by Covid. These 12 states account for 92% of adults eligible for but not covered by expanded coverage. As such, they are last in line for COVID-19 testing, PPE, and vaccines. 

As a recent Health Affairs article concluded: “Addressing these ills through policy is not the only step needed to end racism in our country, but it is a necessary—and long overdue—step.”

Remember Yesterday – The Day The “Full Biden” Emerged From Behind the Screen.

Posted on | September 10, 2021 | 8 Comments

Mike Magee

Yesterday, President Biden made clear he had had enough of McCarthy and Abbott and DeSantis.  “We’ve been patient, but our patience is wearing thin”, were his words. The politics of the moment – muscular, clear, and calculated – were reminiscent of another veteran politician and President, Lyndon B. Johnson.

Johnson brought to the task an encyclopedic knowledge of the federal legislative system, an energy that knew no bounds, and a skill set and style of negotiation that colleagues referred to as the “Full Lyndon.” As Hubert Humphrey said, “He’d come on just like a tidal wave. He went through the walls. He takes a whole room over just like that.”

The Full Lyndon involved using the full scope of his six-foot-four, 250-pound frame to tower over people in such close quarters that they felt both physically overwhelmed and verbally intimidated. Various victims subjected to this unpleasant treatment over the years described clutches, patting, pushing, and bumping intermixed with threats, promises, and flattery.

By May 1964, six months after Kennedy’s death, Johnson had captured the moral high ground for his “Great Society,” which would now include the commitments that had been made within the dead president’s New Frontier. It was about the “quality of our American civilization.” A few weeks later, on July 2, 1964, President Johnson signed the Civil Rights Act. A month later, he launched the War on Poverty. The third leg to the “martyr’s cause” was Medicare.

The presidential contest of 1964 between Johnson and Barry Goldwater was a landslide for the Democrats. Johnson received 61 percent of the roughly 70 million votes cast, and 486 electoral votes to Goldwater’s 52.57 The AMA, which had very publicly run a “Doctors for Goldwater” PR campaign, had egg on its face.

On July 30, 1965, Johnson flew to Independence, Missouri, to celebrate the passage of Medicare with Harry and Bess Truman at his side. In his remarks, he said, “It was really Harry Truman of Missouri who planted the seeds of compassion and duty which have today flowered into care for the sick and serenity for the fearful. . . . Many men can make many proposals. Many men can draft many laws. But few . . . have the courage to stake reputation, and position, and the effort of a lifetime upon a cause when there are so few that share it.”

However, as Johnson flew back to Washington, he knew that the success of Medicare was by no means assured. He had given President Truman the first Medicare card, but now, 19 million other potential recipients needed to be enrolled. The administration had only 11 months before the program would go live, and the scope of the communications and public education challenge was unprecedented, with doctors threatening to boycott the program, and Southern states threatening to resist it.

In the 1960s, hospitals throughout the South still maintained segregated restrooms and segregated floors and wards designed to separate black and white populations. The passage of the Civil Rights Act in July 1964 had sent a clear warning: Title VI of the bill stated, “No person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, denied benefits of, or be subject to discrimination under any program receiving federal assistance.”

As a result, all hospitals, in order to qualify for federal Medicare certification, would have to prove that they were no longer segregating patients. Johnson’s first steps were by the book, deploying 1,000 federal inspectors across the country to ensure that the letter of the law was being implemented. Even with this, 10 months after Medicare had been signed into law, and a month or two before the launch date, half the hospitals inspected in 12 Southern states thumbed their noses in defiance with the support of their Southern governors.

Johnson called a special cabinet meeting and leaned heavily on his work horse vice president, Hubert Humphrey, to head south and communicate directly with every mayor in the noncompliant Southern cities that he was no longer screwing around. (Years later President Obama would entrust his own Vice President, Joe Biden, to go onsite and face off similar blowhards when needed.)

By May 23, 1966, all hospitals were compliant except in Alabama, Louisiana, Mississippi, and South Carolina. By July, they were clearly heading in the right direction, though 320 hospitals had not yet completed the conversions. Though some would still lag behind on the day Medicare went live on July 1, 1966, all would soon comply.

At the same time, the President himself focused on herding in recalcitrant physicians. Johnson saw this challenge as one only he could address. As the Senate was closing in on final approval of Medicare, in early June 1965, AMA president James Appel called the White House to request a meeting. It was scheduled on June 29, the day the Senate would vote its final approval of the bill.

When the delegation arrived with Dr. Appel in the lead, Johnson began by reading them verbatim from the proposed bill: “Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided.” He spent the next half of the meeting “hugging” the doctors, thanking them for their service, day and night, to patients “like his daddy.” He expressed his respect and gratitude for their devoted and selfless service, then asked whether they would be able to help him round up some doctors to address the pressing needs of the war-ravaged Vietnamese people.

The response was unconditional from the doctors—they were at the president’s and the nation’s service. Johnson then immediately pivoted, calling for “a couple of reporters,” who arrived quickly on cue. Johnson praised the doctors and their leaders by name, and the reporters not surprisingly wanted to know whether the AMA intended to support Medicare. Johnson interrupted, visibly shocked by the question. “These men are going to get doctors to go to Vietnam where they might get killed. . . . Medicare is the law of the land. Of course they’ll support the law of the land. Tell him, you tell him,” he said, pointing directly at the AMA leader. Appel had no choice but to confirm their support, stating modestly, “We are, after all, law abiding citizens.”

What the country witnessed yesterday was a journey man politician at work. Addressing members of the same crowd LBJ faced off fifty-five years ago, he said, “Instead of encouraging people to get vaccinated and mask up, they are ordering mobile morgues for the unvaccinated dying from Covid in our communities. This is totally unacceptable.”

Remember yesterday – the day you saw the “Full Biden” emerge from behind the screen.

______________________________________________________________

See CODE BLUE: Inside the Medical Industrial Complex (chapter7) for references and more.

The MIC in Schematic Design with QR2 Interactive Reference Codes.

Posted on | September 2, 2021 | Comments Off on The MIC in Schematic Design with QR2 Interactive Reference Codes.

Laurence M. Raine DrPH is a Senior Science Analyst with the Department of Homeland Security with extensive research and governmental experiences in the life sciences. He holds a Doctorate in Public Health, a  Masters in Botany, and a Certificate in Scientific and Technical Illustration. What Larry enjoys is creating detailed integrated system schematics to describe complex subjects like the Medical Industrial Complex. Here is the MIC through Dr. Raine’s eyes complete with interactive QR2 reference codes. ([email protected])

Source: Academia. Access to Download.

“Metaverse” – What’s In The Word?

Posted on | September 2, 2021 | 4 Comments

Mike Magee

Keying in on words is a habit that dates back to Medical School. From 1969 to 1973, in Syracuse, NY, (experts estimate) I absorbed 15,000 new vocabulary words as part of my training.

dystopian

[disˈtōpēən]

ADJECTIVE

1. relating to or denoting an imagined state or society where there is great suffering or injustice.

NOUN

1. a person who imagines or foresees a state or society where there is great suffering or injustice.

There are certain words that keep popping up in 2021 whose meanings are uncertain and which deserve both recognition and definition. And so, the offering above – the word “dystopian.” Dystopian as in the sentence “The term was coined by writer Neal Stephenson in the 1992 dystopian novel Snow Crash. “

One word leads to another. For example, the above mentioned, dystopian term, referenced by science fiction writer Stephenson three decades ago, was “Metaverse”. He attached this invented word (the prefix “meta” meaning beyond and “universe”) to a vision of how “a virtual reality-based internet might evolve in the near future.”

“Metaverse” is all the rage today, referenced by the leaders of Facebook, Microsoft, and Apple, but also by many other inhabitors of virtual worlds and augmented reality. The land of imaginary 3D spaces has grown at breakneck speed, and that was before the self-imposed isolation of a worldwide pandemic.

But most agree that the metaverse remains a future-facing concept that has not yet approached its full potential. As noted, it was born out of science fiction in 1992, then adopted by gamers and academics, simultaneous focusing on studying, applying and profiting from the creation of alternate realities. But it is gaining ground fast, and igniting a cultural tug of war.

Today multinational corporations are all in. Jason Warnke of giant consulting firm Accenture sees it as a power enhancer and multiplier. He says “…we believe we now have the opportunity to bring our people together in ways never before possible in the physical world.”

Not so fast, says Esther O’Callahan, the Gen-X founder of the online recruitment firm Hundo. She says the term is“… owned by young people who care more about community than profit and use it for the good of the real and virtual world. And if that sounds ludicrously naive and optimistic about it – I am and I’m not sorry!”

Karinna Nobbs, CEO of The Dematerialized, envisions the coming metaverse as a societal builder referring to it as “the next significant third space.” In doing so, she is appropriating a term made famous by sociologist Ray Oldenburg in his 1989 book, “The Great Good Place”. In it, the author advocates for investment in public spaces, outside of home and work that encourage congregation, civic engagement and relationship building. Karinna sees her virtual company as a “third space” to converge and nurture the emerging digital fashion ecosystem.”

Not surprisingly, health entrepreneurs are all over the metaverse as well. Or at least they think they are. Many of the new ventures are led by current or former health executives, attracted by investor demand, selling marginal moves in telemedicine, robotics, behavioral health, consumer wearables and the like.

Deloitte & Touche LLP report that digital health investment has quadrupled in the past four years, including $21.6 billion in 2020. They see health tech invasion of the metaverse as “a prescription for disruption by a growing base of health technology investors armed with funding from special-purpose acquisition companies (SPACs).” Investors are literally betting on an idea since SPACS go public without any existing business operations. They play to profit, not to disrupt.

Journalist turned tech analyst, AMP Creative’s Elena Piech sees the metaverse as “enabling us to be surrounded by information…this is the next iteration of life.” Could that work for health care, and if so, what might be the deliverables. Here are three:

Heal – When humans fall ill, they entrust doctors and nurses to respond in real time with knowledge, touch, and accessible resources. Could a health metaverse allow for a more ethical, equitable, efficient, inclusive and safer system of interventional care?

Health – Prevention and wellness benefit from patient-health professional relationships marked by compassion, understanding, and partnership. Could the metaverse reinforce trust and confidence, reliable information exchange, personalized health planning, and management of fear and worry?

Whole – Health is a function of a wide range of social determinants like housing, nutrition, clean air and water, education, and economic security. These resources are the products of good governance and healthy communities built around individuals, families, and societies. Could the metaverse, as a virtual “3rd space” contribute to community harmony, stability, security and happiness in a manner that kept us whole?

When it comes to a healthy metaverse, what then is the takeaway? Our health is not a game. It is our life. And as Esther O’Callahan said, “…if that sounds ludicrously naive and optimistic about it – I am and I’m not sorry!”

What Comes After Delta?

Posted on | August 25, 2021 | 2 Comments

Mike Magee

“Many still see Alpha and Delta as being as bad as things are ever going to get. It would be wise to consider them as steps on a possible trajectory that may challenge our public health response further.”
       Aris Katzourakis, Evolutionary Biologist, University of Oxford.

In my Jesuit high school, we were offered only one science course – chemistry. I took it in my Senior year and did pretty well. In contrast, I took four years of Latin, and three years of Greek, as part of the school’s Greek Honors tract.

Little did I know that Covid would create a pathologic convergence of sorts six decades later. Let’s review the Covid mutants:

Alpha – A variant first detected in Kent, UK with 50% more transmissibility than the original and has spread widely.

Beta – Originating in South Africa and the first to show a mutation that partially provided evasion of the human immune system, but may have also made it less infectious.

Gamma – First detected in Brazil with rapid spread throughout South America.

Delta – First seen in India with 50% more transmissibility than the Alpha variant, and now the dominant variant in America and around the world.

Our ability to track and identify mutating viruses in real time is now extraordinary. Over 2 million Covid genomes have been cataloged and published. But describing the “anatomy” of the virus is miles away from understanding the functional significance of their codes, or the various biochemical instructions they may instruct.

These deeper questions are in the realm of evolutionary biologists who are currently experiencing sleepless nights. Their recurrent nightmare? “What comes after Delta?”

What they know already is that Delta’s genetic mutation, P681R, affected a spot on the virus spike that cuts through protein chains and sped up human cell entry 1000 times. The speed lit a fuse under colony growth, which in turn allowed the virus’s spread to other unsuspecting human contacts before any immune response generated symptoms appeared. Of course the state of being asymptomatic didn’t last for long. Speedy virus multiplication rates accelerated the microbes movement from upper airways to lower airways leading to hospitalization rates that are twice as common as they were in the original Covid.

What’s next in the Greek alphabet? First a few basics.

1. A virus’s survival, and threat to us, relies on three factors:

a)Infectiousness, b) Virulence, c) Immune Evasion.

But these factors can as easily play against each other as for each other. Natural or vaccine induced immunity slows down infectiousness and potential virulence. But (by narrowing a virus’s options for survival) it also creates a Darwinian reward for any mutant that figures out the Rubik’s Cube solution to becoming “invisible” to the human immune system. According to Rockefeller University virologists, such a change requires the coalescence of 20 independent random changes in the genome. Bottom line: Random escape is a tall order. But under the current system, with Delta transmissibility likely to eventually burn through most of its potential future victims, such a change would be richly rewarded.

2. Viruses depend on us. But we no longer look or act as we did in 2019. Two billion citizens worldwide have had at least one dose of the vaccine, and hundreds of millions of others have survived the infection. The virus each day is increasingly pressured to find its next human victim. One way out is to figure a way past our immune defenses provided by prior infection or vaccination.

So this is a cyclical game, likely to go on for some time. If we global citizens play our vaccination cards right, the virus has fewer turns in the game, and is less likely to draw the cards it needs to evade our human defenses.

So here are five take-away facts:

• The longer we allow Covid to stick around, the worse this could get.
• The majority of the messy replication mistakes are inconsequential, but there are occasional windfalls that rise to Greek alphabet mythical status.
• Delta’s critical weakness – it leaves behind high antibody titers that limit its future.
• Give the virus more time, or access to compromised hosts, and anything can happen. Viruses are constantly rolling the evolutionary dice.
• Mutations hurt us by increasing transmissibility/virulence or immune evasion. The good news is there is some evidence that an immune escaping Covid might not be efficiently transmissible any more.

A guy like Ron DeSantis is not only ignorant of evolutionary biology, he’s playing with fire – and with our human lives. This cannot go unchallenged. Whatever it takes, we need to force this virus into a corner. Otherwise, we run the risk of becoming a Greek tragedy ourselves.

A Long Awaited “Moment of Truth” For FDR and President Biden.

Posted on | August 22, 2021 | 1 Comment

Mike Magee

A word is dead
When it is said,
Some say.

I say it just
Begins to live
That day.

Emily Dickinson

Arguably, no President better understood the power of the word then FDR. When he structured up “a series of programs, public work projects, financial reforms and regulations…to provide support for farmers, the unemployed, youth and the elderly”, he memorably packaged the plan under the label, “The New Deal.”

Seizing alliteration in 1933, he further defined his new policies as the “3 R’s – Relief, Recovery, Reform”, promising “…action, and action now.”

When corporate America began to coalesce against him in 1936, he once again chose his words carefully in the public defense. Seizing the largest venue he could find at the time – Madison Square Garden – he stood tall and erect, supported by heavy leg braces, and declared defiantly, “They are unanimous in their hate for me – and I welcome their hatred.”

As he aged and his general health declined, his will to serve and honor his commitment to serve the American people only grew. With a heavy dose of humility and learned wisdom, he rose again on January 11, 1944, fifteen months before his death, and delivered the State of the Union Address as a Fireside Chat from the Oval Office in the White House. His words once again were clear and ever lasting. He stated that the original Bill of Rights was “inadequate to assure us equality in the pursuit of happiness.”

Powerful words, in their messaging and meaning, survive the ages. Consider these words from that day 77 years ago:

“We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence.”

 “Necessitous men are not free men.  People who are hungry and out of a job are the stuff of which dictatorships are made.”

 “In our day these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.”

 “It is our duty now to begin to lay the plans and determine the strategy for the winning of a lasting peace and the establishment of an American standard of living higher than ever before known.”

“We cannot be content, no matter how high that general standard of living may be, if some fraction of our people—whether it be one-third or one-fifth or one-tenth—is ill-fed, ill-clothed, ill-housed, and insecure.”

“This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights…As our nation has grown in size and stature, however—as our industrial economy expanded—these political rights proved inadequate to assure us equality in the pursuit of happiness.”

In proposing this radical cultural shift, with war still waging across the globe but the tide clearly turning in the direction of the Allies, he defined those rights in black and white:

• The right to a useful and remunerative job in the industries or shops or farms or mines of the nation;

 

• The right to earn enough to provide adequate food and clothing and recreation;

 

• The right of every farmer to raise and sell his products at a return which will give him and his family a decent living;

 

• The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;

 

• The right of every family to a decent home;

 

• The right to adequate medical care and the opportunity to achieve and enjoy good health;

 

• The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;

 

• The right to a good education.

FDR loved America and all Americans. He rests in peace, but his words – and the promise they enshrine – have never died. They remain unfulfilled, their meaning and import reinforced on January 6, 2021 and beyond by the actions of insurrectionists, and anti-vaxxers, and political opportunists whose latest gambit is to sacrifice school children on an altar of profit and privilege.

President Biden shows signs of greatness, but must take care not to come up short – in voting rights, in national health care, in global warming. When dealing with determined and malevolent foes, words must be chosen carefully and delivered with absolute clarity.

“They are unanimous in their hate for me – and I welcome their hatred.”

Those were FDR’s words in 1936. Determined and deliberate. Defiant and dramatic. In defense of Democracy. This is the long awaited moment of truth for FDR, and President Biden.

The Unhealthy Leadership of Governor DeSantis.

Posted on | August 21, 2021 | 1 Comment

Mike Magee

On March 25, 1966,  Rev. Martin Luther King Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhuman…”


This week, my niece in Orlando, Florida, sent her 8-year old son, masked, back to public school. He has a history of severe allergies, including several anaphylactic episodes requiring emergency respiratory intervention. His class included a voluntary mix of masked and unmasked children. He now has a 105 degree fever and has tested positive for the Delta variant of Covid.

His crisis, and those of countless other children in Republican led states, now lies clearly on their governors’ shoulders. It also suggests, as with voting rights, that we can no longer allow health planning and delivery to be captured entities of the states rights crowd. Dying children are just not acceptable in a civilized society.

The impassioned and illogical pleas of leaders like Florida Gov. Ron DeSantis are literally as old as this nation. As with many controversies in human endeavor, the easiest way to decipher history and meaning is often “to follow the money.” Such was the case in the battle between state and federal rights. This battle engaged early and often, with Thomas Jefferson and Alexander Hamilton on opposite sides of the spectrum.

Soon after the 1788 ratification of the U. S. Constitution, Washington’s Secretary of the Treasury, Hamilton, suggested a federal bank to manage debt and currency. Jefferson, then Secretary of State, opposed it for fear of a federal power grab. Regardless, in 1791, Congress created the First Bank of the United States with a 20-year charter.

When the charter ran out in 1811, it wasn’t renewed. But then the War of 1812 intervened, and in 1816 the Second Bank of the United States was created with the Federal government holding 20% of the equity. The divide reinforced the divide of two political parties – the Federalist Party and the Democratic-Republican Party whose members were committed to undermining the bank.

The battle came to a head when, in 1818, Maryland’s state legislature levied a $15,000 annual tax on all non-state banks. There was only one – the Second Bank of the United States, which refused to pay. The suit rose to the Supreme Court with Maryland claiming the right to tax based on their reading of the 10th Amendment claiming state protection against extension of non-enumerated rights to the Federal government.

The landmark 1819 case – McCulloch v. Maryland, defined the scope of the U.S. Congress’s legislative power and how it relates to the powers of American state legislatures. In ruling against Maryland, Chief Justice Marshall argued that:

“Let the end be legitimate, let it be within the scope of the constitution, and all means which are appropriate, which are plainly adapted to that end, which are not prohibited, but consist with the letter and spirit of the constitution, are constitutional.”

 It was the people who ratified the Constitution and thus the people, not the states, who are sovereign.

One hundred and thirty years later, on December 10, 1948, the newly formed United Nations, adopted the Universal Declaration of Human Rights. That day, Eleanor Roosevelt spoke for America, stating: “Where after all do human rights begin? In small places close to home…Unless these rights have meaning there, they have little meaning anywhere.”

Of the rights enumerated and endorsed that day was included Article 25: Right to An Adequate Standard of Living. It read:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control”, and “Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

Professors like Jonathan Mann, director of the Health and Human Rights Center at Harvard School of Public Health, have added political heft to the debate. He agreed with a 2000 UN statement that “Health is a fundamental human right indispensable for the exercise of other human rights.” Why? He gives three reasons.

Political: “Health policies, programs, and practices have an affirmative impact on human rights, especially when state power is considered in the realm of public health.”

Discrimination: “Human rights violations have health impacts.”

A Propitious Cycle: “Protection and promotion of human rights and health are linked fundamentally in a dynamic relationship.”

What is somewhat remarkable is not what Professor Mann said, but rather how long it has taken to make its’ way from the streets of America to the ivy halls of academic, and now back again.

Covid, and its mutants and their enablers like DeSantis, are now part of our history. We the people, not the states, are sovereign. We must have the vote. We must protect our children. And we must have a national health plan based on science and truth.

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