Towards Universal Healthcare Access in the US

3/18/2020 St. Patrick's Day has come and gone, and more Americans are taking seriously the need for social distance, especially those in leadership. More jurisdictions have closed bars, restaurants, and schools, but many still distrust the idea of a pandemic and the guidance from scientists and are crowding onto beaches, in malls and other shopping venues, and in amusement parks and other gathering spaces. The CDC is keeping up with data such as reported cases better, but there is still a remarkable shortage of test kits, so there could be many more (or not many more) cases and carriers out there. The private sector is trying to fill the gap left by trump's refusal to allow World Health Organization kits into the country, and to speed up test development CDC has moved responsibility from Atlanta to the states to certify private test developers, but we are facing a race with the virus and with people refusing to distance from others or change their daily practices. 

March 16, 2020 A lot changed in the past 24 hours. Spain, Italy, and France are closed, and the UK abandoned its "let's develop herd immunity" plan. In this country, city and state governments started taking the pandemic seriously, and some private business did as well. Many schools are closed, San Francisco implemented "shelter in place," many cities closed restaurants and bars, and more drive-through testing sites are up and running, with more in progress. We still don't have enough tests. Several private labs are developing and some deploying tests, but there is no central command and control from CDC as there was for Zika and H1N1 testing. So we don't know how good the tests are, how long it takes for results, and how they are being distributed. Experts believe people will need 2 negative tests in a row before an infected person is cleared to leave isolation, which means we need even more. We have some idea of why the US refused the World Health

3/15/2020 (The Ides of March) Sit-Rep (Situation report - FEMA talk): Over the weekend the calls for significant social distancing and closures of public spaces plus restaurants/bars/events have grown. France, Spain, and Italy have closed these public spaces and are keeping people indoors. Schools in most US states are closed, but Americans continue to crowd into airports, lines at big box stores and gun stores are hours long, and many are flaunting public health recommendations. So stopping the spread of this virus for which we have no vaccine and no treatment will likely not be achieved in the US. It's a pandemic, and we are an epicenter. Numbers: The cloud-based operating system DOMO offers this Coronavirus tracker  which shows at least 2200 confirmed cases of COVID-19 in the US so far, so at least that many tests have been done. Of these 2200, 47 are casualties (they died from the viral infection). March 10 was first day the confirmed case numbers spiked. About 4000

3/13/2020 (Day before π day) Good morning friends - I'm going to give my best health advice and it's not gonna be pretty. We need to stop living our normal lives for a few weeks - probably 6-12 - so we can put a dent in transmission of COVID-19 and keep our health care system from imploding. We don't have enough nurses, doctors, hospitals, ventilators, equipment, supplies, etc. to care for the number of people who will become seriously ill from this virus on our current path, and we were already behind when the pandemic started because our health system is a financial and structural mess. If we don't make drastic change NOW, many will die from this virus and many will die prematurely from other illnesses that they can't get treated because the hospitals are full of coronavirus patients. Like many people, my retirement savings are already destroyed because the market tanked, and the financial crisis now in progress is much worse for many. What we do now - today -

I've been a patient lately. Not just for preventive care, which I've been good about getting when I was working in public health, teaching, or doing telemedicine, but which has been near-impossible to get done when practicing medicine full time. Lately it's been appointments, surgery, follow-up, radiology, specialized tests, more appointments, texts, phone calls, and lots of different and incompatible electronic medical records. It's a mess. I'm as good as an American can be at navigating the health system and advocating for myself, and it's impossible. I cannot get the medical and preventive care I need. Not and keep a job. We must stop looking at the solution as incremental change to the existing structure. None of it works. For my care to be patient-centered, here's what I need: 1. All of my medical records in the cloud, secure and accessible TO ME and, when I give them permission, to doctors, nurses, and hospitals. 2. Medical care will always start w

Hi - if you found this, I appreciate it. I got encouragement to submit as a letter to the editor, so I need to take this down for now. I hope it gets published. If not, I'll put the letter back up here. Thanks Julie Update - I published these: https://www.themedicalcareblog.com/asylum-seekers-family-separation-crisis/ is a post on the American Public Health Association's Medical Care Blog on this topic and https://www.cnn.com/2018/08/06/opinions/open-letter-to-surgeon-general-immigration-graves/index.html was on CNN's opinion page