Archive for March 12th, 2017
In the NY Times Charlie Savage and Eric Schmitt discuss a Trump administration initiative that should give new life to terrorist recruiting:
The Trump administration is exploring how to dismantle or bypass Obama-era constraints intended to prevent civilian deaths from drone attacks, commando raids and other counterterrorism missions outside conventional war zones like Afghanistan and Iraq, according to officials familiar with internal deliberations.
Already, President Trump has granted a Pentagon request to declare parts of three provinces of Yemen to be an “area of active hostilities” where looser battlefield rules apply. That opened the door to a Special Operations raid in late January in which several civilians were killed, as well as to the largest-ever series of American airstrikes targeting Yemen-based Qaeda militants, starting nearly two weeks ago, the officials said.
Mr. Trump is also expected to sign off soon on a similar Pentagon proposal to designate parts of Somalia to be another such battlefield-style zone for 180 days, removing constraints on airstrikes and raids targeting people suspected of being militants with the Qaeda-linked group the Shabab, they said.
Inside the White House, the temporary suspension of the limits for parts of Yemen and Somalia is seen as a test run while the government considers whether to more broadly rescind or relax the Obama-era rules, said the officials, who described the internal deliberations on the condition of anonymity.
The move to open the throttle on using military force — and accept a greater risk of civilian casualties — in troubled parts of the Muslim world comes as the Trump administration is also trying to significantly increase military spending and cut foreign aid and State Department budgets.
The proposal to cut so-called soft-power budgets, however, is meeting with stiff resistance from some senior Republicans on Capitol Hill, as well as from top active-duty and retired generals and admirals, who fear perpetual conflicts if the root causes of instability and terrorism are not addressed.
“Any budget we pass that guts the State Department’s budget, you will never win this war,” Senator Lindsey Graham, a South Carolina Republican on the Armed Services Committee, said during a hearing last week. Referring to the Islamic State, also known as ISIS or ISIL, he added, “As a matter of fact, ISIL will be celebrating.”
In a sign of mounting concern over the government’s policy review, more than three dozen members of America’s national security establishment have urged Defense Secretary Jim Mattis to maintain the thrust of the Obama-era principles for counterterrorism missions, saying strict standards should be maintained for using force outside traditional war zones.
The former officials, in a letter sent on Sunday to Mr. Mattis, warned that . . .
I thought Stephen Bannon read history?
This story does not, unfortunately, belong to the good-news collection. I suppose Trump has not resumed the program of torture, so that’s good news. Subject to change.
Jessica Contrara reports in the Washington Post:
Northfork, W.VA. —Another morning, another list of patients and problems in the hands of 35-year-old Keisha Saunders. Diabetes, depression, heart disease. Robert needs lower blood pressure. Buffy needs prescriptions filled. Mary needs to lose 50 pounds, so she can get what she really needs, a new hip.
Again, the list extends to the bottom of Keisha’s notepad, as it has so many days since the Affordable Care Act mandated that everyone have health insurance. Unlike in Washington, where health care is a contentious policy debate, health care where Keisha is a nurse practitioner is a daily need to be filled. The high rates of chronic diseases in McDowell County have made it the county with the shortest life expectancy in the nation.
It’s also a place that voted overwhelmingly for President Trump, whose promise to repeal the ACA will soon affect nearly every patient Keisha treats at the Tug River health clinic in Northfork, including the one waiting for her in exam room No. 2.
“How are you doing?” she asks Clyde Graham, who is 54 and has been out of work for four years.
“I ate a sandwich from Arby’s,” he says. “And it jumped me out for like, three days. I mean it just burnt.”
Heartburn is just the latest problem for Clyde, a patient Keisha sees every three months. Like so many in this corner of Appalachia, he used to have a highly paid job at a coal mine. Company insurance covered all of his medical needs. Then he lost the job and ended up here, holding a cane and suffering not only from heartburn but diabetes, arthritis, diverticulitis, high blood pressure and high cholesterol.
Because of the ACA, Clyde’s visit is covered by Medicaid. Before the law, most West Virginians without children or disabilities could not qualify for Medicaid, no matter how poor they were. The ACA — better known here as Obamacare — expanded the program to cover more people, such as Clyde, who can depend on Keisha to fix his heartburn without having to worry about the cost.
As for the other problems in his life, he has put his hopes in Trump, who came to West Virginia saying he would bring back coal and put miners back to work. When Trump mentioned repealing Obamacare, Clyde wasn’t sure what that might mean for his Medicaid. But if he had a job that provided health insurance, he reasoned, he wouldn’t need Medicaid anyway, so he voted for Trump, along with 74 percent of McDowell County.
Tug River Health Association treats about 8,700 patients, resulting in some 20,000 visits a year to its five clinics. In 2016, 12,284 of those visits were from patients on Medicaid, up from 5,674 in 2013, before the ACA took effect here. Without the ACA, many of those patients wouldn’t be able to afford care. Will they soon lose their coverage? Will they stop coming to the clinic? Lately, Tug River’s chief executive has been telling his staff, “The key word going forward is uncertainty.”
To Keisha, all is uncertain beyond this moment, in which she prescribes Nexium for Clyde’s heartburn, examines him from head to toe and sends him to the lab across the hall for blood work.
“I’ll see you in three months,” she says, hoping that will be true, and heads to exam room No. 1, where another patient is waiting. “What’s going on today?” she asks, and walks in the room to find out.
Meanwhile in the front of the clinic, more patients are coming in through the heavy doors and up to a glass window where a receptionist is waiting.
“Hi honey, how are you?” Tammy McNew says to each one. Over the past four decades, McDowell County has lost 60 percent of its population, so she rarely needs to ask their names. Instead, she asks what seems like the most important question in health care these days:
“Got your insurance card with you?”
If the answer is no, she will send them back to Keisha anyway, and the clinic will depend on federal grants to make up the cost. But more often in recent years, the answer is what a middle-aged woman with springy curls says as she passes her Medicaid insurance card through the window: “Yes, ma’am,” she tells Tammy, who slides it into a scanning machine.
In other parts of the country, the primary impact of the ACA has been requiring people to have private health insurance, but in poor and sick communities like McDowell County, the law’s dominant effect has been the Medicaid expansion, which has given more people access to the kind of health care that wasn’t widely available or affordable to them before. With an insurance card in her pocket, the patient at Tammy’s window can venture into the realms of medical care that are typically out of reach to those without one: blood work, immunizations, specialized doctors, surgery, physical therapy.
If she needs mental health counseling, the clinic no longer sends her to the next county over; last July, Tug River was able to hire a psychologist, who is now treating 180 people, many of whom are trying to overcome opioid addictions.
If she needs medication, the nurses won’t go digging in a closet of samples left by drug reps as they used to do for the uninsured. The medication will come from a pharmacy and cost no more than a few dollars.
“All right sweetie, I got you,” Tammy tells her, and the patient retreats to a chair to wait for her name to be called. The routine is repeated dozens of times a day as the phone rings behind the front desk. “For appointments, press one,” the callers hear. “Black lung, two.”
This clinic is in Northfork, a community of a few hundred people along the railroad that carries coal through the mountains. Keisha, who is black, was raised in this predominantly white county, in a home overlooking the cinder-block church where her father, a coal miner, serves as pastor. She attended the middle school beside the clinic parking lot, which now has busted windows and gaping holes in its brick facade. There weren’t enough children to fill it, as every year the closing of more mines drove job-seekers out of the county.
Eventually, Keisha was one of them. After graduating high school and becoming a mother at 18, she realized that if she wanted to become something more for her daughter, she would have to leave.
She moved 45 minutes away, to Princeton, W.Va., where she got a nursing assistant certification and a job in a nursing home. But every Sunday, she strapped her daughter Kiana in her car and drove back to McDowell County, checking in on her always-fading town. Bulldozed, shuttered or abandoned: the grocery store, beauty salon, florist and furniture store. Still open: the dollar store, medical equipment store, funeral home and her father’s church, where Keisha would usually sit with her brother Derrick. . .
Continue reading. And do keep reading. The article shows why we must keep and expand the Affordable Care Act, and make it more affordable by using some additional tax revenue from those can most afford to contribute to the common welfare. As God intended, in fact, according to Jesus—just a thought for the Christians among them.
I consider this a hopeful story because it shows how greatly Obamacare helped people, and spent taxpayer dollars taking care of those who most need help rather than all the benefits of government going to the middle class and above. It shows the government doing what the government should be doing: improving the general welfare of the American people.
And she describes why in a very good blog post:
His soon-to-be-boss Jeff Sessions threw away his own credibility by foolishly misleading the Senate and failing to correct the record on his contacts with Russian officials. By contrast, Rod J. Rosenstein, nominee for deputy attorney general, demonstrated how lawyers serving the public should behave. He pledged to ensure every investigation was conducted “independently ” — that is, free of bias and partisanship. He promised to review whether a special prosecutor would be needed to investigate President Trump campaign’s contacts with Russia. However, he appropriately would not prospectively commit to appointing one. He was firm, polite and precise in his testimony, exactly the qualities you would want in a high-ranking Justice Department figure.
Rosenstein would be the only one in the administration who could restore credibility to the Justice Department and reaffirm that everyone, including the president, must abide by the law. As Newsweek reported, Sen. Amy Klobuchar (D-Minn.) said she favors “the idea of getting a seasoned prosecutor who has served under both a Republican and Democratic president into this role.” Newsweek quotes Sen. Sheldon Whitehouse (D-R.I.) as praising Rosenstein’s willingness to stand up to the president, when needed. (“When those circumstances present themselves, it calls upon those highest traditions of honor and independence to perform effectively. Rod Rosenstein seems to come out of that tradition.”)
Unlike Sessions, who exudes ideological fervor, Rosenstein comes across as reasoned and measured. Those who know him say they cannot say which way he leans politically. He has served in the Justice Department in one capacity or another under presidents of both parties for 26 years, currently as a U.S. attorney in Maryland. He has prosecuted political corruption cases and was part of the Monica Lewinsky investigation during Bill Clinton’s presidency. Both of Maryland’s Democratic senators enthusiastically support him. . .
Somehow I am growing averse to bad news—like trying to drink from a fire hose—so I am very pleased to blog this and shall look for more silver linings (in what still seems to be a very dark cloud).