John didn’t start his career mad.

He trained as an emergency medicine doctor in a tidily run Midwestern emergency room about a decade ago. He loved the place, especially the way its management was so responsive to the doctors’ needs, offering extra staffing when things got busy and paid administrative time for teaching other trainees. Doctors provided most of the care, occasionally overseeing the work of nurse practitioners and physician associates. He signed on to start there full-time shortly after finishing his residency.

A month before his start date, a private equity firm bought the practice. “I can’t even tell you how quickly it changed,” John says. The ratio of doctors to other clinicians flipped, shrinking doctor hours to a minimum as the firm moved to save on salaries.

John — who is being referred to by a pseudonym due to concerns over professional repercussions — quit and found a job at another emergency room in a different state. It too soon sold out to the same private equity firm. Then it […]

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Abstract

• Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement.
• Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes.
• Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower.
• Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

Introduction

Mirror, Mirror 2024 is the Commonwealth Fund’s eighth report comparing the performance of health systems in selected countries. Since the first edition in 2004, our goal has remained the same: to highlight lessons from the experiences of these nations, with special attention to how they might […]

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In the aftermath of Hurricane Helene, former President Donald Trump has blasted the Biden administration for its handling of the disaster — going so far as to accuse Democratic leaders of ignoring the needs of Republican storm victims.

But a review of Trump’s record by POLITICO’s E&E News and interviews with two former Trump White House officials show that the former president was flagrantly partisan at times in response to disasters and on at least three occasions hesitated to give disaster aid to areas he considered politically hostile or ordered special treatment for pro-Trump states.

Mark Harvey, who was Trump’s senior director for resilience policy on the National Security Council staff, told E&E News on Wednesday that Trump initially refused to approve disaster aid for California after deadly wildfires in 2018 because of the state’s Democratic leanings.

But Harvey said Trump changed his mind after Harvey pulled voting results […]

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Former President Donald Trump and his allies have claimed the Federal Emergency Management Agency can’t respond well enough to the aftermath of Hurricane Helene because it’s diverted so much money to helping migrants—but that’s not true, as FEMA’s funds for handling disaster relief efforts are separate from money given to immigrant communities.

Trump has repeatedly alleged that FEMA is having money issues because of funds spent on migrants, claiming at a rally Thursday that “Kamala spent all her FEMA money—billions of dollars—on housing for illegal migrants” and quoting Fox News host Jesse Watters as saying, “FEMA is now out of money, because Joe Biden and Kamala spent over a billion dollars of FEMA cash on migrants.”

Homeland Security Secretary Alejandro Mayorkas did say Tuesday that FEMA’s disaster relief efforts are facing a dire cash crunch, warning that while the agency is “meeting the immediate needs” of Hurricane Helene recovery “with the money that we have,” it “does not have the funds to make it through the [hurricane] season.”

But those financial issues aren’t because of money going to migrants: While FEMA and U.S. Customs and Border Protection have […]

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The US Justice Department and Microsoft said Thursday that they seized 107 internet domains used by hackers linked to Russian intelligence to target US government employees, defense contractors, and civil society organizations.

Federal investigators said hackers associated with an element of Russia’s Federal Security Service (FSB) used 41 domains in a spear phishing campaign targeting US-based companies and current and former employees in the US intelligence community, Pentagon, State Department, and Energy Department as well as US defense contractors, according to court documents unsealed Thursday.

Investigators believe the hackers were seeking to obtain “information of value to the Russian government, especially in its efforts to engage in malign foreign influence operations within the United States,” authorities said.

The Justice Department indicted two Russian intelligence officers last December in connection with the hacking campaign.

A federal court in Washington, D.C., also granted Microsoft permission to seize 66 internet domains used by the same cyberespionage group — known as the “Callisto Group” or “Star Blizzard” — to steal information from journalists, think tanks, and […]

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“Menstrual police?” you may be thinking. That’s not possible! Not in America!

The Comstock Act is an 1873 law that, if enforced, would outlaw all abortions in America by banning the shipping via mail, UPS, FedEx, etc., of any device, drug, or instrument that can be used to produce an abortion. It would even shut down hospital abortions.

It could also be used to empower new state or even federal police agencies specifically overseeing women violating its provisions. Like the menstrual police, which a Trump senior advisor just said was a very real possibility.

First the background.

It’s the opinion of the Biden Administration that the Comstock Act — which is still on the books — is no longer enforceable, and the Biden DOJ (along with those of every president since Richard Nixon) refuses to enforce it.

Senator JD Vance disagrees.

He (and a few other Republican senators) sent a letter to […]

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Key Points

Question  What are the incidence, prevalence, and changes from 2017 to 2021 for depression and anxiety diagnosed clinically among children, adolescents, and young adults and are there disparities among subgroups?

Findings  In this cohort study of approximately 1.7 million individuals aged 5 to 22 years in Southern California, the overall incidence and prevalence of depression diagnosed clinically increased by approximately 60%, and anxiety diagnosed without depression incidence increased by 31% from 2017 to 2021. Rates increased across all subgroups and were greater during the COVID-19 pandemic.

Meaning  These findings suggest the increased need for mental health services for youth.

Abstract

Importance  Data from surveys show increased mental health disorders in youths. However, little is known about clinical diagnosis over time.

Objective  To assess the incidence, prevalence, and changes from 2017 to 2021 for depression and anxiety diagnosed clinically among children, adolescents, and young adults and to identify potential disparities.

Design, Setting, and Participants  This cohort study included approximately 1.7 million individuals aged 5 to 22 years in Southern California. Data were extracted from electronic medical records; International Statistical Classification of Diseases, Tenth Revision (ICD-10), […]

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Hundreds of thousands of people across parts of the Southeast will struggle to rebuild their homes after Hurricane Helene for one reason: Hardly anyone has flood insurance.

In dozens of counties in Georgia, North Carolina and South Carolina that were flooded by Helene, less than 1 percent of households have flood insurance through the federal program that sells almost all of the nation’s flood policies.

“People never thought they would have a problem with flooding,” said Jimmy Isaacs, fire chief of Boone, North Carolina, a mountainous town in Watauga County, where less than 2.5 percent of households are insured. “It’s going to be a difficult recovery.”

Helene is highlighting the major gaps in U.S. flood insurance and their consequences as climate change amplifies flood risk both from coastal storm surge and rapidly overflowing rivers in Boone and other inland areas.

Flood insurance is sold separately from […]

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