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Sunday, December 3, 2017

Changes Impacting Consumers Under the Trump Administration-What You Need to Know

Americans have survived a jarring first year under the Trump right-wing juggernaut. This article shows changes which have already occurred in the government, which will have far reaching effects on your wallet, liberty, health, and security. The critical areas are listed in alphabetical order, not necessarily in order of importance.
Banking-Consumer Protections

Consumer Financial Protection Agency (CFPA)
Dodd-Frank Act was created to prevent the global banking collapse of 2007, due to big banks and hedge funds trading on unsecured junk quality mortgages. The U.S. gov. under President Obama had to lend money to banks to prevent a total collapse- 623 billion was loaned and 390 billion has been repaid.
The CFPA was created to fight predatory behavior by banks. When lenders have violated federal regulations, they must pay a civil penalty and/or make financial amends to the consumer. Here is a link to the companies whom have had to pay up:
So far, the CFB has awarded 11.5 billion to 29 million consumers from abusive lenders. This works out to $407 per individual.[1] Money has come from auto lenders, payday operations, and student loans scammers

Banks have been whittling away at the core requirements for adequate reserves. This means banks want to get back to the wild west of gambling with your money. Janet Yellen, retired head of the Federal Reserve oversaw compliance and enforcement of these provisions. Republicans are saying Dodd-Frank is stagnating the economy when the unemployment rate is 5%. Billionaire Treasury Secretary Steve Mnuchin a former Goldman Saks investment banker, is responsible for the rollback. Here is an article on the billionaire banker’s wife expressing no empathy for the average Americans these laws protect.[2]
Congress passed the Financial Choice Act on June 8, 2017.[3] This law will kill many of the Dodd-Frank fiscal responsibility requirements.
Under Obama, in November 2017, Congress approved a rule voiding banks (credit card companies) from mandatory arbitration requirements in contracts with consumers. [4]  Arbitration is a legal trick to limit consumers ability to seek legal remedy (class action settlements) for rip-offs by banks.)
 Trump appointed Mick Mulvaney director of the Consumer Financial Protection Agency, against the recommendations of the outgoing director. Mulvaney, former cabinet appointee of the Office of Management, responsible for slashing funding to healthcare and other programs is determined to limit its effectiveness. This means, no consumer watchdog and a free-for-all for the banking industry.  You can look forward to more of the predatory Wells Fargo behavior reported this year.[5]

Former head of Health and Human Services, Tom Price was fired due to overuse of expensive tax payer funded charter flights. He is replaced by drug company executive, Alex Azar, whose approval is pending.

Republican congressmen are resolute on cutting funding to healthcare, including stopping the subsidies under the Affordable Care Act, removing the requirement that businesses with 50 or more employees provide insurance, and equal access to women’s health services.

Don’t expect to see any reduction in drug prices. He worked for Eli Lily for 10 years. He will look at ways to change the Affordable Care Act. He will certainly review FDA processes. Not sure what he will do about funding.
Currently, the Republican’s have refused to reauthorize funding for the Children’s Health Insurance Plan, which has been used to provide healthcare for low-income children for the last 4 presidencies. Currently 8 million children receive healthcare this way. Republicans are willing to give tax breaks to billionaires but not provide healthcare for kids.[6]
Judiciary-Your Liberty
Republican Congressmen refused to appoint Obama appointees for federal judgeships,[7] the backlog is over 100 open court positions in the circuit court, district courts, and federal court positions.
Trump has nominated 50 judges for lifetime appointments. Currently right wing Republican Congressmen are fast tracking lawyers considered unqualified by the American Bar Association, those whom have never tried a case, and whom have sworn loyalty oaths to obscure religious sects.[8] [9] (Goodstein, 2017) Are these the people you want deciding case law for your property, liberty, and punitive rights? And of course, Republicans want to gain a majority on the Supreme Court to overturn Roe-v-Wade.
National Security

State Department
Republican Congress is shutting down the bioterrorism prevention lab in NY. The department of Homeland Defense already absorbed a 28% budget cut this year and is slated for more. These cuts are short sited and will go to fund tax breaks for corporations and billionaires.

Rex Tillerson, Secretary of State has cut 2,000 international experts from the State Department. Tillerson repeatedly turned down briefings from Chief of Security, Bill A. Miller, whom had to cite the federal law mandating the Secretary of State listen to security briefings before Tillerson would give him fifteen minutes. It is noteworthy that the entire senior diplomatic staff quit rather than work with this administration. Senior Congressman from both sides of the aisle are concerned about the cuts to the department.

Anthrax spores can kill many people and is undetectable in the mail. Lethal bacteria for which there is no known effective treatment exist. The risk of a bioterrorism event is real and growing. The U.S. is underfunded and unprepared. Every hospital administrator in the country is worried about this.

For all of the hatred sowed toward Hilary Clinton over Benghazi, the current Secretary of State is endangering diplomats all over the world by understaffing, under budgeting, and ignoring security briefings.  It takes decades for someone to learn the customs, languages, and protocols required to be a key asset in foreign affairs and these ignorant actions will cost the U.S. dearly just when we need diplomacy the most.
Personal Safety
Even after the Las Vegas massacre the Republican Congress is trying to pass the Sportsman’s Heritage and Recreational Enhancement Act, which will make it easier for people to acquire silencers, high velocity weapons, and explosives.
The NRA is backing this bill and cares nothing about the toll high velocity weapons have had on the general public. It is all about profit for them. Why should a few people who need to owe machine guns and conversion bump stock kits be allowed to endanger us all? There are more regulations to drive a car than for gun ownership. Congress banned funding for gun violence and cut 2.6 million from the CDC budget after a 1993 study found that homes with guns are three times more likely to have a homicide. The NRA was so concerned that the true costs of gun violence would become widely known, it lobbied for the ban. (Sudermann, 2017)
Both the House and the Senate have passed bills to reduce corporate taxes and those for the top 5% of income earners, ballooning the deficit. The bill cuts corporate taxes by 40% and reduces the top income tax rate. Also, 91% of those earning $500,000 or more per year would get a tax cut. The middleclass are paying for a tax cut for the rich while their healthcare is being stripped.
The nonpartisan Joint Committee on Taxation has stated this budget will add 1 trillion dollars to the federal deficit. The only Republican who had cojones to vote no was Senator Bob Corker. If approved, this will assure higher taxes on working class Americans to pay for existing Medicare, Medicaid, and Social Security obligations. It also will adversely impact the ability of the country to meet future obligations. The Republican Congress have federal pensions and healthcare and they do not care if you have even the skimpiest programs. The bill is fiscally irresponsible.

Merry Friggin Christmas from the Republicans. Let us hope for a better New Year.

And this is the healthpolicymaven signing off, encouraging you NOT to sign blank release forms for healthcare treatment. Do stipulate that for which you consent and that for which you do not. Americans are too often asked to sign a blank check to subsidize some profit-making organization's bottom line. Just as our children will be picking up the tab for the Republican tax cut for the privileged in corporate America.
This article was written by Roberta E. Winter, a health policy analyst, nonfiction author, and independent journalist. Please do share this article virally. 


Saturday, October 28, 2017

Microbes Not Missiles-How the U.S. Should Budget and Focus on Real Threats to Our Security

How the U.S. Government Can Budget and Focus on Real Threats to Our Health

As President Trump taunts and brags about his military might to Korean dictator, Kim Jong Un, getting obliterated by accurately fired and sustained nuclear warheads is still unlikely. Even less likely is the “star wars” technology where U.S. defense missiles can intercept and consistently disable nuclear missile attacks. The Trump budget proposed a 54 billion increase for the military and Congress approved 700 billion for military spending in September.[1] This chart shows the primary allocations:

U.S. 2017 Proposed Defense Budget
Financing Wars
Baltic States
$ Allocation

To achieve this target, Congress will approve a deficit budget and make gargantuan cuts in many other programs. Here is a shortlist of programs targeted for cuts which directly impact your health and well-being:

Programs targeted for cuts:
  • Centers for Medicare and Medicaid (your health care)
  • Environmental Protection Agency (clean air and water, protection from chemical hazards)
  • Health and Human Services (medical research, public health disease surveillance)
  • Department of Education (access to school-based nurses in public education)
  • U.S. State Department (where we can travel, restrictions)
  • Homeland Defense Department (biological and chemical weapons defense)

Most alarming are the cuts to the Homeland Defense Department for biological and chemical weapon defense, which absorbed a 28% budget cut in May 2017 and further cuts are slated for 2018. [2]  Programs to detect and respond to biological threats are being stripped, just when we need them the most.
The National Urban Security Technology Lab in New York, considered the national leader for developing systems to detect biological threats is slated for a complete shutdown of the department.[3] 
The October 2015 Blue Ribbon Committee on National Biodefense found the United States is underprepared for biological threats. The nation does not give biological threats the same attention it affords other threats. (Deadliest Enemy-Our War Against Killer Germs, 2017, pp. 139-140)

For more information, do read The Fink Committee Report, which made seven recommendations for biosecurity, especially for experiments involving recombinant DNA.[4] A committee of experts made the following recommendations:
  1. Establishing criteria for biological (dual-use) research
  2. Create a code of conduct for scientific research
  3. Develop strategies and guidelines for communication of bio research
  4. Advise on the use and regulation of synthetic genomes
  5. Foster international cooperation for dual-use research
  6. Improve response rates for deliberate attacks
  7. Publication of scientific research continues to be debated, out of fear the methods could be adopted by terrorists

Top security threats to any country are in order of precedence: (Deadliest Enemy-Our War Against Killer Germs, 2017, p. 300)
  1. Pathogens capable of creating epidemics, of which influenza is currently the greatest risk, because it can be spread through the air and the strains change all of the time.
  2. Antibiotic resistant coronaviruses like SARS or MERS, of which there are very few treatments still effective.
  3. Mosquito acquired diseases like Zika and yellow fever have moved northward and in 2016 there were 7,373 cases of Zika within the United States and its territories. (Deadliest Enemy-Our War Against Killer Germs, 2017, p. 373)
  4. Bioterrorism, which includes transmitting small pox or some other epidemic through the mail or by some other means to a targeted community[5]
  5. Diseases which continue to have a major impact on the world’s health include: tuberculosis (including treatment resistant TB), AIDS, viral hepatitis, bacterial pneumonia, and malaria.

Why We Need to Work Together Across the World
Trump Administration isolationist policies will harm the health of Americans, because we rely on other countries to supply our medicines, medical supplies, and many other products of strategic importance. First, it would take years for production facilities in the U.S. to scale-up and offset the loss of global suppliers. Secondly, because all companies now manufacture in a just-in-time basis, there are no longer large supplies of products in warehouses and this includes pharmaceuticals. In the past, I have written about critical shortages of drugs in our hospitals, and this would be exacerbated in an epidemic.[6] For example, much of our pharmaceutical and medical supply chain comes from India and China, so if a bird influenza epidemic dramatically impacts their populations, it would disrupt supplies for the United States and other countries. The 2009 bird flu epidemic which emanated from China was identified as a strain of the deadly 1918 Spanish flue which is estimated to have killed 100 million people. (Deadliest Enemy-Our War Against Killer Germs, 2017, p. 259) Finally, we really are all in this together and a plague in a distant land eventually finds its way to our shores, so we need to fight disease together. The Trump Administration’s philosophy of denying immigration won’t prevent epidemics, which microscopically flit through the air, on the wings of birds, and inconspicuously in airplane or shipping cargo bays.

To quote from public health expert, Michael Osterholm, in a 2015 TED Talk, Bill Gates asserted, “If anything kills over 10 million people in the next few decades its most likely  to be a highly infectious virus rather than a war.” (Deadliest Enemy-Our War Against Killer Germs, 2017, p. 50)  Both Gates and Osterholm observe that the world tends to minimize the threat of infectious disease. There have been thirty influenza pandemics since the sixteenth century. This is a poor way to prepare for public health epidemics and the ability of our infection fighting drugs has become exhausted, due to antibiotic resistant bacteria. Cipro is now one of the few drugs left which is effective against the flesh-eating bacteria. In India, where there are less restrictions on antibiotic use for animal production, there is currently bacteria which is resistant to all known treatments. And if this isn’t enough to make you forsake meat, Trump has approved the importation of Chinese chicken, which is not subject to inspections like the USDA.[7]

Microbes not Missiles
Of the deadliest foes to human kind plague is the most feared, because it can strike silently and there may be no available treatment as the disease wipes out your community. While all the President’s men rush to meet enemies in bunkers throughout the globe, the real threat will come to our soil as virulent bacteria, without warning.

What You Can Do
  1. Urge your elected officials to provide the necessary funds for public health preparedness as our lives hang in the balance. Now is NOT the time to cut funding for Health and Human Services research. We need to allocate one billion dollars annually on development of new more effective vaccines, especially for influenza.
  2. Support a new collaboration between government and private drug companies to create an efficient reliable pipeline for immunizations. Immunizations are not economically viable for drug companies to produce, but we must create incentives for them to do so.
  3. Support and expand the Coalition for Epidemic Preparedness and Innovations (CEPI) This will give us a fighting chance of being ready for the next pandemic.
  4. Encourage your congressmen (women) to fully implement the recommendations of the Blue-Ribbon Panel on Biodefense.[8]
  5. Establish an international organization to minimize the risk of intentionally created mutations used as pathogens for scientific purposes from falling into the wrong hands.
  6. Educate others on the importance of public health departments and their initiatives to prevent disease, from immunizations to disease surveillance and planning. Cuts to the Health and Human Services Agency hurts local health departments.

Please do read the riveting Deadliest Enemy-Our War Against Killer Germs, though it may make you curl up in a fetal position, with a blanket over your head. And this is the healthpolicymaven signing off encouraging you not to sign blanket hospital authorizations. Stipulate that for which you consent and that which is not permitted (out of network anesthesiologists for example).

Further Resources
Here is a list of other organizations which are working to understand and prevent infectious diseases:

One Health examines the domestication of animals for food and work and how infectious diseases or zoonotic illnesses sprang from that.

Bill and Melinda Gates Foundation is working to eradicate malaria and other tropical diseases and is devoted to public health initiatives in developing countries, especially Africa.

President’s Emergency Plan for Aids Relief (PEPFAR) was created by George W. Bush and combats AIDS worldwide.

National Institutes of Health (funded through Health and Human Services Agency) underwrites global research on health issues, including the H5N1 influenza virus.

National Science Advisory Board for Biosecurity (NSABB) researches and reviews microbiology, infectious diseases, laboratory biosafety, biosecurity, public health, and bioethics.

National Academy of Medicine (formerly Institute of Medicine) is an influential physician-led organization which has brought changes to hospitals for patient safety, especially for infection prevention, and a reduction in preventable patient deaths.

Centers for Disease Control and Prevention is a national organization for research and communication on public health threats, funded through the Health and Human Services Agency.

Works Cited

Olshaker, M,  Osterholm, M. (2017). Deadliest Enemy-Our War Against Killer Germs. New York, New York: Little, Brown, and Company, March 2017

Wednesday, October 11, 2017

Republicans-Creators of the EPA-Have Become the Party of Environmental Degradation

The Trump Administration is run by industry insiders with deep conflicts of interest, the very lobbyists whom were vilified when he promised to “drain the swamp” are running government agencies. Scott Pruitt, head of the EPA is an attorney who built his career by suing the federal agency. Pruitt is dismantling environmental protections at a breathtaking rate, which will impact your health and cost you money.

Fact #1 Global Warming Increases the Acidification of the Oceans
Increased carbon in the atmosphere contributes to global warming, increases acidification of the oceans, which kills coral, which supports marine life eaten by fish, and ultimately by us. Increased temperatures in the oceans have caused rapid melting of stabilizing ice in the Artic and Antarctica, as people have observed in real time due to cameras and satellite transmissions.[1] The Trump Administration has deliberately sought to suppress scientific evidence of irreparable environmental damages from carbon emissions, to such a degree, scientists made a safety cache of their research when the Trump team took over, fearing the rogue-anti-science cabinet would destroy data. Here is a link to the real report by government scientists on the state of the planet and global warming.[2]

Fact #2 Global Warming Increases Ocean Temperatures and Raises Sea Levels
Global warming of the oceans has contributed to the increased frenzy of hurricanes, rising sea levels, and submerging of coastal cities. Destruction of barrier islands and other habitat by dredging for maritime traffic and development contributes to a reduction in storm protection for coastal cities. Construction in floodplains should meet standards for flood tides.

Fact #3 Global Warming Melts Glaciers Which Feed Rivers and Causes Drought and Famine
 Increased carbon is also melting the glaciers on all the mountains in the world, including the tallest, Mount Everest or Denali. Ice samples have been laboriously gathered by scientist and climber, John All in South America, Asia, and North America. All is the author of Icefall: Adventures at The Wild Edge of Our Dangerous Changing Planet[3], a white-knuckle traveler’s tale of peaks and proof of the unrelenting damage humans are inflicting on the planet. Mount Everest or Chomolungma is essentially twice as tall as Mount Rainer or Tahoma, the tallest glaciated peak in the lower forty-eight states. He details evidence of shrinking glaciers even on the top of the tallest mountain in the world, one where you need supplemental oxygen just to survive. In some of the rain forests All has visited, there is no longer rain, and entire animal populations have fled. If there is no rain, there is no water, if there is no fresh water, there is no life. Do read John All’s memoire and shearing tale of environmental science on the frontline.
To inform your decision making, do review this chart for a brief analysis of what Scott Pruitt, U.S. Secretary of the Environmental Protection Agency has done to further erode the environment which we all share:

EPA Rule
How It Impacts You
Inclusion of greenhouse gas emissions in environmental reviews
Overturned the requirement that industry consider environmental damages in developmental plans[4]
Greenhouse gases are the largest contributor to global warming and cause; rising sea levels, acidification of the oceans, increasing global temperatures (records for the last 3 consecutive years)
Methane gas reporting requirement for leak detection and repair was to begin June 2, 2017 as part of the Clean Air Act
Halted this requirement on June 2nd, but federal court in D.C. prevented him from doing so in August.[5]
Methane is a greenhouse gas and one of the greatest contributors to global warming, caused by oil and gas industry
Calculation of the social cost of carbon, which uses a scale to apply dollar values to environmental costs[6] [7] [8]
Struck this requirement for coal, oil, and gas industry; why consider others when you must only think of yourself and how much money you make
The social cost, means impact on citizens, such as health (asthma, poisoning), flood risk, and harm to the environment, such as air quality.
Anti-dumping rule for coal companies; which reviewed surface water impacts in building permits
Blocked the Obama Administration’s Stream Protection Rule-Removed the requirement that coal companies cease from dumping tailings known as excess spoil into streams
This will exacerbate the poisoning of fresh water supplies, just ask Butte, Montana residents what that means. Plus, the repeal of the dumping rule will impact fisheries.
Removed mining and drilling restrictions in the Alaskan National Wildlife Refuge; also opened oil drilling on almost all of AK, including Bristol Bay and off shore drilling in the Artic.
Pristine wilderness area, set to be pillaged by oil industry. Just google Exon oil spill if you want to understand what is at stake[9]
The world is awash in oil, prices are down, and the U.S. is producing so much excess oil Congress approved the sale  of our strategic oil reserves. We don’t need more oil, we need clean air and water and a live-able planet.
Copper filter cake used in electroplating, was listed as a hazardous waste and impacts the semiconductor industry
Delisted this as a hazardous waste effective October 2, 2017, after a petition by Texas based, Samsung[10]
The chemicals in this device include; cadmium, hexavalent chromium, and cyanide, all hazardous to your health.[11]
Limits on toxic discharge from steam electric coal fired power plants, effective January 4, 2016, as part of the Clean Water Act
Compliance with the new rules to reduce water pollution by mercury and other chemicals generated from power plants has been postponed.[12]
Steam electric plant discharges include arsenic, lead, mercury, selenium, chromium, and cadmium. Many of these toxic pollutants, once in the environment, remain there for years.
Pesticide chlorpyrifos, also known as Lorsban, used on orchards, broccoli, cauliflower, and strawberries. It was to be banned in 2016 for farm use and was banned for household use a decade ago.[13]
The EPA had gathered evidence this pesticide was harmful to humans, especially to farm workers; decision not to ban Lorsban on March 27,2017 goes against EPA’s own research. It has been shown to reduce IQ in children.
Pesticide is harmful to humans, and organic food alternatives are available. When you see the product warning label at the market, pay attention, and wash the product!
Federal building standards for improved infrastructure in flood areas were reversed by executive order days before Hurricane Harvey hit.[14]
In other words, requiring FEMA funded rebuilding to take flood risk into replacement design was wiped away by the Trump Administration.
Why not prepare for flooding with better infrastructure, the answer is, if Obama thought of it, Trump wants to dump it. Now we are all going to pay more for this foolish decision when the next Hurricane comes along and the buildings which were rebuilt and didn’t meet flood standards must be rebuilt at tax payer expense.

Mr. Pruitt, an Oklahoman, doesn’t live near an ocean, so rising sea waters may not be of concern, but poisoning the well water and aquifers, in his region of the country will affect his neighbors, which has resulted from fracking, a chemical and hydro-laden process of leaching oil reserves buried deep in the earth.[15] None of us can afford to wait for a more prudent and responsible EPA Administrator to right the calamitous actions of Mr. Pruitt, please contact your state and federal representative and urge action against his callous mandates.

And this is the healthpolicymaven signing off, encouraging you to act on fully informed consent for legislation that impacts your air, water, and food sources. Lung cancer and asthma are just some of the human caused harms we must curb. Winter is the author of

[2] U.S Global Change Research Program Climate Science Special Report, June 28, 2017
[3] John All and John Balzar, Icefall: Adventures At The Wild Edges Of Our Dangerous Changing Planet, Public Affairs, an imprint of Perseus Books, a division of PBG Publishing, a subsidiary of Hatchet Book Group Inc, March 14, 2017;
[4]By NADJA POPOVICH and LIVIA ALBECK-RIPKA  52 Things Environmental Rules On The Way Out Under Trump ,The  New York Times, October 6, 2017

Sunday, October 8, 2017

Retort to Trump's Edict-Religion Must Come First

Trump’s hypocrisy stinks even from the page.
The here-to-for liberal New Yorker whom deflowered more than a few young women has now caught religion, decrying the use of public funds, no matter how paltry, to pay for contraception. This of course, also applies to starving mothers in Africa, where under the 2018 federal budget, the Trump/Pence Presidency has also axed the funding of basic women’s healthcare.[1]
The Edict
Trump has approved memos from both Health and Human Services and the Justice Department to halt the requirement that employers provide birth control or reproductive rights parity in the administration of the Affordable Care Act.[2] The administration intends to exempt any employer from being required to provide birth control coverage in its group insurance plan. This will of course impact millions of women and their families adversely. I note that Trump did not declare a moratorium on Viagra, penile implants, or other accoutrements deployed by his “base.”
Religion Must Come First
What does he mean when he says, “Religion must come first?” Does he mean servicemen and women must only act if their orders coincide with their religious beliefs? What if someone’s religion has different dictates than his, if religion is first, then what about religious differences? The U.S. is a multi-theistic nation, which is to say, there is no single religion and this fact is becoming more pronounced every year.  According to the 2010 United States Census, which is the most current national census data we have, 57.88% of residents reported they were protestants. The second largest demographic at 21.87%, were those without any religious affiliation, the nonbelievers, those who associate their belief systems with either atheism or agnosticism. And in third place, despite all the marketing, were Catholics at 19.63%.[3] Growing religious minorities include Muslim, Buddhist, and Hindu followers, with the national census identifying forty-three religions in the nation. And let’s not forget Judaism. My only response is the same one I had in 2013, “Given this disparity of beliefs, it would seem religion is not a sound method to cast social policy for such a diverse nation’s healthcare delivery.”[4] A social policy that reflects science and evidence in the allocation of public resources may result in better health care for us all.
The Courts
Of course, his grandstanding will not hold up in courts and will be found unconstitutional and discriminatory toward women. How sad, that Trump is so desperate for approval he just assured his unelectable status.
What Women Can Do
First, there are more of us than there are of them, the repugnant Trump team, so act with your voice and your wallet. Contact your elected officials and let them know how unconscionable it is to deny women access to basic healthcare. Also, when you are offered a job, ask the employer if their medical insurance policy covers birth control, and if it doesn’t, don’t work there. If an employer isn’t willing to share their employee benefits policy with you a job candidate, then you don’t want to work there. Refuse to frequent businesses which support policies which treat women as chattel or second-class citizens. Do not send your children to schools which refuse to provide basic healthcare for their teachers.  Frequent healthcare facilities where treatment is not based on someone else’s religion, but on what is best for the patient. Make your voices heard, loud and proud!

This is the healthpolicymaven signing off encouraging you NOT to sign generic consent documents when you approve a health treatment. Be sure to indicate that which you do consent and that for which you do not. This includes approving in-network providers, end-of-life treatment protocols, and women’s health procedures. For more information on how to make your preferences clear, do read, “An American Sickness-How Healthcare Became Big Business and How We Can Take It Back,” by Dr. Elizabeth Rosenthal. [5]

[1] International Women’s Health Coalition, Trump’s 2018 Budget Wages War on Women, May 31, 2017
[2] Robert Pear, Rebecca R. Ruiz, and Laurie Goodstein, Trump Administration Rolls Back Birth Control Mandate, October 6, 2017
[3] U.S. Bureau of the Census, “Table 74. Population in Group Quarters by State 2000 to 2010,” in U.S. Census Bureau, Statistical Abstract of the United States: 2012 (Washington D.C.; U.S. Census Bureau, 2012)
[4] Roberta Winter, Unraveling U.S. Healthcare-A Personal Guide, Rowman & Littlefield, 2013, p. 159