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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
Program
Pentagon
Financing Wars
Baltic States
Israel
$ Allocation
640,000,000,000
60,000,000,000
500,000,000
705,000,000

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
Action
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 https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972



[2] U.S Global Change Research Program Climate Science Special Report, June 28, 2017 https://www.nytimes.com/interactive/2017/08/07/climate/document-Draft-of-the-Climate-Science-Special-Report.html
[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 https://www.amazon.com/Icefall-Adventures-Dangerous-Changing-Planet/dp/1610396936/ref=sr_1_1?s=books&ie=UTF8&qid=1507747688&sr=1-1&keywords=icefall+john+all;
[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    https://www.nytimes.com/interactive/2017/10/05/climate/trump-environment-rules-reversed.html

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 https://iwhc.org/2017/05/trumps-2018-budget-wages-war-women/
[2] Robert Pear, Rebecca R. Ruiz, and Laurie Goodstein, Trump Administration Rolls Back Birth Control Mandate, October 6, 2017 https://www.nytimes.com/2017/10/06/us/politics/trump-contraception-birth-control.html
[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

Sunday, August 6, 2017

Trump Report Card-Cabinet Actions Midway Through First Year

Trump Report Card-Midpoint Year 1


Donald Trump has been POTUS for half of his first year and this article reviews what his cabinet has accomplished and the direct impacts on you. President Trump’s opinions and omissions do create harmful consequences as this report card illustrates.

What’s at Stake
Cabinet Member
Perspectives
Analysis
Your Health
The Secretary of Health and Human Services controls the following agencies: Centers for Medicare and Medicaid, Food and Drug Administration, administers the Affordable Care Act, and grants more money for medical research than any other agency in the world.
Tom Price, Republican from Georgia, He is an orthopedic surgeon, and represents one of the healthcare sectors with expensive medical devices and lucrative profit margins for health systems. Resentful of the 3% medical device tax his industry pays to fund the Affordable Care Act for low-income Americans.
Wants to get rid of Obama Care and replace it with another insurance based payment system. Questions the value of the Centers for Medicare and Medicaid innovation through Demonstration Projects. He wants to reduce the footprint of government policymaking in healthcare. Though he wants consumers to shoulder more responsibility for their health care, he questions the value of performance assessment as a component of government funding and oversight by government agencies. CMS’s Accountable Care Organization program has been successful and 31% of 2015 participants received bonuses. There are 400 healthcare systems participating in this program.
Would he impinge on medical research by eliminating stem cell research as his predecessor George Bush did?
🔻Price has used HHS money to discredit the Affordable Care Act. It is unclear what will be done to support the open enrollment period which starts in 2 months. 🔻Trump may try to strangle the act by refusing to pay the financial subsidies to insurers who participate in the exchanges, thus causing them to drop out. This ploy would produce a result sought by many Republicans-to kill the ACA. Millions could still end up without healthcare and no public option. 🔻Other death knells may include cutting some of the funding provisions for the act, such as the 3% medical device tax. 🔻The agency may also stop enforcing proof of medical insurance requirements with the IRS, thus gutting revenue from fines for companies and individuals who do not comply.[1] 🔻The proposed federal budget seeks a 20% cut for Health and Human Services, which will hurt medical research and is yet to be approved, but is next on the docket.  🔻
And finally, another legislative rollback-loosening the requirement that religious organizations offer birth control under their medical insurance.[2]
Your Air and Water
The Environmental Protection Agency sets standards for air & water quality, extracts fines from offenders, and litigates as required for compliance with federal and state laws.
Scott Pruitt, Republican, former Attorney General and former senator from Oklahoma, Secretary of Environmental Protection Agency
The EPA was created by the Nixon Administration and is responsible for improvements in air and water quality throughout the nation. Pruitt wants to gut the Clean Water and Clean Air Acts signed by the Obama Administration. Has pledged to dismantle the EPA and is in the back pocket of the oil and gas industry. He has been vociferous in his lawsuits against government regulations. Doesn’t think global warming is an issue. Wants to get out of the Paris Climate Change Accords, which were signed by 95 countries.

🔻U.S. dropped out of the Paris Accords, a nonbinding commitment to cut greenhouse gases, the greatest contributor to global warming and the melting of the polar ice caps. Obama Administration Clean Air Act forces power plants, especially coal powered ones, to reduce particulate emissions. The act established standards for emissions but allows flexibility for states to administer. 🔻The Trump administration has provided a 90-day stay on implementation of the Clean Air mandate. Tough luck for the asthmatics. The OMB’s budget will detail financial impacts of this act and Department of Interior revenues.[3] 🔻The Keystone Pipeline is back to transport earth scorching arboreal forest decimating Canadian tar sand oil to the U.S. for exportation. 🔻Congress also approved exportation of U.S. oil reserves because we are producing more than we need, whereas in normal market economics, production would decline when there is a market surplus. This is a subsidy for the oil industry.
Your Children’s Education Department of Education sets national standards for education (No Left Behind and Common Core), provides funding, and enforcement of standards
Betsy DeVos, former chairwoman of the Michigan Republican Party, is from the Amway family of billionaires and has never attended a public school, nor have her children. She attended Calvin College, a private liberal arts college.   She is the sister of infamous military defense contractor, Eric Prince, founder of private mercenary group, Blackwater.

Wants to deconstruct the agency and give more responsibilities to states, counties, and individual districts to set curriculum. She is a huge supporter of charter schools, which are funded with public funds but operate like private schools. She advocates a school voucher system where the government would essentially provide support for private schools. In Michigan, 80% of the schools are run by private companies. She is does not believe in recognizing homosexuality.
🔻Budget includes a 13% reduction in education funding.[4] 🔻This includes reducing college loans for low-income students under federal loan programs. 🔻Other actions include reducing Title IX enforcement of sanctions for campus sexual assaults. 🔻Relaxing federal standards to comply with Every Student Succeeds Act, for which 12 states have already submitted plans.[5]
🔺Surprisingly she appeared to waffle on the lavatory restriction for transgender folks, crossing AG Sessions.
She still needs to learn to spell.

Your Money
The Department of the Treasury, oversees revenue collection through the IRS, and sets standards for currency and financial management for the nation
Steve Mnunchin, former Goldman Saks executive and Hollywood film financier, is a Wall Street banker insider, who graduated from Yale.
Wants to loosen the Dodd-Frank  reserve standards for banks, created to prevent another financial meltdown due to hedge funders and bad bank decisions. The landmark Dodd-Frank Act, stewarded by Senator Elisabeth Warren,  created liquidity standards for banks to prevent the financial collapse of the nation and the world. If the U.S. government hadn’t bailed out AIG Insurance, General Motors, Fannie Mae, Freddie Mac, and a host of banks the depression would have been much more severe. (ProPublica.org, 2016)
Trump and Mnunchin cannot agree on the budget. 🔻He has identified methods to ease banking regulations without Congressional approval, including bank solvency stress tests, passed after the 2007 banking collapse.🔻 And most grievously, reducing the power of the Consumer Financial Protection Bureau, which has been successful in reducing predatory behavior by lenders.[6] Funding for this agency is not subject to Congressional approval-Trump wants to change this. CFPB has created lending standards for banks to verify income before providing mortgages. Enforcment-27 million Americans have received settlements from banks because of its actions.[7]
Your Liberty
The Attorney General of the United States, oversees the administration of federal laws, court system, and the enforcement of anti-trust and civil rights laws.

Jeff Sessions, Attorney General, is a former Republican Senator from Alabama, and former Attorney General of Alabama. He was rejected by the Reagan Administration for a federal judicial appointment because of racist views.
Has a reputation of being anti-immigrant, anti-Muslim, and anti-gay (LBGTQ). One of the most conservative members of Congress often at odds with his own party. Is a supporter of the stop and frisk ethos.  Widely considered to have racist views.
Sessions has been neutered by Trump and the investigation into the Russian election coupe. 🔻The ill-conceived Muslim travel ban is subject to lawsuits. 🔻He has instigated the war on drugs, wants to remove judicial discretionary sentencing, and imprison more people. Think Opioid abusers in jail not in treatment.🔻 Also revived a federal law allowing government to seize property for those suspected of crimes.🔻 He dumped the National Committee for Forensic Science, which aims to improve crime solving techniques and accuracy.[8]
Your National Parks
The Secretary of the Interior oversees the vaunted National Parks system, national forests, and all public lands, including the Bureau of Indian Affairs.
Ryan Zinke is a Republican freshman senator from Whitefish, Montana who is a former navy SEAL commander.
One of his most alarming views is he considers climate change to be unsettled. We don’t know anything about his governance perspectives. He has friends in the coal and fossil fuel industries, which is why the freshman senator with no regulatory experience was made a cabinet member. Montana has many tribal lands, including the Flathead Indian Reservation, near Whitefish.
🔻Reduced the fees coal companies pay to strip coal from our federal lands.[9]🔻Overturned Obama Administration ruling which stopped coal companies from mining on federal lands.[10] Coal is no longer an economical source of power, especially if the gov. makes them pay fair market rate for leases. Coal is one of the greatest contributors to particulates in air pollution. Much of the coal being gouged out of the earth now goes to China, the largest polluter in the world. 🔻Next up-looking to limit the rules which restrict the greenhouse methane gas production from oil and gas sites on federal lands. In other words, it is back to raping and pillaging public lands as usual.
Your World
The Secretary of State is 4th in line to the presidency and is chief negotiator of foreign policy on behalf of the nation, also responsible for coordination and security of diplomatic posts.
Rex Tillerson, former chief executive of Exxon, has lucrative financial interests in countries which are considered enemies, including Russia.
Tillerson has a fifteen-year relationship with Putin, czar of Russia and advocates loosening of economic sanctions. Unlike other Trump nominees, he favors climate change action, including the carbon cap taxes on emissions. He also favors supporting the 2015 Paris Accords for Climate Change Action. He probably would favor the Keystone Pipeline completion.
The far-flung oil and gas interests of Exon and his personal wealth may be impacted by actions of the federal government. With the Mueller subpoenas, no one is safe from the Russian scandal. It appears Trump does not listen to the Secretary of State, preferring to decide foreign policy with those whom were not subject to Congressional approval, the informal Whitehouse advisers and of course, his children. Tillerson is a micromanager focusing on reorganizing the State Department.
Transportation
The Secretary of Transportation
oversees highway safety and road construction projects.
Elaine Chao is the former head of the Department of Labor and married to Senate Majority leader, Mitch McConnell. In other words, the ultimate insider.
One of Trump’s centerpiece platforms is the rebuilding of America, so Chao will be responsible for contract letting, management, and other infrastructure requirements.
Chao has not accomplished anything of note because the federal budget is not yet approved nor is an infrastructure bill. She is waiting in the wings.
Keeping the Lights On
The Secretary of Energy has oversight of the nation’s nuclear arsenal, also sets policy on utilization of resources to develop and maintain the nation’s energy grid.
Rick Perry, is the former Texas Governor, failed presidential candidate, and middling Dancing with the Stars Contestant. Of note, he was once a Democrat.
The only qualification Mr. Perry has for energy expertise, is his support of wind power in his home state. He has no scientific background and has suggested the Department of Energy could be eliminated.
Perry is on the National Security Committee but he does not appear to have done anything to enhance our security. He did slam the Paris Accords. Important to note, two nuclear power projects were shut down in July in South Carolina because they were not financially viable given other less costly energy alternatives. A list of other nuclear power projects which have been cancelled is included in the footnotes. [11] [12] [13]

Progress
Women’s March✅ Science March✅ Defeating the repeal of the Affordable Care Act✅ It is heartening to see the massive efforts of citizens who are thwarting the Trump Administration regularly.  Hopefully this article will provide some ideas on other policy issues which require attention and action.  Trump has proven himself to be the nightmare we all feared, a global disrupter who does more harm than good. A thriving democracy is an essential component of liberty and I am heartened by the participation of millennials in many of the efforts to resist the Trump Administration’s selfish initiatives. For more information on efforts to curb disastrous environmental policies, read  Geoff Dembicki's, "Are We Screwed-How A New Generation Is Fighting To Survive Climate Change," Bloomsbury Press.  And this is the healthpolicymaven signing off and encouraging you to share this article with all who value their democracy.

Roberta Winter is a freelance journalist who publishes under the trademark healthpolicymaven, which has been in continuous use since 2007. She is a public policy and healthcare book reviewer for the New York Journal of Books, a technical writer, and author. Her consumer guidebook to the U.S. healthcare system was published by Rowman & Littlefield in 2013. https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972