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The international medical humanitarian organization Doctors Without
Borders/Medecins Sans Frontieres (MSF) has had to halt its emergency
medical services in the Swat region of Pakistan and reduce activities
in other areas affected by the current warfare. The organization was
the only one supporting the hospital in Mingora and providing ambulance
services in Swat. The reduction of MSF's activities is a result of the
general insecurity, in addition to a number of direct incidents against
MSF itself.
"Even before this new offensive, civilians in north-western Pakistan
were already struggling to survive a terrible situation," said Brice de
le Vingne, Brussels-based coordinator for MSF's programs in Pakistan
and Afghanistan. "Today, curfews, roadblocks, and intensely fierce
warfare make it virtually impossible for them to reach hospitals and
clinics. They are literally locked into this situation of extreme
violence. On top of that, it is largely impossible for our medical
teams to assist them."
Unknown numbers of people cannot escape the warfare. Trapped in
their homes, they cannot go out to buy food, obtain clean water, or
visit a doctor if they need to.
MSF calls on all parties to respect the rights of injured civilians
to medical treatment and to provide space for MSF to assist them
without being subjected to further violence, threats, and intimidation.
As a priority, MSF needs to be able to evacuate wounded people and
replenish Saidu Sharif Hospital in Mingora with urgently needed medical
supplies.
"This is a completely untenable situation," said De le Vingne. "It
has gone from dire to absolutely desperate. And there is every chance
that things will get even worse. Right now, exactly when the risks
facing people are radically increasing, we are simply not able to set
up much of the necessary lifesaving activities."
Hundreds of thousands of people are seeking refuge in less insecure
parts of Pakistan. They often stay with host families, putting extra
strain on local resources including health care, or in improvised camps.
In Lower Dir, MSF continues to provide clean water and basic health
care to displaced people in two camps. In Peshawar, MSF is preparing
for a possible arrival of more displaced, including injured civilians
who cannot find treatment closer to home. MSF has a team on standby in
Dargai to assist all those who need surgery.
From December 2007 to December 2008, during curfew hours, MSF
ambulances transferred approximately 1,300 war-wounded and other
patients from various parts of Swat to Saidu Sharif and hospitals in
Peshawar and Islamabad. In September, MSF treated nearly 4,000 cholera
patients during an outbreak of the disease. Such lifesaving assistance
is no longer possible.
Other MSF activities in Pakistan-in Baluchistan, Kurram Agency, and
in the Peshawar area-continue uninterrupted. MSF works in three basic
health structures in the Peshawar neighborhoods that are hosting
families displaced by the war, and has supported a camp in Charsadda
and distributed essential non-food items to over 30,000 displaced
people in Peshawar, Charsadda, and Mardan since August.
Doctors Without Borders/Medecins Sans Frontieres (MSF) is an international medical humanitarian organization created by doctors and journalists in France in 1971. MSF's work is based on the humanitarian principles of medical ethics and impartiality. The organization is committed to bringing quality medical care to people caught in crisis regardless of race, religion, or political affiliation. MSF operates independently of any political, military, or religious agendas.
North Carolinians who voted for state Rep. Tricia Cotham, who defended abortion rights before switching to the GOP, were "deeply betrayed," said one observer.
The North Carolina Legislature voted Tuesday to override Democratic Gov. Roy Cooper's veto and pass a bill banning abortions after 12 weeks of pregnancy, with Democrat-turned-Republican state Rep. Tricia Cotham giving the GOP the support it needed to ram the measure through in the face of significant public opposition.
Formerly an outspoken defender of reproductive rights—she's still listed as a co-sponsor of Democratic legislation to codify Roe—Cotham switched parties last month in a move that gave Republicans a veto-proof majority in the House, adding to its existing veto-proof majority in the Senate.
Cotham voted for the 12-week abortion ban's initial passage earlier this month and backed the veto override on Tuesday as protesters in the House gallery chanted, "Shame!"
In a statement, the now-Republican lawmaker said she believes the bill "strikes a reasonable balance on the abortion issue and represents a middle ground."
"Some call me a hypocrite since I voted for this bill. They presume to know my story," said Cotham, who has previously spoken about her own abortion. "As I said at the time, I had an ectopic pregnancy that sadly ended in miscarriage, not an elective abortion. In fact, Senate Bill 20 affirms the lifesaving care I received in that dire situation."
Progressive Durham County Commissioner Nida Allam argued that Cotham's statement essentially tells the people of North Carolina that "the bill would've protected me therefore it's enough, screw everyone else."
\u201cLast line from @triciacotham is basically saying \u201cthe bill would\u2019ve protected me therefore it\u2019s enough, screw everyone else.\u201d\u201d— Nida Allam (@Nida Allam) 1684286601
Rejecting Cotham's depiction of the abortion ban as moderate, Dr. Katherine Farris—Planned Parenthood South Atlantic's chief medical officer—warned the new law is "full of medically unnecessary and dangerous restrictions on abortion care that go against medical best practices."
"Not only do the actions of our lawmakers make me angry, but they also scare me," said Farris. "Treating my patients should not be seen as an act of civil disobedience. A person's health, not politicians, should guide important medical decisions at all stages of pregnancy."
As The Washington Postnoted, opponents of the measure have raised particular alarm over a "provision that would require patients to have an in-person consultation with a doctor at least 72 hours before an abortion, in addition to the visit required for the abortion itself."
"The extra in-person visit would make it harder for out-of-state patients to travel to North Carolina, which currently allows abortion until 20 weeks of pregnancy and has become a destination for patients seeking abortions across the South in the wake of the Supreme Court ruling [overturning Roe v. Wade]," the Post reported. "In the first two months after the landmark decision, North Carolina experienced a greater spike in abortions than any other state."
The new law would also, as Vox's Dylan Scott wrote Wednesday, establish "intrusive reporting requirements, such as mandating that doctors report a patient's fertility history to the state government after an abortion, including information such as their number of live pregnancies, previous pregnancies, and previous abortions."
"The law does include some provisions that Republicans say will provide additional support for children and families, including a new paid parental leave policy and increased child care subsidies," Scott observed. "But both programs have significant holes. Paid parental leave applies only to state employees, not the private sector. Increasing the state's child care subsidies for families already receiving them would not alleviate the main problem with accessing child care in North Carolina, as there are already 30,000 children in the state on a waitlist for financial assistance. The law does not do anything to get people off of that waitlist."
The 12-week abortion ban is set to take effect on July 1.
Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America, said late Tuesday that "today's vote will have devastating consequences across North Carolina, and for the thousands of patients in the region who've relied on the state as a key access point for abortion."
"This ban, like all abortion bans, will harm people who have the right to make their own decisions based on what is best for themselves, their lives, their families, and their futures," said Johnson. "No one should be forced to travel out of state to access abortion care. No one should be forced to carry a pregnancy that they do not want, or that is dangerous to their health. And yet, today that is what the North Carolina legislature is forcing them to do."
"Today's vote will have devastating consequences across North Carolina, and for the thousands of patients in the region who've relied on the state as a key access point for abortion."
Citing two former Cotham staffers, Jezebel's Susan Rinkunas reported this past weekend that the lawmaker's decision to switch parties "wasn't really about any genuinely held beliefs, political issues, or even money."
As one ex-staffer put it: "I wish I could say that she took a giant bag of cash at an IHOP and that's why she did this—but it's so much dumber than that. It's just a deeply petty, personal thing."
The staffer told Rinkunas that Cotham felt her Democratic colleagues didn't like her.
"Cotham had also been annoyed that Planned Parenthood didn't endorse her," Rinkunas reported, even though Cotham "blew off the actual endorsement interview for the group multiple times" during her 2022 campaign.
In a Planned Parenthood candidate questionnaire for the 2022 race, Cotham described herself as "an unwavering advocate for abortion rights."
Following Tuesday's vote, Jezebel's Laura Bassett wrote that "North Carolinians are being politically trampled here, as they do not support banning abortion this early in a pregnancy: According to new polling by Carolina Forward/Change Research, 54% of voters in the state oppose the 12-week ban, while only 40% support it."
"It's a shame that people who voted for Cotham, thinking (reasonably) based on her previous speeches that she'd defend abortion rights, were deeply betrayed in the end," Bassett added.
"The American people understand that healthcare is a human right," said the Vermont senator.
"The current healthcare system in the United States is totally broken, it is totally dysfunctional, and it is extremely cruel."
That was how Sen. Bernie Sanders (I-Vt.) kicked off his speech Tuesday night at a town hall in Washington, D.C., convened hours before the planned reintroduction of Medicare for All legislation in the House and Senate on Wednesday.
Sanders, who is leading the updated bill alongside Rep. Pramila Jayapal (D-Wash.), said that the U.S. can "no longer tolerate" a profit-driven healthcare system under which the country spends twice as much per person as other major countries with disastrous results.
The Vermont senator, a longtime single-payer proponent, rattled off the alarming statistics: More than 80 million people in the U.S. are uninsured or underinsured, a quarter of Americans struggle to afford prescription medicines, and tens of thousands die every year in the richest country on the planet due to lack of insurance.
"What an outrage," Sanders said Tuesday to an audience of nurses, doctors, other healthcare workers, and patients.
While the text of the latest Medicare for All bill has not yet been released, it will likely bear a close resemblance to previous versions that called for a dramatic transformation of the U.S. healthcare system over a period of several years, virtually eliminating private insurance and incrementally expanding and improving Medicare until it provides every person in the country with comprehensive care—for free at the point of service.
The bill stands no chance of passing in the current Congress given Republican control of the House and still-insufficient Democratic support, as well as massive industry opposition.
"What we're looking at is an industry that has spent billions of dollars on lobbying and campaign contributions. Right now, as we speak—this moment, right here on Capitol Hill—the pharmaceutical industry has over 1,800 well-paid lobbyists," Sanders said. "They've got three lobbyists for every member of Congress. Former leaders of the Republican Party, the Democratic Party—they are swarming all over this place."
But given how deadly the status quo has become—with its intractable flaws amplified by the coronavirus pandemic—Sanders said the fight for a just healthcare system is more urgent than ever and must continue despite the significant political obstacles.
"Where we are today is not complicated," the senator said. "The American people understand this system is failing, the American people understand that healthcare is a human right."
"And our job," he added, "is to finally end a disastrous system and make it clear that every man, woman, and child in this country is entitled to healthcare because they are a human being."
\u201cLIVE: Join me and @RepJayapal as we hold a town hall at the U.S. Capitol on the need for Medicare for All. https://t.co/Zawjrh77KX\u201d— Bernie Sanders (@Bernie Sanders) 1684280198
Jayapal, the chair of the Congressional Progressive Caucus, stressed during her remarks Tuesday night that support for Medicare for All has been growing across the country in recent years even as congressional backing for the legislation remains inadequate.
More than 100 localities across the U.S. have passed resolutions supporting Medicare for All, according to a Public Citizen tally.
Jayapal pointed specifically to Dunn County, Wisconsin voters' approval of a ballot measure endorsing a national health insurance program in 2022. The county leans heavily Republican, indicating the widespread appeal of a system like the one Medicare for All would usher in.
"The momentum is on our side in this movement," said Jayapal, who also cited growing support in the House Democratic caucus and recent congressional hearings on Medicare for All.
"It can sometimes feel like we're pushing boulders up mountains, but know this: We have made incredible progress," Jayapal added. "And we will continue to do that work across the country."
\u201c"We know that improved #MedicareForAll is the answer to our health care crisis!"\n\nYes we do, @RepJayapal! And nurses are ready to fight and WIN guaranteed health care for every single one of our patients. \u270a\u201d— NationalNursesUnited (@NationalNursesUnited) 1684281417
The town hall also featured remarks from healthcare professionals who have experienced firsthand the horrors of the privatized U.S. system, which has left millions of people one medical emergency away from financial ruin.
"Even during a public health crisis, healthcare corporations prioritized their own profits instead of trying to save lives," said Nancy Hagans, RN, president of the New York State Nurses Association.
According to peer-reviewed research published last year, more than 338,000 Covid-19 deaths in the U.S. could have been prevented if the country had a single-payer healthcare system. Meanwhile, insurance and pharmaceutical giants have seen their revenues continue to skyrocket.
"As a critical care physician, I have seen the results of this," said Dr. Adam Gaffney of the Cambridge Health Alliance, noting the large number of U.S. adults who are likely to experience lapses in insurance coverage over a two-year period. "I have seen patients with life-threatening illnesses due to chronic conditions that were treatable but were not treated because those patients lacked access to care."
"We need Medicare for All in this country for one reason," Gaffney argued. "It is the solution to the inequities and injustices of our healthcare system, and no other reform is."
"MAGA Republicans don't give a damn about the deficit, and today's estimate of the cost of kickbacks for their friends and donors is further proof," said Senate Budget Committee Chair Sheldon Whitehouse.
While congressional Republicans hold the global economy hostage by refusing to raise the U.S. debt ceiling without major spending cuts that would hurt the working class, a federal analysis revealed Tuesday that GOP plans to extend 2017 tax breaks for the wealthy could add nearly $3.5 trillion to the nation's deficit.
The relevant section of the new Congressional Budget Office (CBO) report focuses on the potential extensions of policies from the Tax Cuts and Jobs Act (TCJA), which Republican lawmakers passed and then-President Donald Trump signed in late 2017.
Just extending the TCJA's changes to individual income tax provisions would cost almost $2.5 trillion through 2033, according to the CBO and Joint Committee on Taxation. Debt service costs would tack on another $278 billion.
If three other policies—higher estate and gift tax exemptions, changes to the tax treatment of investment costs, and certain business tax provisions—are extended plus debt service costs are included, the total hits nearly $3.5 trillion.
"MAGA Republicans don't give a damn about the deficit, and today's estimate of the cost of kickbacks for their friends and donors is further proof," said Senate Budget Committee Chair Sheldon Whitehouse (D-R.I.). "Republicans racked up the national debt by giving tax breaks to their billionaire buddies, and now they want everyone else to pay for them. It is one of life's great enigmas that Republicans can keep a straight face while they simultaneously cite the deficit to extort massive spending cuts to critical programs and support a bill that would blow up deficits to extend trillions in tax cuts for the people who need them the least."
"Republicans who say they're worried about the deficit have brought our economy on the brink of default, and yet they want to run up the debt by locking in the Trump tax law that remains horribly skewed toward corporations and the wealthy."
Whitehouse and Senate Finance Committee Chair Ron Wyden (D-Ore.) requested the report. Wyden said Tuesday that "$3.5 trillion is an eye-popping long-term price tag for the Trump tax law that Republicans swore up and down would pay for itself."
"Republicans who say they're worried about the deficit have brought our economy on the brink of default, and yet they want to run up the debt by locking in the Trump tax law that remains horribly skewed toward corporations and the wealthy," he added. "The Republican game plan is clear. For every penny they give in tax handouts to the rich, down the road they're going to demand equivalent cuts that boot people off their health care, increase child hunger, and raise the cost of living for typical Americans."
After economist Marc Goldwein noted the $3.5 trillion figure and a relevant graph from the report on Twitter, the U.S. House Committee on Ways and Means Democrats tweeted an apparent dig at their GOP colleagues: "This doesn't sound very fiscally responsible to us."
\u201cThis doesn't sound very fiscally responsible to us \ud83e\udd14\ud83e\udd14\ud83e\udd14\u201d— Ways and Means Democrats (@Ways and Means Democrats) 1684262841
House Speaker Kevin McCarthy (R-Calif.) has said that the so-called Limit, Save, Grow Act (H.R. 2811), which the chamber's Republicans passed last month, "puts us on a fiscally responsible path." The bill would raise the debt ceiling by $1.5 trillion or until March 31, 2024, whichever comes first, but also impose severe spending cuts.
McCarthy and other congressional leaders met with President Joe Biden at the White House Tuesday afternoon, and pressure for a resolution is mounting, with Treasury Secretary Janet Yellen and other experts projecting that the U.S. could face its first-ever default as early as June 1.
While Biden—whose March budget blueprint called for major social investments along with tax hikes targeting rich individuals and corporations—has publicly insisted on a clean debt limit hike, fears are growing that he'll cave to GOP lawmakers' demands to prevent a default, which economists warn would be catastrophic for the global economy.
The Limit, Save, Grow Act does not include TCJA extensions, but it would repeal billions of dollars in Inflation Reduction Act funding for the Internal Revenue Service (IRS) to crack down on rich tax cheats, which the CBO warned last month could increase the deficit by $120 billion over the next decade.
In a Washington Post opinion piece on Tuesday, economists Natasha Sarin and Mark Mazur explained the true cost could be far higher:
In new work, we estimate how much additional revenue the IRS is likely to collect as a result of the extra funding and, conversely, how much revenue would be lost if House Republicans' proposal became law. We conclude, very conservatively, that the additional funding would shrink the tax gap (the difference between taxes owed and taxes collected) by nearly $500 billion over the next 10 years—and about $1.5 trillion over the course of the next two decades. Without this funding, federal budget deficits would increase by approximately this amount.
What drives the differences between our estimates and official government estimates? We were both engaged with these issues as Treasury Department officials during the period that the Biden administration was making the case for adequately funding the IRS (Mazur as acting assistant secretary for tax policy, Sarin as Treasury's counselor for tax policy and implementation). So, we saw firsthand the ways that the impact of additional investment in the IRS is underestimated or even ignored by government estimators.
In other words, the pair argued, "House Republicans' newfound fiscal responsibility isn't all it's cracked up to be: Theirdebt ceiling demands include a proposal that will balloon the debt—and by much more than previously understood."
Linking to their Post piece, Rep. Emanuel Cleaver (D-Mo.) similarly tweeted that Republicans "don't care about 'fiscal responsibility.' They want to force extreme cuts to veterans' benefits, nutrition assistance for seniors and kids, and affordable housing programs—all so they can continue to cut taxes for the wealthy and well-connected."
\u201cMAGA Republicans don't want you to know: Their plan wouldn\u2019t solve the default crisis\u2014it would WORSEN it.\nhttps://t.co/1XAFGrG1MT\u201d— CAP Action (@CAP Action) 1684274520
As Institute on Taxation and Economic Policy federal policy analyst Joe Hughes highlighted in a blog post earlier this month, rescinding the IRS funds isn't the only way Republicans in Congress plan to serve their superrich benefactors—the GOP is also working to extend 2017 tax cuts.
U.S. Rep. Vern Buchanan (R-Fla.) in February introduced the TCJA Permanency Act (H.R. 976), which "would dramatically increase deficits and would primarily benefit the richest Americans," Hughes wrote, noting that the bill's sponsor is "one of the wealthiest members of Congress."
As he detailed:
The top 5% would receive $112.6 billion in tax cuts in the first year, more than the entire bottom 80%. Under this plan, the richest 1% would save nearly $26,000 on their taxes on average.
When Republicans passed the 2017 tax law, many of its provisions were set to expire at the end of 2025. The lawmakers who wrote the bill didn't actually want those provisions to expire, but they needed to make their bill appear less costly than it actually was so they structured them as temporary measures that they could later extend. (Even as enacted without extension of the temporary provisions, the bill was enormously expensive, increasing deficits by $1.5 trillion.)
When the permanent and temporary provisions of the bill are taken together, its effects are massively tilted toward the rich. The top 1% will receive a benefit of more than $37,000 in 2026 while the bottom 20% will pay more on average. This is an entirely unreasonable proposal for so-called "budget hawks" to put forth in the middle of a conversation about lowering public debt.
"Astoundingly, this is not the only wasteful tax cut proposal floating around House GOP chambers," Hughes continued, citing Roll Call. "Republican tax writers are readying a separate package of tax breaks for big businesses. This package looks to be mostly a refurbishment of a plan that failed to pass at the end of last Congress, largely because Democrats would only get on board if it included support for low-income children."
Roll Callreported in late April that "the bill would revive three tax benefits for businesses that lapsed or began to phase down under the GOP's 2017 tax law, which Republicans have been eager to extend. Tax writers are still working on the package, but it could include a broader set of provisions."
The outlet added that "Republicans are aiming to unveil the legislation in May or June, according to a source familiar with the discussions, though it wasn't immediately clear how quickly it would reach the floor."
Democrats control not only the White House but also the Senate, though tax cuts passed under former Republican President George W. Bush were made permanent with bipartisan support. As Bobby Kogan, senior director of federal budget policy at the Center for American Progress, recently pointed out, "If not for the Bush tax cuts and their extensions—as well as the Trump tax cuts—revenues would be on track to keep pace with spending indefinitely, and the debt ratio (debt as a percentage of the economy) would be declining."
"Instead, these tax cuts have added $10 trillion to the debt since their enactment and are responsible for 57% of the increase in the debt ratio since 2001, and more than 90% of the increase in the debt ratio if the one-time costs of bills responding to Covid-19 and the Great Recession are excluded," Kogan wrote. "Eventually, the tax cuts are projected to grow to more than 100% of the increase."