Daily-Dose/archive-daily-dose/13 January, 2023.html

392 lines
57 KiB
HTML
Raw Blame History

This file contains invisible Unicode characters

This file contains invisible Unicode characters that are indistinguishable to humans but may be processed differently by a computer. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

This file contains Unicode characters that might be confused with other characters. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

<!DOCTYPE html>
<html lang="" xml:lang="" xmlns="http://www.w3.org/1999/xhtml"><head>
<meta charset="utf-8"/>
<meta content="pandoc" name="generator"/>
<meta content="width=device-width, initial-scale=1.0, user-scalable=yes" name="viewport"/>
<title>13 January, 2023</title>
<style>
code{white-space: pre-wrap;}
span.smallcaps{font-variant: small-caps;}
span.underline{text-decoration: underline;}
div.column{display: inline-block; vertical-align: top; width: 50%;}
div.hanging-indent{margin-left: 1.5em; text-indent: -1.5em;}
ul.task-list{list-style: none;}
</style>
<title>Daily-Dose</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><style>*{overflow-x:hidden;}</style><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
<body>
<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What the Twitter Files Reveal About Free Speech and Social Media</strong> - The companys internal documents were supposed to prove a progressive agenda—mostly, they have exposed the limitations of the platform and its new owner. - <a href="https://www.newyorker.com/news/the-political-scene/what-the-twitter-files-reveal-about-free-speech-and-social-media">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Californias Devastating Storms Are a Glimpse of the Future</strong> - Even as the state weathers a megadrought, climate change is increasing the risk of catastrophic floods. - <a href="https://www.newyorker.com/news/annals-of-a-warming-planet/californias-devastating-storms-are-a-glimpse-of-the-future">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Three Climate Reports: The Good, the Bad, and the Ugly</strong> - Some progress was made in 2022, but the forecast still looks bleak. - <a href="https://www.newyorker.com/news/daily-comment/three-climate-reports-the-good-the-bad-and-the-ugly">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Message for the Federal Reserve in the New Inflation Data</strong> - As a new report shows price pressures easing, should the central bank rethink its strategy of raising interest rates? - <a href="https://www.newyorker.com/news/our-columnists/a-message-for-the-federal-reserve-in-the-new-inflation-data">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Investigations of Joe Biden Begin</strong> - A new Republican House subcommittee and a new special counsel pose more of a political threat to the President than a legal one. - <a href="https://www.newyorker.com/news/daily-comment/the-investigations-of-joe-biden-begin">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Congresss bipartisan deal to spend billions more fighting HIV and malaria abroad</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/VEk14KvTuYtk-RAX1ancm7End6g=/917x0:8256x5504/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71860793/1243411823.0.jpg"/>
<figcaption>
World leaders hobnob during the Global Fund Seventh Replenishment Conference on September 21, 2022. The conference led to $15.7 billion in commitments to the fund over the next three years. | Mandel Ngan/AFP via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
At the surface, Congress is a total mess. Below, its actually getting some big stuff done.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="W971vz">
On December 23, while many of us were doing last-minute holiday shopping, Congress passed a <a href="https://www.npr.org/2022/12/22/1144981639/senate-spending-bill-omnibus-vote">big $1.7 trillion spending package</a>, keeping the government funded through September 30, which marks the end of this fiscal year. Youve likely heard of some of the bills more newsworthy provisions, such as a <a href="https://www.vox.com/policy-and-politics/2022/12/21/23520649/electoral-count-reform-act-omnibus-trump">change to the Electoral Count Act</a> to prevent an attempt like Donald Trumps in 2021 to overturn a presidential election result, or the <a href="https://www.coons.senate.gov/news/press-releases/senator-coons-statement-on-passage-of-omnibus-spending-bill">$45 billion in support</a> for Ukraines defense against Russias invasion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fnT5kd">
But tucked into the package was a <a href="https://www.kff.org/news-summary/global-health-funding-in-the-fy-2023-omnibus/">surprisingly large boost in funding</a> for something that doesnt usually generate headlines: global health programs. The Global Fund to Fight AIDS, Tuberculosis, and Malaria, an international organization that provides financing for country-level programs like drug distribution and bednets in developing countries where those diseases are widespread, saw its funding from the US grow from $1.56 billion to $2 billion, a more than 28 percent year-over-year boost. Funding for USAIDs Global Health Programs, which include nutrition programs, efforts against infectious disease, and more, rose from $700 million to $900 million, and the Centers for Disease Control and Preventions Global Public Health Protection division, which works abroad to strengthen health systems ability to respond to outbreaks, saw a $40 million boost as well.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XIRqBc">
An <a href="https://www.cgdev.org/blog/117th-congress-resolves-spend-more-development-new-year-look-back-fy23-omnibus">analysis by the Center for Global Development</a> finds that global health support from the State Department and USAID grew overall from $9.83 billion in fiscal year 2022 to $10.56 billion in 2023, a 7.4 percent increase.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VVdB4q">
These numbers are not huge in the context of a $1.7 trillion spending bill, but theyre significant. “What was interesting about FY23 in the omnibus was that almost all global health areas increased, with the exception of family planning,” Adam Wexler, associate director of global health and HIV policy at the Kaiser Family Foundation, told me. (<a href="https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-international-family-planning-reproductive-health-efforts/">Family planning funding</a> tends to be particularly fraught given how heated debates over abortion and birth control are in Congress.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EZN2mY">
And the increases stand out for another reason: Theyre bipartisan. Global health funding has a number of Republican champions in Congress, like Rep. Hal Rogers (R-KY), the outgoing ranking member of the appropriations subcommittee handling foreign aid funding; Rep. Michael McCaul (R-TX), who chairs the Committee on Foreign Affairs; and Rep. Ann Wagner (R-MO), McCauls deputy on that committee, among others. “The Global Fund has been one of the most successful programs in the history of government,” as Sen. Lindsey Graham (R-SC), the head Republican on the Senate appropriations subcommittee covering the fund, <a href="https://www.youtube.com/watch?v=SeA6CTtEC84">once said</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aZu4vM">
On February 22 of last year, McCaul and Rep. Barbara Lee (D-CA), then the chair of the appropriations subcommittee and the leading Democrat on these issues, <a href="https://lee.house.gov/news/press-releases/representatives-barbara-lee-and-michael-mccaul-urge-biden-administration-to-pledge-for-a-replenishment-in-the-global-fund">organized a letter</a> from 137 members of the House <a href="https://lee.house.gov/imo/media/doc/02-22-22%20Global%20Fund%20Letter%20to%20POTUS.pdf">to President Biden</a> asking for a “robust and increased three-year US pledge” for the Global Fund. Twenty-one of the signatories were Republicans, including not just moderates but Trump-loyalist members like Reps. Elise Stefanik (R-NY) and Joe Wilson (R-SC) (the same guy who <a href="https://www.youtube.com/watch?v=qgce06Yw2ro">yelled “you lie!”</a> during one of Obamas addresses to Congress).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Sni023">
This may seem unusual in a Congress that cant seem to agree on anything — but it isnt. Global health funding has in fact been a major area of bipartisan cooperation for years, so far mostly avoiding Congresss increasing polarization on many other, higher-profile issues. And its managed that in part because it has remained under the radar and received little press attention.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bjlrcO">
Its a prime instance of what Simon Bazelon and Matt Yglesias have called <a href="https://www.slowboring.com/p/the-rise-and-importance-of-secret">Secret Congress</a>: an area where legislators are able to make progress out of the media spotlight, on issues that dont inflame public passions. And given how progress on killer global diseases <a href="https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2022/july/20220727_global-aids-update">has</a> <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00012-3/fulltext">slowed</a> in recent years, putting millions of lives at risk, we should hope that this pattern continues.
</p>
<h3 id="NSeZuG">
How Secret Congress saved lives
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="18zKcq">
While global health funding saw boosts across the board in the FY2023 omnibus, the star of the show was the Global Fund. Founded in 2002, <a href="https://www.kff.org/global-health-policy/fact-sheet/the-u-s-the-global-fund-to-fight-aids-tuberculosis-and-malaria/">the fund</a> is a multilateral organization that collects money from governments and private donors (principally the Bill &amp; Melinda Gates Foundation) and disburses it to local groups working on HIV/AIDS, TB, and malaria. The fund has always received bipartisan support. It was founded <a href="https://georgewbush-whitehouse.archives.gov/news/releases/2001/05/20010511-1.html">partially at the impetus</a> of, and with significant funding from, the George W. Bush administration. That support continued during the Obama years. While the anti-globalist Trump administration <a href="https://www.wsj.com/articles/budget-proposal-adds-funding-for-fighting-hiv-aids-in-u-s-cuts-contribution-to-global-effort-11552339273">sought</a> <a href="https://foreignpolicy.com/2020/02/10/trump-world-health-organization-funding-coronavirus-state-department-usaid-budget-cuts/">massive cuts</a> to the US contribution — especially worrying given that the US is the funds single biggest donor, providing over a third of its resources — Congress, with the help of Republican members like <a href="https://www.theglobalfight.org/friends-applauds-house-committee-approval-of-funding-increase-for-global-fund/">Rogers</a>, <a href="https://www.chron.com/neighborhood/katy/news/article/America-has-saved-a-generation-from-14895900.php">McCaul</a>, and <a href="https://twitter.com/repannwagner/status/1201643580412112896">Wagner</a>, rejected them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="m2x57G">
The fund plans on the basis of “replenishments” every three years, during which donors negotiate pledges for funding the subsequent three years of efforts. The funding boost this year originated in the Biden administrations efforts for the seventh replenishment. For one thing, the United States agreed to host the <a href="https://www.theglobalfund.org/en/seventh-replenishment/">Replenishment conference</a> last year from September 19 to 21 in Washington, a major signal of US support for the global development community.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Outl36">
On March 28, the administration <a href="https://www.whitehouse.gov/omb/briefing-room/2022/03/28/fact-sheet-the-presidents-budget-for-fiscal-year-2023/">released</a> its <a href="https://www.whitehouse.gov/wp-content/uploads/2022/03/budget_fy2023.pdf#page=19">FY2023 budget proposal</a>, which included its proposal for $2 billion in annual funding for the Global Fund and an overall $6 billion three-year pledge. This was followed in June by the House Appropriations Subcommittee for State, Foreign Operations, and Related Programs (SFOPS), then<strong> </strong>led by Rep. Barbara Lee and ranking member Rep. Hal Rogers, <a href="https://www.theglobalfight.org/friends-applauds-house-state-foreign-operations-appropriations-subcommittee-for-including-2-billion-for-global-fund-in-fy-2023/">approving the $2 billion</a> for 2023. In July, the Senate Appropriations Subcommittee, chaired by Sen. Chris Coons (D-DE) with ranking member Sen. Graham, <a href="https://www.theglobalfight.org/friends-lauds-senate-state-foreign-operations-appropriations-subcommittee-for-including-2-billion-for-global-fund-in-fy-2023-2/">did the same</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Vvop2v">
Chris Collins, president of Friends of the Global Fight, which advocates for increased Global Fund commitments from the US, told me the Biden administration effort was led at a high level, with Secretary of State Antony Blinken and National Security Adviser Jake Sullivan playing active roles.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Oxldei">
The US is represented at the Global Fund by John Nkengasong, who serves as US global AIDS coordinator and special representative for health diplomacy, and Loyce Pace, assistant secretary for global affairs at the Department of Health and Human Services. Nkengasong is a <a href="https://time.com/collection/100-most-influential-people-2021/6095972/john-nkengasong/">remarkable figure</a>; Cameroonian by birth, hes a virologist who in his doctoral research was the <a href="https://virchowprize.org/laureates/">first to identify the genetic subtypes of HIV</a> in circulation in Africa. He was also the first leader of the Africa CDC in Ethiopia, an attempt to build a version of the US CDC in Africa, and organized the continent-wide response to Covid.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bdsoBK">
The push for a major investment was partly a result of concerns that the Covid pandemic would overshadow existing health threats. “The administration did not want to be seen to favor future pandemic risk preparedness (and the newly established Pandemic Fund) at the expense of existing global health priorities like [Global Fund] that remain hugely important,” Amanda Glassman, executive vice president and senior fellow at the Center for Global Development, told me. “The US was trying to make the case that the global community should do both.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fSqFT5">
The multilateral nature of the fund also meant that the administration could leverage its pledges: If it pledged more, it could convince partner countries to pledge more in turn. Under US law, the country <a href="https://www.theglobalfund.org/en/news/2022/2022-03-28-president-biden-signals-a-6-billion-pledge-for-the-seventh-replenishment/">cant fund more than one-third</a> of the Global Funds total budget, which effectively means that when the US increases funding, other donors have to match it 2:1 if they want to keep the US funding. The nearly 30 percent increase in the US pledge helped spur an overall three-year pledge total of <a href="https://www.theglobalfund.org/media/12328/core_seventh-replenishment-pledges_list_en.pdf">$15.7 billion</a>, compared to <a href="https://www.theglobalfund.org/media/8882/replenishment_2019sixthreplenishmentconferencepledges_list_en.pdf">$14 billion</a> in the sixth replenishment. And because the Global Fund requires recipient countries in sub-Saharan Africa and South Asia to increase funding for the health of their own people, the US-led boost is “leveraging both other donors and implementing countries to do more and take on more of the burden,” Collins explained.
</p>
<h3 id="PjqYTC">
How effective is it?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KLXeCc">
Increasing funding for measures against HIV/AIDS, malaria, and tuberculosis is of course a good thing. But how big a deal it is depends on how effectively the money is spent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rIuBdo">
While the Global Fund has argued that its work thus far has <a href="https://www.theglobalfund.org/en/news/2022/2022-09-12-new-global-fund-report-shows-50-million-lives-saved-over-20-years-in-fight-against-hiv-tb-malaria/">saved at least 50 million lives</a> over the past 20 years, the truth is that there have been no compelling, independent studies estimating the funds impact on mortality. The Global Fund does provide money for programs that we know on a micro level save lives, like <a href="https://academic.oup.com/cid/article/45/11/1499/334795">antiretroviral drugs for HIV</a> and <a href="https://www.givewell.org/international/technical/programs/insecticide-treated-nets#What_is_the_evidence_regarding_the_general_effectiveness_of_LLIN_distributions">bednets</a> and <a href="https://www.givewell.org/international/technical/programs/seasonal-malaria-chemoprevention#Does_the_program_have_strong_evidence_of_effectiveness">preventive treatments</a> for malaria, to the tune of tens of billions of dollars. That should save many, many lives, but the 50 million number is at best an educated guess, the sort any nonprofit likes to make when its asking for funding.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dDhkJn">
Glassman argues the fund could be doing more to prioritize investments in cost-effective interventions, and maximize the impact it can get from the increased level of funding. While progress against both <a href="https://www.science.org/content/article/battle-malaria-africa-stalled-can-research-mozambique-explain">malaria</a> and <a href="https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2022/july/20220727_global-aids-update">HIV</a> has been slowing in recent years, it seems that Covid is not principally to blame, suggesting that something else is going wrong with the worlds response to these diseases. “The [Covid] disruption in services was pretty minimal in most of [sub-Saharan Africa] except for childhood immunization,” Glassman said. “Unfortunately, the cost-effectiveness of the different procurement and delivery strategies utilized by the different [Global Fund] grantees is not studied or reported by the [Global Fund] or UNAIDS, and these issues are inexplicably absent from the discussion during replenishments.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="M63ppy">
Some of the problem is a lack of data. The Global Fund works directly with NGOs and government agencies in affected countries, and those countries spending patterns are often opaque, making it hard to estimate how much a given intervention cost, and how much in the way of public health improvements a given dollar spent on that intervention can produce.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qU9KNV">
Elsewhere in the aid budget, Congress has put a big emphasis on improving evidence bases and scaling up evidence-based projects. Development Innovation Ventures, a project at USAID meant to <a href="https://www.vox.com/future-perfect/23274306/usaid-foreign-aid-effectiveness-evidence-grants">identify particularly cost-effective interventions</a>, <a href="https://twitter.com/unlockaid/status/1605229123919642625">got a funding bump from $30 million to $40 million</a>. The task in the future will be trying to expand these initiatives so that multilateral projects like the Global Fund get more scrutiny, too.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g9TEw6">
That requires continued support from the odd bedfellows in Congress that have sustained the fund and related programs for decades. Ultimately, when asked, Republicans in the House and Senate explain their support for the Global Fund and global health funding in the same terms that Democrats and global health practitioners do: they think it saves lives, and that thats a worthy use of their role in office. “Most people want to make sure their taxpayer dollars go to a good cause. Once you understand what the Global Fund has done, and can do and will do, the critics kind of melt away,” Graham <a href="https://www.youtube.com/watch?v=SeA6CTtEC84">said at an event</a> where he was honored for his support for the fund.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dg1AoV">
“Its the best thing that Ive been able to do” as a member of Congress, Rep. Kay Granger (R-TX), now the chair of the House Appropriations Committee, said at that same event.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FWWvrh">
The Republican caucus for global health is at least partially a legacy of the George W. Bush years. The then-president made infectious diseases in poor countries a key priority, launching the Global Fund and Presidents Emergency Plan for AIDS Relief (PEPFAR), which have <a href="https://www.kff.org/global-health-policy/fact-sheet/the-u-s-presidents-emergency-plan-for-aids-relief-pepfar/">dedicated over $110 billion</a> to date to fighting HIV, malaria, and tuberculosis. He also launched the <a href="https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-malaria/">Presidents Malaria Initiative (PMI)</a> in 2005, substantially increasing resources fighting that disease specifically. One study estimated that PMI specifically <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697814/">prevented 185 million cases of malaria and saved 940,049 lives</a> from 2005 to 2017; <a href="https://www.kff.org/global-health-policy/issue-brief/assessing-pepfars-impact-analysis-of-mortality-in-pepfar-countries/">multiple</a> <a href="https://med.stanford.edu/news/all-news/2012/05/740000-lives-saved-study-documents-benefits-of-aids-relief-program.html">studies</a> have found that PEPFAR reduced deaths from all causes by about 20 percent in countries receiving assistance, translating to millions of lives saved.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d6hn45">
Shortly before Congress approved its major package of global health funding, Michael Gerson, the Bush administration speechwriter credited as a driving force behind those programs, <a href="https://www.washingtonpost.com/obituaries/2022/11/17/michael-gerson-speechwriter-post-dies/">died of cancer at 58</a>. He wrote a whole book, <a href="https://www.google.com/books/edition/Heroic_Conservatism/T70a7o8BSr8C?hl=en&amp;gbpv=0"><em>Heroic Conservatism</em></a>, that among other things distilled the conservative case for investing in global health. In it, he recounts the story of a friend visiting an HIV and AIDS clinic in Zambia in 2005, where patients told her they came “because we heard the Americans are going to help us.” Gerson continues: “That is a familiar refrain in history. In Nazi-occupied Europe … in the gulags of the Soviet Union … there were many who said, We heard the Americans are going to help us. That is what America has been, and should always be.”
</p></li>
<li><strong>Americas public hospitals are privatizing. Thats bad news for low-income patients.</strong> -
<figure>
<img alt="A person in a winter coast and face mask walking past the entrance of a hospital emergency department." src="https://cdn.vox-cdn.com/thumbor/o42mnF5RVqKPtyl77b7Mg8W0I4w=/0x0:5697x4273/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71860746/GettyImages_1237222777.0.jpg"/>
<figcaption>
A new study found that after a public hospital goes private, the facility admits fewer Medicaid patients, restricting their access to health care. | Wang Ying/Xinhua via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A new study found dire consequences for Medicaid patients when a public hospital is taken over by a private company.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U4C9y3">
Over the past four decades, <a href="https://www.vox.com/policy-and-politics/2022/12/29/23510957/covid-19-surges-rural-hospitals-primary-care-rsv-flu-monkeypox">US hospitals</a> have gradually moved from public hands to private ones. The share of hospitals owned and operated by a government body — as opposed to a private entity, either a for-profit enterprise or a nonprofit — declined by 42 percent from 1983 to 2019.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1A6ajh">
That trend has brought serious consequences for the poorer patients who seek care at these hospitals. When private companies assume control of public hospitals, low-income patients on Medicaid lose access to health care, according to new research on this longstanding but under-analyzed trend in American health care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bjUTvV">
A new <a href="https://www.nber.org/system/files/working_papers/w30824/w30824.pdf">National Bureau of Economic Research working paper</a> by academics from Stanford, Michigan State, and Penn reviewed the consequences of the 258 hospital privatizations from 2000 to 2018 they could identify using national data. (As there were a little more than 1,000 public hospitals in 1999, that would mean one-fourth of all US public hospitals were privatized over the period they studied.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DfyjBL">
These researchers found that after a private company took over a hospital previously controlled by the government, the hospital becomes more profitable. As a public hospital, these facilities lost about $335 on average for every patient. As a private hospital, they earned about $740 per patient.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EAwLoj">
In an ideal world, hospitals could be operating more efficiently, and therefore more profitably, without sacrificing access to health care. And the researchers do find that the hospitals achieve greater profitability in part by reducing spending on administrative and support personnel rather than people most directly involved in patient care. There was no meaningful reduction in nursing staff, for example, after the transfer of control.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VTMQHc">
But the other way in which these hospitals increased their profitability is more worrisome. Hospitals taken over by private companies saw an 8.4 percent decrease in overall patient volume, partly the result of hospitals reducing their capacity in a likely bid to improve efficiency.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aFEF4t">
Admissions for Medicare dropped by only 5 percent, a statistically insignificant change, according to the researchers. But Medicaid admissions fell by 15 percent, as did the decline in “other” admissions (which include the uninsured and private insurance, with the former representing another unprofitable business line for hospitals). Though Medicaid patients made up 20 percent of patient volume at these hospitals, they accounted for 30 percent of the drop in admissions after privatization.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TsdxJM">
“These patterns are consistent with private owners wanting to reduce the share of Medicaid and Other patients at their hospital in order to increase mean revenue per patient,” write the papers authors.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6d7M2z">
I asked the authors what hospitals turning away Medicaid patients might look like in practice. They could only speculate, as that was beyond the scope of the paper, but Mark Duggan at Stanford told me that perhaps the most straightforward way would be for them to decline to renew their Medicaid contracts, taking the hospital out of the provider network for Medicaid patients. Atul Gupta at Penn also said that they could cut certain lines of service, such as psychiatric care, that are more frequently used by Medicaid patients. Or they could decline to admit Medicaid patients; while they are obligated to stabilize a patient in the emergency room, they have more discretion about which patients to actually admit into the hospital.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="faetzY">
In theory, fewer Medicaid patients could mean simply that there are fewer unnecessary hospitalizations. But the researchers tested that idea by examining what happened to patient volume across an entire area when a hospital was privatized. They found patients with Medicare or private insurance were absorbed by the neighboring hospitals — but Medicaid admissions dropped across the region.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f321Rb">
In other words, when newly privatized hospitals decreased admissions, the patients with more lucrative health insurance were picked up by other facilities, which would suggest they still had clinical needs that the market then rose to meet. But Medicaid patients, whose insurance is not as generous, simply lost access to health care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v8IQa0">
“The aggregate decline in Medicaid volume potentially hurts its effectiveness as a social insurance program that ensures access to medical care for vulnerable low-income beneficiaries,” the researchers write. “Privatization therefore emerges as a channel that may curb utilization of care by Medicaid beneficiaries.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1ki1Ny">
The consequences of hospital privatization for Medicaid patients have gained more importance given the recent expansions of Medicaid eligibility. Medicaid has now grown to become the single largest health insurer in the United States, covering <a href="https://www.kff.org/coronavirus-covid-19/issue-brief/analysis-of-recent-national-trends-in-medicaid-and-chip-enrollment/">more than 90 million Americans</a> (including the related CHIP program that covers kids). But, as the authors noted in their analysis, that rise in enrollment has not been matched by a commensurate<strong> </strong>increase in hospital admissions by Medicaid patients. Their findings may help to explain why.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TuYs0X">
Medicaid is vital to the US safety net, providing zero-cost insurance coverage for low-income Americans. It also has its problems, with low reimbursement rates leading fewer doctors to accept Medicaid patients. <a href="https://www.vox.com/policy-and-politics/2022/12/22/23518648/2022-health-care-research-most-interesting-studies">One of the most interesting research papers from last year</a> found that supposedly “adequate” physician networks for people enrolled in Medicaid managed care plans (which are overseen by private companies) were not as robust as they first appeared to be.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1rAfSP">
Giving people Medicaid coverage is the first step to making sure vulnerable Americans get the health care they need — but it is only the first step. They need to find doctors and hospitals that will accept their insurance and treat them. That has been a longstanding struggle because of the programs low reimbursement rates, which are substantially less than Medicare or private insurance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CUZEOc">
And, according to this new research, the trend toward hospital privatization is making the problem worse.
</p></li>
<li><strong>Why Merrick Garland appointed a special counsel to the Biden classified documents case</strong> -
<figure>
<img alt="Attorney General Merrick Garland speaks in front of a large Department of Justice seal, flanked by a US flag." src="https://cdn.vox-cdn.com/thumbor/AmbML5dtEWIYLWQLb0LZZmicCVA=/0x0:5333x4000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71859312/1456027383.0.jpg"/>
<figcaption>
US Attorney General Merrick Garland speaks during a news conference at the Justice Department to announce the appointment of a special counsel to investigate the discovery of classified documents held by President Joe Biden at an office and his home, on January 12, 2023, in Washington, DC.  | Chip Somodevilla/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The role of the special counsel is designed to avoid potential conflicts of interest.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="z9UBE7">
US Attorney General Merrick Garland announced Thursday that he was appointing a special counsel to investigate why <a href="https://www.vox.com/policy-and-politics/2023/1/10/23548189/biden-classified-documents-trump-mar-a-lago">classified materials were found at President Joe Bidens home and a former private office</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a7LQkp">
Robert Hur, a former US attorney in the Trump administration, will take over the investigation. Biden said he is cooperating. Hur will be tasked with determining whether there were any crimes committed in the course of handling the classified materials, which date back to Bidens tenure as vice president, and are therefore the property of the federal government under the Presidential Records Act.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JCb8qH">
Its not the first time in recent months that Garland has called on a special counsel. He also appointed one to <a href="https://www.vox.com/policy-and-politics/2023/1/10/23548189/biden-classified-documents-trump-mar-a-lago">investigate</a> former President Donald Trumps withholding of classified material found at his Florida residence at Mar-a-Lago.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BjTkHN">
Its a role that is designed to act at a distance, but not entirely independently, from the Justice Department to avoid the appearance of impropriety in cases where there might be a conflict of interest. Heres what you need to know.
</p>
<h3 id="T6qBdN">
When is a special counsel required?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hvCs8a">
Justice Department regulations require the attorney general to consider appointing a special counsel when a criminal investigation of a person or matter is warranted, and when the DOJ may face a conflict of interest in carrying out such an investigation itself; for example, if the attorney general or another member of the executive branch is under investigation. Special counsels are also required when there are other “extraordinary circumstances” that make it in the public interest to appoint a special counsel, such as a sitting president being under investigation. Garland said Thursday extraordinary circumstances existed in Bidens case.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="o7Fy03">
Its not yet clear whether Biden committed any crimes by storing classified documents outside of secure federal facilities; thats something the special counsel will look into. That Biden is now the president, and that an investigation is underway into former President Donald Trump for mishandling classified documents, makes this a particularly high-profile inquiry. But its not unusual for the DOJ to open an investigation in this kind of case.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OMoblG">
“Any time classified materials go to a place theyre not supposed to go, there is almost always an inquiry into how they got to that place,” said Kristy Parker, the former deputy chief of the criminal section of the DOJs civil rights division and now counsel at Protect Democracy, an organization that seeks to check authoritarian attacks on American democracy. “The department always takes that really seriously.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XRVJns">
Garland was appointed by Biden and, if he were to lead the investigation, that history could present a conflict of interest. Thats likely the primary reason why Garland handed over the investigation to a special counsel. Its also likely why Garland chose Hur, who was not associated with the Biden administration. (Notably, Garland didnt appoint a special counsel to investigate the mishandling of classified documents found at Trumps property until the former president announced his 2024 candidacy, making him Bidens political opponent and creating a potential conflict of interest.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Zq9V4w">
“Whats really crucial in a democracy is to have the nations primary law enforcement agency operating to the greatest extent possible free of any partisan politics,” Parker said. “So my view is that he is acting appropriately to put someone in charge of this investigation who is not someone who was appointed by Joe Biden or who was already working in the department that the Biden administration oversees.”
</p>
<h3 id="546SAm">
What are the powers and limitations of the special counsel?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4xbk2N">
The special counsel has all the same powers that a US attorney would have to conduct a criminal investigation: for example, subpoenaing witnesses and documents, directing federal agents to conduct investigative activities, and seeking a warrant in court. But there are some limitations to those powers, in that the special counsel is required to consult with the attorney general on major decisions.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wvcJ3r">
“While hes at arms length from the attorney general and hes not an employee of the current Department of Justice, he still reports to the attorney general. Its ultimately the attorney generals final call as to whether a case should be indicted or closed,” Parker said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MNnsJb">
Regulations dont require the recommendations of the special counsel to be made publicly available. But if the attorney general goes against the special counsels recommendations, they must report that to Congress after the investigation concludes, and then lawmakers can publicize that decision.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U5Z6dp">
In the case of special counsel Robert Muellers investigation into Russian interference in the 2016 election, his findings were <a href="https://www.justice.gov/archives/sco/file/1373816/download">made public</a> — but only after then-Attorney General Bill Barr issued his own summary that <a href="https://www.acslaw.org/projects/the-presidential-investigation-education-project/other-resources/stark-contrasts-between-the-mueller-report-and-attorney-general-barrs-summary/">downplayed</a> the extent of Trump campaign associates contacts in Russia and evidence that Trump obstructed justice.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7JMV2W">
It might not make sense to make the findings publicly available in cases where the DOJ is seeking an indictment, so as not to reveal all of the evidence before taking the case to court. But in cases where the DOJ declines to prosecute, “its customary and, in my view, in the public interest, to explain that to the public,” Parker said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I12nas">
Whether that will happen in Bidens case is still unclear, as is the timeline for concluding the investigation. But so far, Parker said that the DOJ is functioning as it should.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3J3Ih5">
“I think this is a really important step by the attorney general to do what he said he was going to do when he was appointed, which is to restore the departments reputation as an independent law enforcement agency,” she said.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Yuki Bhambri and Saketh Myneni in Challenger semifinals</strong> - In the semifinals, the Indian pair will meet fourth seeds Marek Gengel and Adam Pavlasek who pipped Anirudh Chandrasekar and Vijay Sundar Prashanth 10-8 in the super tie-break of their quarterfinals</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Will be lovely game of chess: Labuschagne on making changes to combat Ashwin</strong> - Marnus Labuschagne was dismissed twice by Ashwin even though he emerged as the leading run-scorer in the 2020-21 Border-Gavaskar Trophy in Australia</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Data | From Lara and Sachin to Smith and Labuschagne, who are the best batsmen in Tests across eras</strong> - Labuschagne and Smiths batting averages tower over their peers in a way that places them among the all­-time greats of the game</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Premier League 2022-23 | Joao Felix sent off on debut as Chelsea lose to Fulham</strong> - Joao Felix looked sharp one day after completing a loan move from Atletico Madrid but he was shown a straight red card in the 58th minute as Chelsea lost to Fulham 2-1 in the Premier League</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Morning Digest | CBI books former Finance Secretary Arvind Mayaram; vegetable prices help cool inflation, and more</strong> - Heres a select list of stories to read before you start your day.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Praja Dhwani yatra of Congress to highlight administrative collapse under BJP</strong> - Yatra to traverse across Mysuru-Chamarajanagar-Mandya belt on January 26, 27</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>No evidence of leopard in Bangalore University: Forest Department</strong> - A video clip of the animal on the university campus went viral on social media on January 12</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dak Adalat to solve postal complaints in A.P. on January 23</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>KU invites applications for Philosophical Counselling course</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Disrupting livelihood on the basis of caste not acceptable</strong> -</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Russia claims control of salt mine town Soledar</strong> - Russia says it has captured the town after a months-long battle, but Ukraine says fighting is ongoing.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Putin ally says expat war critics should lose homes</strong> - Parliament speaker Vyacheslav Volodin says Russian critics abroad should have property confiscated.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine defence minister: We are a de facto member of Nato alliance</strong> - Oleksii Reznikovs comments are set to provoke Russia, which frames the war as a battle with the West.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Czech presidential vote: All to play for after 10 years of Zeman</strong> - Seven men and one woman are vying to succeed Milos Zeman, in a vote likely to go to a run-off.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Budapest police officer dies after alleged Hungary stabbing</strong> - The suspect is alleged to have stabbed three policemen while trying to escape arrest in Budapest.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>New imaging finds trigger for massive global warming 56 million years ago</strong> - 56 million years ago, hot magma scorched the sediments under the Atlantic seafloor. - <a href="https://arstechnica.com/?p=1909428">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rocket Report: Starship may actually be near liftoff; Chinas copycat booster designs</strong> - “This is not the outcome we were hoping for today.” - <a href="https://arstechnica.com/?p=1908951">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I disconnected from the electric grid for 8 months—in Manhattan</strong> - What started as an experiment has turned into a habit I hope will inspire others. - <a href="https://arstechnica.com/?p=1909067">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Vulnerability with 9.8 severity in Control Web Panel is under active exploit</strong> - A patch was released in October, but not all servers have installed it. - <a href="https://arstechnica.com/?p=1909755">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>This cool new approach to refrigeration could replace harmful chemicals</strong> - New method uses salt and an organic solvent to change a materials melting point. - <a href="https://arstechnica.com/?p=1908760">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Harold got in bed, kissed his lovely wife, and fell into a deep sleep. He awoke before the pearly Gates and St. Peter said..</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“You died in your sleep, Harold.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Harold was stunned. “Im dead…? No, I cant be! Ive got too much to live for. Send me back to my wife!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
St. Peter said, “Perhaps that can be arranged, but there arent many open spots right now. Youve got two alternatives: you can come back to your house as a goldfish or as a hen.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Harold never liked swimming and thought that perhaps being a hen wouldnt be that bad after all. The chickens his wife raised just ran around pecking at the ground, no stress, and at least hed still be close to her.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Harold replied, “Okay, then I choose to be a hen.” The next thing he knew, he was covered with feathers, clucking, and pecking the ground in his old backyard! Another hen strolled up and said, “So, youre the new hen, nice to meet you. Hows your first day here?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Not bad,” replied Harold, “but I have this strange feeling inside like Im gonna explode!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Youre ovulating,” explained the hen. “Dont tell me youve never laid an egg before!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Never..” said Harold.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Well, just cluck twice and then push.” Harold clucked twice and pushed, and voila, out popped an egg. Harold was overcome with emotion as he experienced motherhood for the first time. He then clucked twice, pushed, and out came another egg. It felt amazing. He never new it was like this! Just as he was about to lay his third egg, his wife called out to him. “Harold! Harold!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Happiness filled Harold as he saw her running towards him. Knowing she was there to share this moment, he was overwhelmed by joy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He clucked once, clucked twice, and suddenly felt his wife smack the back of his head. “Dammit, Harold wake up! Youre shitting the bed!”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/awksaw"> /u/awksaw </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/10adlua/harold_got_in_bed_kissed_his_lovely_wife_and_fell/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/10adlua/harold_got_in_bed_kissed_his_lovely_wife_and_fell/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A woman brought a very limp duck into a veterinary surgeon. As she laid her pet on the table, the vet pulled out his stethoscope and listened to the birds chest.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After a moment or two, the vet shook his head and sadly said, “Im sorry, your duck, Cuddles, has passed away.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The distressed woman wailed, “Are you sure?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Yes, I am sure. Your duck is dead,” replied the vet.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“How can you be so sure?” she protested. I mean you havent done any testing on him or anything. He might just be in a coma or something.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The vet rolled his eyes, turned around and left the room. He returned a few minutes later with a black Labrador Retriever. As the ducks owner looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The vet patted the dog on the head and took it out of the room. A few minutes later he returned with a cat. The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of the room.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The vet looked at the woman and said, “Im sorry, but as I said, this is most definitely, 100% certifiably, a dead duck.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The ducks owner, still in shock, took the bill. “$1500!” she cried, “$1500 just to tell me my duck is dead!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The vet shrugged, “Im sorry. If you had just taken my word for it, the bill would have been $50, but with the Lab Report and the Cat Scan, its now $1500.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/CaptainBeans_"> /u/CaptainBeans_ </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/10a3a8p/a_woman_brought_a_very_limp_duck_into_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/10a3a8p/a_woman_brought_a_very_limp_duck_into_a/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>An old Jewish man is lying in his deathbed with his tearful wife by his side.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
An old Jewish man is lying in his deathbed with his tearful wife by his side.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Moira, beautiful Moira. You were with me many years ago when the Germans took our home and so many of us suffered” to which his wife simply nodded.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“And years later, you were with me when my business failed and I lost nearly everything”. And again,Moira Nodded.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“And now, you are here. Through my sickness,to my last moment. Im starting to think youre bad luck Moira”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Affectionate_Crow327"> /u/Affectionate_Crow327 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/10ahsj2/an_old_jewish_man_is_lying_in_his_deathbed_with/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/10ahsj2/an_old_jewish_man_is_lying_in_his_deathbed_with/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Son: “Dad, whats the difference between toilet paper and a curtain?” Dad: “I dont know.”</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Son: “So it was you.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/NopeNopeNope2020"> /u/NopeNopeNope2020 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/10a066k/son_dad_whats_the_difference_between_toilet_paper/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/10a066k/son_dad_whats_the_difference_between_toilet_paper/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I told my therapist Im afraid my girlfriend will cheat on me because Im not that good in bed</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He said “We have to work on your thrust issues”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/algabanan"> /u/algabanan </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/10a01sk/i_told_my_therapist_im_afraid_my_girlfriend_will/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/10a01sk/i_told_my_therapist_im_afraid_my_girlfriend_will/">[comments]</a></span></p></li>
</ul>
<script>AOS.init();</script></body></html>