Tom Cooney MD

@pdxtom.bsky.social

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Internal Medicine physician and educator | #IMProud | @acpinternist | Health Policy | environmental and climate health.| built infrastructure and micro mobility

Highlights Insurance coverage and access to care: The U.S. and Mexico are the only countries in the analysis where a substantial portion of the population lacks any form of health insurance. In the U.S., about 8 percent of the population, or about 27 million people, are uninsured. Mexico, however, recently announced a reform plan intended to close its coverage gap. Affordability of care: For over four decades, the United States has spent more on health care than any other nation. In 2024, the U.S. spent 18 percent of gross domestic product on health care, nearly twice as much as the average OECD country, and among the highest rates in the world. Care delivery: The U.S. have one of the lowest rates of physician graduates at 8.6 per 100,000 people, and the lowest rate of primary care physicians per 1,000 people. Equity of outcomes: Americans die prematurely at among the highest rates. Men are more likely to die from avoidable causes than women, and the U.S. gap is among the largest. Maternal deaths occur at the highest rate among U.S. Black women. High U.S. suicide rates are far more elevated in rural areas.
The physicians continue, “And so, in order to uphold our professional covenants, we call for an immediate end to the violence and trauma that is being inflicted on our patients and our communities by ICE. We implore all in our medical community to use the power of your voices as well, to protect our patients and your own” (italics mine) (5).
Image of Trump taking giant Westminster dog show trophy and the winning Doberman ripping at his sleave. Caption: "Donald Trump decides that he also needs the Westminster Kennel Club Trophy to feel whole.
When our patients go without medical care, the harm is not theoretical. It is measurable. Fear doesn’t just keep people away from clinics and EDs, it pushes patients into crisis. We know what happens when the symptoms that signal a medical crisis are ignored in the hope that they will just go away. When their conditions worsen, patients arrive in EDs and hospitals with advanced cases of illness. We have seen the cost of waiting: appendixes rupture, mild infections transform into lifethreatening sepsis, patients end up on ventilators in the ICU because they could not get medications they needed. And sometimes, it is too late; those hours of waiting in fear become their last.
Trump portrayed as an infant lying in a cradle, captivated by the dangling overhead toy with Nobel Prizes on strings
a The distribution of ages (years) across each dataset (dHCP = Developing Human Connectome Project; BCP = Baby Connectome Project; CALM = Centre for Attention Learning and Memory; RED = Resilience in Education and Development; ACE = Attention and Cognition in Education; HCPd = Human Connectome Project Development; HCPya = Human Connectome Project Young Adult; camCAN = Cambridge Centre for Ageing and Neuroscience; HCPa = Human Connectome Project Ageing). b A histogram and density plot of sex distribution across age for the entire sample. c Methods schematic demonstrating that fiber tracking was performed for all participants, each registered to an age-appropriate AAL90 atlas, followed by harmonization using the ComBat algorithm37 across the atlases and datasets. Next, two thresholding analyses were conducted—variable density and density-controlled. For variable density analysis, networks were thresholded to an age-specific average density (70% of raw density) to preserve variation in network density across the lifespan. For the density-controlled analysis, all networks were thresholded to exactly 10% density91 to allow for direct topological comparisons, which are not biased by differences in total connectivity.
Marcotte: I think history will look back, and the thing that will be most striking is that while all these elite journalists and politicians and businessmen kissed the ring and bowed down and were afraid of Trump, people in their jammies and slippers—ordinary people—when they see ICE coming into their neighborhood, they confront them in the street. And the courage of ordinary people in this moment has been quite stunning, especially when you compare it to the elite in this country.
Amanita mascaria #Mushroom season in #Oregon. Not one of our edibles (contains several biologically active agents, at least one of which, muscimol, is known to be psychoactive)
Statement from Leading Medical, Health and Patient Advocacy Groups on CDC Autism Website Changes Nov. 20, 2025—Our organizations, representing autistic individuals, their families, medical professionals and public health workers, are alarmed that the Centers for Disease Control and Prevention is promoting the outdated, disproven idea that vaccines cause autism. Medical researchers across the globe have spent more than 25 years thoroughly studying this claim. All have come to the same conclusion: Vaccines are not linked to autism. This false rumor distracts from pressing, urgent issues in children’s health. Amplifying this claim and encouraging unnecessary investigations only worsens parents’ fears; it will not lead to better therapies, improved support for caregiving families, or changes in health care, education, and society in ways that would help children with autism thrive. Rather than devoting needed resources right now to support people with autism and their families in every community, our taxpayer-funded health agencies are using public resources to spread harmful rumors. Autistic people are valued members of society and, like all of us, deserve research that helps health care and other systems address genuine needs. Today, our organizations reject this latest attempt to create fear around routine childhood immunizations. Vaccines rank among our greatest medical success stories. Thanks to vaccines, serious diseases that once made thousands sick every year and caused life-long health issues have become rare. We cannot risk losing this progress. Together, we call on the CDC to return to its long history of promoting evidence-based information in the service of protecting the health and well-being of all Americans.
Widescreen view of the atrium of The National Gallery of Art with its beautiful fountain, circle of columns, and spectacular rotunda ceiling.
The GOP elephant, speaking to Jesus, says "Quick question. Do I still have to feed the poor if my Christianity is purely performative?"
photo of downtown Portland, Willamette river and distant Mt. St Helens with fall leaf colors
Neil Young on stage with an orange ‘harvest moon’ above right.
Sunsetting behind Haystack Rock at Canon Beach, Oregon