Analyze

 “Under a 1986 federal law titled the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to treat people who come to the ED presenting with an emergency medical condition, defined as a condition that, without treatment, will likely lead to serious impairment or death. … EMTALA is one of the largest federal mandates to provide services to have gone unfunded (Friedman 2011); costs instead fall on states and local health care systems.” 481

“In bringing ethnographic attention to hot spotting as a technique of governance, we find that it provides lifesaving humanitarian interventions while operating within the racialized structures of violence that produce continual life crises. The institutional rationality of hotspotting and the encounters of care that it produces illustrate the often-contradictory role of medicine in the lives of poor people: both caring and coercive, it intertwines care and violence.” 475; “we conclude by suggesting that economic investment and return are becoming a reigning logic in the governance of poverty, generating hot spots as sites of interest for both policing and health care and decentering normative assessments of deviance, illness, and social problems” 476; “Neoliberal social assistance, as it is practiced in the health care safety net, is conceptualized as an “investment “in the population, as a strategic and targeted deployment of basic resources, one that promises to generate a return on investment for the state or health system in the form of cost savings.“ 485

The authors examine the practice of “hot spotting,” a form of surveillance and intervention through which health care systems in the US intensively direct health and social services towards high-cost patients.  Health care hot spotting is seen as a way to improve population health while also reducing financial expenditures on healthcare for impoverished people. The authors argue that argue that ultimately hot spotting targets zones of racialized urban poverty—the same neighborhoods and individuals that have long been targeted by the police. These practices produce “a convergence of caring and punitive strategies of governance” (474). The boundaries between the spaces of healthcare and policing have shifted as a “financialized logic of governance has come to dominate both health and criminal justice” (474).

"The purpose of this essay is to discuss a truly formidable task, the creation of an international nuclear emergency response team"

This quote sets up the rest of the article by showing the reader, regardless of their background or knowledge, that the creation of such a team is going to be difficult.  Beyond the standard challenge of creating a unified emergency response team, it is an international one - therefore with language barriers, geographical differences, and large distances to travel in the case of an emergency. And futhermore, it is a team created to deal with the incertainty of nuclear materials in an emergency situation - even more of a challenge.

The author states a background in STS studies, futher work with organization, disasters, and sociocultural risk studies.

"In the interest of sustainable and socially legitimate solutions, arguably decisions to even the technical responses to disasters should not be left to scientists and engineers alone"

This statement is very thought-provoking and is not exactly expected in a research article - that a scientist's or engineer's decision should be influenced or editied by those without such specific education or expertise.

-balancing point between safety and profitability

-disaster did not happen as a chain of events that made it bound to occur at some point, it happened on a system that was in good shape

-over regulation of the industry and workers results in a lack of flexibility and therefore an inability to be creative in emergency situations

-need emergency response team to be skilled professionally and socially, but on a low budget - and very importantly - cooperation from nuclear corporations

The author compares existing and previous nuclear regulation/safety/etc committees, analyzing differences between them and various shortcomings. This information is used to develop the author's idea of a more effective and safe oganization to enforce regulations and train an emergency response team.

The author also looked at how previous emergencies were handled and what new regulations stemmed from each, as well as how those have worked since their implementation, and what more can be done.

Emergency response is the main idea in this article, but specifically that related to nuclear emergencies. An interesting point was made about the confidentiality of the plants and their "trade secrets" of sorts. While being transparent is helpful for safety reasons, it also reduced the profitability of the company, since other companies would be able to use their ideas. EMS knows a lot about respecting privacy through HIPPA, however it is also important to know the layout of important or potentially hazardous buildings within a response district. This would be a necessary compromise to make between the nuclear emergency response team and the nuclear leaders.

The author of the article is Sonja D. Schmid. She is an associate professor in the Department of Science and Technology in Society at Virginia Tech. She holds a Ph D in STS from Cornell University. Dr. Schmid speaks fluent Russian and primarily investigates the history and organization of Soviet and Eastern European nuclear affairs, as well as the the challenges of global nuclear emergency response.

This article argues that the creation of an international nuclear emergency response group would be an important undertaking due to the global increases in the nuclear industries. The article also establishes some of the chalenges that would be faced in forming, staffing, training, and operating the group.