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Navajo Nation (Diné Bikéyah), USA: Setting

Thomas De Pree
In response to

On July 16th 1979, the largest by volume radioactive spill in US history took place in Church Rock (Kinłitsosinil), which is located in the southeastern “checkerboard area” of the Navajo Nation (Diné Bikéyah) and northwestern New Mexico. Due to a breach in the former United Nuclear Corporation’s uranium mill tailings dam, an estimated ninety-four (~94) million gallons of radioactive, toxic, and highly acidic effluent spilled into the Puerco River (Brugge et al. 2002; SRIC 2009).

The Church Rock Uranium Mill Tailings Spill marked the disastrous beginning of the end for the uranium mining industry in the Navajo Nation and New Mexico. Ironically, the spill occurred on the very same day as an event 34 years prior that marked the beginning of the uranium boom and the dawn of the atomic age: the Trinity Test of July 16th 1945, “the day the sun rose twice.” (Szasz 1984) Unlike the world’s first nuclear explosion in southern New Mexico, the Church Rock mill spill remains relatively underreported and has not yet registered at a national scale of collective memory.

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joerene.aviles
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In response to

1. Under private equity ownership, some ambulance response times worsened, heart monitors failed and companies slid into bankruptcy, according to a Times examination of thousands of pages of internal documents and government records, as well as interviews with dozens of former employees. In at least two cases, lawsuits contend, poor service led to patient deaths.

2. “Private equity has, in this case, threatened public safety,” said Richard Thomas, the mayor of Mount Vernon, N.Y, which relied on TransCare. “It’s not the way to treat the public.”

3.  Do the Write Thing “didn’t sit well with the firefighters,” said Nico Latini, who has worked at Rural/Metro for a decade. “We operate under a high level of integrity and we do the right thing every day — with an R, not a W.”

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joerene.aviles
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In response to

The main point of the article is that private ambulance and fire department agencies have questionable policies and business practices that hurt not only patients but also their employees. It's supported with anecdotal evidence following several agencies that have filed for bankruptcy, going over incidents of lateness, understaffing, lack of supplies, and aggressive billing or lawsuits to get payments from patients.

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joerene.aviles
Annotation of
In response to

Private equity firms like "Warburg Pincus, Kohlberg Kravis Roberts & Company" that invest in emergency medical services.

TransCare EMS, an EMS provider owned by the firm Patriarch Partners that served East coast states, filed for bankruptcy; had trouble paying its employees and was losing contracts with counties.

Rural/Metro, another privately owned EMS/fire provider known for lateness, suing patients, and had deteriorating patient care, and was losing contracts with counties in several states.

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joerene.aviles
Annotation of
In response to

The article addresses the public health inequities caused by for-profit ambulance agencies, which can put low-income families in a worse situation when they bill outrageously and/or sue their patients after sometimes providing sub-par or negligent treatment. Also shows the poor examples of emergency response when first responders are delayed due to understaffing or don't have the drugs/ equipment to adequately treat patients ("hospital shopping" done by desparate ambulance agencies). 

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Andreas_Rebmann
Annotation of
In response to

"Today, people interact with private equity when they dial 911, pay their mortgage, play a round of golf or turn on the kitchen tap for a glass of water."

"Supervisors regularly paid for supplies out of their own pockets and hoped for reimbursement, emails show. Some workers said the ambulances carried expired medications. Others went “E.R. shopping.”  "