Hospitals & Asylums 








October 2019


By Anthony J. Sanders


The United Nations Secretary-General warned in mid-October that the organization is facing a "cash crisis" if member states do not pay the annual dues they owe: $1.3 billion in payments are outstanding. As of October 9, the UN regular budget was $386 million overdrawn, and by the end of the month it will surpass last year’s record cash deficit of $488 million. As of the end of September, member states had paid just 70% of what they owe for the regular budget for the 2019 fiscal year. At the same time last year, that figure was 78%. By Tuesday, October 8, 64 states had yet to pay their assessments in full – among them the United States, the U.N.'s largest contributor. Each year, the regular budget has cut into extra funds earlier and earlier, and 2019 is the second year in a row in which the organization exhausted all regular budget reserves and is staying afloat with funds left over from closed peacekeeping missions. The UN general budget allocates $955 million in spending for the last quarter of 2019. But with only $147 million of cash left to draw from closed peacekeeping missions, the organization needs $808 million to stay in operation. A single payment from the United States would cover that, and more. The U.S. owes $674 million for 2019, and $381 million from previous budgets, a spokesman for the Secretary-General confirmed to NPR. The United States is currently responsible for $1.1 billion ($1,055 million) of the unpaid fees to the general budget, a portion of which is carried over from prior years. This is roughly 75% of money owed to the general budget. The US also owes $2.4 billion to the peacekeeping budget, some of which is a build-up of late payments from previous years. The US Congress capped its contribution to the peacekeeping budget in 1994, and has regularly passed special measures since then to pay its bill in full. Since 2017, however, the US has enforced the cap and now owes nearly $1.1 billion in missing payments. The U.S. generally makes its dues payments in October, and an official from the U.S. mission told NPR that it will pay "the vast majority of what we owe to the regular budget this fall."  The United States needs to pay all international  


The Secretary of State must pay $61.6 billion FY 20 including all arrears, $60.6 billion or $54.6 billion FY 21.  The Secretary of State must pay $2.1 billion (FY 20) to restart P.L. 480 International Agricultural Assistance Program. The USA also owes $1.1 billion to settle UN regular budget arrears and current year contribution. $1 billion more arrears are owed dues to discrimination against United Nations Educational, Scientific and Cultural Organization and United Nations Relief (UNESCO) and Works Administration for the Relief of Palestine Refugees in the Near East (UNRWA) FY11 and FY19. State Department program levels must be re-estimated from $56.0 billion FY 16, to $61.6 billion FY 20 including arrears for the regular budget, UNESCO and UNRWA and peacekeeping.  Department spending growth must stabilize at 2.5% for all programs, 3% for P.L. 480. State Department Security Assistance costs, and total, may be reduced by $6 billion when International Military Assistance, International Military Education, International Narcotic Control and Law Enforcement and non-UN peacekeeping, are terminated.  Due to mounting arrears, Congress must require the Secretary of State to pay $61.6 billion FY 2020 for the Foreign Service budget. Congress must vote to terminate $6 billion treason FY 21.  The Secretary of State must pay $61.6 billion FY 20 including all arrears, $60.6 billion or $54.6 billion FY 21.  Furthermore, the USA must repay Iran pursuant to Alleged violations of the 1955 Treaty of Amity, Economic Relations, and Consular Rights (Islamic Republic of Iran v. United States of America) $3.6 billion 3 October 2018 whence-forth interest in the return of property stolen since 1980 is redoubled.  Congress is encouraged to pay for the irregular costs of returning stolen property to Iran and UN arrears with an 1%-6% energy export tax to better insure the oil industry against wrongful anti-colonial nationalization and oil spills.  Congress shall be billed again in November pursuant to a review of Buy American Act discrimination under 24USC§225h and the United Nations System Mental Health and Well-Being Strategy (2017).


Digestion HA-30-10-19


Humans require 0.7 to 3.7 liters of distilled or filtered water for drinking and cooking daily per person. The adult bladder holds about 400 mL of urine and the kidneys produce 1 liter of urine a day, from 4-6 liters of blood.  Each 24 hours about 100-200 grams of stool is evacuated.  Sedentary calorie requirements in the United States for children 2-3 years is 1,000 calories, children 4-8 years 1200-1400 calories. Girls 9-13 1600 calories. Boys 9-13 1800 calories. Girls 14-18 years 1800 calories. Boys 14-18 years 2200 calories. Females 19-30 years 2000 calories. Males 19-30 2400 calories. Females 31-50 years 1800 calories. Males 31-50 2200 calories. Females 51+ years 1600 calories. Males 51+ years 2000 calories. Good nutrition is the foundation of health and well-being for all. Everyone needs four basic nutrients – water carbohydrates, proteins and fats – as well as vitamins, minerals and other micronutrients. The human body is two-thirds water. Fatty acids are used by the body as a source of energy and are provided for in our diet by animal fat and vegetable oils that when metabolized supply 9 cal/g. Proteins, are complex chains of amino acids, supplied chiefly by animal proteins –meat, milk, cheese and eggs – and plants such as rice and legumes and nuts, that when metabolized yield 5 cal/g. Carbohydrates are complex compounds made up of sugars that when metabolized yield 4 cal/g.  Protein and calorie requirements vary, with pregnant and lactating women, children, teenagers and young adults and strenuous exercise requiring larger amounts. Pregnant and lactating women in emergency settings should be provided with an extra liter of water and fortified blended food commodities, in addition to the basic general ration, that are designed to provide 10–12% (up to 15%) of energy from protein and 20–25% of energy from fat. The fortified blended food should be fortified to meet two thirds of the daily requirements for all micronutrients. Teenagers and young adults also require extra food. Cheese sandwiches. Beyond infancy a child requires about 10 percent of caloric intake in protein. Protein deficiency, especially during the first year of life, has been associate with decreased brain development and lowered IQ.  The amount of protein in a mother’s breast milk is 5 percent of calories. According to the World Health Organization (WHO) the human minimum protein requirement is 5 percent of total calories, according to the US Recommended Dietary Allowance (RDA) for adults 10 percent of total calories. For optimum protein intake WHO recommends 10-15 percent of calories. Total fat intake should be less than 30 percent of total energy intake, Saturated fatty acid intake should be less than 10 percent of total energy intake. Trans-fatty acid intake should be less than 1 percent of total energy intake. At least 1 percent of calories should come from fat. Therefore, 55-75 to 94 percent of calories in the diet should come from carbohydrates. Calcium + vitamin D + phosphorus = Apatite. Bones and teeth contain 99 percent of all the body’s calcium and phosphorus, that is where the body gets it. For osteoporosis therapeutic and preventive measures should emphasize adequate intake of calcium (1500 mg/day), vitamin D (400-800 IU/day) and 1,000-1,250 mg/day of phosphorus.


Calcium Supplement HA-7-10-19


It would be an honor to edit WHO Essential Nutrition Actions: Mainstreaming Nutrition Through the Life-Course (2019) to provide for calcium supplementation for menopausal women, but a 'Calcium supplement' would suffice. Furthermore, I would like the Food and Agriculture Organization (FAO) and World Food Program (WFP) to ensure the United States restarts payments for international agricultural assistance P.L. 480 terminated in 2018 to redress the Arts. 23, 55 and 147 of the Fourth Geneva Convention Relative to the Protection of Civilians in Times of War (1949). International agriculture assistance is the only federal welfare program that was totally cut, in comparison with international assistance that was not defended by the defective congressional zero spending growth policy in CR 18, and federal programs slowly losing the war of attrition with no hope for the future. International agriculture assistance is the first program that must be settled at the start of FY 20 that began Oct. 1, 2019. The FAO/WFP Joint Assessment of Democratic People's Republic of Korea (2019). Based on the analysis and converging findings of the November 2018 and April 2019 household assessments, the Mission estimated that 10.1 million people are food insecure and in urgent need of assistance, including 7.5 million PDS dependents and 2.6 million farmers. The food gap stands at 1.36 million mt for the whole marketing year 2018/2019. 2-3 million North Koreans died from famine 1994-1996. The Secretary of State must pay $2.1 billion (FY 20) to restart P.L. 480 International Agricultural Assistance Program. He also owes $1.1 billion to settle UN regular budget arrears and current year contribution. $1 billion more arrears are owed dues to discrimination against United Nations Educational, Scientific and Cultural Organization and United Nations Relief (UNESCO) and Works Administration for the Relief of Palestine Refugees in the Near East (UNRWA) FY11 and FY19.  $13.4 billion is needed to restore US international assistance spending to 2.5% annually more than FY 16 program levels, 3% for P.L. 480 International Agricultural Assistance.  State Department program levels must be re-estimated from $56.0 billion FY 16, to $60.5 billion FY 20 including arrears, $61.6 billion to also pay arrears for peacekeeping, and stabilize the Department with 2.5% annual growth for all programs, 3% for P.L. 480,


USDA Consolidated Balance Sheet Settlement Requirements HA-16-10-19


The Historical Supplemental Nutrition Assistance Program (SNAP) budget table has been switched with a patently defective monthly and Food and Nutrition Service (FNS) is unavailable by regular email. Due to undeclared use of undistributed offsetting receipts by the United States Department of Agriculture (USDA) and Office of Management and Budget (OMB) to, for instance, subsidize agriculture with commodity insurance for trade war losses, with unspent food stamp agricultural subsidy estimates, there is not much cause for alarm regarding theft, this is a declaration of anorexia by the FNS incidental to failing to sustain SNAP benefit growth. Having Bachelored the exclusion of revenues in federal outlay estimates, the USDA Budget Office must take full responsibility accounting for FNS, especially the largest UDSA program SNAP, and cannot rest until the Historical SNAP table is updated right. FNS has made many verifiable mathematical errors since they started to cut SNAP benefits. Cutting SNAP benefits is also the reason that morale is low in the USDA. It is an unrelated issue that the Forest Service (FS) needs to be transferred to the Interior Department, who cannot currently afford to adopt the FS budget, in every case, and by Congress, to prevent agricultural fire risk, 65 times greater in National Forests than National Parks. The USDA budget does not fit on a page, and should not be squeezed by a gambler's standard of beauty. To master their job the burden of proof is on the USDA budget office to upgrade their balance sheet(s) at the end of their congressional budget justification, to account for undistributed offsetting receipts, federal outlays and program level, in one consolidated balance sheet, that is internally consistent with sub-agency descriptions in the same document, that requires further investigation, regarding the Department's largest program, from most recent Historical SNAP spending data, as directed.


FDA FY 20 HA-22-10-19


The Food and Drug Administration (FDA) has finally produced a hyper-inflationary FY 19 budget.  FDA budget authority spending growth must be reduced from 14.4% FY 18-FY 19 to 2.5% FY 19 – FY 20. The FDA is in an unique position among federal 'revenuers' to possibly find Congress's patented defective zero budget authority growth acceptable, thanks to the liberal sharing of easy Alcohol, Tobacco and Marijuana (ATM) user fees within the FDA. It is essential that the FDA learn to compete with, and regulate, generalized medical hyperinflation, within the limits of 7.5% growth in user-fees FY 18-FY 19 to sustain normal 2.5% government and 3% services annual spending growth. The strategy is to sustain user-fee revenue growth, including alcohol, tobacco and marijuana (ATM) inspection fees, while requiring the complete abolition of Center for Tobacco Products (CTP) spending under the Family Smoking Prevention and Tobacco Control Act, in the strongest terms of the Nuremberg Code (1949) and Eighth Amendment to the US Constitution. $662 million FY 19 CTP spending of $712 million user-fees in the All-Purpose Table and page 211 must be terminated FY 20 to put an end to their ill-informed adulteration of tobacco and vaping products terrorizing Sec. 301 and 302 of the Food, Drug and Cosmetic Act (FD&CA) under 21USC§331 and §332. Furthermore, the FDA must better distinguish their congressional budget request from federal outlays and corporate executive officer income growth. The FDA must admit that 14.4% budget authority hyperinflation is neoplastic and that they have cachexia regarding food spending, and 2.5% growth in budget authority and 7.5% growth in user-fees, would help to combat medical hyperinflation in the Department. As successful small-time 'revenuer' the FDA has a collective duty to be non-violent and distribute user fees within the agency on the basis of need. Zero budget authority growth in a future bright with ATM user fees, remains to voted on after 2.5% budget authority growth is tried FY 20.


Book 8 Drug Regulation (DR)


To supplement Chapter 8 Gorgas Hospital 300-320. The FAO reports a rise in world hunger since 2016 after a prolonged decline. P.L. 480 International Agricultural Assistance Programs is due arrears for 3% annual outlay growth from 2017. Proposed Agriculture Department budget cuts are overruled by recalls of Salmonella contaminated eggs, moldy grain, and imported coffee contaminated with equal parts bad water, farm animal feces, coffee leaf rust Hemileia vastatrix damaged Coffea arabica, and robusta C. canephora genetically inferior rust resistant strain to be labeled and sold for less under Arts. 24 and 25 of the Cartagena Protocol on Biosafety of 2000 and Nagoyo Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from Their Utilization to the Convention on Biological Diversity of 2010. The USDA budget request is re-estimated to grow 2.5% while most outlays and other estimates for USDA agricultural services grow 3% annually. The Budget office must produce a consolidated balance sheet to more accurately estimate federal outlays, undistributed offsetting receipts and congressional budget authority. Agriculture outlays grow 2.5% government, 3% services and 3.3% SNAP to sustain 2.7% average annual consumer price inflation and 0.6% population growth, 1% net new employees and 1.5% raise, except the Forest Service who deserves to be cut to prevent 65 times greater risk of forest fire than the Park Service. The Court held that the import controls were discriminatory. The guiding principles were economic liberty without any inequality and equality of treatment in the Case concerning rights of nationals of the United States of America in Morocco (1952). To end trade war tariffs must not exceed 6%. States must remove any impediments arising to the free exportation of goods required for humanitarian needs such as food, medicine and civil engineering Alleged violations of the 1955 Treaty of Amity, Economic Relations, and Consular Rights (Islamic Republic of Iran v. United States of America) (2018). To legalize marijuana worldwide the UN is sued to remove it from the Drug Schedule, delete Drugs from the UN Office of Crime, and transfer INCB to WHO under Art. 36 of the Statute of the Court. Congress must repeal the Authority for Employment of the FBI and DEA under 5USC3151-3152 and at the end of 5USC5301(b), DEA first under 28CFR0.85(a). Since 2001 prescription opiate drug overdoses increased 1,000%, in 2005 the epidemic spread to methadone and in 2014 to heroin, a 10% reduction in prescription opiate supply in 2018 is the first successful intervention. Narcan (naloxone) injections and naltrexone pills are needed to prevent death from opiate adulteration by fentanyl under Sec. 301 of the FD&CA under 21USC331. Corticosteroid inhalers must be exempted from the Ozone export ban in 2020 under the Montreal Protocol. Amantadine (Symmetrel) cures human influenza type A and the extra-pyramidal side-effects of antipsychotic drugs; corticosteroid inhalers treats asthma; antibiotics cure endocarditis, to solve resistance: ampicillin treats pneumonia and meningitis, doxycycline, the once a day antibiotic, and clindamycin (Cleocin) for children under 8 and pregnant women, treat bubonic plague, Lyme disease and Staph and metronidazole treats gastroenteritis and joints to be sold in hospitals cleansed with dissolved salt water and on Federal property by the Randolph-Sheppard Vending Stand Act (Pub. L. 74-732) under 34CFR395.30 et seq. and 20USC107 et seq.


Message of the Public Trustee HA-17-6-19


The tax-loopholes, poverty traps, in-kind-support mechanisms (ISMs), home invasions, slash piles, budget cuts and accounting errors, disabling achievement of a profitable shoestring budget, federal budget surplus and United Nations Sustainable Development Goals for 2030, must be abolished. Congress must authorize federal government officials 2.5% annual payroll growth, and finally exact the full 12.4% Old Age Survivor Disability Insurance (OASDI) Trust Funds payroll tax on the rich and state employees, on all their income. Adjustment of the contribution and benefit base in Sec. 230 of the Social Security Act under 42USC§430 is repealed and replaced with a Supplemental Security Income (SSI) Trust Fund', 'To create in the Treasury a Federal SSI Trust Fund to end child poverty by 2020 and all poverty by 2030.' For the record, Congress must also retroactively amend the effective DI tax rate to 2.1% (2018) in Sec. 201(b)(1)(T) of the Social Security Act under 42USC§401(b)(1)(T). To fulfill the SSI Trust Fund's mission of ending poverty the Commissioner of Social Security must interpret the Cost-of-living adjustment (COLA) in Sec. 215(i) of the Social Security Act under 42USC§415(i) right, to provide low-income beneficiaries with an automatic 3% Cost of Living Adjustment (COLA), while inflation continues to run between 2.5%-3% as it has since 1980. Even if the maximum benefit is not immediately sufficient to raise family income above the poverty line, benefits would not be subjected to attrition and theoretically beneficiaries would not be poor in the future. To sustain this automated, systematic, nationwide process to end poverty in the United States, Congress must amend the $7.25 an hour federal minimum wage since the Great Recession to $7.50 in 2019, $7.75 in 2020, $8.00 in 2021 and 3% more every year thereafter.' in one final sentence at 29USC§206(a)(1)(D). The Unemployment Compensation (UC) program must abolish travel restrictions and ratify three International Labour Organization (ILO) Conventions to insure contributor sick days, family vacations, childbirth and childcare, with three weeks annual Holidays with Pay Convention (Convention 132) of 1970, for new fathers and Workers with Family Responsibilities (Convention 156) of 1981, as extended without pay under the Family and Medical Leave Act of 1993 P. L. 103–3 and most of all fourteen weeks Maternity Protection (Convention 183) of 2000.