Dog Brothers Public Forum
Return To Homepage
Welcome, Guest. Please login or register.
April 25, 2014, 03:22:07 AM

Login with username, password and session length
Search:     Advanced search
Welcome to the Dog Brothers Public Forum.
79267 Posts in 2227 Topics by 1037 Members
Latest Member: DCoutinho
* Home Help Search Login Register
  Show Posts
Pages: 1 ... 58 59 [60] 61 62 ... 76
2951  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / To the nation's school children on: September 04, 2009, 01:54:17 PM
JFK twisted??   To our school children:

"Ask NOT what your country can do for you",

but ask,

what you can do FOR Obama?"  angry
2952  Politics, Religion, Science, Culture and Humanities / Politics & Religion / The Obama Phenomena-over? on: September 04, 2009, 11:56:11 AM
Great news.
I have to admit it is really great to start to see pictures of BO without that smug grin.
He has to triangulate.  It appears he has no other option.
The truth though is we still have a huge proportion of Americans who still believe in entitlements.
We have to somehow get that to change.
Entitlements are NOT the answer to our problems.
Yet I agree with O'Reilly - it is crazy not do something with health care.  Something has to be done.
But what?

 
« HEALTH BILL BREACHES IRS PRIVACYPOLL DISASTER FOR OBAMA
By Dick Morris And Eileen McGann 09.3.2009 Published in the New York Post on September 2, 2009

This week’s polls are a disaster for President Obama. The Rasmussen poll has his approval dropping to 45 percent, after several weeks at 49 percent. The Zogby poll has it even lower — at 42 percent.

Worse yet, he’s losing his political base:

* People under 30 — long a key element of his support — give him no better than break-even ratings, with 41 percent approving and 41 percent disapproving of the job he’s doing, according to Zogby.


* Only 75 percent of Democrats, who formerly have supported Obama strongly, now approve of his performance in office. Zogby reports that this represents a slide of more than 10 points over the summer.

* Even among blacks, only 74 percent approve of the job he’s doing (also a drop of more than 10 points).

* Hispanics, who voted for him by a margin of more than 40 points, now break even (36-36) when rating his performance.

Independents, the key swing group in our politics, now deliver a sharply negative 37-50 verdict on Obama’s job performance. The elderly also give him negative ratings by 42-51.

This poll-implosion leaves Obama with few good options.

He obviously can’t get 60 votes in the Senate for his health-care proposals in their current form. No Republican will support them, and moderate Democrats aren’t likely to vote with him.

If he tries to pass it with 50 votes, using so-called reconciliation procedures, he may also fail — because he’d also lose the votes of less-moderate Democrats who’d quail at using parliamentary tricks to pass such a radical, unpopular program.

If Obama waters down his proposals to attract moderate support, he’d lose votes on the left — perhaps more than he’d gain, at this point.

Yet the longer he takes to resolve this political problem, the more his ratings will slip — diminishing his power to achieve anything. No president with support in the 30s would be able to push through a program like his health-care agenda.

It now looks like health-care reform will cripple the Obama presidency, as it did Bill Clinton’s in 1993.

Of course, Clinton was able to move to the center and secure re-election in 1996. But can a true believer like Obama do the same? He’s shown a willingness to move to the center on foreign policy, leaving troops in Iraq and adding them in Afghanistan. But on the domestic front, the only aread where he’s been willing to embrace centrist positions is education.

At best, Obama will be months if not years recovering from this disaster. In the short term, he’s likely to finish September wishing he’d stayed in Martha’s Vineyard.
 
Copyright © 2009 DickMorris.com | Privacy Policy | Terms and Conditions | Login   
Permanent Link to POLL DISASTER FOR OBAMAhttp://www.dickmorris.com...
2953  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Government Programs, spending, budget process on: September 01, 2009, 12:25:51 PM
I guess the economy is just going to collapse.
I hear no one stating the obivous - less doles, less pulbic pensions, social security/medicare at age 70 not younger etc.
Otherwise we are done as we know it.

Illegals out of the  country - Americans taking their jobs for less.  We have to get more people off the dole and get them working.

As for my part doctors making less - although as it is my expenses are already sky high.

Bama is heading right for the proverbial end of the line.


2954  Politics, Religion, Science, Culture and Humanities / Politics & Religion / More thoughts on: September 01, 2009, 09:49:56 AM
"Americans only receive 55% of recommended care."

Well it depends on what measures.  Probably they are looking at flu vac. rates, objective BP, cholesterol, diabetes goals, cancer screening, such as pap smears, mammograms and colononoscopies.

It could very well be that 55% are not at the goals that are recommended.

But there are many reasons for this, including but not limited to patients simply refusing such tests.  I have many patients who outright refuse flu shots.

"In March 2007, a team of Harvard researchers published a study in the New England Journal of Medicine that looked at nearly 10,000 patients at community health centers and assessed whether implementing similar quality measures would improve the health of patients with three costly disorders: diabetes, asthma and hypertension. It found that there was no improvement in any of these three maladies."

Actually, my experience is somewhat different.  I believe there can be some improvement in measures and some patients can be caught that fall throught the cracks.  However the improvement may be only short lived and the long term cost savings is still rather dubious despite what anyone may tell you as far as I know at least.

I do care coordination work and results are mixed and so far appear to be somewhat short lived though this is just one small experience.  There are probably many reasons for this and multifactorail.

"Even when experts examine the same data, they can come to different conclusions. For example, millions of Americans have elevated cholesterol levels and no heart disease. Guidelines developed in the U.S. about whom to treat with cholesterol-lowering drugs are much more aggressive than guidelines in the European Union or the United Kingdom, even though experts here and abroad are extrapolating from the same scientific studies. An illuminating publication from researchers in Munich, Germany, published in March 2003 in the Journal of General Internal Medicine showed that of 100 consecutive patients seen in their clinic with high cholesterol, 52% would be treated with a statin drug in the U.S. based on our guidelines while only 26% would be prescribed statins in Germany and 35% in the U.K. So, different experts define "best practice" differently. Many prominent American cardiologists and specialists in preventive medicine believe the U.S. guidelines lead to overtreatment and the Europeans are more sensible. After hearing of this controversy, some patients will still want to take the drug and some will not."

The above is so true of how complicated it is.  For example, we could treat 100 people with a drug for the rest of their lives and perhaps to extend one person's life.  Some including the greats from the Cleveland Clinic who are now proponents of their own supposed cost saving system might say this is great.  Some years ago there was a debate between two editorialists on which clost busting drug was better TPA vs streptokinase.   The guy from the Cleveland clinic who did research on TPA (the newer one and ten times more expensive one) would state how it could save one or two more lives per at best 100 people.  The article writer suggested that if we don't take a stand against the extra cost to society we "NEVER WILL".  We as a profession have to say enough already.  We can't keep spending more and more for trivial gains.  In my opinion he was right.  But it is just that - my opinion.  It is not unreasable for some to say that any gain in human life has no limits on how much we spend.

Needless to say the expensive drug won out.  Streptokinase was essential never ever used again.  What Er doctor or cardiologist would use a drug that is 1 or 2% inferior for no other reason than to save money.  If YOUR patient dies no one can say THAT was the one who would not have died if only the more expensive drug was used.  No one wants to be sued.   And no lawyer will mind loking at taking such a case and arguing their client died because a drug known to be "inferior" was used. 

And the other side of it is if you, or I are lying in the ER with a massive heart attack and you or I can choose which drug to use AND if the cost goes to someone else which would you or I pick??

The answer is obvious.

"Dr. Rodney Hayward, a respected health-services professor at the University of Michigan, wrote about this negative result, "It sounds terrible when we hear that 50 percent of recommended care is not received, but much of the care recommended by subspecialty groups is of a modest or unproven value, and mandating adherence to these recommendations is not necessarily in the best interest of patients or society."

I would say this statement is for the most part certainly true - at least the second half of the sentence.

• The World Health Organization ranks the U.S. 37th In the world in quality. This is another frightening statistic. It is also not accurate. Yet the head of the National Committee for Quality Assurance, a powerful organization influencing both the government and private insurers in defining quality of care, has stated this as fact.

By some measures this is probably true.

But why?

probably many reasons one being some don't or can't pay to see a doctor.
I am not sure how much is obesity, drug addiction, too many people refuse to bother to get health care for whatever reason.







2955  Politics, Religion, Science, Culture and Humanities / Politics & Religion / From TIME rag, I mean mag on: September 01, 2009, 09:06:10 AM
This could easily have been written by the DNC posing as journalism.  No where does it mention a proposed 500 billion cut to Medicare.  Of course there is the usual, "Republicans have been capitalizing" and of course the obligatory leftist mention of Sarah Palin as confusing our elderly.  Nothing of course about the fact the bill is 1000 pages long, virtually no law makers had read it yet were happy to vote for it, that few in the public were or still are aware of what is even in it or what it means to them individually or us as a nation yet the problem is not with that - it is with the evil opponents of the bill.
Typical left wing media. angry

By KATE PICKERT Kate Pickert – Tue Sep 1, 5:40 am ET
Many observers are puzzled by the level of anger and vitriol senior citizens have been directing toward their besieged elected representatives during recent health-care town halls. But no one can be more surprised, or put in a more uncomfortable position, than the organization that supposedly represents their interests, AARP. The 40 million–member advocacy group, after all, signed on early as a key supporter of President Obama's health-care-reform plan, and now it finds itself on the defensive, scrambling to win back much of its own membership. "A year ago, it seemed obvious that AARP would be for health reform," says the group's legislative-policy director David Certner. "Our membership as far as we could tell was quite ginned up about health-care reform." (See TIME's guide to understanding the health-care debate.)

Since then, members' views have apparently shifted. At least 60,000 AARP members quit the organization between July 1 and mid-August specifically because of its pro-reform stance, and the organization's online message boards are littered with anti-reform posts. (AARP is quick to point out that during the same period, it signed up 400,000 new members.) According to a poll conducted Aug 4-11 by the Kaiser Family Foundation, just 23% of Americans over 65 feel they would be better off under reform proposals and even fewer believe the Medicare program would benefit. While plenty of other groups are united against reform, opposition from seniors, who consistently have the highest voter turnout rates of any age group - especially in midterm elections like the one next year - may prove especially perilous for the reform effort. (Read "The Real Issues of End-of-Life Care.")

AARP's support for Democrats' health-care-reform proposals is critical this year. The group is one of several health-care power players the White House struck deals with in hopes of shoring up support for reform early on. In June, AARP, President Obama and PhRMA, a group representing drug companies, announced they had agreed to a plan to help close the Medicare Part D prescription-drug coverage gap known as the "doughnut hole," which leaves seniors without coverage after their drug costs exceed $2,700 and until they spend $4,350 of their own money. The White House deal, triggered if reform becomes law, would save seniors 50% on name-brand drugs and cost the drugmakers $80 billion. But this boon for the elderly was apparently not enough to sell seniors on reform overall. "Somewhere along the line, we seemed to have veered really off course based on a lot of the misinformation and disinformation that clearly is making its way to the older population in particular," says Certner.


It's not hard to see how seniors got spooked, which to some degree is an indictment of AARP, not to mention the Democrats. Sarah Palin and other conservative opponents have helped fuel rumors that the House health-reform bill calls for the establishment of "death panels" to decide when to cut off medical care for seniors. (This is not true - the House bill includes a provision to reimburse doctors who provide voluntary end-of-life counseling to patients.) Judging by comments at town-hall meetings, the elderly are also fearful that Democratic proposals would take funding away from Medicare to pay for coverage for Americans who don't currently have health insurance. This is not entirely untrue; Democratic proposals call for spending money to help insure the uninsured, alongside targeted reductions in Medicare reimbursements to doctors and hospitals and major funding cuts to Medicare Advantage, which allows seniors to buy private insurance with federal dollars. Most health-policy experts, however, believe these cuts are necessary for the program to remain financially solvent.




See the top 10 health-care-reform players.


Certner, of AARP, says the group agrees with this sentiment, but simultaneously opposes any proposals that would cut Medicare benefits or services. He says Democratic health-reform proposals "can strengthen the Medicare system," by "finding savings through reducing inefficiencies, waste and overpayment." "If that's done correctly, there shouldn't be any harm to the program," says Certner. "But most people hearing about cuts to Medicare have no idea how the cuts are being done." (See five truths about health-care in America.)

Critics might say that AARP has been out of touch with its members, while defenders could say that it is taking a more fiscally responsible view of what needs to be done to fix Medicare for the long-term. But part of the organization's current bind stems from its uniquely hybrid functions and makeup. In addition to being the voice of seniors in Washington, it also offers all Americans over the age of 50 reduced prices for gym memberships, travel and rental cars, while also selling AARP-branded insurance policies; AARP Services, a for-profit subsidiary, earned some $650 million in royalty revenue in 2008, 65% of which came from health-related offerings like insurance. (This dual advocacy/insurance brokerage role has made AARP a lightning rod for criticism over the years, especially in cases when the group lobbied for legislation that would have been a boon to its for-profit operations.) AARP, therefore, has to balance the interests of members aged 50-64 with those of members over 65. Its younger members are among the fastest growing cohorts of the uninsured and pay some of the highest premiums for insurance policies on the open market; these members would be most affected by private health-insurance reform and a public health-insurance option that could reduce costs. AARP's Medicare-eligible members, on the other hand, are focused on preserving that program's benefit levels. (See TIME's video on the struggles of an uninsured woman.)

To try to get its membership back in line with AARP's pro-reform stance, the group is stepping up its communication efforts. A national television advertising campaign got underway in August, 8 million pieces of direct mail related to Medicare and health reform will be sent out after Labor Day and the September issue of AARP Bulletin, which reaches some 40 million households, will include a cover story on health-care myths. The White House is also gearing up for a new message campaign aimed at seniors; it hosted a late-August conference call with advocacy groups with the power to reach seniors, including AARP, to brief them on a new eight-page talking-points memo from the Department of Health and Human Services (HHS) about how reform could help older Americans.

The HHS memo outlines reasons seniors need reform, including increasingly high out-of-pocket costs for Medicare beneficiaries to pay for drugs and medical services that could be lowered if comprehensive reform brought down the overall growth in health-care spending. The memo also points out ways that comprehensive reform could benefit seniors indirectly - uninsured Americans, who typically get less routine medical care, are sicker once they become eligible for Medicare, increasing costs for everyone in the program, for example. Unfortunately for Democrats, these nuanced points are not easily translated into sound bites, further evidence of why Democrats are currently losing the public-relations battle.

Meanwhile, Republicans have been capitalizing on the moment, suddenly presenting themselves as the defenders of a government health-care program they have spent years attacking. Republican National Committee chairman Michael Steele published an Op-Ed in the Washington Post on Aug. 24 titled "Protecting Our Seniors," and the RNC issued a press release on Aug. 28 titled "Real Solutions for Seniors."

Edward Coyle, executive director of the Alliance for Retired Americans, a union-affiliated pro-reform advocacy group that represents some 4 million seniors, says the "solo drum beat" from the opposition has so far successfully drowned out its and AARP's message. "Frankly, the other side has done a better job of raising issues that are of concern to seniors," he says. "I think the right word to use about seniors right now is confused."
2956  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 31, 2009, 11:49:18 AM
Some different thoughts on the matter:

Political considerations
Obama must pull a Clinton - "triangulate" if that is what you want to call and move to the center guided strictly aka D. Morris style by daily polls.
If he wants to maintain power this is what he will do.  This is what I suspect he will do; esp. with the armey of Clintonites in his administration.
I really doubt he will continue to shove his radical agenda down Americans and throw away his power - and the Dems.
The cans can only gain so much by being the party of NO.  They really gain traction then thye do need to come up with alternatives.
I guess the risk to them if they do is BO will steal their thunder aka CLinton with welfare reform.

Economic considerations
with or without trying to cover 50 million new peopel the system is broke.
First are there really 50 million people or is it the rights alleged much lower number that can't get insurance?
I don't know who to believe.

As Body points out
"so you want to be in charge of making your own medical decisions and utilize the most innovative and advanced medical system in the world, or do you want your government to make those decisions for you and control costs by limiting innovation and ceding advance status?"
I think most would agree that people would rather be able to choose though I am speculating.
We must ration somehow.
either insurance will decide for us or we have some sort of tiered system wherein people can decide with their doctors what they are willing to pay for meds, procedures, etc.

People who get dropped from insurance need to be albe to get it somewhere.
Those with preexisting conditions need to get it somewhere without having to go into poverty and get medicaid or go on disability.
We do need to decide what we are doing with illegals who are here.
WE do need to know in the medical field which things we do are more expensive than less cheaper alternatives if the option exists.  We need more studies but as Charles Kruathammer points out the publication of these in journals is not enoght for us doctors who neither pay attention or don't want to be bothered with cost savings when it doesn't do anything for ourselves.
We do need some tort reform.
There is no quesiton we order tests "just in case" the one person in front of us is the one that happens to have the cancer or other hidden though rare condition.  Miss it and our lives and carreers are in jeopardy.
But when is rare 'rare enough' to not justify a an expensive test?  It depends who you talk to.

I think it a terrible mistake to make health care a gigantic government entiltilement though a lot of it already is.
I prefer reversing this not expanding this.
Of course those in this country who like to have others pay for them thnk the opposite.

 
2957  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 29, 2009, 12:31:04 PM
"What’s not to like? If you have insurance, you’ll never lose it. Nor will your children ever be denied coverage for pre-existing conditions."

Well we will still go broke and care will be rationed.

That is what is not to like.

Crafty your questions need TO BE answered by the cans and I have not heard any of them do that explicitly.

Not even supersalesman Shawn Hannity.  He can sit there and rattle off five changes he would make to health care and not one addresses these issues directly.

That is why I can barely stand him.  He is just another blowhard - but from the right.

 
2958  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Political Economics on: August 29, 2009, 08:26:54 AM
Well that certainly does sound like we are headed for a collapse.

It doesn't even seem as though number One would mind.
He doesn't believe in our system as it was anyway.
2959  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Buchanan flaw of Democracies on: August 28, 2009, 02:47:04 PM
John Adams said this?  We may as well pack it in and go home:

"Remember," said John Adams, "democracy never lasts long. It soon wastes, exhausts and murders itself. There never was a democracy yet that did not commit suicide."   

Fatal Flaw of Democracies
by  Patrick J. Buchanan

08/25/2009

"We just can't afford it!"

Not long ago, every America child heard that, at one time or another, in the home in which he or she was raised.

"We just can't afford it!" It may have been a new car, or two weeks at the beach, or the new flat-panel TV screen.

Every family knew there were times you had to do without. Every father and mother has had to disappoint their kids with those words. Why is it that what parents do many times a year politicians seem incapable of doing: saying no.

How many times in the last decade have the political leaders of either party stood up and declared, "No, we cannot afford this."

Consider. Friday, the White House conceded that the deficits over the next 10 years will total $2 trillion more than they had reported just months ago. Instead of $7.1 trillion, we will run $9 trillion in deficits.

Meanwhile, the White House demands a new entitlement -- health care coverage for 47 million uninsured who can't afford it or refuse to buy it -- that will cost at least $1 trillion over 10 years. Can we afford this -- now?

"We can't afford not to," comes the retort. This is "a core ethical and moral obligation," says Barack Obama.

But is it not a core ethical and moral obligation not to debauch the currency in which most of the hard-earned wealth of the American people is invested? Yet, as Warren Buffett writes in The New York Times, collapse of the dollar and the end of its days as the world's reserve currency is what we are risking.
Government expenditures are running at 185 percent of revenue, which is like the lone family breadwinner earning $50,000 a year, while the family spends $92,500 a year. With families that do that, it is not too long before the credit cards are cut off, the mortgage is called in and the family Chevy is repossessed.

According to those same White House figures, this year's deficit will be closer to $1.6 trillion than the $1.8 trillion previously projected. Now, there are only three basic ways to finance that deficit.

The first is by borrowing the savings of one's own citizens, thus consuming the seed corn of the private economy. The second is by borrowing from abroad. The third is by having the Fed, "through a roundabout process," writes Buffett, "printing money."

Assume the Treasury borrows most of the savings of the American people this year, say, $500 billion. Then Uncle Sam is able to persuade Beijing to buy another $500 billion in Treasury bonds. The Fed must still run the printing presses to create another $600 billion.

How long before our Chinese, Japanese and OPEC creditors conclude that the Americans are depreciating their currency, and dump their U.S. Treasury bonds, or demand a higher rate of interest to cover the risks of their dollar-denominated assets sinking in value?

Can anyone believe the dollar can even retain its present diminished purchasing power if we run $9 trillion in deficits over 10 years? How long before producers conclude the same and start to demand more dollars for their goods -- and inflation takes off?

As Buffett argues, even when the U.S. economy returns to full employment, the new tax revenue it would throw off cannot close a deficit of that size. One must either slash spending or raise taxes to balance a budget where the feds are spending a fourth of gross domestic product.

But how do we cut spending when the five largest items in the budget -- Social Security, Medicare, Medicaid, interest on the debt and national defense -- are untouchables and growing faster then the 3 percent to 4 percent a year a full-employment economy can manage?

Are we going to cut veterans benefits, spending on our crumbling infrastructure or education, when Obama is promising every kid a college degree? Are we going to cut funds for Afghanistan and Iraq, and risk losing both wars? Are we going to cut foreign aid after Hillary Clinton has been touring Africa telling one and all America is here to stay?

How about cutting funds for food stamps and the Earned Income Tax Credit? Good luck. How about PBS and the National Endowment for the Arts? Just try it.

Does either party have any plan to cut federal spending from today's near 28 percent of GDP to the more traditional 21 percent?

George W. Bush didn't even try, and Obama is making that Great Society Republican president look like Ron Paul.

When a democracy reaches a point where the politicians cannot say no to the people, and both parties are competing for votes by promising even more spending or even lower taxes, or both, the experiment is about over.

"Remember," said John Adams, "democracy never lasts long. It soon wastes, exhausts and murders itself. There never was a democracy yet that did not commit suicide."     



--------------------------------------------------------------------------------
Mr. Buchanan is a nationally syndicated columnist and author of Churchill, Hitler, and "The Unnecessary War": How Britain Lost Its Empire and the West Lost the World, "The Death of the West,", "The Great Betrayal," "A Republic, Not an Empire" and "Where the Right Went Wrong."

--------------------------------------------------------------------------------
    Reader Comments: (248)
And in 1787, when old Benjamin Frankliln cam doddering out of the Constitutional Convention, someone asked him, "What kind of government did you give us?" and old Ben replied, -- "A Republic -- IF YOU CAN HOLD IT."

Old Ben seemed to believe that the triumph of Democracy was NOT inevitable, but that it depended on the caliber of its citizenry to uphold it.

And according to his colleague John Adams, the necessary caliber of its citizenry needs to be sober, wise, and virtuous.

America is indeed "tolerant." But is it wise and virtuous?

And if America's citizenry does not measure up to the calber of citizenship that is equired to sustain democracy, can democracy be sustained?

Benjamin Franklin doubted it. So too do I.

It's a shame, in a way, because the ULTIMATE blame for thse problems is WE THE PEOPLE. It is WE THE PEOPLE who demand more services than we can afford. It is WE THE PEOPLE who picked Obama Osama and his ilk - and who likewise picked both of the George Herbert Hoover Bushes who did nothing to rein in spending.

Special interests have learned that the power is in the Federal Government, and they will crucify a politician that tries to cut down their government largess. The same with voters.

Voters don't want to tighten their belts. Don't cut my farm subsidies, don't cut my welfare, don't cut my federal contract, don't cut my medicare.

2960  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Jews selling body parts on: August 28, 2009, 10:12:01 AM
Well there is some recent news concerning Jews and body parts I am sad to say.
I don't know about taking these parts from Palestinians but I certainly wouldn't write it off.
When money is involved all bets are off - as always whether the people are Jews or non Jews.

I am not going to defend Jews just because they are Jews if they commit criminal acts.

****July 23: FBI agents lead arrested suspects from their headquarters as part of a corruption investigation in Newark, N.J.
NEWARK, N.J. —  Levy Izhak Rosenbaum of Brooklyn called himself a "matchmaker," but his business wasn't romance.

Instead, authorities say, he brokered the sale of black-market kidneys, buying organs from vulnerable people from Israel for $10,000 and selling them to desperate patients in the U.S. for as much as $160,000.

The alleged decade-long scheme, exposed this week by an FBI sting, rocked the nation's transplant industry. If true, it would be the first documented case of organ trafficking in the U.S., transplant experts said Friday.

"There's certainly cross-national activity, but it hasn't touched the United States or we haven't known about it until now," said University of Pennsylvania medical ethicist Arthur Caplan, who is co-directing a U.N. task force on international organ trafficking.

Rosenbaum was arrested Thursday, 10 days after meeting in his basement with a government informant and an FBI agent posing as the informant's secretary. The agent claimed to be searching for a kidney for a sick uncle on dialysis who was on a transplant list at a Philadelphia hospital.

"I am what you call a matchmaker," Rosenbaum said in a secretly recorded conversation. "I bring a guy what I believe, he's suitable for your uncle." Asked how many organs he had brokered, he said: "Quite a lot," the most recent two weeks earlier.

As part of the scheme, the organ donors were brought from Israel to this country, where they underwent surgery to remove the kidneys, authorities said. Prosecutors did not identify which hospitals in the U.S. received the donors and their kidneys.

"The allegations about an organ trafficking ring in the United States are appalling," said John Davis, CEO of the National Kidney Foundation.

Israel Medical Association spokeswoman Orna Cohen said the organization had no reports there of Israelis selling organs. "If it's true, then it's shocking," she said.

Related StoriesInformant, Rabbi's Son Allegedly Aided Massive New Jersey Corruption Bust
New Jersey Mayors, Rabbis Allegedly Trafficked Knock-Off Gucci Bags With Laundered Money
Micky Rosenfeld, a spokesman for Israel's national police force, said Israeli police were not involved in the investigation, and he would not comment further.

Under 1984 federal law, it is illegal for anyone to knowingly buy or sell organs for transplant. The practice is illegal just about everywhere else in the world, too.

But demand for kidneys far outstrips the supply, with 4,540 people dying in the U.S. last year while waiting for a kidney, according to the United Network for Organ Sharing. As a result, there is a thriving black market for kidneys around the world.

Nancy Scheper-Hughes, an anthropology professor at the University of California at Berkeley and the author of an upcoming book on human organ trafficking, said that she has been tracking the Brooklyn-connected ring for 10 years and that her contacts in Israel have called Rosenbaum "the top man" in the United States.

Scheper-Hughes said she was told Rosenbaum carried a gun, and when a potential organ seller would get cold feet, Rosenbaum would use his finger to simulate firing a gun at the person's head.

Scheper-Hughes said she was also told that some of the kidney transplants using sellers procured by Rosenbaum were performed at Mount Sinai Hospital in New York.

The hospital said it is aware Rosenbaum has been charged but that its transplant screening process is rigorous and that it assesses each donor's motivation.

"All donors are clearly advised that it is against the law to receive money or gifts for being an organ donor," spokeswoman Brenda Perez wrote in an e-mail. "... The pre-transplant evaluation may not detect premeditated and skillful attempts to subvert and defraud the evaluation process."

Rosenbaum was arrested in a sweeping federal case that began as an investigation into money laundering and trafficking in kidneys and fake designer bags. It mushroomed into a political corruption probe, culminating in the arrests this week of 44 people, including three New Jersey mayors, various other officials, and five rabbis. The politicians and rabbis were not accused of involvement in the organ trafficking.

Rosenbaum, 58, is a member of the Orthodox Jewish community in the Borough Park section of Brooklyn, where he told neighbors he was in the construction business.

For someone who was not a surgeon, Rosenbaum seemed in his recorded conversations to have a thorough knowledge of the ins and outs of kidney donations, including how to fool hospitals into believing the donor was acting solely out of compassion for a friend or loved one.

He was recorded saying that money had to be spread around liberally, to Israeli doctors, visa preparers and those who cared for the organ donors in this country. "One of the reasons it's so expensive is because you have to shmear (pay others) all the time," he was quoted as saying.

"So far, I've never had a failure," he bragged on tape. "I'm doing this a long time."

At a 2008 meeting with the undercover agent, Rosenbaum claimed he had an associate who worked for an insurance company in Brooklyn who could take the recipient's blood samples, store them on dry ice and send them to Israel, where they would be tested to see if they matched the prospective donor, authorities said.

Four checks totaling $10,000, a down payment on the fictitious uncle's new kidney, were deposited in the bank account of a charity in Brooklyn, prosecutors said.

An after-hours phone call to Rosenbaum's lawyer, Ronald Kleinberg, was not immediately returned Friday.

Dr. Francis Delmonico, a Harvard professor, transplant surgeon and board member of the National Kidney Foundation's Board of Directors, said similar trafficking is going on elsewhere around the world. He said an estimated 10 percent of kidney transplants — 5,000 to 6,000 each year — are done illegally. Hot spots are Pakistan, the Philippines and China, where it is believed organs are obtained from executed prisoners, he said.

Caplan, the University of Pennsylvania ethicist, said he expects the U.N. task force to make recommendations in October that would hold hospitals worldwide accountable for establishing the origins of each organ they transplant and whether it was freely donated without compensation.

"There is a black market, almost exclusively in kidneys," Caplan said. "All international medical groups and governments ought to condemn any marketing in body parts. It's simply too exploitative of the poor and vulnerable. The quality of the organs is questionable. People lie to get the money. The middle men are irresponsible and often criminals. They don't care about the people who sell."

Scheper-Hughes said her research has uncovered hundreds of cases of illegal organ transactions brokered by and for Israelis in Israel, South Africa, Turkey and other countries, with sellers recruited from poor communities in Moldova, Brazil and elsewhere.

In 2003 and 2004, 17 people were arrested in Brazil and South Africa on suspicion of participating in an international human organ trafficking organization. Investigators said Brazilians who passed a medical checkup were flown to South Africa, where their kidneys were extracted.

A few transplant surgeons support changing the law to allow a system of regulated compensation to increase the pool of donor kidneys.

Arthur Matas, a transplant surgeon who directs the kidney transplant service at the University of Minnesota Medical School, said donors could be compensated with some combination of lifetime access to medical care, life insurance, a tax credit, help with college and a small direct payment.

"It would minimize the extraordinary black market and exploitation of impoverished people internationally," Matas said.

Martin Weinfeld, who lives around the corner from Rosenbaum in Brooklyn, said the allegations bring shame on the community.

"It puts a bad name on good people," he said. "Religion is supposed to be about God, helping others, not about the cash."****
2961  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Media Issues on: August 27, 2009, 03:27:48 PM
Thanks Doug.
I don't believe for one second that "enhanced interrogation techniques" or whatever one wants to call it might not work if other methods fail.

Even the mere "threat" of it should improve outcome.

Now our enemy knows thanks to Bama we use kid gloves only.  So now our enemies know they only need say,
"I want to speak to my lawyer".

I do agree it is a huge problem to know when to use such techniques and when does one know when the enemy is truly ignorant vs. willfully witholding information.  No one wants to harm innocents.  Clearly the three guys in your article were not innocents.

Even the gigantic Democrat/liberal/progressive/socialist Alan Dershowitz was for torture if needed acutely to save lives.

He seems distinctly silent now we have the socialist in office.
2962  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 27, 2009, 03:12:50 PM
"IMO people like Hannity earned the right to spend his own money on their own services, just as I have 'earned' the right to spend up to my Blue Cross coverage limits."

I agree.

I am sick and tired of endless instrusion by government into our lives and am not for expanding medicare/medicaid at all.

I read through about 1/4 of Mark Levin's bestseller Liberty and Tyranny and agree with most of what I read.
To me he is a hero for opening our eyes to what is going on with the increasing and sometimes subtle and sometimes not so subtle encroahment of the government into every aspect of our lives.

On the other hand I was personally offended by Rush Limbaugh telling the "moderates" who ciriticized him that the recent uproar against Bama et al's health plan has caused a cratering of the Dems and BO in the polls that "let this be a lesson to you".

I love Levin but I am sick of Rush.  While they both come from the right Levin makes more sense to me for reasons that I am not even totally clear about.  Maybe because he is not such an egotist as Limbaugh who also comes off as a blowhard.

As far as Hannity all I can say he is one of the world's greatest salesman.  He could sell anything from a potion that cures all sexual dysfunction to promoting eternal life.

Can't you just picture walking into any retail store and seeing him standing there ready to move in for the kill (I mean sale)?



2963  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / flu or not to flu??? on: August 25, 2009, 01:02:22 PM
Well that is the question that everyone asks.  And everyone has their own answer - half wrong and half right.

No one knows but you'd think everyone does listening to the opinions.

Politicians are darned if they do and darned if they don't.

Remember when the Bush haters railed against W for Katrina.  Naturally the whole thing from lack of preparedness to a slow response was his.

So BO could ignore the hypothetical threat of H1N1 and more likely then not it will fizzle out like the previous flu scares.
And risk another great pandemic the likes not seen in 81 years.
Or he can push for preparedness with funds, a vaccine that could pose unknown health risks and take no risk.

Either way there is someone to ciritcize him.



****Hospitals May Face Severe Disruption From Swine Flu 

By Tom Randall and Alex Nussbaum

Aug. 25 (Bloomberg) -- Swine flu may hospitalize 1.8 million patients in the U.S. this year, filling intensive care units to capacity and causing “severe disruptions” during a fall resurgence, scientific advisers to the White House warned.

Swine flu, also known as H1N1, may infect as much as half of the population and kill 30,000 to 90,000 people, double the deaths caused by the typical seasonal flu, according to the planning scenario issued yesterday by the President’s Council of Advisers on Science and Technology. Intensive care units in hospitals, some of which use 80 percent of their space in normal operation, may need every bed for flu cases, the report said.

The virus has sickened more than 1 million people in the U.S., and infections may increase this month as pupils return to school, according to the Centers for Disease Control and Prevention in Atlanta. If swine flu patients fill too many beds, hospitals may be forced to put off elective surgeries such as heart bypass or hernia operations, said James Bentley with the American Hospital Association.

“If you have 1.8 million hospital admissions across six months, that’s a whole lot different than if you have it across six weeks,” said Bentley, a senior vice-president of the Washington-based association, which represents 5,000 hospitals.

The scenario projections were “developed from models put together for planning purposes only,” said Tom Skinner, a spokesman for the CDC, at a briefing in Atlanta today. “At the end of the day, we simply don’t know what this upcoming flu season is going to look like. It could be severe, it could be mild, we just don’t know.”

Past Pandemics

The models were based on past pandemics, and the CDC is working on new projections based on the latest data gathered from swine flu patients, Skinner said. Those estimates should be available “soon,” he said, without further specifying.

President Barack Obama was urged by his scientific advisory council to speed vaccine production as the best way to ease the burden on the health care system. Initial doses should be accelerated to mid-September to provide shots for as many as 40 million people, the panel said in a report released yesterday. Members also recommended Obama name a senior member of the White House staff, preferably the homeland security adviser, to take responsibility for decision-making on the pandemic.

“This isn’t the flu that we’re used to,” said Kathleen Sebelius, U.S. health and human services secretary. “The 2009 H1N1 virus will cause a more serious threat this fall. We won’t know until we’re in the middle of the flu season how serious the threat is, but because it’s a new strain, it’s likely to infect more people than usual.”

Clinical Trials

Data from clinical trials to assess the safety and effectiveness of swine flu vaccines will start to become available in mid-September, health officials reported Aug. 21. Full results from the two-dose trials won’t be available until mid-October.

“We are making every preparation effort assuming a safe and effective vaccine will be available in mid-October,” Sebelius said today at the CDC’s Atlanta offices.

H1N1 has already reached more than 170 countries and territories in the four months since being identified, the Geneva-based World Health Organization said. Swine flu causes similar symptoms as seasonal strains. It has so far resulted in worse than normal flu seasons, with increased hospitalizations and cases of severe illness, the WHO said in an Aug. 12 release.

New Zealand and Australia, in the midst of their normal flu seasons, have reported intensive care units taxed to capacity by swine flu patients. The experience provides clues to what the U.S., Europe and Japan may see when the H1N1 virus returns.

President’s Advisers

The president’s advisory council describes as a “plausible scenario,” that 30 percent to 50 percent of the U.S. population will be infected in the fall and winter. As many as 300,000 patients may be treated in hospital intensive care units, filling 50 percent to 100 percent of the available beds, and 30,000 to 90,000 people may die, the group’s report said.

“This is a planning scenario, not a prediction,” according to the report. “But the scenario illustrates that an H1N1 resurgence could cause serious disruption of social and medical capacities in our country in the coming months.”

Peter Gross, chief medical officer at Hackensack University Medical Center in New Jersey, said if the group’s scenario comes true, “I think every hospital in America is going to be in a crunch. We’ll be hard pressed to deal with those predictions,” he said.

‘Overblown’ Estimates

The estimates seem “overblown,” Gross said, given that swine-flu outbreaks in 1968 and 1957 failed to cause as many deaths, even with medical technology and disease surveillance less advanced than today.

“Influenza, you can make all the predictions you want, but it’s more difficult than predicting the weather,” Gross said yesterday in a telephone interview, after the advisory report was made public. “If influenza was a stock, I wouldn’t touch it.”

The 775-bed hospital is planning for an outbreak, upping its order of flu medications and discussing where to put patients if the worst occurs, Gross said.

The President’s Council of Advisers on Science and Technology is chaired by John Holdren, the director of the White House Office of Science and Technology, Eric Lander, the head of the Broad Institute of Massachusetts Institute of Technology and Harvard University in Cambridge, Massachusetts, and Harold Varmus, the chief executive officer of Memorial Sloan-Kettering Cancer Center in New York.

The 21-member group of scientists and engineers, created by Congress in 1976, advises the president on policy involving scientific matters.

New Estimates

Seasonal flu usually kills about 36,000 Americans, Skinner said. Swine flu causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw of the CDC.

The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.

“We don’t know whether the number of severe illnesses will be much greater, but we do know that it’s a new virus and therefore people are very vulnerable,” said Anne Schuchat, director of the CDC’s Center for Immunization and Respiratory Diseases, in an interview yesterday.

Disease Burden

About 100 million people in the U.S. get the annual flu shot, Schuchat said. Pregnant women, who have “a disturbingly high burden of disease” from swine flu, only get vaccinated for seasonal flu about 15 percent of the time. Pregnant women are a top priority for vaccinations, she said.

Seasonal flu usually kills about 36,000 Americans. Swine flu causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw, associate director of laboratory science at the CDC’s flu division.

The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.

“People who get infected with this strain happen to be the healthiest members of our society,” said Shaw in a presentation yesterday at the agency.

The H1N1 strain is genetically related to the 1918 Spanish Flu that killed an estimated 50 million people. Variations of the Spanish Flu circulated widely until about 1957, when they were pushed aside by other flu strains. People whose first exposure to a flu virus was one of those Spanish Flu relatives may have greater immunity to the current pandemic, Shaw said.

To contact the reporters on this story: Tom Randall in New York at trandall6@bloomberg.net; Alex Nussbaum in New York at anussbaum1@bloomberg.net ****

2964  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 25, 2009, 12:30:42 PM
****The difference with this is to enter the government, uninvited, into the room during the discussions, holding all the cards, on a mission to control costs - for the children... sounds like a death panel to me.****

Well the problem is that governement already does foot a huge proportion of our health care bill through medicaid / medicare.

And we doctors don't often do our jobs. and patients and sometimes the families have unrealistic expectations.
So it is not totally unreasonable that payers have a right to some input.

And that IS part of the problem when we have others paying for the health care of others and the costs are not with the people using the care.

To say we should spare no dollars at the end of life is a nice thought from Shawn Hannity but in the meatime we are going broke.



2965  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Here it comes - the Dem planned response on: August 25, 2009, 10:18:35 AM
Here comes the Dem response from those who benefit from big government who will give their case for big gov health care.
Here comes the big push back.  We'll see who shouts the loudest I guess - because that is what it is in our daily politics now.
Bo makes it worse.  The wolf in lambs clothing.  Pretend you are one of them and you can subtly shove your radical agenda through.
Then when the opposition voices dissent - blame them for not coming to the compromise table.

Yeah yeah.

anyway - here it comes. 

***"Health care reform supporters will hold more than 500 events between Wednesday and when lawmakers return Sept. 8.
Faced with a souring public mood on health care reform, Democrats and their supporters are launching a national grassroots push Wednesday to show lawmakers that the majority of Americans still support overhauling the system.

Reform supporters are planning to hold more than 500 events between Wednesday and when lawmakers return to Washington Sept. 8, ranging from neighborhood organized phone banks to professionally staffed rallies with hundreds of people.

The Democratic National Committee and its grassroots arm, Organizing for America, are helping to organize the effort along with the Health Care for America Now, a group pushing to create government-run insurance plan.

“In these last few weeks of recess we want to demonstrate the energy, passion and commitment that the American people have to health insurance reform so that when members return after Labor Day they know that they can turn their attention to getting this done because they have the backing of the American people,” said DNC spokesman Brad Woodhouse.

Supporters have their work cut out for them. Many lawmakers were thunderstruck over the August recess by the anger and outrage expressed by their constituents in town hall meetings across the country. And in poll after poll, support for reform has eroded throughout the month.

But Democrats and their allies insist that the majority of Americans still support reform and have organized the grassroots campaign to buck up lawmakers as they get ready to head back to Washington.

A health-insurance-reform-now bus will travel the country starting Wednesday and anchor events in 11 cities: Phoenix, Albuquerque, Denver, Des Moines, Pittsburgh, Raleigh, Charlotte, Milwaukee, St. Louis, Indianapolis and Columbus, Ohio.

But the talk of broad health insurance reform does mean that progressives have backed off their push for a government-run insurance option.

“We want members of Congress to get back to work and pass reform that means something. We need affordable care. We need real insurance regulation. And we need a strong public health insurance option,” said HCAN spokeswoman Jacki Schechner. “It’s doable and we expect it to get done now.”***

2966  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Glenn vs. Van Jones on: August 25, 2009, 08:46:13 AM
"Self describes enenmy of capatilism and communist who graduated from Yale (IVy league school - breeder of liberal doctrine) in some ways now that he has profitied handsomely from it sounds like a conservative; see an excerpt of what he wrote in his book below (between the stars).

It is plainly obvious his strategic use of corporate boycotts to cut the feet off his political enemies sounds curiously suspicious of another tactic used by another fabulously wealthy African American - Jesse Jackson.

Except for eco philosophy he now sounds like a capatilist.  It sounds to me this guy should be held up as taching point to all those who subscribe to the purported "horrors" of big money, capatilism in general.  Now that he learned and BENEFITTED handsomely from the capatilist system - he has been transformed from a Communist, black nationist, to one of capatilism biggest proponents.

I know what that tells me.  What does that tell you?  What lesson can the world learn from such a transformation?

Anyone see any hypocrisy from another lib IVY leaguer?

FWIW the Wikepia story with caveats that it is just Wikepia:

Van Jones
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Van Jones


Van Jones as White House Council on Environmental Quality's Special Advisor for Green Jobs, 2009
Born 1968
 
Nationality United States
Education University of Tennessee at Martin
Yale Law School
Occupation Civil Rights, Human Rights, and Environmental Activist
Employer White House Council on Environmental Quality
Known for 2009 Time Magazine 100 Most Influential People
2009 New York Times Bestselling Author
Title Special Advisor for Green Jobs
Van Jones (born 1968) is (since March 2009) the Special Advisor for Green Jobs at the White House Council on Environmental Quality (CEQ).[1]

He is an environmental advocate, a civil rights activist and attorney, and an author. A self-described former communist and black nationalist, Jones was active in the Rodney King protests in 1992.[2] Formerly based in Oakland, California, Jones is the founder of Green For All, a national NGO dedicated to "building an inclusive green economy strong enough to lift people out of poverty."[3] His first book, The Green Collar Economy, released on October 7, 2008, was a New York Times bestseller.[4] Jones also founded the Ella Baker Center for Human Rights, a California NGO working for alternatives to violence and incarceration.[5]

In 2008, Time magazine named Jones one of its "Environmental Heroes."[6] Fast Company called him one of the "12 Most Creative Minds of 2008."[7]

Contents [hide]
1 Early life
2 Social and environmental activism
2.1 Ella Baker Center for Human Rights
2.2 Green For All
2.3 Other
3 The Green Collar Economy
4 Political Evolution
5 Awards and honors
6 Publications
7 See also
8 References
9 Further reading
10 External links
 


[edit] Early life
Van Jones was born in 1968 in rural West Tennessee. His father was a junior-high-school principal and his mother was a high-school teacher. His grandfather was the leader of the Christian Methodist—formerly Colored Methodist—Episcopal Church.[8] As a child, Jones was, by his own description, “bookish and bizarre.”[8] When his parents gave him Luke Skywalker and Han Solo action figures, instead of arranging them to fight he would have them run for imaginary public offices. His twin sister, Angela, remembers him as “the stereotypical geek—he just kind of lived up in his head a lot.” During the summers, Jones accompanied his grandfather to religious conferences, where he recalls sitting “in these hot, sweaty black churches,” listening to the adults talk, all day and into the night.[8] He graduated from Jackson Central-Merry High School in Jackson, Tennessee, in 1986. After earning his B.A. from the University of Tennessee at Martin, Jones left his home state to attend Yale Law School. In 1993, Jones earned his J.D. and moved to San Francisco.


[edit] Social and environmental activism

[edit] Ella Baker Center for Human Rights
In 1995, Jones started Bay Area PoliceWatch, the region's only bar-certified hotline and lawyer-referral service for victims and survivors of police abuse. PoliceWatch began as a project of the Lawyers' Committee for Civil Rights, but by 1996 had grown big enough to seed a new umbrella NGO, the Ella Baker Center for Human Rights.

From 1996-1997, Jones and PoliceWatch led a successful campaign to get officer Marc Andaya fired from the San Francisco Police Department. Andaya was the lead officer responsible for the in-custody death of Aaron Williams, an unarmed black man. In 1999 and 2000, Jones was a major leader in the failed campaign to defeat Proposition 21, which sparked a vibrant youth and student movement that made national headlines. In 2001, Jones and Ella Baker Center launched the Books Not Bars campaign. From 2001-2003, Jones and Books Not Bars led a successful campaign to block the construction of a proposed "Super-Jail for Youth" in Oakland's Alameda County. Books Not Bars later went on to launch a statewide campaign to transform California's juvenile justice system. That campaign is still winning major reforms.[9]

In 2005 the Ella Baker Center expanded its vision beyond the immediate concerns of policing, declaring that "If we really wanted to help our communities escape the cycle of incarceration, we had to start focusing on job, wealth and health creation."[9]

In 2005, Van and the Ella Baker Center produced the "Social Equity Track" for the United Nations' World Environment Day celebration, held that year in San Francisco.[10] It was the official beginning of what would eventually become Ella Baker Center's Green-Collar Jobs Campaign.

The Green-Collar Jobs Campaign was Jones' first concerted effort to combine his lifelong commitment to racial and economic justice with his newer commitment to solving the environmental crisis. It soon took as its mission the establishment of the nation's first "Green Jobs Corps" in Oakland. On October 20, 2008, the City of Oakland formally launched the Oakland Green Jobs Corps, a public-private partnership that will "provide local Oakland residents with job training, support, and work experience so that they can independently pursue careers in the new energy economy."[11]


[edit] Green For All
In September, 2007, Jones attended the Clinton Global Initiative and announced his plans to launch Green For All, a new national NGO dedicated to creating green pathways out of poverty in America. The plan grew out of the work previously done at local level at the Ella Baker Center. Green For All would take the Green-Collar Jobs Campaign mission — creating green pathways out of poverty — national.

Green For All formally opened its doors on January 1, 2008. In its first year, Green For All organized "The Dream Reborn," the first national green conference where the majority of attendees were people of color. It co-hosted, with 1Sky and the We Campaign, a national day of action for the new economy called "Green Jobs Now." It launched the Green-Collar Cities Program to help cities build local green economies. It started the Green For All Capital Access Program to assist green entrepreneurs. And Green For All, as part of the Clean Energy Corps Working Group, launched a campaign for a Clean Energy Corps initiative which would create 600,000 'green-collar' jobs while retrofitting and upgrading more than 15 million American buildings.[12]

In reflecting on Green For All's first year, Jones wrote, "One year later, Green For All is real – and we have helped put green collar jobs on the map…We have a long way to go. But today we have a strong organization to help get us there."[12]


[edit] Other
Jones has also served on the boards of numerous environmental and nonprofit organizations, including 1Sky, the National Apollo Alliance, Social Venture Network, Rainforest Action Network, Bioneers, Julia Butterfly Hill’s "Circle of Life" organization and Free Press. He was also a Senior Fellow with the Center for American Progress and a Fellow at the Institute of Noetic Sciences. He recently was a key speaker at the youth conference PowerShift 2009 in Washington, D.C. In 2005, following Hurricane Katrina, Jones co-founded a Web-based grassroots organization addressing Black issues called Color of Change. Jones left the organization several years later to move on to other pursuits, such as Green For All.[13]


[edit] The Green Collar Economy
On October 7, 2008, HarperOne released Jones's first book, The Green Collar Economy. The book outlines Jones's "substantive and viable plan for solving the biggest issues facing the country--the failing economy and our devastated environment."[14] The book has received favorable reviews from such environmental activists as Al Gore, Nancy Pelosi, Laurie David, Paul Hawken, Winona LaDuke and Ben Jealous.[15]

Jones had a limited publicity budget and no national media platform. But a viral, web-based marketing strategy earned the book a #12 debut on the New York Times bestseller list.[4] Jones and Green For All used "a combination of emails and phone calls to friends, bloggers, and a network of activists" to reach millions of people.[4] The marketing campaign's grassroots nature has led to Jones calling it a victory not for him but for the entire green-collar jobs movement.

The Green Collar Economy is the first environmental book authored by an African-American to make the New York Times bestseller list. [12]


[edit] Political Evolution
Having started his career as a staunch critic of capitalism, by the late 1990s Jones's views were evolving. Today, he has emerged as one of the foremost champions of green business, entrepreneurship and market-based solutions. In his book The Green Collar Economy, Jones wrote:

***[W]e are entering an era during which our very survival will demand invention and innovation on a scale never before seen in the history of human civilization. Only the business community has the requisite skills, experience, and capital to meet that need. On that score, neither government nor the nonprofit and voluntary sectors can compete, not even remotely.

So in the end, our success and survival as a species are largely and directly tied to the new eco-entrepreneurs — and the success and survival of their enterprises. Since almost all of the needed eco-technologies are likely to come from the private sector, civic leaders and voters should do all that can be done to help green business leaders succeed. That means, in large part, electing leaders who will pass bills to aid them. We cannot realistically proceed without a strong alliance between the best of the business world — and everyone else.****

Speaking to the East Bay Express, Jones explained that as a young person he became further politicized in the wake of the Rodney King verdict. Jones was still a law student at Yale Law School at the time. While volunteering as a legal monitor during a peaceful protest in San Francisco following the Rodney King trial, Jones was arrested along with other legal monitors and some protesters. He and the other detainees were released after being illegally arrested; the charges were later dropped and Jones was financially compensated by the City of San Francisco's Attorneys Office for the unlawful arrest.[16] In jail, however, Van Jones said,

"I met all these young radical people of color -- I mean really radical, communists and anarchists. And it was, like, 'This is what I need to be a part of.' I spent the next ten years of my life working with a lot of those people I met in jail, trying to be a revolutionary. I was a rowdy nationalist on April 28th, and then the verdicts came down on April 29th. By August, I was a communist."[17]

In 1994 the group of activists Van Jones was involved with Standing Together to Organize a Revolutionary Movement (STORM), a collective which "dreamed of a multiracial socialist utopia".[17]


[edit] Awards and honors
 This section does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (August 2009)

Jones's awards and honors include:

2009 - New York Times Bestselling Author for The Green Collar Economy
2009 - Time 100 Most Influential People, Time Magazine
2009 - selected as one of the Ebony Power 150
2009 - the Hubert H. Humphrey Civil Rights Award, presented to those who best exemplify selfless and devoted service in the cause of equality.
2009 - "Rolling Stone 100: Agents of Change” (#89); Rolling Stone Magazine[18]
2009 - Eco-Entrepreneur Award, Institute for Entrepreneurship, Leadership & Innovation; Howard University
2009 - Individual Thought Leadership, Energy & Environment Awards; Aspen Institute[19]
2008 - One of 17 “Sexiest Men Living”; Salon.com[20]
2008 - Best Dressed Environmental List (#1 of 30); Sustainable Style Foundation[21]
2008 - Time Magazine Environmental Hero
2008 - designation as one of Essence Magazine's 25 most influential/inspiring African-Americans
2008 - Elle Magazine Green Award
2008 - One of the George Lucas Foundation's "Daring Dozen"
2008 - Hunt Prime Mover Award
2008 - Campaign for America's Future "Paul Wellstone Award";
2008 - Global Green USA "Community Environmental Leadership" Award
2008 - designation as one of the nation's "Plenty 20" in the October/November 2008 edition of Plenty Magazine
2008 - San Francisco Foundation Community Leadership Award
2008 - One of Fast Company's "12 Most Creative Minds"
2008 - Puffin/Nation prize for "Creative Citizenship"
2008 - World Economic Forum "Young Global Leader"
2000 - International Ashoka Fellowship
1998 - Reebok International Human Rights Award
1997-1999 - Rockefeller Foundation "Next Generation Leadership" Fellowship
In 2008, Tom Friedman profiled Van in his bestselling book, Hot, Flat & Crowded. Also in 2008, Wilford Welch featured him in the book Tactics of Hope, and Joel Makower highlighted Van's ideas in the book Strategies for the Green Economy.


[edit] Publications
The Green Collar Economy: A Revolutionary Plan to End Global Warming, Beat Poverty, and Unite America HarperOne (2008)
2967  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Palin phenomenon on: August 24, 2009, 12:49:49 PM
Charles is right.  To state there are "death panels" in the health care panel "debases the debate".

From a purely policital point of view Palin's cOmments were a stroke of pure genius!

With regard to much of what else Charle's has to say I don't quite agree.  There are an INFINITE end of life scenerios.
No size fits all.  Of course liberals, aka "progressives" will come up with gov. regs that are so ridiculously complex as it attempts to cover every single possible one of these scenerios we will have books about it.

Yet Charles does not address the point that much care if provided at the end of some people's lives with little if any gain in lifespan and to some extent often worsens quality of life.

We must be spending countless billions of people who just can't or won't except the fact they ARE dying.  Esp. when the bill goes to someone else.

This can't be ignored while costs sky rocket.


*****Jewish World Review August 14, 2009 / 24 Menachem-Av 5769

The Truth About Death Counseling

By Charles Krauthammer

http://www.JewishWorldReview.com | Let's see if we can have a reasoned discussion about end-of-life counseling.

We might start by asking Sarah Palin to leave the room. I've got nothing against her. She's a remarkable political talent. But there are no "death panels" in the Democratic health-care bills, and to say that there are is to debase the debate.

We also have to tell the defenders of the notorious Section 1233 of H.R. 3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling — whether or not the patient asked for it — is to create an incentive for such a chat.

What do you think such a chat would be like? Do you think the doctor will go on and on about the fantastic new million-dollar high-tech gizmo that can prolong the patient's otherwise hopeless condition for another six months? Or do you think he's going to talk about — as the bill specifically spells out — hospice care and palliative care and other ways of letting go of life?

No, say the defenders. It's just that we want the doctors to talk to you about putting in place a living will and other such instruments. Really? Then consider the actual efficacy of a living will. When you are old, infirm and lying in the ICU with pseudomonas pneumonia and deciding whether to (a) go through the long antibiotic treatment or (b) allow what used to be called "the old man's friend" to take you away, the doctor will ask you at that time what you want for yourself — no matter what piece of paper you signed five years earlier.

You are told constantly how very important it is to write your living will years in advance. But the relevant question is what you desire at the end — when facing death — not what you felt sometime in the past when you were hale and hearty and sitting in your lawyer's office barely able to contemplate a life of pain and diminishment.

Well, as pain and diminishment enter your life as you age, your calculations change and your tolerance for suffering increases. In the ICU, you might have a new way of looking at things.

My own living will, which I have always considered more a literary than a legal document, basically says: "I've had some good innings, thank you. If I have anything so much as a hangnail, pull the plug." I've never taken it terribly seriously because unless I'm comatose or demented, they're going to ask me at the time whether or not I want to be resuscitated if I go into cardiac arrest. The paper I signed years ago will mean nothing.

And if I'm totally out of it, my family will decide, with little or no reference to my living will. Why? I'll give you an example. When my father was dying, my mother and brother and I had to decide how much treatment to pursue. What was a better way to ascertain my father's wishes: What he checked off on a form one fine summer's day years before being stricken; or what we, who had known him intimately for decades, thought he would want? The answer is obvious.

Except for the demented orphan, the living will is quite beside the point. The one time it really is essential is if you think your fractious family will be only too happy to hasten your demise to get your money. That's what the law is good at — protecting you from murder and theft. But that is a far cry from assuring a peaceful and willed death, which is what most people imagine living wills are about.

So why get Medicare to pay the doctor to do the counseling? Because we know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we've nudged you ever so slightly toward letting go.

It's not an outrage. It's surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.****
2968  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 22, 2009, 08:25:24 AM
With regard to post 363 please take note of the increase in life expectancy from around 70 to close to 80 since the 1970s.
This is true.  Yet we have the self promoting Andrew Weil, the constantly reminding us guy who graduated Harvard Medical school  poinint out that medical htechnology only saves about one in 16,000 lives.  That was what I read in his post on the Huffington Post about a week ago.
Almost all the increase in lifespan since 1900 is imporved sanitation vaccines etc.
Well the last statement is true and obvious.
That was the easy gain.

But what about the increase since 1970?  Is he telling me that is from a decrease in cholera, typhoid, better sanitation and hepatitis B vaccine?

And the increase since than while only a couple of years is still an increase and no one would argue it is due to healthier life styles.

In fact the average lifespan would be even greater if it were not for less healthy lifestyles.
The only major killer that kills more today than then is diabetes obviously because of the epidemic of this from obesity.

So DESPITE less healthy lifestyles the field of medicine has achieved an increase in lifespan. 

Anyone who denies this is a total blow hard - as is Weil.

Perhaps this post would be better on the Huffington Post but I don't really want to bother.
2969  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Politics on: August 21, 2009, 01:15:53 PM
***Obama also has shown more adherence to his convictions than former Pres. Clinton who was happy to jump ship and sail a different direction whenever his poll analysts gave him the green light.  Obama instead will cling to incrementalism toward his goals versus abandonment.***
"cling to incrementalism"

He appears to be doing just that.

Those of us who are opposed to big government have no choice but to not give one inch.
He is not about compromise.  He is about suckering the right.

If we continue to stand up to him his fellow Dems will really start jumping ship when his numbers continue to tank.

I fear we are going to witness a gigantic counter offensive from the left with all sorts of smears, distortions, frenzy and the rest very soon.
"we need to hit back twice as hard"

This includes bribing more voting blocks.

I am surprised we have not seen more violence yet.
Just wait till we start getting double digit inflation.




2970  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: U.S. Census 2010 on: August 21, 2009, 11:08:48 AM
IIRC, the Census was constitutionally assigned to ask how people in your household - period - for congressional district and electoral college purposes, not to 'sample' populations or design or support new government programs.

excellent point.
What are all the questions about?

Good topic for a real investigative reporter if any exist.
2971  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: Political Rants on: August 21, 2009, 11:05:19 AM
He has lived a charmed life.  I have always felt Ted Kennedys, in particular believes the rules don't apply to him.


***What Ted Kennedy Wants
He's trying to change election rules—again.Article Comments (108) more in Opinion »Email Printer
Senator Ted Kennedy, who is gravely ill with brain cancer, has sent a letter to Massachusetts lawmakers requesting a change in the state law that determines how his Senate seat would be filled if it became vacant before his eighth full term ends in 2012. Current law mandates that a special election be held at least 145 days after the seat becomes available. Mr. Kennedy is concerned that such a delay could leave his fellow Democrats in the Senate one vote short of a filibuster-proof majority for months while a special election takes place.

"I therefore am writing to urge you to work together to amend the law through the normal legislative process to provide for a temporary gubernatorial appointment until the special election occurs," writes the Senator.

Sen. Edward Kennedy, D-Mass.
What Mr. Kennedy doesn't volunteer is that he orchestrated the 2004 succession law revision that now requires a special election, and for similarly partisan reasons. John Kerry, the other Senator from the state, was running for President in 2004, and Mr. Kennedy wanted the law changed so the Republican Governor at the time, Mitt Romney, could not name Mr. Kerry's replacement. "Prodded by a personal appeal from Senator Edward M. Kennedy," reported the Boston Globe in 2004, "Democratic legislative leaders have agreed to take up a stalled bill creating a special election process to replace U.S. Senator John F. Kerry if he wins the presidency." Now that the state has a Democratic Governor, Mr. Kennedy wants to revert to gubernatorial appointments.

Beacon Hill has long sported heavy Democratic majorities, so the state legislature has the votes to grant Mr. Kennedy's wish. But does it have the chutzpah? An election is the more democratic option. After witnessing recent attempts by incompetent Governors in Illinois and New York to fill Senate vacancies, Massachusetts voters may have soured on such appointments. Especially when Mr. Kennedy's motivation for changing the law is so obviously born of partisan interest, not principle.***

2972  Politics, Religion, Science, Culture and Humanities / Politics & Religion / second us civil war on: August 21, 2009, 10:16:01 AM
I don't know if this deserves a thread but I think it does.
I have posted we are in a "soft" civil war.

Others have noticed and stated this.  It is not new.

This article suggest BO is creating it.  I don't agree.  It already existed and has for years.  But let there be no doubt - BO is certainly making it worse - far worse.

He has never been about conciliation or post partisanship or getting past the rancor except that he thought but persistantly claiming that he could ram his agenda down the throats of those who are against it.

It was all talk all shmooz.

In any case we need more people to point this out about what is happening.  IF the right can get a better spokeperson a better plan going BO is toast.  If not he will hang in there with the potential of a comeback ala Clinton.
Though he is far more of an ideologue the Bill and so far has not shown the ability to change or adapt to preserve his power.
I guess he will eventually.  He can't be that pig headed - or can he?

http://www.washingtontimes.com/news/2009/aug/21/inside-the-beltway-68484451/
2973  Politics, Religion, Science, Culture and Humanities / Politics & Religion / BO will drive this country into the gutter. on: August 21, 2009, 09:36:04 AM
Doug,
My arm chair opinion is that unless we all start sacrificing now this country is headed for a total collapse.
Even Buffett finally came out and said the obvious - all this spending will destroy us.
Entitlements will have to stop.
We should get the illegals to leave this country and stop allowing US employers to use them for beans on the dollar.

So some diners will close, gas stations, and consrtruction jobs.
Americans who are unemployed will have to take some of these jobs at lower rates and/or the owners will have to do the work themselves.

We need to stop giving life ling pensions to people who retire at 50 and then get other jobs.
Medicare and social security ages will have to increase to 70.

As a primary care doctor I have had to make due with less for years.
Nothing new to me.

I have had some skeptics decry that THIS IS the MO of BO.
Destroy the country so it has to be rebuilt from the bottom up - as a socialist state.
I am short of personally subscribing to this but I don't discount it altogether.

Yet the BO still has a 57% approval rating?

The only explanation for this is many still do not see any attractive alternative.
2974  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The electoral process, vote fraud (ACORN et al), corruption etc. on: August 20, 2009, 04:30:48 PM
***I don't have a smoking gun, but I do have the good sense to recognize when something doesn't pass the smell test. It might well be happenstance that Soros' "repositioning" was completely unrelated to the decision to invest American dollars in Petrobas, but there are too many dots that have at least a tenuous connection to assume that it's a completely innocent coincidence.***

This is to pay Soros back for all his support.
Plus it replenishes there own war chest so to speak as Soros we all know is happy to support their radical cause.

Even if there is a smoking gun somewhere we can all forget about anyone looking for it.
Not with a leftist controlled governent.
Reminds one of the famous cattle futures bribe.
2975  Politics, Religion, Science, Culture and Humanities / Politics & Religion / 2ndNew England Journal article - interview with Wilensky.W's 1st HCFA's administ on: August 20, 2009, 04:23:26 PM
Another NEJM:

01:53:23 PM August 20, 2009
from web
Reform, Regulation, and Research — An Interview with Gail Wilensky
Posted by NEJM • August 19th, 2009 • Printer-friendly
John K. Iglehart



Gail Wilensky, Ph.D., is an economist who served in the administration of President George H.W. Bush, first as the administrator of the Health Care Financing Administration (forerunner to the Centers for Medicare and Medicaid Services) and later as White House health policy advisor. In 1997, she became the first chair of the Medicare Payment Advisory Commission, and during the 2008 presidential campaign, she was an advisor to Senator John McCain (R-AZ). She is a senior fellow at Project HOPE. John Iglehart, a national correspondent for the Journal, interviewed Dr. Wilensky on August 7, 2009.


John Iglehart: Many Republicans oppose reform proposals put forward by Democrats. Do you consider the pursuit of health care reform an urgent matter?

Gail Wilensky: There is obviously a deep divide between the parties about what reform legislation should look like, but I do believe it is important that we press on with reform. We can’t continue the unsustainable health care spending of the past several decades, not to mention problems regarding the value of care, its clinical appropriateness, and a large and growing uninsured population.

Iglehart: How confident are you that by the end of 2009 a reform measure will be signed into law?

Wilensky: I think it’s likely that we will see a significant expansion in insurance coverage, maybe get to 93 to 95% of the population, through reform legislation. I’m quite discouraged that we will do anything significant about the other problems — slowing spending or improving value and clinical outcomes.

Iglehart: There are provisions in the Democratic reform bills that you oppose.1 Of them, which one gives you the greatest pause?

Wilensky: The public plan is one of the most contentious issues, and I hope it will not be in a final bill. I believe that a public plan would ultimately unravel private insurance coverage in the United States.

Iglehart: Do you favor the increased regulation of private insurance plans that their advocates, America’s Health Insurance Plans, volunteered to accept early in the negotiating process, such as guaranteed issue of insurance, elimination of preexisting-condition requirements, and so forth? Is that good public policy?

Wilensky: I believe it is good policy. I favor regulations that would guarantee renewability of insurance policies, place limits on how much premium rates could vary according to the health status of an individual, and eliminate preexisting-condition exclusions, as long as most people are covered. If large blocks of people are allowed to remain uncovered, the system could saddle some insurers with a higher risk profile of covered lives that could make their products unaffordable. But as long as most people are covered, these regulations are an appropriate quid pro quo, and they should be adopted.

Iglehart: Over the past generation, the GOP’s interest in health-related legislation has been modest compared with the emphasis that Democrats have placed on these issues. One exception was the relentless drive of President George W. Bush to enact a Medicare outpatient prescription-drug benefit, a pursuit that most Democrats opposed because of the enhanced role it gave private health plans. In your view, what’s the reason for the modest Republican record on health care issues?

Wilensky: People sometimes accuse the Republicans of not having any ideas in health care. But I don’t think that’s true; it’s more a failure to aggressively promote their ideas once they are introduced. For example, the first President Bush introduced a very good proposal that would have provided coverage to every individual whose income was below 133% of the federal poverty level, reformed private insurance, and changed the medical liability system. But it was released too late in his term, and perhaps even more importantly, the passion for health care reform that President Clinton demonstrated and that now engages President Obama has never been articulated by Republican leadership in the executive branch or, in some instances, the Congress.

Similarly, you could say that George W. Bush put forward a reasonable reform proposal to expand coverage by providing tax deductions for people without employer-sponsored insurance. John McCain offered a plan that called for taxing the employer-paid insurance premiums of workers, just as their salaries are taxed. At the same time, his plan would have granted refundable tax credits to employees so they could purchase their own coverage rather than accept the insurance offered by their employers. Don’t forget, during the election campaign, Obama attacked McCain repeatedly for this proposal, although equalizing the tax treatment of all workers has long been supported by virtually all economists because the current policy favors people with higher incomes. Health issues have just not been a primary focus for Republicans. Even on an issue that Republicans feel passionate about — reforming how professional liability issues are addressed — they have been unable to enact legislation during the brief periods when they controlled Congress and the White House, or at least Congress, in the past decade or so.

Health care reform is a difficult challenge for both parties, as the August [2009] town hall meetings are underscoring. We can see it now with our Democratic president and substantial Democratic majorities in the House and Senate, and still some uncertainty about if, let alone what kind of, health care reform may be enacted.

Iglehart: The Obama administration has been promoting the idea of creating an Independent Medicare Advisory Council within the executive branch,2 with the authority to make recommendations to the president on annual Medicare payment rates and other reforms, shifting some power from Congress to the executive branch. If the president disapproved the recommendations or Congress passed a resolution of disapproval, the recommendations would be null and void, although Congress would have to enact a bill with comparable savings within a short period. What’s your view of that idea?

Wilensky: I think it’s a bad idea. It would be trading off the difficulty Congress encounters when legislators face tough choices for granting power to a body that is unaccountable to the electorate. I find it very odd that the Congress has been unwilling to grant greater discretionary authority to the Centers for Medicare and Medicaid Services [CMS] at the same time that a few legislators — Senator Jay Rockefeller [D-WV] and Representative Jim Cooper [D-TN] — are sponsoring measures that would provide almost unlimited authority to an independent body of individuals who, once appointed, would be completely unaccountable to the American people. I think the right strategy is for Congress to approve the general structure of provider payment and the spending it deems appropriate, enact payment reforms, broadly defined, that it favors — bundling payments for physicians, moving to more accountable alignment between physicians and hospitals or between physicians and health care plans — and grant CMS far greater discretionary authority to implement these changes. After all, the CMS administrator is a presidential appointee, subject to confirmation by the Senate, reporting to a secretary who is similarly subject, who reports to the president, who is ultimately accountable to the American people.

Iglehart: So you favor providing CMS with greater resources to administer Medicare and Medicaid, even though members of Congress seem to criticize its performance at every turn?

Wilensky: Yes, and I’ve been one of a number of Republicans and Democrats3,4 who have indicated that all recent administrations — and Congress as well — have starved CMS in terms of providing the kind of management resources and administrative support the agency needs to capably run Medicare and Medicaid.

Iglehart: You’ve been a strong advocate of greatly expanding the government’s investment in comparative-effectiveness research [CER].5 The administration’s stimulus package included $1.1 billion to fund an accelerated CER program. Do you anticipate that reform legislation will expand the available CER resources? And what kind of impact will such research have on practicing physicians and the content of medical care?

Wilensky: I am hopeful that we will continue to see additional funding and program implementation policies for CER in whatever reforms are passed by Congress. There are many questions — about governance, about where an entity should be located, about how priority setting should occur, about the involvement of patient advocates and industry in some of these deliberations — that were not addressed in the stimulus package. That was a jump-starting action for CER, but these critical questions of place and priorities must soon be resolved.

We invest so much in the NIH’s pursuit of basic research but often fail to rapidly translate the results of those efforts into clinical care. It is just enormously frustrating to me that many interests, including quite a few physicians, do not recognize CER as a companion project to NIH’s basic research that would help doctors and patients determine what are the most effective therapies for a particular condition or disease. And I am frustrated and disappointed by some of the Republican posturing, too, which asserts that additional information provided through CER is a threat or a first step to rationing care. I believe that providing information about what works when, and allowing that information to be used as part of a reimbursement decision, is reasonable and sensible.

Iglehart: You have been emphatic that, initially, a CER agenda should focus its greatest attention on medical and surgical procedures and their value, rather than on drugs and devices. Why?

Wilensky: Because that’s where the money is. I’m looking at this as a way to learn how to spend smarter and treat better, and that involves the use of medical procedures because we’ve had so little investment in comparative-effectiveness information in that area.


Dr. Wilensky reports serving on the boards of Cephalon, Quest Diagnostics, SRA International, and UnitedHealth Group.

Source Information

This article (10.1056/NEJMp0907415) was published on August 19, 2009, at NEJM.org.

References


Antos J, Wilensky GR, Kuttner H. The Obama plan: more regulation, unsustainable spending. Health Aff (Millwood) 2008;27:w462-w471. [Free Full Text]
Orszag PR. Letter to House Speaker Nancy Pelosi, July 17, 2009. Washington, DC: Executive Office of the President, 2009.
Butler SM, Danzon PM, Gradison B, et al. Crisis facing HCFA & millions of Americans. Health Aff (Millwood) 1999;18:8-10. [CrossRef][Medline]
Iglehart JK. Doing more with less: a conversation with Kerry Weems. Health Aff (Millwood) 2009;28:w688-w696. [Free Full Text]
Wilensky GR. The policies and politics of creating a comparative clinical effectiveness research center. Health Aff (Millwood) 2009;28:w719-w729. [Free Full Text]
Download a PDF of this article
Read this article at NEJM.org
ShareThis


Tagged as: politics  © 2009 Massachusetts Medical Society  Entries (RSS)  Comments (RSS)
2976  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 20, 2009, 04:09:56 PM
Can anyone think of any other profession whose pay is and will become even more complicated?
I would rather sit and attempt to invent calculus that try to figure this out.
One real concern is the incentive under these situations to with hold care.
Otherwise it is so complex I have no clue whether I should be for or against.  Whether it would save money, improve care, make my life better or God knows what.

All the more reason not to ram 1000 pages of craziness down our throats.


****Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model
Posted by NEJM • August 19th, 2009 • Printer-friendly
François de Brantes, M.S., M.B.A., Meredith B. Rosenthal, Ph.D., and Michael Painter, J.D., M.D.

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction toward accountability for high-value care. Ideally, these new structures would promote clear accountability for both improving quality and controlling costs and would encourage health care professionals to organize themselves into teams working on behalf of patients. For such structures to be sustainable, however, the payment system must reward professionals for the quality and efficiency of services, rather than the quantity.

Our fee-for-service payment schemes have contributed to, if not largely created, the current fragmentation. Fee-for-service payments create incentives to provide high volume rather than high value — more, not better, care. So what kinds of payment could promote and sustain high-value care and motivate the development of accountable care organizations? Most experts agree that some sort of bundled, episode-based payment would help to move the system in the right direction. Our own approach, the Prometheus Payment model, for instance, bundles services and provides a budget with three components: evidence-informed base payment with patient-specific severity adjustments and an allowance for potentially avoidable complications (see box, “The Prometheus Model”).1,2 The model has been developed and evaluated through several small pilot projects, which offer some lessons about the ability of episode-based payment to improve cost and quality within the current fee-for-service system. This kind of payment aims to foster outcomes-focused collaboration among otherwise unaffiliated providers and offers a bridge from our fragmented system to a more integrated, accountable one.

The model encourages two behaviors that fee for service discourages: collaboration of physicians, hospitals, and other providers involved in a patient’s care; and active efforts to reduce avoidable complications of care (and the costs associated with them). It accomplishes these goals by paying for all the care a patient needs over the course of a defined clinical episode or a set period of management of a chronic condition, rather than paying for discrete visits, discharges, or procedures.

When incentives are used to drive changes in behavior, it is important that people and organizations are held accountable only for the variables that are actually under their control.3 That’s why, in designing the Prometheus model, we decided to focus on the potentially avoidable costs of patient care. We separated the costs attributable to patient-related factors from those attributable to providers’ actions. These latter costs are critically important in terms of accountability. In Prometheus, these potentially avoidable costs are called PACs and are recognized as the result of “care defects” — problems necessitating technical care that are under the professionals’ control and that, with the best professional standards, could have been avoided. PACs might include the cost of hospitalization of a patient with uncontrolled diabetes or the readmission for a wound infection of a patient who had recently been discharged after cardiac bypass surgery.

The opportunities for improving quality while reducing costs are substantial, reaching far beyond the well-publicized problem of avoidable readmissions. Our analyses of several national and regional data sets, in addition to our pilot work, show that PACs account for 22% of all private-sector health care expenditures in the United States.4,5 The data show that PACs can account for as much as 80% of all dollars spent for conditions such as congestive heart failure that require intensive management and that there are significant regional variations in PACs. On the basis of our current findings, we project that even a modest reduction in PACs from one year to the next would have a considerable effect on the private sector’s portion of health care spending over the next 10 years (see graph). If such results were replicated in a Medicare population, the potential savings would double, reducing the country’s health care bill by more than $700 billion over 10 years.



Projected Private-Sector National Health Expenditures under Current Assumptions and If Potentially Avoidable Costs Were Reduced by Either 10% or 15% Per Year.

Data are from the Department of Health and Human Services 2009 and our own analysis. PAC denotes potentially avoidable cost.




Unlike the current payment system, Prometheus provides larger profit margins for providers who can eliminate these complications, since they keep any unused PAC allowance — they profit by delivering optimal care, not a greater volume of care. Prometheus also avoids some of the classic pitfalls of capitation. Capitation has the unfortunate effect of transferring essentially all risk (including insurance risk) to providers and then encouraging them to pursue undifferentiated reductions in services in order to maximize financial gain. Prometheus mitigates those capitation problems — in part because the occurrence of a new case simply triggers a new patient-specific, severity-adjusted case rate and in part because typical costs and PACs are tracked and accounted for separately and, for now, opportunities for increasing financial gain are limited to decreases in PACs.

Clinical integration may be one way for providers to succeed under Prometheus, but it’s not the only way. In fact, for most of the delivery system, the changes that are required to achieve full integration are neither feasible nor desired by many potential participants. Though there may be minimal organizational requirements for managing patient care in ways that minimize PACs, it is the act of collaboration, not a particular form of organization, that Prometheus attempts to promote.

One lesson from our pilots is that hospital-centric provider organizations can expect increased internal tension when they implement an episode-of-care payment system. Prometheus does provide a sort of bonus to the hospital and physicians for working together to avoid readmission (see box, “Prometheus in Practice”). However, physician groups that are paid under the model for managing chronic conditions have substantial opportunities to increase the profits that come from avoiding expensive hospitalizations. This incentive can highlight potential conflicts between the financial interests of physicians and those of hospitals and cause us to question the proposition that hospital-centric provider organizations will deliver the best results for the country.

Prometheus does not require that a single integrated organization accept payment for an entire episode of care; we recognize that unrelated providers often overtly or tacitly comanage a patient’s care. A limitation of many episode-payment programs is their reliance on prospective payment, which forces the payer to find organizations that will accept the global fee. The Prometheus model, by contrast, can be implemented in a fragmented, largely fee-for-service delivery system if the payer retains the role of financial integrator. Over time, as providers collaborate to improve patient care and optimize their margins, they could more formally integrate into accountable organizations. However, it will and should be their choice to do so.

To facilitate this transition, the current Prometheus pilot sites are not using prospective payment. Instead, budgets are set prospectively, and payers reimburse providers for all fee-for-service claims submitted. Quarterly actual spending for typical and potentially avoidable care is reconciled against the budgets, and detailed reports are made available. Yet the incentives are the same as they would be with prospective payment: if actual spending is under budget, the difference is paid out as a bonus; if it is over budget, some payment is withheld.

Prometheus is not appropriate for reimbursements for all conditions, but there is sufficient evidence to define both typical care and PACs for types of episodes that account for half to two thirds of health care expenditures. At a minimum, our efforts to translate our conceptual model into practice suggest that it can effectively provide a bridge from the current fragmented delivery system to an accountable care system in which collaboration and the pursuit of excellence are the norm.

The Prometheus Model

Developed in 2006, the Prometheus Payment model now has three pilot programs in operation, supported by the Robert Wood Johnson Foundation. The model attempts to go beyond pay-for-performance approaches to pay for individual, patient-centered treatment plans that reward providers fairly for coordinating and providing high-quality and efficient care. Prometheus packages paymentaround a comprehensive episode of medical care that covers all patient services related to a single illness or condition. Decisions about which services will be covered for a given type of episode are made according to commonly accepted clinical guidelines or expert opinions that outline the tested, medically accepted best method for treating the condition from the beginning of an episode to the end. The prices of all included treatments are tallied to generate an “evidence-informed case rate” (ECR),which becomes a patient-specific budget for the entire care episode. ECRs include all the covered services related to the care of a single condition — services provided by everyone who would typically be involved (hospital, physicians, laboratory, pharmacy, rehabilitation facility, and so forth). The ECR isadjusted for the severity and complexity of the individual patient’s condition, and it incorporates an allowance for a portion of the current costs associated with potentially avoidable complications.


Prometheus in Practice

A 63-year-old white man with chest pain and a history of unstable angina is admitted to a teaching hospital. The patient has hypertension and diabetes. An electrocardiogram reveals ST-segment elevation in the lateral leads. The man is taken to the cardiac catheterization laboratory, where coronary angiography reveals severe triple-vessel disease as well as 60% stenosis of the left main coronary artery. A left ventriculogram shows mitral regurgitation (grade 2 to 3) with papillary muscle dysfunction. The patient is then taken urgently to the operating room, where he receives two venousgrafts and a left-internal-thoracic-artery graft. In addition, a mitral-valve reconstruction procedure is performed to correct the mitral regurgitation. The surgery is a success, and the patient returns to the intensive care unit in stable condition. However, his blood sugar is out of control, and he requires an insulin drip. His stay in the intensive care unit is prolonged by 2 days, and he must stay another day in the step-down unit. He is discharged 8 days after surgery in stable condition. One week after discharge, he is readmitted for a wound infection in his leg from the vein harvest site. He requires wound débridement and a course of antibiotics.

Under fee-for-service payment, the hospital would receive $47,500 for the bypass surgery, and the surgeon would receive $15,000 for performing the procedure. The extended hospital stay that was necessitated by the uncontrolled diabetes would result in an additional $12,000 for the hospital and $2,000 for the physician, and the readmission costs would total $25,000, for a grand total of $101,500.


Under Prometheus, the case-payment rate for this patient would include a severity-adjusted budget for typical costs of $61,000 for the hospital and $13,000 for the physician. The severity-adjusted allowance for PACs would be $15,300, for a total budget of $89,300. Had the readmission been prevented, the hospital and physician would effectively have earned a bonus of $12,800 ($101,500 – $25,000 = $76,500, which is $12,800 less than the Prometheus budget).


Mr. de Brantes reports serving as chief executive officer of Bridges to Excellence, which runs the Prometheus Payment model. Dr. Rosenthal reports having served on the original design team for Prometheus Payment and on the board of Prometheus Payment and participating in the evaluation of Prometheus pilots with funding from the Robert Wood Johnson Foundation. Dr. Painter reports supervising the implementation grant for the Prometheus Payment pilots for the Robert Wood Johnson Foundation. No other potential conflict of interest relevant to this article was reported.




Source Information

From Bridges to Excellence, Newtown, CT (F.B.); the Harvard School of Public Health, Boston (M.B.R.); and the Robert Wood Johnson Foundation, Princeton, NJ (M.P.).

This article (10.1056/NEJMp0906121) was published on August 19, 2009, at NEJM.org.

References


de Brantes F, Camillus J. Evidence-informed case rates: a new health care payment model. Washington, DC: The Commonwealth Fund, April 17, 2007. (Accessed August 13, 2009, at http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/Apr/Evidence-Informed-Case-Rates–A-New-Health-Care-Payment-Model.aspx.)
Gosfield A. Making Prometheus Payment rates real: ya’ gotta start somewhere. Princeton, NJ: Robert Wood Johnson Foundation, June 2008. (Accessed August 13, 2009, at http://www.rwjf.org/pr/product.jsp?id=32051.)
Rosenthal MB, Fernandopulle R, Song HR, Landon B. Paying for quality: providers’ incentives for quality improvement. Health Aff (Millwood) 2004;23:127-141. [Free Full Text]
Rastogi A, Mohr BA, Williams JO, Soobader MJ, de Brantes F. Prometheus payment model: application to hip and knee replacement surgery. Clin Orthop Relat Res 2009 June 23 (Epub ahead of print).
de Brantes F, D’Andrea G, Rosenthal MB. Should health care come with a warranty? Health Aff (Millwood) 2009;28:w678-w687. [Free Full Text]***
2977  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 20, 2009, 03:18:55 PM
***WASHINGTON – President Barack Obama guaranteed Thursday that his health care overhaul will win approval and said any bill he signs will have to reduce rapidly rising costs, protect consumers from insurance abuses and provide affordable choices to the uninsured — while not adding to the federal deficit.***

He still doesn't get it.

Who is going to pay for this???

He still is not being honest with the public.


2978  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / Simon Cowell yells foul. Plus: 100 to 150 missing songs & MJ's hard Drive on: August 19, 2009, 10:10:38 AM
***But it turns out there is a whole underworld of techie criminals who hack into emails and servers to get hold of the sought-after new tracks.***

Yeah no kidding.  I've been saying this for years.  And it is far worse than this.  We are not only talking hacking into servers, we are talking listening devices, surveillance, bribery (up to the US copyright office), payoffs and more.

And it isn't just people lifting songs from the suppossed creators of this music.  For example Justin Timberlake has done songs exactly like those stolen from Katherine. 

I must also point out the 100 to 150 songs (depeding on which story you read) that went missing from Michael Jacikson's home after he died (see the reports of the missing hard drive all over the news reports) is also no accident.

I strongly doubt it is as simple as Lotaya Jackson "backing up the moving van" and taking away the hard drive though elements in the music industry would like us believe it is that simple.

The hard drive was stolen.  It might reappear but it will likely be switched (if not already).
I VERY STRONGLY SUSPECT that the parade of people recently announcing they are coming out with new albums in September (including Gretchen Wilson - it will be  more rock than country this time) are going to get buy some of the materials from this HD.
I am not clear that Jackson didn't get the material for a price from those that steal and supply the material to the singers.
Now that he is dead these same elements aren't about to let Lotaya have it all.
I suspect they took it back and are out around the music world selling them off.

Remember those songs could be worth multiple millions.  People who don't think there is organized crime doing business in this realm are totally niave - as I was years ago.

"called the cops"

What a laugh - those guys are way in over their heads.  Plus they earn little - get my drift.

*****SIMON COWELL has called in cops after LEONA LEWIS's new track was leaked on to the internet.

On the case ... Simon Cowell
The X Factor boss discovered his record company Syco's computers have been targeted by hackers on a mission to nick tracks.

Last month I told you how these leeches had got their grubby mitts on some unfinished tracks by last year's X Factor winner ALEXANDRA BURKE and had been touting them around as the finished article.

The truth is the songs were rough, unmastered recordings and may not even make it on to the album.

But this latest leak is the hotly-anticipated single from Leona Don't Let Me Down, a collaboration with JUSTIN TIMBERLAKE.

The track is seriously being considered as the first release from her second album but it has found its way on to the web - and is the final straw for Cowell.

I always assumed songs that went missing were hard copies pinched from the studio.

But it turns out there is a whole underworld of techie criminals who hack into emails and servers to get hold of the sought-after new tracks.

It sounds like something out of Spooks.

These guys compete to be the first to get hold of a new song because there is huge kudos in it - and a shed load of cash to be made.

Dodgy file-sharing websites pay hackers top dollar for stolen tracks as they try to attract more downloaders to the site so they can rake in more money from advertisers.

The hackers put a bit of digital code - a geeky version of a graffiti tag - on to the tracks to prove they got there first when the track spreads like wildfire on the web.


A spokesman for Syco - part of Sony BMG - said: "Syco are working alongside the International Federation of the Phonographic Industry, the British Phonographic Industry, the police and investigators in this and they are making fast progress.

"We will certainly look to bring charges against those who are responsible. We cannot give any more details at this stage for operational reasons."

Advertisement
 
I hope the police manage to bang the criminals up.

They ruin it for everyone.

It is always better to hear the finished version than a stolen demo.****
2979  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 18, 2009, 10:17:36 AM
"He sounds like he is campaigning for the office instead of leading and he sounds like he competing not against Pelosi-Barney Frank-Durban-Schumer but against a Republican congress, which maybe he already sees coming..."

Yes,  and, I feel he always been this way.
*The pretend you are one of them, then you can change them strategy.*

Though at times he dons the sheep skin costume more then others depending on who he is conning.
2980  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 17, 2009, 03:46:40 PM
I only post this because it is actually humerous if not maddening.
Here is the biggest spender in the history of government who now is advised to come out speaking in defense of the *taxpayer*.

Of course if it isn't only to decry the waste in miliatry spending - true to form from a gigantic liberal.
We don't need any more tanks.  We need cultural compentancy and language experts to defend America:

Obama criticizes a Cold War approach to defense
PHOENIX – President Barack Obama chastised the defense industry and a freespending Congress on Monday for wasting tax dollars "with doctrine and weapons better suited to fight the Soviets on the plains of Europe than insurgents in the rugged terrain of Afghanistan."

"Twenty years after the Cold War ended, this is simply not acceptable. It's irresponsible. Our troops and our taxpayers deserve better," he told a national convention of the Veterans of Foreign Wars. "If Congress sends me a defense bill loaded with a bunch of pork, I will veto it."

Turning to the two foreign wars engaging the United States, Obama spoke of fierce fighting against Taliban and other insurgents leading up to Thursday's national elections in Afghanistan. He said U.S. troops are working to secure polling places so the elections can go forward and Afghans can choose their own future.

Attaining that peaceful future "will not be quick, nor easy," Obama said.

He said the new U.S. strategy recognizes that al-Qaida has moved its bases into remote areas of Pakistan and that military power alone will not win that war. At the same time, confronting insurgents in Afghanistan "is fundamental to the defense of our people."

As to Iraq, Obama reiterated his commitment to remove all combat brigades by the end of next August and to remove remaining troops from the country by the end of 2011. U.S. troops withdrew from cities and other urban areas in June.

Obama, in his third appearance before the VFW but his first as president, got hearty applause and standing ovations as he spoke at the Phoenix Convention Center to several thousand veterans, though only about two-thirds of the seats were filled.

That may have been partly because he started his speech nearly an hour before it was scheduled. Aides say he was anxious to get back to Washington after a four-day trip out West that was part family vacation and part business, including the VFW speech and town hall meetings in Montana and Colorado to push his health care agenda.

Obama told the veterans that overhaul would not change how they get their medical services — and that nobody in Washington is talking about taking away or trimming their benefits.

Instead, he said he's instructed senior aides to work with the secretary of veterans affairs to come up with better ways to serve veterans.

Obama said he wants each of the 57 regional VA offices "to come up with the best ways of doing business, harnessing the best information technologies, breaking through the bureaucracy."

He said the government would then pay to put the best ideas into action "all with a simple mission — cut these backlogs, slash those wait times and deliver your benefits sooner."

Even at a time when Obama needs as much congressional support as he can summon for his health care priorities, he spared no party from his harsh critique of business-as-usual by some in the military establishment, some defense contractors and some lawmakers who write defense budgets.

He assailed "indefensible no-bid contracts that cost taxpayers billions and make contractors rich" and lashed out at "the special interests and their exotic projects that are years behind schedule and billions over budget."

He took on "the entrenched lobbyists pushing weapons that even our military says it doesn't want" and blistered lawmakers in Washington whose impulse he said was "to protect jobs back home building things we don't need (with) a cost that we can't afford."

He said such waste was unacceptable as the country fights two wars while mired in a deep recession.

"It's inexcusable. It's an affront to the American people and to our troops. And it's time for it to stop," Obama said.

As a candidate and as president, Obama has held up the weapons-buying process as the perfect example of what's wrong with Washington and why the public doesn't trust its leaders. He essentially picked a political fight with a large part of the congressional-military-industrial alliance.

He sounded much like his campaign rival of a year ago, Arizona Sen. John McCain. And, while in Arizona, Obama praised McCain for seeking to rein in costs and reform the weapons-buying process.

In seeking to overhaul the weapons-buying process, Obama hopes to make good on a campaign promise to change the way Washington does business. But it certainly won't be easy to do; lawmakers protecting jobs at home are certain to put up enormous fights over Obama's efforts to stop production on weapons like the F-22 fighter jet.

Despite objections and veto threats from the White House, a $636 billion Pentagon spending bill was approved by a 400-30 vote in the House late last month. It contains money for a much-criticized new presidential helicopter fleet, cargo jets that the Pentagon says aren't needed and an alternative engine for the next-generation F-35 Joint Strike Fighter that military leaders say is a waste of money.

The Senate will deal with the spending measure in September.

The president laid out a vision of a nimble, well-armed and multilingual fighting force of the future, not one that was built to fight land battles against the Soviets in Europe.

"Because in the 21st century, military strength will be measured not only by the weapons our troops carry, but by the languages they speak and the cultures they understand," he said.

He praised McCain for joining him and Defense Secretary Robert Gates in opposing unneeded defense spending.

Shortly after Obama won the White House, McCain had pointedly suggested there was no need for the Marine Corps to bring on newer helicopters to ferry the president at a cost of billions of dollars.

On the subject of the helicopters, Obama told the veterans: "Now, maybe you've heard about this. Among its other capabilities, it would let me cook a meal while under nuclear attack. Now, let me tell you something. If the United States of America is under nuclear attack, the last thing on my mind will be whipping up a snack."

2981  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 17, 2009, 10:43:05 AM
Here is an example of research that is the kind of thing we do need more of.
There is a procedure called vertebroplasty wherein a cement is surgically or radiographically injected into a vertebra that has collapsed as a result of osteoporosis.
Two studies just published and released call into question whether or not this procedure is of any value whatsoever.
I have sent a few patients for kyphoplasty ( a related procedure) with some mixed though sometimes beneficial results - there pain was reduced.  Yet these two studies with a total of around 100 patients suggests the treatment may have no more benefit over a placebo sham procedure.
So these procedures may be a total wast of money except to those who perform them or supply the cement.

Isn't it remarkable these procedures get approved without better evidence they work?

Why should we pay for this?

How much more do we do that is a waste of money?

We do need more data on these kinds of things:


Orthopedic and Dental Industry News  Complete Archive »
NEJM Studies Challenge the Efficacy of Vertebroplasty
BY LAUREN UZDIENSKI, AUGUST 7, 2009
Two studies published this week in the New England Journal of Medicine cast doubts over the efficacy of vertebroplasty.

The first study, conducted in Australia, randomized 78 patients in a multicenter, double-blind, placebo-controlled trial in which participants with one or two painful osteoporotic vertebral fractures were assigned to vertebroplasty or a sham procedure. The authors found that "similar improvements were seen in both groups with respect to pain at night and at rest, physical functioning, quality of life, and perceived improvement." No significant advantage was found for vertebroplasty at any time point during follow-up.

The second study, conducted by the Mayo Clinic, found similar results. 131 patients with one to three painful osteoporotic vertebral fractures were randomized to undergo either vertebroplasty or a sham procedure. Improved disability and pain scores were noted immediately following both procedures, with the study authors noting a trend toward a higher rate of clinically meaningful improvement in pain (a 30% decrease from baseline) in the vertebroplasty group.

These results have been met with some surprise and disbelief among physicians treating VCF patients. The Wall Street Journal quoted Allan Brook, the director of interventional neuroradiology at Montefiore Medical Center in New York City, as saying, “We take a patient who’s been lying in bed in a hospital, bedridden, you do the procedure and they’re home the next day. That is not a placebo."

Some of the limitations of the analysis include a small sample size and crossover between the groups (that is, patients were able to guess they had a sham procedure and proceeded to have the vertebroplasty.) Additionally, the Wall Street Journal noted a type of enrollment bias in that the patients in the most pain, and therefore the most to gain from the procedure, may not have been willing to risk being randomized to the simulated procedure. Enrollment may also have been limited by physicians' concerns that the study was unethical, and the WSJ reported that some hospitals did not allow their doctors to participate.

In an editorial also published in the NEJM, James N. Weinstein (SPORT's principal investigator) described some of the possible adverse events associated with vertebroplasty, which, while rare, include soft-tissue damage and nerve-root pain and compression related specifically to the leakage of bone cement as well as pulmonary embolism, respiratory and cardiac failure and death. He also used the editorial as an opportunity to encourage collaborative decision-making between the physician and patient, stressing that patients prefer to be more informed and will make decisions based on the best available evidence, echoing a an opportunity for further study of vertebroplasty.

Among the companies that may be affected by this data, Orthovita CFO Nancy Broadbent told Reuters, "We don't expect our Cortoss business to be affected at all by this." The company recently launched Cortoss for use in vertebroplasty and closed down 25% yesterday afternoon, just a day after reporting a strong 2Q:09 and beating both top and bottom-line estimates.

Medtronic was also slightly down at the close. Their Kyphon business contributed $609 million to total spinal and biologics sales of $3.4 billion in fiscal year 2009, though it should be noted that kyphoplasty differs from vertebroplasty in several key aspects. Vertebroplasty involves the delivery of bone cement into a vertebral fracture; kyphoplasty first inserts a balloon to create space in the fractured vertebra, restoring its height and shape, before the balloon is removed and the bone cement is delivered to the resulting space. Both procedures are typically performed by interventional radiologists. Medtronic has not commented publicly on these results. Stryker and JNJ, who are among several companies developing VCF treatments, have also not commented.

While investors may be wary, it's unclear how these studies will affect procedure volumes or product penetration. The Wall Street Journal offered examples of other cases where study results questioned established treatments, including a 2002 study that found no benefit to arthroscopic knee surgery, which appears to have only a limited effect on practice habits. While we don't expect procedure volumes to change overnight, these studies may signal a different trend: level I evidence is somewhat rare in orthopedics, but similarly rigorous studies may become more common as payers and other stakeholders demand increasingly strong data and comparative effectiveness gains traction.

2982  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Noonan BO looking more like Jimmy Carter on: August 14, 2009, 09:10:01 AM
I wonder if this is the first time his charm isn't working.  Using his charm and a veiled means of bribery (well just take from the rich and share it with you all.) he was able to get by with deception.

I am not sure it is so much people finally seeing him for the person he is or people finally realize his policies will hurt and not help them in the long run.

Whether the independents finally see he despises the America we knew for 200 years and is intent on molding it into his conceptual ideal or simply that they will all be paying for it I don't know for sure.

I suspect he will compromise big on the health care plan.  I don't underestimate his need to cling to power and I don't think he will try to ram it through without huge compromises - and then of course claim credit.

Anyway her take:
 
OPINION: DECLARATIONS AUGUST 13, 2009, 10:51 P.M. ET From 'Yes, We Can,' to 'No! Don't!' Obama turns out to be brilliant at becoming, not being, president.By PEGGY NOONAN
Don't strain the system. Don't add to the national stress level. Don't pierce when you can envelop. Don't show even understandable indignation when you can show legitimate regard. Realize that the ties that bind still bind but have grown dryer and more worn with time. They need to be strengthened, not strained.

Govern knowing we are a big, strong, mighty nation, a colossus that is, however, like all highly complex, highly wired organisms, fragile, even at places quite delicate. Don't overburden or overexcite the system. America used to have fringes, one over here and the other over there. The fringes are growing. The fringes have their own networks. All sorts of forces exist to divide us. Try always to unite.

These are things one always wants people currently rising in government to know deep in their heads and hearts. They are the things the young, fierce staffers in any new White House, and the self-proclaimed ruthless pragmatists in this one, need to hear, be told or be reminded of.

***
The big, complicated, obscure, abstruse, unsettling and ultimately unhelpful health-care plans, proposals and ideas keep rolling out of Washington. Five bills, thousands of pages, "as it says on page 346, paragraph 3, subsection D." No one knows what will be passed, what will make its way through House-Senate "conference." They don't even know what the president wants, what his true agenda is. He never seems to be leveling, only talking. Everything's open to misdirection and exaggeration, and everything, people fear, will come down to some future bureaucrat's interpretation of paragraph 3, subsection D, part 22.

What a disaster this health-care debate is. It strains, stresses and pierces, it unnecessarily agitates and is doomed to be the cause of further agitation. Who doubts the final bill will be something between a pig in a poke and three-card Monte?

Which is too bad, because our health care system actually needs to be made better.

***
There are smart and experienced people who say whatever the mess right now, the president will get a bill of some sort because he has the brute numeric majority. A rising number say no, this thing has roused such ire he won't get much if anything. I don't know, but this is true: If he wins it, will be a victory not worth having. It will have cost too much. It has lessened the thing an admired president must have from the people, and that is trust.

It is divisive save in one respect. The Obama White House has done the near impossible: It has united the Republican Party. Social conservatives, economic conservatives, libertarians—they're all against the health-care schemes as presented so far. They're shoulder-to-shoulder at the barricade again.

***
More Peggy Noonan
Read Peggy Noonan's previous columns.

And click here to order her new book, Patriotic Grace.
The president's town hall meeting on Tuesday in Portsmouth, N.H., was supposed to be an antidote to the fractious town halls with members of Congress the past weeks. But it was not peaceful, only somnolent. Actually it was a bit of a disaster. It looked utterly stacked, with softball after softball thrown by awed and supportive citizens. When George W. Bush did town halls like that—full of people who'd applaud if he said tomorrow we bring democracy to Saturn—it was considered a mark of manipulation and insecurity. And it was. So was Mr. Obama's.

The first question was from a Democratic state representative from Dover named Peter Schmidt. He began, "One of the things you've been doing in your campaign to change the situation is you've been striving for bipartisanship."

"Right," the president purred. They were really holding his feet to the fire.

"My question is," Mr. Schmidt continued, "if the Republicans actively refuse to participate in a reasonable way with reasonable proposals, isn't it time to just say ,'We're going to pass what the American people need and what they want without the Republicans'?"

Stop, Torquemada, stop!

The president said it would be nice to pass a bill in a "bipartisan fashion" but "the most important thing is getting it done for the American people."

Then came a grade-school girl. "I saw a lot of signs outside saying mean things about reforming health care" she said. Here one expected a gentle and avuncular riff on the wonderful and vivid expressions of agreement and disagreement to be seen in a vibrant democracy. But no. The president made a small grimace. "I've seen some of those signs," he said. There's been a "rumor" the House voted for "death panels" that will "pull the plug on grandma," but it's all a lie.

I'm glad he'd like psychiatric care included in future coverage, because after that answer that child may need therapy.

***
The president seemed like a man long celebrated as being very good at politics—the swift rise, the astute reading of a varied electorate—who is finding out day by day that he isn't actually all that good at it. In this sense he does seem reminiscent of Jimmy Carter, who was brilliant at becoming president but not being president. (Actually a lot of them are like that these days.)

Also, something odd. When Mr. Obama stays above the fray, above the nitty-gritty of specifics, when he confines his comments on health care to broad terms, he more and more seems . . . pretty slippery. In the town hall he seemed aware of this, and he tried to be very specific about the need for this aspect of a plan, and the history behind that proposal. And yet he seemed even more slippery. When he took refuge in the small pieces of his argument, he lost the major threads; when he addressed the major threads, he seemed almost to be conceding that the specifics don't hold.

When you seem slippery both in the abstract and the particular, you are in trouble.

***
Looking back, a key domestic moment in this presidency occurred only eight days after his inauguration, when Mr. Obama won House passage of his stimulus bill. It was a bad bill—off point, porky and philosophically incoherent. He won 244-188, a rousing victory for a new president. But he won without a single Republican vote. That was the moment the new division took hold. The Democrats of the House pushed it through, and not one Republican, even those from swing districts, even those eager to work with the administration, could support it.

This, of course, was politics as usual. But in 2008 people voted against politics as usual.

It was a real lost opportunity. It marked the moment congressional Republicans felt free to be in full opposition. It gave congressional Democrats the impression that they were in full control, that no one could stop their train. And it was the moment the president, looking at the lay of the land, seemed to reveal he would not govern in a vaguely center-left way, as a unifying figure even if a beset one being beaten 'round the head by the left, but in a left way, without the modifying "center." Or at least as one who happily cedes to the left in Congress each day.

Things got all too vividly divided. It was a harbinger of the health care debate.

I always now think of a good president as sitting at the big desk and reaching out with his long arms and holding on to the left, and holding on to the right, and trying mightily to hold it together, letting neither spin out of control, holding on for dear life. I wish we were seeing that. I don't think we are.

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
2983  Politics, Religion, Science, Culture and Humanities / Politics & Religion / $200 cash for school supplies on: August 12, 2009, 11:39:59 AM
I give Soros credit for putting up some money.  Why he thinks it ok to confiscate tax payer money for the rest though I disagree with.
Why not just buy the books supplies and uniforms and pass out at school rather than hand out cash to people with the promise they will use it for school supplies?

That is a joke. 

Another politically correct adorable program that is wasted IMHO.
Oh sure the government can do these things.

****Back to school spree: Billionaire, feds give out $175M to aid neediest students around the state
BY Erica Pearson, Tanyanika Samuels, Kenneth Lovett and Adam Lisberg
DAILY NEWS STAFF WRITERS

Wednesday, August 12th 2009, 8:14 AM

Billionaire George Soros speaks at P.S. 208 in Harlem where he announced a $35 million gift for low-income families in New York to purchase supplies and clothing for the new school year.

Roberta Aguilar and her daughter Lilly Gomez (11) plan to buy a uniform for her first day of school wait at the Chase Bank on Junction Blvd in Queens.
People wait to receive 200 dollars given to disadvantaged families for school supplies.
Take our PollSoros, feds hand out $175M to needy NY kids
A $200 back-to-school giveaway for needy kids sparked a mad rush for money on the streets of New York on Tuesday.

"It's free money!" said Alecia Rumph, 26, who waited in a Morris Park, Bronx, line 300 people deep for the cash to buy uniforms and book bags for her two kids.

"Thank God for Obama. He's looking out for us."

Thousands of people lined up at banks and check-cashing shops to withdraw the cash that magically appeared on their electronic benefit cards.

Some rushed out because of rumors the money would vanish by the end of the day.

"Rumors, there's always rumors," said Teresa Medina, who waited four hours at a Pay-O-Matic in Clinton Hill, Brooklyn, to get $600 for her three teenagers - just in case they were true.

The no-strings-attached money went to families receiving food stamps or welfare.

Every child between 3 and 17 was eligible for $200, which worked out to 813,845 kids across the state - including 498,866 in the city.
"Times are really tough right now. The situation is bad with money. So it's easy to want to use the money for other things," said Ana Barcos, 31, of Corona, Queens, where 200 people waited outside a check-cashing business.

"But if the money's supposed to be for my kids, then I will use it for my kids."

Billionaire philanthropist George Soros gave $35 million toward the program, with $140 million in federal stimulus funds routed through state government making up the rest.

"It's a help," said Tania Gomez of Chelsea, who withdrew $600 for her kids. "Every penny counts nowadays. It's really something that was unexpected."

Storekeepers were glad to hear about the program, too - and the notebooks, clothes and backpacks it would buy.

"It's good for everyone," said Aziz Boughroum, 31, who works at Stevdan Pen & Stationers in the West Village.

Gov. Paterson and Mayor Bloomberg joined Soros to announce the payments at Public School 208 in Harlem, where the billionaire reminisced that as a penniless student in London, he survived because of a handout he got from Quakers.

"This gift has a special personal meaning to me, because I was once also a recipient of charity," Soros said in a choking voice. "I'm very pleased that I'm able to repay what they gave me."

Paterson's Republican critics blasted the giveaway, saying he should spend the money to reduce property taxes.

"It is a plan that is ripe for fraud and abuse," said Senate Republican leader Dean Skelos. "This is a totally irresponsible use of federal stimulus money."
2984  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 02:30:48 PM
 Doug,  I agree with you.  I got that idea from a few Rep. pundits on cable were saying it is the cost issue over the weekend though clearly others are pointing out just as Mr. Sowell is  with regards to some of the other issues.

The problem as I see it is I am just not sure how many people read Sowell who are not already inclined to agree.
Same is true for Fox and right talk radio.

It is truly a fight for the ears and minds of those in the middle.
BO and the msm still have the advantage.



2985  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Way too soon to celebrate on: August 10, 2009, 02:18:11 PM
I think Buchanan rejoices way too soon.
BO does not continue to crash in the polls like constantly stated by the right pundits.  Yes he is down but stabilizing.
And I think that they underestimate there are many people who do want a "public option" (not me), and do want a government nanny.
And I think he underestimated the Dems ability to spin this right back.
And there is still no spoke people for the Republicans.
Palin has a lot of studying to do if he thinks she can attract more than her base.
Who can convince the skeptical that the job of government is to keep level and honest the playing field and then GET OUT OF THE WAY?

The cans are still singing to the choir IMHO.

****A GOP That Can Say No
by  Patrick J. Buchanan

08/07/2009


Reports of the death of the Republican Party appear to have been premature.
     
Not since Sen. Bob Griffin derailed LBJ's scheme to replace Chief Justice Earl Warren with crony Abe Fortas, before Nixon got to the Oval Office, has the GOP defied this city and voted to reject a liberal judicial activist for the court.
     
In 1970, after revelations of scandal forced Fortas to resign, Rep. Gerald Ford moved to impeach "Wild Bill" Douglas on similar grounds. Then the fire went out -- for 40 years.
 
     
Meanwhile, Democrats trashed Republican nominees Clement Haynsworth, Harrold Carswell and Robert Bork, forced Reagan to withdraw Douglas Ginsburg, and made Clarence Thomas and Sam Alito run an Iroquois gauntlet.
     
Finally, yesterday, Senate Republicans, defying threats of an Hispanic backlash if they voted to reject the first Hispanic nominee, stood up and said no more EZ passes for any liberal judicial activist.
     
And this is only the most recent act of defiance by a party that, at long last, seems to have found its conservative compass and to be finding its way home.
     
Recuperation began when House Republicans stood beside Middle America and rejected the Bush-McCain-Kennedy-Clinton amnesty for illegal aliens, inflicting a humiliating defeat on the establishment.
     
The next sign of recovery was the decision of John McCain to damn the torpedoes and put Sarah Palin on the ticket. The smashing reception Palin received stunned mainstream media, vaulted McCain into the lead, and signaled the party what America wants it to become again.
     
The next act of defiance was the Republican rebellion against the $700 billion bank bailout of last September. Though House resistance was swiftly broken, Republican instincts were subsequently proven right.
     
Next came rock-solid Republican opposition to the mother of all pig-outs, the Pelosi stimulus package. Not one Republican voted for it in the House and only three went over the hill in the Senate. How many Blue Dogs are back home bragging about having supported that beauty?
     
Then, yesterday, mirabile dictu, the Republican minority in the Senate voted four-to-one to send Sonia back to Greenwich Village.
     
Wailed retiring Republican Sen. Mel Martinez of Florida, "We have allowed ideology to hold a preeminent role as opposed to qualifications. I find it very, very appalling."
     
But what is truly appalling is the senator's inability to understand what is going in his country.
     
For decades, a leftist ideology has permeated the Supreme Court. Protected by lifetime appointments, liberal justices have imposed upon this once-democratic republic a social, cultural and moral revolution no Congress could ever have survived imposing and no majority would ever vote for.
     
Prayer, Bible study, the Ten Commandments were purged from public schools of a nation whose coins bear the inscription "In God We Trust" and whose Constitution never mandated any kulturkampf on the birth faith of the West.
     
Pornographers were awarded First Amendment protections. Abortion, a crime in every state half a century ago, was declared a constitutional right. New shackles were put on police and prosecutors. The death penalty was outlawed for 20 years because Bill Brennan and friends did not like it. Forced busing for racial balance was imposed, generating white flight, destroying urban schools, and tearing communities apart.
     
For decades, federal judges and justices were on a rampage. For decades, we lived under a judicial dictatorship.
     
As for Sotomayor, she was a political activist whose academic and legal career is marked at every step by clamors for raced-based hiring, promotions and admissions. As a judge, she trashed the appeal of Frank Ricci and the New Haven firefighters who had been robbed of promotions they had earned in competitive exams solely because they were white.
     
She declared the New York state law denying voting rights to convicts a violation of the U.S. Civil Rights Act because it had a disparate impact on minorities, who are overrepresented in prison. Using that yardstick, Justice Sotomayor would have to vote to outlaw the death penalty.
     
Suddenly, in national politics, the momentum has shifted.
     
The Republican Party is stirring. Its poll numbers are rising, as support for Obama has fallen to 50 percent in the Quinnipiac Poll, support for his handling of the economy and deficit has fallen into the 40s, and support for his health insurance scheme has plunged to 39.
     
Of his big initiatives, the stimulus bill is looking like a loser, cap-and-trade may not survive the Senate, and national health insurance may have to be pared back -- or be killed by nervous Blue Dogs.
     
In both big races three months off, the Virginia and New Jersey governors' contests, Republicans are running 14 points ahead.
     
As they say in the press box, "Fans, we have a brand-new ball game."
     
And the reason is that some exasperated Republicans decided to declare independence of the White Houses of both George W. Bush and Barack Obama -- and "dance with the girl what brunt ya."


--------------------------------------------------------------------------------
Mr. Buchanan is a nationally syndicated columnist and author of Churchill, Hitler, and "The Unnecessary War": How Britain Lost Its Empire and the West Lost the World, "The Death of the West,", "The Great Betrayal," "A Republic, Not an Empire" and "Where the Right Went Wrong."****

2986  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The electoral process, vote fraud (ACORN et al), corruption etc. on: August 10, 2009, 01:10:44 PM
Except for Lou Dobbs everyone else is silent on the illegal issue. Even the cans are afraid of the racist label.

Geraldo Rivera states Lou Dobbs is "slandering" latinos (Dobbs is married to a latina!).

The crats are silent because they benefit from the invasion.  The media is silent because they are predominantly crat by nature.
The cans well...  are cowards?

2987  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 01:06:30 PM
Yes a lot of what is being claimed is unproven.

Even the concept of getting people to quit smoking may not reduce costs in thelong term.

From a long term financial cost vs benefit analysis it may be better to pay for the emphysema and lung and bladder cancers and till the patient dies than pay for them to live much longer lives and health cost, medicare, and social security utilization.

Surely I am not adocating this I am just stating the probable false premise that it is a cost saver.

"Even Republicans have been caught up in this idea that preventive care"

Your right.   So is the idea of moving everything to IT data based (a Gingrich focus).
No one has proven to me that this would save costs either in the short term or the long term.

I do agree it has theoretical benefits in this day of fragmented care, ie, people going to multiple hospitals, seeing multiple doctors, labs, imaging centers.  And it may have cost benefits.

But the more I read about computer systems the harder it seems to determine if they are beneficial.  Doctors' accounts that I read about are somewhat mixed.



 

2988  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 10, 2009, 10:14:17 AM
You know the crats are dissecting every criticism on their health care reform.

They will be coming out all over the airwaves with the complicit media bombarding us with denials of all the legitimate criticisms.

The cans will have to continue to expose the deceit for what it is - just that.
They should not harp on just the cost issue as I hear some talking heads saying lately.

BO's doctor from Chicago was originally quoted as saying he was against this reform.
He was on one station this weekend.  He certainly sounded like a bonified BO supporter of Democratic health reform to me.
Someone got to him and persuaded him to change his tune.  I wonder what he got.
2989  Politics, Religion, Science, Culture and Humanities / Politics & Religion / The media and BO's health care on: August 08, 2009, 09:34:45 AM
It really is astouding.  After witnessing decades of liberal rallies, anti war protests (their glory days were back when they got to rally against the Iraq war) to watch the left howl and scream over protests against the Democrat health care bill.

Almost no comments about the many deceptions of the bill itself, or Bo himself saying clearly he is for single government sponsered single payer and implying that to get there will take years of maniulation, tricks, and deception.

Here was BO on the cover of TIME in a doctor's outfit - all about a bill he neither wrote or read.



***Can't Blame Liberal Media for Health Bill Stall
BMI Study: 70 Percent of ABC, CBS and NBC Coverage Promoted Obama's Huge Health Care Takeover
By: Rich Noyes and Julia Seymour | View PDF Version 
July 28, 2009 10:48 ET



Liberal hopes for a quick health care bill are in collapse, as Senate Democrats push any floor action off until the fall, a move House Democrats may match this week. But if the Obama White House is upset that their plans for a huge expansion of government health care have been delayed, they surely cannot complain about the media coverage.

Last week, a new study by the Media Research Center’s Business & Media Institute (BMI) found broadcast coverage during the first six months of 2009 tilted heavily in favor of Barack Obama’s big government plan. BMI’s analysts looked at 224 health care stories on the ABC, CBS and NBC morning and evening news shows from Obama’s January 20 inauguration through his June 24 prime time special on ABC.

Among the key findings:

# Fully 70% of soundbites (243 out of 347 total) supported Obama’s liberal health care ideas. Only nine percent of stories (21) suggested the total price tag for Obama’s “reform” would top $1 trillion.

# Reporters exaggerated the number of uninsured Americans. Omitting non-citizens, those capable of paying, or those eligible for assistance programs already in place, a reasonable figure would be between 8 million and 14 million uninsured, not the “50 million Americans” statistic BMI’s analysts found touted by the networks.

# The networks also spent virtually no time investigating states that had experimented with big government health schemes — just one story on how Massachusetts’ plan for mandatory health insurance is working out (costs are rising faster than expected), and no stories on Hawaii’s already-cancelled program to insure all children.

BMI’s study period ended in late June, but the networks’ favors for Obama have continued in July, even as public sentiment shifted against both the President and his plan. On July 16, for example, both the NBC Nightly News and CBS Evening News skipped over how, in the words of ABC White House correspondent Jake Tapper on World News, “the President's case was dealt a blow today” when the Congressional Budget Office chief told Congress the health care plans will require massive additional spending.

The next morning, after the House Ways and Means Committee had formally passed an estimated $554 billion tax increase to help pay for the ambitious health plans, CBS skipped that development, too, as ABC and NBC’s morning news shows offered only a single sentence. NBC’s Natalie Morales, on her network’s four-hour Today, gave it just 12 seconds: “During the night, the House Ways and Means committee voted to increase taxes on higher income earners as part of a health care reform bill.”

If these had been setbacks for a big Bush administration initiative, do you think the network coverage would have been so paltry?

Reporter commentary has also betrayed a lack of objectivity. In a July 22 interview with California’s Arnold Schwarzenegger on Good Morning America, ABC's Chris Cuomo painted Republicans as endangering Americans’ health: “Do you believe that Republicans are playing politics here, at the risk of people's health care....Is this getting to be a little bit of a reckless situation?”

That night on MSNBC, after the President’s press conference, NBC medical reporter Nancy Snyderman confessed she was “rooting” for him: “As a physician, you know, I felt like I understood the complexity of the problem. As an American citizen, I was rooting for the President to hit a home run.”

The public’s anxiety seems to have delayed the day of reckoning on health care until at least this fall. The big questions: Will network reporters continue their favors for ObamaCare? And will the tilted media landscape be enough to make liberals’ policy dreams come true?***



2990  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 07, 2009, 11:38:14 AM
"Instead of angering me, the dishonest people in my world bore me.  They tell me what happened and I still don't know what happened so they waste my time by speaking.  I don't know when, if not already, the overexposed Obama will start to have that affect."

Yes I agree but the larger issue is this what we should expect or should get from our leaders?
It is now common place to assume all politicians are liars.
Why even bother to complain about this one or that one doing it, "they all do it".
Is spin, bull, and lies effective leadership?

Don't people want someone they can trust leading them?
Is this where we are in today's world?

When the occasional lie from our leaders becomes an art form of spin and deceit we have lost our way.

Some would say that W lied about the weapons of mass destruction.

At the very worst he believed they were there and believed what he was doing was best for America.
I can't think of anything else that he lied about just to make himself look good.

I can say the same about Reagan.

Why can't we have honest leaders who say what they mean and mean what they say other?

I understand why BO won't say what he means because,

he clearly has a socialist agenda.  Clearly he wants single payer government controlled health care and to redistribute wealth and put the historically white male led America in "its place".
But all of our leaders this way??

Perhaps I am expecting too much.
2991  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: August 07, 2009, 10:27:55 AM
***The bottom line is that when the government spends money on health care, the patient does not. The patient is then separated from the transaction in the sense that costs are no longer his concern. And when the patient doesn’t care about costs, only those who want higher costs—like doctors and drug companies—care.***

Well the know it all Harvard types expect that the ultimate goal - single payer and governement controlled - and conversion of all health information onto the internet will give them the control to ration, and, in that way hold down costs.


***A patient-centered approach focuses on the patient-doctor relationship and empowers the patient and the doctor to make effective and economical choices.
A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.
By empowering patients and doctors to manage health-care decisions, a patient-centered health-care reform will control costs, improve health outcomes, and improve the overall efficiency of the health-care system.***

To some extent that already takes place.  Pts all the time ask for the cheapest drugs that will work.  Some would rather pay more, if they can or choose to take the expense.

I am less clear that doctors go out of their way to hold down costs when they do get paid to do more especially when they get paid for tests.
Of course if the patient pays for a substantial part of it then they might dissuade the doctor.


2992  Politics, Religion, Science, Culture and Humanities / Politics & Religion / The great conciliator on: August 07, 2009, 09:03:41 AM
From Bama
"I expect to be held responsible," Obama said. "But I don't want the folks who created the mess to do a lot of talking. I want them to get out of the way so we can clean up the mess. I don't mind cleaning up after them, but don't do a lot of talking."

One never really knows about a  person until he is under pressure.
The real Bama is coming out.

This kind of language will only anger people even more and lead to more divisiveness.

This guy appears to be cracking.

2993  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 06, 2009, 08:01:53 PM
Doug,

The other night there was some discussion by the talking heads about this "rescue".
One asked the other who would you believe as to the true nature of what went on behind the scenes, the N. Korean government or the US government.  The intent was to suggest that only a crazy person would believe N Korea's story over the talking crats.

Sadly all I could think was that I wouldn't trust a Democrat any more than I would a N. Korean official.

Also I remember all too vividly that I could never know when Clinton was (if ever) telling the truth.  He would lie so much even if or when he was being truthful one could not know.  Clearly the same is true of BO.  Clearly the same is true of most if not all of the outspoken Democrats.

As for the picture you posted I wonder where the one is of Clinton carrying his bags full of cash on his way over to N. Korea.

2994  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Cognitive Dissonance of His Glibness on: August 05, 2009, 05:56:19 PM
And yet BO remains popular - his ratings still over 55%.
He appears divorced from the health care issue in the polls.

How can the right convince so many people that socialism is not better for them?

Obviously there are people who are fine with this notion.
2995  Politics, Religion, Science, Culture and Humanities / Politics & Religion / We are in the midst of a "soft" civil war on: August 05, 2009, 05:52:45 PM
"Cash for clunkers is an example of government doing something right"?

first one billion than three.

A billion here, a billion there.
What's a billion dollars anymore anyway?

In an age of government wherein we speak of hundreds of billions and trillions the concept of  a billion has been relegated to pocket change.

I don't listen to Sullivan.  I have seen him on the talk circuit and I have never heard anything this guy has said that made any sense.
He always sounds bizarre and makes no sense.

I have said I was for compromise.  I thought the initial Tarp had saved a castrophe.  If there was no such thing as FIDC I am convinced we would have seen a rush on banks and a collapse like '29.

But, my idea of compromise was not to spend like crazy.

Jonah Goldberg was right when he said the Democracts are like Huns crashing the gates and going nuts looting and (my words) raping and pillaging, and stealing everything they can get their paws on and throwing it all around to their friends and cronies and allies.

We really are in a "soft" civil war.

Years ago the plundering would have been done with guns.  Now it is "legal" and legitimized because the plunderers have bribed enough of an electorate to get away with it.

And yet the Rebublicans have not yet found a savior of the United States of America if one exists.

I can only hope Dick Morris is right.

2996  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Buchanan: "No evidence" Iran is working on a nuclear bomb on: August 04, 2009, 10:12:00 AM
Buchanan on the threat to Israel:

Comments Tell Israel: Cool the Jets!
by  Patrick J. Buchanan

07/31/2009


Former U.N. Ambassador John Bolton, who is wired into the cabinet of "Bibi" Netanyahu, warns that if Iran's nuclear program is not aborted by December, Israel will strike to obliterate it.

Defense Secretary Gates' mission to Israel this week, says Bolton, to relay Obama's red light, was listened to attentively, but will not be decisive.

Israel will decide.
 

One trusts Gates got into the face of Defense Minister Ehud Barak. For an Israeli strike on Iran, which Joe Biden foolishly said was Israel's call, would drag this country into a third war in the Middle East and destroy a policy that is visibly succeeding.

The Iranian regime is still reeling from the June 12 election, widely perceived in Iran and worldwide as stolen, and its tumultuous aftermath. Hundreds of thousands poured into the streets to protest the election, and then attack the legitimacy itself of the Islamic regime.

The government is gripped by its worst crisis since the revolution of 1979. Members of Iran's establishment with unimpeachable revolutionary credentials have declared the election a fraud.
   
Ahmadinejad's selection as first vice president of Esfandiar Rahim Mashaie, whose son is married to his daughter, and who has said some kind words about Israel, outraged conservatives.
   
Ahmadinejad was ordered by Ayatollah Khamenei to rescind the Mashaie appointment. For days he balked, then sent a curt note saying he would comply. Ahmadinejad further affronted the ayatollah by naming Mashaie his chief of staff.
     
Teheran is now ablaze over reports that scores of street protesters arrested in June may have been beaten to death in prison.
     
There is talk in Teheran, even before he has been sworn in for a second term, that Ahmadinejad may be impeached or ousted long before he can complete it.
     
America's policy of patience is working.
     
And as Ahmadinejad is Israel's bete noire, who Netanyahu cites as the religious fanatic who wants to "wipe Israel off the map" and will launch a nuclear weapon on Tel Aviv as soon as he gets it, why would Israel strike now, and reunite Iranians behind this regime?
     
Why does Israel insist that America has only five months to halt Iran's nuclear program, or Israel must attack?
     
Says Bolton: "(W)ith each passing day, Iran's nuclear and ballistic laboratories, production facilities, and military bases are all churning. Israel is focused on these facts, not the illusion of 'tough' diplomacy."
     
Now, Iran's nuclear "production facilities" may be "churning" out the low-enriched uranium of which it has produced enough for one test bomb. But IAEA inspectors still have their eyes on this pile. None of the LEU has been diverted anywhere.
     
There is no evidence Iran has built the cascade to raise LEU to highly enriched weapons-grade uranium, or that the facilities even exist to do this. The Iranian regime has declared it has no intention of building nuclear weapons, indeed, that their possession would be a violation of Koranic law.
     
And the United States has not rescinded its own National Intelligence Estimate of 2007 that Iran, in 2003, abandoned its weapons program.
     
Israel has been saying for years an Iranian bomb is months away.
     
Where is the proof? Where is the evidence to justify a new U.S. war in the Middle East to destroy weapons of mass destruction that may not exist in Iran, as they did not exist in Iraq?
     
Iran may wish to have a nuclear deterrent, considering what happened to neighbor Iraq, which did not. But the idea that the regime, having built a nuclear weapon, would launch it on Tel Aviv and bring massive retaliation by scores of Israeli nukes on Teheran and other cities, killing millions of Iranians and all the leaders and their families of all factions of this disputatious people, seems like total madness.
     
For Israel to launch a war on such reasoning would seem to meet Bismarck's definition of preemptive war as "committing suicide out of fear of death."
     
America lived for decades under a threat of nuclear annihilation. We relied on a policy of containment and deterrence, outlasted the Soviet regime in a 40-year Cold War, and are now at peace with Russia.
     
Ahmadinejad is not so tough a customer as Stalin, Khrushchev or Mao, who talked of accepting 300 million dead in a nuclear exchange. Moreover, Ahmadinejad has no nukes, no authority to take Iran to war, and is looking like a very lame duck before his second term has begun.
     
And when one looks to U.S. and Iranian interests, they coincide as much as they conflict. Iran detested the Taliban before we took them down, and no more wants them back than do we. Iran is even more pleased with the Shia regime we brought to power in Baghdad than we are.
     
Iran needs technology to restore its depleted oil and gas fields, and an end to sanctions to restore an economy whose disintegration helped put the regime in crisis and lose it the support of its young.
     
Obama should tell the Israelis, "Cool the jets!" literally.


--------------------------------------------------------------------------------
Mr. Buchanan is a nationally syndicated columnist and author of Churchill, Hitler, and "The Unnecessary War": How Britain Lost Its Empire and the West Lost the World, "The Death of the West,", "The Great Betrayal," "A Republic, Not an Empire" and "Where the Right Went Wrong."

--------------------------------------------------------------------------------
    Reader Comments: (844)

Here are a few of the comments submitted by our readers. Click to view all
Please remember the opinions expressed by our readers are in no way those of Human Events, nor are they condoned by us, and we reserve the right to remove abusive posts. Report Abusive Post
Seems like every time the price of oil sags, Israel (or her apologists) start floating the idea of striking Iran. Funny, isn't it?
Jul 31, 2009 @ 10:18 AMWallaby, The outback
Report Abusive Post
Is everyone who posts here anti-Semitic or just plain ignorant?
Jul 31, 2009 @ 10:35 AMRandy, Dallas
Report Abusive Post
The problem with this, of course, is that US concerns aren't the primary concern of Israel; Israel is. They also aren't stupid so I find it unlikely that they will actually launch an attack until they are sure they have no choice because they are just as aware of the fallout they'll have to deal with. However, if they believe that Iran is close to a working bomb and knowing what the likely repercussions of that would be for Israel, they're not going to care what we think. Since we're obviously not overly concerned with the effect our policies have on them, I fail to think them blamable for that attitude.
Jul 31, 2009 @ 10:48 AMMDF, Mass
Report Abusive Post
Amen. I totally agree with this. Any strike now would reverse all the hard work already done
Jul 31, 2009 @ 10:51 AMGraham, Slough
Report Abusive Post
ISRAEL, SEND THE JETS TO IRAN. Let's get this show on the road.
Jul 31, 2009 @ 10:52 AMHarold Reimann, Lucerne Valley, CA
Report Abusive Post
One big problem with your analysis Pat. The leaders of the Soviet Union were not suicidal. The leaders of Iran are. The MAD policy worked with the Soviet Union because they had no personal interest in dying. Ahmadinejad on the other hand believes he will get lots of virgins and eternal drunken party if he dies in a conflict with the “Great Satan” or “Little Satan”. He has no reason to fear annihilation.
Jul 31, 2009 @ 10:59 AMRD, Texas
Report Abusive Post
Wrong, Pat. Israel has no choice but to attack Iran and she will. She is just waiting for Obama's popularity to fall.
Jul 31, 2009 @ 11:06 AMjorgen, SShare Your Comment  Show All Comments
 
     
2997  Politics, Religion, Science, Culture and Humanities / Politics & Religion / For further evidence of the distortion of what America is about on: August 03, 2009, 09:20:27 AM
Remember how I point out the multitude of left articles published in the New England Journal.  This one is only surprising because it is written by a guy from S. Carolina.

This guy who I presume got his history lessons while residing in Russia states he has no clue what is being talked about when we speak of "American Values".

Folks, the America I knew growing up is gone.   
 
******HEALTH CARE 2009

Previous Volume 361:440-441  July 30, 2009  Number 5
 Next
 


"American Values" — A Smoke Screen in the Debate on Health Care Reform

Allan S. Brett, M.D.
 

 
 
 PDF
 PDA Full Text
 
 


 
 
 Add to Personal Archive
 Add to Citation Manager
 Notify a Friend
 E-mail When Cited
 E-mail When Letters Appear
 
 


 
 
 PubMed Citation
 
 
 
Amid all the rhetoric about health care reform, one claim has emerged as a trump card designed to preserve the current patchwork of private and public insurance and to stop discussion of a government-sponsored single-payer system in its tracks: the claim that single-payer health care — a Canadian-style Medicare-for-all system — is antithetical to "American values." The idea that American values dictate a particular approach to health care reform is often stated explicitly, and it is implicit in the generalization that "Americans want" a particular system. The underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry. Remarkably, this premise has received very little scrutiny.

Two related assumptions are buried in the language of "American values." The first is that there are archetypical Americans — that if we know someone fits the category "American," it should be possible to predict his or her general worldview accurately. However, we have good reason to doubt that assumption. In nearly all respects — ethnically, culturally, religiously, politically, and socioeconomically — Americans are increasingly diverse. The recent presidential campaign provides evidence that a monolithic conception of what it means to be "American" is problematic and outdated: those who championed the idea of "real" Americans (as distinct from Americans who are somehow less representative of American ideals) were precisely those whose candidate lost the election.

The second assumption is that Americans' personal values predictably translate into certain organizational structures for the financing and provision of health care — and that a single-payer system is not among them. Exactly what might those values be? Are they self-regarding values directed toward maximizing individual well-being and potential? Or other-regarding values such as altruism or concern for community? Clearly, most people — regardless of political, ethnic, or cultural identity — regard both sets of values as important in varying proportions; nothing precludes a single-payer system as one possible means of realizing a blend of these values.

The notion that American values militate against a single-payer system is advanced not only by advocates of preserving the status quo or making incremental changes but also by some who propose major reforms that nibble around the edges of a single-payer system. For example, Ezekiel Emanuel — now a special adviser on the Obama administration's health care team — has proposed universal health insurance funded by a value-added tax on sold goods and services; all citizens would receive government-issued vouchers to purchase health insurance from private insurance companies. According to Emanuel, such a plan "coheres with core American values: individualism and equality of opportunity." He argues that equality of opportunity dictates universal coverage and government funding, but individualism dictates preservation of the private insurance system: "Americans clamor . . . for the chance to choose. . . . We want to choose our insurance plans, our hospitals, our doctors."1

The theme of "choice" also surfaces in the writing of Tom Daschle, President Barack Obama's initial pick for secretary of health and human services. In his book Critical, Daschle proposes universal coverage delivered through a private–public hybrid plan. He all but admits that a single-payer system is the best solution but abandons the idea because it is "politically problematic" and because "compared to residents of [European countries], Americans are more supportive of choice and suspicious of government."2

Suppose that "freedom to choose" is indeed the paramount American value relevant to health care. For many people, it would surely imply choice of physician, hospital, or clinic. For such choice, a single-payer system beats the competition hands down. Incremental reforms preserving the private insurance industry and employer-based insurance would probably perpetuate the restricted choice of health care providers that many Americans already encounter: private plans typically limit access to certain physicians or hospitals, and physicians often refuse to accept certain plans. In contrast, single-payer proposals eliminate those restrictions.

Another possible meaning of "choice" is the freedom to choose from an array of private insurance companies. Here it is important to acknowledge that insurance is only a means for collecting and disbursing health care funds — not an end in itself. The key question is therefore whether private insurance is superior to single-payer insurance in achieving the desired end of efficient, cost-effective health care. Here, too, the single-payer system would probably prevail. Because administrative costs are consistently lower in single-payer systems than in private-based systems, more of the health care budget goes directly to patient care (and less to administration) in single-payer systems. Thus, Americans have been misled by the rhetoric about choice. In contrast with the single-payer option, a system with multiple private insurers would continue to restrict one dimension of choice (selection of physicians) and perpetuate a choice most people would consider irrational (wasteful spending on administrative overhead).

A third dimension of choice is the freedom to choose whatever test or treatment a patient wants. This choice is system-neutral, pointing to neither single-payer nor alternative systems. Any reform initiative must control spending; unproven or unnecessary medical interventions should not be available in any system.

A closely related rhetorical device — the idea that Americans or American values are "unique" — also deserves attention. For example, Emanuel describes individualism and equality of opportunity as "uniquely American."1 Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, asserts that a public–private hybrid is essential because it is a "uniquely American solution."3 Others describe rugged individualism as a "uniquely American" value that makes us "reluctant to provide our tax dollars to support someone else's health care."4 Such defiant-sounding assertions imply that "uniqueness" is a matter of pride and an end in itself. But these generalizations are impossible to prove, a distraction in the debate, and ultimately irrelevant. What is relevant is whether a solution works, not whether it is unique. Indeed, the aspect of the current U.S. system that is truly unique among developed countries is its failure to cover everyone — hardly something to brag about.

In their book Benchmarks of Fairness for Health Care Reform, Norman Daniels and colleagues reject these "ungenerous" views of our values, arguing that past failures to reform health care are better explained by the influence of interest groups whose wealth and power are threatened by reform.5 The authors propose that fair equality of opportunity is a more promising and relevant American value. Opinion polls support this proposal: in multiple surveys of randomly selected Americans during the past decade, more than 60% of respondents have favored government-guaranteed health care for all. Although these responses don't necessarily specify a single-payer system as the only model for government-guaranteed insurance, they surely do not exclude it.

Policymakers debating health care reform should stop hiding behind the smoke screen of "American values." Discussions dominated by references to uniquely American individualism, uniquely American solutions, or narrowly defined conceptions of choice tell us more about the political and economic interests of the discussants than about the interests of the Americans they claim to represent. In an increasingly diverse country that has a widening gap between rich and poor, a more promising approach is to start with the questions that matter to everyone: Will the system care for us when we're sick and help prevent illness when we're well? Will we have access to medical care throughout our lives without risking financial ruin? Will we be able to navigate the system easily, without jumping through unnecessary hoops or encountering excessive red tape? Will health care spending be managed wisely? Health care reformers owe Americans a system that best addresses these questions — not one that merely pays lip service to ill-defined "American values."

No potential conflict of interest relevant to this article was reported.


Source Information

From the University of South Carolina School of Medicine, Columbia.

References


Emanuel EJ. Healthcare, guaranteed: a simple, secure solution for America. New York: PublicAffairs, 2008:12-6.
Daschle T. Critical: what we can do about the health-care crisis. New York: Thomas Dunne Books, 2008:144, 204.
Medical News Today. Sen. Baucus hopes to introduce comprehensive health reform legislation this summer. March 5, 2009. (Accessed July 10, 2009, at http://www.medicalnewstoday.com/articles/141193.php.)
Garson A Jr, Engelhard CL. Health care half-truths: too many myths, not enough reality. Lanham, MD: Rowman & Littlefield, 2007:131-2.
DanielsComments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.
 
2998  Politics, Religion, Science, Culture and Humanities / Politics & Religion / I don't know *big* government can be defeated on: August 03, 2009, 09:14:16 AM
"The wild success" raves we are hearing all over the air waves about the cash for clunkers situation just goes to show how tax payers have no say in anything.
One guy is on cable this am saying he bought his car some years ago for $4K and traded it in with 220K miles for $4500.
I don't get it.  This is not monopoly money.  This is tax money going to give this guy a huge discount - more than the value of his car.

Why is there not outrage?

Why is there this glee in the media that this plan is great?

Am I missing something?

Of course people willl  rush for these deals if they can qualify for free funny money.

The greatness of the US is over folks.
2999  Politics, Religion, Science, Culture and Humanities / Politics & Religion / Re: The Politics of Health Care on: July 31, 2009, 10:04:26 AM
"And providers could be paid an annual fixed fee for the primary care of an individual and a separate fixed fee for the treatment of a specific condition"
Hospitals are already paid by Medicare this way. It is called the diagnostic related groups.
As for providers our reimbursements have continually gone down for years.
The incentive for doctors is to see more patients if you are a thinking type doctor and do more procedures if that is how you get paid.
I am not sure how up front or say yearly payments to treat overall conditions would work.
Certainly the incentive is then to do less.
Is that good?  I don't know.
3000  Politics, Religion, Science, Culture and Humanities / Science, Culture, & Humanities / correction on: July 29, 2009, 10:44:32 AM
I owe Friedman an apology.
Katherine tells me I mixed up Kelly Clarkson with Carrie Underwood who was the one who was "inducted" into the Gran Ole Opry.
My correction noted.  As for Clarkson, Katherine believes her lyrics were oddly like words she wrote and disappeared from her possesion (the same is believed for Underwood).  Perhaps that was the whole modus oper. behind Clarkson's suddenly deciding to "write her own songs".  Someone simply got her the songs and a deal was made.  It is possible Davis knew they stunk and after they proved to be bombs then said more or less, "I told you so".

Many of the lyrics are not that great.  It appears that when the crooks run low on material they start using the less good lyrics.
It only takes one really good set of lyrics out of ten songs to get one over the top.
And one never knows.  Songs thought to not be likely to sell sometimes do.

 
Pages: 1 ... 58 59 [60] 61 62 ... 76
Powered by MySQL Powered by PHP Powered by SMF 1.1.19 | SMF © 2013, Simple Machines Valid XHTML 1.0! Valid CSS!