Since so many essayists and commenters are interested in the activities and consequences of people espousing ideology of false patriotism, dominionism, fundamentalism and other -isms, I thought I'd play with the principles a bit and explore what can be done to counteract the effects.

The framework of a preferred paradigm that I'm using is that of embracing the classic virtues. Don't remember them? You're not alone.

But along with rediscovering our shared history, we might do worse than to rediscover and revisit the classic virtues.

A caveat for those of you who aren't familiar with my posts: I am very dyslexic, myopic, and arthritic. I re-read my posts and most often continue to edit them for wrong words, poor grammar and unclear sentences after I post. I appreciate it when readers point our errors, and I do my best to make posts works-in-progress which reflect commenters' participation and contributions.

There are many scholarly texts which outline characteristics of cults and attributes of members. This isn't a post to regurgitate or criticize those foundational works.

Essentially, the things that most people look to cults to fill are factors of socialization:

• Clear rules of membership
• Delineation of US and OTHERS
• Reward system for compliance
• Punishment and threat of shunning/ostracism for noncompliance
• Clear normative values

This post originally was going to compare the attributes of cults with today's two major political parties in how they court voters, but I'm now going to hijack my own essay and speak to leadership values. Keep the attributes of cults handy in looking at attributes NOT to reward, enable or use in selecting political candidates.

My own education and academic career - what little of it there is - revolves around the study of leadership, albeit confined to that in healthcare settings.

I am going to generalize some of the qualities to that of the concept of leadership per se. Your mileage will vary, so please take away what is useful, and save the rest as bird cage liner or fodder to ponder another day.

I come at leadership characteristics and qualities from a pragmatic point of view. If a leader can only lead in the abstract sense, then I don't tend to find it useful.

Some of the characteristics of effective leaders - those who are able to affect the targeted and desired changes with the least amount of resistance or impediment, are those who demonstrate the following:

Consistency: they don't act in unpredictable and surprising ways, unless that is their usual mode of operation.

Congruency: they act according to the values they espouse, and the target behaviors they set for others

Visibility and Accessibility or MBWA: the old management by walking around style is always in evidence. They seek out members of the group they lead - either all of them or representative samples. They listen, they ask questions, depending on the work, they may try it, they solicit feedback, and they communicate in accessible face to face venues.

Honesty and Transparency: they deliver progress reports which include negative information. They deliver news accurately, in context and comprehensively.

Reward desired behaviors liberally: there is a little cognitive psychology in evidence. Behaviors, acts and benchmarks that move toward the desired targets are praised, rewarded and highlighted. Negative behavior and active resistance is ignored.

Value contributions: they actively seek out and pay attention to the contributions of their team members/constituents/followers

Own Failures and Limitations/Give Away Successes: they take full responsibility for failures and setbacks, and they give full credit to others for successes.

External appearances are deceiving: they rarely present self-conscious fashionable or glamorous appearances. They tend to be the work horses in organizations. They show up, listen, take note, contribute to the success of the organization, and they work diligently by placing the success of the organization ahead of their own personal gain.

It's this last that is being lost in the US. Those people now are often shunted aside for the younger/wealthier-appearing/smoother-talking/connected person. And it's showing in the treatment of workers, in the quality of work overall, and in the falling behind in competition of US centered businesses.

What's the point?

You can use these qualities to rate the presidential candidates for leadership attributes and likely leadership in the White House. You can use them to evaluate candidates for any position of responsibility and leadership. You can use them to work on your own progress as a leader.

If you used a Likert scale of 0 = does not exhibit, 3 = sometimes exhibits, and 5 = consistently exhibits to measure each of the candidates, who takes top honors?

Apply the criteria to Bush, Cheney, Rumsfeld, Rice, Powell, etc. See any patterns emerging?

One ready reference that uses many of these characteristics is Jim Collins in his work, Good to Great.

One concept that he emphasizes is getting the core values right. What are they?

In the case of the office of president of the US, they are simple: supporting and defending the Constitution. It's critical that you can say what the core values are of any activity that is important to you: work, school, hobby, elected representative, civic group, social group, entertainment, spirituality, commerce, etc. When you do something, "just because" or you allow yourself to make an uninformed choice, you run much higher risks - whether it's in something small, as in the flavor of your coffee, or something huge, as in the course of cancer treatment or whether or not to choose resuscitation in the case of your heart stopping. And if it isn't already obvious, it also applies to group choices, as in the selection of a president - for a country or for a local parent teachers association.

Why?

If you don't know what qualities are important to you for a given situation, you cannot choose a leader who emulates and supports those values, even when the leader is yourself.

Take Aways

To evaluate any candidate for leadership, use the following criteria to rate on a scale from never exhibits to consistently exhibits:

• Consistency
• Congruency
• Visibility and Accessibility
• Honestly and Transparency
• Reward desired behaviors liberally
• Value Contributions
• Own failures and limitations
• Share/Give away successes
• Outward appearances are deceiving

Use the criteria in your individual lives. Treat people using these leadership characteristics in all situations other than crises. (Crisis management calls for very different skill sets used for very short term purposes - say, for example, evacuating everyone in immediate danger from a fire.) Use them to select your candidate of choice at the voting booth. Use them to help move the progressive values system forward. Use them to highlight the failures and limitations of the current occupants of the White House.

And now back to my original post - about using the classic virtues to fight against fighting faux values that the Republicans espouse: the definition of marriage, the criminalization of women's health choices, the criminalization of everything that fringe dominionist fundamentalists oppose, etc.

Classical virtues

First a definition from The Free Dictionary:

Noun
1. cardinal virtue - one of the seven preeminent virtues
virtue - a particular moral excellence
natural virtue - (scholasticism) one of the four virtues (prudence, justice, fortitude, and temperance) derived from nature
supernatural virtue, theological virtue - according to Christian ethics: one of the three virtues (faith, hope, and charity) created by God to round out the natural virtues

• Auctoritas — "Spiritual Authority" — The sense of one's social standing, built up through experience, Pietas, and Industria.
• Comitas — "Humour" — Ease of manner, courtesy, openness, and friendliness.
• Clementia — "Mercy" — Mildness and gentleness.
• Dignitas — "Dignity" — A sense of self-worth, personal pride.
• Firmitas — "Tenacity" — Strength of mind, the ability to stick to one's purpose.
• Frugalitas — "Frugalness" — Economy and simplicity of style, without being miserly.
• Gravitas — "Gravity" — A sense of the importance of the matter at hand, responsibility and earnestness.
• Honestas — "Respectability" — The image that one presents as a respectable member of society.
• Humanitas — "Humanity" — Refinement, civilization, learning, and being cultured.
• Industria — "Industriousness" — Hard work.
• Pietas — "Dutifulness" — More than religious piety; a respect for the natural order socially, politically, and religiously. Includes the ideas of patriotism and devotion to others.
• Prudentia — "Prudence" — Foresight, wisdom, and personal discretion.
• Salubritas — "Wholesomeness" — Health and cleanliness.
• Severitas — "Sternness" — Gravity, self-control.
• Veritas — "Truthfulness" — Honesty in dealing with others.

Notice, though, that this is merely a listing of classic Roman virtues.

There are many other notable systems of prescribed and proscribed virtues. But for utility, I am limiting the discussion to these, as many are referenced in the qualities and characteristics of leadership above.

If we as a society used this framework of preferred or desired characteristics by which to measure our elected representatives, the congruence of legislation with the Constitution, and used the classic virtues to measure the overall "meta" success of US society, would this not be more useful than continuing on the current path of divisiveness, class separation, socioeconomic disparity and faux morality being used as a disguise to install theocracy in government?

Journalism Under Bush's Off-The-Record Briefing Ground Rules

Open post to Brian Williams of NBC News:

In response to this from your Daily Nightly blog, in which you wrote

A number of television journalists gathered for lunch with the president at the White House today -- a practice becoming more and more common when this president has a major speech to deliver. The following is a review of my notes, and is offered here under the ground rules established by the assembled White House senior aides. Vice President Cheney attended but did not speak.

I realize that you don't publish my comments, pointed and critical as they are, but I hope that you are at least reading and considering them in the spirit in which they are offered.

Journalists are considered the 4th estate. To that end, the public relies on you (the plural you) to be assertive in pursuing clear, accurate and comprehensive information from reliable sources, and that you perform adequate fact-checking. Moreover, the public expects you to refrain from editorializing to the extent that is possible for educated humans to accomplish.

That translates into questioning and protesting such intolerable conditions as the "ground rules" that the White House is mandating for off-the-record briefings.

We, the people, supposedly elect those occupants of that branch, and we have full rights to know what the president and his cabinet (and whatever the heck the VP is calling his position in the branches these days) are doing, what his plans are, what his rationale is, what resources he is actually using, who his advisers are, etc.

It is not acceptable for NBC News, a la Tim Russert's court testimony, to assert that everything is assumed to be off the record as baseline, and that only when express permission is obtained, that sources are revealed.

To be blunt, that is un-American.

We now live in a topsy Orwellian world of doublespeak.

I am no politico, no genius and no one of import. But I highly recommend that you reacquaint yourself with Orwell's 1984 and Sinclair Lewis' It Can't Happen Here. Read some Morrow. Read some 1930's history.

Speak with your international print and television news colleagues. Try to step outside the US media market and look at it from a global point of view.

It's frightening. And you, your counterparts at ABC and CBS, and the anchors of the political commentary cable "news" shows are not meeting the public need.

What would be a good start?

In the transcripts, include the citations for all presented facts and sources.

In the NBC News Division, include professional CVs for all anchors, reporters, correspondents and news writers and researchers. Tell us your academic credentials, your professional experience, and even jobs held in other industries to help us understand your perspective.

Most important, provide full disclosure for any and all relationships between you and your subjects.

If you're still reading, I thank you!

Please consider hosting reader/blogger fora. Having Chris Colvin present her blog round-up twice weekly is a real treat, and she's first rate, but that's just a start.

It would be very interesting to have a working forum with key bloggers and NBC News staff to develop working relationships and to create some synergistic effects.

Not for "nuthin'" - it might be useful to get a better handle on the demographics of bloggers - especially those in the political blogosphere. My guess is that's where your market share growth is, but only if you learn how to tap in to the blogging fire hose.

Thanks for reading. I'm always open to criticism, too, and please don't hesitate to provide it. *g*

That SCHIP Won't Sail

{Crossposted at DocuDharma. Permission to use noncommercially with attribution.}

While Congress was away, Bush continued to do his sneaky freaky Friday attack on S-CHIP. Much of this post is simply a replay of events that occurred prior to Congress' return last week. But one thing Bush forgot in his unrelenting quest to punish the poor, the sick, the elderly and the vulnerable: the senators are facing those people at the polls, and they aren't looking too good when it comes to cutting off people at the knees.

So the senators are mutinying against Bush's bowl of strawberries re-enactment. The only think lacking is the presidential candidate with enough spine to act as a realistic Mister Roberts. A cross between the mutiny on the Bounty and Mister Roberts, the governors are finding themselves smack dab in the middle of where policy meets constituent suffering.

On Friday August 17th in the usual news dump, timed to garner the least amount of traditional media attention, the Bush White House orchestrated two attacks on healthcare: CMS announced that it will no longer reimburse for healthcare services provided as a result of some types of what it deems preventable medical errors, and Bush announced that he is severely crippling the SCHIP program. Scarecrow, at FireDogLake, analyzes this from a sociopolitical standpoint that makes one's straw spontaneously combust.

In addition, just prior to the Senate's August recess, Jim DeMint (R-SC) put a hold on the SB 558 Mental Health Parity bill.

Robert Pear of the NY Times has been providing excellent descriptions and analyses of the seemingly disparate news items. In the SCHIP Friday night stealth attack, states would be held to an unrealistic standard of covering eligible children at a 95% rate.

The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.

Administration officials outlined the new standards in a letter sent to state health officials on Friday evening, in the middle of a monthlong Congressional recess. In interviews, they said the changes were intended to return the Children’s Health Insurance Program to its original focus on low-income children and to make sure the program did not become a substitute for private health coverage.

After learning of the new policy, some state officials said yesterday that it could cripple their efforts to cover more children and would impose standards that could not be met.

“We are horrified at the new federal policy,” said Ann Clemency Kohler, deputy commissioner of human services in New Jersey. “It will cause havoc with our program and could jeopardize coverage for thousands of children.”

Stan Rosenstein, the Medicaid director in California, said the new policy was “highly restrictive, much more restrictive than what we want to do.”

The poverty level for a family of four is set by the federal government at $20,650 in annual income. <snip>

As with issues like immigration, the White House is taking action on its own to advance policies that have not been embraced by Congress.

In his budget in February, President Bush proposed strict limits on family income for the child health program. Both houses of Congress voted this month to renew the program for five years, but neither chamber accepted that proposal. Legal authority for the program expires on Sept. 30.

The administration’s new policy is explained in a letter that was sent about 7:30 p.m. on Friday to state health officials from Dennis G. Smith, the director of the federal Center for Medicaid and State Operations. The policy would continue indefinitely, though Democrats in Congress could try to override it.

--snip--

In his letter, Mr. Smith set a high standard for states that want to raise eligibility for the child health program above 250 percent of the poverty level.

Before making such a change, Mr. Smith wrote, states must demonstrate that they have “enrolled at least 95 percent of children in the state below 200 percent of the federal poverty level” who are eligible for either Medicaid or the child health program.

Deborah S. Bachrach, a deputy commissioner in the New York State Health Department, said, “No state in the nation has a participation rate of 95 percent.”

And Cindy Mann, a research professor at the Health Policy Institute of Georgetown University, said, “No state would ever achieve that level of participation under the president’s budget proposals.”

In the Medicare Friday news, Pear reports about the policy change, and also a little-noticed, but important fact: healthcare insurers are waiting with bared fangs, ready to rip into hospital and physician reimbursement with more claims denials. Patients are at risk of being denied care when they are deemed too high risk to incur an infection, illness or injury as a result of a designated "preventable medical error" such as a bedsore or a venous access infection. Hospitals, physicians and insurers will be in direct adversarial positions to patients, who are going to be blamed for preventable errors at every opportunity.

The other risk is that when hospitals are denied reimbursement, they will respond by decreasing direct care staff - and usually the highest earners in this category are registered nurses, and hence, they are the most vulnerable to downsizing. This starts another cycle of poorer patient care and leads to yet more complications and preventable errors. And so the vicious cycle spins with more patients caught in its vortex.

In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

--snip--

Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients.

Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”

Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

Susan M. Pisano, a spokeswoman for America’s Health Insurance Plans, a trade group, said, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.”

In early August, just before the Senate recessed, Jim DeMint put a hold on SB 558, the Mental Health Parity bill. The Congressional Quarterly via the Kaiser Network reported:

A hold placed by Sen. Jim DeMint (R-S.C.) has delayed until after the August recess Senate consideration of a bill (S 558) that would mandate mental health parity, CQ Today reports. The measure, sponsored by Sen. Pete Domenici (R-N.M.), was on track to be passed by voice vote before the August recess after insurers, businesses and mental health advocates had reached a compromise. However, DeMint and Sen. Tom Coburn (R-Okla.) placed holds on the legislation. Coburn’s hold was dropped after his concerns were addressed, but DeMint maintained his hold, saying that the bill should be discussed on the floor before approval, according to CQ Today. “Sen. DeMint isn’t holding this bill, he is simply objecting to passing it without a chance for debate or amendments,” DeMint spokesperson Wesley Denton said, adding, “[T]his is a very large and costly mandate that could price a lot of Americans out of health insurance, and it needs to be considered carefully” (Armstrong/Wayne, CQ Today, 8/7).

What links these three seemingly disparate actions by Bush and the Republicans?

• All three were done when Congress was caught unawares.


• All were done under tight time frames and little time for Congress to respond and take defensive action.


• All were taken against populations that either can't vote (children) or that are more likely to be unable to vote (those with untreated or under-treated mental illness and those who suffer life-altering complications as a result of the types of "preventable medical errors" listed in the Medicare reimbursement proposal).


• All are direct attacks on providing essential healthcare to the most vulnerable segments of the US population.


• All are aimed at attacking single payer insurance


• All are aimed at providing more sources of profit for private healthcare insurers.


• All are aimed at undermining government agencies' efficacy and efficiency.

A couple of other related facts:

There are 1.8 million veterans who have no health insurance whatsoever, and of whom the majority suffer from untreated or under-treated mental illness and chronic physical illness. The Army has been issuing chapter 5-13 discharges in order to get out of providing needed mental healthcare to returning Iraq and Afghanistan soldiers and marines. With the gross disparity in mental health benefits being shockingly restricted or nonexistent, and the almost 50% rate of soldiers incurring symptoms of acute mental illness, how are these denials of care, parity and reimbursement going to "support our troops"?

When children don't receive vaccines, preventive dental and healthcare, and subsequently transmit communicable diseases in their communities, how are all Americans assured of adequate and safe public health?

When patients who are at high risk to fall, have compromised immune systems leaving them vulnerable to infections, or are confused and wander denied hospital admission and physician care due to the perceived risk that the providers may not be reimbursed for care, what happens to them?

Americans' public health is not secure. Bush is not protecting America. He's doing just the opposite; he's making Americans much, much more vulnerable to becoming victim to communicable diseases, to suffering needlessly because of a lack of accessible and affordable essential healthcare, and of causing those preventable deaths and complications - the very things he won't allow Medicare to pay for.

What can you do?

• Write to your Senators and to your Representatives.


• Politely demand that the hold on SB 558 - the Mental Health Parity Bill - be lifted and the bill passed.


• Demand that the promised Bush veto of the S-CHIP Reauthorization bill be overridden in order to protect more children.


• Demand that the Senate take action to prohibit Bush from restricting eligibility of children for SCHIP.


• Explain how denying children essential healthcare puts the nation's public health at risk.


• Explain that withholding reimbursement for healthcare after patients receive infections or bed sores ultimately punishes the patients. Suggest that Medicare reward optimal patient outcomes with higher reimbursement rates instead of denying reimbursement altogether for errors. Explain that determining what is and is not preventable is at best a grey area, and that some patients will be denied care as a result.


• Write letters to the editor of your local newspaper explaining the Bush and Republican attack on Americans' health.


• Blog about health issues, and how your health is being affected.

What Goes Around, Comes Around

One need not travel far to read the current Republican/Democratic argument about healthcare. It goes like this:

‘There’s another fellow,’ muttered Scrooge; who overheard him: ‘my clerk, with fifteen shillings a week, and a wife and family, talking about a merry Christmas. I’ll retire to Bedlam.’

This lunatic, in letting Scrooge’s nephew out, had let two other people in. They were portly gentlemen, pleasant to behold, and now stood, with their hats off, in Scrooge’s office. They had books and papers in their hands, and bowed to him.

‘Scrooge and Marley’s, I believe,’ said one of the gentlemen, referring to his list. ‘Have I the pleasure of addressing Mr. Scrooge, or Mr. Marley?’

‘Mr. Marley has been dead these seven years,’ Scrooge replied. ‘He died seven years ago, this very night.’

‘We have no doubt his liberality is well represented by his surviving partner,’ said the gentleman, presenting his credentials.

It certainly was; for they had been two kindred spirits. At the ominous word ‘liberality,’ Scrooge frowned, and shook his head, and handed the credentials back.

‘At this festive season of the year, Mr. Scrooge,’ said the gentleman, taking up a pen, ‘it is more than usually desirable that we should make some slight provision for the Poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir.’

‘Are there no prisons?’ asked Scrooge.

‘Plenty of prisons,’ said the gentleman, laying down the pen again.

‘And the Union workhouses?’ demanded Scrooge. ‘Are they still in operation?’

‘They are. Still,’ returned the gentleman, ‘I wish I could say they were not.’

‘The Treadmill and the Poor Law are in full vigour, then?’ said Scrooge.

‘Both very busy, sir.’

‘Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course,’ said Scrooge. ‘I’m very glad to hear it.’

‘Under the impression that they scarcely furnish Christian cheer of mind or body to the multitude,’ returned the gentleman, ‘a few of us are endeavouring to raise a fund to buy the Poor some meat and drink, and means of warmth. We choose this time, because it is a time, of all others, when Want is keenly felt, and Abundance rejoices. What shall I put you down for?’

‘Nothing!’ Scrooge replied.

‘You wish to be anonymous?’

‘I wish to be left alone,’ said Scrooge. ‘Since you ask me what I wish, gentlemen, that is my answer. I don’t make merry myself at Christmas and I can’t afford to make idle people merry. I help to support the establishments I have mentioned—they cost enough; and those who are badly off must go there.’

‘Many can’t go there; and many would rather die.’

‘If they would rather die,’ said Scrooge, ‘they had better do it, and decrease the surplus population. Besides—excuse me—I don’t know that.’

‘But you might know it,’ observed the gentleman.

‘It’s not my business,’ Scrooge returned. ‘It’s enough for a man to understand his own business, and not to interfere with other people’s. Mine occupies me constantly. Good afternoon, gentlemen!’

Seeing clearly that it would be useless to pursue their point, the gentlemen withdrew. Scrooge resumed his labours with an improved opinion of himself, and in a more facetious temper than was usual with him.

Senators' Revolt and The Defense Takes The Field

This is why I admire the Kaiser Daily Health Policy Report. It posted a very deep and broad listing of actions, measures and groups working in opposition to the Bush offensive against S-CHIP.

New York is already in court against the Bush administration's strangling restrictions.

Forty four senators sent a letter to Bush appealing for him to lift the odious enrollment compliance regulation (it states that 95% of all eligible children be enrolled, and the best practice is in the range of 65-70%).

Current authorization for SCHIP expires at the end of the month. Contact your senator today to express your view that S-CHIP eligibility must be allowed for states to determine the baseline given cost of living variabilities. The Senate must have enough votes to override Bush's veto. Or else.

Or Else?

Many more children will die preventable deaths.

On our watch.

In our names.

Health News Roundup

I'm still making this up as I go along. Today's focus is on finding some of the gems about healthcare and health policy that you can subscribe to via email. These are typically daily reports with excerpts and kinks to primary health and policy resources. They are deeply referenced, cited transparently, and they have a high degree of reliability and validity.

Feedback makes me all warm and fuzzy - and it makes the quality and focus better for you, dear reader. Please let me know what you think, what you would like to read, and what stories and issues you're interested in reading about. Here's your cup to sip from the health fire hose. *g*

Health References About Public Health And Pandemic Influenza

The Flu Wiki

The purpose of the Flu Wiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic. This is a task previously ceded to local, state and national governmental public health agencies. Our goal is to be:

* a reliable source of information, as neutral as possible, about important facts useful for a public health approach to pandemic influenza
* a venue for anticipating the vast range of problems that may arise if a pandemic does occur
* a venue for thinking about implementable solutions to foreseeable problems

No one, in any health department or government agency, knows all the things needed to cope with an influenza pandemic. But it is likely someone knows something about some aspect of each of them and if we can pool and share our knowledge we can advance preparation for and the ability to cope with events. This is not meant to be a substitute for planning, preparation and implementation by civil authorities, but a parallel effort that complements, supports and extends those efforts.

While we will continue to administer and maintain the Wiki, we are turning the wheel over to the community, to take it where the road leads us.

Influenza Pandemic Preparation and Response: A Citizen’s Guide v.1.3 (PDF)

Use Doctrine
This manual is meant to be a guide for many citizens in its present form, but we
encourage individuals, communities, and organizations to revise and adapt it to their
individual needs and cultures and to translate it into other languages. We ask that
such revisions reference the original document and remain in the public domain.
Revisions should be posted on fluwikie.com so that those derivates will be widely
available. To check for current updates to this manual, please visit
http://www.fluwikie.com/pmwiki.php?n=Consequences.VersionHistory
Corrections and Additional Acknowledgments
If you wish to correct an error in this manual or if you find material for which the
original author or source is not properly acknowledged (an increasingly common
and unavoidable problem in the age of multiple postings and of extracts that do not
retain identification of the original source) please document your concern and email
it to PandemicPrepAndResponse@gmail.com.

Reuters Humanitarian Crisis Alerts

Want to know about flu in Fiji or cholera in Colombia? Easy and fast search functions to find crisis, locations, severity and statistics.

AHRQ Public Health and Pandemic Flu Information, News and Guides

The Agency for Healthcare Research and Quality's research in public health emergency preparedness is an outgrowth of its mission to develop evidence-based information to improve the quality of the U.S. health care system. This is critical to the U.S. Department of Health and Human Services developing programs to combat bioterrorism and other public health emergencies such as pandemic flu.

To help communities prepare for a flu pandemic and other emergencies, AHRQ offers these tools from its Bioterrorism and Emergency Preparedness Program.

Health Policy Subscriptions

Kaiser Daily Health Policy Report

Add Daily Reports via RSS

Kaisernetwork.org provides four daily online reports -- summaries of news stories with links to the original articles and a fully searchable archive. The Kaiser Daily Health Policy Report, the Kaiser Daily HIV/AIDS Report, the Kaiser Daily Women's Health Policy Report and the Kaiser Health Disparities Report keep you in touch with legislative, political, legal, scientific, and business developments in each area. Issues include Medicare reform, Medicaid, patients' rights, access, the uninsured, minority health, children's health and health care advertising.

Kaiser First Edition, available each weekday morning at 8:30, provides headlines and links to the day's top stories and events.

You may also be interested in GlobalHealthReporting.org's Weekly TB/Malaria Report, which provides summaries of malaria and tuberculosis news stories, containing links to original articles and related resources.

Email DailyReports@kaisernetwork.org with story submissions and press releases.

Enhanced Search: Based on user feedback, we have improved the Daily Reports Search so you can more effectively search by date, sort by date or relevance, narrow your search results and more.

This is my favorite. The reportage is fast, timely, heavily referenced and fairly comprehensive.

Fierce Healthcare is a proprietary daily newsletter that is also referenced well, has a fairly comprehensive approach to issues coverage, and leans heavily toward promoting healthcare IT issues, in which it has a business interest.

AHRQ Patient Safety Network

AHRQ Patient Safety Network (PSNet) is a new national web-based resource featuring the latest news and essential resources on patient safety. The site offers weekly updates of patient safety literature, news, tools, and meetings ("What’s New"), and a vast set of carefully annotated links to important research and other information on patient safety ("The Collection"). Supported by a robust patient safety taxonomy and web architecture, AHRQ PSNet provides powerful searching and browsing capability, as well as the ability for diverse users to customize the site around their interests (My PSNet). It also is tightly coupled with AHRQ WebM&M, the popular monthly journal that features user-submitted cases of medical errors, expert commentaries, and perspectives on patient safety. AHRQ PSNet and AHRQ WebM&M are both funded by the Agency for Healthcare Research and Quality and edited by a team at the University of California, San Francisco, with the technical support of Silverchair.

Subscribe here.


Today's Health News

Health Insurance Gaps Keep Would-Be Retirees Working

The number of Americans between 65 and 74 who are still working has jumped sharply, from 19.6% in 2000 to 23.2% last year, the Census Bureau said today. This morning’s Washington Post suggests several reasons for the jump, but one caught the Health Blog’s eye: Cuts in retiree health benefits have pushed employees to work longer to save on health care costs.

“People are simply hanging on to their job as a way to hang on to their income and to their health insurance so they can supplement their Medicare coverage,” Christian Weller, a University of Massachusetts professor and a senior fellow at the liberal Center for American Progress, told the paper.

Health Savings Accounts Aren't Catching On

A closely watched survey of employer-sponsored health insurance released today is getting attention for finding a 6% rise in premiums this year.

That headline number is climbing faster than inflation, though still below the double-digit increases of a few years back.

But the Health Blog was interested in a nugget buried inside the results. High-deductible insurance plans tied to special savings accounts continue to lag behind expectations, despite being praised high and low as a tool to slow the rise in health-care costs.

The Wall Street Journal is always looking for the free market, employer-focused angle.

Here's the New York Times' take on the same report:

Cost of Health Insurance Rises Again, but at a Slightly Slower Rate

The cost of employer-sponsored health insurance premiums has increased 6.1 percent this year, well ahead of wage trends and consumer price inflation, but below the 7.7 percent increase in 2006, the Kaiser Family Foundation reported yesterday.

Because doctor and hospital costs continue to rise at an even faster rate, the modest slowdown in insurance inflation mainly reflects cutbacks in coverage by many health plans, which have found ways to make employees pay more for their care. Industry experts said that without those measures, premium costs would have risen by 9 percent or more.

The total average annual cost for family coverage premiums rose this year to $12,106.

“For that kind of money, you could buy a compact car every year,” said Drew Altman, president of the Kaiser Foundation, a nonprofit group that produces the widely watched annual survey. He noted that health costs had increased 78 percent since 2001, more than four times the pace of prices and wages.

The 2007 increase was the smallest annual rise since 1999, when health premiums jumped 5.3 percent.

When the cupboard is bare, there isn't anything left over to put into HSAs (healthcare savings accounts).

That's a wrap for today. Your doses of flu references, email health news subscriptions and individuals' healthcare insurance costs will keep you wise to the latest in prevention and self-preservation.

Where The Surge Is Working

There is a real effective surge in Iraq. It just isn't with the combat forces.

Cholera is surging through the country.

A cholera epidemic in northern Iraq has infected approximately 7,000 people and could reach Baghdad within weeks as the disease spreads through the country’s decrepit and unsanitary water system, Iraqi health officials said Tuesday.

The World Health Organization reported that the epidemic is concentrated in the northern regions of Kirkuk and Sulaimaniya and that 10 people are known to have died. But Dr. Said Hakki, president of the Iraqi Red Crescent Society, a relief organization that has responded to the epidemic, said that new cases had turned up in the neighboring provinces, Erbil and Nineveh, indicating that the disease had spread.

What is cholera?

Cholera is an acute diarrhoeal infection caused by ingestion of the bacterium Vibrio cholerae. Transmission occurs through direct faecal-oral contamination or through ingestion of contaminated water and food. The disease is characterized in its most severe form by a sudden onset of acute watery diarrhoea that can lead to death by severe dehydration and kidney failure. The extremely short incubation period - two hours to five days - enhances the potentially explosive pattern of outbreaks, as the number of cases can rise very quickly. About 75% of people infected with cholera do not develop any symptoms. However, the pathogens stay in their faeces for 7 to 14 days and are shed back into the environment, potentially infecting other individuals. Cholera is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. Individuals with lower immunity, such as malnourished children or people living with HIV, are at greater risk of death if infected by cholera.

Isn't that a disease from the Middle Ages?

During the 19th century, cholera spread repeatedly from its original reservoir or source in the Ganges delta in India to the rest of the world, before receding to South Asia. Six pandemics were recorded that killed millions of people across Europe, Africa and the Americas. The seventh pandemic, which is still ongoing, started in 1961 in South Asia, reached Africa in 1971 and the Americas in 1991. The disease is now considered to be endemic in many countries and the pathogen causing cholera cannot currently be eliminated from the environment.

Two serogroups of V. cholerae - O1 and O139 - can cause outbreaks. The main reservoirs are human beings and aquatic sources such as brackish water and estuaries, often associated with algal blooms (plankton). Recent studies indicate that global warming might create a favourable environment for V. cholerae and increase the incidence of the disease in vulnerable areas.

Who is at risk? How do they get it? Global warming - is Al Gore behind this?

Cholera is mainly transmitted through contaminated water and food and is closely linked to inadequate environmental management. The absence or shortage of safe water and sufficient sanitation combined with a generally poor environmental status are the main causes of spread of the disease. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met. However, it is important to stress that the belief that cholera epidemics are caused by dead bodies after disasters, whether natural or man-made, is false. Nonetheless, rumours and panic are often rife in the aftermath of a disaster. On the other hand, the consequences of a disaster -- such as disruption of water and sanitation systems or massive displacement of population to inadequate and overcrowded camps -- can increase the risk of transmission, should the pathogen be present or introduced.

Since 2005, the re-emergence of cholera has been noted in parallel with the ever-increasing size of vulnerable populations living in unsanitary conditions. Cholera remains a global threat to public health and one of the key indicators of social development. While the disease is no longer an issue in countries where minimum hygiene standards are met, it remains a threat in almost every developing country. The number of cholera cases reported to WHO during 2006 rose dramatically, reaching the level of the late 1990s. A total of 236 896 cases were notified from 52 countries, including 6311 deaths, an overall increase of 79% compared with the number of cases reported in 2005.

Was it a surprise? Um - NO!

AMMAN, March 22 (Reuters) - United Nations agencies working in Iraq warned on Thursday a chronic shortage of safe drinking water risks causing more child deaths and an outbreak of waterborne disease such as cholera during the summer.

Four years after the U.S.-led invasion of Iraq in 2003, millions of Iraqi children still find that safe water is no easier to access, said a statement issued by leading U.N. aid agencies operating in Iraq.

Does General Petraeus have a slide for this?

The major human displacement caused by the Iraq conflict — people being driven from their homes or simply choosing to leave — is likely to be driving the epidemic, officials say.

Who is helping?

Between 23 August and 6 September 2007, the cumulative number of cases of acute watery diarrhoea reported from five out of eleven districts of Sulaymaniyah Governate stands at 3,182 including 9 deaths (case fatality rate, CFR: 0.3%). Of these reported cases, Vibrio cholerae has been laboratory confirmed in 283 stool specimens.

During the period from 29 July to 2 September 2007, the health authority of Kirkuk Governate reported a total of 3,728 cases of acute diarrhoeal disease including 1 death (CFR: 0.03%). The first index case of cholera, confirmed by laboratory test, was reported from Kirkuk Governate on 14 August 2007. Most recently, six laboratory-confirmed cases of cholera were reported from Erbil Governate.

The Government of Iraq has mobilised a multi-sectoral response to the outbreak. A high-level National Committee on Cholera Preparedness and Outbreak Response has been established. The provincial health authorities of Sulaymaniyah, Kirkuk and Erbil Governates have initiated a number of public health control measures to contain the outbreak, including risk assessment, improving water safety and sanitation, strengthening the surveillance system for diarrhoeal disease, improving coordination and information flow, standardising clinical case management, mobilising medical and other essential supplies, and implementing social mobilisation and health education campaigns. All public water supply systems in the affected districts have been chlorinated by the provincial authorities. In addition, water samples from the public water supply sources are being collected and tested routinely to ensure they meet potable water safety standards.

WHO, UNICEF, UNDP, International Committee of the Red Cross (ICRC), a number of non-governmental organisations including the International Medical Corps (IMC), and Médecins Sans Frontières (MSF - France) are supporting the Ministry of Health and local health authorities in ongoing response operations.

The Numbers

Up until the Iraq epidemic, in 2005 WORLDWIDE, there were 236,896 total number of cases with 6311 deaths.
In Iraq alone now, there are 3182 cases with 9 deaths, and the number is exploding. For comparison, in 2004, the WHO reported 35 cases of cholera in Iraq with zero deaths.

Imagine for just a moment. You have explosive, debilitating diarrhea. It's over 100 degrees. You have no refrigeration, no bottled water, no cans of broth, soup and jello, no rehydration fluids, no toilet paper, no air conditioner or fans, no ice, no flushing toilets, no clean potable water of any kind, no medication, no clinic or hospital. How do you feel now?

Not a single US agency in the mix of health and relief agencies tackling this national nightmare. The US breaks a country, causes a 100% preventable epidemic, causes untold suffering, and leaves the mess for the international relief community to address.

And Americans have already learned that every single governmental agency is headed up with partisan political appointees who will report distorted and false information at the mandate of the Bush White House. So there is no trust in anything that the CDC or the HHS has to say about a cholera epidemic.

In Iraq with military supply lines becoming increasingly imperiled, it's only a matter of time before the beleaguered and exhausted troops also succumb to cholera. They are tired, they may not have timely and adequate deliveries of bottle or treated water, and just as they had to host bake sales to raise funds to purchase their own body armor, they have no guarantee that the White House won't fail them again, since the budget always funds political donors, regardless of what the troops need.

Love in the time of cholera. Not just a book title anymore.

Hearts and minds, baby.

Health News Roundup

{Crossposted at DocuDharma. Permission to use noncommercially with attribution.}

I thought I'd create a little links fest for those who would like to sip from the firehose that is health and healthcare. 

This post is for novice readers and features some core and must-have reference links.

Since I'm a two a day essayist, and I already used one of my daily offerings, I'll add the links for the major highlights of today at the bottom.  If you like what you read, or if you would enjoy something different, please let me know in the comments, and I'll adjust accordingly.

Health Policy Links

Kaiser Network Health08.org

Excellent website with RSS feeds, links and stories about politics intersecting with healthcare.  All of the presidential candidates' stances on healthcare are included in table format.

The Commonwealth Fund

The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries.

Health Affairs Blog

After twenty-five years as a non-profit, bimonthly print journal and six years in online publishing, Health Affairs has entered the blogosphere as a new means of engaging readers in the health policy debate. The journal is all about an ongoing dialogue on health policy issues of concern to a diverse audience of interested readers. Read more from Health Affairs' founding editor John Iglehart on why the journal has started a blog.

What will the blog include?

Health Affairs plans to experiment with the blog. Some posts (short, invited commentary) will be clustered around a hot topic. Some will be one-time postings on news items of interest. Linking and interactivity will be key. Our goal is to offer a range of views, not to push a particular agenda.

The main elements will include:

  * invited posts from leading policy analysts;
  * responses from a variety of health care stakeholders;
  * comments welcome from all readers;
  * links to timely information both within Health Affairs and from other sources;
  * staff-written posts on policy briefings, new reports, hot policy topics

Institute of Medicine

The nation turns to the Institute of Medicine (IOM) of the National Academies for science-based advice on matters of biomedical science, medicine, and health. A nonprofit organization specifically created for this purpose as well as an honorific membership organization, the IOM was chartered in 1970 as a component of the National Academy of Sciences.

The Institute provides a vital service by working outside the framework of government to ensure scientifically informed analysis and independent guidance. The IOM's mission is to serve as adviser to the nation to improve health. The Institute provides unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society, and the public at large.

Health News Links

Highlight Health blog

Highlight HEALTH serves as an information medium to provide knowledge and understanding of dietary supplements, nutrition and health news. We evaluate scientific information, disseminate research results and educate readers who are seeking better health to promote an enhanced quality of life.

PhysOrg.com

This is a don't miss site which lists breaking stories from the science, health and tech fields.  Best to subscribe from a reader as the content flows fast and furious, and almost always ahead of everyone else.

PogoWasRight.org blog

Privacy news, discussions, and resources.

The Pump Handle blog

The Pump Handle is a place for people interested in public health and the environment to discuss the issues that interest us, particularly when they're not getting the treatment we think they deserve in the mainstream media.

The story of the pump handle is familiar to any first-semester public health student: During the London cholera epidemic of 1854, John Snow examined maps of cholera cases and traced the disease to water from a local pump. At the time, the prevailing theory held that cholera spread through the air, rather than water, so Snow faced criticism from others in the science community - not to mention resistance from the water companies. He finally convinced community leaders to remove the pump's handle to prevent further exposure.

More than a century later, thousands of people still die from cholera each year, and providing clean drinking water to the world's entire population is a far-off goal. The Pump Handle symbolizes both a public health victory and the challenges facing the public health and environmental fields today.

Most of this blog's founding members are epidemiologists from the US, and we'd like to bring in writers from other disciplines and places.

Today's Health News Links

Compensation for 9/11 Rescue, Recovery, and Cleanup Workers

It is time for Congress to enlist the nation's science and policy experts to help develop a federal workers' compensation program for 9/11 rescue, recovery, and cleanup workers. The inadequacy of state worker programs led Congress to legislate special compensation programs for uranium miners, and civilian workers in nuclear weapons facilities. We did not require the families of those killed in the terrorist attacks to rely on state workers' compensation programs. The September 11th Victim Compensation Fund (pdf) provided more than $7 billion to families of the victims. 

Wall Street Journal Health Blog Renewed Calls for Better Care for 9/11 Responders

"To think we're indebted to their efforts but we're really not doing enough to deal with their health concerns and their health impacts, it's really a sad commentary," New Jersey Democrat Frank Pallone said yesterday, the Associated Press reported.

The ailments common among those close to the site after the attack include post-traumatic stress, gastrointestinal illnesses and a range of respiratory conditions, such as asthma.

Pallone is part of a bipartisan group on Capitol Hill that recently wrote to administration officials asking for more information about plans to continue funding health care for responders and others. He'll chair a hearing on the subject next week.

And a few days ago, three New York congressmen (Democrats Carolyn Maloney and Jerrold Nadler, and Republican Vito Fossella) said they will introduce a bill that would establish a federal program that among other things would guarantee monitoring and care for residents, area workers and school children, in addition to those who worked and volunteered at ground zero.

Last, but in the theme of the last shall be first, please pay attention to this.  The HHS has been using progressives most recently by hosting a phony blog about pandemic flu planning.  Its chief shill, Dr. John Agwunobi, went from blogging false information about flu pandemic planning to jumping ship and going directly to Wal-Mart as its director of health and wellness.  A true Orwellian use of the term.. The AMA should be looking very sharply at a physician who is shilling for Republicans and spouting misinformation. There's a word for that - malpractice.

Hard Time on the HIPAA Front

It's been a week of bad news for lazy or sloppy health care organizations. An employee fired after a security breach of protected health information filed a wrongful termination suit against his former employer, and it may have merit because of poor policies. A community health care provider hacked by a disgruntled employee may be dragged into a compliance quagmire because it's not clear that the organization took basic steps to revoke his access. And to top it off, the U.S. Department of Health and Human Services (HHS) is starting to swing the enforcement rule -- a dowdy part of the Health Insurance Portability and Accountability Act (HIPAA) that few people read -- like a scythe in a field of weedy policies and overgrown practices.

GAO Report Reveals Serious Shortcomings in National Strategy to Counter Pandemic Influenza

Chairman Waxman, along with Rep. Tom Davis, Rep. Bennie Thompson, and Sen. Judd Gregg, release a new GAO report revealing serious shortcomings in the nation's pandemic preparedness.

The report urges a clearer definition of the federal government's role, promotes interagency cooperation, and advises the development of a coherent national strategy to deal with pandemic influenza. The lawmakers call on the Administration to address the problems identified in the GAO analysis.

That's the link patrol for today.  Too much?  Not enough?  Just right?

Take the temperature and let me know the diagnosis.

Liberal and Conservative Hard-wired

PhysOrg is just rich with interesting bits today. The latest to come across the site is that I-Told-You-So study which demonstrates that there appear to be hard-wired traits that are distinguishable between people who self-describe as liberal as opposed to conservative.

Aristotle may have been more on the mark than he realised when he said that man is by nature a political animal.

Dozens of previous studies have established a strong link between political persuasion and certain personality traits.

Conservatives tend to crave order and structure in their lives, and are more consistent in the way they make decisions. Liberals, by contrast, show a higher tolerance for ambiguity and complexity, and adapt more easily to unexpected circumstances.

The affinity between political views and "cognitive style" has also been shown to be heritable, handed down from parents to children, said the study, published in the British journal Nature Neuroscience.

Intrigued by these correlations, New York University political scientist David Amodio and colleagues decided to find out if the brains of liberals and conservatives reacted differently to the same stimuli.

A group of 43 right-handed subjects were asked to perform a series of computer tests designed to evaluate their unrehearsed response to cues urging them to break a well-established routine.

{snip}

The match-up was unmistakable: respondents who had described themselves as liberals showed "significantly greater conflict-related neural activity" when the hypothetical situation called for an unscheduled break in routine.

Conservatives, however, were less flexible, refusing to deviate from old habits "despite signals that this ... should be changed."

Interesting that many doctoral programs insist upon entering students signing a commitment to tolerate and to embrace ambiguity and uncertainty.