Search results for healthcare

This week is a busy travel week, but I’m thankfully staying put. Particularly in light of the media firestorm and passenger reactions over TSA’s full-body scanners and pat down procedures. The centrepiece of all of this is the “don’t touch my junk” meme::

Last year, I blogged about Jeffrey Goldberg going after TSA’s policies, dubbing them security theatre. He wrote an article in The Atlantic about how he snuck contraband on flights, going on The Colbert Report showing what he was able to sneak through en route to the taping.

The problem with security theatre is that it might make passengers feel safer, but it does little to thwart terrorism. Take the liquids ban for example. If liquids are found by TSA screening, which isn’t a 100% probability, it’s just pitched into a pile that goes into a landfill. None of the liquids are tested before the flight, so there’s no way to know if there was a real threat. What does this tell terrorists? It’s a numbers game. Getting caught and the discovery of an actual terror plot is a matter of probability.

It’s not feasible to test all liquids, but it insults the intelligence of passengers to think that security measures are effective. Plus, security is only as good as the weakest link in the security chain. If a passenger clears security in Amsterdam and if they’re on a suspected terrorist list and this isn’t communicated between airports and security agencies, that’s a gaping hole in security.

Another issue is security with respect to cargo and freight. Also of note is that the recent package threat from Yemen wasn’t found by chance, but by counter-terrorism intel. What I’ve been reading on the issue is that its the intel, not the security theatre that matters.

On CNN a few minutes ago, there was a story on the issue and mention of a GAO report calling into question the effectiveness of the full-body scanners. Moreover, there is another report that alleges that the scanners do a poor job at detecting things without edges. So, if you have a pancake-shaped flat explosive, it would be hard to catch. An ASU researcher, Peter Rez, found that the probability of dying from a terror strike and from radiation emitted from the scanners is the same. His concern::

“The thing that worries me the most, is not what happens if the machine works as advertised, but what happens if it doesn’t.”

It’s apples and oranges to compare this technology to X-rays, given that TSA employees aren’t healthcare professionals and X-ray machines don’t get the throughput of an airport.  I cannot find evidence that there’s proper training and failsafes to prevent accidents. My take is that the technology is offering little security benefits above existing measures {which may be doing precious little in terms of thwarting real terrorism}, at added cost, and added health risks.

Public opinion is turning on the TSA, as we approach the 10 year anniversary of 9/11. I think the public has a sense that this is being sprung on them, which is possibly a TSA communication failure. If it turns out that the GAO report {CNN could not obtain a copy} and Rez’s work starts to foster doubts with the media, the public, and policymakers, the TSA will be on the firing line. While John Pistole, TSA head is trying to spin that they’re trying to balance security and privacy, it’s clear that their policies are evolving and that the agency is rolling out technologies and procedures that aren’t passing muster::

“Yes, what we have done is go back to those entities such as the GAO (Government Accountability Office) and the inspector general who have done covert testing to show that we are not being thorough enough in our screening because they’re able to get through the screening, gone back to them and to say, OK, how can we be better informed if we modify our screening then what are the risks we deal with, so that’s what we’re dealing with.”

The scanners cost $130,000—$160,000 and are part of an increasing US tendency to move towards technological solutions in matters of security. I’m getting a sense that the deployment of the full body scanners is a boondoggle and that the Obama administration should review TSA policies and perhaps make an example out of them in order to show an interest in eliminating wasteful spending.  Overhauling an unpopular agency, cleaning house, and cutting costs, well, that seems like low-hanging fruit to me.

Twitterversion:: [blog] Thanksgiving approaches w/TSA pwned for costly scanners & invasive patdowns. Will Obama administration clean house? @ThickCulture @Prof_K

This Chronicle of Higher Education article, “The Shadow Scholar”, was posted to a friend’s Facebook wall yesterday and I’ve been enjoying the fracas in the comments {I personally love the grammar pedants}, which are more interesting than the article itself. The article does know its audience and how to extract the most emotion and righteous indignation from those in the ivory tower and the blowback from those who realize that the institution of higher learning is what it is—increasingly, a business.

The article is written in half-sneer {hint:: all part of the formula} that chronicles an academic mercenary’s career path and his work of crafting prose and poetry for those with ambitions beyond their abilities. Perhaps this is part of a trajectory of a more egalitarian system that is open not just to those with pedigrees, but to those who, let’s face it…can navigate the system. The article describes the clients who are desperate and willing to pay to get through their academic hurdles, from admissions essays to doctoral dissertations. He points the finger squarely at acadème itself, which is bound to raise hackles. He takes direct aim on the field of education::

“I, who have no name, no opinions, and no style, have written so many papers at this point, including legal briefs, military-strategy assessments, poems, lab reports, and, yes, even papers on academic integrity, that it’s hard to determine which course of study is most infested with cheating. But I’d say education is the worst. I’ve written papers for students in elementary-education programs, special-education majors, and ESL-training courses. I’ve written lesson plans for aspiring high-school teachers, and I’ve synthesized reports from notes that customers have taken during classroom observations. I’ve written essays for those studying to become school administrators, and I’ve completed theses for those on course to become principals. In the enormous conspiracy that is student cheating, the frontline intelligence community is infiltrated by double agents. (Future educators of America, I know who you are.)”

Then, there’s this wry observation::

“The 75-page paper on business ethics ultimately expanded into a 160-page graduate thesis, every word of which was written by me. I can’t remember the name of my client, but it’s her name on my work. We collaborated for months. As with so many other topics I tackle, the connection between unethical business practices and trade liberalization became a subtext to my everyday life.”

I think many in acadème have stories of know of less than honourable behaviour by colleagues and acquaintances. I know of a Masters of Healthcare Administration student, at a large public university in California, who graduated after submitting a thesis with statistical analyses he outsourced but was clueless with respect to what the printouts meant. More disconcerting was the fact that he didn’t have a clue on what consisted of an interesting research question, let alone how one would go about crafting a research design. His advisor gave him comments, but the student quickly deleted them off of his Blackberry—a combination of “who cares, I passed” and a gnawing sense of inadequacy, as this student wasn’t accustomed to receiving anything but high praise for his work and knew he just “got by”. The advisor could have held up his degree, but that would just mean more work and I’m sure he his plate was full.

Regarding academic scholarship, I know of questionable tactics regarding authorship played by those navigating the tenure game. Grad students get shafted, coauthors get dumped. I think it would be naïve to believe that there aren’t mercenaries out there helping the ambitious get tenure and promotion, ghostwriting books, chapters, and solo-authored articles.

Is higher education broken and, if so, why?

Well, higher education is a business, but it also is one of the last, enduring feudal systems. I feel this combination is a recipe for disaster in these late-modern times. Being a business, colleges and universities need to profit maximize, but are also tied to a more feudal tradition, with concepts like honour and mentorship are regarded highly. I recall being in a business faculty meeting and we were discussing ethics and cheating in the classroom. Talk was circulated on how Chinese students often see “cheating” as part of business and defended their actions as learning how to game the system. Well, if you think about it, gaming the system in varying degrees is what we’re all being taught—it’s what’s rewarded in our everyday lives.

Entrepreneurs are often celebrated in our culture, as risk taking mavericks that innovate and create new paradigms, Schumpeterian growth, and wealth. Take a look at this TED talk with entrepreneur Cameron Herold::

About 5 minutes in, he freely admits to cheating and having others do his accounting assignments at Carleton. His take is that entrepreneurs don’t do accounting, they hire accountants. It’s all about figuring out the system and gaming it. Sounds like those accounts of what the Chinese students were allegedly saying. Getting back to the original article, one commenter {3. skaking} makes a good point about whether the author’s services are in less demand where there’s an emphasis on education, not evaluation. Getting back to business side, the question is whether or not there’s a market for truly “educated” students versus “evaluated” ones. I’m not so sure there is, but I hope one can be developed. It should be a charge of higher education to make this happen.

Twitterversion:: [blog] Commentary on “The Shadow Scholar” article in The Chronicle of Higher Educ. Plagiarism, feudalism, & capitalism http://url.ie/86an @ThickCulture @Prof_K

I’m from New Orleans and have been studying the city in the five years since Hurricane Katrina hit.  One of the ongoing stories has been about how to restore and improve medical care in Post-Katrina New Orleans.  The immediate aftermath of Katrina saw many potential patients receiving care in the cities to which they had evacuated.  Not so in Haiti, where the doctors have come to the patients.

Two days ago, I went to the field hospital set up by Médecins Sans Frontieres (Doctors without Borders) to see my housemate, Joris.  This was a hospital without walls, at least the kind that don’t flap in a strong thunderstorm like the one that hit the day after my housemate suffered an injured shoulder in a motorcycle accident.  According to the statistics reported in an article last month in the Los Angeles Times, of 20, 000 surgeries from 2001 to 2008 performed by Doctors Without Borders in remote or impoverished areas such as Haiti, only 0.2 percent resulted in fatalities.  This demonstrates that such procedures can be performed in resource-poor regions with little or no technology.

One technological limitation that affected Joris was the absence of an MRI machine.  The MRI could tell doctors about the extent of damage to the meniscus in his shoulder, something the X-ray device available to them couldn’t do.  As a result, Joris left Port-au-Prince to return to his country of origin and citizenship, Belgium, for an MRI.  He hopes to be back before the Haitian presidential election in the second half of November.  It is his opinion that medical care is better after the earthquake than it was before January 12.

What if MSF/DWB came to New Orleans?  They did do an assessment soon after Katrina struck the city.  Customarily, they operate in less developed countries such as Haiti, where they have been since 1991.  While Haiti’s health care has improved because of their work, New Orleans needs a Lobbyists Without Borders to advocate in the state capital in Baton Rouge for healthcare for people without many resources.

I’m from New Orleans and have been studying the city in the five years since Hurricane Katrina hit.  One of the ongoing stories has been about how to restore and improve medical care in Post-Katrina New Orleans.  The immediate aftermath of Katrina saw many potential patients receiving care in the cities to which they had evacuated.  Not so in Haiti, where the doctors have come to the patients.

Two days ago, I went to the field hospital set up by Médecins Sans Frontieres (Doctors without Borders) to see my housemate, Joris.  This was a hospital without walls, at least the kind that don’t flap in a strong thunderstorm like the one that hit the day after my housemate suffered an injured shoulder in a motorcycle accident.  According to the statistics reported in an article last month in the Los Angeles Times, of 20, 000 surgeries from 2001 to 2008 performed by Doctors Without Borders in remote or impoverished areas such as Haiti, only 0.2 percent resulted in fatalities.  This demonstrates that such procedures can be performed in resource-poor regions with little or no technology.

One technological limitation that affected Joris was the absence of an MRI machine.  The MRI could tell doctors about the extent of damage to the meniscus in his shoulder, something the X-ray device available to them couldn’t do.  As a result, Joris left Port-au-Prince to return to his country of origin and citizenship, Belgium, for an MRI.  He hopes to be back before the Haitian presidential election in the second half of November.  It is his opinion that medical care is better after the earthquake than it was before January 12.

What if MSF/DWB came to New Orleans?  They did do an assessment soon after Katrina struck the city.  Customarily, they operate in less developed countries such as Haiti, where they have been since 1991.  While Haiti’s health care has improved because of their work, New Orleans needs a Lobbyists Without Borders to advocate in the state capital in Baton Rouge for healthcare for people without many resources.

Video:: Biden to Obama, “This is a big f*cking deal”

The signing of the healthcare bill last week was significant in more ways than one. I feel it galvanized the Democrats and I also feel it was critical for Obama to make the healthcare bill “personal” and get fellow Democrats to be rowing in the same direction. I think this was quite a challenge, as the liberal factions of the party are ideologically distinct from the more conservative Blue Dog Democrats.

In the wake of the signing, the Democrats got good news in the form of a public opinion poll reporting 49% saying the bill was a good thing, compared to 40% saying it was bad. There was also a spike in donations, with $1M pouring in last Tuesday without a direct ask.

There has been a backlash and alleged incidents of offices being vandalized. The Republicans needed to respond to thwart any momentum, but I’m not convinced their strategy is sound. Sarah Palin started a bit of controversy with her reload and targeting comments in a speech in Senate Majority Leader Harry Reid’s hometown of Searchlight, NV::

The media tried to whip Sarah Palin’s “targeting” and “reload” comments into pageview fodder, but I think the big issue for Republicans is a lack of a message that resonates with a country in the economic doldrums. John McCain claims that Palin’s words are just political rhetoric::

While this all makes for good drama, I’m not sure how effective this type of press coverage is in building support. I can’t help but think of the utter carnage of the 1994 midterm elections. Bill Clinton was weakened by a lack of support in Congress from his own party as a Washington outsider and…Newt Gingrich’s Contract with America. This C-SPAN footage is a bit dry, but it shows a systematic delineation of undermining public support of Democrats and was more successful than many anticipated. The Democrats would go on to lose 8 seats in the Senate and 54 in the House, earning a majority in both.

I think there was and perhaps still is an opportunity for the Republicans to pick up quite a few seats, but there needs to be rhetoric that moderates can sink their teeth into. Without a more substantial agenda resonating, I predict low turnout, as voters sit the midterms out.

Twitterversion:: Post healthcare, Dems get bump in polls & donations last wk. Rep. backlash ensues. Doubtful if 2010 will be another 1994 @Prof_K

Song:: Okkervil River-‘Our Life Is Not a Movie’

Tonight is Barack Obama’s State of the Union address. Let’s hope it’s more exciting than Steve Job’s iPad announcement and I’m sure many Dems. hope it elicits less ridicule.

The WSJ has an even article on Rahm Emanuel, the White House Chief of Staff, about how he’s taking heat from the left.

“The friction was laid bare in August when Mr. Emanuel showed up at a weekly strategy session featuring liberal groups and White House aides. Some attendees said they were planning to air ads attacking conservative Democrats who were balking at Mr. Obama’s health-care overhaul.

‘F—ing retarded,’ Mr. Emanuel scolded the group, according to several participants. He warned them not to alienate lawmakers whose votes would be needed on health care and other top legislative items.”

From a strategic perspective, I feel both the Republicans and Democrats are rudderless. The Republicans have taken potshots at Obama and the Democrats, but don’t have a unifying vision. The Democrats led by Obama are taking heat for not addressing the problems-at-hand head-on and the left wing of the party feels the administration is compromising ideology.

A year ago, Obama was ushered in on a mandate of change. Emanuel is a Clintonian centrist and deals in a raw pragmatism in the service of getting things done. So, while many in the Democratic party in wake of the loss of Ted Kennedy’s old Senate seat in Massachusetts {hey, I spelled it right, unlike Coakley} think the party should go more centrist. Strategically, the Obama administration needs to address the concerns of the people in effective ways. While Emanuel’s centrist pragmatism may seem like a reasonable way to push policies through, it’s passive. Love him or hate him, George W. Bush was good at changing the game with the help of Karl Rove. Jon Stewart for weeks has lambasted the Dems. for focusing so much on retaining a filibuster-proof Senate majority, something W never had. While it could be argued that this is because of many centrist constituencies that Senators are beholden to, I see a dearth of effective communication and policies that people can get behind.

The lack of support on health care reform is a perfect storm. The right has framed it as a government interventionist boondoggle and the left have failed to communicate what they perceive the stakes to be. I see “centrist pragmatism” as resulting in the proposed healthcare legislation, which is overly complex, hard to understand, and reeks of compromise.  As we’ll see below, healthcare is now the “wrong” issue, no matter how hard politicians try to spin it as being tied to the economy.

Rahm’s centrism is wrongheaded, but blindly following a hard left agenda would also be a mistake. I think the Obama administration needs to look at the priorities of the people and the challenge will be to craft policy addressing these and communicating how the policy will effect change.

What are the public’s priorities?  According to a Pew Research study conducted earlier in the month, overall, the economy is looming large as a concern::

Terrorism is third, with the Christmas airline bombing attempt fresh in people’s minds. The next three are interesting with possible drivers:: social security {decimated retirement plans and obliterated pensions}, education {rising costs}, and Medicare {rising pharmaceutical costs}. Breaking things down by ideological lines, the following pattern emerges::

Interestingly, what matters to all groups is pretty similar. Healthcare is only in the top 5 for Democrats, painting the issue as partisan, given its divisiveness.

What to do? All roads lead to the economy and while the deficit is a concern, strategically, I see populist Keynesian measures that put people to work as a way to win over independents, appeal to the Democratic base, and would be hard for Republicans to fight.

Twitterversion:: Centrist pragmatist R. Emanuel under fire from left-Democrats, but what about people’s priorities? Insights fr. Pew data. http://url.ie/4sen  @Prof_K

I’m on the road in Iowa City, but I saw that this has been floating around the blogosphere {“hat” tip:: LQ}::

So, how do you take this?  Straight-up or with a twist?  Apparently, this caused a ruckus on HuffPo.  Some days are facepalm days over there.

Twitterversion:: #TheHat takes on healthcare in lowfi multimedia glouriousness.  #ThickCulture @Prof_K

Song:: Tymps (The Sick in the Head Song) – Fiona Apple

I was up in the wee hours when I saw the BBC announce that Obama won the Nobel Peace Prize.  I recall reading years ago that the process is not necessarily a rigorous screening, in that the decision can be guided by a select few.  I wondered if this was perceived as a contrast effect, with Barack being perceived as an internationalist, despite being in the office for a very short period of time when the nomination was submitted.  A friend of mine put on my Facebook wall a link to this article were Polish Solidarity leader Lech Wałęsa echoed the sentiments of many…too fast.

Malcolm Gladwell had this Tweet::

“Question: Is the goal of the Nobel Peace Prize committee to reward progress of an individual or to encourage the progress of society?”

If we think about progress in peace, what would that look like?  What should be the next steps, globally, for the Obama administration?  It’s tough given the state of the economy, as the electorate is less interested in peace and more interested in jobs and the healthcare issue.  So, will this be a headache for him as the US decides what to do in Afghanistan?   Is there pressure for him to act in a certain way?  At the end of the day, it’s the US electorate that matters.  It might spur some thinking about creative solutions for situations like Afghanistan where peacekeeping is an oxymoron no matter the deployment of resources.  It might also accelerate some housecleaning of US detention policies of foreign suspects.  Like the Nobel Peace Prize committee and the world, we shall see.

Twitterversion::  Obama wins #Nobel Peace Prize, but what does it represent? What r next steps,globally? Natl security polcy? #ThickCulture http://url.ie/2mcp @Prof_K

Song:: If I Had A Rocket Launcher – Bruce Cockburn

In honor of the Obama’s campaign’s decision to adopt a creative commons copyright license over a traditional copyright, I’ve added a video of the Health Care Transition Team responding to calls for citizen feedback on how to address the health care issue. The video includes former Senate Majority Leader and soon to be Health and Human Services Secretary Tom Daschle (BTW — I dig the red specs).

Matthew Burton is underwhelmed about the whole thing. I’m definitely whelmed (which apparently means the same as overwhelmed). While the clip fails to uncover the magic bullet solution to the health care crisis, it does something perhaps as important — it brings thousands of people into the conversation about the health care issue. The participatory potential for the web is not that it will turn every American into a policy wonk. God forbid! Seriously! The promise is that it will democratize the process of elite selection. All the participatory tools in the world are not going to yield more that a subset of Americans to be engaged in most policy issues. But having an additional 4,000 voices in a discussion can help policy makers identify blind spots that a handful of “experts” might overlook. This video has amassed 3,700 comments in 36 hours. The big question for those of us who think and write about stuff like this is what happens to those 3,700 after they have watched the video and posted a comment? Do they read the other posts? Are they promoting their own blog? What results from this semi-structured, popcorn popper of ideas, insults, and negotiations? Citizens!?!?!