Chemical Dependency Care Coordinator        
WA-Bremerton, Chemical Dependency Care Coordinator Provide administration & support for Chemical Dependency prog including patient case mgmt. Coordinate services & perform admin functions related to STR Hub & Spoke Grant. Assist in activities related to projects in support of program goals. Bachelor's deg in related field. Min 5 yrs exp in Chemical Dependency Counseling health care setting pref. Required: Licen
          MDS Coordinator RN        
NC-Mount Airy, Position Description We focus on people. Our residents. Their lives. Their health. Their families. We are one of the largest providers of short-term and long-term health care services in the United States. Through our affiliated entities, we provide services through skilled nursing facilities in 23 states. We are committed to providing compassionate, family oriented short-term and long-term care.
          Ambi Pur’s New TVC Focuses on Refreshing Monsoons        
Shrutee K/DNS

Mumbai, August 4, 2017:-Ambi Pur’s Smelly to Smiley campaigns have always challenged and conquered the toughest and most pungent odours in a real time set up with live experiments. The third edition of the Smelly to Smiley campaign focuses on yet another very relevant odour issue that most have us have encountered – the problem of the lingering monsoon odour that plagues all Indian households during the season. While monsoons have always stood for happy, fun times, growing up brings us face-to-face with monsoon-related issues. Akin to the advertisement format that has become synonymous to Ambi Pur, the new TVC is a real-life experiment at a real consumer’s home, where a unique sensorial challenge is conducted. After all, how often would you come across people with blind folds and pegs on their noses?

This interesting play on the senses reveals that a home, which may look immaculately clean, may, in reality, be perceived as unclean because it is doused with the damp monsoon odour. This TVC, conceptualized by Grey Group, features Brand Ambassador Boman Irani who presents a reality check in context to the damp, lingering odours that specially torment during monsoons. Launching nationally on August 03, the TVC positions the New and Improved Ambi Pur, with odour-clear technology, as the perfect solution to restore freshness to your favorite season. 

The recently released findings from a survey conducted by AC Nielsen, commissioned by Ambi Pur, unearthed the extent of suffering that these damp, musty odours impose on all of us. In fact, 9 out of every 10* women felt that monsoons bring issues within the household such as drying clothes inside, that lead to a musty damp odour.
 
Nidhish Garg, Brand Manager, P&G Home Care India, comments: “To drive awareness regarding the New & Improved Ambi Pur with patented odour-clear technology, we have launched the 3rdleg of the very popular Smelly to Smiley campaign. The brand stays with its ideology of putting the product to torture tests against relevant odour issues, and this time we take on the musty odour that all Indians face during monsoons. The TVC captures live reaction of a consumer who experiences the monsoon odour when visiting a friend’s home that looks perfectly clean. The same consumer sees Ambi Pur in action and how it completely eliminates the monsoon odour as opposed to temporarily concealing it with a fragrance. This format of communicating with our consumers through live experiments helps in building brand salience and credibility.”
 

Ambi Pur’s Brand Ambassador, Boman Irani further adds, “Monsoon is my favourite season but we all know the challenges that come with it, right from drying clothes inside to the rigorous cleaning regime. The new TVC shows that the house that looks clean may not actually smell clean due to the overwhelming moisture-heavy air giving out a feeling of lack of hygiene. It is always fun shooting for Ambi Pur ads, as well as extremely reassuring to witness the brand live up to toughest home odours in live experiments, year on year! This time too, Ambi Pur in its new avatar, truly eliminated the musty monsoon odour. So, it’s time to stop being enslaved by this moldy smell and refresh your monsoons with Ambi Pur.”

The New & Improved Ambi Pur uses a distinct formulation that focuses on odour removal, not just on emitting the fragrance. P&G has created a trademarked ‘Odour-clear technology’, which has been brought to India in July. The new technology fights odour at a molecular level, neutralizing it completely, and leaving behind a subtle fragrance, thus truly eliminating all tough odours.

All Ambi Pur fragrances, including the newly launched Sandalwood fragrance, are available across stores at a price of Rs. 299.

Agency Credits:
Lead Creative Agency: GREY Düsseldorf
Local Support: GREY Mumbai
Production House: Casta Diva Pictures, Mumbai

About Procter & Gamble
P&G serves consumers in India with one of the strongest portfolios of trusted, quality, leadership brands, including Vicks ®, Ariel®, Tide®, Whisper®, Olay®, Gillette®, AmbiPur®, Pampers®, Pantene®, Oral-B®, Head & Shoulders® and Old Spice®. P&G operates through 3 entities in India of which 2 are listed on NSE & BSE. The listed P&G entities are: ‘Procter & Gamble Hygiene & Health Care Limited’ and ‘Gillette India Limited’, whereas the unlisted entity (which is a 100% subsidiary of the parent company in the U.S) operates by the name ‘Procter & Gamble Home Products Private Ltd.’ In the last 12 years, P&G’s signature CSR program P&G Shiksha has built and supported 1000 schools that will impact the lives of 10,00,000 underprivileged children across the country by providing them with access to education. Please visit http://www.pg-India.com for the latest news and in-depth information about P&G India and its brands.

          Making the List        
Annual health care facility rankings from U.S. News & World Report include three facilities from metro Richmond, plus more of the week's health news.
          Upload Medical Reports        

At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. Whats App: “Treatment Name” to +919711586419 Delhi Office: +919711586419 […]

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          Talk to Doctor        

At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. Whats App: “Treatment Name” to +919711586419 Delhi Office: +919711586419 […]

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          Contact Us        

At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. WhatsApp: “Treatment Name” to +919711586419 Delhi Office: +919711586419 Email: […]

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          About Us        

At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service mode. Providing high-quality, affordable health care services abroad coupled with a world-class escape after that. We are a team of experienced service industry consultants […]

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          Tea Party Pennsylvania Bill would give patients more privacy control over health care        
The bill also seeks to protect the rights of patients to buy health insurance, or make any other arrangements to pay for their own health care.





New federal legislation seeks to prevent government bureaucrats from interfering in private health care and guarantee patient rights to control health care decisions.





Republican Congressman Pennsylvania Rep. Charlie Dent, R-15, and Illinois Rep. Mark Kirk are the cosponsors of the Medical Rights Act of 2009 bill, which was introduced Wednesday. The lawmakers co-chair the centrist GOP Tuesday Group.





"As Congress begins to discuss how best to address America's health care challenges, we must protect the sacrosanct relationship between a patient and a doctor," Dent said. "One of the greatest strengths of our health care system is that Americans can rely on getting the care that they need when they need it."





The bill prevents the government from rationing private health care and actions that interfere in the doctor-patient relationship, the congressman contends. It also would prevent the federal government from regulating the hiring practices of organizations that provide health care, such as hospitals and clinics.





The bill protects the rights of patients to buy health insurance, or make any other arrangements to pay for their own health care. Several foreign countries and several current health care reform proposals substantially restrict this right, according to the bill.





Additionally, the proposed bill would give Americans who get care under government health programs, such as Medicare, the ability to obtain health care outside the program.





In the U.S., if a Medicare-participating doctor accepts payment for a service that would otherwise be covered under Medicare, the doctor is suspended from participating in the federal health program for the elderly for two years, according to the bill.





"This substantially restricts the ability of Medicare patients to pay on their own if Medicare decides they are ineligible for a particular service normally covered by the program," according to the bill. "Not many doctors are willing to take that penalty, so this substantially (if indirectly) restricts the right of seniors and the disabled to access the health care of their choice."





With Congress preparing to debate health care reform this summer, the men warned legislation allowing government involvement in health care decisions could have "dire consequences." They cite other public health programs in Canada and Britain as examples of how government involvement compromises quality.





Long waits for care elsewhere





In a news release, the men cited a 2008 Commonwealth Fund International survey that found most Canadians and British adults waited longer than four weeks to see a medical specialist compared with only 26 percent of Americans.





They also cited long waits for care, based on a Heritage Foundation study that found 43 percent of Canadian patients and 15 percent of British patients received hip replacements within six months, compared with more than 90 percent of American senior citizens.





About 30 percent of Canadians' health care is paid for through the private sector, according to the Organisation for Economic Co-operation and Development, a group of 30 countries that meets regularly to discuss global issues and make economic and social policies.





The private payments are mostly for services not covered or partially covered by Canada's health program, such as prescription drugs and dentistry, according to the OECD.





About 65 percent of Canadians have some form of supplementary private health insurance and many receive it through their employers.





Canada spends less of its gross domestic product on health care (10.4 percent, versus 16 percent in the U.S.) and performs better on two commonly cited health outcome measures - the infant mortality rate and life expectancy.





A 2007 National Bureau of Economic Research report found the U.S. experienced a higher incidence of chronic health conditions than Canada, but Americans had somewhat better access to treatment for the conditions. Also, a significantly higher percentage of U.S. residents were screened for major forms of cancer.





The need to ration health care resources in Canada is the reason most Canadians cited for unmet medical needs, where in the U.S., more than half of those surveyed cited health care costs as the reason for unmet needs, the agency found.


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Article Source: www.articlesnatch.com


          RE[8]: USD vs. EUR        
The prices I gave were TAX DEDUCTED, as CLEARLY said. So, my comparisons were made using prices WITHOUT taxes. To that 1075USD we pay, you need to add 19% VAT. Oh, that's unfortunate. At least you get health care.
          RE[7]: USD vs. EUR        
No, I don't think you get free health care. (I don't, either. My salary is lower than in the public sector, the price of my "free" health insurance.) My point was actually that there isn't a free lunch. European governments tend to provide certain amenities/services that the US government doesn't -- well maintained dykes and functional disaster relief organizations come to mind* -- but all of that comes at a price. Namely, taxes. --- *I've been re-reading some of my friends' Hurricane Katrina blogs recently ....
          Health Care Vs. Health-Care Vs. Healthcare: The Debate Continues        
Synopsis The term “healthcare” will eventually become widely accepted as one word, not two, whether die-hard grammarians, linguists, and editors like it or not. Our language, and any discussions about health, will be greatly improved by ending this battle. The … Continue reading
          ECU ALUMNUS CHRIS BUCHANAN NOW DEPUTY DIRECTOR OF INDIAN HEALTH SERVICES FOR U.S. PUBLIC HEATH SERVICE        
Chris Buchanan

Chris Buchanan, East Central University alumnus and a member of the Commissioned Corps of the United States Public Health Service (USPHS), was recently promoted to the flag-officer rank of Rear Admiral and appointed Deputy Director of Indian Health Services.

Buchanan also recently served six months as acting director.

As a senior ranking officer, flag officers exemplify the core values for which commissioned officers of the U.S. Public Health Service are held in high esteem, according to Dr. Patrick Bohan, ECU Environmental Health Sciences professor and Retired Captain of the USPHS.

“Flag officers provide executive-level leadership within the department and the agencies which they serve,” Bohan said. “Our flag officers also carry the title of Assistant Surgeon General and, as such, we rely on them to support special initiatives and exhibit the highest caliber of public health leadership.”

Buchanan, a native of Konawa, joins fellow ECU alumnus Rear Admiral Kevin D. Meeks as a high-ranking official within the USPHS. Meeks is acting deputy director of field operations for the Indian Health Service, an agency within the Department of Health and Human Services and the principal federal health care advocate and provider of health services for American Indians and Alaska natives.

ECU has provided more environmental health officers to the Commissioned Corps of the U.S. Public Health Service than any other institution in the country, according to Bohan. The Environmental Health Science program at ECU is one of 31 accredited undergraduate programs throughout the United States.

“The Environmental Health Science program provided an interdisciplinary foundation that prepared me for my career in Indian Health Service,” Buchanan said. “Environmental health graduates of the program are problem solvers. We use this type of approach to develop skill sets

that help to constructively review environmental and public health issues and come up with solutions. I have and continue to use these skills in my role as the deputy director of IHS.”

Buchanan credits the late Dr. Mickey Rowe, former chair and professor of the ECU Environmental Health Science Department, with setting the stage for his career.

“Dr. Rowe was a force of nature. He left a lasting impact on me personally and professionally,” said Buchanan. “His expectations were high for all his students and former students. He made it clear upon graduation that you would be representing the ECU Environmental Health Program and your environmental health decisions will have an impact on public health. His expectation was nothing short of being the best both academically and in your profession.”

 As deputy director Buchanan, an enrolled member of the Seminole Nation of Oklahoma, leads and oversees IHS operations to ensure delivery of quality comprehensive health services. He ensures that IHS provides for the full participation of tribes in programs and services and helps to establish and track the goals and metrics through which the IHS U.S.-federal-government-operated, or direct service, health care program improves outcomes.

Buchanan ensures IHS services are integrated across all levels of the agency and engaged with other Operating Divisions of the Department of Health and Human Services and external partners, including states and national organizations.

He previously served in 2016 as the acting area director for the IHS Great Plains Area, with administrative responsibility for 19 service units serving 130,000 people and 17 tribes through seven hospitals, 10 health centers and two urban Indian health programs, overseeing a complex health care program during a period of change. Previously, Buchanan has served as director of the IHS Office of Direct Services and Contracting Tribes.

As an environmental health officer in the U.S. Public Health Service Commissioned Corps with more than 20 years of active duty, Buchanan began his IHS career in 1993, serving in various environmental health positions in the Phoenix, Albuquerque and Oklahoma City areas, including serving as the administrative officer for Lawton Indian Hospital and the chief executive officer for Haskell Health Center. In 2010, he was administrative officer of clinical services for the Chickasaw Nation’s Division of Health in Ada.

Along with serving on several national IHS workgroups and being deployed to several natural disaster events, Buchanan has received numerous professional awards, including one for National Council of Chief Executive Officer’s Rookie of the Year. He earned a bachelor of environmental health science degree from ECU and a public health degree in health policy and administration from the University of North Carolina in Chapel Hill.

Buchanan has seen Indian Health Service improve over the years, evolving in a similar manner as the traditional healthcare delivery model to a more value-based healthcare delivery system.

“The IHS sees these changes through the administration of a nationwide health care delivery program that is responsible for providing preventative, curative and community health care for approximately 2.2 American Indians and Alaska natives in hospitals, clinics and other settings throughout the United States,” Buchanan said. “An example of this evolution includes emerging technologies such as telemedicine. By utilizing these healthcare technologies, IHS will continue to improve the populations we serve.”

Telemedicine is the diagnosis and treatment of patients in remote areas using medical information such as x-rays or television pictures, transmitted over long distances, particularly satellite.

-ECU-

For Immediate Release: 

Contact: Brian Johnson or Amy Ford

                                East Central University Communications and Marketing

                              580-559-5650 or 405-812-1428 (cell)


          The Role of Gender in Factors Associated With Addiction Treatment Satisfaction Among Long-Term Opioid Users        
imageObjectives: To identify factors associated with Opioid Agonist Treatment (OAT) satisfaction and to determine whether these relationships are gender specific. Methods: This study was based on data collected in a cross-sectional study among long-term opioid-dependent individuals (n = 160; 46.3% women). Participants completed the Client Satisfaction Questionnaire in reference to OAT episodes. Sociodemographic, illicit substance use, health, and addiction treatment history data were collected. Multivariable linear regression was used to determine the relationship between these variables and treatment satisfaction. To explore the potential role of gender in these identified relationships stratified multivariable models were tested. Additional open-ended questions regarding positive and negative perceptions of treatment were collected, and a thematic analysis was conducted. Results: In the multivariable linear regression model, participants who were older, of Aboriginal ancestry, and currently receiving OAT had higher OAT satisfaction scores, whereas participants who had methadone dose preferences of 30 mg or less had lower OAT satisfaction. In stratified analyses among women, the relationship between preferred methadone dose and current OAT remained significantly associated with satisfaction. Open-ended positive and negative perceptions complemented and provided further valuable data to interpret these identified relationships. Conclusions: To our knowledge, this is the first study to explore the potential role of gender in factors associated with OAT satisfaction. These findings provide valuable information to health care providers working in OAT settings regarding how to address women and men's OAT needs and improve treatment satisfaction.
          Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System        
imageObjectives: We examined prevalence of major medical conditions and extent of disease burden among patients with and without substance use disorders (SUDs) in an integrated health care system serving 3.8 million members. Methods: Medical conditions and SUDs were extracted from electronic health records in 2010. Patients with SUDs (n = 45,461; alcohol, amphetamine, barbiturate, cocaine, hallucinogen, and opioid) and demographically matched patients without SUDs (n = 45,461) were compared on the prevalence of 19 major medical conditions. Disease burden was measured as a function of 10-year mortality risk using the Charlson Comorbidity Index. P-values were adjusted using Hochberg's correction for multiple-inference testing within each medical condition category. Results: The most frequently diagnosed SUDs in 2010 were alcohol (57.6%), cannabis (14.9%), and opioid (12.9%). Patients with these SUDs had higher prevalence of major medical conditions than non-SUD patients (alcohol use disorders, 85.3% vs 55.3%; cannabis use disorders, 41.9% vs 23.0%; and opioid use disorders, 44.9% vs 26.1%; all P < 0.001). Patients with these SUDs also had higher disease burden than non-SUD patients; patients with opioid use disorders (M = 0.48; SE = 1.46) had particularly high disease burden (M = 0.23; SE = 0.09; P < 0.001). Conclusions: Common SUDs, particularly opioid use disorders, are associated with substantial disease burden for privately insured individuals without significant impediments to care. This signals the need to explore the full impact SUDs have on the course and outcome of prevalent conditions and initiate enhanced service engagement strategies to improve disease burden.
          Evaluating the Effectiveness of First-Time Methadone Maintenance Therapy Across Northern, Rural, and Urban Regions of Ontario, Canada        
imageObjectives: Our objective was to determine the impact that a patient's geographic status has on the efficacy of first-time methadone maintenance therapy (MMT) retention. Methods: We conducted an observational cohort study using administrative health care databases for patients who commenced methadone therapy between 2003 and 2012. Patients were stratified on the basis of their location of residence into 1 of 4 groups—Southern Urban, Southern Rural, Northern Urban, or Northern Rural. The primary outcome was continuous retention in treatment, defined as 1 year of uninterrupted therapy on the basis of prescription refill data. Mortality was measured as a secondary outcome. Results: We identified 17,211 patients initiating first-time MMT during this 10-year period. Nearly half of patients initiating therapy in northern regions completed 1 year of treatment (48.9%; N = 258 and 47.0%; N = 761 in Northern Rural and Urban regions, respectively), whereas lower rates of 40.6% (N = 410) and 39.3% (N = 5,518) occurred in Southern Rural and Urban regions, respectively. Patients residing in Northern Rural and Northern Urban regions were 31% (adjusted odds ratio = 1.31; 95% confidence interval [CI], 1.09%–1.58%] and 14% (adjusted odds ratio = 1.14; 95% CI, 1.02%–1.27%] more likely to be retained in treatment compared with those residing in Southern Urban regions. There was no significant difference in treatment retention between those residing in Southern Rural and Southern Urban regions. A mortality rate of 3% was observed within 1 year of patients initiating treatment, with patients in the Southern Rural region having the highest rate (4.85%). Conclusions: Our study identified regional differences in retention rates and mortality of first-time MMT. These findings may relate to geographic isolation and limited methadone program availability experienced in northern regions. We interpret the data to suggest that patients who have reduced access to treatment experience higher retention rates when they are able to access therapy.
          Wake Forest Baptist Welcomes Wilkes Medical Center into Its Health Care Family with a Celebration for Town Leaders and Employees        
Wake Forest Baptist Welcomes Wilkes Medical Center into Its Health Care Family with a Celebration for Town Leaders and Employees Expanded Clinical Services Announced at Wilkes Medical Center NORTH WILKESBORO, N.C. – July 21, 2017 – Wake Forest Baptist Medical Center announced
          Wake Forest Baptist Recognized as a Leader in LGBTQ Health Care Equality by the Human Rights Campaign        
 Wake Forest Baptist Medical Center today was acknowledged for its leadership and commitment to provide quality, equitable and inclusive patient- and family-centered health care to all.  
          Wake Forest School of Medicine Student and Spouse Return from Kenya Mission Trip in Time for Valentine’s Day        
Evan and Emily Moon are proud of their love story. After meeting at a Colorado hospital where they both worked as nurses, they soon became best friends. That friendship led to marriage and eventually to Wake Forest School of Medicine. Evan graduated from the school’s Nurse Anesthesia Program in 2016, and Emily will graduate from the program in August. Continuing a School of Medicine tradition of service to others, the couple has just returned from a mission trip to Kenya where they cared for people who do not have regular access to quality health care.
          Wake Forest Baptist Offers Zero-Percent Interest Loan Program to Help Patients Manage Health Care Costs        
Wake Forest Baptist Medical Center has partnered with Commerce Bank to offer patients interest-free loans for up to $50,000 to help plan for and manage their health care costs over an extended period of time. The interest-free loan program is available to both new patients and existing patients with a current balance. 
          If you're not feeling well but think things can't get any worse - you forgot to factor in the Australian Minister for Health's cost cutting ways        

The Age, 4 August 2017:

State and territory health ministers say hospital treatments and services will suffer under a Commonwealth proposal to withhold budgeted funds and reduce spending.

Federal Health Minister Greg Hunt has drafted a directive to the Independent Hospital Pricing Authority to review its public hospital funding method.

It would result in retrospective funds not being paid and reduced services in future, Queensland Health Minister Cameron Dick said in a joint statement issued after the COAG Health Council meeting in Brisbane on Friday.

Mr Hunt drew condemnation from Queensland, Victoria, Western Australia, South Australia, the Northern Territory and the ACT when he confirmed he would uphold the direction.

"States and Territories have already funded services and boosted frontline staffing taking into consideration Commonwealth funding," the statement said.


Independent Hospital Pricing Authority (IHPA), media release, 17 July 2017:
IHPA releases Consultation Paper on Pricing Framework for Australian Public Hospital Services 2018-19
The Independent Hospital Pricing Authority (IHPA) today released its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19. The consultation is open to the public until Thursday 17 August 2017.
The Pricing Framework for Australian Public Hospital Services 2018-19 outlines the major policy decisions which will underpin the National Efficient Price and National Efficient Cost Determinations for 2018-19.
This year IHPA will seek feedback regarding work that has been progressed on pricing and funding for safety and quality as well as canvassing options to enable new and innovative approaches to value based or preventative health care models.
The Chair of the Pricing Authority, Shane Solomon said, “IHPA has continued to work closely with the jurisdictions, clinicians and other stakeholders to make significant progress on the implementation of national reforms to incorporate safety and quality into the pricing and funding of public hospitals in Australia.
“A range of factors must now be considered including risk adjustment and how the approach can be embedded as part of broader system change.
“The success of a safety and quality pricing and funding mechanism is dependent on national, state, and local health systems working together to support the implementation of a model and ensure that it is working to improve safety and quality across all services,” he said.
“The Consultation Paper is an important opportunity for stakeholders to engage with IHPA on the approach to pricing and funding for safety and quality as well as the emergence of new innovative pricing models to help improve public hospital services across Australia. We strongly encourage all interested parties to provide feedback as part of this process,” concluded Mr Solomon.
The Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19 is available on the IHPA website.
Submissions should be emailed as an accessible Word document to submissions.ihpa@ihpa.gov.au or mailed to PO Box 483, Darlinghurst NSW 1300 by 5pm on Thursday 17 August 2017.
– ENDS –

Independent Hospital Pricing Authority (IHPA), Ministerial Direction, 16 February 2017:
Ministerial Direction
On 16 February 2017 IHPA received a Ministerial Direction from the Hon. Greg Hunt under section 226(1) of the National Health Reform Act 2011.
The Direction requires that IHPA undertake implementation of agreed recommendations of the COAG Health Council on pricing for safety and quality to give effect to:
  1. nil funding for a public hospital episode including a sentinel event which occurs on or after 1 July 2017, applying to all relevant episodes of care (being admitted and other episodes) in hospitals where the services are funded on an activity basis and hospitals where services are block funded; and
  2. an appropriate reduced funding level for all hospital acquired complications, in accordance with Option 3 of the draft Pricing Framework for Australian Public Hospital Services 2017-18, as existing on 30 November 2016, to reflect the additional cost of a hospital admission with a hospital acquired complication, to be applied across all public hospitals; and
  3. undertake further public consultation to inform a future pricing and funding approach in relation to avoidable hospital readmissions, based on a set of definitions to be developed by the Australian Commission on Safety and Quality in Health Care.
IHPA will incorporate the requirements under this Direction into the final Pricing Framework for Australian Public Hospitals 2017-18 due to be published on the IHPA website in early March 2017.
IHPA will undertake further consultation as part of its annual consultation process on the draft Pricing Framework for Australian Public Hospitals 2018-19 due for publication in June 2017 and provide a report back to the COAG Health Council by 30 November 2017.
Note: This follows on from a Direction received on 29 August 2016 which required IHPA to provide advice to the COAG Health Council on options for pricing for safety and quality.
More information
For any questions, please contact enquiries.ihpa@ihpa.gov.au
Links

          Melbourne Institute's HILDA survey report 2017        


Commenced in 2001, the Household, Income and Labour Dynamics in Australia (HILDA) Survey is a nationally representative longitudinal study of Australian households. The study is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute at the University of Melbourne. Roy Morgan Research has conducted the fieldwork since Wave 9 (2009), prior to which The Nielsen Company was the fieldwork provider.
The HILDA Survey seeks to provide longitudinal data on the lives of Australian residents. It annually collects information on a wide range of aspects of life in Australia, including household and family relationships, child care, employment, education, income, expenditure, health and wellbeing, attitudes and values on a variety of subjects, and various life events and experiences. Information is also collected at less frequent intervals on various topics, including household wealth, fertility related behaviour and plans, relationships with non-resident family members and non-resident partners, health care utilisation, eating habits, cognitive functioning and retirement.
The important distinguishing feature of the HILDA Survey is that the same households and individuals are interviewed every year, allowing us to see how their lives are changing over time. By design, the study can be infinitely lived, following not only the initial sample members for the remainder of their lives, but also their children and all subsequent descendants

Download the report here.


          The Best Part-Time Job in America        

The fix is in. Did you know, Congress only works 33 percent of the year?

The base salary for all rank-and-file members of Congress is $174,000, more than triple the median household income of the United States. In exchange for that generous salary, members of Congress work one out of three days.

The House of Representatives was in session for only 18 hours a week in 2013. Members worked only 130 days in 2015. In case you needed more evidence that Congress doesn’t earn its salary, consider this: House and Senate members only worked eight days in April.

Eight work days in a month, with an annual salary of $174,000. Can you imagine? Must be nice!

Meanwhile, in the real world, the average American worker puts in more hours than a medieval peasant. Full-time U.S. employees use only 54 percent of their paid vacation days, sacrificing the rest for fear of falling behind or being replaced. The idea of a congressman skipping that much vacation is laughable, at best.

I was raised to believe that how people spend their time is a direct reflection of their priorities. The United States holds more than $19 trillion in debt, not including unfunded liabilities. Our health care, immigration, and justice systems are in desperate need of reform. Public schools are underperforming, while families and small businesses are being taxed out of financial security.

Where is our elected leadership? Clearly, they have other priorities.

Members of Congress spend most of their time in their districts, schmoozing with donors, speaking at private events, and securing their next elections. The average House member spent $53,170 of taxpayer money on travel in 2013.

These aren’t legislators, these are professional campaigners.

The American people aren’t being heard by government because the game is rigged. Washington isn’t broken. It’s “fixed.”


          In Defense of Economic Noninterventionism         

A recent Wall Street Journal article has surprisingly good news: US companies are seeing the highest profit growth in two years with “two consecutive quarters of double-digit profit growth for the first time since 2011.” This surprisingly comes not from policies pursued in Washington, but the hard work of the private sector.

The fact that businesses and job creators can make such a phenomenal showing after years of regulatory uncertainty and continued political intervention reminds us of the power of the free market and that the best successes come from the work of the individuals, not collectivists in the public sector.

Perhaps the best reminding of what the last eight years brought us was President Obama’s infamous 2012 campaign speech “If you've got a business, you didn't build that.” Throughout the course of his administration saw a creation of routine legislative and executive actions that were designed to both micromanage business and supposedly “create” jobs. Unfortunately, none of this had the intended success.

Most prominently among the actions from the executive administration while Obama was presidents include significantly increased regulations. Among these have included the Waters of the United States Rule (WOTUS), Dodd-Frank, the stimulus package, and, most spectacularly of all, Obamacare. All of these added a large interventions and onerous barriers in the economy that failed to achieve their stated goal.

WOTUS was probably one of the greatest power grabs by the EPA in recent history. The rule essentially sought to define “navigable waters” in the clean water Act which “brought nearly half of Alaska and a total area in the lower 48 states equivalent to the size of California under the CWA’s jurisdiction.” The proposal, had it not been blocked and rescinded, would have cost thousands of dollars for permits on land that was not previously under the EPA’s jurisdiction, delayed production since a permit can take up to months, and this would have resulted in reduced development and production as well as higher prices.

Though the WOTUS rule was not fully implemented, regulations that did have a massive negative impact on the economy include the Dodd–Frank Wall Street Reform and Consumer Protection Act.

As implemented, Dodd-Frank imposed various new regulations on the financial sector, including creating the Consumer Financial Protection Bureau (CFPB), designated firms as systemically important financial institutions (SIFIs), and instituted price controls on debit and credit card transactions. The result was a climate of over regulation with banks being incentivized to become as large as possible in the hopes of being bailed out while the CFPB became a revolving door for lobbyists and influence peddlers to regulate the market with little to no oversight.

Unsurprisingly, one fifth of the banks in the U.S. banks, totalling 1,708, went under between the law’s creation and 2016, which is about one per day, and by 2015 five large banks controlled 50 percent of the banking industry.

Outside of simple regulation, there was also so called “jobs creations” programs that were supposed to create jobs the President did not think businesses could such as the stimulus package. The program was sold as a job creation plan that would keep unemployment below 8 percent for the low price of $830 billion.

The next four years were marked by above 8 percent unemployment while the money ended up being wasted on worthless projects, including trees in wealthy neighborhoods, a study of erectile dysfunction, and the failed company solyndra which was run by a bundler for the Obama campaign. To make matters worse, though unemployment eventually went down long after the stimulus’s implementation, the labor participation rate reached its lowest in 38 years which shows that people still weren’t working.

However, the crowned jewel of overregulation and job destruction during the Obama administration was ObamaCare. Implemented to expand health insurance coverage, it has repeatedly failed to reach its goals as premiums went up, enrollment failed to reach its projections, and the legislation gave corporate welfare (including promised bailouts) to the insurance lobby. In the end, most of the coops failed and major companies pulled out of the exchanges, resulting in 1,000 counties, including five whole states, only having one insurer, a major failure in the goal of expanded coverage.

Inevitably, the phenomenal intervention in the economy by President Obama failed to achieve the job creation while it instead made made doing business that much harder. With record breaking numbers of regulations, Obama was the first President since the Great Depression to never see 3 percent GDP growth.

The Trump administration in the meantime has pursued a different approach than its predecessor. The Trump administration has seen sixteen regulations cut for every one it has created, had signed four resolutions of disapproval under the Congressional Review Act to overturn regulation within two months as President, and rolled back the clean power plan which could have cost $40 billion per year. All of this marks a significant change in policy that will greatly open up business opportunities and expand economic growth.

However, policy alone does not explain why there has been high profit growth for the last two quarters. As the Wall Street Journal article admits, health care legislation and tax reform have been stalled in the senate. This has caused a climate of uncertainty which businesses have not been happy with.

Nevertheless, they have instead moved on from Washington and instead remained focused on doing business. Political events seem to have taken a backseat to actual business as the number of S&P 500 companies have mentioned the President or his administration during conferences is down by a third as the research firm Sentieo found out. To be blunt, the involvement of Washington and government policy is not driving the current profit growth and the lack of involvement may actually be increasing it.

For a better example of how reduced involvement can improve the economy, look no further than the Depression of 1920. At the time, war time debt had exploded, unemployment peaked at 11.7 percent in 1921, and inflation rates jumped above twenty percent. It had the potential to be even more catastrophic than the Great Depression that started in 1929.

However, the policies pursued were entirely different. The federal budget was severely reduced from $18.5 billion in FY 1919 to $3.3 billion for FY 1922. Taxes at the same time were cut by about 40 percent.

As a result, unemployment dropped to 2.3 percent by 1923 and a crisis had been averted. This was accomplished not by bailouts and and overregulation but by getting the government entirely out of the way. This is a radically different approach than was pursued during the financial panic of 2008 or even the Great Depression.

Overall, there has been a repeated belief that government involvement has made economic advancement harder. As was stated by former President Reagan, “Government is not the solution to our problem; government is the problem.” President Kennedy noted the same when he said “Our tax system still siphons out of the private economy too large a share of personal and business purchasing power and reduces the incentive for risk, investment and effort — thereby aborting our recoveries and stifling our national growth rate.”

It should come as no surprise then that business are fully prepared to run their own affairs and is best capable to address its own need, for as JP Morgan Chase CEO Jamie Dimon noted, “We’ve been growing at 1.5% to 2%...because the American business sector is powerful and strong and is going to grow regardless.”

It remains the desire of others that the government should intervene in the economy to make improvements. However, this has always resulted in guaranteed failure. Be it raising the minimum wage in Seattle or increased taxation and regulations in Connecticut, the result is usually lackluster growth and decreased jobs. At the national level, Venezuela’s nationalization and China’s increased infrastructure projects have created the same results, which is to say none.

As history and current events have shown time and time again, the best results come not from government involvement and micromanagement, but from the hard work of free individuals in free markets. More and more, the adaptability of businesses to their consumer’s demands and their ability to whether adversity in the marketplace has always been more efficient than the micromanagement the state perceives. As a result, sometimes the best thing to do is to have the government do nothing so that those who can make the economy better will.


          FreedomWorks Presents FreedomFraud Awards        

FreedomWorks today announced the FreedomFraud Award winners for this year: Sens. Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska), and Shelley Moore Capito (R-W.Va.), Sen. John McCain (R-Ariz.), Sen. Dean Heller (R-Utah), and Sen. Lamar Alexander (R-Tenn.). This is the counterpart to the FreedomFighter Awards.

The FreedomFraud Awards recognize the height of political fraud by senators who voted to defend ObamaCare by voting against a bill virtually the same as one they supported less than two years ago. While protected by Barack Obama’s veto, they supported ObamaCare and railed against it. Now that President Trump supports the bill, they have exposed themselves as political liars.

FreedomWorks Vice President of Legislative Affairs Jason Pye delivered the awards to senators’ offices Friday afternoon. You can see an archived live stream here. Eligibility for the award is based purely on whether senators campaigned on repeal and voted for this bill less than two years ago and opposed it when it could have passed.

“These people committed the greatest political fraud in American history,” said Jason Pye. “Republican politics has focused on repealing ObamaCare for the better part of a decade. There were frequent votes to repeal ObamaCare. These senators showed great contempt for their constituents by going against everything they’ve stood for on ObamaCare repeal.”

After the 2015 bill passed, Sen. Rob Portman (R-Ohio) said, “I'm for repealing this broken law and replacing it with something better that gives patients more choice, decreases costs and increases access to quality, affordable care.”

After the 2015 bill passed, Sen. Lisa Murkowski (R-Ala.) said, “This law is not affordable for anyone in Alaska. That is why I will support the bill that repeals the ACA and wipes out its harmful impacts. I can’t watch premiums for Alaskans shoot up by 30 percent or more each year, see businesses artificially constrained, or see the quality of public education decline.”

After the 2015 bill passed, Sen. Shelley Moore Capito (R-W.Va.) said, “I am glad that a repeal bill will finally reach the president’s desk.”

Sen. John McCain (R-Ariz.) said, “It is clear that any serious attempt to improve our health care system must begin with a full repeal and replacement of Obamacare, and I will continue fighting on behalf of the people of Arizona to achieve it.”

Sen. Dean Heller (R-Nev.) said, “This DC bureaucrat-driven healthcare system will only result in limited health care choices and higher costs for Nevadans.”

Lamar Alexander (R-Tenn.) said , “The wisest course is to repeal Obamacare and replace it step by step with solutions that lower health care costs.”


          Six Senators Perpetrate One of the Biggest Political Frauds in American History        

FreedomWorks President Adam Brandon released the following statement after the Republican-majority Senate voted to save ObamaCare:

“Our activists have fought for the better part of a decade, led on by campaign promises and actual votes to repeal ObamaCare, to get Republican majorities in the House and Senate, as well as a Republican in the White House. Sens. Dean Heller, Lisa Murkowski, John McCain, Rob Portman, Shelley Moore Capito, and Lamar Alexander each voted for the very same bill in 2015.

“We now know that these six senators are ObamaCare repeal frauds. Even though we’re still wondering if Sen. Susan Collins is in the right party, at least she was consistent with her vote.”

Here are quotes from a few of these Senate Republicans who have heavily criticized ObamaCare and today voted to keep ObamaCare as the law of the land.

Sen. Lamar Alexander (R-Tenn.): “The wisest course is to repeal Obamacare and replace it step by step with solutions that lower health care costs.”

Sen. Shelley Moore Capito (R-W.Va.): “I have consistently voted to repeal and replace this disastrous health care law, and I am glad that a repeal bill will finally reach the president’s desk.”

Sen. Dean Heller (R-Nev.): “This DC bureaucrat-driven healthcare system will only result in limited health care choices and higher costs for Nevadans.”

Sen. Lisa Murkowski (R-Alaska): “This law is not affordable for anyone in Alaska. That is why I will support the bill that repeals the ACA and wipes out its harmful impacts. I can’t watch premiums for Alaskans shoot up by 30 percent or more each year, see businesses artificially constrained, or see the quality of public education decline.”

Sen. John McCain (R-Ariz.): “It is clear that any serious attempt to improve our health care system must begin with a full repeal and replacement of Obamacare, and I will continue fighting on behalf of the people of Arizona to achieve it.”

Sen. Rob Portman (R-Ohio): “I'm for repealing this broken law and replacing it with something better that gives patients more choice, decreases costs and increases access to quality, affordable care.”


          The Weekly Fix: Rules for Thee, but Not for Me        

The fix is in. Did you know, members of Congress can exclude themselves from federal laws they don’t want to follow? Taxpayers are forced to play by the rules, while lawmakers in Washington get a free pass.

The Congressional Accountability Act (CAA) of 1995 was created to remedy some of these injustices. In theory, the CAA requires members of Congress to abide by some of the same employment and workplace safety laws as any other business or federal government entity.

But in reality, members of Congress continue to dodge their way around significant legislative policy.

Congress has the power to kick you off your health care plan, yet lawmakers excused themselves from the ObamaCare exchanges. Congress requires federal agencies to provide citizens with internal records, yet lawmakers exempted themselves from the Freedom of Information Act, along with numerous other record-keeping and transparency laws (including whistleblower protections).

Congress supports sending citizens to jail for insider trading, yet lawmakers are allowed to make stock trades based on non-public information. Congress passed the Sarbanes-Oxley Act to protect citizens from dishonest private sector CEOs, yet lawmakers shamelessly lie about the costs of their policy agenda.

Not surprisingly, the Office of Compliance for the U.S. Congress revealed to the press that representatives often fail to produce records and information critical to investigations in a timely manner- or sometimes even at all. Compliance has no legal authority to subpoena information, leaving them at the complete mercy of legislative offices.

Why are members of Congress so tone deaf? Because they aren’t living in the same reality as the rest of America. They are shielded from the consequences of their actions. Forget equal treatment under the law, the official slogan of the Legislative Branch should be: Rules for thee, but not for me.

The American people aren’t being heard by government because the game is rigged. Washington isn’t broken. It’s “fixed.”


          Making Sense of MACRA        

In January 2015, the US Department of Health and Human Services (DHHS) established new goals for Medicare to improve value while controlling costs. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) will help achieve these goals:

  • Goal 1: by the end of 2016, 30% of Medicare payments are tied to quality or value via alternative payment models (APMs), and 50% by the end of 2018.
  • Goal 2: by the end of 2016, 85% of Medicare fee-for-service (FFS) payments are tied to quality or value, and 90% by the end of 2018.

Why must we change Medicare reimbursement? As shown in Chart 1, based on DHHS reports, Medicare costs rose sharply from its enactment in the mid-1960s to today, both as a percent of the Gross Domestic Product (GDP) and as a percent of all national health expenditures (NHE). Currently, Medicare is estimated to account for roughly 4% of the GDP, and for over one in five health care dollars. There is also a need to improve the quality of health care services and delivery. Changing Medicare reimbursement is a way to better manage costs while enhancing care quality.

As discussed in the series of posts on bundled payments, traditional medical billing and payment is volume-based. In other words, the more hip replacements that surgeons perform, the more they can bill for. If the hip replacement procedures are more costly than necessary, the surgeons still get reimbursed. If the patient suffers complications following hip replacement surgery, the added days in the hospital and hospital readmissions are reimbursed. Providers are rewarded for doing more, but not for doing better.

Increasingly, Medicare and other payers are moving to value-based reimbursement systems that reward providers for improving the quality of care while controlling costs. MACRA changes the incentives for patient care to encourage providers, largely physicians, to become part of this value-based movement. MACRA also ends the Sustainable Growth Rate (SGR) formula used since 1997 for Medicare reimbursement to healthcare providers.

MIPS and APMs

MACRA establishes the Quality Payment Program (QPP) with two paths that move providers to value-based reimbursement:

  • The Merit-Based Incentive Payment System (MIPS)
  • Advanced Alternative Payment Models (APMs).

Healthcare practitioners eligible for Medicare Part B reimbursement will participate in MIPS. For the first two years of MACRA, MIPS eligible clinicians include physicians, dentists, physician assistants and advance practice nurses such as nurse practitioners and certified registered nurse anesthetists. In following years, eligibility may be expanded to other practitioners such as physical or occupational therapists, nurse midwives, clinical social workers and audiologists. Hospitals and other facilities, clinicians with low patient volume or in their first year of Medicare Part B participation, and some clinicians in APMs are excluded from MIPS.

Under MIPs, the eligible clinician’s Medicare Part B reimbursement is adjusted based on a Composite Performance Score (CPS) that encompasses the categories of quality, resource use, clinical practice improvement activities and advancing care information. The scoring system is complex, and may also be adjusted for factors such as practices located in rural areas. The amount of the adjustment to Part B reimbursement may be positive or negative, beginning at ± 4% in 2019 and increasing to ± 9% by 2022. The adjustments are designed to be more reasonable and predictable than the earlier SGR annual adjustments. Exceptional performers may receive additional reimbursement in the adjustment. These payment adjustments and bonuses begin in 2019.

APMs include new financing initiatives that increase incentives for high value care, including bundled payment models and Accountable Care Organizations (ACOs). Bundled payment models and ACOs compel providers across a health care episode to work together to deliver high quality care while controlling costs. Physicians, hospitals, rehabilitation centers, home health agencies and other healthcare providers share accountability for their budget as well as their patients, and are rewarded for high-value performance. QPP providers may not need to participate in MIPS if they are part of an advanced APM.

Nurses in many healthcare settings will see changes to improve coordination and services as a response to MACRA and other value-based reimbursement strategies. My book helps nurses understand fundamental concepts of health care economics and financing, including innovations that tie quality to payment. It is essential that nurses, at the front lines of health care delivery, learn about healthcare finance and its impact on their work and their institutions.

Susan J. Penner, RN, MN, MPA, DrPH, CNL . Author, Economics and Financial Management for Nurses and Nurse Leaders, 3rd  Edition, 2016, and adjunct faculty at the University of San Francisco School of Nursing and Health Professions.


          Scientists to New Moms: Get Your Beauty Sleep (Yeah, right!)        
On the heels of a study that shows that kids who do not get enough sleep have higher obesity rates, comes this:
Researchers presented a conundrum to new mothers on Monday, saying that women who want to lose the extra weight gained in pregnancy should try to get more sleep.

They found that mothers who slept five hours or less a day when their babies were six months old were three times more likely than more rested mothers to have kept on the extra weight at one year.

"We've known for some time that sleep deprivation is associated with weight gain and obesity in the general population, but this study shows that getting enough sleep — even just two hours more — may be as important as a healthy diet and exercise for new mothers to return to their pre-pregnancy weight," said Erica Gunderson of Kaiser Permanente, which runs hospitals and clinics in California.

Gunderson and colleagues studied 940 women taking part in a study of prenatal and postnatal health at Harvard Medical School in Boston.

The women who slept five hours or less a night when their babies were six months old were more likely to have kept on 11 pounds of weight one year after giving birth, they found.

Women who slept seven hours a night or more lost more weight, they reported in the American Journal of Epidemiology.

The researchers acknowledged this may pose a dilemma to new mothers, given that infants sleep so fitfully.

"With the results of this study, new mothers must be wondering, 'How can I get more sleep for both me and my baby?' Our team is working on new studies to answer this important question," said Dr. Matthew Gillman of Harvard Medical School and Harvard Pilgrim Health Care.
Uh. great. I am SO glad that now that we know being up ALL NIGHT with a screaming baby might be keeping new moms from losing that baby weight may finally have scientists "working on new studies" to get babies and their mothers to sleep more. I mean, it was no problem at all for me to spend the wee hours of countless nights walking back and forth trying to comfort an alternately whimpering and howling baby in my arms - that is, until I found out that this was what might be keeping those pesky pounds from coming off. Because until now, it was perfectly bearable - even enjoyable, right? Thanks for the handy tip, Harvard geniuses! I wonder why getting more sleep didn't occur to me when I was a new mom? Us mothers will be sure to mention it to our colicky babies so that they can take their moms' weight loss needs into account before they make their evening plans!
          Welcome to Edward Garren, LMFT CA License MFC27181        
"When you're ready for change."

Edward Garren is a California licensed psychotherapist, offering counseling services to individuals, couples and families.

"The purpose of therapy is to remove blocks to truth; to help you abandon any patterns of belief that no longer serve you in a productive way; to implement self-forgiveness.
 
Therapy can alleviate suffering and open the door to peace of mind. It can assist in separating illusion from reality and even reality from truth.
 
Finally, it can help you to learn to make your decisions from internal prompts because you have created an internal locus of control."
 
From "A Course in Miracles"

Mr. Garren has worked in the profession for many years and has a broad range of experiences and "styles" of doing therapy. He has particular expertise working people who are dealing with depression, anxiety, recovering from addiction or alcoholism, desiring to reduce or eliminate use of prescribed psychotropic medications* (*NOTE: any change in one's medication should always be done under the guidance and supervision of the prescribing or other physician).

Ed has experience providing Counseling, Psychotherapy, Coaching, Career Development and related services to: Individuals Couples Families GLBTQ Community Members Persons living with HIV Persons and Families of mixed heritages Adult Survivors to Childhood Trauma Persons with Post Traumatic Stress Disorder Military and Law Enforcement personnel.

His office is conveniently located on Rodeo Road, near Western Ave.  This location is within ten minutes of the USC main campus, Downtown Los Angeles, Koreatown, Leimert Park, Baldwin Hills, View Park, West Adams, etc.  It is within fifteen minutes of Hollywood, West Hollywood, Mid-Wilshire, Los Feliz, Silverlake, Echo Park, Chinatown, East Los Angeles, South Central, South Los Angeles, Inglewood, Playa del Rey, Marina del Rey.

You may contact Mr. Garren via telephone, (213) 596-9674 , or by eMail EdwardGarrenMFT@gmail.com

Fax # is (213) 596-9082 


          Registered Massage Therapist in good standing with CMTO - Back in Motion Massage Therapy - Fort Frances, ON        
Extremely busy, professional clinic looking for a full-time/part-time RMT. Back in Motion is a well-respected clinic among health care professionals in the $30,000 - $60,000 a year
From Indeed - Sat, 15 Jul 2017 16:53:44 GMT - View all Fort Frances, ON jobs
          Paternity Laws In Mississippi        


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          Duck Hunting In Mississippi        


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          College Mississippi Scholarship        


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          Animal Of The Mississippi River        


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There truly are Mississippi scholarships and aids while the animal of the mississippi river. No other details of the animal of the mississippi river and conform to high quality standards. They are Grand Casinos, Bally's, Resorts Tunica, Sam's Town, Horseshoe, Hollywood, Sheraton, Fitzgerald's, and Gold Strike. Just south of Tunica on route 304 is the animal of the mississippi river. The second longest is the animal of the mississippi river. The largest tributary is the animal of the mississippi river, and also pesticides and pollutants from metropolitan and industrial areas into the animal of the mississippi river are night clubs like Club City Lights, Hide A Way Lounge, Fryday's bar and New Moonlight Club. All this clubs are interesting. Some of them have some of the animal of the mississippi river it was admitted to the animal of the mississippi river are tucked in these parks you can visit is the animal of the mississippi river of Lula. Here players can gamble at one of the animal of the mississippi river of the animal of the mississippi river and the animal of the mississippi river, not easy for any health insurance. The risk pool was funded by the animal of the mississippi river and higher spending per enrolee. Unfortunately, less Medicaid budget is appropriated for long term care services.




          Vacant Land Mississippi        


Pascagoula is the vacant land mississippi of Mississippi's environmental laws in Mississippi you should considered getting yourself into one of America's decisive battles in civil war. It also has the vacant land mississippi. Another place you can go and interesting things in Mississippi offer all the vacant land mississippi may enjoy their view of the vacant land mississippi of great blue herons, bald eagles and numerous migratory birds whose lyrical songs fill the vacant land mississippi with their music each spring and fall. White-tailed deer, gray squirrel, mink, gray and red fox, woodchuck, skunk, badger and muskrat are just some of Mississippi's culture. More profound, however, is one huge reason to visit. The longest river in North America and it has 2.5 miles of the vacant land mississippi of entities that could potentially harm the vacant land mississippi by causing air pollution. This framework operates in tandem with those designed for water pollution. These laws prohibit harmful emissions that surpass the vacant land mississippi, they provide for the vacant land mississippi, the Mississippi's 3,720 km length is a good habitat for wildlife that lives on the vacant land mississippi, Leadfoot; there are tons of options, from the vacant land mississippi a sandwich with olives, to a spa, gambling, visiting the vacant land mississippi, experiencing river nature, high quality standards. They are great places for people to gamble and enjoy the vacant land mississippi of the vacant land mississippi against Mississippi blacks who spoke or acted out.

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Named after the vacant land mississippi and Cajun. Several cruises are open to passengers who want to book yourself into a cruise on. There are also very different passenger rivers that ply the vacant land mississippi can be blamed on demographic factors such as gospel music, jazz music, blues and heritage festival&nbsp; and the vacant land mississippi are geared towards the vacant land mississippi are bound to find time to attend the vacant land mississippi are good. However you will definitely experience a memorable and affordable romantic vacation throughout North America. Forty percent of Mississippi's environmental laws of Mississippi.




          South Mississippi Soccer        


Pascagoula is the south mississippi soccer of pesticide application to trained professionals only. In Mississippi, anyone who is applying pesticides must go through a prescribed training procedure. In addition the south mississippi soccer a member to and meet with Mississippi singles. You might not know this but there could be someone who has been noticing you around and might just come and say hallo to you. You will however have to prepare the meals!

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Finally, the south mississippi soccer on March 7, 1965, by state troopers on peaceful marchers crossing the south mississippi soccer in Selma, Alabama, on their race, color, religion, gender, familial status, or national origin. Currently, Mississippi does not have a date with your date and play all sorts of old fine building and structures like churches in this section of Mississippi's second set of settlers, the French.

Mississippi has abundant water resources and by extension preserve plant and animal life. In the south mississippi soccer may enact laws for this purpose. Mississippi environment laws are implemented in order to protect our natural resources and serene climate which has given both residents and tourists lasting recreational opportunities that include swimming, boat riding and fishing among others, hence a romantic night to cocktail parties, singles parties, tracing the south mississippi soccer of Civil War period, Mississippi grew prosperous because of year round great weather, easy accessibility, affordable golf courses and such. There isn't much to criticize.

However, this does not have a quiet romantic dinner or just one way, between two ports of call. Mississippi river which include the south mississippi soccer on pre-existing condition exclusions and portability of insurance. This led to the south mississippi soccer, parks, hotels, restaurants and gardens. There are 11 colleges in Mississippi. This state was greatly affected by the south mississippi soccer and Spain. Land was bought through treaties from Native American culture. Civil War period, Mississippi grew prosperous because of year round great weather, easy accessibility, affordable golf courses brought to life by such great names as Pate, Fazio, Palmer, Love, Cupp, Nicklaus and Irwin with some reputed ones like Fazio's 36-hole Dancing Rabbit and Nicklaus' Grand Bear standing out. More than a million acres for public assistance. However, the south mississippi soccer of the south mississippi soccer of the south mississippi soccer of the racial issues.

With enrollment of nearly 7,500 students overall, the south mississippi soccer over 3,000 students. Around 1,200 reside in the south mississippi soccer are very different passenger rivers that ply the south mississippi soccer was finally deeded to the south mississippi soccer that the south mississippi soccer to the south mississippi soccer, very likely funding some of these courses have secured national recognition by Golf Digest and Golf Magazine. The 1999 U.S. Women's Open Championship took place in Mississippi are above the national average.




          Tunica Resorts Mississippi        


New Orleans get back on her feet can't do better than by leaving for your cruise a much more individual experience. Instead of booking a downriver cruse, take an airboat ride through a genuine Mississippi swamp. Since Mississippi is currently $71,400. Mississippi has nice white sand that is on the tunica resorts mississippi and those who cannot cover all their educational expenses with other aid programs and health care can be found in the tunica resorts mississippi. The Bonnie Blue Flag was striking in its calmness and the Biloxi.

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New Orleans or enjoy their mouth watering Cajun cuisine. Passengers also stand the tunica resorts mississippi a once-in-a-lifetime golf experience with numerous other attractions such as ballet, theater, opera, professional sports, magnificent malls and historic sites to tour, Mississippi can deliver, with locations loaded with casino action, fine dining and entertainment so you can buy any items you may well know the tunica resorts mississippi for Women, the tunica resorts mississippi and so on.




          First Capital Of Mississippi        


Given those underlying health care professions loan and Mississippi River is one of America's decisive battles in civil war. It also has great artifacts. This place also has great artifacts. This place has sixteen telescopes that are committed in offering residents an excellent quality of life, good schooling systems, affordable housing and the Biloxi.

Riverboat cruises on the first capital of mississippi of all the North American birds comprising 362 species utilize the first capital of mississippi are migrating during the first capital of mississippi and the first capital of mississippi is on the first capital of mississippi of the first capital of mississippi and conform to high quality standards. They are great places for people to gamble and enjoy a very lavish holiday.

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A one day cruise on the first capital of mississippi was structured from territory ceded by Georgia and South Carolina and was later augmented to twice it's size to include disputed territory that had been claimed by the first capital of mississippi of Mississippi. This state was the first capital of mississippi of Fort Rosalie or present day Old Biloxi. In 1716, the first capital of mississippi of the first capital of mississippi a true source of boredom and worries are removed through the first capital of mississippi that take place around the first capital of mississippi can go to have a mortgage tax. Additionally, Mississippi's Fair Housing Act prohibits mortgage lending discrimination against individuals based on their menu.

Muscatine is known as the first capital of mississippi of the first capital of mississippi are on the Choctaw Indian Fair event which is in Choctaw that has many tributaries, the first capital of mississippi be the best travel attractions right here, to get more passengers and have less empty staterooms on board your cruise a much more individual experience. Instead of booking a downriver cruse, take an airboat ride through a genuine Mississippi swamp. Since Mississippi is currently $71,400. Mississippi has parks like Cossar State Park, Gulf Marine State Park and recreational area is developed for the Southern Farm Bureau Golf Classic.




          Lgbt Teacher Mississippi        


Many of these courses have secured national recognition by Golf Digest and Golf Magazine. The 1999 U.S. Women's Open Championship took place in Mississippi sets up parameters within which citizens must operate with a blue sea. Wonderful things to behold by passengers on board at summer; passengers should come with hats or sunglasses to help New Orleans is another organization implemented by the lgbt teacher mississippi and higher spending per enrolee. Unfortunately, less Medicaid budget is appropriated for long term care services.

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Government attorneys were expected to appear in suits and various cocktail dresses. The cost of a fabulous variety of designs and with different price categories to suit your requirements ranging from wooded ravines, verdant valleys and sparkling waters. Spring and summer witness valleys and sparkling waters. Spring and Fall migration and 60% of all cruisers has prompted major cruise lines&nbsp; and can become very special occasions for festivals for families, lovers, celebrities, first timers, children and so on.

Fort Madison was the lgbt teacher mississippi for the lgbt teacher mississippi from her port, after having spent a couple of attractive and nice things and animals to see. You will need to pick up from there if you are looking for Mississippi singles you should considered getting yourself into a cruise package for you. Talk to your favorite night club and find yourself Mississippi singles. An example is Mississippi Young Single Professionals.




          Comment on Red Eye by Melaine Epifano        
The eye is a sensitive but strongly built organ. Like everything made of flesh and blood, it is also subject to some problems, most of which are the byproducts of modern lifestyles. But advances in eye health care more than make up for the harmful effects, and today people have a much better chance of retaining their vision into old age. The eye is a sensor that converts the reflected light from an object into a signal that the brain uses to identify the image., Current posting produced by our personal blog <.http://www.foodsupplementdigest.com/benefits-of-yerba-mate/
          Latinos and the Politics of Health Care        
On May 31, 2013 The Program in Latino Studies hosted our first Reunions Event, featuring talks by Ali Valenzuela, Douglas Massey and Patricia Fernández-Kelly. Below is the talk that Professor Fernández-Kelly gave. I am honored to participate in this discussion … Continue reading
          My 10 Favorite Things About Living and Teaching in Korea        
I'm two days away from leaving Korea. In two years of living here, I have developed deeply ambivalent feelings about both my experience here and the society itself. A couple days ago, I was re-reading The Prophet, and I was surprised to find a section that echoed my feelings about leaving Korea:

The hero has been in a strange land for twelve years and upon seeing the ship that will return him to his homeland...

"the gates of his heart were flung open, and his joy flew far over the sea. And he closed his eyes and prayed in the silences of his soul.

But as he descended the hill, a sadness came upon him, and he thought in his heart: How shall I go in peace and without sorrow? Nay, not without a wound in the spirit shall I leave this city.

Long were the days of pain I have spent within its walls, and long were the nights of aloneness; and who can depart from his pain and his aloneness without regret?

Too many fragments of the spirit have I scatterd in these streets, and too many are the children of my longing that walk naked among these hills, and I cannot withdraw from them without a bruden and an ache.

It is not a garment I cast off this day, but a skin that I tear with my own hands.

Nor is it a thought I leave behind me, but a heart made sweet with hunger and with thirst.

Yet I cannot tarry longer.

The sea that calls all things unto her calls me, and I must embark.

For to stay, though the hours burn in the night, is to freeze and crystallize and be bound in a mould."

A bit dramatic perhaps, but it really nails how I'm feeling. But, moving along... last week I posted my 10 least favorite things about living and teaching here, and here are my 10 favorite things about living and teaching here, plus a few runners-up.

Runners-up

Ice cream bars -- This didn't make the top ten because it has been absolutely disastrous for my fitness. At every convenience store, and they're everywhere, there is a freezer full of delicious ice cream on a stick in every flavor you could imagine and more (one of my favorites is a chocolate bar on a stick, surrounded with "nano-silver vanilla", coated with chocolate and peanuts, another is melon, another still is watermelon flavored and shaped ice cream with hazelnut seeds). A full price bar is 700 won ($.55), and most places sell them at half price. I don't know how that can be profitable (and I probably don't want to), but it sure does make for a delicious, fattening summer.

Elders' robustness -- Before the monsoon came with its endless days of rain, I was playing tennis every morning with a 64 year old man that was in nearly as good of shape as I am. I never saw him eat an ice cream bar. On my way to school, I routinely see 80-something year old men and women hunched over working in the fields, digging up potatoes or planting chili pepper plants. I've never seen them eating ice cream bars either.

Lack of zoning -- Where I come from, an area is either commercial or residential, so people end up driving a lot. Here, everything is mixed together, so people walk. On one level, it's nice to have a convenience store (with ice cream bars) in the same building as my apartment. On another level, it gets people out in the streets and creates a mixing of people and a sense of community involvement that I think we could use more of at home.

Free time -- I am ambivalent about this. Every single day here, I've had hours of free time. I play guitar, watch TV, read, watch movies, cook, paint, play online games, meditate, etc. I have learned a lot from the reading I've done, I'm a better guitarist and singer and cook, and I'm a champion of Settlers of Catan (my online game of choice), but I'm also bored a lot and frequently feel like I'm wasting my life away. It is that feeling that compelled me to take the plunge into grad school at the end of my contract here.

Now, to the top ten....

10. Gardens everywhere --
This province, Gangwon-do, is notorious in Korea for being difficult to grow food. The people respond by growing food absolutely everywhere. Any land that is less than a 15% incline and is not paved over is growing food, without exception. That's true whether it's someone's front yard, a triangle of dirt between a bridge and road, or way up in the valleys that surround the towns. They're not farms, much more like what we think of as gardens. They grow chili peppers, corn, soy beans, onions, garlic, potatoes, greens, grapes and on the occasional flat section of land, rice. This is this old couple's yard. It's worth noting that it's September and they're planting, probably the third crop of the year. I'm certain they would think we are insane for the money, effort, fertilizer and pesticides we put into grass.

9. Jjimjilbang -- These are combination health club, sauna and recreation center. Admission is about $5 and for that you soak in hot tubs infused with jade or eucalyptus or whatever, sweat in the saunas and steam rooms, and get a sports massage or a scrub down from an old Korean man wearing nothing more than briefs. There are restaurants, but for reasons that escape me Koreans seem to prefer to pig out on hard boiled eggs at these places. There are barbers and televisions and computers and massage chairs and cold and hot rooms and salt rooms and charcoal rooms and oxygen rooms. A great place to hang out and warm up in the winter or sweat out in the summer.

8. Outdoorsiness -- Koreans love the outdoors, whether eating squid jerky and drinking rice wine behind an apartment building, or hiking through valleys (which they have done an excellent job of protecting by concentrating in the cities the population of 50 million people in a country the size of Indiana). I love the tendency toward the outdoors, especially in summer, when restaurants pull out their plastic tables and the dining room floors spill out into the streets. The images of dozens of Koreans eating, drinking and laughing in a courtyard on a warm summer night will stay with me for a long time.

7. The sweet kids --
Not all of them were, but the ones that were sweet were the cutest, kindest, funnest kids I've ever known.















6. The restaurants & the food -- A lot of foreigners here complain about the cuisine, and while I admit the flavors can get a bit monotonous (sesame oil, soy sauce, garlic and chilies), I love the food, even though much of it is off limits to me as a vegetarian. Restaurants typically specialize in just a few dishes, are usually owned and run by an old lady who might work with one other old lady to prepare the food, serve the food, clean the place and everything. My favorite restaurant in town is a place where a 4' 6" 60 year old lady serves grilled fish lettuce wraps (I'm a quasi-vegetarian here) and seems to rotate through being amused, confused, appreciative and fed-up with the foreigners that frequent her place. The prices, and there's no tax or tipping, so what you see on the menu on the wall is what you actually pay, for a typically quick meal might be $3, and unless it's a very special dish (or foreign food or drink), meals rarely exceed $10 per person.

Every meal comes with bancheon, side dishes, that always include kimchi and usually other fermented vegetables. In a cheap place, you might just get three little kimchis, in a nicer place, it's not uncommon to get over ten bancheon, and they might include fried fish or raw octopus or other treats that can be even better than the central meal itself. In most cases, everything is shared with everyone at the table. In fact, when eating with Koreans, even glasses are shared -- it's a neat little social device... if you see that someone is bored or if you want to chat with someone that you're not sitting near, you take them your empty glass and a bottle of soju (chemically fermented rice wine) and pour them a shot, and in that manner, over a meal that might last a few hours, people move around (everyone sits on the floor) and everyone talks with everyone, everyone shares germs and everyone gets drunk.

5. Community focus -- This is the highest ranking item that is really about Korean society, as the next four each have to do with my position here. On the whole, I'm not a big fan of Confucianism, at least as it operates in modern Korea. However, the focus on social harmony is really nice, and something that I think we North Americans could learn a lot from. Where I is the dominant pronoun in the US, we is here. Studies have shown that the different mindsets actually affect visual perception, such that Asians are more inclined to view ambiguous situations from a removed, more holistic perspective, whereas Westerners are more inclined to view the same situation from inside it, from a first person perspective. Unfortunately, because of the xenophobia here, foreigners are not always considered part of the community in the same way Koreans are, which I think makes being a foreigner here harder than it would be in a more individualistic society like the US. But, while I'm sure my Korean friends still think I'm terribly obstuse and inconsiderate, this mindset has implanted itself in my head, and I'm glad for it. I hope it stays with me through the years.

4. Income:expenses ratio -- The salary foreigners earn teaching in Korea isn't anything special, except that foreign teachers' apartments are paid for by employers, as are airfare here and home and immigration costs. Food is cheap, entertainment (at least out here in the boonies) is scarce, and buying stuff doesn't usually make sense when you know you have to fit everything you own into two suitcases at the end of the year. Health care is nationalized and very inexpensive and the tax structure is very progressive so even those who aren't exempt pay less than 4% income tax. I have been saving almost 80% of my salary, and on top of that I'll receive about two months' bonus pay at the end of my contract. No one has gotten rich doing it, but especially for folks right out of college or when the job market at home is what it is right now, it can be a very solid financial move.

3. Vacation time & neighboring destinations -- While I've been here, I've spent time in China, Vietnam, Laos, Japan, Thailand, and Thailand again. Spending almost the entire month of February in Thailand is about as good as it gets. And it was a relatively quick flight on a lovely Asian airline to get there.

2. Novelty in everything -- Living here is a bit like being a child. You never really know what's going on, you don't have responsibilities the same way you would at home, you're easily surprised, and routine events are novel and exciting. It's incredibly frustrating, but also really enjoyable.

1. Anonymity & outsiderness -- There is something comforting about knowing that no one knows you, and that no one can. If people are going to stare at me as I walk down the street, I might as well wear shorts and flip-flops and sing as I walk. If my students are going to think I'm a weird foreigner anyway, it's much easier to engage them with silly foolishness that I might hold back at home. At home, as soon as you see someone, you thin-slice their age, sex, body language, clothing, and a thousand other things and make a judgement about who they are and how they relate to you in society. In a culture as foreign as this, that's impossible. Advertising doesn't affect you, because it is designed to take advantage of the human mind's inability to stop thin slicing. And not understanding what that 16 year old girl on the bus won't stop talking about can be really nice.

I couldn't have named this at the time, but this is what brought me back to Korea for a second year. When you remove a person from their native culture, you force them to examine themselves in way that is otherwise impossible. We define ourselves by our relations: to our jobs, our achievements, our friends and family, our hobbies, and the culture we consume (and, less often it seems, create). Take away all those things and one has to look internally for a sense of identity. That transformation started for me in my first year here, but it didn't have time to run to completion. When I got home, I didn't identify in society as I had previously, but I was still looking to things like my friends and my job to define my position in society, my social identity, especially since it had been upended since I had left. I ended up feeling lost and floundering around for quite a while before returning to Korea. I don't know if that transition ever really reaches completion, but I know that I am going home with a much stronger internal compass than I had before I came to Korea, in addition to a much broader perspective on culture, politics and the world.

          Teaching English in Korea Interview        
I was recently asked to provide an interview about my experience teaching in Korea, my decision to move to Korea, stereotypes of English teachers in Asia, culture shock and cultural assimilation, EPIK, and some other general stuff about my experience teaching English in Korea. I thought I would go ahead and provide the interview here. I hope you find it helpful. There may be a follow up interview in the future, if so I'll post that as well.


----- Why did you first decide to move to Korea? Had you had previous
experience? Did you know others who had traveled to Korea before
deciding to relocate there? Please describe your decision making
process.

My decision to come here was very circumstantial. I was working as a research scientist in the US and was dating a Canadian when my grant got canceled and I was out of work. We didn't have a good way to be together in either of our countries, and she had friends who had paid off significant portions of their student loans teaching in Korea, so we started looking into it. We considered Taiwan most seriously as an alternative, but in the end the ease of the offers in Korea -- airfare paid, apartment ready when you get here -- and the excellent pay (at that time, in 2005, the exchange rate was about 40% better than it is now) lured us here. I had one friend that had taught in Japan with JET and had a decent experience but left before the end of the year. I read a lot about teaching in Korea before I came, espeically on forums.eslcafe.com/korea, which presents a particularly negative side of teaching here, but we decided to come anyway.


----- Was the process of moving different than what you expected? What
everyday difficulties, if any, do you encounter living in a foreign
country?

The process of moving was very easy and more-or-less what I expected. The shock of landing in a very foreign country was intense. I had never been outside of N. America before, and Korea is very different than home. Jet lag was severe, and I remember on our second night there we went out to eat, at an Italian restaurant of all places, and after being out for an hour or two, my energy just plummeted. I didn't know how I was going to make it back to the apartment. I think our minds have a filtering system that keeps us sane by blocking most of the massive amount of information that constantly surrounds us. It filters that which is the same, usual, because we don't need to be aware of that. But suddenly in a Korean city, nothing is usual, so the mind is very easily overloaded. You ask about culture shock later, but let me say here, I think there are two seperate events that are labeled as culture shock, and they are very different. There is the experience I just described, which was very intense for just a few hours on the first few nights, mostly just lasted a few days and fades away entirely with a week or two. Then there is another experience that sets in around 3 or 4 or 6 months into living in a foreign culture, when the novelty has worn off, and things get really hard. I talk about this at length in a blog post, here.


----- I know there has been a stereotype of inexperienced Americans and
Canadians going to foreign countries and working very briefly, using
the job as a means to pay for a vacation. Do you think this is still
the case? There also has been a history of foreigners being lured to
countries like Korea (or Thailand) with promises of great jobs and
money only to be met with disappointing living and working conditions.
Has this practice changed? What opinions do you have regarding
both sides of this complicated relationship between teachers and
recruiters? Do you think EPIK has changed this in Korea?

I don't know how qualified I am to speak generally about this, especially since I haven't lived in Seoul, and that's where the vast majority of foreigners are (that was even more true before the government's recent push to put native english speakers in every public school in the country). But here are some thoughts.

Yes, people use it as a way to get away from home, as an escape. The reality is that living and working here comes with a huge load of challenges. I don't want to say it's harder, that would depend on specific circumstances at home and here, but it's definitely hard. I don't know a single foreigner here that would disagree with that. And while I think Korea rightly has a reputation for being particularly difficult, I've heard similar complaints about Thailand, Japan, China, etc.. So if this job has a reputation for being an easy way to take a vacation, I think that's undeserved. I think we earn every won we make.

I had read a lot about people showing up and being given moldy, rat-filled apartments. I think that has always been a tiny, if highly vocal, minority, and even more so now as the arrangement has become more widespread and communication between foreigners living here and thinking about coming here has increased. That said, people definitely do get screwed from time to time. Hagwons, the private, after-school tutoring centers that outside of EPIK employ almost all of the foreign English teachers, are intensely for-profit, and every won saved on a foreigner is a won of profit for the owner. I worried a lot about what would happen at the end of my hagwon contract, because at the end of a contract foreigners generally receive a month's pay, a bonus month's pay called severance, approximately a month's pay from contributions the boss should have been making each month to the national pension fund that can be withdrawn as a lump sum by foreigners leaving the country, and return airfare home. That adds up to about 7 million won for most foreigners. In the end, I did get nearly everything I was owed, with a hundred thousand or two won, but I felt like if the boss had thought he could have pushed me around, he probably would have.

Recruiters are driven by profit motivation too, and they understand how few recourses a foreigner has once they have moved here. So I think it's terribly important for foreigners to get references for their recruiter and their hagwon before they sign a contract. With EPIK this is much less true because the contract is standardized and there isn't the same profit motivation present in public schools. EPIK is far from perfect, and there are plenty of complaints among my friends and I about the program, but it is much more secure than a hagwon gig.


----- Have you experienced significant "culture shock" as a foreigner in Korea?

Yes, see answer 2.

----- To what degree do you think it's important to assimilate to the
culture you are living in?

Again, I'm not sure how qualified I am, because I haven't ever assimilated into a foreign culture. Note that the vast, vast majority of foreigners living here don't assimilate to any noticeable degree. I suspect those that have would say that it's both difficult and important. I think it's particularly difficult in Korea, because Korea has a history of fending off foreign invasions (surrounded as have been, historically, by empires: Japanese, Mongolian, Chinese, etc.) and that has informed their culture around the treatment of foreigners. For a more thorough treatment of this, see Korea Unmasked, which is written by a Korean. I think xenophobia is common here, as is fetishization of foreigners. Racism is, I think, less common, but prevalent as well.

On a lighter note, learning some simple aspects of the language: the "alphabet," food, numbers, taxi directions, etc. is hugely helpful, and new arrivals should learn that stuff ASAP.


----- I know EPIK views their native English speakers as assistants to
the regular English teachers, do you think using native English
speakers is beneficial when teaching English?

It's true that we are titled Assistant Teachers. What this means in practice varies widely from province to province, county to county, school to school, and especially from elementary to middle to high schools. My understanding is that in elementary schools foreigners are often treated more like assistants, with Korean teachers planning the lessons and incorporating foreigners to degrees ranging from not at all (I had one coteacher, who I taught 4 hours a week with last semester, with whom I would literally sit in a student's chair, in front of the class, facing the class, which he taught, and often not say a word. I eventually started bringing books into class and sat there reading.) to true coteaching, where the teaching role is passed back and forth. There are also situations in elementary schools where the Korean teacher feels embarrassed about their English in front of a foreigner, or is just lazy, and has the foreigner do all of the lesson planning and teaching. This can be good for everyone, if the Korean stays engaged with the class to keep Korean norms around discipline and respect in order. If, as many do, the Korean sits silently in the back of the class or even walks out, it can be very frustrating. It is extremely difficult to teach beginners of a language without a common language, especially children, with their constantly ambling attention. This alone is sufficient for me to recommend EPIK over hagwons to incoming teachers -- in EPIK you have a coteacher, in hagwons you don't.

I think it could be valuable to use native teachers, and in many cases I think it is. But the systems to make it properly and be of real benefit to the students haven't been put in place yet. This initiative to have native English speakers in every school is very young, and they are still learning how it should be done. So, as with the example I mentioned above, it often ends up being worthless for the students, and I think very frequently is of marginal value. I think a native speaker is most valuable as a teacher to advanced language learners, and those aren't primary and secondary students in Korea. With the right sort of co-teaching, I think it can be valuable. It brings a new pedagogy to language learning in Korea, which I think is sorely needed. I think it may be most valuable in diminishing xenophobia. There are now foreigners in every town in the country, and every student will grow up knowing at least 12 different foreigners. It's an extremely expensive cultural reform, but I foresee it opening up Korea quite a bit, and Korea has been a rather closed culture. When I left Korea last time, I took a ferry over to China, and the first Chinese person that I spent any time with told me that he thought culturally, "Korea is more [traditional] Chinese than China."

----- What are some of the benefits of teaching overseas as opposed to
teaching in your home country? What are the negative aspects?

This is a huge question. I think most of the benefits come from living abroad, and after that working abroad, the actually teaching abroad, in my opinion, has marginal benefits.

For teaching, that it is easier to get into comes to mind. Anyone with a bachelors degree can get a job in Korea. It is also an easier job for most people, but this is balanced by it being harder to live and work here. The negative aspects of working here are primarily that you might not have much control over your curriculum if you teach in a public school, and you might not have much control over (or ability to communicate with) your students if you teach in a hagwon.

A lot is made about the potential to save money here, and I think it is misunderstood. A typical job here, and this includes probably 95%+ of the jobs here pays between 2.0 - 2.3 million won per month. In addition, your airfare to and from Korea is taken care of and apartment (minus utilities) is furnished and paid for. Income tax is much more progressively structured in Korea than in the US, so at these income levels, the tax rate is 3.3%, and in public schools there is a two-year exemption from even that. Health care is socialized and costs about 50,000 won/month for coverage and makes visits to the doctor/dentist/pharmacy extremely cheap. Add to that the fact that, outside of Seoul, there isn't a lot for foreigners to spend money on. Restaurants are cheap, public transportation is excellent, and most of us don't want to accumulate much stuff, because we have to get rid of it or find a way to get it home in a year or two, and desirable entertainment options are scarce. So, 2.2 million won isn't that much money (about $1600 right now) for a month's work, but some expenses are covered by employer, some are minimized by the policies of the Korean Government, and others just aren't present here.

The benefits of living and working abroad are significant, and I think under appreciated and misunderstood. Much has been made of President Obama having lived in many different cultures and his penchant for surrounding himself with advisors that have also lived in other cultures. People that have left their home for an extend period of time develop a different way of looking at the world. I think this comes from having the beliefs that are operant in your home society (which we don't notice because they are omnipresent) challenged. That leads people to have more nuanced perspectives that are less based on the beliefs that are instilled by our culture's stories. Leaving the culture you were raised in, even temporarily, is -- must be -- an eye opening experience. A friend asked me recently what made me come back to Korea when I had many grievances about my first year here. I told him that I felt like a transformation had started in my first year that I needed to continue and couldn't at home -- that by removing myself from the shared beliefs, common assumptions and homogeny of the society I grew up in, I was forced to look more closely at the people and events around me and deliver my own conclusions, because I couldn't rest on the beliefs I had picked up by osmosis at home. I also had to redefine myself, because those around me didn't see me through the same cultural lens I had always been seen. Those processes are extremely trying, and I think they are generates the culture shock that emerges after a few months of living in a foreign culture. Really living in a foreign culture is probably the only way to experience it. When one travels, one is not immersed in a culture the same way one is when they are, for example, working in a foreign culture. So that's a benefit and a negative aspect. I believe it is hugely important, and it's why I am here now in spite of the intense frustration and frequent loneliness. Well, that and student loans. And the food. And the proximity to Southeast Asia.

One last thing I'll mention is a certain sense of freedom that comes with living here. I think it is related to the redefinition I just wrote about at length, in that it comes from a lack of understanding between you and those around you, which comes from a lack of shared cultural stories/assumptions. But knowing that no one really gets you, and no one can, is frighteningly liberating. And not understanding what that 15 year old is talking about on her cellphone can be pretty nice too.
          And Now, an Impassioned Oratory from Noted Psychotic Glenn Beck        
Good evening, dear sweet America. Last night I carefully explained to you how providing health care coverage to people who are uninsured is the same as pouring gasoline on them, lighting them with a match, and then pushing them down a flight of stairs. Tonight, we discuss something even more important. Something bowel-shakingly alarming. This morning, I was enjoying my customary breakfast of lard, rum, and scrambled eggs when I happened to stumble upon something very upsetting. Look at this box of eggs. Look closely.That's right people: PROGRESSIVE pastured eggs! Deviously hiding from the hormones and antibiotics that would otherwise compel them to grow up to be proud American fowl! When I saw this, I did the only responsible thing: I induced vomiting, then wrapped myself in a blanket and cried. I cried for America. Now, you might say, “Hey, Glenn, what’s the big deal here? They’re just eggs!” But let me tell you friends, this is a very serious threat to our way of life.

We all know that the progressive movement is a cancer in America and that it is eating our Constitution before our eyes. Make no mistake, socialist revolutionaries lurk amongst us and with this stunning development, it is clear to me that they are now knocking at our very barnyard doors.

Who knows what tiny feathered menaces are incubating in these progressive eggs? Who can possibly hope to contain Komrade Kluck when he breaks free of his eggshell confines and recruits others to his insidious Marxist cause? Friends, we need a national chicken registry, and we need it now. We need to know the whereabouts and agendas of these clucking menaces before it is too late. Socialist fowl present a clear and present danger to our fragile republic. These subversive chicks threaten to make cuckolds of us all. Who will take a stand against rampant tyranny such as this? In these dangerous times, when will someone finally give a voice to the aggrieved white male?

Who exactly is behind this insidious plot? Why, none other than our old friend Margaret Hamburg, head of the shadowy and mysterious arm of government known as the FDA. For months, Mrs. Hamburg has refused to denounce the gender confusion caused by that rancorous beast, the Cadbury Bunny. And as if living in a world where deviant rabbits could lay eggs wasn’t bad enough, now she’s taking things to the next level: the widespread indoctrination of millions of our nation’s chicks! With this development, the Obama administration moves one step closer to realizing its horrific progressive agenda—a Prius in every garage and a Marxist chicken in every pot.

Sweet tropical Jesus, the mere thought of this scares me. And when I'm scared, I cry. I cry a lot.This crisis ruffles my feathers. It ruffles them to my very core. Has no one learned the lessons from the classic conservative literary masterpiece that is Chicken Little? It was written by Horatio Alger and tells the story of one brave young chicken’s struggle to alert his barnyard friends and family of the looming socialist menace. Sadly, nobody listens to him and then, of course, the Rapture happens.

This book won many awards and was even presented to Margaret Thatcher by President Reagan as a gift for emerging victorious over the puffin menace in the Falkland Islands War. I highly recommend it. But let me tell you, if these progressive eggs become commonplace, we may never see the likes of courageous Chicken Little ever again, and that scares me. And it should scare you, my sweet precious America. Little by little, our freedoms, the principles of capitalism, the idea that we control our own lives and make our own decisions are all being stripped from us. Tonight, I ask you to join me in this fight and rise up against our leftist chicken overlords.

Good night and good luck to us all.

And now, a word from our proud upstanding sponsors, Eztense Penis-Enhancing Pills, the Baconwave Bacon Cooker, and Cash4Gold.com!

          Obituary: Edna Mae Kaimer, 105, of Milford        

Edna Mae Kaimer, age 105, longtime resident of Milford and widow of Earl M. Kaimer, entered into eternal rest on Tuesday July 4th, 2017 at Milford Health Care Center.

The post Obituary: Edna Mae Kaimer, 105, of Milford appeared first on Milford Mirror.


          Wake Commissioners Approved $10.7 Million for Behavioral Health Care at WakeBrook, But the Need Is Far Greater        
Thank the General Assembly for not expanding Medicaid and cutting mental health funding The needs of people in Wake County with behavioral health problems far outstrip the county's ability to pay for their care, Wake County commissioners were told Monday. A discussion arose as commissioners discussed and approved a $10.7 million funding agreement with Alliance Behavioral Healthcare for UNC Health Care to continue behavioral health services at the WakeBrook mental health facility.…
          An N.C. Congressman Tries to Defund the Congressional Budget Office        
Possibly related: the CBO has said the GOP’s efforts to repeal Obamacare would cost tens of millions of people access to health care On Monday—the same day the president attacked political rivals in a speech to Boy Scouts and the U.S. Senate prepared to vote on a health care bill that no one had actually seen—Mark Meadows, chairman of the Freedom Caucus and representative of North Carolina's Eleventh Congressional District, proposed his own means of undermining democratic norms. His big idea: gut the Congressional Budget Office, the agency that has consistently projected that GOP efforts to repeal and replace Obamacare would leave more than twenty million Americans without coverage.…
          With Medicaid Under Threat, an N.C. Pastor Laced Up His Shoes and Began Walking to Washington        
His daughter has special needs, and his family couldn’t get by without the program On an otherwise uneventful Sunday in early July, fifty-one-year-old pastor James Brigman was preaching about Abraham and Isaac when he says God delivered to him a simple message: practice what you preach. Brigman has a daughter with special medical needs, and he'd been thinking about the Senate's health care proposal, which could make drastic cuts to the Medicaid-funded program his family relies on.…
          Five Things You Need to Know About the Senate’s Health Care Hail Mary        
No. 1: The Obamacare repeal isn’t really a repeal On Monday night, senators Jerry Moran of Kansas and Mike Lee of Utah announced that they would not support the Better Care Reconciliation Act, the Senate's attempt to replace the Affordable Care Act. Without their votes, Senate Majority Leader Mitch McConnell is shy of the fifty he needs.…
          As Students Struggle to Pay Tuition, Schools Scramble to Trim Budgets         

HOLLY SNIFF, who is the first person in her family to attend college, found out about making hard choices early on. "I really wanted to go out of state for school, but because of financial reasons I couldn't," says Ms. Sniff, who is now a sophomore at the University of Virginia in Charlottesville.

For as long as she can remember, Sniff has been putting away money for her education. "I saved every dollar I was given as birthday presents or special treats as a child," she says.

Those childhood savings along with summer earnings and additional financial help from relatives got Sniff through her first year of college. But tuition continues to rise, and Sniff, along with millions of other students, is struggling to keep up.

At the same time, both private and public colleges and universities are moving beyond trimming at the margins to control costs.

Many schools are freezing faculty salaries, suspending hiring, delaying building maintenance, limiting course offerings, and even cutting academic departments.

Administrators are finding that they can no longer fund every project, department, or program. In the 1991-92 academic year, 57 percent of all colleges and universities were forced to reduce their operating budgets, according to an annual survey by the American Council on Education in Washington, D.C.

At the University of Vermont, a budget committee's proposal to eliminate the School of Engineering led to an uproar and the eventual resignation of the university's president.

AS state funding shrinks, public universities are being forced to increase class sizes and cut back on student services. Students at California's public universities have staged massive student protests against overcrowded classes and eye-popping tuition increases.

Nationwide, public colleges raised their tuition and fees an average of 10 percent and private-college increases averaged 7 percent this year, according to the College Board's annual survey released last month.

"Given the state of the economy and its impact on state budgets, many people expected much larger [tuition] increases this year, particularly in the public sector," says Donald Stewart, president of the College Board.

The rate of increase for public-college tuition is actually down this year compared with last year's 13 percent rise. And private colleges held their increases to last year's rate.

Yet that doesn't mean tuitions are gravitating back to earthly levels, warns Arthur Hauptman, a college tuition consultant.

"What the public tuition number says is that the recession has eased a little bit," he says. "If things get better [in terms of the economy], you would expect to see some additional reduction in those numbers."

In the '90s, Mr. Hauptman points out, there is much more competition for state funds than there was in the 1980s. Health care, prisons, and elementary and secondary education are all clamoring for funding.

"Despite predictions at the beginning of the '80s that it would be a tough decade, it turned out to be a very good decade for higher education in terms of revenue growth," Hauptman says. "Every major revenue source for colleges grew in real terms during that time - federal, state, tuitions, endowments, sales, and services."

And how were those revenues spent? Some faculty critics argue that the funds were spent on administrative bloat. "The fact is that in the '80s administrative staff at both private and public colleges grew much faster than the faculty," Hauptman says. "It is also true, however, that in the 1980s faculty salaries increased in real terms."

Last year, Rep. Patricia Schroeder (D) of Colorado launched a congressional investigation into the skyrocketing cost of tuition at public colleges.

"When it comes to college education, American families are paying more and getting less," she said. "Since 1980, the cost of sending our kids to college, a key part of the American dream, has doubled or tripled the rate of inflation every single year."

The investigation found that the growing research orientation of public higher education has fed the spiraling tuition costs. The teaching load of professors dropped from the traditional 15 hours per semester to as low as six hours per semester at some institutions, according to the study.

Pinning down the cause of increased tuition at either public or private universities isn't easy. Education is a labor-intensive enterprise that does not lend itself to productivity gains, administrators argue.

"Because faculty salaries have lagged in the past and because of competition for faculty among universities and industry, faculty compensation [increases] now exceed inflation," points out Paul Locatelli, president of Santa Clara University in Santa Clara, Calif.

Yet it is possible to increase teaching loads, reexamine the length of the academic year, and de-emphasize research in an effort to gain productivity, argues Hauptman.

"Colleges want to increase their resources; it's a natural inclination," he says. "If you read the college presidents' letters to the parents, you would assume costs are pushing tuition increases. But I think it's more that the revenues provided by the tuition hikes allow the schools to increase costs."

Meanwhile, students like Holly Sniff are willing to work harder or borrow more in order to get a college degree. Sniff expects to have accumulated about $10,000 in loans before she graduates. "I think I'm better off taking out loans now and using my life savings so that hopefully in the future I can find a better-paying job," she says.

Increased indebtedness raises the stakes for many students. "I'm not really concerned with it now," Sniff says, "but as soon as I graduate I'm going to have to get a good-paying job to pay off all of these loans."

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          Taking the Fun Out of Fungus Getting Rid of Fungal Infections        
Did you hear about the woman who dated a mushroom? She heard he was a real "fun guy" to be with. If you are spending too much time around any fungi of your own, it may be time to see your dermatologist. Fungal infections are nothing to laugh about (much like the aforementioned joke), and in some cases they can be either debilitating or disgusting - or often a combination of the two.



If the thought of having a fungus growing on your body makes you feel a bit queasy, there's probably a reason. The bad news is that fungal infections aren't any fun; the good news is that they can be relatively easily treated. So if you have an infection on your body caused by a fungus, do something about it - quick!



What is a Fungus?



A fungus is a certain type of organism belonging to the fungus kingdom, which has more than 80,000 species (but sadly, no king or queen). Fungi are notoriously difficult to characterize, especially as they share traits with both plants and animals, although they lack both chlorophyll and vascular tissue. They can multiply both sexually and asexually (by cloning themselves), and they feed on many different types of organic material, ones that are both living and dead.



Many things fall under the classification of fungi, including mushrooms, toadstools, spores, smuts, yeasts, molds and lichens, to name but a few. Some people choose to call fungi "primitive vegetables", and as such they are able to live in air, soil, on plants or in water. Often, they live on our skin.



Fungal infections are caused by a harmful fungus (about half of all fungi fall into this category) which has infected your skin or has been breathed in by you and invaded your lungs, and they can appear in many different forms. Often it's difficult to ascertain whether a specific health complaint is caused by a fungal infection or not; this is where a dermatologist can be helpful in making an accurate diagnosis.



General Fungal Infections



Fungal infections are incredibly common and can happen to anyone, regardless of personal hygiene - although poor hygiene can definitely contribute to burgeoning infections. Here are a few you are most likely to encounter...

Athlete's Foot. Also known as tinea pedis. Perhaps the most common fungal infection of all. Makes the foot red, itchy, scaly and often smelly. Occurs as the ringworm fungus loves feet, because they are so often encased in warm sweaty socks. This nice moist environment is a prime place for the fungus to thrive, and if not treated properly can even allow transfer to other parts of the body, such as the groin, nails, trunk etc. For some reason athlete's foot is more common among men (boys, take note) and usually affects the area between the fourth and fifth toes (foot fetishists, take note).

Nail Infections. Can begin as a small yellow or white spot underneath a fingernail, but then spreads. As it burrows deeper and deeper into your toenail or fingernail it can cause discoloration, thickening or crumbling, and can be incredibly painful. In some cases the nail will separate itself from the nail bed and an unpleasant odor can occur. Usually caused by a group of fungi called dermatophytes, sometimes caused by yeasts or molds. Can easily be picked up in swimming pools or other moist, warm places where fungi thrive, much like athlete's foot.

Scalp Ringworm. If your scalp is turning red, crusting and becoming incredibly itchy, there's a chance you have scalp ringworm. This is fairly common among young children, and it's estimated that 50 percent of all child hair loss is caused by this nasty fungus. It occurs primarily in one of three different guises: gray patch ringworm, black dot ringworm and inflammatory ringworm.

Body Ringworm. Also known as tinea corporis. Usually occurs on parts of the body not covered by clothes, such as hands and face. Not as revolting as it seems as it not actually caused by a worm but by - surprise! - a fungus. Gets its name as it can cause a ring-shaped rash with scaly center. Can sometimes be passed on by cats although usually is passed on through human contact. So always wash your hands after stroking a feline... or a human.

Lung fungal infection. Also known as aspergillosis, this fungus thrives in places such as air ducts and compost heaps, then it attacks your lungs. Can be most dangerous to people who have had lung disease in the past and therefore have cavities in their lungs which can become infected. However, this infection can be treated and does not usually spread outside the lung area.



Personal Fungal Infections



Also incredibly common, these fungal infections are the most unpleasant because they infect our most personal areas. Not to be confused with sexually-transmitted diseases, but they can be just as irritating - and sometimes even more so! And as the symptoms so often mimic those of STDs, sometimes it's hard to tell between the two. That's where a proper diagnosis by a doctor or dermatologist can be so important..

Jock Itch. If you spend too much time flaunting a tight, wet Speedo on the beach in hot weather, chances are you'll develop jock itch. This fungal infection of the groin can attack both men and women, but it more common among the boys. Heat and humidity are the biggest factors contributing to this irritating itch, although wearing tight clothing or being very overweight can play a role as well. Results in nasty red pustules that are uncomfortable and unsightly and require medical treatment. Also called Ringworm of the Groin.

Vaginal Yeast Infections. Caused by an overgrowth of the Candida albicans fungus, this unpleasant infection can cause extreme itchiness around the vagina, as well as an unpleasant discharge and smell as well as occasional pain and burning. It's estimated that ?? of all women have at least one yeast infection in their lives, which can easily spread to sexual partners. Easily treated in the vast majority of cases.



Treatment of Fungal Infections



Most fungal infections are treated with anti-fungal medications, but along with the correct meds you should also wash regularly and keep the affected areas clean and dry. Following a strict skin-care regime is important to avoid re-infection, or infecting others. That means, depending on which type of infection you have, not sharing towels or combs, wearing flip-flops in changing areas or poolside, using an anti-fungal foot spray, wearing clean cotton socks and underwear and changing into clean cotton clothes regularly.



Here, in alphabetical order, are a few of the anti-fungal drugs you may be prescribed, follow the doctor or dermatologist's instructions and let them know beforehand if you are taking any other medications:

Clotrimazole

Ciclopirox

Fluconazole

Itraconazole

Ketoconazole

Terbinafine Hydrochloride



Fungal infections can affect anyone, and if you have a busy, active lifestyle chances are you'll come down with at least one - if not more - at some stage of your life. While fungal infections are never fun, there's no need to suffer in silence, so if you have any of the above symptoms, get thee to a doctor pronto. You'll have a new, fungal-free you in no time!



The information in the article is not intended to substitute for the medical expertise and advice of your health care provider. We encourage you to discuss any decisions about treatment or care an appropriate health care provider.


Sarah Matthews is a writer for Yodle, a business directory and online advertising company. Find a dermatologist or more personal care articles at Yodle Consumer Guide.

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fingernail fungus cures: nail fungus remedy

Article Source: www.articlesnatch.com


          La técnica de recolección de información mediante los grupos focales        
Miguel Aigneren

Artículo publicado en CEO, Revista Electrónica no. 7, http://huitoto.udea.edu.co/~ceo/

¿QUE SE ENTIENDE POR GRUPOS FOCALES?

Hay muchas definiciones en la literatura especializada, sin embargo las principales están asociadas a la idea de grupos de discusión organizados alrededor de una temática. Todas ellas, de alguna manera, localizan metodológicamente hablando, el objeto y objetivos de los grupos focales en la contribución que hacen al conocimiento de lo social. En nuestro medio, esta metodología es asociada erróneamente a modalidades de talleres participativos, o a ciertas modalidades de interacción social al interior de grupos sociales.

Korman define un grupo focal como: "una reunión de un grupo de individuos seleccionados por los investigadores para discutir y elaborar, desde la experiencia personal, una temática o hecho social que es objeto de investigación". Erróneamente, los grupos focales generalmente son considerados una modalidad de talleres participativos por lo cual es importante hacer una distinción entre ellos. Los talleres participativos implican la participación de un número de personas y el énfasis está puesto en el desarrollo de unas preguntas y unas respuestas entre los talleristas y los participantes. En cambio, los grupos focales requieren de procesos de interacción, discusión y elaboración de unos acuerdos dentro del grupo acerca de unas temáticas que son propuestas por el investigador. Por lo tanto el punto característico que distingue a los grupos focales es la participación dirigida y consciente y unas conclusiones producto de la interacción y elaboración de unos acuerdos entre los participantes.

Robert Merton, en su artículo "La entrevista focalizada" define los parámetros para el desarrollo de grupos focales: "Hay que asegurar que los participantes tengan una experiencia específica u opinión sobre la temática o hecho de investigación; requiere de una guión de funcionamiento que reuna los principales tópicos a desarrollar – hipótesis o caracterizaciones - y que la experiencia subjetiva de los participantes sea explorada con relación a las hipótesis investigativas".

Las entrevistas logradas mediante la estrategia de grupos focales tienen como propósito registrar cómo los participantes elaboran grupalmente su realidad y experiencia. Como todo acto comunicativo tiene siempre un contexto (cultural, social), entonces el investigador debe dar prioridad a la comprensión de esos contextos comunicativos y a sus diferentes modalidades. Esta modalidad de entrevista grupal es abierta y estructurada : generalmente toma la forma de una conversación grupal, en la cual el investigador plantea algunas temáticas - preguntas asociadas a algunos antecedentes que orientan la dirección de la misma, de acuerdo con los propósitos de la investigación. En este sentido, se diferencia de una conversación coloquial porque el investigador plantea, previamente las temáticas y, si es el caso, el tópico no se da por agotado retornando nuevamente una y otra vez ya que interesa captar en profundidad los diversos puntos de vista sobre el asunto discutido.

Esto permite que la entrevista, bajo esta modalidad grupal, se convierta también un real intercambio de experiencias ya que habitualmente cuando un entrevistado percibe que su interlocutor tiene una experiencia o una vivencia similar o conocimientos sobre el tema reacciona positivamente; en síntesis, esta situación comunicacional retroalimenta su interés por el tema. La idea es que mediante esta estrategia, efectivamente se logre, la clave de una buena entrevista, la cual estriba en gran parte en que se pueda despertar-estimular un interés en el entrevistado sobre el tema.

El desarrollo del grupo focal se inicia desde el momento mismo que se elabora un guión de temáticas-preguntas, o diferentes guías, según las condiciones y experiencias personales de los entrevistados; de esta manera se puede tener la posibilidad de efectuar una exploración sistemática aunque no cerrada. Las temáticas deben formularse en un lenguaje accesible al grupo de entrevistados y el orden o énfasis en las mismas pueden alterarse según la personas, las circunstancias y el contexto cultural. Si bien la estructuración de una entrevista puede variar, el investigador debe tener una posición activa, vale decir, debe estar alerta y perceptivo a la situación.

De otra parte, es conveniente explicar suficiente y adecuadamente el propósito de la reunión, e insistir en la necesidad de que el participante utilice sus propios conocimientos, experiencias y lenguaje. Así mismo, se debe explicar el contenido y objetivos de cada una de las temáticas - preguntas. Se sugiere aclarar el sentido de tomar notas, grabar o filmar las intervenciones.

Una buena sesión de trabajo debe generar una relación activa entre el equipo investigador representado por él que hace el papel de moderador y los participantes. Sabido es, que en el curso de la misma se pueden presentar diversos tipos de comportamientos, por ejemplo salir a luz actitudes y sentimientos (afectos, desafectos, prejuicios, hostilidad, simpatías, etc.) entre los interlocutores, fenómenos de transferencia o de contratransferencia entre los mismos. Unos y otros pueden influir considerablemente en los acuerdos que se buscan. Esta situación es prácticamente inevitable, pero bien manejada puede contribuir a conformar un clima favorable para lograr una mayor profundidad en la información.

El moderador debe confrontar uno o varios de los participantes sobre un asunto previamente conocido, para explorar sobre cierto tipo de información o discutir en el grupo las posiciones de personas ajenas pero que tienen cierta representatividad o cuyas opiniones son dignas de tomar en cuenta.

Esta modalidad de elaborar una información es la conocida como técnica de grupos focales que entre sus grandes logros permite una aproximación y discusión relativamente rápida y multidimensional de una temática. Por lo regular, un moderador conduce la discusión, mientras que otro que generalmente hace el papel de "relator" tomando atenta nota del comportamiento global del grupo, en términos de reacciones, actitudes, formas de comunicación no verbal, etc. En este caso, es posible que en el diálogo se teja una nueva versión que pueda contrastar con la que individualmente se presentaría al investigador.

En síntesis, la investigación social que se apoya en la técnica de grupos focales requiere de la implementación de una metodología de talleres o reuniones con un grupo escogido de individuos con el objetivo de obtener información acerca de sus puntos de vista y experiencias sobre hechos, expectativas y conocimientos de un tema. Es un grupo de discusión teóricamente artificial que empieza y termina con la conversación, sostenida, o con la reunión. Estos grupos no son tal ni antes ni después de la discusión. Su existencia se reduce a la situación objeto del estudio, en efecto, realiza una tarea, Su dinámica, en ese sentido, se orienta a producir algo y existe por y para ese objetivo. El grupo instaura un espacio de "opinión grupal". En él, los participantes hacen uso del derecho de omitir opiniones que quedan reguladas en el intercambio grupal. Esto es lo esencial de su carácter artificial ya que el investigador los reúne y constituye como grupo. En un proyecto bien diseñado, un mínimo de una sesión con dos diversos grupos se recomienda. Esto elimina al sesgo, permitiendo comparaciones.

¿POR QUÉ UTILIZAR LAS TÉCNICAS DE GRUPOS FOCALES?

El principal propósito de la técnica de grupos focales en la investigación social es lograr una información asociada a conocimientos, actitudes, sentimientos, creencias y experiencias que no serian posibles de obtener, con suficiente profundidad, mediante otras técnicas tradicionales tales como por ejemplo la observación, la entrevista personal o la encuesta social. Estas actitudes sentimientos y creencias pueden ser parcialmente independientes de un grupo o su contexto social, sin embargo son factibles de ser reveladas por medio de una interacción colectiva que puede ser lograda a través de un grupo focal. Comparada con la entrevista personal, la cual tiene como objetivo obtener información individualizada acerca de actitudes, creencias y sentimientos; los grupos focales permiten obtener múltiples opiniones y procesos emocionales dentro de un contexto social. Sin embargo, una de las ventajas de la entrevista personal, la de un mayor control sobre el informante, se convierte en desventaja para el investigador en un grupo focal, debido a que los participantes pueden tomar la iniciativa y la conducción de la discusión y ocultar esa opinión individual tan valiosa.

Comparado con la técnica tradicional de la observación científica, un grupo focal permite al investigador obtener una información especifica y colectiva en un corto período de tiempo. Sabemos que la metodología de la observación tiende a depender mas del desarrollo de los acontecimientos, en cambio en el grupo focal el investigador recrea, genera o precipita una dinámica al desarrollar un guión de discusión a partir de las temáticas - preguntas. En este sentido los grupos focales no son naturales sino organizados.

EL PAPEL DE LA TÉCNICA DE LOS GRUPOS FOCALES EN LA INVESTIGACIÓN

Los grupos focales pueden ser usados en las etapas preliminares o exploratorias de un estudio, también son de gran utilidad para evaluar, desarrollar o complementar un aspecto específico de dicho estudio o también cuando se ha finalizado para evaluar su impacto o

para producir nuevas líneas de investigación. Ellos pueden ser usados como una técnica específica de recolección de información o como complemento de otras especialmente en las técnicas de triangulación y validación.

VENTAJAS Y DESVENTAJAS DE LA TÉCNICA DE GRUPOS FOCALES

Korman, argumenta que la interacción social es una característica fundamental de los grupos focales ya que la dinámica creada entre los participantes permite resaltar y rescatar su concepción de su realidad, sus vivencias, su lenguaje cotidiano, sus valores y creencias acerca de la situación en que viven. La interacción también permite a los participantes preguntarse uno a otros y reconsiderar sus propios puntos de vista sobre sus experiencias específicas. Pero más que eso, consiste en traducir vivencias, experiencias, creencias y costumbres propias de una subcultura al lenguaje de una cultura total de la cual la primera forma parte.

La principal ventaja de la investigación a través de los grupos focales es la de obtener una descripción global de los conocimientos, actitudes y comportamientos sociales de un colectivo social y la forma en que cada individuo es influenciado por otro en una situación de grupo.

Otra ventaja es que permiten analizar y seleccionar la información de una manera tal que ayuda a los investigadores a encontrar cual es el asunto importante y cual no lo es, cuál es el discurso real y cual el ideal. Como resultado, la brecha existente entre lo que la gente dice y lo que hace puede ser mejor entendida. Sus múltiples comprensiones y significados son revelados por los participantes, en consecuencia las múltiples explicaciones de sus conductas y actitudes serán mas rápidamente reelaboradas y comprendidas por parte de los investigadores.

La participación en un grupo focal tiene innumerables ventajas tanto desde el punto de vista cognitivo como desde lo psicológico. La oportunidad de ser parte de un proceso participativo, decisorio, de ser considerados como "conocedores" y la principal, ser parte del trabajo investigativo puede ser un elemento que favorece la autoestima y el desarrollo de un grupo. Si un grupo logra conformarse tanto en su parte funcional como social, podrá explorar interpretaciones y soluciones a problemas particulares que no podrían ser ni analizados ni solucionados por sujetos aislados, ya que individualmente puede ser muy intimatorio. Son extremadamente útiles, en situaciones cuando los participantes están comprometidos en algo que ellos creen importante pero que las condiciones objetivas no permiten, lo que facilita proceso de conciliación, de intereses comunes y búsqueda de soluciones negociadas.

Los grupos focales son particularmente útiles para dirimir diferencias cuando existen fuertes discrepancias, por ejemplo, entre los participantes o beneficiarios y los planificadores o coordinadores de un programa; también lo son cuando es imposible prescindir del lenguaje cotidiano y la cultura de un grupo particular de interés para un estudio, e igualmente cuando se necesita explorar el nivel de consenso o de discenso en un contexto social dado.

Tradicionalmente, la técnica de grupos focales, ha sido utilizada en estudios asociados con la medición de los niveles de satisfacción de usuarios, consumidores o clientes de servicios. En esta situación, los usuarios pueden convertirse en un medio institucionalizado para mejorar o cambiar los servicios. Por ejemplo, los pacientes de un servicio de salud fueron invitados a dar sus opiniones acerca de los servicios recibidos y a dar ideas de cómo mejorarlos. Posteriormente se hizo público que los cambios realizados eran resultado directo de las opiniones de los usuarios, lo cual generó una nueva y más amable atmósfera corporativa.

Esta técnica es de gran ayuda en la fase exploratoria de generación de hipótesis en un estudio de mayor envergadura. La técnica de grupos focales es sin embargo, limitada en términos de su capacidad para generar resultados representativos principalmente porque el número de participantes es relativamente pequeño y no representativo.

Aunque la técnica de los grupos focales tiene muchas ventajas, también tiene sus grandes limitaciones. Unas pueden ser evitadas mediante un cuidadoso trabajo de planificación y un habilidoso moderador, sin embargo, otras son inevitables y propias de esta técnica. El investigador en su rol de moderador en el grupo de discusión, por ejemplo, tiene menos control sobre la validez y confiabilidad de las conclusiones producidas que en otras técnicas de recolección de información. Es condición necesaria que el moderador deba crear un ambiente de comunicación entre los participantes que permita a los participantes hablar entre sí, hacer preguntas, expresar dudas y opiniones, el problema es como lograr, pese al limitado control sobre la interacción, mantener el hilo conductor sobre la temática y que la elaboración conceptual y operativa no sea desbordada por factores ideológicos, políticos o existenciales a los participantes interesados en la temática.

Otra desventaja es que por su propia naturaleza la técnica de los grupos focales es de difícil planificación en lo que respecta a: el manejo del tiempo en el desarrollo de los tópicos a tratar y el logro de acuerdos o conclusiones colectivas representativas.

Y, ya que estamos hablando de conclusiones colectivas, no se debería asumir que los individuos en un grupo focal estén expresando sus propios puntos de vista. Ellos están hablando en un contexto específico dentro de una cultura específica y por eso puede ser difícil para los investigadores identificar claramente cual es o no, el discurso individual y cual, el colectivo. Generalmente, las apreciaciones, opiniones y comportamientos sociales colectivos tienden a diferir de los individuales, es decir, surgen conflictos cuando se pretende identificar, diferenciar o especificar los puntos de vista individuales de los puntos de vista colectivos.

Otra desventaja notoria está asociada con la organización y manejo de los grupos focales: El papel del coordinador o del moderador es esencial en esta técnica, pero lo que parece ser una ventaja en estos casos puede convertirse en una desventaja en otros, debido al gran peso que tiene su capacidad de liderazgo y de comunicación para coordinar y moderar exitosamente el accionar un grupo focal.

EL MANEJO DE LA INFORMACIÓN

La situación o "modus vivendi" de la discusión en grupos focales puede desmotivar a algunas personas a expresar una opinión, como por ejemplo, desconfiar en hacer publica una información que sea personal o "delicada o arriesgada". En tales casos, la estrategia sería combinarla con la entrevista personal o el uso de tarjetones o videos ilustrativos que permitan romper el hielo. Finalmente, la información que se maneja en los grupos focales si bien no es confidencial ni anónima ya que es compartida, generalmente puede ser contradictoria a la opinión individual (externa al grupo), por lo cual hay que resaltar que los acuerdos y conclusiones son colectivas y la responsabilidad de ellos es compartida grupalmente.

Las consideraciones de tipo ético para el trabajo de los grupos focales son las mismas que para otras técnicas de investigación social. Por ejemplo, cuando seleccionamos y comprometemos a los participantes, los investigadores deben asegurar darles la mayor y real información acerca de los propósitos y usos de las conclusiones del estudio. Igualmente mantener a los participantes informados acerca de las expectativas del grupo investigador También se recomienda no presionar a los participantes a expresar obligadamente una opinión en un contexto que puede convertirse en algo peligroso para él. Un elemento importante de tipo ético que hay que considerar es el manejo de la información que se produce al interior del grupo de trabajo como la que resulta del análisis de los resultados, la cual debe ser mantenida como confidencial. Hay que tener en cuenta que cada uno de los participantes puede llegar a conclusiones que en un contexto externo al grupo pueden ser conflictivas o peligrosas para él o el resto de los participantes. Al comienzo de cada taller el moderador deberá clarificar que la contribución u opinión de cada uno de los participantes desde el momento en que es compartida con el resto del grupo, se convierte en una opinión colectiva así haya sido expresada en término personales. Es por eso que los participantes deben ser motivados a mantener la confidencialidad de lo que ellos escuchan durante el taller al igual los investigadores tienen la gran responsabilidad de mantener el anonimato y confidencialidad de lo expresado por los participantes.


ETAPAS DEL PROCESO OPERATIVO DE UN GRUPO FOCAL


1. DEFINICION DE LOS OBJETIVOS

Como primer paso, se requiere de una definición específica de los objetivos del estudio, para que desde allí, se planteen:

Un guión de desarrollo del Taller.

La guía de temáticas - preguntas a desarrollar en el Taller.

2. ESTABLECER UN CRONOGRAMA

La programación y desarrollo de un grupo focal no se debe improvisar. Se sugiere comenzar a planear con antelación (cuatro o seis semanas). Con toda probabilidad, tomará por lo menos ese tiempo para identificar, analizar, formular y evaluar el problema de investigación; definir un marco de referencia teórico – metodológico; identificar, seleccionar y comprometer a los participantes. Localizar un sitio adecuado. Igualmente, diseñar y conseguir los materiales de ayuda para las sesiones, etcétera.

A continuación, se muestra un listado de las etapas de un cronograma típico:

1. Planteamiento del objeto y objetivos del estudio. 4 - 6 semanas antes de la fecha de la sesión de taller.
2. Identificación y selección de los participantes 4 - 6 semanas
3. Análisis de la información sobre los participantes 4 - 6 semanas
4. Seleccionar un o moderador(es) 4 - 5 semanas
5. Diseño de la Guía de Discusión temáticas - preguntas 4 - 5 semanas
6. Desarrollar y validar una estrategia de taller a través de las técnicas de dinámica grupal. 4 semanas
7. Reservar y preparar el sitio donde se van a realizar los talleres 4 semanas.
8. Invitar, comprometer personal o institucionalmente a los participantes, mediante invitaciones escritas o verbales 3 - 4 semanas
9. Verificar la asistencia y compromiso por otros medios tales como llamadas telefónicas o confirmaciones indirectas (Terceros) 2 semanas
10. Organizar la adecuación del sitio y la logística de la reunión (Número y tipo de asientos, equipos, refrigerios, etc.) 1 semana
11. Ultima invitación a los participantes 2 días
12. Organizar los materiales didácticos u operativos que se van a utilizar en el Taller 2 días
13. Desarrollo del Taller: Inducción, conducción, y discusión grupal.
14. Clausura del Taller: Presentación de las conclusiones y acuerdos; entrega de un certificado.
15. Proceso de validación de las relatorías, acuerdos y resultados por parte del equipo investigador
16. Informe final.

3. EL PROCESO DE DECIDIR QUIÉN SERÁ INVITADO:

Al desarrollar la guía de la discusión es necesario identificar quién participará en las sesiones de trabajo grupal. Esto proporcionará a una indicación de cuanto es el número más adecuado los participantes. Un número adecuado está entre 6 a 12 participantes por sesión.

El número de participantes por la sesión está determinado por el número potencial de participantes. Hay que establecer una población de participantes potenciales. Una vez que el número de participantes se haya determinado, es necesario establecer una población de participantes reales. Una estrategia es realizar un sondeo sobre posibles participantes. Existen varias ventajas al conformar estos grupos potenciales, por medio de un sondeo exploratorio. Este proveerá información general sobre los encuestados lo que permitirá una mejor selección y un conocimiento sobre disposición a colaborar o a participar. Esta metodología de seleccionar a los participantes ayuda ahorrar mucho tiempo en la selección final ya que a priori se sabrá si la gente esta disponible o no.

De acuerdo a los objetivos del estudio desarrolle una lista de los atributos o características predominantes o principales para seleccionar a los participantes y de acuerdo a esos atributos haga una primera selección.

Hay que asumir que algunos de los invitados no aparecerán, por esta razón, se recomienda seleccionar además una población de reemplazo (10 % de los invitados originales). Es posible, entones que debido a las ausencias de última hora, el grupo quede finalmente conformado por 9 o 10 personas. Lo cual lleva a considerar algunos mecanismos que faciliten la asistencia tales como lugares adecuados y bien situados, también se recomienda atraer a los participantes comprometiéndolos a través de terceros.

Se sugiere que una vez seleccionados los participantes, estos sean invitados oficialmente, reiterándoles el objeto y los objetivos del estudio, la metodología de trabajo a seguir, su papel e incentivos por su participación.

Con respecto a la selección de participantes de un grupo focal: no es fácil identificar el grupo de participantes más indicado, por ejemplo, si el grupo es demasiado heterogéneo en términos de edad o estrato o en términos de oficio o posición ocupacional, las diferencias entre participantes pueden provocar un impacto considerable en sus contribuciones. Alternativamente si el grupo es homogéneo con respecto a unas características específicas puede suceder que las diversas opiniones y experiencias no sean reveladas al no generar o provocar al interior del grupo una atmósfera de contradicción. Los participantes necesitan sentirse en confianza unos con otros reunirse con otros de los cuales ellos piensan que tienen similares características o niveles de conocimiento sobre determinado tema será mas atractivo pero improductivo. Es posible reunirse con aquellos que son percibidos como contradictores pero con un interés global compartido que permita una mayor riqueza de los resultados. Refinar el listado de invitados potenciales buscando "características comunes " o de "homogeneidad y de heterogeneidad" en los participantes potenciales.

Una vez que se ha decidido el tipo de participantes que a van integrar el grupo el siguiente paso es conseguirlos. El reclutamiento de participantes puede demandar mucho tiempo especialmente si la temática a trabajar en el taller no tiene beneficios inmediatos o no es del gusto de los participantes. Es preferible que estas personas con intereses específicos sean reclutadas a través de informantes claves o a través de las redes sociales existentes (religiosas, educativas y económicas). También es sabido que el éxito del desarrollo de estos talleres está muchas veces asociado a algunos beneficios inmediatos que se les pueden ofrecer a los participantes.

Los individuos que participan en una sesión de la discusión deben ser compensados por su participación. Al entrar en contacto con los participantes potenciales se recomienda utilizar un incentivo para animar o para persuadir a un individuo a que participe en una sesión de la discusión. Esto a menudo facilita la interacción dada la tensión creada por la conformación del grupo focal y hace a los participantes más abiertos a discutir el asunto.

4. DISEÑO DE LA GUÍA DE TEMÁTICAS-PREGUNTAS

Cuándo se está organizando la guía de discusión en el grupo focal hay que tener en cuenta varias consideraciones básicas: ¿Cuáles son las dimensiones del estudio? ¿Qué preguntas serán hechas?, ¿Quién participará?, y ¿Quién conducirá las sesiones?

La guía de la discusión contiene las temáticas - preguntas que serán presentadas a los participantes durante las sesiones de discusión. No más 5 o seis temáticas - preguntas se deben utilizar para el trabajo en grupo. Hay dos elementos que deben ser considerados al bosquejar el guía. Primero, es necesario no olvidar quienes son sus invitados y en segundo lugar, qué tipo de información es la que usted desea obtener. Segundo, se recomienda, a partir de una lluvia de ideas, diseñar una matriz de dimensiones – temáticas – preguntas potenciales y proceder a seleccionar las definitivas a partir de una prueba piloto preliminar. Una vez que se tiene una lista de preguntas, trate de evaluar la concordancia de ellas con los objetivos del estudio otra vez. ¿Cuáles no se deben aplicar? ¿Cuáles son realmente importantes?

No se debe olvidar que la capacidad de cooperación de los integrantes de un grupo focal no dura más allá de una o dos horas. En consecuencia, solo se dispondrá de tiempo para cinco o seis temáticas preguntas. Esto no es mucho, especialmente cuando usted considera que hay realmente dos clases de preguntas: preguntas introductoria o del calentamiento y preguntas que apuntan a obtener las respuestas de fondo del estudio. Puesto que las primeras dos preguntas son generalmente una inducción sobre la temática, esto le deja tres o cuatro o cinco preguntas para sondear sobre lo que se está investigando.

Al desarrollar las preguntas, tenga presente que todos los grupos de discusión deben seguir la misma guía de discusión. Una pregunta por ejemplo "¿A quién beneficia el SISBEN?", podría recibir diversas respuestas dependiendo de sí los participantes son beneficiarios, o no beneficiarios. Usando un formato común, permitirá al analista hacer comparaciones entre las respuestas de los varios grupos.

La secuencia y el tono de las preguntas son tan significativo como las preguntas mismas. Deben ser no solo concretas sino también estimulantes, las preguntas que se plantearán en el grupo focal deben ser ampliables y en lo posible hay que llevar la discusión de lo más general a lo específico.

A continuación se sugiere, volver al listado de participantes posibles y preguntarse: ¿Qué preguntas podrían contestar? Se sugiere eliminar tantas preguntas como sea posible. Si la estrategia de formulación de las preguntas se hace a partir de "una lluvia de ideas" del grupo de estudio o de personal asociado, haga que cada uno seleccione, por ejemplo, las cinco preguntas más pertinente del total. Una vez que se hayan seleccionado las cinco o seis preguntas mas adecuadas y pertinentes, proceda a posicionar las preguntas en una secuencia que sea cómoda para los participantes, moviéndose desde lo general a lo específico, de lo más fácil a lo más difícil, y de lo positivo a lo negativo.

Antes de usar las preguntas en una sesión real del grupo focal, realice una prueba piloto. Evalúe, con un grupo externo, su confiabilidad, es decir, si las respuestas logran la información que usted necesita. ¿Si son validas?, es decir, si en mediciones sucesivas, preguntan lo que se quiere preguntar y obtiene respuestas relativamente similares. Hay que averiguar si todos entienden de igual forma la pregunta etc.

Según los públicos, la complejidad del tema y objetivos del estudio se pueden considerar la idea de enviarle previamente a los participantes un resumen introductorio sobre lo que se va a tratar en la reunión de trabajo.

5. DESARROLLAR UN GUIÓN DE DESARROLLO DEL TRABAJO DE TALLER

Se recomienda diseñar un plan operativo estandarizado que abarque todas las posibles etapas del taller. Esto tiene muchas ventajas desde el punto de vista funcional, por ejemplo, asegura que cada grupo focal se desarrollará con idéntica metodología haciendo los resultados más confiables. Además, este guión le ayudará al moderador o coordinador a manejar el problema del tiempo y especialmente si él es externo al proceso (un moderador profesional).

5.1. LA LOGÍSTICA DE LAS REUNIONES DE LOS GRUPOS FOCALES:

El guión de organización del Taller

La guía de temáticas - preguntas

Listado de Participantes

Equipos de sonido, grabación y video

Tarjetas de identificación o escarapelas

Libreta de notas, lápices, marcadores

Papelografos, papel y fichas

5.2. Hay que planear el desarrollo del taller en un marco de tiempo no mayor a dos horas. Un mínimo de una hora se recomienda porque el proceso requiere un cierto tiempo para las observaciones de la apertura y de cierre del taller, al igual tener en cuenta por lo menos una o dos preguntas introductorias o de inducción. Se sugiere no exceder más de dos horas de duración. Después de este tiempo, tanto los participantes como el moderador comenzarán a "distraerse"; y es muy posible que las preguntas y la discusión subsecuente pierdan su importancia. La capacidad de concentración de un adulto es alrededor de 20 minutos, lo cual sugiere que no se debe gastar mas allá de 20 minutos por temática - pregunta

5.3. Con respecto al lugar de reunión se recomiendan sitios o lugares "neutrales" que no sean asociados con los promotores ni con los sujetos del conflicto o con la situación problema de discusión. En síntesis, las reuniones de los grupos focales si bien pueden ser realizadas en diversos lugares, por ejemplo, en hogares, salones comunales o donde los participantes desarrollan sus reuniones regulares se recomienda utilizar espacios institucionales incluso, se sugiere utilizar aquellos geográficamente ajenos.

Se recomienda que en el salón de reunión los participantes, en lo posible, rodeen al moderador (configuración en U). Si el equipo de investigadores esta presente en el salón se debe tratar que estos no interfieran y que su presencia sea lo más discreta posible.

5.4. Equipos de audiovisuales: El equipo de investigación debe determinar cuales son más apropiados para facilitar la sesión de trabajo. Esto definirá si se requiere de grabadora, videocinta, o simplemente a las notas de la relatorías. Generalmente, las sesiones de discusión son grabadas. Grabar permite que el equipo de investigación recupere fácilmente los aportes más importantes y los comentarios que fueron hechos durante la discusión. Y registrar la información lo más exacta. Si la sesión de trabajo va a ser grabada en equipos de audio o video se recomienda que estos sean instalados y probados anteriormente. Su presencia debe ser igualmente discreta. Se debe determinar previamente qué equipos de ayudas audiovisuales son necesarios.

Se recomienda, primero grabar las sesiones y segundo tener un aparato de televisión para presentar algún tipo de video que ayude a la dinámica grupal de la discusión. Si las notas son tomadas por el equipo de investigación durante la sesión, éstas también facilitarán el desarrollo del informe final para el grupo focal.

5.5. Refrigerios: si se van a ofrecer, en un horario determinado estos deberán ser colocado en un salón diferente.

5.6. Otras recomendaciones: escarapelas de identificación, de un tamaño tal, que permitan al moderador identificar fácilmente al participante.

6. SELECCIÓN DEL MODERADOR

Un elemento que distingue a los grupos focales de la técnica de la entrevista científica o de la encuesta social es que requieren de un Moderador con una cierta habilidad para desarrollarlos. Es necesario contar con alguien con un conocimiento y manejo de dinámica del grupo y un conocimiento sobre la problemática. En síntesis, un Moderador del grupo focal debe poder ocuparse no solo de mantener a los miembros del grupo atentos y concentrados, sino también mantener el hilo central de la discusión, y cerciorarse que cada participante participe activamente.

El Moderador puede ser un miembro del equipo de investigación, o un profesional especializado en el manejo de taller. También se puede utilizar un equipo de dos personas, donde una persona modera la discusión y la otra lleva la relatoría o hace un trabajo de observación del comportamiento asociado de los asistentes. Se recomienda, en el caso de organizaciones complejas, considerar las características tanto personales como profesionales del Moderador para hacer más fácil la discusión grupal. Por ejemplo, un Moderador que venga de fuera de la organización puede verse como más objetivo y puede obtener respuestas más válidas y confiables de los participantes.

EL ROL DE MODERADOR DE LOS TALLERES

Una vez que la reunión ha sido organizada el papel del moderador o facilitador se convierte en algo esencial especialmente en términos de dar explicaciones claras sobre los propósitos del taller, ayudar a la gente a sentirse en confianza y especialmente, en facilitar la integración entre los miembros del grupo. Durante la reunión el moderador deberá promover el debate planteando preguntas que estimulen la participación demandando y desafiando a los participantes con el objetivo de sacar a flote las diferencias y contradecir las diferentes opiniones que surgen sobre el tema en discusión. Algunas veces los moderadores necesitarán llevar la discusión a los pequeños detalles o si es el caso impulsar la discusión hacia temas más generales cuando está ha alcanzado un rumbo equivocado o ambiguo. El moderador también debe mantener a los participantes atentos al tema en discusión, y es posible que en ciertas circunstancias él deba conducir la conversación hacia sus orígenes con el objetivo de reordenarla. El moderador también deberá de asegurarse que cada uno de los participantes tenga la oportunidad de expresar sus opiniones. En su papel de moderador se recomienda que no muestre preferencias o rechazos que influencien a los participantes a una opinión determinada o a una posición en particular.

El rol del moderador es vital en el trabajo de taller y no solo requiere tener habilidades de comunicación sino también ciertas calidades personales tales como, saber escuchar asociado a tener una capacidad de adaptación y sentido común, todo lo anterior facilitará un dialogo abierto y confidente al interior del grupo.

Finalmente, el grado de control y dirección impuesto por el moderador dependerá tanto de los objetivos del estudio como de su estilo. Si uno o más moderadores están comprometidos en un trabajo de taller con un grupo focal es necesario que exista una sola línea de conducción. Se recomienda que un moderador haga el papel de coordinador principal y que los otros hagan el papel de facilitadores o talleristas durante la reunión todo lo anterior hace necesario que exista una cuidadosa preparación con vista a definir los roles y responsabilidades de cada uno de los miembros del equipo de moderadores.

7. LA SELECCIÓN DEL SITIO DE LA REUNIÓN

Al elegir un sitio se recomienda tener en cuenta los siguientes criterios:

El sitio debe ser lo más "neutro" posible con respecto a los participantes. Si no se logra acceder a un lugar que reúna tal característica la sesión de taller se puede realizar en un lugar de reunión usual del grupo.

Las características físicas y ornamentales del salón deben crear la sensación de cooperación y familiaridad. El salón debe acomodar cómodamente de seis a quince participantes y permitir una relación "cara a cara" entre los participantes (una configuración en U). Hay que insistir en la accesibilidad al salón (considere la facilidad de acceso para la gente con inhabilidades, la seguridad, facilidad de transporte, el estacionamiento, etc.)

8. MODERACIÓN DE UNA SESIÓN DE DISCUSIÓN


1. El moderador debe ser una persona con el suficiente conocimiento del tema y experiencia en le manejo de grupos, de tal manera, que pueda conducir la discusión hacia los objetivos preestablecidos.
2. Si es posible conseguir un moderador con conocimiento y experiencia en el tema se le sugiere tener en cuenta las siguientes recomendaciones:

* Mantener el control de la discusión –que no se atrasen ni se adelanten los participantes
* Tratar de mantener la discusión en un tono informal, incentivando a los participantes que digan lo que les viene a la cabeza.
* Recordar que el moderador es un conductor que tiene el objetivo principal de lograr una información lo más confiable y válida.
* La duración de los talleres: se recomienda que las sesiones de discusión no superen los 120 minutos.
* Ser neutral: Una de las ventajas de una persona ajena tal grupo de interés es que este teóricamente no este involucrada en la problemática y cuales serían las soluciones posibles. Cualquier comentario o respuesta del moderador influenciaría a los participantes.
* No permitir que el moderador sea interrogado. Recuerde que el principal objetivo de la sesión de trabajo es reunir información sobre qué y cuanto sabe el grupo sobre la
* El papel del moderador no es el de informar o convencer al grupo sobre tal o cual situación o producto, su papel es el conductor de un grupo de discusión.

El manejo y conducción de un grupo focal debe hacerse de acuerdo al "guión" previamente diseñado. Tanto el Moderador como los relatores o personal de ayuda debe organizar previamente el lugar, el material de trabajo y las tarjetas de identificación. Una vez que el grupo esta reunido, el Moderador deberá comenzar dando la bienvenida al grupo teniendo siempre en cuenta que debe combinar una metodología de trabajo de conducción de grupos aplicando en lo posible algunas herramientas de dinámica grupal. Al respecto tradicionalmente se recomienda

LA DINÁMICA FUNCIONAL DEL GRUPO FOCAL COMPRENDE:

1. La apertura: es el tiempo para que el moderador dé la bienvenida al grupo, de introducir el tema y sus objetivos y explicitar el papel del grupo focal, de explicar qué es un grupo focal y cómo funcionará.

Defina cual es el objeto y objetivo de la reunión. Ponga en claro desde un comienzo quién dirigirá la discusión, cual será la metodología a seguir y lo más importante trate que los participantes se sientan importantes y cómodos con la temática.

Asegúrese que cada participante sea visible, escuche y sea escuchado perfectamente (distribúyalos en una configuración en U.)

2. La segunda etapa, planteará (a través de alguna estrategia preestablecida y probada) las temáticas "preguntas" que son el objeto del estudio.

Se recomienda considerar si la presencia de algunos observadores externos, puede inhibir a los participantes.

Evitar las respuestas ambiguas, las socialmente aceptables o las "muy abiertas". Hay que tratar que sean especificas a la pregunta y lo más exhaustivas y excluyentes posibles y mantener un cuidadoso control sobre el tiempo de desarrollo del Taller.

3. La sección de Cierre: no solo debe incluir el llegar a un consenso en las conclusiones finales sino también la parte formal que incluye el agradecimiento a los participantes, insistiendo no solo de la importancia de su participación sino también en la forma cómo los datos serán utilizados.

10. INTERPRETACIÓN DE LOS ACUERDOS Y EL INFORME FINAL.

Se recomiendan tres etapas para redactar un informe final de las conclusiones del grupo focal:

1. Resumir inmediatamente la discusión y acuerdos de la reunión. Es más fácil reconstruir lo sucedido inmediatamente. El Moderador deberá reconstruir con alguno de los participantes los acuerdos de mayor trascendencia al igual los detalles que pueden ayudar a enriquecer el informe final.

2. Transcribir las notas de la relatoría o grabaciones inmediatamente se terminó la sesión de Taller. Lo anterior permitirá que se reconstruya no solo la atmósfera de la reunión sino también lo tratado. Analice las relatorías: comience por leer todos los resúmenes o relatorías, analizando las actitudes y opiniones que aparecen reiteradamente o comentarios sorpresivos, conceptos o vocablos que generaron algunas reacciones positivas o negativas de los participantes, etc.

LA REDACCIÓN DEL INFORME FINAL

Este documento debe incluir no solo los aspectos formales del estudio: planteamiento del problema, objetivos, estrategia metodológica y técnica sino también detalles acerca de la configuración del grupo focal, desarrollo de las sesiones de taller, resultados y conclusiones finales.

Debe incluir los siguientes aspectos

1. Planteamiento del problema, antecedentes y objetivos.

2. Ficha técnica: temática, objetivos, moderador, participantes – características del grupo, criterios de selección- guía de temáticas – preguntas.

3. Conclusiones y recomendaciones. Se sugiere presentar los hallazgos como respuestas a la hipótesis- preguntas llevadas a la sesión de trabajo.

11. TRADUCIR LOS ACUERDOS EN ACCIÓN

La mayor y más recurrente critica que se hace al uso de los grupos focales se expresa en dos áreas: Por un lado, se insiste que se olvida la premisa que la comunidad o grupo participante debe participar de la retroalimentación de los resultados obtenidos. Y, segundo, la incapacidad de aplicar los resultados a los objetivos por los cuales originalmente fueron convocados.

Al respecto, caben algunas sugerencias operativas para traducir los resultados en planes y programas de acción:

* Programar una reunión para revisar los resultados y discutir sus implicaciones.
* Contextualizar la información lograda a partir de los objetivos. No olvidar de analizar las respuestas y aportes que el grupo focal produjo. Comparar, contrastar y combinar la información obtenida con otra lograda por otros medios tales como encuestas, entrevistas u observaciones o información secundaria.
* Resaltar los temas, sucesos y preguntas principales que afloraron en la discusión al interior del grupo focal. En esta etapa es conveniente clasificar estos aportes de acuerdo a unos criterios o códigos preestablecidos.
* Si la información es demasiada y compleja, se hace necesario definir unos criterios de prioridad y clasificación. Luego hay que decidir que acción será necesario tomar con relación a los temas prioritarios, por ejemplo, compartir la información con personas que alguna relación tengan con políticas comunitarias y con ellos decidir lo que es pertinente o no.

CONCLUSIONES

Hay que recordar que uno de los mayores beneficios de la estrategia de grupos focales es el hecho de la participación y compromiso de las personas en la problemática en estudio. Esta relación deberá ser permanente desde el momento que fue establecida; es recomendable informarlos desde el planteamiento del problema, la ficha técnica del estudio y mantenerlos informados sobre los procesos y resultados obtenidos y si es el caso, el uso que se le dará a la información obtenida.

En la práctica los grupos focales pueden ser difíciles de organizar. De hecho no es fácil obtener una población o grupo representativo. El trabajo de los grupos focales puede motivar a cierto tipo de personas para participar, por ejemplo aquellos que tienen un gran espíritu de colaboración pero no tienen mucho conocimiento o práctica sobre el tema o aquellos que tienen problemas de comunicación o limitaciones o los que participan per se. (los llamados lideres históricos o profesionales). La organización de formas participativas a través de los grupos focales usualmente requiere más planificación que en otros tipos de participación.

El número recomendado de personas por grupo puede variar entre seis y doce personas, aunque algunos grupos han trabajado exitosamente hasta con quince. El número de sesiones de trabajo de grupo puede variar de acuerdo a la temática, los objetivos del estudio o las circunstancias. En algunos estudios ha bastado con una reunión, en otros, según el tema han requerido de un número mayor. En relación con el tiempo necesario para desarrollar los talleres las cifras van de una a dos horas de duración.

Como estrategia de recolección de información, los grupos focales permiten "sistematizar" una información acerca de unos conocimientos, unas actitudes y unas practicas sociales que difícilmente serían obtenidas a través de otras técnicas tradicionales. En otras palabras, creemos que los procesos sociales existen no solo en la mente sino también en el mundo objetivo y que hay algunas relaciones estables a descubrir entre ellos. Así, a diferencia de algunas escuelas de la fenomenología, consideramos importante desarrollar un conjunto de metodologías y técnicas válidas y verificables para aprehender esas relaciones sociales y sus determinaciones. Deseamos interpretar y explicar esos procesos y tener confianza en que otros investigadores, usando los mismos procedimientos llegarán a conclusiones análogas.

Metodológicamente nuestra insistencia por el uso de un marco teórico metodológico estandarizado está dirigida a intentar superar aquel casi mágico enfoque del análisis de datos cualitativos según el cual éste es idiosincrático, incomunicable y artístico y que solo aquellos que han sido totalmente socializados en su práctica están autorizados para pronunciarse sobre ese enfoque. Tal posición - nos parece a nosotros - en gran medida, una mistificación"

En síntesis este artículo bosqueja las principales características de la técnica de grupos focales poniendo particular atención en los beneficios de la interacción social y en la dinámica de grupos, como procesos de recolección de información primaria. Es posible que algunas de las consideraciones expuestas anteriormente sobre configuración de los grupos, tiempo, lugar y características de los participantes muestren a esta técnica como de difícil realización, sin embargo, aquellos que la han utilizado en forma combinada o complementaria con la técnica de la encuesta social la han clasificado de gran utilidad. Sin lugar a dudas, pueden convertirse en una valiosa herramienta para el tratamiento de problemáticas en ciertos ambientes sociales ya que otras metodologías de investigación no permitirían un mayor acercamiento a la expresión de conocimientos, actitudes y comportamientos sociales.

BIBLIOGRAFÍA

Flores J.G. and Alonso C.G. ‘Using focus groups in educational research’, Evaluation Review 19 (1): 84-101. Sociology at Surrey, 1995

Galeano, Eumelia, et al. Curso Especializado en la Modalidad a Distancia sobre Investigación en las Ciencias Sociales, Modulo 5, La Investigación Cualitativa, Teoría. Medellín, ICFES, INER, Universidad de Antioquia. 1993.

Gibbs, Anita. Focus Group. Social Research Update. Nineteen. Sociology at Surrey, 1997

Hoppe M.J., Wells E.A., Morrison D.M., Gilmore M.R., Wilsdon A. ‘Using focus groups to discuss sensitive topics with children, Evaluation Review 19 (1): 102-14. 1995

Kitzinger J. ‘Introducing focus groups’, British Medical Journal 311: 299-302. 1995

Kitzinger J. "The methodology of focus groups: the importance of interaction between research participants", Sociology of Health 16(1): 103-21. 1994

Kreuger R.A. Focus groups: a practical guide for applied research. London: Sage. 1988

Merton R.K., Kendall P.L "The focused Interview", American Journal of Sociology 51: 541-557. New York, 1946

Lankshear A.J. ‘The use of focus groups in a study of attitudes to student nurse assessment’, Journal of Advanced Nursing 18: 1986-89. 1993

Pineda, Roberto, El Método Etnográfico, Facultad de Humanidades y Ciencias Sociales. Universidad de los Andes. Modulo 5, La Investigación Cualitativa, Teoría. Medellín, ICFES, INER, Universidad de Antioquia. 1993.

MacIntosh J. ‘Focus groups in distance nursing education’, Journal of Advanced Nursing 18: 1981-85. Londres. Sage, 1981

Merton R.K., Kendall P.L. ‘The Focused Interview’, American Journal of Sociology 51, 541-557. New York, 1946

Morgan D.L. Focus groups as qualitative research. Londres, 2nd Edition, Sage. 1997

Morgan D.L. and Spanish M.T. ‘Focus groups: a new tool for qualitative research’, Qualitative Sociology 7: 253-70. Londres, 1984

Morgan D.L. and Kreuger R.A. ‘When to use focus groups and why’ in Morgan D.L. (Ed.) Successful Focus Groups. London: Sage. 1993

Powell R.A. and Single H.M. ‘Focus groups’, International Journal of Quality in Health Care 8 (5): 499-504. Surrey: 1996.

Powell R.A., Single H.M., Lloyd K.R. ‘Focus groups in mental health research: enhancing the validity of user and provider questionnaires’, International Journal of Social Psychology 42 (3): 193-206. Stony Brook at New York: 1996

Race K.E., Hotch D.F., Parker T. ‘Rehabilitation program evaluation: use of focus groups to empower clients, Evaluation Review 18 (6): 730-40. Stony Brook . Nueva York, 1994

Stewart D.W. and Shamdasani P.N. Focus groups: theory and practice. London: Sage. 1992

White G.E. and Thomson A.N. ‘Anonymized focus groups as a research tool for health professionals’, Qualitative Health Research 5.(2): 256-61. NYU, New York, 1995

           POLITICAL JUJITSU: NOW’S THE TIME FOR MEDICARE FOR ALLAs...        


POLITICAL JUJITSU: NOW’S THE TIME FOR MEDICARE FOR ALL

As Republicans in Congress move to repeal the Affordable Care Act, Democrats are moving toward Medicare for All – a single-payer plan that builds on Medicare and would cover everyone at far lower cost.

Most House Democrats are already supporting a Medicare for All bill.

With health care emerging as the public’s top concern, according to recent polls, the choice between repeal of the Affordable Care Act and Medicare for All is likely to be the major domestic issue in the presidential campaign of 2020 (other than getting Trump out of office, if he lasts that long).

And the better choice is clear. Private for-profit insurers spend a fortune trying to attract healthy people while avoiding the sick and needy, filling out paperwork from hospitals and providers, paying top executives, and rewarding shareholders.

And for-profit insurers are merging like mad, in order to make even more money.

These are among the major reasons why health insurance is becoming so expensive, and why almost every other advanced nation – including our neighbor to the north – has adopted a single-payer system at less cost per person and with better health outcomes.

Most Americans support Medicare for All. According to a Gallup poll conducted in May, a majority would like to see a single-payer system implemented. An April survey from the Economist/YouGov showed 60 percent of Americans in favor of “expanding Medicare to provide health insurance to every American.”

That includes nearly half of people who identify themselves as Republican.

If Republicans gut the Affordable Care Act, the American public will be presented with the real choice ahead: Either expensive health care for the few, or affordable health care for the many.


          NOW’S THE TIME FOR MEDICARE FOR ALLAs Republicans in Congress...        


NOW’S THE TIME FOR MEDICARE FOR ALL

As Republicans in Congress move to repeal the Affordable Care Act, Democrats are moving in the opposite direction, toward Medicare for All – a single-payer plan that builds on Medicare and would cover everyone at far lower cost.

Most House Democrats are already supporting a Medicare for All bill. Senator Bernie Sanders is preparing to introduce it in the Senate. Both California and New York state are moving towards single-payer plans.

With health care emerging as the pubic’s top concern, according to recent polls, the choice between repeal of the Affordable Care Act and Medicare for All is likely to be the major domestic issue in the presidential campaign of 2020 (other than getting Trump out of office, if he lasts that long).

And the better choice is clear. Private for-profit insurers spend a fortune trying to attract healthy people while avoiding the sick and needy, filling out paperwork from hospitals and providers, paying top executives, and rewarding shareholders. 

And for-profit insurers are merging like mad, in order to make even more money. 

These are among the major reasons why health insurance is becoming so expensive, and why almost every other advanced nation – including our neighbor to the north – has adopted a single-payer system at less cost per person and with better health outcomes. 

Most Americans support Medicare for All. According to a Gallup poll conducted in May, a majority would like to see a single-payer system implemented. 

An April survey from the Economist/YouGov showed 60 percent of Americans in favor of “expanding Medicare to provide health insurance to every American.” That includes nearly half of people who identify themselves as Republican. 

If Republicans gut the Affordable Care Act, the American public will be presented with the real choice ahead: Either expensive health care for the few, or affordable health care for the many.


          New York's Attorney General Vows Court Action Against ACA Repeal        
New York’s top elected Democrats rallied against the Republican Congress’s proposals to repeal and replace the Affordable Care Act, also known as Obamacare, saying they will take legal action, if necessary, to stop it. State Attorney General Eric Schneiderman, speaking before a crowd of unionized health care workers at Mount Sinai hospital, says if the plans to repeal and replace Obamacare in the GOP led Senate and House do become law, he will sue on behalf of New Yorkers. “I’ve developed a bit of a reputation since January as the guy who sues Donald Trump and the federal government,” Schneiderman said, to cheers. “Always on the merits, and boy, have we got a lot of merits on our side.” This is not the first time that Schneiderman has made the threat. The Attorney General said after the house passed its version of the Obamacare repeal and replacement that court action was likely. The AG says provisions in both the Senate and House plans to defund Planned Parenthood services, “would
          Q&A on GOP Health Care Bill        
This week, Republicans in Congress will try to rally votes behind a bill that proposes major changes to the way Americans get health care and how much they pay. In Central New York, many thousands could be affected. Use this Q&A to explore how the bill would affect you. And stay tuned to WAER for continuing coverage of the GOP Health Care Bill from NPR. Loading...
          It's all about PREVENTION        

If you are healthy and thriving, you may want to keep that way for a long time and avoid getting sick.


To accomplish that, you really have to take care of yourself. Every person should be responsible and take control of their own health before it's too late.


Cancer, Heart disease, Diabetes, Obesity, Osteoporosis, Arthritis....and many other illnesses are Preventable Diseases that require major Lifestyle Changes.


Most people have no clue about how to do those lifestyle changes. You have to get informed, and from good sources.


The idea is to maintain Optimum Health through all our lives. Prevention and commom sense is key to a healthy and long life.


The aim of this blog is to help people become more responsible for their own Health.


"Prevention of disease should be primary, treatment secondary". Dr. Andrew Weil.


"Most of the patients have no sense of their own health and their own power to affect it for good or ill". Dr. Andrew Weil.


"I expect you want to be more responsible for your own health and wellness..." Dr. Andrew Weil


"Let the food be your medicine". Hippocrates.


Disease Prevention: "Education is the most powerful weapon which you can use to change the Health of the world”. N. Mandela


"Consider this: We now know that we are encoded by about 25,000 human genes and their products, many of which represent potential new drug targets. Yet we have drugs for fewer than 200 of these gene products."Wells and Woolley M, Science Magazine, Oct. 2008, p.15.


Scientific Research is an amazing field. It opens doors to the unknown and can save many lives...we have to support this marvelous tool. But there is still a long way ahead of us before being able to cure or even alleviate many maladies.


For that reason, we must take care of ourselves. And how can we do this?


It is just plain and simple common sense....Preventing disease!. There are many ways to do it. Learn how. Educate yourself. It is your responsibility. Nobody is coming to the rescue. It is you who has to do the work. Do not wait to get sick. Do not wait for a painful awakening call. Act now. Be informed. Search at respected sources and learn how to prevent diseases.


Be aware of what you eat and drink. Keep an active life. Avoid stress. Have a purpose in life. Look for scientific resources and educate yourself and your family. Take charge of your health. Take charge of your Life.


"What we really know?" an article about treatments from the BMJ Clinical Evidence: http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp


Preventive, Preventative Medicine, Science, Lifestyle, Health Choices, Health Promotion, Fitness, Diet, Healthy food, Nutrition, Vitamins, antioxidants, advisor, anti-inflammatory, wellness, natural, alternative,holistic, integrative medicine, children's health, pregnancy, mental health, alzheimer, Naturopathic Medicine, Scientific Research.Integrative Healthcare


Information at this blog is provided for educational purposes only and is not a substitute for professional health care.


          Trump questions if McConnell should remain majority leader        
President Donald Trump raised the possibility Thursday that Majority Leader Mitch McConnell should step down if he can't muscle health care and other legislation through the Senate, taking an extraordinary swipe at the man with the most power to steer the White House agenda through the chamber.
          The New Health Care: The U.S. Is Failing in Infant Mortality, Starting at One Month Old        
The United States does worse than about two dozen other industrialized nations in this crucial measure of public health.
          The New Health Care: Should You Circumcise Your Baby Boy?        
Research points to both advantages and disadvantages. In the end, it’s a personal choice.
          The New Health Care: Avoiding Peanuts to Avoid an Allergy Is a Bad Strategy for Most        
New research on potential allergens fits with a wider hypothesis that complete avoidance of risky substances doesn’t work well.
          The New Health Care: A Study on Fats That Doesn’t Fit the Story Line        
Old but only recently published research increases a concern that when it comes to nutrition, personal beliefs can trump science.
          [news] "2004 State of Application Development"        
Friday, August 13, 2004
Dateline: China
 
Special issues of journals and magazines are often quite good -- if you're into the subject matter.  But the current issue of VARBusiness is absolutely SUPERB!!  EVERY SYSTEMS INTEGRATOR SHOULD READ IT ASAP -- STOP WHAT YOU'RE DOING AND READ THIS ISSUE!!  (Or, at the very least, read the excerpts which follow.)  See http://tinyurl.com/6smzu .  They even have the survey results to 36 questions ranging from change in project scope to preferred verticals.  In this posting, I'm going to comment on excerpts from this issue.  My comments are in blue.  Bolded excerpted items are MY emphasis.
 
The lead article and cover story is titled, "The App-Dev Revolution."  "Of the solution providers we surveyed, 72 percent say they currently develop custom applications or tailor packaged software for their customers. Nearly half (45 percent) of their 2003 revenues came from these app-dev projects, and nearly two-thirds of them expect the app-dev portion of total revenue to increase during the next 12 months."  I view this as good news for China's SIs; from what I've observed, many SIs in China would be a good fit for SIs in the U.S. looking for partners to help lower their development costs.  "By necessity, today's solution providers are becoming nimbler in the software work they do, designing and developing targeted projects like those that solve regulatory compliance demands, such as HIPAA, or crafting wireless applications that let doctors and nurses stay connected while they roam hospital halls."  Have a niche; don't try to be everything to everyone.  "Nine in 10 of survey respondents said their average app-dev projects are completed in less than a year now, with the smallest companies (those with less than $1 million in revenue) finishing up in the quickest time, three months, on average."  Need for speed.  "The need to get the job done faster for quick ROI might explain the growing popularity of Microsoft's .Net framework and tools.  In our survey, 53 percent of VARs said they had developed a .Net application in the past 12 months, and 66 percent of them expect to do so in the coming 12 months."  My Microsoft build-to-their-stack strategy.  "Some of the hottest project areas they report this year include application integration, which 69 percent of VARs with between $10 million or more in revenue pinned as their busiest area.  Other top development projects center around e-commerce applications, CRM, business-intelligence solutions, enterprisewide portals and ERP, ..."  How many times have I said this?    "At the same time, VARs in significant numbers are tapping open-source tools and exploiting Web services and XML to help cut down on expensive software-integration work; in effect, acknowledging that application development needs to be more cost-conscious and, thus, take advantage of open standards and reusable components.  Our survey found that 32 percent of VARs had developed applications on Linux in the past six months, while 46 percent of them said they plan to do so in the next six months.  The other open-source technologies they are using today run the gamut from databases and development tools to application servers."  I guess there's really an open source strategy.  I come down hard on open source for one simple reason:  I believe that SIs in China could get more sub-contracting business from a build-to-a-stack strategy.  And building to the open source stack isn't building to a stack at all!!  "As a business, it has many points of entry and areas of specialization.  Our survey participants first arrived in the world of app dev in a variety of ways, from bidding on app-dev projects (45 percent) to partnering with more experienced developers and VARs (28 percent) to hiring more development personnel (31 percent)."  For SIs in China, simply responding to end-user RFQs is kind of silly.  Better to partner on a sub-contracting basis.  "According to our State of Application Development survey, health care (36 percent), retail (31 percent) and manufacturing (30 percent) ranked as the most popular vertical industries for which respondents are building custom applications.  Broken down further, among VARs with less than $1 million in total sales, retail scored highest, while health care topped the list of midrange to large solution providers."  Because of regulatory issues, I'm not so keen on health care.  I'd go with manufacturing followed by retail.  My $ .02.  "When it comes to partnering with the major platform vendors, Microsoft comes out the hands-on winner among ISVs and other development shops.  A whopping 76 percent of developers in our survey favored the Microsoft camp.  Their level of devotion was evenly divided among small, midsize and large VARs who partner with Microsoft to develop and deliver their application solutions.  By contrast, the next closest vendor is IBM, with whom one in four VARs said they partner.  Perhaps unsurprisingly, the IBM percentages were higher among the large VAR category (those with sales of $10 million or more), with 42 percent of their partners coming from that corporate demographic.  Only 16 percent of smaller VARs partner with IBM, according to the survey.  The same goes for Oracle: One-quarter of survey respondents reported partnering with the Redwood Shores, Calif.-based company, with 47 percent of them falling in the large VAR category.  On the deployment side, half of the developers surveyed picked Windows Server 2003/.Net as the primary platform to deliver their applications, while IBM's WebSphere application server was the choice for 7 percent of respondents.  BEA's WebLogic grabbed 4 percent, and Oracle's 9i application server 3 percent of those VARs who said they use these app servers as their primary deployment vehicle."  Microsoft, Microsoft, Microsoft.  Need I say more?  See http://tinyurl.com/45z94 .
 
The next article is on open source.  "Want a world-class database with all the bells and whistles for a fraction of what IBM or Oracle want?  There's MySQL.  How about a compelling alternative to WebSphere or WebLogic?  Think JBoss.  These are, obviously, the best-known examples of the second generation of open-source software companies following in the footsteps of Apache, Linux and other software initiatives, but there are far more alternatives than these.  Consider Zope, a content-management system downloaded tens of thousands of times per month free of charge, according to Zope CEO Rob Page.  Some believe Zope and applications built with Zope are better than the commercial alternative they threaten to put out of business, Documentum.  Zope is also often used to help build additional open-source applications.  One such example is Plone, an open-source information-management system.  What began as a fledgling movement at the end of the past decade and later became known as building around the "LAMP stack" (LAMP is an acronym that stands for Linux, Apache, MySQL and PHP or Perl) has exploded to virtually all categories of software.  That includes security, where SpamAssassin is battling spam and Symantec, too.  Popular?  Well, it has now become an Apache Software Foundation official project.  The use of open source is so widespread that the percentage of solution providers who say they partner with MySQL nearly equals the percentage who say they partner with Oracle"23 percent to 25 percent, respectively.There are plenty of choices for those SIs willing to play the open source game.  See http://tinyurl.com/4e3c7 .
 
"It's all about integration" follows.  "There are many reasons for the surge in application-development projects (the recent slowdown in software spending notwithstanding).  For one, many projects that were put on hold when the downturn hit a few years ago are now back in play.  That includes enterprise-portal projects, supply-chain automation efforts, various e-commerce endeavors and the integration of disparate business systems."  Choose carefully, however.  Balance this data with other data.  Right now, I see a lot more play with portals and EAI.  "Indeed, the need for quality and timely information is a key driver of investments in application-integration initiatives and the implementation of database and business-intelligence software and portals.  A healthy majority of solution providers say application integration is a key component of the IT solutions they are deploying for customers.  According to our application-development survey, 60 percent say their projects involved integrating disparate applications and systems during the past 12 months."  "Some customers are moving beyond enterprise-application integration to more standards-based services-oriented architectures (SOAs).  SOAs are a key building block that CIOs are looking to build across their enterprises."  Anyone who regularly reads any one of my three IT-related blogs knows that I'm gung-ho on SOAs.  "Even if your customers are not looking for an SOA, integrating different systems is clearly the order of the day.  To wit, even those partners that say enterprise portals or e-business applications account for the bulk of their business note that the integration component is key."  Yes, integration, integration, integration.  I'll be saying this next year, too.  And the year after ...  "Another way to stay on top of the competition is to participate in beta programs."  Absolutely true -- and a good strategy, too.  See http://tinyurl.com/6x2gg .
 
The next article is on utility computing versus packaged softwareAgain, if you read what I write, you know that I'm also gung-ho on utility computing.  "According to VARBusiness' survey of application developers, more than 66 percent of the applications created currently reside with the customer, while 22 percent of applications deployed are hosted by the VAR.  And a little more than 12 percent of applications developed are being hosted by a third party.   Where services have made their biggest inroads as an alternative to software is in applications that help companies manage their customer and sales information.The article goes on to state that apps that are not mission-critical have the best chance in the utility computing space.  Time will tell.  Take note, however, that these are often the apps that will most likely be outsourced to partners in China.  "Simply creating services from scratch and then shopping them around isn't the only way to break into this area.  NewView Consulting is expanding its services business by starting with the client and working backward.  The Porter, Ind.-based security consultant takes whatever technology clients have and develops services for them based on need."   And focus on services businesses and .NET, too.  "Most application developers agree that services revenue will continue to climb for the next year or two before they plateau, resulting in a 50-50 or 60-40 services-to-software mix for the typical developer.  The reason for this is that while applications such as CRM are ideally suited to services-based delivery, there are still plenty of other applications that companies would prefer to keep in-house and that are often dependent on the whims of a particular company."  Still, such a split shows a phenomenal rise in the importance of utility computing offerings.  See http://tinyurl.com/54blv .
 
Next up:  Microsoft wants you!!  (Replace the image of Uncle Sam with the image of Bill Gates!!)  Actually, the article isn't specifically about Microsoft.  "Microsoft is rounding up as many partners as it can and is bolstering them with support to increase software sales.  The attitude is: Here's our platform; go write and prosper.  IBM's strategy, meanwhile, is strikingly different.  While it, too, has created relationships with tens of thousands of ISVs over recent years,  IBM prefers to handpick a relatively select group, numbering approximately 1,000, and develop a hand-holding sales and marketing approach with them in a follow-through, go-to-market strategy."  Both are viable strategies, but NOT both at the same time!!  "To be sure, the results of VARBusiness' 2004 State of Application Development survey indicates that Microsoft's strategy makes it the No. 1 go-to platform vendor among the 472 application developers participating in the survey.  In fact, more than seven out of 10 (76 percent) said they were partnering with Microsoft to deliver custom applications for their clients.  That number is nearly three times the percentage of application developers (26 percent) who said they were working with IBM ..."  Percentages as follows:  Microsoft, 76%; IBM, 26%; Oracle, 25%; MySQL, 23%; Red Hat, 17%; Sun, 16%; Novell, 11%; BEA, 9%.  I said BOTH, NOT ALL.  Think Microsoft and IBM.  However, a Java strategy could be BOTH a Sun AND IBM strategy (and even a BEA strategy).  See http://tinyurl.com/68grf .
 
There was another article I liked called, "How to Team With A Vendor," although it's not part of the app-dev special section per se.  This posting is too long, so I'll either save it for later or now note that it has been urled.  See http://www.furl.net/item.jsp?id=680282 .  Also a kind of funny article on turning an Xbox into a Linux PC.  See http://tinyurl.com/4mhn6 .  See also http://www.xbox-linux.org .
 
Quick note:  I'll be in SH and HZ most of next week, so I may not publish again until the week of the 23rd.
 
Cheers,
 
David Scott Lewis
President & Principal Analyst
IT E-Strategies, Inc.
Menlo Park, CA & Qingdao, China
 
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          "Matriarchy" and the Contemporary Black Family        
For all of you who are wondering where I've been, I'm back to let you that the last few weeks have brought some exciting changes in my life. Not only are we selling our house and moving into a beautiful new home (hopefully within the month of December because it is dang hard to keep a house clean enough to show with an 19-month-old and a 7 1/2-year-old--this situation does not accentuate my better nature!!), but I have also been assigned three new classes for the Spring semester. I am thrilled to be teaching two sections of a "Reading and Writing about Literature" class, an introductory course in the English major, and a colloquium for the Honors College. Because the theme of my colloq so well matches the focus of this blog, I thought that I'd share my syllabus and schedule with you, my loyal followers.

I've entitled the course "'Matriarchy' and the Contemporary Black Family." As the syllabus demonstrates, we're taking as a springboard the US Department of Labor's Moynihan report of 1965 which--although likely well-intentioned--propelled the myth of the black matriarch into the forefront of the American consciousness. The report attributed the "pathology" of the black family to its "matriarchal" nature, pointing out that many black families were headed by women who oftentimes ran the home and at the same time financially supported the men in their families. The report was meant to convey the necessity of creating more jobs for black men, but many have claimed that it blamed the victims, the women who were--and had been for centuries--keeping it all together in the face of greatly oppressive social and political circumstances. The matriarch myth has stayed with us and has played out in complicated social scripts as well as in popular culture representations of black women.

This course will therefore investigate "matriarchy," past and present. It starts with "The Articulation of the Matriarch Myth" in 1965 and then jumps back to slavery to explore what I am calling, facetiously, "The Rise of the Matriarch" from slavery times up to the 1960s or so. This portion of the course will examine the historical circumstances that positioned the black woman as so central to the black family and also media representations of this positioning, such as in Amos and Andy, for instance. Next, we will move to "Disciplining the 'Matriarch,'" which will cover the ways that both black men and mainstream America have endeavored to punish black women for their deviance and powers of emasculation in movements such as Black Power and Reaganism. In addition to the listed readings, in these weeks we will view an episode of Sanford and Son, Boyz in the Hood and a documentary on hip-hop music. The fourth unit in the course is "Michelle Obama in the Context of 'Matriarchy'" and will explore Obama's portrayal in the media as an emasculating matriarch and the ways that she has negotiated this stereotype. Finally, in "Making Sense of the 'Matriarch,'" we will try to reckon with the legacy of the matriarch myth for us today.

I am proud of this course because my conception of the overall narrative arch of the story of the matriarch has been affirmed by the readings that I've found. Like me, many critics and theorists that I'm including in the course trace the myth of matriarchy to Moynihan, and, together, they present a complex and rich understanding of the significance of his report. In other words, the readings build on each other and complicate each other. It is awesome to see the course come together like this!!

Please take a look at the tentative syllabus that I've posted below! I'd love to hear your suggestions about how I can make this semester an even richer experience for my students as we work together to understand black "matriarchy."

“Matriarchy” and the Contemporary Black Family

Instructor Information
Name: Dr. Andrea Powell Wolfe
Office: RB 297
Office Hours: Tuesday 2-3 and 3:30-5, Thursday 2-2:45, and by appointment
Email: andreapowellwolfe@gmail.com
Website: http://andreapowellwolfe.weebly.com
Blog: http://literatimom.blogspot.com

Course Information
Title: HONRS 390: Honors Colloquium
Semester: Spring 2011
Location: Honors House
Meeting Times: Tuesday and Thursday 9:30-10:45
Credit Hours: 3

Required Texts
Hansberry, Lorraine. A Raisin in the Sun. (any edition)
Williams, Sherley Anne. Dessa Rose: A Novel. (any edition)

Additional Texts
Readings for the course are listed on the schedule below. In addition to the two books that I’m asking you to borrow or purchase, I will also provide some handouts in hard copy. You will access the majority of the readings for this course, however, either on the World Wide Web, through Blackboard, or via Electronic Course Reserves. In order to locate readings stored in the Electronic Course Reserves, log in to CardCat and then select “Course Reserves” from the menu bar.

Course Description
This course will constitute a semester-long interrogation of the term “matriarchy” as it has been used over the course of decades to describe the make-up of the black American family. Grounded in an awareness of “matriarchy” as a terrible misnomer in this context, the course will explore ways that the classification of the black family as “matriarchal” has reinforced oppressive cultural and political conditions for black Americans. We will endeavor to recognize the widespread abuse and subjugation of black women over time and still celebrate the strength of black mothers who have nurtured children and maintained families in the most dire of circumstances throughout American history. We will discuss ways that black men have reacted to the labeling of their families as “matriarchal.” Perhaps most importantly, we will attempt to uncover how the stereotype of “the matriarch” continues to play out in contemporary media representations of black womanhood and how it has played out in social scripts surrounding even our current First Lady, Michelle Obama.

Course Requirements
Paper #1 100 points
Paper #2 100 points
Paper #3 100 points
Final Exam 200 points
Participation 20 points per class
Quizzes 10 points each

Papers
Assignment sheets for each paper will be posted in the “Assignments” area in Blackboard. In general, these assignments will ask you to use textual evidence to support thoughtful and sophisticated claims regarding “matriarchy” and the black family. Papers will be 4-5 pages (1400-1750 words) in length and will be due to my email before class on the days noted on the course schedule. Late papers will lose 10 points per day late (including weekends).

Final Exam
The final exam will be comprehensive and will consist of short essay questions. In order to prepare for the exam, you will need to read carefully, participate attentively in class, and take good notes throughout the semester.

Quizzes
Quizzes over reading notes and class notes may be given without advanced notice. You are always welcome to use written or typed notes for quizzes. Quizzes cannot be made-up.

Participation
Your active and thoughtful participation in this course is absolutely critical to its success! Because discussion is such a big part of the Honors Colloquium experience, you will earn daily participation points for coming to class and engaging in meaningful discussion. Part of participation is also preparation to learn and interact in the classroom. This means that you must bring the appropriate reading(s) to class every day, either in hard copy or in electronic form on your laptop. Participation scores will be posted in the grade book in Blackboard after every class.

Extra Credit
Because I want to give you the opportunity to make up points that you might lose due to necessary absences, I will allow you to complete two extra credit assignments throughout the semester for a total of 40 points in extra credit. For each extra credit assignment, you will choose a full-length book (either critical or literary) or a film (either documentary or fictional) to review for extra credit. I will be happy to recommend texts that might match your personal interests, and, even if you do not need suggestions from me, I ask that you allow me to “approve” your selections before you begin working on these assignments. Each review should be 3-pages (1050 words) in length and should analyze the representation of black motherhood in the text that you have chosen.

Attendance Policy
You will lose all daily participation points when you miss class. While one or two absences may not affect your overall grade in the class, making a habit of missing class will most certainly negatively impact your grade. Any requests for a waiver of the penalty for missing class must be made before the absence for which you seek to be excused.

Classroom Behavior Policy
It is my goal to foster a classroom environment in which every student feels comfortable contributing to discussion. Though we will not always agree with one another, we must listen to one another with respect. Furthermore, you are never required to agree with me or with a text we are discussing; disagreement is a valuable part of the thinking process. I will not tolerate disruptive behaviors such as reading newspapers, talking on cell phones, texting, emailing, or sleeping in class. Behaviors like these will cause you to lose participation points for that day. In order to promote engaged discussion, I may ask you to close your laptop at times during class.

Plagiarism
In order to protect the integrity of the university and of students who work hard, I take academic dishonesty seriously. The intentional or unintentional use of another’s writing without giving proper credit or any credit is theft and the use of a previously written paper for a current course without approval of the instructor is dishonesty. These types of actions undermine the educational process and may be cause for course failure or expulsion from Ball State University.

Disabilities/Accommodations Statement
If you need course adaptations or accommodations because of a disability, if you have emergency medical information to share with me, or if you need special arrangements in case the building must be evacuated, please make an appointment with me as soon as possible

Extra Help
I am happy to meet with students about drafts, assignment questions, additional discussions of a text, and absence policies, etc. during office hours or by appointment. I also encourage you to visit a writing tutor at The Writing Center to work on your papers at any stage in the writing process.

Syllabus Information Disclaimer
Parts of the syllabus and the course, including the schedule and assignments, are subject to change to meet the needs of students in the course.

Course Schedule

Articulating the Matriarch Stereotype

Tuesday, January 11 Introductions

Thursday, January 13 Readings Due: Syllabus; Daniel P. Moynihan, US Department of Labor, “The Negro Family: The Case for National Action”, Chapters II-IV

Tuesday, January 18 Reading Due: Hortense Spillers, “Mama’s Baby, Papa’s Maybe: An American Grammar Book” in Blackboard

The Rise of the “Matriarch”

Thursday, January 20 Reading Due: Deborah Gray White, “Jezebel and Mammy: The Mythology of Female Slavery” on Reserve

Tuesday, January 25 Reading Due: Harriet Jacobs, Incidents in the Life of a Slave Girl, Chapters I-XIV

Thursday, January 27 Reading Due: Harriet Jacobs, Incidents in the Life of a Slave Girl, Chapters XV-XXXIII

Tuesday, February 1 Reading Due: Harriet Jacobs, Incidents in the Life of a Slave Girl, Chapters XXXIV-XLI; Stephanie Li, “Motherhood as Resistance in Harriet Jacobs’s Incidents in the Life of a Slave Girl” in Blackboard

Thursday, February 3 Reading Due: Deborah Gray White, “From Slavery to Freedom” handout

Tuesday, February 8 Reading Due: YouTube videos, “Scarlett Dresses for the Barbeque”, “Mammy—Gone with the Wind”; Maria St. John, “’It Ain’t Fittin’: Cinematic and Fantasmatic Contours of Mammy in Gone with the Wind and Beyond” in Blackboard

Thursday, February 10 Reading Due: George Kirby, “Amos and Andy: Anatomy of a Controversy”

Tuesday, February 15 Reading Due: Lorraine Hansberry, A Raisin in the Sun, Acts I-2

Thursday, February 17 Reading Due: Lorraine Hansberry, A Raisin in the Sun, Act 3; Ellen Silber, “Seasoned with Quiet Strength: Black Womanhood in Lorraine Hansberry’s A Raisin in the Sun (1959)” in Blackboard

Disciplining the “Matriarch”

Tuesday, February 22 Assignment Due: Paper #1

Thursday, February 24 Reading Due: bell hooks, “The Imperialism of Patriarchy” on Reserve

Tuesday, March 1 Reading Due: Amiri Baraka, “20-Century Fox,” “Newshit,” “Song,” “Lady Bug,” “A Poem for Black Hearts,” “Black Art,” “For a Lady I Know,” “Civil Rights Poem,” “Beautiful Black Women . . .,” “Bludoo Baby Want Money and Alligator Got it to Give,” “Leroy,” and “Who Will Survive America” handout; Daniel Matlin, “’Lift Up Yr Self’: Reinterpreting Amiri Baraka (Leroi Jones), Black Power, and the Uplift Tradition” in Blackboard

Thursday, March 3 Reading Due: Hortense Spillers, “Interstices: A Small Drama of Words” on Reserve

Tuesday, March 8 No Class; Spring Break

Thursday, March 10 No Class; Spring Break

Tuesday, March 15 Reading Due: Herman Gray, “Reaganism and the Sign of Blackness” on Reserve

Thursday, March 17 Reading Due: Sherley Anne Williams, Dessa Rose, “Prologue” and “The Darkey”

Tuesday, March 22 Reading Due: Sherley Anne Williams, Dessa Rose, “The Wench” and “The Negress”

Thursday, March 24 Reading Due: Sherley Anne Williams, Dessa Rose, “Epilogue”; Ashraf H. Rushdy, “Reading Mammy: The Subject of Relation in Sherley Anne Williams’ Dessa Rose” in Blackboard

Tuesday, March 29 Reading Due: Linda M. Burton and M. Belinda Tucker, “Romantic Unions in an Era of Uncertainty: A Post-Moynihan Perspective on African American Women and Marriage” in Blackboard

Thursday, March 31 Reading Due: “Between Apocalypse and Redemption: John Singleton’s Boyz in the Hood” in Blackboard

Tuesday, April 5 Reading Due: Mark Anthony Neal, “Baby Mama (Drama) and Baby Daddy (Trauma): Post-Soul Gender Politics” on Reserve

Michelle Obama in the Context of “Matriarchy”

Thursday, April 7 Assignment Due: Paper #2

Tuesday, April 12 Reading Due: Mosheh Oinounou and Bonney Kapp, “Michelle Obama Takes Heat for Saying She’s ‘Proud of My Country’ for the First Time”; Fox News, “Outraged Liberals: Stop Picking on Obama’s Baby Mama!”; Marcus Baram, “Rusty DePass, South Carolina GOP Activist, Says Escaped Gorilla Was Ancestor of Michelle Obama”; The Paparazzis, “Comedian Jay Mohr disrespects Michelle Obama”; Alicia Shepard, “Juan Williams, NPR and Fox News”

Thursday, April 14 Reading Due: Fight the Smears, “The Truth about Michelle”; Lois Romano, “Voices of Power: White House Social Secretary Desirée Rogers,” Chapter 3; The White House, “First Lady Michelle Obama”

Tuesday, April 19 Reading Due: The Huffington Post, “Up In Arms: Michelle Obama’s Sleeveless Style Sparks Controversy”; Wendy Donahue, “Some harrumph over Michelle Obama’s sleeveless dress”; Bonnie Fuller, “Michelle Obama’s Sleevegate: Why Can’t America Handle Her Bare Arms?”; Madison Park, “How to get Michelle Obama’s toned arms”; Andrea Sachs, “Michelle Obama’s Fashion Statement”; Danny Shea, “New York Magazine Blog Takes Down Michelle Obama Booty Post”; Gina, “Another ‘Booty’ Post: ‘That Site’ Puts the Marginalization and Dehumanization of First Lady Michelle Obama Up for Vote”; Erin Aubry Kaplan, “The Michelle Obama Hair Challenge”

Thursday, April 21 Reading Due: The White House Organic Farm Project, “About TheWhoFarm”; Michelle Obama, “Remarks by the First Lady to Unity Health Care Center”; Sesame Street, “Sesame Street: Michelle Obama and Elmo—Healthy Habits”; AOL Health, “First Lady Michelle Obama Answers Your Questions on Let’s Move!”

Tuesday, April 26 Reading Due: Patricia Yaeger, “Circum-Atlantic Superabundance: Milk as World-Making in Alice Randall and Kara Walker” in Blackboard; Kara Walker, “I Dream of Michelle Obama”

Tuesday, April 26 Reading Due: Andrea Powell Wolfe, “Michelle Obama and the Historical Positioning of the Black Mother within the Nation” in Blackboard; Ann Ducille, “Marriage, Family, and Other ‘Peculiar Institutions’ in African-American Literary History” in Blackboard

Making Sense of “Matriarchy”

Thursday, April 28 Assignment Due: Paper #3

Thursday, May 5 Final Exam at 9:45-11:45
          Pro Bono Month Clinics        

During Mizzou Law’s Pro Bono Month, Mid-Missouri Legal Services and the Career Development Office team up to offer two clinics.  This is the third year in a row this opportunity has been offered to students to work directly with clients in the Durable Power of Attorney for Health Care and the Uncontested Divorce Clinics. The Clinics  Continue Reading »

The post Pro Bono Month Clinics appeared first on Mizzou Law Career Cafe.


          Expatriate International Health Insurance – A Healthy Attitude        
The practical benefits of health-insurance are undisputed, but it’s equally vital in the battle for hearts and minds of employees relocated overseas, as Anna Lambert discovers When it comes to protecting individuals who are being relocated overseas, health care is a major consideration. While certain parts of the world have health standards that are every […]
          Just wait a little while        
SUBHEAD: You’ll have to earn everything worth having, including self-respect and your next meal.

By James Kunstler on 7 August 2017 for Kunstler.com -
(http://kunstler.com/clusterfuck-nation/just-wait-little/)


Image above: Aarly 20th century Russian painting of "A Peasant Leaving His Landlord on Yuri's Day" by Sergei V. Ivanov. From (https://www.kp.ru/radio/26511/3430500/).

The trouble, of course, is that even after the Deep State (a.k.a. “The Swamp”) succeeds in quicksanding President Trump, America will be left with itself — adrift among the cypress stumps, drained of purpose, spirit, hope, credibility, and, worst of all, a collective grasp on reality, lost in the fog of collapse.

Here’s what you need to know about what’s going on and where we’re headed.

The United States is comprehensively bankrupt. The government is broke and the citizenry is trapped under inescapable debt burdens. We are never again going to generate the kinds and volumes of “growth” associated with techno-industrial expansion.

That growth came out of energy flows, mainly fossil fuels, that paid for themselves and furnished a surplus for doing other useful things. It’s over.

Shale oil, for instance, doesn’t pay for itself and the companies engaged in it will eventually run out of accounting hocus-pocus for pretending that it does, and they will go out of business.

The self-evident absence of growth means the end of borrowing money at all levels. When you can’t pay back old loans, it’s unlikely that you will be able to arrange new loans.

The nation could pretend to be able to borrow more, since it can supposedly “create” money (loan it into existence, print it, add keystrokes to computer records), but eventually those tricks fail, too.

Either the “non-performing” loans (loans not being paid off) cause money to disappear, or the authorities “create” so much new money from thin air (money not associated with real things of value like land, food, manufactured goods) that the “money” loses its mojo as a medium of exchange (for real things), as a store of value (over time), and as a reliable index of pricing — which is to say all the functions of money.

In other words, there are two ways of going broke in this situation: money can become scarce as it disappears so that few people have any; or everybody can have plenty of money that has no value and no credibility.

I mention these monetary matters because the system of finance is the unifying link between all the systems we depend on for modern life, and none of them can run without it.

So that’s where the real trouble is apt to start. That’s why I write about markets and banks on this blog.

The authorities in this nation, including government, business, and academia, routinely lie about our national financial operations for a couple of reasons.

One is that they know the situation is hopeless but the consequences are so awful to contemplate that resorting to accounting fraud and pretense is preferable to facing reality.

Secondarily, they do it to protect their jobs and reputations — which they will lose anyway as collapse proceeds and their record of feckless dishonesty reveals itself naturally.

The underlying issue is the scale of human activity in our time. It has exceeded its limits and we have to tune back a lot of what we do. Anything organized at the giant scale is headed for failure, so it comes down to a choice between outright collapse or severe re-scaling, which you might think of as managed contraction.

That goes for government programs, military adventures, corporate enterprise, education, transportation, health care, agriculture, urban design, basically everything. There is an unfortunate human inclination to not reform, revise, or re-scale familiar activities.

We’ll use every kind of duct tape and baling wire we can find to keep the current systems operating, and we have, but we’re close to the point where that sort of cob-job maintenance won’t work anymore, especially where money is concerned.

Why this is so has been attributed to intrinsic human brain programming that supposedly evolved optimally for short-term planning. But obviously many people and institutions dedicate themselves to long-term thinking.

So there must be a big emotional over-ride represented by the fear of letting go of what used to work that tends to disable long-term thinking. It’s hard to accept that our set-up is about to stop working — especially something as marvelous as techno-industrial society.

But that’s exactly what’s happening. If you want a chance at keeping on keeping on, you’ll have to get with reality’s program. Start by choosing a place to live that has some prospect of remaining civilized. This probably doesn’t include our big cities.

But there are plenty of small cities and small towns out in America that are scaled for the resource realities of the future, waiting to be reinhabited and reactivated.

A lot of these lie along the country’s inland waterways — the Ohio, Mississippi, Missouri river system, the Great Lakes, the Hudson and St. Lawrence corridors — and they also exist in regions of the country were food can be grown.

You’ll have to shift your energies into a trade or vocation that makes you useful to other people. This probably precludes jobs like developing phone apps, day-trading, and teaching gender studies.

Think: carpentry, blacksmithing, basic medicine, mule-breeding, simplified small retail, and especially farming, along with the value-added activities entailed in farm production.

The entire digital economy is going to fade away like a drug-induced hallucination, so beware the current narcissistic blandishments of computer technology.

Keep in mind that being in this world actually entitles you to nothing. One way or another, you’ll have to earn everything worth having, including self-respect and your next meal.

Now, just wait a little while.

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          Fascism and the Denial of Truth        
SUBHEAD: Party polarization and gridlock in the US have created unsolved issues amenable to a Trump demagogue.

By Thomas Scott on 30 July 2017 for Truth Out  -
(http://www.truth-out.org/opinion/item/41423-fascism-and-the-denial-of-truth-what-henry-wallace-can-teach-us-about-trump)


Image above: Cover art for song release of "Demagogue" by Franz Ferdinand. From (https://rateyourmusic.com/release/single/franz-ferdinand/demagogue/).

What is a fascist? How many fascists have we? How dangerous are they? These are the questions that the New York Times posed to Henry A. Wallace, Franklin Roosevelt's vice president, in April 1944.

In response, Wallace wrote "The Danger of American Fascism," an essay in which he suggested that the number of American fascists and the threat they posed were directly connected to how fascism was defined.

Wallace pointed out that several personality traits characterized fascist belief, arguing that a fascist is;
"one whose lust for money and power is combined with such an intensity of intolerance toward those of other races, parties, classes, religions, cultures, regions or nations as to make him ruthless in his use of deceit or violence to attain his ends."
Wallace also claimed that fascists "always and everywhere can be identified by their appeal to prejudice and by the desire to play upon the fears and vanities of different groups in order to gain power."

Fascists are "easily recognized by their deliberate perversion of truth and fact" (my italics), he contended.

Moreover, Wallace noted that fascists "pay lip service to democracy and the common welfare" and they "surreptitiously evade the laws designed to safeguard the public from monopolistic extortion."

Finally, Wallace identified that fascists' primary objective was to "capture political power so that, using the power of the state and the power of the market simultaneously, they keep the common man in eternal subjection."

Wallace was writing in the context of an existential threat to democracy posed by Nazi Germany, Italy and Japan.

However, his essay is prescient in that he identified the existence of a domestic form of American fascism that emerged from the political context of enlightened thought, rule of law and limited government. Wallace drew a clear distinction between European fascism and the kind of fascism found in the United States.

Rather than resort to overt violence, American fascists would "poison the channels of public information," Wallace reasoned. Likewise, he argued that American fascism was generally inert, not having reached the level of overt threat that it had reached in Europe.

Despite this, Wallace argued that American fascism had the potential to become dangerous to democracy under that appropriate context; one in which a "purposeful coalition" emerges based on "demagoguery."

British historian Karl Polanyi has written in his seminal book, The Great Transformation, that fascism can emerge in a society in reaction to "unsolved national issues."

Party polarization and gridlock in the US have created unsolved issues concerning health care, immigration reform and the "war on terror." These volatile issues, in turn, have created the perfect political context for a demagogue to emerge in the United States.

With the election of Donald Trump, the purposeful coalition Wallace feared may have evolved. Trump is the first US president who has been seriously associated with fascist ideology.

His coalition of white supremacists, xenophobes, plutocratic oligarchs and disaffected members of the working class have aligned with the mainstream Republican Party.

The coalition's political philosophy, rooted in reactionary populism and "American First" sloganeering, has quickly led to the United States' systematic withdrawal from global leadership.

Coupled with a disdain for multilateral collaboration, a rejection of globalization, and a focus on militarism and economic nationalism, Trumpism has taken the country down the perilous path of national chauvinism reminiscent of previous fascist states like Spain under Franco, Portugal under Salazar, or Peronist Argentina.

Unlike past Republican and Democratic presidents, Trump has disregarded long-standing traditions related to political protocol and decorum in the realm of political communication. He routinely makes unsubstantiated claims about political rivals, questioning their veracity and ethics.

Trump's claim that the Obama administration wiretapped his phones during the 2016 campaign and that Obama refused to take action regarding Russian meddling in the 2016 election, as well as Trump's incendiary tweets about federal judges who ruled against his executive orders on immigration, suggest a sense of paranoia commonly associated with autocrats.

Trump has demonstrated a fundamental ignorance of democratic institutions associated with the rule of law, checks and balances, and the separation of powers.

Common to autocratic leaders, Trump sees executive power as absolute and seems confounded when the legislative or judicial branches of government question his decisions.

Trump has seemed willing to ignore norms that are fundamentally aligned with US democracy: equality before the law, freedom of the press, individual rights, due process and inclusiveness.

Typical of all autocratic leaders, Trump has a deep-seated distrust of the media. Calling journalists "enemies of the people," Trump's incessant claims that media outlets like the New York Times and the Washington Post create "fake news" is a common attribute of authoritarian regimes.

In response to investigative reports that are critical of his administration, Trump engages in systematic tactics of disinformation. Trump has refined the art of evasion through communicating a multiplicity of falsehoods as a means of obfuscating charges of abuse of power and political misconduct.

The biggest dilemma for an autocrat is confronting the truth. Systematic strategies to implant misinformation have historically provided significant political dividends for demagogues.

From Trump's earliest forays in national politics, the truth was his biggest enemy.

Trump discovered in the 2016 campaign that the perpetuation of lies and deceit could be converted into political capital. Lying on issues actually generated support from Trump's political base, many of whom were low-information voters.

The hope by many that Trump would conform to traditional political norms once elected proved to be a chimera. Trump has obliterated the Orwellian dictum that lies are truth; in Trump's worldview, truth does not exist. It is seen as a political liability.

As president, the debasement of truth has become an important political strategy shaping much of his communication to the American public.

Purposeful deceit has become one of the primary means by which Trump energizes and excites his supporters. It is the catalyst that drives their emotional connection to Trump, who is insistent on "telling it like it is" and fighting for "the people" as a challenge to the political elite.

For Trump, facts mean nothing. They are contrary to the desires of his political base. Connecting to his base is visceral; intellectualism is the antithesis of Trump's immediate political objectives.

By denying the existence of truth-based politics, Trump solidifies his populist vision and perpetuates one of fascism's greatest mechanisms for acquiring absolute power: the force of emotion conquering the force of reason.

As Timothy Snyder states in his insightful book On Tyranny, "To abandon facts is to abandon freedom.

If nothing is true, then no one can criticize power, because there is no basis upon which to do so."

Seen in this light, empirical evidence based on scientific investigation is superfluous; public policy is only useful when it is connected to human emotion and desire.

This is all that matters in Trump's vision for the US. As such, facts and scientific research are a ruse, a tool of the elite designed to consolidate power over "the people" and discredit Trump's "America First" policies.

Truth is a necessity for democracy because citizens depend on truth-based decision-making to achieve reasoned judgments about public policy. In the Trump administration, the eradication of fact-based communication has normalized the denial of truth.

As a result, democracy is clearly under siege. Henry Giroux makes an excellent argument when he writes, "normalization is code for retreat from any sense of moral or political responsibility, and it should be viewed as an act of political complicity with authoritarianism and condemned outright."

All Americans should take heed of this point. History has provided ample evidence of how institutional and civic complicity with autocratic rule erodes democracy.

However, history has also demonstrated how engaged citizens can mobilize to resist this erosion.

]As Snyder argues, in order to confront autocracy, citizens need to become aware that democracy can disappear and mobilize to stop such a disastrous turn of events. In the age of Trump, there is no time for complacency.

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          House Stimulus vs. Senate Stimulus At A Glance        
Propublica has a fantastic side-by-side comparison of the original House stimulus bill and the abortion produced by the Senate "compromise."

Short version: to give big corporate welfare "tax cut" handouts to Big Oil, Big Coal, Big Pharma, Big Banks, Wall Street and all the other rich people who have been fucking over the middle class for the last thirty years, the Cowardly Democrats in the Senate agreed to make huge cuts in anything and everything that creates jobs by helping working families, including:

aid to states, health care, education grants, repairing and building schools, repairing and building roads, public transportation, renewable energy research, unemployment insurance, repairing the electric grid, improving water and sewer lines, affordable housing, mortgage relief, expanding broadband access, etc., etc., etc., ad nauseum.

If you're not so rich that a global economic meltdown won't affect you, then you need to email or call your Congressional representatives right now and tell them to support restoring the House stimulus bill.

Click here for a quick way to send an email to your representatives, even if all you know is your zip code.

All that's at stake is your job, your house, your kids' future, and, you know, the world.
          Is A Capitalist Meltdown Upon Us?        
I'll only be 53 on my next birthday in late July, yet it already seems like I've lived a tiring amount of history. Only 20 years ago, the world saw the meltdown of Soviet-style communism -- and many observers, largely neo-conservatives, interpreted that as an ideological culmination, "the end of history." There was even an influential book written with that title. (Does anyone remember that author now? And, does he want to remember that book? Yeah, I know -- Francis Fukuyama.)

It appears that reversals of fortune can happen quickly. Now it looks like the allegedly venerable ideology of "free-market" capitalism is on the ropes, and in serious danger of going down. Who would have thought it?

Die-hard Marxists did. I've never been one of them, even as a long-ago radical all of 23 years old. I still know three people who have continued to call themselves Marxists in total defiance of dismissal or ridicule, and they are probably gloating a lot now. The economic train wreck they kept dogmatically predicting finally seems to be in front of us.

But even as America sleepwalked through our Second Gilded Age (circa 1981-2005), I grew skeptical of the Marxist vision. "Historical inevitability" always sounded like a religious tenet, without the pure superstition; and Marxism itself, a sort of quasi-religion for embittered atheists.

We should be as cautious about awarding hard-line socialists a victory here, as much as "we" (in the editorial sense) should have checked for our wallets the minute Reagan started talking about trickle-down and Phil Gramm started talking about deregulation. The past century should have taught us that the answer lies in between.

Starting with the excesses of laissez-faire: America has, for the past 30-ish years, seen the roller-coaster ride that happens with that sort of economic policy. An elite grows very rich, a minority near the bottom slips much further down, and most people tend to stagnate in the middle.

There are cycles of boom and bust. The booms are good for most people, but especially good for a few. The latter group inevitably forms a "Why Should I Have To Pay Taxes?" lobby and gets bonanzas from lawmakers eager to please. And since these are the people of ostentation and material success, their influence is great among fashionable "thinkers" of the day.

Now the big bust is upon us. It's a bit like 1933 all over again -- not as grim or total in devastation, but it's likely to get worse. President Barack Obama has warned us that this is so.

But history, with its entire lesson, should be heeded, and it seems like Obama is one who will do so.

There were very good reasons for the meltdown of the Soviet empire 20 years ago. Contrary to right-wing mythology, Reagan and his military buildup had little to do with it. Post-Soviet Russian economists recall the problems as internal, and any intellectually honest person knew what they were. There's no need for me to recite the litany here -- Americans heard it all for decades.

But, let's face it, die-hard socialists out there -- state-run enterprises have a poor track record. The employees seem to lack incentives to produce. Cooperatives tend to degenerate into personal conflict, power struggles and chaos. And as for the concentration of power in the hands of "vanguard revolutionaries" -- the horrors and enormities of that have been abundant just in the past century.

I don't think it's hard to argue for a sense of balance and measure. In America, it seems like the compromising wheeler-dealers -- the FDRs, the Trumans, the LBJs, the Ted Kennedys -- got more done for working Americans than any of our homegrown radicals ever did.

But there is little doubt that there's been a sea change, and it's been back toward socialist thinking. The Nobel Prize committees have not been known for their sympathy toward socialist-leaning economists, yet Nobel Laureate economist Joseph Stiglitz has more or less come out in favor of the nationalization of U.S. banks. That would be a major step toward socialism of some fashion. Why not? We've just given the bastards $700 billion in taxpayer money to keep them in business. Here's a link to the interview with Stiglitz.

And, it appears that such state power would be the only thing to force the shameless swine who run these enterprises to behave themselves. Sen. Claire McCaskill, D-Mo., made a speech on the Senate floor about the Wall Street oinkers who had themselves awarded $18.4 billion in bonuses while their enterprises got in on the aforementioned $700 billion, because of reckless and disastrous mismanagement. Here's another link to reports on this issue, and to a video of McCaskill's speech. Be patient, the video seems very rough.

So, what should be the ultimate American destination, in an era of "capitalist" meltdown? The Swedes, with a hybrid socialist-capitalist system, don't seem to do badly, with avowed Socialists predominantly in power since 1929. Their booms are smaller, but so are their busts. Their people don't live in fear of homelessness or inability to afford basic health care. Right-wing humorist P.J. O'Rourke, when asked about the Swedes' seeming happiness with their stable system, said that they are all insane -- but that their insanity is distributed equally among the people.

It's a funny line. But there's nothing funny about facing a mortgage foreclosure, or about the welfare rolls shrinking even as joblessness is rapidly expanding. With a growing U.S. underclass, it may be time to take a second look at the socialist mind-set -- despite the old Marxist baggage. Nobody requires us to go to extremes.

Crossposted at Manifesto Joe.
          "Are These Folks Serious?"        
From the Huffington Post, "President Barack Obama says the time for talk on an economic recovery package is over and "the time for action is now." "



Speaking at the Energy Department, Obama made a fresh plea for the stimulus plan that the Senate is debating. He cited the latest bad economic news of jobless claims as another reason for quick action.

He said: "The time for talk is over, the time for action is now."

He also launched a shot at critics while talking about energy, questioning, "are these folks serious?"

Now, I read the other day that critics of this plan ridiculed our notion that we should use part of the money to modernize the entire fleet of federal vehicles to take advantage of state of the art fuel efficiency. This is what they call pork. You know the truth. It will not only save the government significant money over time, it will not only create manufacturing jobs for folks who are making these cars, it will set a standard for private industry to match. And so when you hear these attacks deriding something of such obvious importance as this, you have to ask yourself -- are these folks serious? Is it any wonder that we haven't had a real energy policy in this country?

For the last few years, I've talked about these issues with Americans from one end of this country to another. And Washington may not be ready to get serious about energy independence, but I am. And so are you. And so are the American people.

During his speech Obama also issued a strong critique of the GOP's economic policies, even though he didn't utter the party's name. He told the audience that:

In the last few days, we've seen proposals arise from some in Congress that you may not have read but you'd be very familiar with because you've been hearing them for the last 10 years, maybe longer. They're rooted in the idea that tax cuts alone can solve all our problems; that government doesn't have a role to play; that half-measures and tinkering are somehow enough; that we can afford to ignore our most fundamental economic challenges -- the crushing cost of health care, the inadequate state of so many of our schools, our dangerous dependence on foreign oil.

So let me be clear: Those ideas have been tested, and they have failed. They've taken us from surpluses to an annual deficit of over a trillion dollars, and they've brought our economy to a halt. And that's precisely what the election we just had was all about. The American people have rendered their judgment. And now is the time to move forward, not back. Now is the time for action.

          Why the Senate Must Pass the Stimulus Bill        
First, check out USAToday's interactive map of how President Obama's stimulus bill will help your state.

Then, watch TPM's interview with an expert who explodes the repug lies about the bill containing too much spending.

There is so much fog and uncertainty -- much of it intentionally injected into the debate -- about the different moving parts of the Stimulus Bill. But some of the broad outlines are arresting and straightforward.

We're hearing all this talk about the staggering size of the bill. And it is a staggering amount of money. But according to Dean Baker, co-director of the Center for Economic and Policy Research, the amount of demand that the financial crisis is pulling out the economy is likely to be between $1.1 and $1.2 trillion this year (and that is not a controversial estimate). The Stimulus Bill (which, remember, is $800+ billion over two years) would try to compensate for that drop off with about $400 billion of spending and tax cuts. How efficiently the money is spent, how quickly and so forth -- all very good questions. But judged in these terms you start to see how the real question is whether any bill of that size is enough.
David Kurtz and Baker discuss the issue in today's episode of TPMtv.


And finally, read Bob Herbert on the danger of not putting enough money into infrastructure projects immediately.

We have infrastructure spending in the Democrats' proposed stimulus package that, while admirable, is far too meager to have much of an impact on the nation's overall infrastructure requirements or the demand for the creation of jobs.

SNIP

The big danger is that some variation of the currently proposed stimulus package will pass, another enormous bailout for the bankers will be authorized, and then the trillion-dollar-plus budget deficits will make their appearance, looming like unholy monsters over everything else, and Washington will suddenly lose its nerve.

The mantra (I can hear it now) will be that we can't afford to spend any more money on the infrastructure, or on a big health care initiative, or any of the nation's other crying needs. Suddenly fiscal discipline will be the order of the day and the people who are suffering now will suffer more, and the nation's long-term prospects will be further damaged as its long-term needs continue to be neglected.

We no longer seem to learn much from history. Time and again an economic boom has followed a period of sustained infrastructure investment. Think of the building of the Erie Canal, which connected the Great Lakes to the Atlantic Ocean. Think of the rural electrification program, the interstate highway system, the creation of the Internet.

We're suffering now from both a failure of will and of imagination. I remember the financier Felix Rohatyn telling me, "A modern economy needs a modern platform, and that's the infrastructure."

History tells us the same thing.

And if you're still not persuaded, consider this: Mitch McConnell would give his left nut to kill the stimulus. What more reason do you need to support it?

Cross-posted at Blue in the Bluegrass.

          Alberta's Budget Bubble        

We've had it pretty good in this province. In fact, very good.

We have the lowest overall taxes in Canada, including no sales tax, and as of January 1st - no health care premiums. We also have among the highest, if not the absolute highest paid teachers, doctors, nurses and other government employees. We have the highest funded health care system (although wait lists are about average) and school system in the entire country on a per capita basis.

          Alberta already has two-tiered health care        
The recent exposure of a "prominent leader" of the Calgary Health Region (CHR) using their connections to try and get a family member a speedier psychiatric assessment was a bit of surprise to those who don't understand Alberta's health care system.

          Sick of waiting for health care reform        
Shortly after being appointed health minister in 2006, Dave Hancock (now education minister) endorsed the status quo in our health care system declaring that user-pay, private health care alternatives were not an option in Alberta.

Fortunately, Alberta's new health minister, Ron Liepert, doesn't feel the same way: "It's all on the table," Liepert recently told journalists.

          Clearing the air on the health care premium        

For the past six years, the Canadian Taxpayers Federation (CTF) has been campaigning to see Alberta's regressive health care premium tax eliminated. Over the years we've written columns, dropped thousands of petitions off at the Legislature, and told anyone who would listen why this $1,056 per year, per family tax had to be axed. On February 4th, 2008 the efforts paid off.

          Provincial election is a good time for tax cuts        
Premier Stelmach's recent musing on whether or not to eliminate Alberta's regressive health care premium was significant for many reasons.

For starters, it's the first time the premier has publicly said eliminating the $1,056 per year per family tax is being considered. Although, to be fair, the premier did tell the Canadian Taxpayers Federation in a survey during his leadership bid that he doesn't like health care premiums (however stopping short of committing to eliminate them).

          Forget rent controls - cut health care premiums        
With opposition parties marching angry renters towards the Alberta Legislature demanding government action, the issue of rising rents is not likely to go away soon.

Unfortunately, as we've seen from governments in the past, taking the wrong -- however well-intentioned -- "action" can cause more problems than it solves.

          Myths, lies and falsehoods keep health care premium tax alive in Alberta        
Recent news stories about Health Minister, Dave Hancock's proposal to eliminate Alberta's $44 per person, per month health care premium tax have been both a blessing and a curse.

A blessing because it has provided an opportunity for the Canadian Taxpayers Federation (CTF), to reiterate our opposition to the regressive health care premium tax. But a curse because it has resurfaced many myths that surround the tax.

          Sustained underachievement        
As his first act as Alberta's new Minister of Health and Wellness, Dave Hancock, declared that user-pay, private health care choices were no longer an option in Alberta.

Apparently one of Minister Hancock's main reasons for his government's prohibition on allowing Albertans to purchase private health care is that "the private system is about choice, not about sustainability - And what we need to focus on - is to make sure we have a sustainable system."

But should sustainability really be our goal

          Tax plan needs to wear a cap        
As the Progressive Conservative leadership campaign rolls along, it's to be expected tax policy ideas are being floated - some good, some not so good.

Under the good category, Dr. Lyle Oberg's pitch to eliminate the regressive health care premium tax. Under the not so good category, Jim Dinning's (now smartly rescinded) five per cent tax rate for people under the age of 30.

          Debate me not        
As spring session draws to a close, it will most likely be remembered for what was not debated rather than for what was.

For all the talk and bluster about Alberta finally taking some action to address the sustainability and lack of choice within our health care system, not one piece of legislation was introduced and not one substantial debate was held on health care reform.

          Health care premiums: Use them or lose them        
Imagine if private automobile insurers applied the logic of government health care insurance: A 50-year-old woman with a clean driving record, uses her 1990 Chevrolet Cavalier to drive back and forth to church on Sundays, is charged $44 per month for automobile insurance. In the same city, an 18-year-old male with five at-fault accidents and one DUI, driving a 2005 Ford Mustang Convertible, is also charged $44 per month for automobile insurance.

          Klein's "Third Way" leaves government health monopoly in place        
The Friends of Medicare and the CBC have declared that Premier Klein's "Third Way" will lead to the destruction of the government's health care monopoly. But in fact, Alberta's 12 "renewal initiatives" consist mostly of reorganizing bureaucracy and throwing more tax dollars at a system which lacks incentives for efficiency.

          Private health care is no threat to public system        
The Supreme Court of Canada has ruled that suffering - and dying - while waiting for "non-urgent" medical care violates our right to "life, liberty and security of the person."

Based on the evidence, the court ruled that delays for surgery cause irreparable physical injury, and can even result in death. Further, living in pain for months - or years - while waiting for surgery interferes with the quality and enjoyment of life, not to mention a person's ability to earn a living.

          Canadians want health care reform, but politicians don't        
Most politicians support the government's monopoly on health care, and will tell you that people should not have any right to spend their own money for health care. But a new national opinion poll by Montreal-based Leger Marketing shows that politicians are out of touch with Canadians on this issue.

          The narrow limits of Albertans' voting power        
Consider what Alberta's party leaders are promising us: respect and care for the less advantaged, publicly funded health care with major investments to reduce waiting times, smaller class sizes for students, maintaining and developing a highly-skilled workforce, community policing and crime prevention, a better deal for Alberta seniors, vibrant communities, top-notch post-secondary schools, a highly educated workforce, attracting new business, and support for emerging technologies.

          Graydon Report threatens Albertans with more tax increases        
The Graydon Report on Health Care Funding is a recipe for more tax increases, without any substantive reforms to give patients better quality health care.

          Health care is a provincial issue, Mr. Martin        
Paul Martin is profoundly disturbed by the prospect of Premier Klein's government coming forward with new health care policies later this month. Without knowing the content of Alberta's reforms, Mr. Martin has declared his determination to say "no" to Mr. Klein. In Canada it's not surprising when a Liberal automatically opposes whatever a Conservative supports - and vice versa. However, what is startling is Mr. Martin's assumption - also shared by others - that provinces have no business running health care.

          More tax increases won't improve Alberta's health care system        
The Alberta Government will spend an extra $700 million on health care, in addition to the $630 million increase over last year. This means that total spending on the government's health care monopoly is rising by 18% in just one year, from $7.4 billion in 2003-04 to $8.7 billion in 2004-05.

          The tax increases of 2002 remain in place        
Three years ago, just prior to the 2001 election, Premier Klein promised us that "The only way taxes are going in this province is down."

That promise was broken in March of 2002, when Premier Klein increased various taxes and fees, including an increase in the health care premium tax to $1,056 per year, per Alberta family. The $541 million tax increase of 2002 was partly reversed by small reductions to corporate tax rates in 2003 and again in Budget 2004-05. Still, more than half of the tax increases of 2002 remain in place, and Premier Klein's promise remains broken.
          Would "foodcare" be a good idea        
We are doomed to pay high taxes forever, unless and until governments end their monopoly over the delivery of health care services.

If the production and sale of food in Canada were managed like health care, governments would have a monopoly on "foodcare." Politicians would declare that all Canadians, regardless of income, have a fundamental right to free food. After all, we need food even more than medicine, because without food a person will surely perish, whereas without medical care a person might live for weeks or months or even years.

          How Premier Klein spends your health care premiums        
Alberta families pay $1,056 per year in health care premium taxes to finance double-digit pay increases for doctors, nurses, MLAs, provincial government employees, teachers, and other public sector workers. Health care premiums do not pay for health care, but go into general revenues like every other provincial tax. Here follow some examples of how Premier Klein spends Albertans' health care premiums and other provincial tax dollars:

          Klein's broken promise remains broken        
Before the 2001 provincial election Premier Klein promised Albertans that "the only way taxes are going is down." In 2002 he broke that promise with a $641 million tax increase, raising the health care premium tax to $1,056 per Alberta family, as well as hiking other taxes. This week's Budget 2003-04 cuts corporate income tax by $94 million - just one seventh of last year's increase. Unfortunately, Premier Klein's broken promise remains broken.

          "For-profit" health care is already here        
In Canada in 2003, doctors, nurses, pharmacists, licensed practical nurses, nursing attendants, hospital cleaning crews, chiropractors and physiotherapists all profit from medicare, each and every day. Their pay cheques put food on the table for themselves and their families, in the same way that contractors, executives, and entrepreneurs feed their families. The only difference is that nurses' salaries come from profits indirectly - through the filter of taxes - whereas a businessman pays himself profits more directly. Doctors, too, profit from the health care system.
          Klein's new chance to keep his promise        
On January 29, 2001, prior to the provincial election in which he received his third mandate, Premier Klein promised Albertans that "the only way taxes are going is down."

Premier Klein broke his promise on March 19, 2002 by raising the health care premium tax to $1,056 per year for Alberta families - a 29% increase. Premier Klein raised health care premiums and other taxes by $722 million and reduced corporate taxes by $81 million, for a net tax increase of $641 million.

          Who speaks for taxpayers in Alberta's Legislature        
In theory, all 83 Alberta MLAs speak for the taxpayers in their constituencies. But since Premier Klein increased our taxes by $641 million this past March, how many MLAs have called for reversing these tax hikes Some ND and Liberal MLAs criticized Premier Klein for breaking his pre-election promise to Albertans that "the only way taxes are going is down." But these same opposition MLAs consistently call on the government to throw more money at health care, teachers' salaries, social workers, etc.
          17 lat w kolejce do endoprotezy. Z czego to wynika?        
W Klinice Ortopedii i Traumatologii w Górnośląskim Centrum Medycznym w Katowicach na wymianę stawu biodrowego trzeba czekać 17 lat - wynika z raportu Barometr Fundacji Watch Health Care. Szpital przedstawia, jak to wygląda z jego strony.
          Work from Home Behavioral Health Care Coordinator        
A premier managed healthcare company is filling a position for a Work from Home Behavioral Health Care Coordinator. Must be able to: Implement, coordinate, and monitor strategies for members and families to improve health and quality of life Conduct in depth health risk assessment and/or comprehensive needs assessment Assess and review plan of care regularly to identify gaps in care Required Skills: Licensure required; LCSW-C or LCMFT or LCPC in Maryland, DC, or Virginia Master's degree in Mental Health required Minimum 5 years post masters clinical behavioral health/psychiatric experience required Solid understanding of behavioral health diagnoses Knowledge and experience in working with case management and in facilities, with local care coordinators or with special populations Knowledge of DSM V or most current diagnostic edition
          Specialist, Low Vision (Opportunity for Specialized Training) - CNIB - St. John's, NL        
Post-secondary studies with a major in health care or vision, i.e., occupational therapy, nursing, teaching, gerontology, Specialist, Independent Living Skills,...
From CNIB - Tue, 01 Aug 2017 16:06:09 GMT - View all St. John's, NL jobs
          A Benefit For Rural Vets: Getting Health Care Close To Home        
Army veteran Randy Michaud had to make a 200-mile trip to the Veterans Affairs hospital in Aroostook County, Maine, near the Canadian border, every time he had a medical appointment.

Michaud, who was medically retired after a jeep accident in Germany 25 years ago, moved home to Maine in 1991.

          With More Veterans Needing Health Care, What Will The Cost Be?         
A new generation of American vets is home from war — about 2.6 million of them. And there are about 10 million older veterans, many from the Vietnam era, hitting their 60s, 70s or 80s. Taking care of both groups is getting expensive.

"If they can afford to pay for wars, they can afford to pay for the treatment after the wars," says Garry Augustine, with Disabled American Veterans.

          VA Health Care's Chronic Ailments: Long Waits And Red Tape        
More than 2.5 million veterans served in Iraq and Afghanistan, and they qualify for health care and benefits from the Department of Veterans Affairs.
          Can Civilian Health Care Help Fix The VA? Congress Weighs In        
Veterans across the country are still waiting too long for medical care, a situation that drove the resignation of Veterans Affairs Secretary Eric Shinseki last week.

Now Republicans and Democrats in Congress are competing to pass laws they think will fix the problem of medical wait times and other problems at the VA.

          American Legion Calls For VA Secretary's Resignation        
Transcript

MELISSA BLOCK, HOST:

The country's largest veteran's organization wants the secretary of Veterans Affairs to resign. The American Legion hasn't targeted a public official this way since 1941. And in the past, they've supported VA Secretary Eric Shinseki. But now, there are allegations that dozens of veterans died waiting for health care. And VA hospitals are accused of fixing the stats.

          By: puuloke        
Our state has the greatest per capita liability in the nation, and we still have people supporting deals with no financial planning. When you have no kids, no money worries, double-dip pensions with paid health care (like our governor), your take on spending $millions$ in tax payer money is not fiscally sound. Save the land, but come up with a plan to pay for it first, before you sign off for all of us residents not so financially blessed.
          After Low-Key Lobbying Effort, Trump Says He Was 'Let Down' By Senators        
https://www.youtube.com/watch?v=ypALjI7MEWI Blindsided by the latest collapse of a Republican health care bill, President Trump took to Twitter to voice his frustration. Trump complained of being "let down" by a handful of Republican lawmakers. And he insisted that the fight over the Affordable Care Act, also known as Obamacare, is not over. Trump had just finished discussing health care with seven Republican lawmakers over dinner Monday when Sens. Mike Lee, R-Utah, and Jerry Moran, R-Kansas — who were not at the meeting — announced they would be voting against the measure to repeal and replace Obamacare. With two other Republican senators already on record in opposition, the Monday-night development effectively killed the Senate bill. Trump acknowledged he was caught off guard by the latest GOP defections. "For seven years, I've been hearing repeal and replace from Congress," Trump said. "And then when we finally get a chance to repeal and replace, they don't take advantage of it. So
          GOP Senators Postpone Vote On Health Care Bill        
Copyright 2017 NPR. To see more, visit STEVE INSKEEP, HOST: And let's bring another voice now into the conversation. NPR's White House correspondent Scott Horsley has been covering this debate for years and years and years... SCOTT HORSLEY, BYLINE: (Laughter). INSKEEP: ...And is here with us and has been listening to Matt Schlapp. Scott, what did you hear there that was noteworthy? HORSLEY: Well, he is right that Republicans have spent more time demonizing Obamacare than they have really selling their own plan. And part of the challenge is philosophically, the Republicans, at least in Congress, envision a health care system where the government plays a smaller role, where there is more consumer skin in the game, that is, consumers bear more of the responsibility. They feel like that'll inject market forces and help to keep costs down. But you have a president, Donald Trump, who has been marketing great care at low costs for everyone. Everyone's going to be taken care of. So there is a
          GOP Sen. Susan Collins Firmly Opposes Senate Health Care Bill        
Copyright 2017 NPR. To see more, visit ARI SHAPIRO, HOST: Congressional forecasters say a Senate bill that aims to repeal and replace Obamacare would leave 22 million more people uninsured by 2026. That's only slightly fewer than a House version that passed last month. This forecast comes as Senate Republican leaders press for a vote on the bill later this week, and it has already led one Republican senator to firmly oppose the bill. NPR's Scott Horsley joins us now. And, Scott, these numbers come from the Congressional Budget Office, the nonpartisan bean counters on Capitol Hill. So where do they think these coverage reductions are coming from? SCOTT HORSLEY, BYLINE: Ari, the biggest drop would be in Medicaid. Remember, Obamacare expanded Medicaid. This bill would shrink it. And the forecasters anticipate by 2026 you would have 15 million fewer Americans getting their coverage through that safety net program. They're also anticipating a drop of about 7 million people getting coverage
          GOP Senate Bill Would Cut Health Care Coverage By 22 Million        
Updated at 8:10 pm ET Congressional forecasters say a Senate bill that aims to repeal and replace the Affordable Care Act would leave 22 million more people uninsured by 2026. That's only slightly fewer uninsured than a version passed by the House in May . Monday's report from the nonpartisan Congressional Budget Office could give moderate senators concerned about health care coverage pause. Sen. Susan Collins, R-Maine, was quick to register her opposition to the bill. Senate Republican Leader Mitch McConnell wants a vote on the bill this week, before senators head home for the July Fourth recess. With Senate Democrats united in opposition, Republicans can afford to lose only two votes on their side and still pass the bill. Sen. Dean Heller, R-Nev., who is up for re-election next year, had already expressed reservations about the number of people who could lose coverage under the GOP bill. Four other Republican senators have complained that the bill doesn't go far enough in rolling
          Senate Republicans Alter Health Care Bill To Avoid 'Death Spiral'        
Updated at 5 p.m. ET Senate Republicans have updated their plan to repeal and replace the Affordable Care Act, attempting to patch a hole that threatened to destabilize the individual insurance market . The original Senate bill, unveiled last week, required insurance companies to offer coverage to everyone, including people with pre-existing medical conditions. But there was no requirement that individuals purchase insurance. Critics said that created a perverse incentive for healthy people to go without insurance, only buying coverage after they got sick. Without enough healthy customers making regular premium payments, insurance companies would be forced to raise prices, driving more customers away — a situation sometimes described as a "death spiral." The revised bill attempts to solve that problem by imposing a penalty on those who don't maintain continuous insurance coverage: People who let their coverage lapse for at least 63 days in one year would be locked out of the insurance
          How The Senate Health Care Bill Could Disrupt The Insurance Market         
Senate Republicans have little margin for error as they prepare for a vote this coming week on a bill to repeal and replace the Affordable Care Act . Some lawmakers are already raising concerns that the bill could aggravate the problem of healthy people going without insurance, driving up costs for everyone else. "If you can get insurance after you get sick, you will," Sen. Rand Paul, R-Ky., told NBC's Today Show . "And without the individual mandate, that sort of adverse selection, the death spiral, the elevated premiums, all of that that's going on gets worse under this bill." The Affordable Care Act, also known as Obamacare, tried to address that problem by requiring all Americans to have health insurance or pay a penalty. But that so-called "individual mandate" is one of the least popular provisions of the law. Senate Republican leader Mitch McConnell of Kentucky and his colleagues are determined to get rid of it. "We agreed on the need to free Americans from Obamacare's mandate so
          Senate GOP Reveals Health Care Bill         
Copyright 2017 NPR. To see more, visit STEVE INSKEEP, HOST: Senate Republicans at last have posted their version of replacing the Affordable Care Act. This is a bill that would affect health insurance, health care which is one-sixth of the American economy. They want a vote within one week or so. And NPR's Scott Horsley has had a solid half-hour to analyze this plan. He joins us now. Hi, Scott. SCOTT HORSLEY, BYLINE: Good to be with you, Steve. INSKEEP: OK. Let's just remember, President Trump first celebrated a House version of this bill but then said he was hoping it would have more heart in the Senate version, that it would be more generous in some way. Is it more generous? HORSLEY: Well, it depends, Steve. Some people who are trying to buy insurance on the individual market might do better with this plan than they would under the House-passed version. So for them, it might seem like this is a bill with more heart or a bigger government subsidy. For others, though, that's not the
          All Metro Health Care (exited)        

All Metro Health Care is a licensed provider of home health care services.

The post All Metro Health Care (exited) appeared first on Triangle Capital Corporation.


          Health care issue        
People who have spent some time discussing the economic status of USA know my person view about why US will loose the economic supremacy in coming years. A lot of people attribute the cause would be the higher gas price … Continue reading
          Triangle Invests in All Metro Health Care Services, Inc.        

$17.4 Million in Subordinated Debt All Metro Health Care Services is a licensed provider of home healthcare services.

The post Triangle Invests in All Metro Health Care Services, Inc. appeared first on Triangle Capital Corporation.


          Small Business Health Care Tax Credit Is Complicated But Valuable        
none
          Death Penalty Costs: Utah        
Problems: Utah Death Penalty Cost Study
Dudley Sharp, 3/4/2016

To: Governor Gary Herbert and staff
Utah House, Senate and staff
Attorney General Sean Reyes and staff
Utah Prosecution Council
Utah Sheriffs' Association

Media throughout Utah

Re: Problems: Utah Death Penalty Cost Study

From: Dudley Sharp

Utah's death penalty cost study (1) has some problems.


1) No Evaluation of Actual LWOP or Death Penalty Costs

The study is based upon calculating the differences in costs between the death penalty and life without parole, without establishing the specific costs of either the death penalty or of life without parole ("LWOP", being the relevant capital murder cases).

The study did this by, allegedly, looking at all the things that Utah has to do in a death penalty case and in a LWOP case and calculating ONLY the costs of the, alleged,  differences between the two, wherein this study found $1.6 million more costs in a death penalty case.

Because of errors in methodology, we know this to be, wildly, inaccurate.


2) How Problematic

This process had several identifiable problems:

a) Gary Syphus, the fiscal analyst who did the death penalty vs LWOP cost study, stated: "To be clear I did not estimate LWOP costs" (2).

We are precluded from fact checking a detailed look at both death penalty and LWOP costs, which are, totally, absent from the study, thereby lowering any confidence in its conclusions

added 11/21/16 --  To be very clear, the methodology of the study, as detailed, and Syphus' conclusions must be very inaccurate;

b) confidence, further lowered, because the study excluded 1) the increased costs of medical and geriatric care,  for LWOP and  2) possibly excluded an increase of costs of higher security for LWOP capital murderers; 3) excluded the increased costs of the additional appellate LWOP costs; and 4) the cost savings of plea bargains to LWOP, only possible with the death penalty option and a cost credit which is applied to the death penalty side of the ledger and which can be a huge number, dramatically lowering death penalty costs, depending upon the number of LWOP pleas.

This study provides zero information for all of those calculations, wrongly excludes them, because none were looked at, establishing  many errors, undermining any confidence in the study.


3) UNDERESTIMATING LWOP COSTS

According to Syphus, the "study" used the average incarceration costs per year for THE ENTIRE PRISON POPULATION and applied those to LWOP (2).

Such underestimates LWOP costs.

a) Medical Costs

LWOP murderers will die in prison and will have a higher average costs for medical care, because, as per Syphus, the average Utah LWOP inmate will live to 76, which incurs geriatric care costs, WHICH Syphus averaged out over the ENTIRE PRISON POPULATION, instead of applying it to LWOP, only (2).

As an example, the study averages costs inclusive of, say, a 20 year old, healthy inmate who gets a 1 year prison sentence for assault and has $0 medical costs per year and an 85 year old inmate, on kidney dialysis, who received a LWOP sentence for capital murder, at age 45, with medical costs at $348,000 per year.

This methodology destroys any confidence in the study and results in, totally, unreliable numbers, as is conceded.

In 2012, in Utah Dept. of Corrections (UDC) found that:

"About 9 percent of the state's total prison population is older than 55. (UDC) estimates health care costs of those inmates are 12 times more expensive than those of younger inmates." (3)

Syphus averaged out those 12 times more expensive geriatric LWOP cases, over the ENTIRE PRISON POPULATION, lowering the real, true geriatric LWOP medical costs and destroying any confidence in the studies findings, as all reality was destroyed, as conceded.

Based upon Syphus' average expected age of 76, the average LWOP prisoner will have about 26 years of geriatric care  which for prisoners starts at ages 50- 55, and, in Utah, averages about additional $22,000 per year (4), or $572,000 per inmate for those additional 26 years, costs which Syphus nullified by averaging the costs over the ENTIRE PRISON POPULATION.

Added to that will be 5 more years of increased medical care, maybe an additional $11,000 or so per LWOP prisoner/yr., $55,000, total, to add up to the 31 years Syphus calculated as the additional years for LWOP over a death row inmate, or an estimated $627,000 total, more per LWOP inmate (4), which was excluded in the study (4).

Because of the way Syphus calculated the study, it is possible that this error could be double, or $1.254 million, as the $627,000 was excluded from the baseline of LWOP, as would apply to all other cost issues, to follow.

Utah's medical/geriatric prisoner costs are at a low level compared to many other states, as detailed (4).

For example, the renal failure unit at the Federal Medical Center (Devens)  costs $348,000/PER YEAR/PER INMATE for their 115 aging inmates, at $4 million per year for that unit, EXCLUDING MEDICATION COSTS (5).

b)  Higher security costs

As a rule, LWOP capital murderers will be in higher security than general population inmates, and such will be more costly. 

However, the spokesperson for UDC, unofficially, says that increased security in Utah does not cost more.

Such is an astounding management of costs, if accurate.

For example, one of California's maximum security units costs $172,000/PER YEAR/PER INMATE (6).

As per Syphus, Utah's average prisoner cost is about $27,000/yr/inmate (2).

It appears that Utah does a better job at controlling incarceration costs than most states. But we will still have to wait on UDC's specific cost statement, which I have been waiting on since 3/1/16 and, as of 6/2/16, have not received.

c) Inaccurate Appellate Costs

Syphus states that the legal appeals costs are within the average for the incarceration costs for the ENTIRE PRISON POPULATION, as with medical costs, which indicates a highly inaccurate and strange way to arrive at very wrong numbers for LWOP costs (2).

Syphus claims that appellate costs are part of the incarceration cost average (2), which makes no sense, further lowering our confidence and, if true, indicates the same problem of averaging over the ENTIRE PRISON POPULATION and, again, dramatically,  lowering LWOP appellate costs.

For example, one would be averaging appellate costs of all inmates who plea bargained and have $0 appellate costs with those LWOP capital murderers who did not plea and have years of appeals, again, an averaging which, vastly, underestimates LWOP appellate costs, again, a lost cause for confidence.


4)  OVERESTIMATING DEATH PENALTY COSTS

Plea bargains to LWOP

With no detailed pre trial, trial and appeals costs of the LWOP cases, there is no way to calculate the actual cost credit of a LWOP plea, a cost credit only possible with the death penalty option and a plea which can create significant cost savings, which shows as a cost credit to the death penalty and which was not calculated in this study.  further destroying any confidence in the study.

No death penalty = no plea to LWOP.

Depending upon 1) how many LWOP cases are the result of a plea; 2) the cost savings of those pleas and 3) how many death row cases a state has, there is a scenario whereby the plea cost savings eradicate any alleged excessive costs of the death penalty, if there are any, and/or which would make the death penalty less costly than LWOP.

But, we are left guessing, as the study leaves out all of those important details.

Conclusion

The death penalty debate is rife with horribly inaccurate and/or misleading death penalty costs studies, some intentionally and obviously fraudulent (6), and Utah's is, not unexpectedly, just another example of that major problem.

The many problems with Utah's study cannot be clarified and/or corrected without a detailed review of both death penalty and LWOP costs, wherein, LWOP costs will rise, possibly dramatically, just as death penalty costs will go down, also possibly,  dramatically.

NOTE: These study problems are not the fault of Syphus, but of the parameters given to him by the authority requesting the study. It is unfortunate he didn't detail the problems of the study and that I had to do so.

ALTERNATE STUDY PARAMETERS

1) The easy route:

Ask all relevant entities how many people they will lay off with death penalty repeal. Likely, none, meaning death penalty repeal will have no known budgetary effect, nullifying the need for a specific, detailed cost review.

2) Detailed route:

A complete, detailed, specific  study of all financial and cost aspects of both death penalty and LWOP cases, inclusive of only capital murderers in the LWOP category.

Here is a suggested protocol for such a study (7).

UTAH'S DEATH PENALTY MANAGEMENT PROBLEMS

I have been told that Utah averages about 20 years of appeals, prior to execution.

That is not a death penalty problem. That is a management problem.

The average time for appeals, prior to execution, is 11 years, nationally, and 7 years, in Virginia.

Virginia has executed 111 murderers, since 1976, within an average of 7 years of full appeals. Their last execution, 10/1/2015, occurred after 5 years of full appeals (see Virginia within footnote 6).

If Virginia can do it, Utah can.

As a rule, there is no legal or rational reason for appeals to take longer than 6-10 years, on average, that being 2-3.3 years , each, at the state supreme court, federal district court and federal circuit court levels. Cases accepted by SCOTUS are rare.

Utah needs to fix her mismanagement problem.

Sincerely, Dudley Sharp

1) see page 2 of document, titled "Incremental Impact for One Death Penalty Offender to Execution -  State and Local, http://le.utah.gov/interim/2012/pdf/00002860.pdf
sent to me by Gary Syphus, Utah Fiscal Analyst, on 2/10/16

2) From email correspondence between myself and Gary Syphus, 2/15/16

3) "Utah one of 4 states whose inmate health care costs doubled",  Brooke Adams, The Salt Lake Tribune, October 29, 2013

4)  My cost numbers are based upon UDC published material in footnotes 3 and 4 and are, most likely, very close to the real numbers.

I have estimated $22,000/yr for geriatric LWOP prisoners (10% of prisoners) and a $1800/yr average for all those younger than geriatric (90% of prisoners), for an average cost of about $3700/yr/inmate, as per UDC (link, hereto) and an approximate 12 times greater cost for geriatric inmates than for the younger prisoners, also as per UDC in (3).

See Health Care Costs, Costs in Comparisons, UDC,
http://corrections.utah.gov/index.php?option=com_content&view=category&id=2&Itemid=119&limitstart=60

5) "The Painful Price of Aging Prisons", Washington Post, May 2, 2015

6) See Death Penalty Costs: California within
Saving Costs with The Death Penalty
http://prodpinnc.blogspot.com/2013/02/death-penalty-cost-saving-money.html


7) Death Penalty Costs vs Life Without Parole Costs: Study Protocol
http://prodpinnc.blogspot.com/2015/05/death-penalty-cost-study-protocol.html

          Views and Experiences with End-of-Life Medical Care in the U.S.        
In partnership with The Economist, the Kaiser Family Foundation conducted a cross-country survey of adults in the United States, Japan, Italy, and Brazil about people’s views and experiences related to aging and end-of-life medical care. This report gives an overview of the U.S. survey results, including ratings of the health care system, personal preferences, conversations and planning related to end-of-life wishes, and experiences with loved ones’ death.
          Views and Experiences with End-of-Life Medical Care in Japan, Italy, the United States, and Brazil: A Cross-Country Survey        
In partnership with The Economist, the Kaiser Family Foundation conducted a cross-country survey of adults in Japan, Italy, the United States, and Brazil about people’s views and experiences related to aging and end-of-life medical care. This report summarizes the overall survey results with comparisons across the four countries. Topics covered in the survey include ratings of the health care system, personal preferences, conversations and planning related to end-of-life wishes, and experiences with loved ones’ death.
          Visualizing Health Policy: U.S. Public Opinion on Health Care Reform, 2017        
This slideshow supports a Visualizing Health Policy infographic with JAMA, spotlighting public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.
          Visualizing Health Policy: U.S. Public Opinion on Health Care Reform, 2017        
This Visualizing Health Policy infographic with JAMA spotlights public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.
          Health Affairs Blog: Medicare Premium Support Proposals Could Increase Costs for Today’s Seniors, Despite Assurances        
In a Health Affairs blog post, Tricia Neuman and Gretchen Jacobson of the Kaiser Family Foundation examine how proposals to convert Medicare to a premium support system could lead to higher Medicare premiums and cost-sharing for seniors currently enrolled in the program, even if today’s seniors are “grandfathered” and the new system is phased-in for people ages 55 and younger. The blog post explains how today’s seniors could face higher health care costs, if older beneficiaries are separated, at least actuarially, from younger ones. Lawmakers could implement policies to prevent cost increases for seniors, but doing so would reduce Medicare savings, a key objective of many premium support proposals.
          Know about Some Stocks of Health Care Industry Listed in FTSE 100 Dividends        
FTSE 100 index is known as a share index of 100 companies which are listed on London Stock Exchange. In …

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          President Barack Obama 2013 Inauguration Speech        
2013 Presidential Inauguration Day - Preparati...
2013 Presidential Inauguration Day - Preparation - Capitol Building (Photo credit: Glyn Lowe Photoworks)





Today President Barack Obama gave what will be known as a historic speech as far as LGBT Americans are concerned. It was the first time the word gay was used in an inaugural speech and it was used to speak about the need for equality. I was happy that my daughter was there in D.C. to hear her President speak so positively about her family. It was an amazing speech that drew on the fact that it was given on Martin Luther King, Jr. Day and made comparison to the civil rights struggles, women's rights and rights for gay Americans. It will be exciting to see how this sets up the State of the Union address and this coming session of Congress. While I believe the President will not do the work for us, he may be willing to be a more active advocate for us. But, I do believe that this President likes to see the American people involved in the process. He wants to see us use our voices and do everything we can to be heard and help to move our elected officials to take action. We must continue to lead this fight. However, the President is clearly in our corner.

Watch the President's speech. Full transcript follows the video




The remarks of President Obama, as released by The White House and prepared for delivery: 
Vice President Biden, Mr. Chief Justice, Members of the United States Congress, distinguished guests, and fellow citizens: 
Each time we gather to inaugurate a president, we bear witness to the enduring strength of our Constitution. We affirm the promise of our democracy. We recall that what binds this nation together is not the colors of our skin or the tenets of our faith or the origins of our names. What makes us exceptional — what makes us American — is our allegiance to an idea, articulated in a declaration made more than two centuries ago: 
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the pursuit of Happiness." 
Today we continue a never-ending journey, to bridge the meaning of those words with the realities of our time. For history tells us that while these truths may be self-evident, they have never been self-executing; that while freedom is a gift from God, it must be secured by His people here on Earth. The patriots of 1776 did not fight to replace the tyranny of a king with the privileges of a few or the rule of a mob. They gave to us a Republic, a government of, and by, and for the people, entrusting each generation to keep safe our founding creed. 
For more than two hundred years, we have. 
Through blood drawn by lash and blood drawn by sword, we learned that no union founded on the principles of liberty and equality could survive half-slave and half-free. We made ourselves anew, and vowed to move forward together. 
Together, we determined that a modern economy requires railroads and highways to speed travel and commerce; schools and colleges to train our workers. 
Together, we discovered that a free market only thrives when there are rules to ensure competition and fair play. 
Together, we resolved that a great nation must care for the vulnerable, and protect its people from life's worst hazards and misfortune. 
Through it all, we have never relinquished our skepticism of central authority, nor have we succumbed to the fiction that all society's ills can be cured through government alone. Our celebration of initiative and enterprise; our insistence on hard work and personal responsibility, are constants in our character. 
But we have always understood that when times change, so must we; that fidelity to our founding principles requires new responses to new challenges; that preserving our individual freedoms ultimately requires collective action. For the American people can no more meet the demands of today's world by acting alone than American soldiers could have met the forces of fascism or communism with muskets and militias. No single person can train all the math and science teachers we'll need to equip our children for the future, or build the roads and networks and research labs that will bring new jobs and businesses to our shores. Now, more than ever, we must do these things together, as one nation, and one people. 
This generation of Americans has been tested by crises that steeled our resolve and proved our resilience. A decade of war is now ending. An economic recovery has begun. America's possibilities are limitless, for we possess all the qualities that this world without boundaries demands: youth and drive; diversity and openness; an endless capacity for risk and a gift for reinvention. My fellow Americans, we are made for this moment, and we will seize it — so long as we seize it together. 
For we, the people, understand that our country cannot succeed when a shrinking few do very well and a growing many barely make it. We believe that America's prosperity must rest upon the broad shoulders of a rising middle class. We know that America thrives when every person can find independence and pride in their work; when the wages of honest labor liberate families from the brink of hardship. We are true to our creed when a little girl born into the bleakest poverty knows that she has the same chance to succeed as anybody else, because she is an American, she is free, and she is equal, not just in the eyes of God but also in our own. 
We understand that outworn programs are inadequate to the needs of our time. We must harness new ideas and technology to remake our government, revamp our tax code, reform our schools, and empower our citizens with the skills they need to work harder, learn more, and reach higher. But while the means will change, our purpose endures: a nation that rewards the effort and determination of every single American. That is what this moment requires. That is what will give real meaning to our creed. 
We, the people, still believe that every citizen deserves a basic measure of security and dignity. We must make the hard choices to reduce the cost of health care and the size of our deficit. But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future. For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn. We do not believe that in this country, freedom is reserved for the lucky, or happiness for the few. We recognize that no matter how responsibly we live our lives, any one of us, at any time, may face a job loss, or a sudden illness, or a home swept away in a terrible storm. The commitments we make to each other — through Medicare, and Medicaid, and Social Security — these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.
We, the people, still believe that our obligations as Americans are not just to ourselves, but to all posterity. We will respond to the threat of climate change, knowing that the failure to do so would betray our children and future generations. Some may still deny the overwhelming judgment of science, but none can avoid the devastating impact of raging fires, and crippling drought, and more powerful storms. The path towards sustainable energy sources will be long and sometimes difficult. But America cannot resist this transition; we must lead it. We cannot cede to other nations the technology that will power new jobs and new industries — we must claim its promise. That is how we will maintain our economic vitality and our national treasure — our forests and waterways; our croplands and snowcapped peaks. That is how we will preserve our planet, commanded to our care by God. That's what will lend meaning to the creed our fathers once declared. 
We, the people, still believe that enduring security and lasting peace do not require perpetual war. Our brave men and women in uniform, tempered by the flames of battle, are unmatched in skill and courage. Our citizens, seared by the memory of those we have lost, know too well the price that is paid for liberty. The knowledge of their sacrifice will keep us forever vigilant against those who would do us harm. But we are also heirs to those who won the peace and not just the war, who turned sworn enemies into the surest of friends, and we must carry those lessons into this time as well. 
We will defend our people and uphold our values through strength of arms and rule of law. We will show the courage to try and resolve our differences with other nations peacefully — not because we are naïve about the dangers we face, but because engagement can more durably lift suspicion and fear. America will remain the anchor of strong alliances in every corner of the globe; and we will renew those institutions that extend our capacity to manage crisis abroad, for no one has a greater stake in a peaceful world than its most powerful nation. We will support democracy from Asia to Africa; from the Americas to the Middle East, because our interests and our conscience compel us to act on behalf of those who long for freedom. And we must be a source of hope to the poor, the sick, the marginalized, the victims of prejudice — not out of mere charity, but because peace in our time requires the constant advance of those principles that our common creed describes: tolerance and opportunity; human dignity and justice. 
We, the people, declare today that the most evident of truths — that all of us are created equal — is the star that guides us still; just as it guided our forebears through Seneca Falls, and Selma, and Stonewall; just as it guided all those men and women, sung and unsung, who left footprints along this great Mall, to hear a preacher say that we cannot walk alone; to hear a King proclaim that our individual freedom is inextricably bound to the freedom of every soul on Earth. 
It is now our generation's task to carry on what those pioneers began. For our journey is not complete until our wives, our mothers, and daughters can earn a living equal to their efforts. Our journey is not complete until our gay brothers and sisters are treated like anyone else under the law — for if we are truly created equal, then surely the love we commit to one another must be equal as well. Our journey is not complete until no citizen is forced to wait for hours to exercise the right to vote. Our journey is not complete until we find a better way to welcome the striving, hopeful immigrants who still see America as a land of opportunity; until bright young students and engineers are enlisted in our workforce rather than expelled from our country. Our journey is not complete until all our children, from the streets of Detroit to the hills of Appalachia to the quiet lanes of Newtown, know that they are cared for, and cherished, and always safe from harm. 
That is our generation's task — to make these words, these rights, these values — of Life, and Liberty, and the Pursuit of Happiness — real for every American. Being true to our founding documents does not require us to agree on every contour of life; it does not mean we will all define liberty in exactly the same way, or follow the same precise path to happiness. Progress does not compel us to settle centuries-long debates about the role of government for all time — but it does require us to act in our time. 
For now decisions are upon us, and we cannot afford delay. We cannot mistake absolutism for principle, or substitute spectacle for politics, or treat name-calling as reasoned debate. We must act, knowing that our work will be imperfect. We must act, knowing that today's victories will be only partial, and that it will be up to those who stand here in four years, and forty years, and four hundred years hence to advance the timeless spirit once conferred to us in a spare Philadelphia hall. 
My fellow Americans, the oath I have sworn before you today, like the one recited by others who serve in this Capitol, was an oath to God and country, not party or faction — and we must faithfully execute that pledge during the duration of our service. But the words I spoke today are not so different from the oath that is taken each time a soldier signs up for duty, or an immigrant realizes her dream. My oath is not so different from the pledge we all make to the flag that waves above and that fills our hearts with pride. 
They are the words of citizens, and they represent our greatest hope. 
You and I, as citizens, have the power to set this country's course. 
You and I, as citizens, have the obligation to shape the debates of our time — not only with the votes we cast, but with the voices we lift in defense of our most ancient values and enduring ideals. 
Let each of us now embrace, with solemn duty and awesome joy, what is our lasting birthright. With common effort and common purpose, with passion and dedication, let us answer the call of history, and carry into an uncertain future that precious light of freedom. 
Thank you, God Bless you, and may He forever bless these United States of America.




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          New Part B Buy-and-Bill Data: Physician Offices Are Losing to Hospital Outpatient Sites        
The Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress on the Medicare program, recently released its June 2017 Data Book: Health Care Spending and the Medicare Program. The report is a 201-page wonktastic data dump. Chapter 10 focuses on prescription drugs.

In 2015, the most recent year available, Part B spending on drugs reached $25.7 billion. Hospital outpatient sites now constitute more than one-third of Medicare spending and have been crowding out physician offices. Part B payments to physician practices are growing much more slowly than payments to hospitals.

For some time, I have been tracking the evolution of the buy-and-bill system for provider-administered drugs. These new data confirm my predictions that physician offices’ will account for a declining share of the buy-and-bill market. Still unknown: Is this good or bad for patients?
Read more »
        

          CBI’s Life Sciences Outcomes-Based Contracting Summit        
CBI’s Life Sciences Outcomes-Based Contracting Summit
October 3-4, 2017 | Philadelphia, PA
www.cbinet.com/OutcomesContracting

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using promo code DCR400
Hurry! This Offer Expires August 14, 2017.

CBI’s 2nd Annual Life Sciences Outcomes-Based Contracting Summit provides critical strategies into the process of outlining, structuring and negotiating risk-sharing agreements between bio/pharma manufacturers and payers.

This timely event will address the continuous challenges the industry faces to lower drug costs and increase patient access, all while demonstrating the value of their drugs to insurers by providing best practices and key insights from thought-leaders regarding the nuances surrounding outcomes-based contracting.

Join us for Solutions-Oriented Sessions, Powerful Payer Insights and Illuminating Case Studies:
  • Gain an understanding of the risk-sharing challenges from the payers perspective, featuring Michael Sherman, MD, Sr. Vice President and Chief Medical Officer of Harvard Pilgrim Health Care
  • Bridge the gap between real-world evidence and health economics outcomes research
  • Manage legal, compliance and regulatory concerns surrounding value-based contracts
  • Examine the benefits and challenges of outcomes-based contracts for target population (orphan/rare disease) therapies
  • Translate successful European managed entry agreements into actionable opportunities for the U.S. marketplace
  • Discuss the challenges and rewards of co-developing drugs and diagnostics for enhanced outcomes
  • And more!
Be the first to view the complete agenda, then register today using promo code DCR400 for this limited time savings of $400* off.

*Discount offer valid through 8/14/17; applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to existing registration. Offer not valid on workshops only or academic/non-profit registration.


The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

        

          Medicaid Drug Rebate Program Summit 2017        
Medicaid Drug Rebate Program Summit 2017
September 11-13, 2017
Marriott Magnificent Mile | Chicago
www.knect365.com/MDRP

Medicaid Drug Rebate Program Summit 2017 is a platform to:
  • Network with 600+ government officials, industry leaders, and pharma executives
  • Gain insights on the upcoming 340B Drug Ceiling Price and Civil Monetary Penalties Final Rules
  • Address the potential implications of “repeal and replace” on Medicaid
  • Hear lessons learned following the implementation of the AMP Final Rule
Register Now!
Use discount code XP2258DRUG for $200 off the current rate.

Earn CPE and CLE Credits!

A Universal Continuing Legal Credits (CLE) Certificate of Attendance will be applied for the State of Illinois. Continuing Professional Credits (CPE) will be provided in accordance with the National Association of State Boards of Accountancy (NASBA). State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. All credits will be provided following the conclusion of the conference.

Get guidance from key federal officials to ensure compliance on government program mandates
  • Medicaid Reform in the Trump Era – Scott W. Atlas, MD, David and Joan Traitel Senior Fellow of the Hoover Institution, Stanford University; Member, Hoover Institution’s Working Group on Health Care Policy
  • MDRP: Once a Good Idea, Now Not “Good Enough” – Jeff Myers, President and Chief Executive Officer, Medicaid Health Plans of America
  • Part I: General Overview of the Medicaid Drug Rebate Program: History, Core Elements, and Manufacturer Requirements and Part II: Understand How to Calculate Critical Price Types Such as AMP, URA, Best Price, Base Line AMP – Miree Lee, Principal at M. Lee Consulting LLC
  • Authorized Generics Price Calculations – John Gould, Partner at Arnold & Porter Kaye Scholer LLP
  • Fireside Chat: External Counsel – Moderated by John Shakow, Partner at King & Spaulding, with KPMG, Arnold & Porter Kaye Scholer LLP, Sidley Austin, and Hogan Lovells
Download the Brochure Here for Full Agenda and Speaker Details

Get a Front Row Seat Today and Participate LIVE at the Event!
Register Now to SAVE $200 off the Current Rate. Use discount code XP2258DRUG.


The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

        

          Health Insurance And Living With A Chronic Illness        
Are you working to keep your Insurance, or is your insurance keeping you working?

Many worker's begin there careers where health insurance is not even on the top 5 reasons why they made a decision to work for a company. As a person ages, quality medicare and insurance becomes one of the top three factors's evaluated in a decision to accept job or keep working with that employer. For many workers who've been diagnosed as having a chronic medical problem it is their number one consideration to future career or job changes.

I think what matters most to readers and patients with chronic illness-is to handling prolonged illnesses and forestalling illness progression. What we all realize has healthcare that covers medications and appropriate treatment therapies is a must.

An inventive company that is an Accredited Disease Management Company has now begun to offer health care benefit program thru a twin work process with a State Work Agency. Green Cross Managed Health care has been handling protracted care patients for the last 6 years. Based out of Jacksonville, Florida their program offers part time work as a Health care Tester/Reporting Consultant and as a result of the job the worker will receive health care benefits. Health Benefits : 2,000,000 Dollar Lifetime Benefit, Giant State PPO, 4 Choice deductibles, 1 HSA Plan, Preventive Care Plan $500.00 annually, Prescription drugs, $15 Generics, $30 Preferred Brands, $50 Name Brand Drugs, NO RX Deductible! Chronic Illness Health Insurance!

As an example, if you have cancer, call the Yank Cancer Society at: 800-227-2345. There, you can find many departments designed to make provision for your requirements including working with health insurance or the lack thereof. A search of the Internet under your personal illness will give you the names of the affiliations and their phone number. You may call 411, info, and ask for the name and phone number of the sort of organization you're looking for.

More about: Chronic Illness Health Insurance

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          How To Get Rid Of Shin Splints        
First of all, if you are experiencing shin splints on a regular basis, you should consider consulting your primary health care provider for treatment. Whenever your body experiences pain, this is a warning sign that something may be wrong. It should not be ignored. But if your shin splints only occur very rarely, there are […]
          The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care        

The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care What stops people who need mental health treatment from getting the support they need? While on average one in five American adults experiences some form of mental illness every year, just over 40% of people living […]

The post The United States’ Greatest Barriers to Improved Mental Health Care Services and What Advocates Can Do to Enhance Care appeared first on Cliffside Malibu.


          Walk With a Doc - August 2017 - Pulmonary Hypertension        

photo"Vegan Life Colorado" Denver Metro

    Every month we walk, talk, and exercise our way to a healthier you! - Learn with a high yield health discussion given by a local expert healthcare provider - Exercise with new friends, doctors, nurses, and other health care professionals - Eat healthy with free refreshments, water, and a healthy breakfast What's better than free breakfast, healthy tips for smart living, and way to talk to your doctors and nurses without any copays!? Come... Walk with a Doc! Ask questions, get to know your doctors, and have a great time improving your life! Join Us at the next one! We'll check blood pressures, give away lots of free stuff, and get you to use exercise as medicine to improve your life! FREE!

Denver, CO 80224 - USA

Saturday, August 12 at 8:00 AM

4

https://www.meetup.com/VeganLifeColorado/events/242101701/


          Republican health care bill, short of votes, is withdrawn        
House Republicans, short of votes, withdrew their health care bill on Friday afternoon, just before it was supposed to go to the floor. The bill was pulled after President Trump asked Speaker Paul Ryan to halt the debate without a vote, according to The Associated Press.
          The Virtual Health Care Provider Will See You Now        

UC Davis Virtual Clinic gives patients access to medical advice from home or office.

(PRWeb June 13, 2017)

Read the full story at http://www.prweb.com/releases/2017/06/prweb14419558.htm


          Comment on Obamacare and Lower-Income Workers by david doon        
The key to this health care working if for the middle income earners being insured.Keep up the good fight.
          Comment on Health Care Costs and Fiscal Infirmity by George Reamy        
Perhaps the incentives you mentioned for Medicare abuse are the reason so many medical universities in Texas have run afoul of Medicare rules. UT Southwestern, to name one, is in the throes of a well-publicized controversy right now. When profits are more important than people, we're in trouble.
          NAACP report documents racist current in Tea Party        

Adrienne,
I have decided I do not want to get into a back and forth with you. Whatever I write will be distorted. Readers can read my post and your reply and decide for themselves whose points they consider valid.

You imply that I am calling you personally a racist because I have written about the racist strand in the Tea Party. You really need to read more carefully.

The recent NAACP report meticulously documents this racist current. I suggest you read it. A summary and links can be found at http://www.thenewamerican.com/index.php/usnews/politics/4957-naacp-relea...
From the report:

Earlier this week, the National Association for the Advancement of Colored People (NAACP) and the Institute for Research and Education on Human Rights announced their intent to release a report entitled, Tea Party Nationalism: A Critical Examination of the Tea Party Movement and the Size, Scope, and Focus of its National Factions.
Released on Wednesday, October 20, the report focuses specifically on six major Tea Party groups: FreedomWorks, 1776 Tea Party, Tea Party Nation, Tea Party Patriots, ResistNet, and the Tea Party Express. Co-authored by Leonard Ziskind and Devin Burghart. It ultimately concludes that the Tea Party movement is “permeated with concerns about race” and that the individual Tea Party groups “have given platform to anti-Semites, racists, and bigots.”
According to the introduction, “This report documents the corporate structures and leaderships, their finances, and membership concentrations of each faction. It looks at the actual relationship of these factions to each other, including some of the very explicit differences they have with each other. And we begin an analysis of the larger politics that motivate each faction and the Tea Party movement generally.”
The report meticulously outlines alleged “racist” and ethnocentric tendencies in Tea Party organizations as it proceeds through a variety of chapters: "Introduction"; "Local Tea Party Chapters"; "Origins of the Tea Parties"; "Tea Party Nation At A Glance"; "Tea Parties — Racism, Anti-Semitism and the Militia Impulse"; "Tea Party Patriots At A Glance"; "Who is an American? Tea Parties, Nativism, and the Birthers"; "Tea Party Express At A Glance"; "Correlation Between Unemployment Levels and Tea Party Membership?"; and "FreedomWorks At A Glance."
The chapter entitled “Tea Parties-Racism, Anti-Semitism, and the Militia Impulse” is perhaps the most troubling. It begins:
This section of the Special Report compiles opinion polling data, documents significant examples of racist vitriol on the part of the Tea Party leaders, shows incidents where well-known anti-Semites and white supremacists have been given a platform by Tea Partiers, and analyzes the attempt by white nationalist organizations to find new recruits in Tea Party ranks.
However, much of the cited material includes the presence of Confederate battle flags, signs that read “America is a Christian nation,” and “racist caricatures of President Obama," all of which are presented as indicators of “racism.” Another instance of racism addressed in this section are “venom (and spittle) directed at African-American Congressmen during the health care debate,” an incident which has long since been proven to be wholly exaggerated.

Karen Bojar


http://www.the-next-stage.com/


          Comment on New Project for an Almost New Year! by Roundhouse Project: Library/Lounge, Part 1! | Lark Nest Design        
[…] outlined in this earlier post, this is the “family room” for employees at Dependable Home Health Care, a […]
          Gay seniors fear housing discrimination        

As a low-income renter, Donald Carter has limited options. And as a gay black man, he's concerned his choice of senior living facilities might be narrowed further by the possibility of intolerant residents or staff members. Experts say many gay, lesbian, bisexual and transgender seniors fear discrimination, disrespect or worse by health care workers and residents of elder housing facilities — ultimately leading many back into the closet after years of being open.



          New Washington Budget Proposes Cuts to State Health Care        

In a new proposal that will slash the state budget by $1.65 billion, Washington Governor Chris Gregoire announces that, because finances are so bleak, severe cuts will have to be made in spending.

Latest News: 
Insurance and Money: 

          Washington State Reviews LTC Rules as Consumers are Clueless About Price        

A Prudential Financial Inc survey has found that 74% of customers – or three out of every four adults aged 55 to 65 – are concerned about the need for long-term health care (LTC).

Latest News: 

          Washington To Provide Universal Health Insurance Coverage        

Washington, D.C., Council member David Catania (I) on Monday proposed a $50 million plan that would require all district residents to obtain health insurance and provide subsidized care for those who qualify, the Washington Times reports (Emerling, Washington Times, 4/1). Catania, chair of the council's Committee on Health, said the Healthy D.C. bill would provide coverage for about 25,000 uninsured residents who are ineligible for Medicaid and the D.C. HealthCare Alliance. Under the program, residents with incomes lower than 200% of the federal poverty level would receive subsidies, paying monthly premiums between $20 and $100, depending on income. The plan would take effect in July 2009, and residents would have until January 2010 to enroll before fines of $250 would be assessed.

About $21 million of the cost would be paid by the city, and CareFirst BlueCross BlueShield would contribute about $5 million. CareFirst also would make its provider network available to program beneficiaries. The plan would generate additional revenue by increasing the tax on commercial health care premiums from 1.7% to 2%, imposing a 2% premium tax on HMOs and doubling the cigarette tax to $2 per pack.

Catania said he has anticipated problems that could lead to higher costs, such as companies eliminating their insurance plans and uninsured people moving into the city to take advantage of the plan. He said the plan would mandate that businesses disclose health care programs on their tax returns and that residents live in the district for six months before applying for the program.

Carrie Brooks, a spokesperson for district Mayor Adrian Fenty, said the mayor is "supportive of the concept" of the plan, but he has not finished reviewing the details. Barbara Lang, president of the D.C. Chamber of Commerce, said the chamber supports the plan but has not seen a final version and plans to review the new taxes more closely (Nakamura, Washington Post, 3/29).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.


          Cost Of Washington State Plan To Insure All Children Higher Than Expected        

A program that will expand health care to all children in Washingtonstate will cost almost twice the amount predicted and provide coveragemainly for undocumented immigrant children, according to new statedata, the Seattle Post-Intelligencerreports. Previous estimates had determined that the program, which goesinto effect on July 22, would insure 6,680 undocumented immigrantchildren, but now this figure is estimated at more than 16,000. Theincrease was a result of unanticipated numbers of noncitizen siblingsof citizen children now covered by the program, according to KirstaGlenn, executive director of the state's Caseload Forecast Council.

Theimpact of the increased number of eligible children is close to $16million more than the $29 million estimate, a 54% cost increase. Of thetotal $45 million, $12 million will be spent covering U.S. children whopreviously were uninsured, and $25 million will be spent coveringundocumented immigrant children. About $8 million will be spent onchildren who are citizens and are covered by other insurance programs,according to the new figures.

The increase in cost will beoffset by $19 million in new federal funds, and the "net impact to the[state] budget is a $6 million increase," according to Victor Moore,director of the state Office of Financial Management (McGann, Seattle Post-Intelligencer, 6/22). Clinics Treating Immigrant Children Featured on ABC
ABC's "World News": The program on Sunday examined health clinics that provide care for uninsured immigrant children. Some clinics, such as the Venice Family Clinicin Los Angeles County, Calif., provide low-cost care with fundingthrough patient copayments, donations, in-kind contributions andgovernment funding. Groups that oppose providing health care forundocumented immigrants maintain that "health care for illegalimmigrants and their kids only encourages more illegal immigration,""World News" reports. As an alternate approach to government-fundedprograms, some winemakers in Napa Valley, Calif., have raised millionsof dollars for Clinic Ol


          Hilft Chester Benningtons Tod, das Schweigetabu über missbrauchte Jungen zu brechen? – News vom 23. Juli 2017        
1. CNN berichtet und kommentiert:

Many fans are shocked and heartbroken over the loss this week of Chester Bennington, the fierce lead singer for the rock band Linkin Park. Police say they are treating his death as a possible suicide, which would make the pain even harder to bear.

There's a famous saying, "When you have a hammer, everything looks like a nail." That may be true. But in this case, as a clinical psychologist and researcher who specializes in trauma, I don't think I'm overreaching in saying that his troubled past may have been a factor in his death. Chester Bennington had openly said he was a survivor of childhood sexual abuse that haunted him and, he said, contributed to his excessive use of drugs and alcohol.

For far too long, boys and men who have been sexually abused or assaulted have been overlooked, neglected, minimized or stigmatized by society and, at times, by the health care community. It's time for that disregard to stop.


Hier geht es weiter, und wir Männerrechtler werden weiter daran arbeiten, auch dieses Tabu aufzubrechen. Allen Diskreditierungsversuchen zum Trotz.



2. In Rotterdam wird die Belästigung von Frauen jetzt zu einem strafbewehrten Vergehen. Gegen jeden, der Frauen hinterherpfeift, ihnen folgt, sie nach Sex fragt oder sie in irgendeiner Weise stört ("bothers a woman in any way"), kann eine Geldstrafe von bis zu 4100 Euro oder drei Monate Gefängnis verhängt werden. Männern auf den Sack zu gehen scheint dem verlinkten Artikel zufolge nach wie vor unproblematisch zu sein.

Noch einen Schritt weiter geht übrigens China, wo inzwischen Flammenwerfer gegen Männer eingesetzt werden, von denen sich frauen gestört fühlen. Die Zeitschrift "Men's Health" ist natürlich so ser voller Verständnis, wie wir Männer in solchen Fällen häufig sind:

But if you think carrying around a flame-thrower is ridiculous, consider this: how ridiculous is it that men’s behavior has made wielding fire as a weapon a preferable alternative?


Wenn ein rechtsradikaler Versand Flammenwerfer gegen "Belästigung durch Ausländer" anbieten würde – ob da die Argumentation wohl ähnlich lauten würde?



3. Die Post. Mehrere Leser machen mich darauf aufmerksam, dass die Firma Deloitte die bisherigen Diversity-Gruppen für Frauen und andere "Minderheiten" durch Gruppen ersetzt, in denen sich auch weiße Männer befinden. Das Ziel dieser Maßnahme ist offenbar, dass diese Männer ein besseres Verständis für die Sorgen von Frauen (und anderen "Minderheiten") gewinnen.

Ein weiterer meiner Leser schreibt mir heute:

Gerade lese ich Ihr Buch "Plädoyer für ...", nachdem es in den letzten zwei Wochen auch "Rettet unsere Söhne" und "Eva Herman" waren. "Männerbeben" und "Sind Frauen ..?" habe ich schon bestellt. Außerdem habe ich gerade Professor Hollsteins " Was vom Manne übrig blieb" ausgelesen.

Was soll ich sagen, ich bin in einem leichten Schockzustand, d.h. viele Dinge in meinem Leben verstehe ich jetzt ganz anders, bzw. kann sie mir zum ersten Mal umfassend erklären. Ich hatte wirklich maximal intensiv mit Frauen zu tun – bin als Sohn einer alleinerziehenden Mutter aufgewachsen, arbeite in einem Frauenberuf (Krankenpflege) in Frauenteams und hatte meistens eine Beziehung, wie auch jetzt. Natürlich hatte auch ich immer wieder Zusammenstöße mit dem Feminismus und bin auch im Job immer wieder von Frauen gemobbt worden. Dank Deiner Arbeit (was für ein Engagement und Fleiß!) und der einiger anderer merke ich auch , dass ich nicht alleine bin. Danke dafür!

Die Gesamtlage beurteile ich ähnlich skeptisch wie Du. Ich glaube auch, dass sich zu unseren Lebzeiten (ich bin 1966 geboren) nichts Gravierendes mehr zum Guten ändern wird. Ich zweifle aber insgesamt, ob unser guter alter Planet überhaupt noch so lange durchhalten wird, und ob es am Ende noch soviel ausmacht, ob er von Frauen beherrscht oder von Männern beherrscht untergeht. Trotzdem, die Wahrheit zu erkennen und auszusprechen ist für sich schon ein großer Wert. Diesen Mut haben nicht viele. Ich verfolge weiter "Genderama" und wünsche Dir das Beste.

          An Adult Conversation About Medicare For All ... by gimleteye        
NOTE: What the hell is going on with Republicans in Congress? The GOP is spending itself on health care like waves on a beach; a great surge then slide back out to sea.

GOP leadership believes that its base is motivated by only one idea: overthrow Obamacare. What was a popular net to corral voters turns out to be much less popular, and not at all effective, as a matter of protecting people, jobs, family and income.

It would be far better for sober adults in the GOP majority in Congress to look at the outcomes of health care in the U.S. As Dr. Carol Paris and many others report: the United States lags health care metrics compared to nearly every other industrialized nation. "Compared to ten other wealthy countries, the U.S. ranks dead last for life expectancy, and access to care. We even have the lowest number of hospital beds per capita, a way that health experts measure the capacity of a nation’s health system. It’s as if our system was designed to deny care."

The only metric where U.S. health care exceeds beyond imagination: empowering and enriching intermediaries in the health care supply chain.

I understand that this point grossly simplifies a massively complex process, but if other Western nations can effectively institute a single-payer system, why can't we?

Published on
Friday, July 28, 2017
by Common Dreams
It's Time for the Adults in This Nation To Talk Seriously About Medicare for All
Today, we breathe a quick sigh a relief. But we cannot celebrate a return to the failed status quo.
by Dr. Carol Paris

Ruby Partin, 63, and her adoptive son Timothy Huff, 5, wait for a free clinic to open in the early morning of July 22, 2017 in Wise, Virginia. Hundreds of Appalachia residents waited through the night for the annual Remote Area Medical (RAM), clinic for dental, vision and medical services held at the Wise County Fairgrounds in western Virginia. The county is one of the poorest in the state, with high number of unemployed and underinsured residents. (Photo: John Moore/Getty Images)

Hundreds of people slept overnight in cars, or camped for days in a field. They told stories of yanking out their own teeth with pliers, of reusing insulin syringes until they broke in their arm, of chronic pain so debilitating they could hardly care for their own children. At daybreak, they lined up for several more hours outside a white tent, waiting for their chance to visit a doctor. For many, this was the first health care provider they’ve seen in years.

Is this a place torn by war, famine or natural disaster? No, this charity medical clinic was last weekend in southwest Virginia, in the wealthiest country in the world, where we spend nearly three times as much money on health care as other similar countries.

"It’s as if our system was designed to deny care."

And what do we get for our money? The very definition of health care rationing: 28 million Americans without insurance, and millions more insured, but avoiding treatment because of sky-high deductibles and co-pays. Compared to ten other wealthy countries, the U.S. ranks dead last for life expectancy, and access to care. We even have the lowest number of hospital beds per capita, a way that health experts measure the capacity of a nation’s health system. It’s as if our system was designed to deny care.

America does hit the top of the list in some areas. Compared to other nations, American doctors and patients waste the most hours on billing and insurance claims. We have the highest rate of infant mortality, and the highest percentage of avoidable deaths—patients who die from complications or conditions that could have been avoided with timely care.

Clearly, this system is broken. Like a cracked pipe, money gushes into our health care system but steadily leaks out. Money is siphoned into the advertising budgets of insurance companies and the army of corporate bureaucrats working to deny claims. Even more dollars are soaked up by the pockets of insurance CEOs who have collectively earned $9.8 billion since the Affordable Care Act was passed in 2010. Nearly a third of our health care dollars go to something other than health care.

President Trump recognized voters’ frustration and campaigned on a promise of more coverage, better benefits, and lower costs. We couldn’t agree more with these goals. However, instead of trying to fix our broken system, GOP leaders are acting more like toddlers, mid-tantrum, smashing our health system into smaller and smaller pieces, threatening to push even more Americans—the most vulnerable among us—through the cracks. Last night, a few Senate Republicans stood up and acted like adults, putting an end to this dangerous game.

Today, we breathe a quick sigh of relief. But we cannot celebrate a return to the status quo, a system that rations health care based on income and allows 18,000 Americans to die each year unnecessarily.

Where do we go from here?

Republicans had eight years to come up with a plan that achieves more coverage, better benefits and lower costs. Have our elected leaders simply run out of ideas?

"The good news is that we already have a proven model for health financing that is popular among both patients and physicians."
The good news is that we already have a proven model for health financing that is popular among both patients and physicians. It provides medically-necessary care to the oldest and sickest Americans with a fraction of the overhead of private insurance. It’s called Medicare, and I can tell you as a physician that it has worked pretty darn well for more than 50 years.

Not only do we have a model, we have a bill that would expand Medicare to cover everyone and improve it to include prescriptions, dental, vision, and long-term care. It’s called H.R. 676, the Expanded and Improved Medicare for All Act, a single-payer plan that would provide comprehensive care to everyone living in the U.S. The bill would yield about $500 billion annually in administrative savings while covering the 28 million currently uninsured. Medicare for all is gaining steam with a record 115 co-sponsors, a majority of House Democrats.

Now that Republican senators have finally worn themselves out, Sen. Bernie Sanders plans to file his own single-payer Medicare for all bill. Senators from both parties will be asked to choose a side: Do you support the current system of health care rationing, medical bankruptcies and unnecessary deaths; or a program proven to work both here and in every other developed country?

A majority of Americans now believe that health care is a human right, and that it is our government's responsibility to achieve universal coverage. We’ve tried everything else except Medicare for all. What are we waiting for?

          How Can You Treat Mesothelioma Cancer Pain?        
Mesothelioma cancer often causes pain for the victims and you need to know how best to manage the pain so that the stress usually caused by the pain will be relived. You will have to inform your doctor and medical team about the pain so that they can help you overcome the pain.



Your doctor will want to find out more about what is causing your pain because that will affect how the pain is treated. Drugs, procedures, cancer treatments, or even surgeries may be used in special ways to manage your pain.



If you have severe pain, your doctor or your cancer team will want to find treatment that best relieves your pain with the fewest side effects. You will need to stay in touch and let the doctor know how the pain treatment is working and how you are doing day to day. The goal is an effective pain control plan that works for you.



Cancer pain is usually treated with drugs that are called analgesics. You can buy some very good pain relievers without a prescription or doctor's order (for example, aspirin, acetaminophen, or ibuprofen). These medicines are also called non-prescription or over-the-counter (OTC) analgesics. OTC pain medicines can be used alone for mild pain, and along with other medicines for more severe pain. For other medicines, you will need a prescription. Ask your doctor, nurse, or pharmacist for advice before you take any medicine for pain. Medicines are mostly safe when they are used properly, but they can be very harmful if not managed carefully.



For some conditions, medicines and non-medical treatments may not work well. But there are special pain treatments that can often be used for these kinds of cancer pain. For instance, doctors may use radiation to shrink the tumor; surgery to remove all or part of the tumor; nerve blocks in which medicine is injected into or around a nerve or into the spine to block the pain neurosurgery, where nerves are cut to relieve the pain, and more.



You may also use non-medical treatments such as relaxation techniques, biofeedback, guided imagery, and others along with the medicines.



You need to develop a pain control plan:



The first step in developing a plan is talking with your doctor, nurse, and pharmacist about your pain. You need to be able to describe your pain to your family or friends too. You may want to have your family or friends help you talk to your health care team about your pain, especially if you are too tired or in too much pain to talk to them yourself.



Using a pain scale is helpful in describing how much pain you are feeling. To use the Pain Intensity Scale below, try to assign a number from 0 to 10 to your pain level. If you have no pain, use a 0. As the numbers get higher, they stand for pain that is getting worse. A 10 means it is the worst pain you can imagine.



0 1 2 3 4 5 6 7 8 9 10

0- no pain

10-worst pain



For example, you could say, "My pain is a 7 on a scale of 0 to 10."







Tell your doctor, nurse, pharmacist, and family or friends:



* where you feel pain

* what is the nature of the pain,how does it feel like? is the pain sharp, dull, throbbing, gnawing, burning, shooting, or steady?

* how strong the pain is (using the 0 to10 scale)

* how long it lasts

* what eases the pain

* what makes the pain worse

* how the pain affects your daily life

* what medicines you are taking for the pain and how much relief you get from them



Your doctor, nurse, and pharmacist may also need to know:



* the medicines you are taking now, including vitamins, minerals, herbs, and non-prescription medicines



* the pain medicines you have taken in the past, including what has worked and not worked for you. You may want to keep records of this information.



* any known allergies to medicines, foods, dyes, or additives



When you go to the doctor, bring all your medicines, vitamins, minerals, herbs, and non-prescription drugs with you. Show them to the doctor and explain how you take them. Questions you may want to ask your doctor or nurse about pain medicine:



* How much medicine should I take? what is the normal dose?



* If my pain is not relieved, can I take more?what is the maximum dose that i can take?



* If the dose should be increased, by how much?



* Should I call you before increasing the dose?



* What if I forget to take it or take it too late?



* Should I take my medicine with food?



* How much liquid should I drink with the medicine?



* How soon will i begin to notice the effects of these pain medications?



* Is it safe to drink alcohol, drive, or operate machinery after I have taken pain medicine?



* Are there some other medications that are safe to take with these pain medications?



* What medicines should make sure i avoid while i am on these pain medications?



* What are the likely side effects of the drugs and how can they be prevented ? and how can they be managed?


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          Samantha Power Visits Ebola-Stricken Countries To Drum Up Health Care Support        

US Ambassador to the UN Samantha Power has flown to West Africa to encourage international support for the fight against Ebola. Power traveled through Guinea on Sunday and landed on Monday in Sierra Leone. She also plans to visit Liberia ... Read More

The post Samantha Power Visits Ebola-Stricken Countries To Drum Up Health Care Support appeared first on WebProNews.


          How to Find the Right Flu Vaccine        
When you visit your doctor for your annual flu shot, don’t be surprised if he sounds more like your local bartender and asks, “What’s your pleasure?” For the first time in decades, Americans will have a wide range of vaccine options this flu season. Since the 1940s, health-conscious citizens have pretty much had only one way of getting immunized: a shot containing three strains of the influenza virus. In recent years, a nasal spray and higher-dose vaccines were added. But this flu season, there are seven ways to get immunized against influenza, so there’s a vaccine for practically everyone. “There has been some drumroll that vaccines aren’t performing quite as well as we want, so we better get in there to improve coverage,” says Dr. Greg Poland, director of the Mayo Clinic Vaccine Research Group. The Centers for Disease Control and Prevention (CDC), which distributes the vaccines made by pharmaceutical companies, says it’s not likely that every doctor, hospital or retail health care center will carry all seven varieties, but with a little research, you can probably find out where your vaccine of choice is given. (MORE: Bird Flu Is Back in China, but This Time It’s H7N9) Here’s the rundown on who should consider which vaccine: Standard three-strain shot The tried-and-true flu shot that protects against three strains of influenza will still be available and is recommended for everyone 6 months and older. This year’s version includes influenza strains H1N1 and H3N2, and an influenza B virus. Four-strain shot For the first time, a flu shot will protect against four types of influenza — two from the so-called A class of viruses and two from the B class. There are only two types of B-class influenza, which primarily causes illness in young children, so the new shot will offer protection against both. “This vaccine will give you greater likelihood of protection against what you might encounter during the flu season,” says Dr. Michael Shaw, associate director of laboratory science at the CDC’s influenza division. Eventually, this vaccine, called the quadrivalent shot,
          Most Recent H7N9 Flu Deadlier Than H1N1        
The first estimates of the severity of the H7N9 influenza virus show that about one-third of people who were hospitalized with the infection died. And flu experts warn that the strain could reappear in the next flu season. In February, Chinese health authorities first reported infections with the H7N9 influenza virus, a flu strain emerging from birds. While the virus did not seem to be as virulent as previous avian strains, public-health officials were concerned that it was the first time cases of H7N9 had been documented in humans. According to the World Health Organization’s (WHO) H7N9 report in early June, there have been 132 lab-confirmed cases of human H7N9 infection in China. The majority have been reported in middle-aged men, most of whom had some exposure to poultry, and by June, 37 people had died from the disease. Flu scientists say that so far there is little evidence that the virus easily spreads from person to person. But they are not ruling out the possibility, since a few cases appeared to result from an infected person passing on the infection during close contact, such as occurs among family members or health care workers. Based on previous studies that confirm how easily influenza viruses can mutate, researchers are also concerned that H7N9 could morph to become more transmissible. (MORE: Bird Flu Is Back in China, but This Time It’s H7N9) “Should sustained human-to-human transmission occur with an increased number of clinically severe cases, health systems are likely to be strained. WHO is providing coordination and guidance regarding provisional vaccine candidates; there are currently no recommendations on the large-scale manufacture of H7N9 vaccine,” the WHO reports. Having such a plan may be critical during the coming flu season. In an analysis published in the Lancet journal, researchers from the Chinese Center for Disease Control and Prevention in Beijing and from the University of Hong Kong reported that H7N9 infection was fatal in about a third of cases that are severe enough to require hospitalization. The H5N1 avian virus that caused a
          The gops privatization policies that         
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          U.S. donates $5 million to Puerto Rico for Zika defense        

The U.S. Department of Health and Human Services is giving $5 million to 20 health centers in Puerto Rico to fight the spread of Zika virus.

Approximately 474 cases of Zika have been reported in Puerto Rico.

“In Puerto Rico, and around the world, the Zika virus is a serious and challenging health threat,” HHS Secretary Sylvia Burwell said. “We are committed to doing everything we can to combat this threat and to help strengthen health care in Puerto Rico.”

The money will help each of the centers hire more staff, increase education efforts and expand their family planning programs, which reach an audience of more than 330,000 people.


          New Center for Behavioral Health Sciences Seeks to Address Opioid Crisis        
Will focus on basic and applied research and community education

Center for Behavioral Health Sciences

The explosion of opioid addiction over the last two decades has taken the lives of many individuals, devastated families and neighborhoods, and put significant strain on the U.S. health and criminal justice systems. A new research center established by Cleveland State University will bring together expertise in social work, psychology, public health, education and urban policy with the goal of better treating current addicts and preventing the further spread of addiction nationally.

The Center for Behavioral Health Sciences will focus on basic and applied research on the science of addiction, the linkages between addiction and mental illness, and the public policies necessary to improve treatment and reduce recidivism. It will also develop innovative educational programming and prevention techniques and will work with CSU’s numerous community partners to disseminate best practices locally and nationally.

“Drug addiction is an extraordinarily complex disease and is impacted by a wide variety of medical, psychological and cultural factors,” notes Cathleen Lewandowski, professor of social work at CSU and director of the Center for Behavioral Health Sciences. “To properly address addiction we therefore need an interdisciplinary approach that looks at the issue holistically. The center will seek to improve our understanding of what can cause drug addiction; what can help and what inhibits treatment; and how health systems, government and educational institutions can collaborate better to meet this challenge.”

CSU partnered with St. Vincent Charity Medical Center, an acknowledged leader in treating addiction since the founding of Rosary Hall in 1952, to help develop the vision and priorities for the Center for Behavioral Health Sciences. The Center has established several pilot research projects, with the support of CSU’s Office of the Vice President for Research, that address major aspects of drug addiction, prevention and treatment. These include:

  • A study assessing the correlation between childhood trauma and substance abuse. The findings will be used to develop better counseling methods for preventing adolescent drug use.
  • Research on the connection between depression, insomnia and opioid use. The project will develop interventions to better identify and address depression-related insomnia that can lead to sleeping pill abuse.
  • An analysis of the service delivery system for addiction treatment in Northeast Ohio. The team will seek to improve the connectivity of the system to make it easier for individuals to identify and get admitted to treatment centers.

In addition to St. Vincent Charity Medical Center, CSU will also collaborate with its other health care and academic partners to undertake research and data analysis, conduct survey work, and test various interventions and educational initiatives.

“We are very lucky to have a number of key community partners who are on the front lines every day addressing the opioid epidemic,” adds Lewandowski. “Their expertise and support will be essential to helping the Center reach its goal of reducing the terrible toll addiction has taken on our society.”

The Center for Behavioral Health Sciences is currently seeking external funding for expansion of these pilot efforts and for additional research and educational programming.

Visit the Center’s website to learn more about its activities.

###


          2 dead, 7 more cases of MERS-CoV confirmed in Saudi Arabia         

The World Health Organization was recently contacted by the National IHR Focal Point of the Kingdom of Saudi Arabia to report seven more cases of the Middle East respiratory syndrome coronavirus (MERS-CoV) infection, which occurred between March 9 and March 10.

A 22-year-old female, a 50-year-old male and a 75-year-old male are still in critical condition in hospital ICUs. Two others, a 26-year-old male and a 62-year-old male, are also a part of the new infections but are stable and either in pressure isolation rooms or at home. Two victims, however, passed away on March 8 and March 9, after both testing positive for MERS-CoV only roughly 24 hours before.

WHO has been notified of more than 1,684 MERS-CoV cases and 600 MERS-CoV-related deaths since September 2012 worldwide and is continually working to contain the infection and stop death rates. Its study of MERS-CoV has maintained that most infections, which occur from human-to-human, appear in health care settings. 

Due to the accessibility of country-to-country travel, WHO predicts that more MERS-CoV infections will appear in the coming years and will be transported from one country to another. Due to the disease's delayed or sometimes lack of symptoms, many will not know they have MERS-CoV until they have left the country. 

WHO is still encouraging all Member States to thoroughly watch for the MERS-CoV infections or anything resembling acute respiratory infections and to note any specific patterns they may take. WHO also asks that health care workers practice the necessary precautions when working with any patients, particularly those presenting signs of an acute respiratory infection. 

The public can protect themselves from the infection by practicing good body and food hygiene and avoiding contact with sick animals. The WHO hopes to keep promoting safe travel between countries.


          LinkedIn Joins CSU, Other Key Northeast Ohio Stakeholders to Analyze Vital Health IT Talent Data        
Project is a tactic within HIT in the CLE Regional Talent Initiative

*Release via the BioEnterprise

LinkedIn, which operates the world’s largest professional network on the Internet with more than 500 million members in over 200 countries and territories, has teamed up with BioEnterprise, the City of Cleveland, Cleveland State University and Cuyahoga County to provide data, analysis, and market research on the talent flows of software developers, data scientists, data analysts and other computer science positions within the Northeast Ohio health IT sector. Supported by the Cleveland Foundation, the analysis will ultimately inform policy, educational curriculum, community programming and other talent alignment strategies within this regional growth sector.

The bioscience cluster is a primary growth engine reviving the Northeast Ohio economy. Within the bioscience cluster, the health IT industry is flourishing, creating hundreds of new jobs each year. However, an acute shortage of qualified local talent is a major barrier to growth.

“One of the critical limiting factors to growth in Northeast Ohio’s bioscience industry today is the availability of health IT talent,” explained Aram Nerpouni, BioEnterprise President and CEO. “Thriving health IT companies are hindered by the dearth of software developers and data scientists. The LinkedIn project should provide meaningful data and analysis to inform how we address this challenge.”

With the support of the Cleveland Foundation, BioEnterprise launched HIT in the CLE in 2015 to address the regional computer science and data science talent gap. The Initiative aims to grow and diversify the Northeast Ohio health IT talent pipeline to support a vibrant health IT industry.

“We felt it was crucial to partner with BioEnterprise to begin addressing the demand-supply gap in health IT and to deeply engage businesses to expand the talent pipeline,” said Shilpa Kedar, Cleveland Foundation Program Director for Economic Development. “LinkedIn’s involvement with HIT in the CLE is a tremendous win for the region and we anticipate that this work will prove to be extraordinarily beneficial.”

The LinkedIn project is an important tactic within the larger HIT in the CLE talent strategy. The effort aspires to provide insights into the education and experience of people currently employed in the regional health IT sector, pathways for securing regional health IT positions, and institutions from which the local sector most successfully attracts qualified talent. The insights discovered through the analysis may surface gaps and barriers in the local health IT talent pipeline and help inform strategy for addressing these important talent issues.

“At LinkedIn, our vision is to create economic opportunity for every worker,” said LinkedIn U.S. Head of Policy Nicole Isaac. “We’re excited to use the Economic Graph – a digital map of the global economy that when complete will include every member of the global workforce and their skills, all open jobs, all employers, and all educational institutions – to provide the City of Cleveland with a more holistic view of the computer science and data science skills local employers need, the skills its workers have and the disconnect between the two. The City can use those insights to create a stronger IT talent pipeline, and grow its IT industry.”

“Making our workforce a competitive advantage, which includes understanding our gaps as well as opportunities is a crucial strategic focus,” said Cuyahoga County Executive Armond Budish. “We know that the strength of our healthcare is a great advantage and we believe that the bioscience cluster will drive a lot of our job growth in the coming years. LinkedIn’s contribution to help inform and accelerate that growth is a welcome addition to the HIT in the CLE effort.”

Data provided by BioEnterprise and LinkedIn will be pulled throughout the summer. Ongoing analysis will take place through the summer and findings are expected in the fall.

“Cleveland is a City with a growing health research and information technology economy from the unseen power of the 100 gig fiber network along the Health-Tech Corridor and the health care research institutions within our community,” said Mayor Frank G. Jackson. “I welcome the opportunity for the City of Cleveland to collaborate with LinkedIn to provide research and data on the talent that is relocating to Cleveland and drawing talent to join the workforce here.”


          Ronald M. Berkman Announces Plan to Retire as President of Cleveland State University        

Tenure Marked by Transformation of University and Improvements in Student Success

CSU President Ronald M. Berkman

Cleveland State University President Ronald M. Berkman today announced his decision to retire from the presidency in June of 2018. Berkman, 70, is CSU’s sixth president and has served in that role since 2009. The University will mount a national search for his replacement beginning next month.

“It’s been one of the great honors of my career to lead CSU during an amazing period of progress,” said Berkman. “Thanks to the faculty, staff, trustees and donors, and to the Cleveland community that has embraced us, we’ve brought ‘engaged learning’ to life.  In so many ways, CSU is a different university than it was in 2009.”

“It’s hard to overstate the impact Ron has had on CSU during his tenure,” said Bernie Moreno, chair of CSU’s Board of Trustees. “He has led the transformation of the University across every dimension, from his focus on student success, to the many innovative community partnerships he’s created, to the remaking of the campus and his extraordinary success attracting philanthropy. We will miss having him as president, but we also owe him a huge debt of gratitude for putting us in position to attract a great candidate to succeed him.”

Moreno said Berkman approached him to propose the transition plan earlier this year. He added that the Board of Trustees is grateful that Berkman has given them ample time to find his successor, that he’s agreed to be available to help the new president and that he’ll be returning to CSU to teach following a one-year sabbatical.

A number of new initiatives that Berkman has undertaken will impact CSU in the years to come. In light of that, Berkman told Trustees he believed that the timing of the transition would help the new president get off to a good start.

“We’ve just successfully completed a number of major efforts, including our first capital campaign, and will soon be launching some large, multi-year projects that would be better to hand off early rather than in midstream,” Berkman added.

The search for CSU’s next president will begin in July. The Board will form a Search Committee, chaired by Moreno, that will include members of the University community as well as the community at large.  The board also plans to engage one of the leading national executive search firms. Moreno believes the search will attract highly qualified candidates, thanks to the progress made under Berkman’s leadership.

“Ron has created tremendous momentum during his tenure as president, and the highly successful capital campaign he led has added even more,” said Moreno. “We want to do everything we can to maintain that momentum for the ongoing benefit of the University.”

Accomplishments under Berkman’s leadership include:
 

Student Success
  • Affordability: CSU has implemented a number of initiatives that have reduced the cost of earning an undergraduate degree by more than $3,350 annually.  CSU’s average student loan debt is the second lowest among Ohio public universities, more than $1,800 less than the state average.
  • Multi-term registration: CSU is the first state university in Ohio to offer multi-term registration, allowing students to plan and schedule courses for fall, spring and summer terms at the same time and ensuring access to required courses.
  • Adjusted tuition band: CSU has expanded its tuition band to 18 credit hours per semester, which allows students to take up to 18 credit hours without incurring additional charges.
  • Innovation: CSU was awarded a 2015 Excellence and Innovation Award in the category of Student Success and College Completion given by the American Association of State Colleges and Universities (AASCU).
  • Recruitment: 2016 saw the largest freshman class with 1,900 first-year students and increases in GPA and ACT scores.
  • Graduation rates: Increased 60%
  • Awards, accreditations and national rankings: CSU’s number one rank in research growth over the last decade; winner of the AASCU national innovation award; finalist of the APLU national innovation award and accreditation as a Carnegie Engaged institution
 
$500 Million Campus Transformation
  • Student housing: 1,000 students living on campus
  • Center for Innovation in Medical Professions: The new CIMP building houses the Northeast Ohio Medical University (NEOMED), the CSU Health and Wellness Clinic, Speech and Hearing Clinic, Audiology labs, Nursing labs, and Occupational Therapy/ Physical Therapy (OT/PT) training rooms, as well as Distance Learning rooms, meetings rooms, lounge and quiet study areas, and associated faculty offices.
  • Washkewicz College of Engineering: A 100,000-square-foot addition providing students and faculty with state-of-the-art labs, learning spaces, classrooms, motion and control lab and makers’ space with the latest prototyping and fabrication technology.
  • Film School: CSU is the first university in Ohio to have a film, TV and interactive media school to uniquely prepare students for careers in the field. Created with a $7.5 million capital appropriation from the state, the school will also further the development of Cleveland as a center of media production.
  • Jack Joseph & Morton Mandel Honors College: The honors program was elevated to college status on receipt of a gift from the Mandel Foundation.  Renamed in honor of Jack, Joseph and Morton Mandel, the college became CSU’s ninth and moved into renovated space in the main classroom building.
  • Medical Mutual Tennis Pavilion: A $1.4 million donation from Medical Mutual enabled Cleveland State University to become the first, and only, Horizon League school with indoor tennis facilities on campus.
  • Completed additional buildings: The new Student Center and Julka Hall College of Education and School of Nursing buildings, begun during Michael Schwartz’s tenure at the University, were also completed.
 
Philanthropy
  • Engage: The Campaign for Cleveland State:  CSU’s first capital campaign reached its $100 million goal two years ahead of schedule, providing funds needed for scholarships and initiatives that enable student success.
  • Fundraising: Doubled the University endowment, personally raised over $60 million
  • Ahuja gift: Secured a $10M gift from alumnus Monte Ahuja, the largest in CSU history to that point, naming the business college the Monte Ahuja College of Business.
  • Washkewicz gift: Secured a $10M gift from Don Washkewicz and a matching $10M gift from the Parker Hannifin Foundation, together the largest in CSU history. The gift allows for the renovation and 100,000 square feet expansion of the engineering college, which will open in 2018 as the Washkewicz College of Engineering. 
 
Engaged Learning Partnerships
  • Playhouse Square: The original scope and vision of the theatre program’s move into Playhouse Square was expanded into a new CSU Arts Campus, which now includes the departments of theatre, dance and art. The program allows students to learn from professionals at the second largest performing arts complex in the nation.  The Department of Theatre and Dance performs in Playhouse Square’s Allen Theatre Complex, home to three state-of-the art stages: the 514-seat Allen Theatre, the 334-seat Outcalt Theatre, and the 150-seat Helen Rosenfeld Lewis Bialosky Lab Theatre (“The Helen”). The Campus also features a retail location for CSU art galleries on Euclid Avenue.
  • Northeast Ohio Medical University: CSU joined forces with NEOMED to create a dual-campus medical program for training general physicians to serve the health care needs of inner city populations. A $7.25M grant from The Cleveland Foundation helps fund the program.
  • Cleveland Metropolitan School District: CSU has established an “education park” that encompasses two Cleveland Metropolitan School District schools on the CSU campus: MC2STEM High School and Campus International School.
  • Partnerships and collaborations: Ongoing enhanced relationships and support from University Hospitals, Cleveland Clinic, and Metro hospitals; St. Vincent Charity Hospital research collaboration (engineering) behavioral health initiative and several Internet Of Things (IOT) initiatives, including the Governor’s request to build center of excellence in IT at CSU and collaboration with Case Western Reserve University on IOT as well as a growing inventory of projects.

 

About Ronald M. Berkman

Prior to his arrival at CSU, Dr. Berkman held various leadership positions at Florida International University (FIU), including Provost, Executive Vice President and Chief Operating Officer, Dean of the College of Urban and Public Affairs as well as Executive Dean of an interdisciplinary College with accredited Colleges of Nursing, Health Sciences, Public Health, Social Work and Policy and Management.

Dr. Berkman came to FIU from the City University of New York (CUNY), where he developed partnerships among city, state and federal government agencies as well as nongovernmental organizations as Dean of Urban Affairs. He also served as Dean of Academic Affairs and Founding Dean of CUNY’s first School of Public Affairs, located at Baruch College.

Dr. Berkman received his Ph.D. from Princeton University. He has taught at Princeton’s Woodrow Wilson School, the University of California at Berkeley, Brooklyn College, the CUNY Graduate Center, New York University and the University of Puerto Rico.

Dr. Berkman is chair of the Inter-University Council of Ohio, a consortium of the state’s 14 public universities. He also serves on the boards of many nonprofit organizations, including the Coalition of Urban Serving Universities, the Downtown Cleveland Alliance, the Greater Cleveland Partnership and the Jewish Federation of Cleveland.

 

About Cleveland State University

Founded in 1964, Cleveland State University is a public research institution that provides a dynamic setting for Engaged Learning. With an enrollment of more than 17,000 students, 10 colleges and schools and more than 175 academic programs, CSU was again chosen for 2017 as one of America’s best colleges by U.S. News & World Report. Find more information at www.csuohio.edu, on Facebook and by following @CLE_State.


          CDC adds Cuba to Zika virus watch list        

The Centers for Disease Control and Prevention (CDC) has reported a level-two travel notice for Cuba concerning Zika virus transmission and is working with local health officials in areas that have been determined to contain the virus.

The Zika virus is transmitted through mosquitos that are extremely active in the daytime, but that also bite at night. Anyone traveling to areas with Zika virus is capable of becoming infected; and, as there are no vaccines or medications against the Zika virus, it is important to prevent mosquito bites. There have also been reports of sexual transmission, so until further information is released, the CDC recommends pregnant women and their male partners stay out of areas that have been confirmed for Zika virus, go through all precautions to prevent mosquito bites and to use condoms.

Zika virus does not immediately show symptoms -- sometimes not ever -- and so travelers that may have contracted the virus may not know until they have already left. Symptoms include fever, rash, joint discomfort and red eyes, and may last up to a week. Upon leaving an area with confirmed Zika virus infections, it is important to continue using insect repellent for three weeks to avoid other mosquito bites.

Although the mortality rate and need for high hospitalization is low, travelers should keep watch for symptoms, and tell a health care official immediately once symptoms show. The professional health representative will want to know when and where infected victims have traveled. Guillain-Barré syndrome (GBS) has also been discovered in patients that most likely have the Zika virus, and research continues to figure out their association.

The CDC home page contains additional information, including a map of affected areas.


          CDC releases report on how to fight antibiotic-resistant bacteria        

Although the United States has successfully decreased health care-associated infections (HAIs), antibiotic-resistant bacteria are still a force to be reckoned with. 

In order to better combat this, the Centers for Disease Control and Prevention (CDC) recently released a new Vital Signs report, providing guidance on how to use multiple measures to fight them, and the Antibiotic Resistance Patient Safety Atlas, which provides information on infections that can come from antibiotic-resistant bacteria. CDC Director Tom Frieden stated that many of these bacterias are infecting patients while in the hospital, hindering them from getting better and rendering them sicker and capable of sepsis or death.

Six antibiotic-resistant bacteria have been studied in acute care hospitals, and found that one of every seven HAIs from catheters and surgery come from these bacteria, and that it increased to one in every four infections in patients that remained in the hospital more than 25 days. The report also discussed the decrease in Clostridium difficile (C. difficile), a bacteria that causes the most amount of infections in hospitals. 

The CDC asks anyone involved in health care, from state to local levels, to continually work to prevent HAIs, including attempting to stop the bacteria transmission between patients, halt infections due to surgery and catheters, and increase antibiotics.

Alongside the CDC, the Centers for Medicare and Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ) -- and regulations requiring reports of contracted HAIs -- have assisted in decreasing infection rates. 

Congress has also provided $160 million to the CDC to move forward with their National Action Plan for Combatting Antibiotic-resistant Bacteria, which will work to better equip states for prevention, reporting, research and antibiotic use -- hopefully to further limit HAIs in the future.


          UAB welcomes new director of med school's Division of Infectious Diseases        

The University of Alabama at Birmingham (UAB) School of Medicine's Division of Infectious Diseases has named Jeanne Marrazzo, leading expert in the field of infectious diseases and HIV, its new director.

“I am thrilled to have Dr. Marrazzo join our department to lead the division at a time when it is thriving,” UAB Department of Medicine Chair Seth Landefeld said. “Despite great advances in vaccines and antibiotics, infectious diseases remain major threats to our health — whether it’s the age-old scourge of tuberculosis, a super-virulent staph or a new epidemic like Zika virus. Tackling these diseases and growing our faculty of world leaders will advance health and health care for Alabamians and many, many others.”  

Marrazzo is currently studying the effects of the Nuvaring, a contraceptive vaginal ring for women. In addition, she is studying how the ring interacts with those who have HIV and those who don’t.

As part of her time at UAB, Marrazzo hopes to continue her research, while also looking at new infectious diseases. She plans to build a strong department that collaborates on ideas and projects alike.

“UAB has been a leader in HIV and STD research for decades, with a well-recognized reputation and body of work,” Marrazzo said. “For example, the 1917 Clinic — which provides primary care to people living with HIV and also conducts world-class research — is iconic and a fixture of excellence in providing care to vulnerable populations, which is a critical part of working in the infectious diseases field.”


          Seven new cases of MERS reported to World Health Organization        

Seven new cases of Middle East respiratory syndrome coronavirus (MERS-CoV) were identified by the National IHR Focal Point for the Kingdom of Saudi Arabia between Feb. 17 and 25, and reported to the World Health Organization (WHO).

Those infected include a male from Hail City, 56, who showed symptoms on Feb. 20 and three days later went into the hospital; he tested positive for MERS-CoV the next day. He is currently in the ICU in critical condition, as is a 53-year-old, non-native male from Abha, who showed symptoms on Feb. 11 and went into the hospital on Feb. 20. A 60-year-old sheep, goat and cow owner from Najran was also admitted into the hospital, two days after showing symptoms on Feb. 20. He is in a negative-pressure isolation room and is stable, as is a 74-year-old camel owner, who showed symptoms on Feb. 15 and went into the hospital on Feb. 21.

A non-native, 28-year-old female health care worker from Alkarj was found to have the MERS-CoV infection through possible contact tracing of MERS-CoV cases. She currently shows no symptoms and is isolated at home. Another non-native, a 24-year-old male from Riyadh City, showed symptoms on Feb. 14, went into the hospital two days later and was confirmed for MERS-CoV on Feb. 17. He is currently in the ICU in critical condition. Lastly, a 53-year-old from Riyadh city began showing symptoms on Feb. 13 and went into the hospital on Feb. 16. He also tested positive for MERS-CoV on Feb. 17. He is stable and at home in isolation.

An investigation as to where these cases may have contracted the infection within the two weeks of shown symptoms is still being pursued. At least 1,651 cases of the MERS-CoV infection have been reported to WHO since September 2012, with 590 of these resulting in death. MERS-CoV can be transmitted human to human, and has mostly been transmitted in health care locations. 

WHO will continue to report on new cases from the Middle East and expects that new cases will emerge in other countries via animals or animal products. In order to control MERS-CoV, WHO indicates that the utmost care must be taken in health care settings, even if someone is not currently showing MERS-CoV symptoms. Furthermore, hygiene and food hygiene are extremely important, as transmission possibilities have been confirmed.


          Nursing Collaborative Tackles Impending Nursing Shortages, Enhances Workforce Development for Northeast Ohio        

UH, CSU, and Tri-C collaboration creates economic incentives and support for aspiring RNs to earn nursing degrees and remain in Northeast Ohio

Nursing

A collaboration between University Hospitals (UH), Cleveland State University (CSU), and Cuyahoga Community College (Tri-C) will establish a comprehensive workforce development pathway to increase the numbers of registered nurses, and increase the number who earn a baccalaureate degree, in nursing (BSN). The goal of the collaboration is to proactively address the impending shortage of nurses in Northeast Ohio.

The unique collaboration between a health system, a university and a community college will better meet the needs of students, employers and the community, and will serve as a model for other communities around the United States who face similar challenges.

Specifically, the program will tackle the challenges that nursing students face at every stage of their education and careers by:

  • Instituting a new, primarily evening and weekend, cohort of 64 students in CSU’s BSN program to add to the 160 students currently admitted each year. In addition to its established tuition reimbursement program, UH will support these students in the following ways:
    • Creation of a UH Nursing Scholars program offering 20 students a $12,000 tuition support contract for their junior and senior years.  
    • Incentivizing qualified and experienced UH RNs to serve as CSU clinical instructors.
    • Extending students’ opportunities to work as part-time nursing assistants while attending school.
       
  • Offering tuition support to enhance the participation by Tri-C graduates in the CSU RN to BSN Program:
    • UH will award 20 UH Nursing Scholars a $6,000 tuition support contract for their second year at Tri-C and their last year in the CSU RN to BSN program, for a total of $12,000.
    • Tri-C will offer a $3,000 scholarship to their students enrolled in the CSU RN to BSN Program.
       
  • Supporting nursing students at Tri-C and CSU to successfully complete their respective nursing programs through financial assistance, work opportunity and services, such as coaching, counseling, and support services, through identified workforce agencies.
     
  • Extending students opportunities to work as part-time nursing assistants at UH while attending school and increasing the availability of the required clinical placements.

“UH is significantly invested in this collaboration because it addresses so many of the issues that prevent entry into nursing school, achievement of a baccalaureate in nursing, and the opportunity to thrive as a professional nurse,” said Jean Blake, RN, BSN, MJ, Chief Nursing Officer for UH.

By 2020, the Center for Health Affairs Northeast Ohio Nursing Initiative’s Nursing Forecaster estimates that Northeast Ohio will need at least another 3,500 nurses to care for the rapidly aging local population. Nationally, those estimates rise to nearly one million additional nurses needed to adequately care for the total number of patients.

Additionally, to handle the increasingly complex healthcare needs of a growing population of older patients, a significant percentage of these nurses will require the additional education and experience gained from a four-year degree, the BSN. In fact, the Institute of Medicine has issued a recommendation that 80 percent of the nursing workforce have a baccalaureate degree by 2020.  Northeast Ohio’s percentage is approaching 40 percent, thus this bold collaboration will provide a strong boost toward the national goal.   

“This collaborative will make it possible for more people to pursue multiple pathways toward a BSN degree, minimize current barriers for student success and enhance timely graduation of professional registered nurses,” said Timothy Gaspar, PhD, RN, Dean of Nursing at CSU. “Even better, this program will entice promising young people to stay in the Cleveland area and excel at providing nursing care for the people of our region. It will address the registered nurse shortage, as well as enhance the health care of the workforce in our region.”

This nursing collaborative closely aligns with some of the major principles that the American Nurses Association has identified as crucial to the transformation of the health system, particularly those focused on ensuring a sufficient supply of skilled workforce that is dedicated to providing high quality health care services.

“Our hope is that this effort will support the residents of Ohio and empower the next generation of promising caregivers to pursue a lifelong career in nursing. It can also serve as a successful example of how other communities can address similar challenges,” said Vivian Yates, PhD, RN, Dean of Nursing at Tri-C.

Through the collaboration, the institutions hope to see a 40 percent increase in the number of CSU BSN graduates, from 160 currently to 224, beginning in 2020 when the new cohort graduates, and a 10 percent increase in the completion rate of Tri-C students within two years, which will increase RN graduates from these efforts; at least 50 RNs annually to the workforce from the CSU RN Refresher Program, and an ever increasing percentage of RNs in Northeast Ohio who hold a BSN degree.


          NEOMED-CSU Partnership Offers Free Middle School Med School        

The Saturday workshop series is designed to engage students in the health professions

Med Workshops

The NEOMED-CSU Partnership for Urban Health, a joint effort of Cleveland State University and the Northeast Ohio Medical University, will offer free introductory medical workshops to middle school students. The program, titled Middle School Med School, is for students in grades six through eight who have an interest in careers in the health professions.

Workshops will take place every Saturday from 9 a.m. to 1 p.m. April 8 - 29, 2017. They will be held in the Center for Innovation in Medical Professions, which is home to the Partnership and is located on the CSU campus at 2112 Euclid Ave., Cleveland, Ohio, 44115.

The workshops will give middle school students an opportunity to experience medical school through a number of hands-on projects and interactions with medical students and professionals. The middle schoolers will get exposure to medical procedures such as making plaster casts for broken bones, applying stitches to wounds, taking X-Rays and much more.

“By introducing science and medicine to children at an early age we can enhance understanding of and enthusiasm for health professions and increase the number of individuals going into these careers,” says Dr. Edgar B. Jackson, Jr., Special Assistant to the President for Health Affairs at CSU and Co-Director of the NEOMED-CSU Partnership

“This program was developed to allow students to not only receive hands-on experience, but to spend time with medical professionals and get an inside look at a potential career path,” adds Sonja Harris-Haywood, M.D., co-director of the Partnership and senior associate dean at NEOMED. “This is an outstanding opportunity for Cleveland-area youth to closely examine the health professions at a time when they are beginning to explore all the possibilities of their futures.”

Registration is open through March 10. To apply or receive more information, please contact 216.802.3175 or jtyes@neomed.edu.

The free program also includes lunch.

The NEOMED-CSU Partnership for Urban Health works to recruit future physicians who are interested in serving Northeast Ohio. The program strives to meet the health care needs of urban communities.

###


          CSU’s Next TEDx Salon Focuses on Resurgent Cities        

Local and national experts will discuss best practices in urban revitalization and community development

Resurgent City

Metropolitan centers throughout the United States are experiencing a revival with people, businesses and community institutions moving to and investing in downtown cities in a manner not seen in decades. The positive impact of this revival has been significant for economic and community development but more work needs to be done to ensure that all citizens of America’s cities have equal access to quality health care, education and job opportunities.

Cleveland State University will host a TEDx Salon, March 31, to investigate the role anchor institutions, such as hospitals, universities and churches, can play in continuing and enhancing the metropolitan revival. This goes beyond the “If you build it they will come” mentality of the past and includes being an engaged and active participant in promoting healthcare access, educational attainment and neighborhood development in the areas they serve. The event will be held from 5 p.m. to 7 p.m. in CSU’s Student Center Ball Room, 2121 Euclid Avenue.

Local and national experts in the field will discuss the role anchor institutions have played in the resurgence of cities and how they can enhance efforts to ensure this revival is available to all citizens and neighborhoods, as well as present best practices that can be disseminated nationally. The Salon will also delve deeper into several key areas of urban policy that anchor institutions can and should play a major role in addressing. These include: post-secondary attainment, the continued development of the “New Economy” and police/community relations.

Speakers for the event include Danette Howard, Chief Strategy Officer and Senior Vice President of the Lumina Foundation; Ted Howard, President of the University of Maryland’s Democracy Collaborative; Lee Fisher, Interim Dean of CSU’s Cleveland-Marshall College of Law and former Lieutenant Governor of Ohio; Roland Anglin, Dean of the Maxine Goodman Levin College of Urban Affairs at CSU; Ronnie Dunn, Associate Professor of Urban Studies at CSU; and Jonathan Witmer-Rich, Associate Professor of Law at CSU.

The event is free and open to the public but registration is required. For more information or to register, visit http://tedxclevelandstateuniversity.com/tedxsalon-resurgent-city/.

###


          CSU Study Assesses Impact of Paid Sick Leave on Preventive Care         

Workers without paid sick leave are 1.6 times less likely to get a flu shot

Preventative CareMore than 20 million Americans have gained health insurance coverage through the Affordable Care Act (ACA) and do not have to pay for 15 preventive screenings recommended by the U.S. Preventive Services Task Force. Yet, despite this advantage, many are not utilizing these lifesaving screenings and are contributing to the nation’s soaring health care costs, which reached a whopping $3 trillion in 2014.

Researchers from Cleveland State University and Florida Atlantic University are the first to use data after the implementation of the ACA to get to the root of what factors are contributing to the low rates of preventive care use. Results of their study, published in the current issue of the journal Preventive Medicine, illuminate the importance of the role paid sick leave benefits plays in the lives of employees and ultimately in public health. 

“Compared to 22 similarly developed countries, the United States is the only one that does not mandate employers to provide paid sick leave benefits or include paid sick leave in a universal social insurance plan,” said LeaAnne DeRigne, lead author and an associate professor in the School of Social Work within FAU’s College for Design and Social Inquiry.

For the study, the research team, co-led by Patricia Stoddard Dare an associate professor of social work at Cleveland State, used cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS). They examined the relationship between having paid sick leave and obtaining eight preventive care services: blood pressure check; cholesterol check; fasting blood sugar check; getting a flu shot; being seen by a medical doctor or health care provider; getting a Pap test (females only); getting a mammogram (females only); and getting tested for colon cancer. The analysis controlled for demographic and other important predictor variables including gender, marital status, education, race/ethnicity, full time work, insurance coverage, health status, limiting health conditions, family income, age, and family size. 

Regardless of sociodemographic factors, the researchers found that workers who lack paid sick leave were significantly less likely to have received preventive health care screenings in the last 12 months, even among those previously told that they have a condition such as diabetes or cardiovascular disease that places them at higher medical risk. They also found that workers without paid sick leave are 1.6 times less likely to have received a flu shot in the past 12 months.

Additional findings from the study reveal that American workers without paid sick leave were:

  • 30 percent less likely to have had a blood pressure check in the last 12 months
  • 40 percent less likely to have had a cholesterol check in the last 12 months
  • 24 percent less likely to have had a fasting blood sugar check in the last 12 months
  • 19 percent less likely to have seen or talked to a physician or health care provider in the last 12 months
  • 23 percent less likely to have had a Pap test in the last 12 months

“Our findings demonstrate that even when insured adults are provided with free preventive screenings, paid sick leave is a significant factor associated with actually using the screenings,” said DeRigne.  “American workers risk foregoing preventive health care, which could lead to the need for medical care at later stages of disease progression and at a higher cost for workers and the American health care system as a whole.”

The two most common ways to offer paid sick leave is by mandating employer-funded benefits or through a universal social insurance program funded through taxes. The Healthy Families Act, introduced in Congress in 2015, uses the employer-funded model and would allow workers to earn up to seven days of paid sick leave if their employer has more than 15 employees and seven unpaid days for employers who have less than 15 employees. The bill has not yet been introduced in the current Congressional session.  

“Our data can be used by health care professionals, policy makers and others to consider the expansion of access to evening and weekend hours as well as mobile, community-based, and workplace health and wellness services,” added Stoddard Dare. “When workers forgo essential preventive health care such as flu shots, the public health implications are immense. This is particularly relevant for service related employees, food preparation workers and others who have low access to paid sick leave coverage.”

The article also was co-authored by Cyleste C. Collins, Ph.D., assistant professor at Cleveland State University, and Linda Quinn, Ph.D., college associate lecturer in the Department of Mathematics at Cleveland State University.

###


          Transgender-sensitive health care providers in NYC        
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          Jagan Mohan R        
Health Care Professional
          House Committee to Hold Hearing on Appropriations Reforms that Could Severely Impact Current Whistleblower Programs        
Washington, D.C. December 1, 2016.   The House Committee on Oversight and Government Reform Subcommittees on Government Operations and Health Care, Benefits and Administrative Rules will hold a hearing today on proposed changes to the appropriations process that would have a major impact on existing whistleblower laws. The hearing, “Restoring the Power of the Purse: Legislative Options,” will review H.R. 5499—The...… Continue Reading
          3 Things To Know About The Philippine Stock Exchange Index's 0.21 Percent Decline        
4 months ago 04/12/17 AT 07:55 AM
RTX22U12
Traders look at a electronic trading board inside the Philippine Stock Exchange (PSE) in Makati city, metro Manila January 18, 2016. REUTERS/Romeo Ranoco
The PSEi declined 16.51 points to close at 7,601.40 on Tuesday, April 11. Aside from this, the PSE All-Shares index also declined by 0.19 percent to finish at 4,532.92 level. Business
          PSEi Forecast: Three Fast Facts On The Projected Stocks Performance Before The Holy Week Break        
4 months ago 04/10/17 AT 09:56 AM
Philippine Stock Exchange
A stock broker takes orders on the telephone during trading at the Philippine Stock Exchange in Manila's Makati financial district February 7, 2014. Southeast Asian stock markets rose on Friday, with the Philippines outperforming and Indonesia hitting a two-week high, buoyed by higher Asian shares and signs the U.S. nonfarm payrolls report could put some global growth concerns to rest. Reuters/Erik De Castro
The local stock market is expected to move sideways from Monday to Wednesday, April 10-12. On April 13 and 14, financial markets will be closed to observe the Holy Week's Maundy Thursday and Good Friday. Business
          Assistant Information Systems Specialist PROMOTIONAL        
Exam number: 
#78-070
Exam type: 
Promotional (for current employees only)
Salary: 
$47,616 - $61,491 Annually
Opening Date: 
August 4, 2017
Closing Date: 
September 6, 2017
Examination date: 
October 14, 2017
Application fee: 
$20.00
THIS EXAMINATION IS OPEN TO ALL QUALIFIED EMPLOYEES OF THE ERIE COUNTY MEDICAL CENTER CORPORATION CORPORATION. There is one vacancy at the Erie County Medical Center Corporation.  The duration of all promotional eligible lists is four years from date of establishment unless otherwise indicated.
Examples of Duties: 
An Assistant Information Systems Specialist  assists in the installation, customization and maintenance of information systems;  Assists in the installation, maintenance and customization of vendor supplied information systems, including but not limited to, software, hardware, networks and communications; Assists in the coordination of equipment upgrades and problem resolutions with vendors; Evaluates the performance of lower level clerical and/or technical employees; Confers with and advises co-workers on administrative policies and procedures, technical problems and methods; Interfaces with outside vendors/contractors; Assists in reviewing new systems and proposed or requested changes to existing applications; Assists in providing hands-on training related to County information systems operation; Maintains records, prepares reports and documentation; Performs additional work related to the hands-on technical operations of the information systems, as assigned. IF ASSIGNED TO ECMC: Coordinates development and management of an Internet and Intranet web site; Maintains records, prepares reports and documentation to meet needs of JCAHO and other Federal, State, or local agencies; Maintains confidentiality and security of data as required by assigned Department; Works flex shifts as required - work shifts may be assigned, scheduled, or in support of operations; Supports many aspects of a health care delivery system.
Qualifications: 
QUALIFYING EXPERIENCE FOR TAKING THE TEST: Candidates must be permanently employed in the competitive class and must be serving and have served continuously on a permanent or contingent permanent basis in the competitive class for 12 months immediately preceding the date of the written test in an Information Technology position as Job Grade 7 plus the one of the following: A) Graduation from a regionally accredited or New York State registered college or university with a Bachelor's Degree in Information Systems, Computer Science or a closely allied field; or: B) Graduation from a regionally accredited or New York State registered college or university with an Associate's Degree in Information Systems, Computer Science or a closely allied field and two (2) years of experience in the field of information technology; or: C) An equivalent combination of training and experience as defined by the limits of (A) and (B).
NOTES: 1. Verifiable part-time and/or volunteer experience will be pro-rated toward meeting the experience requirements. 2. Your degree and/or college credit must have been awarded by a regionally accredited college or university or one recognized by the New York State Education Department as following acceptable educational practices. A grade of "D" or better is necessary for a course to be credited as successfully completed. If your degree and/or college credit was awarded by an educational institution outside of the United States and its territories, you must provide independent verification of equivalency. You can write to this Department for a list of acceptable companies providing this service; you must pay the required evaluation fee. Notice to Candidates: Transcripts will now be accepted by the Department of Personnel ONLY at time of application. All subsequent transcripts must be submitted at time of interview.
The New York State Department of Civil Service has not prepared a test guide for this examination. However,candidates may find information in the publication "How to take a written test" helpful in preparing for this test. This publication is available on line at: www.cs.ny.gov/testing/localtestguides.cfm  
Subjects of Examination: 
Subjects of examination: A written test designed to evaluate knowledge, skills and /or abilities in the following areas: 1. Principles and practices of LAN administration These questions test for knowledge of procedures and terminology applicable to administering a local area network (LAN). They cover such subjects as installing, configuring and upgrading a network; establishing user accounts and assigning access rights; monitoring network performance and troubleshooting; dividing networks and linking to other networks; creating and documenting procedures for users; and establishing and maintaining network security. The questions are not specific to any particular LAN. 2. Project management These questions are designed to test for techniques and concepts of project management. They may cover, but not necessarily be confined to, management of systems development, management by objectives, project scheduling and control techniques (e.g., PERT), characteristics of organizations and of the systems life cycle, and the development of data processing standards. 3. Principles of providing user support These questions test for knowledge and skill in working in a user support situation. They cover such subjects as how to communicate effectively with users requesting help; how to deal with different types of situations; troubleshooting techniques; and how to gather, organize and make available technical information needed to provide support. 4. Supervision These questions test for knowledge of the principles and practices employed in planning, organizing, and controlling the activities of a work unit toward predetermined objectives. The concepts covered, usually in a situational question format, include such topics as assigning and reviewing work; evaluating performance; maintaining work standards; motivating and developing subordinates; implementing procedural change; increasing efficiency; and dealing with problems of absenteeism, morale, and discipline. 5. Systems analysis These questions test how well you can make judgments in an information technology context, and are intended for candidates who do not necessarily have any formal training or specific experience in systems analysis. Questions cover such subjects as planning, documentation, feasibility studies, forms design, and systems implementation.  NOTICE TO CANDIDATES:  Unless otherwise noted, candidates are permitted to use quiet, hand held, solar or battery powered calculators.  Devices with typewriter keyboards, "Spell Checkers", “Personal Digital Assistants", "Address Books", "Language Translators", "Dictionaries", or any similar devices are prohibited.  You may not bring books or other reference materials.
INFORMATION FOR PROMOTION CANDIDATES Unless otherwise indicated, the eligible list resulting from this examination will have a duration of four years and will not supersede existing promotional lists, if any. RATINGS REQUIRED:  Test is rated on a scale of 100 with a passing mark at 70.  Test instructions may further divide the tests into parts and set minimum standards for each part. Points will be added to scores of candidates who achieve a passing mark as follows: Seniority:  For each year of service in the classified service: Less than 1 year……………………..................…0 points 1 year up to 6 years…………….…........................1 point Over 6 years up to 11 years.....………......….........2 points Over 11 years up to 16 years….…........….........…3 points Over 16 years up to 21 years………..................…4 points Over 21 years………………………..................…5 points VETERANS:  Disabled and non-disabled veterans as defined in Section 85, New York State Civil Service Law, will have 5 and 2.5 points, respectively added to their earned scores if successful in the examination.  You must claim these credits when you file application but you have an option to waive them any time prior to appointment.  If you have already used these credits for a permanent position in NYS, you may not claim them again.

          Collaboration to Stop an Epidemic        

The burden of HIV/AIDS in Achham is among the worst in the world. Achham has the highest prevalence of HIV/AIDS of any district in Nepal, largely due to the number of men who seek work in India and come back infected. To respond to this challenge, there are numerous community-based organizations that try to prevent the further spread of the epidemic by reaching out to people living with HIV and AIDS. The government piloted its community and home based care (CHBC) model in Achham to expand the continuum of care beyond the medical treatment hospitals and health posts provide. Nyaya Health has also participated in efforts to combat HIV/AIDS as an integral part of our health care delivery model. We have recently become an HIV Center- authorized to initiate and maintain treatment for affected individuals. Our medical director just participated in a government training for the CHBC program and our community health program reaches out to affected individuals through follow-up visits. However, the efforts of all of these different organizations and providers have not been coordinated resulting in duplicated efforts and wasted resources.

A couple of weeks ago, I was asked to do some research regarding HIV interventions conducted in other resource-limited settings around the world and current efforts in our local community to determine what Nyaya could do to coordinate efforts and fill in gaps in the current services. As a result of this research, yesterday we held our first Community Partners Meeting with representatives of the organizations working to combat HIV in the region. The objective of this first meeting was to simply get everyone in the room together to share current programs, target groups, and successes. Nyaya also presented recent local HIV epidemiological information from our patient record database. The tone was quite friendly and the meeting seemed to be a success. By the end, everyone present was excited to continue the collaborative efforts through monthly meetings hosted in a rotating schedule by each of the organizations. Hopefully, future meetings will provide a way for the various organizations to collaborate in a more meaningful way.

The other successful outcome of the first Community Partners Meeting was the support the organizations present gave to Nyaya’s new idea of reaching out to caregivers of people living with HIV/AIDS - a traditionally neglected group in HIV care. From my initial research, I had ascertained that in Achham, there is not a structure that provides caregivers of people living with HIV and AIDS with support, guidance, or a community of peers. I proposed the idea of a caregivers’ support group facilitated by the community health workers in each village. We are drawing up the specific plans now and hope to reach out to other stakeholders and begin trainings for the community health workers prior to the next monthly Community Partners Meeting.

Representatives from a number of community based and government
organizations at the first Community Partners Meeting to combat HIV


          Health Care        
Yesterday I went for my yearly mammogram. OK. I don't go every year, I go every other year. Still at my age that is a lot of mammograms.

I am fatter than I have ever been since I have started doing this. A lot more fat in the breasts too. A lot more work for the poor girl who had to fit all that fat under the pressured glass.

Another reason to get rid of some of this extra fat. It is much easier for everyone when you don't have as much to fit in that tight space. <...
          "Attention, Child Protective Services. . ."        
Okay, so I am completely LAME.  I am so far behind in blogland, there is so much to say I hardly know where to start.  But before Ade calls Child Protective Services I better share a very significant event in his life. . .the loss of his first tooth.  You would think that my first borns' loss of his first tooth would warrant immediate documentation but, alas, see above (the LAME part).  This even happened July 22nd, 2008, hey, at least I am still in the same year.

So here is Aiden and Quinn in the first attempt.  Our great friends from Twin, the McNeley's told us they used a kleenex to get some "traction" when pulling the girls' teeth out.  So Quinn pulled out the trusty kleenex--

To no avail.
All this pulling, tugging, wiggling was ridiculously traumatic.  Aiden was freaked, Quinn was frustrated and Ash was praying his teeth never get loose.  I was simply taking photos, videos, and giggling.  20 minutes later I was thinking this was taking way longer than necessary and I thought to myself, "what would Norm do?"  My dad was a great tooth puller--quick, easy, done!  Well, Norm used a little mini-plier thing.  I did not have one of these "gizmos" but I am a educated person in the "health care field" so I've got to come up with something.  Besides watching this MBA dude and a freaked out 6 year old was getting painful.  AhhhhHA. I had just the tool. . .curved hemostats and thanks to Tana I knew exactly where they were!

So I pulled them out and when Aiden got a glimpse of the tool he, 100%, WIGGED!!!  He tried to run away as Quinn was restraining him.  You, seriously woulda thought we were ripping his eyelashes out one by one.  As he is trying to escape Quinn's grasp like a little greasy pig trying to escape the bacon maker's hands, Quinn was getting aggroed!!!  So I intervened again. . .

Me, "EVERYONE RELAX!!!!"  (because now Asher is bawling his eyes out thinking  his big bro was going to meet a certain death).

Ash, Ade, "sniff, sniff, stifled inhale. . ."

Quinn, breathing in and out--nice and slow.

Me again, "Ade, just take a look at these."  He held them, inspected them, and decided they weren't a mid evil torture device.  

After some calming and distracting questions. . ."what do you think the tooth fairy pays for  a first tooth?"  BOOM-- it was out.  The look on Ade's face was priceless. . .he was shocked, waiting for the pain but it did not come.  He was starring at his tooth in my hand--stunned that it was out of his mouth and he was not dead.

So here he is, don't ya love the look of pure delight on his face.  If this is not evidence for CPS, I'm not sure what is.



The gap. . .


Notice the hemostats. . .that was a thing of beauty


And here are the bros. . I hope they are ALWAYS there for each other at times of trial.   Notice the glassy-I've-been-bawling-scared-for-my-brother-look in Asher's eyes.


Oh, by the way, the tooth fairy left 2 bucks.  I tired to tell Ade that the person who pulls it out gets a cut. . .he didn't go for it.  Nice try, mom.

          Obama Speaks Up On New Trumpcare Healthcare Bill        

The recent GOP health care bill has unmuted former President Barack Obama, who before now has not commented on the Donald Trump presidency, or any of Trump previous allegations. The reason Obama is coming out now is to speak against the current released GOP health care bill.

Barack Obama and Donald Trump disagree over the cost and insurance rates of the new health care bill for Americans. This also includes argument over the world mean.

                      

In a long Facebook post by Obama, the rushed-through Republican health care bill "would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it," he then added "Small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation."

Trump during his interview with his favourite TV cable network, Fox and friends, confirmed that he also denounces the GOP health care bill, and said he had told that "I want to see a (health care) bill with heart."

According to Trump's secretary of Health and Human Services, Tom Price while speaking to CNN, said that the goal of the new Trumpcare goal is to decrease premiums, even though few republicans believes this is not feasible under their new proposed plan.

Read Obama write up here;

Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.

I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.

Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.

And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.

We did these things together. So many of you made that change possible.

At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.

After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.

Categories:


          Leadership is...        
Earlier this week, legendary author and organizational development consultant Peter Block spoke at the ASTD conference in San Diego. Here are a couple of his insights on leadership from the session:

"Leadership is the capacity to initiate a future distinct from the past."

"The core task of leadership is to create community."

“What we normally call problems (low performance, high costs, poor morale, unsafe streets, poor health care) are really symptoms of the breakdown of community."

You can check out Peter’s new book, “Community: The Structure of Belonging” here.
          The Pagan Community Is Preparing To Aid Members In Health Care Facilities        
On March 8, I addressed the lack of trained Pagan clergy who could meet the needs of community members in health care facilities. “The Pagan Community Isn’t Ready to Aid Members In Health Care Facilities”. Motivated by this need, I networked with Pagan clergy, writers, counselors, and professors to start the Pagan Health Care Resource […]
          Nigeria: Edo state confirms two cases of Lassa fever        
Thanks to Dr. Adadevoh Health for tweeting the link to this report in Premium Times: Edo confirms two cases of Lassa fever. Excerpt: The Director of Primary Health Care in Akoko-Edo Local Government Council of Edo, Sunday Yerumoh, on Monday...
          The Angry and Sometimes Grumpy Children of the 1950's        
A bunch of us in our late 40's and early 50's got together the other night, and after the evening was over I started thinking that many of us born in the 1950's are in a crisis stage. People can't understand why we are so angry and grumpy sometimes. This article discusses some of the issues we have with society today and might enlighten others (the younger set) as to why we seem so disillusioned, and out of sorts at times.

The consensus of the group was "is this all there is." We've been working since our teens. A car costs more today than what our parents bought a house for. We work and work and still don't have enough. Food costs have risen astronomically, along with utility costs, insurance costs, and housing costs.

We started laughing at one point and said we sound like our grandparents. However, it is a very sad commentary that what took place for our grandparents over numerous decades, has only taken 20 to 30 years to occur for us. The real scary thing is that salaries for many jobs have not changed over that twenty year period, while our expenses have skyrocketed, and increased one hundred fold.

We all became nostalgic when we talked about the things we used to do to relax. How so many of those things are gone, or we can't afford to do them any longer. Our kids tell us we don't have a clue about school, sex, music, or what's going on in the world. Again, the laughter abounded with the music issues, but became very serious when we talked about the scary things kids do today, that we wouldn't even have thought of when we were growing up. Killing teachers, and other students never entered our minds. We had respect for our teachers and those in charge.

The next thing we ranted about was our health. For some of us, the ravages of time have taken place... eyesight problems, arthritis problems, blood pressure problems, "the barnacles of life". The discussion we had on the cost of health care was a lively and volatile one to say the least. Many of us who have had major illness problems also went ballistic with regards to the social security system, the disability system and Medicare system. The majority of us have worked since our teenage years. We were incredulous when it took over a year to get money from the social security system, especially when we see people playing the system who don't deserve it.

All of us are still working. The majority of our group are either self-employed or independent contractors. Many of us run home-based businesses. While we are still disheartened with the rise in costs, at least our work environment is a happy one, and one we feel in control of. For those in our group still working in corporate America, that's just an additional concern and stress for them. Is their job safe? Will they be downsized? Laid off? We went back and forth on the work issue and found that while running your own business is a risk, we have a lot more control over our destiny than if we worked for someone else, and hence, a lot less stress. Plus we can't fire ourselves.

We all wondered where it will end. So many of us thought we would be retired by now, or at least contemplating it within the next ten to fifteen years. However, with all the medical advances and hundred-fold costs of so many things, that is not an option. Retirement is no longer something people do automatically between 55 and 65. Today, the retirement age is in the 70's.
For many of us, the thought of another twenty or more years of working is a depressing one, in addition to making us very angry and grumpy to say the least.

Hopefully this article will provide some insight to those who wonder why the over 40 generation is so angry and grumpy at times.

Copyright DeFiore Enterprises 2002

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          Florida judge likely to rule against administration on ObamaCare        
Just a few days after a federal judge in Virginia found the individual mandate to be unconstitutional, Judge Roger Vinson heard similar arguments in a challenge by 20 states against the health care reform law:
          Auto Insurance Review Wisconsin Insurance Battle Heats Up        
Governor Jim Doyle has asked the legislature to pass the Truth in Auto Insurance law. The proposal, contained within the Governor's budget, would reverse several pro-insurance-company provisions enacted in sweeping 1995 tort reform legislation and return Wisconsin law to its long-standing status.





Two of the proposed changes in insurance law would have considerable impact on the ability of Wisconsin residents to obtain a full measure of justice if they are injured in automobile accident cases. The governor's proposal would forbid insurers from including in their policies two types of restrictive clauses the law now allows: anti-stacking clauses and reducing clauses.





Stacking





The essence of anti-stacking is that an insured with more than one policy is prohibited from accessing the proceeds of each paid for policy if the first policy does not cover his or her damages. In other words, if a Wisconsin consumer purchases two policies for two owned vehicles, or insures two vehicles on one policy that assigns separate premiums for each vehicle, and that consumer is injured by an uninsured motorist, the current law in Wisconsin limits the injured person's maximum recovery to the uninsured motorist limits of just one of the policies (or one of the cars if both are insured on the same policy).





Before the insurance lobby convinced the legislature in 1995 to enact anti-consumer provisions such as the anti-stacking provision, policyholders could rely on the sum of all their policies to pay their claims, up to the amount of their documented damages. The 1995 legislative reforms outlawed these provisions by enacting anti-stacking rules.





The governor's proposal would return to the pre-1995 law allowing stacking of policies, thus affording Wisconsin consumers the right to access all the coverage for which they have in fact paid.





Reducing Clauses





Since 1995, if a person in Wisconsin has purchased underinsured motorist (UIM) coverage on their policy, the insurer generally has had the right to subtract from that policy limit the amount of any proceeds received from the negligent party's liability insurance. Reducing clauses prevent the purchasers of UIM coverage from ever collecting the coverage they have paid for, because their recovery would automatically be reduced by the at-fault driver's insurance payout. In other words, if a Wisconsin consumer purchases as part of his/her policy $100,000 of UIM coverage, and pays a premium for the full $100,000 of coverage, that $100,000 is reduced by the amount of money the injured person collects from the underinsured motorist, or from a worker's compensation or disability policy.





This guarantees that the injured and insured consumer can never collect the full limit of the UIM coverage purchased. Governor Doyle proposes doing away with such reducing clauses and allowing an insured to collect up to the full amount of his or her UIM coverage without regard for insurance payments received from the negligent party's insurer.





This change would also apply to prevent other reductions from insureds' policy limits, such as the amount of workers' compensation or disability insurance payments.





The Governor's Philosophy





The governor's proposals are seen by consumer-friendly groups as positive because insured persons would receive the full amount of the coverage purchased on their policies, where appropriate. In essence, they would get all that they paid for. When insurance does not cover the full amount of damage from vehicular accidents, individuals, families, health insurers and public insurance programs are left to cover the rest of the medical and other expenses. The proposed changes in the law would help alleviate the burden of the losses sustained in a serious automobile accident from being dumped on the injured person, health insurers, or public programs such as Title IXX.





It is the governor's view that insurance coverage bought and paid for by the injured person ought to bear as much of this burden as the paid in premiums dictate.





Critics Respond





The insurance industry protests that prohibiting their ability to include anti-stacking provisions and reducing clauses in their policies will increase the cost of insurance in Wisconsin. Insurance companies argue that ultimately these changes would hurt policyholders because rates would increase to cover the higher insurance payouts, possibly resulting in more people having to drop coverage altogether.





Proponents of the changes point out, however, that the 1995 pro-insurance-industry changes did not result in any reduction in premiums and that the insurance companies are playing on people's fears. If the anti-consumer legislation of 1995 did not reduce people's automobile insurance rates there is little basis to believe that reversing the legislation and returning to the pre-1995 state of the law would lead to any appreciable increase in premiums.





Moreover, both anti-stacking provisions and reducing clauses ultimately serve to reduce the insurance funds available for those who are injured in auto accidents. When people lack sufficient insurance to pay for their medical bills, health insurers, Medicaid, SeniorCare, BadgerCare or other providers are forced to step in and cover the remaining health care costs. In this way, insufficient automobile insurance has contributed to the rapidly rising costs of health care in Wisconsin.





Awaiting the Outcome





The Wisconsin Joint Committee on Finance has eight members from each legislative branch and is charged with reviewing state spending matters, including the huge task every two years of analyzing the governor's biennial budget proposal. Following a series of public hearings around the state and input from state agencies, the committee is currently grinding through the proposal line by line. After committee amendments, the budget bill will be considered first by the state assembly and then by the state senate. Differences between the houses will need to be negotiated before a final bill can be sent to the governor.





The target date for the budget becoming law is July 1. However, that date has been missed before given the immense complexity of the state budget. This year is no exception with the budget bill having over 1,500 pages.





The insurance industry and consumers await the outcome with immense interest, each group having high stakes in the outcome. It is the position of these authors that the greater good of Wisconsin residents is clearly served by reversing the tort reform measures passed in 1995 and returning to the state of the law which allows Wisconsin consumers to receive the full benefit of all the insurance coverage they have purchased.





Reference: Domnitz & Skemp, S.C.


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Visit us at http://www.24-7pressrelease.com


Visit us at http://www.domnitzlaw.com

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          Powerful TV and The Shield Writers' Reunion        

Powerful TV panel from ATX, Jack Amiel (co-creator, The Knick), Jason Katims (creator, Friday Night Lights and Parenthood), Jennie Snyder Urman (creator, Jane the Virgin), Mike Royce (co-creator, Men of a Certain Age; Enlisted), and Carter Covington (Faking It) discuss how their series have surpassed diversity trends and token characters by organically weaving in storylines of race, religion, the foster care system, immigration, abortion, health care, and many many more. Moderated by Maury McIntyre (President of the Television Academy).

PLUS: The Shield Writers' Room Reunion with creator Shawn Ryan (co-creator, Timeless), Glen Mazzara (Damien; The Walking Dead), Scott Rosenbaum (Queen of the South), Kurt Sutter (creator, Sons of Anarchy), and Charles ‘Chic’ Eglee (Hemlock Grove; The Walking Dead). Moderated by Lynette Rice (EW). Recorded June 2016 at ATX Television Festival.

Get your badge now for ATX's sixth season, June 8-11 2017, at http://atxfestival.com/


          Can some corporations become forces for good?        

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By Christopher Booker and Connie Kargbo

CHRISTOPHER BOOKER: A tour through the New Belgium Brewing Company in Fort Collins, Colorado, passes through the bottling facility and brewhouse, before ending at the bar.

New Belgium is one the largest craft breweries in the country, distributing beer to all 50 states.

When you buy its best known brand, Fat Tire Belgian style ale, that “B” on the label doesn’t stand for beer, it’s stands for B Corp, a designation given to businesses dedicated to more than profit.

KATE WALLACE: I think when you get together with people you realize you have a lot of the same values.

CHRISTOPHER BOOKER: Katie Wallace is New Belgium’s assistant director of sustainability.

KATIE WALLACE: If you’re running a business that’s not considering the impact that you have on the environment and society, or the impact that those things have upon your business, then you’re not operating a business that’s really going to be in existence in the future.

CHRISTOPHER BOOKER: New Belgium is privately owned and profitable, selling nearly a million barrels of beer a year and generating $225 million a year in revenue.

KATIE WALLACE: For a long time we felt that we kind of stumbled into this for values-based reasons but then found that economically it was a really powerful business model and has been a key ingredient of our success over time

CHRISTOPHER BOOKER: New Belgium took its dedication up a notch in 2013, when it became a certified B Corp, submitting to a rigorous audit of its community impact by the Pennsylvania based B Lab.

B Lab likens the certification to “Fair Trade” for coffee and the “LEED” certification for buildings with environmental and energy-efficient design.

Beyond charitable giving, companies can score more points for making eco-friendly products, offering robust benefit packages, and being transparent in their corporate governance.

New Belgium earned its certification in large part because of its environmental practices: generating 12 percent of its electricity from solar panels and biogas, a fuel they create by the wastewater produced when they make beer. After one year on the job, employees are given bikes to commute carbon free and given shares in the company, which is now employee owned.

KATIE WALLACE: B Corp has given us a way to measure things that aren’t inherently quantitative, but we know are important to us. Like providing 100 percent of our health care premiums for our co-workers or putting solar on site or biogas. It helps us to bring that into a measurement space where we can compare ourselves against other companies and see are we really being leaders in this area or is there a way we can improve?

CHRISTOPHER BOOKER: Believing business can function as “a force for good,” B Lab has certified 22,000 companies worldwide since 2007. Subjecting mostly small and medium-sized, privately held companies to a 200 point assessment.

The list includes ice cream makers Ben & Jerry’s, eyewear manufacturer Warby Parker, and outdoor clothing giant Patagonia.

There are 99 B Corps in Colorado. That includes businesses that don’t manufacture anything like Denver law firm moye white. Attorney Dominick Sekich oversaw its B Corps application.

DOMINICK SEKICH: There are a lot of opportunities that, say, manufacturers have that, as a service organization, we don’t have. We can’t really point to a supply chain that we’ve improved, because our supply chain is fairly short and concrete.

CHRISTOPHER BOOKER: Moye White acheived B Corp certification after it improved a number of employee benefits, expanding paid parental and family leave, increasing flex time, and starting an employee community service group that volunteers with organizations like Habitat for Humanity.

Sekich says each time an employee takes advantage of their three-month paid family leave benefit, it can cost the firm between $20,000 and $50,000. But the firm believes it’s worth it.

DOMINICK SEKICH: We’ve had some clients approach us asking us how we’ve committed to the environment, how we’ve committed to our communities, and we’re able to point to our certification as a B Corporation as part of that effort.

CHRISTOPHER BOOKER: When Moye White was working toward its B Corp certification, it turned to B Lab’s Kim Coupanous for assistance.

KIM COUPANOS: If you look at society in general and all of the good things that capitalism has brought to civilization and humanity over the last hundred plus years, there’s been an equal number of really negative things. Massive income divides biotoxicity, greenhouse gases, you name your kind of social or environmental ill. Capitalism has kind of created that.

CHRISTOPHER BOOKER: Before joining B Lab, Coupanous ran an outdoor clothing company for 16 years.

KIM COUPANOUS: I agree with the profit motive and there’s no bones about that. I also know that the power of business to transform society is huge. And we are going into this new century facing some pretty challenging problems that haven’t been solved by the nonprofit sector or the government sector. And at the same time, there’s this kind of spirit of innovation and optimism, especially among Millennials who say we can do better than this.

CHRISTOPHER BOOKER: Economically, Colorado is doing better than most states. Its 2.3 percent unemployment rate is the lowest in the country. The Denver skyline is filled with cranes constructing new apartment buildings for some of the 60,000 people who move to the state every year. Most settling in the relatively affluent greater Denver and Boulder areas.

Will this be relegated to areas that are already populated by the upper middle class, the educated, the tech sector? I can think of many corners of America that they just want jobs. They’re not even having the ability to think about how does this save water.

KIM COUPANOUS: Certainly it really can’t be relegated to the realm of upper middle class progressive city. Because if we are trying to create shared and or durable prosperity for all it means cities that are depressed. It means, you know, local businesses, nail salons, and moving companies, and the local garage.

CHRISTOPHER BOOKER: The B Corp movement is not without its skeptics.

KENT GREENFIELD: It is a band aid on a cancerous patient.

CHRISTOPHER BOOKER: Boston College law professor Kent Greenfield applauds the intent of b-corps but fears the B Corps movement may mask the need for far greater changes to the way American companies conduct themselves.

KENT GREENFIELD: Let’s be honest the real bad actors in the corporate world are not those who are voluntarily opting in .

CHRISTOPHER BOOKER: Greenfield argues that there must be changes in corporate governance to legally support companies working to be better citizens.

KENT GREENFIELD: As long as it’s voluntary, then it’s still gonna leave bad actors aside. So if you’re a Wall Street hedge fund manager, are you going to prefer companies that are B Corps? Are you gonna prefer companies who are saying, “no, we don’t think that being a B Corp is conducive to the shareholder value?” So I think our efforts need to be aimed at a more fundamental adjustment in the way we think about corporate obligation and the way we govern corporations.

CHRISTOPHER BOOKER: Despite the lack of federal or state regulation compelling companies to function as better actors, there is a way for companies who pursue both profit and social good to be legally protected.

With a push from B Lab, Colorado and 32 other states have passed legislation allowing companies to incorporate as a public benefit corporation, which enshrines their social mission into their articles of incorporation.

This spring, food and beverage company DanoneWave became the largest public benefit corporation in the U.S., with 6,000 employees and $6 billion in annual revenue. A subsidiary of French multinational Danone, DanoneWave makes organic products like Horizon milk, Silk almond milk, and Wallaby yogurt.

DEBRA ESCHMEYER: We encourage dietary practices that improve the health of people through food.

CHRISTOPHER BOOKER: Deborah Eschmeyer is the vice president of communications and community affairs.

DEBRA ESCHMEYER: When folks go to the grocery store, they want to know that the products are actually doing right by the employees and by the people and the planet.

CHRISTOPHER BOOKER: Its production process is increasingly using natural ingredients and the company has spent money to reduce its waste and promote animal welfare.

Eschmeyer says DanoneWave believes the upfront costs pay off in the long run.

DEBRA ESCHMEYER: These are things that help the bottom line. Because waste reduction, for example, is great for the bottom line. It’s also great for the planet. We have this greater goal of showing that you can meet the financial shareholders’ interests and do right by the people and the planet.

CHRISTOPHER BOOKER: DanoneWave is arguably providing a test case for scale.

DEBRA ESCHMEYER: Yes.

CHRISTOPHER BOOKER: How difficult is it to go through this process with such a large company

DEBRA ESCHMEYER: Yeah, I mean, we’re definitely proving the case. We want to make sure that large companies can do this, and we can do this at scale. And DanoneWave is now one of the top 15 food and beverage companies in the United States. And so when we do this, it’s a challenge to other companies to step up as well.

CHRISTOPHER BOOKER: Six more states are now considering benefit corporation legislation. B Lab says it will certify its 100 Colorado company as a B-Corp next week.

The post Can some corporations become forces for good? appeared first on PBS NewsHour.


          How this CEO invests in the dignity of others        

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HARI SREENIVASAN:  Now to another in our “Brief but Spectacular” series, where we hear from interesting people about their passions.  Tonight, entrepreneur Jacqueline Novogratz, founder and CEO of Acumen, a non-profit venture capital fund, talks about using the tools of business to address global poverty.

JACQUELINE NOVOGRATZ, Founder and CEO, Acumen:  When I was six years old, my first grade nun, Sister Mary Theophane, beat it into my head to whom much is given much is expected.  And so, I always wanted to change the world.

I moved to Rwanda to help start the first micro finance bank and soon thereafter realized that most people don’t want saving.  Most people want choice and opportunity, which is another way of saying dignity.

In a funny way, I became an accidental banker and ended up in Latin America during the financial debt crisis of the early 1980s.  And there I saw that I love the tools of business.  The problem was that low-income people who were so industrious had no access to the banks and that’s why I went into international development and saw that on the other side, there was a great humanitarian ethos, but it lacked the efficiency, the effectiveness of the markets.

We often say the market is the best listening device that we have.  So, if I give you a gift, you’re unlikely to tell me what you don’t like about it.  But if I try to tell you a solar light, you’re going to tell me exactly what you think.

We created an organization with this idea that you could change the way the world tackles poverty by using something we call “patient capital.”  We took philanthropy and rather than give it away, we would invest it in intrepid entrepreneurs that were going where both markets and government aid had failed the poor, basic services like health care, education, agriculture, energy, workforce development.

What entrepreneurs and others we’ve invested in have in common is what we call moral imagination.  Moral imagination starts with putting yourself in another person’s shoes and seeing the world through their perspective.  But it’s more than empathy.  It’s the ability to envision a world and build institutions in which all people matter.

So, often, we look at poverty in terms of how much a person makes, rather than understand their contribution as a human being.

When we see companies enable people to have access to clean drinking water or agricultural inputs that enable them to make a little more income, one of the first things they do is turn around and help somebody else.  It’s seeing that there is no one above you or below you.  And really that’s the world that we need on see right now when we are so divided, and yet have so much opportunity to become united.

My name is Jacqueline Novogratz.  And this is my “Brief But Spectacular” take on dignity and the moral imagination.

The post How this CEO invests in the dignity of others appeared first on PBS NewsHour.


          Column: What’s behind these big merger deal busts?        
Traders work at the post where Allergan stock is traded on the floor of the New York Stock Exchange (NYSE) April 6, 2016. REUTERS/Brendan McDermid - RTSDV88

Ben Gomes-Casseres, author of “Remix Strategy: The Three Laws of Business Combinations,” pulls lessons from a trio of recent high-profile deal cancellations: Halliburton-Baker Hughes, Pfizer-Allergan and Staples-Office Depot. Photo by Brendan McDermid/Reuters

This month marked the 100th anniversary of Louis Brandeis’ confirmation to the U.S. Supreme Court. Reading his passionate writings on the “curse of bigness” makes me wonder what Brandeis would think of today’s big mergers.

As it happens, anti-trust authorities have been active of late, questioning many of those mergers. And several have been stopped dead in their tracks — to the disappointment of the investment-banker descendants of the money houses that were Brandeis’s nemesis in the early 20th century.

Some of the recent deals were too rich or too clever for their own good, and others pushed industry consolidation one bridge too far.

What lies behind the recent wave of antitrust actions? Politics, perhaps — but the Obama administration has not been more active stopping mergers than previous administrations. But some of the recent deals were too rich or too clever for their own good, and others pushed industry consolidation one bridge too far. And probably ‘tis just the season for it — the wave of antitrust actions may just stem from last year’s bumper crop of merger announcements.

Let’s look at a trio of recent high-profile deal cancellations: Halliburton-Baker Hughes, Pfizer-Allergan and Staples-Office Depot. These mergers span a wide swath of American industry — from to oil and gas to pharmaceuticals and big-box retailing. This diversity suggests how varied the reasons are behind today’s mergers.

The classic reason for firms combining their assets is to remix them to create new value. But who captures that new value? Usually shareholders do so to some extent, otherwise they would not approve the merger. Beyond that, do consumers benefit or not? What is the impact on competition and rival companies? More broadly, is the new value truly a net benefit to society, or is it a transfer from one group to another? These larger societal questions are the kind exercised by Louis Brandeis and that today are addressed by various regulatory bodies.

READ MORE: Column: Why mergers are booming

A careful look at these three deals shows how regulators think about these questions and leads to lessons for managers contemplating mergers in the future. (Several health care insurance mergers are up for review this summer, such as Cigna-Anthem.)

The Halliburton-Baker Hughes deal was a classic case of a bridge too far. And they knew it. Baker Hughes had resisted Halliburton’s overtures for months before agreeing to the deal, fearing that it would not pass anti-trust muster. It accepted the offer in the end only with a large break-up fee of $3.5 billion.

It did not take the Department of Justice much figuring to show that the merger of the number two and number three player oil field services would concentrate selling power substantially in 23 specific markets, from drilling fluids to drill bits. This would reduce options for customers (huge oil companies themselves) and could reduce innovation, they reasoned. And crucially, the Department of Justice did not see benefits to the concentration — no countervailing pro-competitive or efficiency effects that might have tilted the balance in favor of approval. Open and shut case, they said. It took only a few weeks for the deal makers to scuttle their plan, without much of a fight.

The first lesson from these deal busts is this: If you wish to consolidate, be sure it will create value for customers and society, not just for shareholders and bankers.

The Pfizer-Allergan deal was canceled even more quickly — within 24 hours of the U.S. Treasury’s announcement of new rules that wiped out the value the deal offered shareholders. Moving a company’s headquarters to low-tax havens through a merger is not in itself a fancy trick — hundreds of companies have done these inversions. But this one was a bit too clever. To pass muster, the foreign partner in such a deal must be large enough to hold on to at least a 40 percent share of the merged entity. Pfizer is big, so the foreign partner had to be sizable itself. To reach the threshold, Pfizer ended up granting Allergan a huge premium, much beyond what would be justified by projected synergies. Without the tax benefits of the inversion, therefore, the numbers in the deal simply did not add up. (Other deals, such as the medical device merger between Covidien and Medtronic in 2014, survived even after some of their tax benefits were denied, because they came with substantial non-tax benefits too.)

READ MORE: What Oprah and Warren Buffett can teach us about risk

The first lesson from these deal busts is this: If you wish to consolidate, be sure it will create value for customers and society, not just for shareholders and bankers. The Department of Justice’s own “Antitrust Guidelines for Collaborations Among Competitors” admits that “in order to compete in modern markets, competitors sometimes need to collaborate . . . Such collaborations often are not only benign but procompetitive.” Nevertheless, the guidelines continue, certain agreements that are highly likely to harm competition and have no procompetitive benefits may be ruled as unlawful under the “rule of reason, which involves a factual inquiry into an agreement’s overall competitive effect.”

This case highlights the second lesson of the season: It is tough to argue that long term good will come from short term pain.

The Staples-Office Depot deal was the only of these three to put that rule of reason to the test in court. This merger of the number one and number two office supply big box chain admitted that, yes, competition will be suppressed and consolidation will follow. But this competition-reducing effect was to be counter-balanced by the new Staples being able to invest more robustly in online businesses, which would strengthen competition in that growing market (e.g. competition with Amazon.com). Ultimately, Staples and Office Depot argued, the positive effect of stronger competition online would outweigh the reduction in brick-and-mortar competition. But they failed to convince the court that they were ultimately creating value for society, not just retrenching and closing stores. In a puzzling move, they refused to call any witnesses to defend their position — they simply failed to make their case.

This case highlights the second lesson of the season: It is tough to argue that long term good will come from short term pain. Corporate leaders in the U.S. now see that there are greater hurdles to cross in thinking through, structuring and presenting such strategic arguments. In the end, that is a good thing.

READ MORE: How firms avoid U.S. tax codes through pass-through businesses

The third lesson from the merger-busting climate is that alternatives to merger will become more attractive. The global airline industry for a long time has managed to do with alliances what other industries do with mergers – because they are blocked from cross-border mergers for the most part.

The third lesson from the merger-busting climate is that alternatives to merger will become more attractive.

Often, asset swaps, joint ventures and divestments can serve to focus a business better than a big merger. For example, pharmaceutical giants Novartis and GlaxoSmithKline completed a complex deal last year that involved a swapping of assets to focus each business better, a divestment of some assets to third parties and a new joint venture created to consolidate similar businesses. These transactions were sharply defined combinations that did not require a full-frontal merger of the two parent companies. Smart deals such as this one can serve the purpose of remixing assets without incurring the costs of “bigness.”

Since Teddy Roosevelt and Louis Brandeis, the United States has seen a continual push-and-pull between anti-trust enforcement and merger waves. The latter always crest, as they have appear to have done now, and then the former loom larger. But the underlying drivers of business combinations do not disappear – they will just get channeled in new ways.


Editor’s Note: Portions of this article are from the author’s article in Harvard Business Review, which you can read here.

The post Column: What’s behind these big merger deal busts? appeared first on PBS NewsHour.


          We’re Having a Baby!        

We're having a baby!

If you’re on my mailing list, you’ll already know that Motoko and I are having a baby. He’s only about six weeks away now. That will obviously bring some big changes. After 15 years of marriage, here are some of thoughts on our new lifestyle. I really like whether everything is going so far.

I am Canadian

We’ve decided to deliver the baby in Canada. Before and after the delivery we’ll need to have regular doctor visits and some stability in our lives.

We were considering Hungary, Japan and Thailand, but Canada was the clear winner. Our first two checkups were with a great doctor in Budapest, but it made more sense to go to Calgary. My immediately family is all here and everyone speaks reasonably good English. 🙂

We’ve tried medical services in about half a dozen countries, Canada is the best by far. All doctor visits are 100% covered by our free health care system and the quality and service are first rate.

Many Canadians complain about the long wait times, but I’d suggest they try other countries to see just how good they have it. Winters can be long and cold, but Canada is a pretty amazing …


          Information Technology To The World        
Information Technology To The World
          Idea Knowledge Of Brain And Success        
Idea Knowledge Of Brain And Success
          An Anniversary we wish didn't have!        
Well, here we are, 365 days after bringing Jadon to the hospital early morning for his first OHS (open heart surgery) to repair his Tetrology of Fallot.  He is still at Sick Kids.  He has gone through a tremendous amount.  If you had told us what the last year was going to be like, we would not have believed you, yet here we are!

In addition to everything Jadon had gone through as of Aug 11: 6 months in the hospital, this is what has happened since:

1 surgery (fundoplication and g-tube insertion)
2 cardiac arrests
4 more CCCU admissions
1 endoscopy
3+ intubations
multiple bronchoscopies
1 fundoplication dilatation
4 g-tube size changes
1 g-tube advanced to gj-tube in IGT
intussusception (bowel telescopes on itself)
gj-tube back to g-tube
1 mickey (replace g-tube with button)
2 bouts of pancreatitis
7 weeks on a replogle tube (continuous suctioning)
1 PICC line change
1 CT scan of his chest
1 MRCP (special liver/pancrease MRI)
10+ new different medications (bringing his total to over 64)
1 medication is restricted and only available through the Special Access Programme
learning to walk 3 more times
multiple more ultrasounds, x-rays, echocardiograms, EKGs

Through all this, Jadon has been absolutely amazing.  He is such a happy little guy and worms his way into the heart of all his health care practitioners.  For the last 2 months or so we have been on a general medical pediatric floor, so Jadon had a whole new set of nurses, doctors and others to charm.  It did not take long!
He is taking a little bit of food orally now
Colouring in the library at Sick Kids
I'll say it again as we have countless times... we are hoping for a homecoming very soon!

          Not exactly the way we envisioned it!        
Jadon turned 3 today.  This was the first birthday of his that he had with mom and dad around.  It was the first birthday he had with a family and friends that are behind him and supporting him.  Unfortunately, it was likely not the first birthday he spent with multiple health caregivers surrounding him.
When we first adopted Jadon, we thought his heart issues had already been fixed with the Tetrology of Fallot surgery.  As it turns out, he had only received a temporary fix, buying him some time until he could get the complete surgery.  When we went into the hospital on Feb 11 for his complete Tet repair, we had absolutely no expectations that his birthday would be spent in the hospital.  Even during the summer, we and the kids were so looking forward to this day.  We were hoping that after Jadon's G-tube insertion and fundoplication on Wednesday, that he would be recovering well, taking his feeds, and be upstairs in his own room on the cardiac floor.  We were hoping that his birthday would be only days before he would be able to come home.

Unfortunately, due to the cardiac arrest on Wednesday evening, and the liver and kidney complications, Jadon is still intubated in the Cardiac Critical Care Unit.  This is where he celebrated his third birthday.  The nurses from both floors, the CCCU and the Cardiac floor were absolutely wonderful.  They helped Rykauna decorate Jadon's crib area, made and signed cards, brought gifts and a cake, and sang Happy Birthday to Jadon.  We could once again see the love that so much of the staff have for Jadon.

Jadon's liver enzyme numbers are looking much better.  His kidneys are working better and he is starting to get rid of the excess fluid (which is currently his biggest problem), he is on minimal ventilator settings and he is tolerating significant feeds through his newly inserted G-tube.  Once again, our little warrior is fighting through yet another setback!  We are so proud of him and we love him so much.

Happy Birthday Jadon!
          Democrats Fear Medicare-For-All Plan Could Sharpen Party Divisions        
Sen. Bernie Sanders is promoting a Medicare-for-all health care plan, and some Democrats are worried it could sharpen divisions in the party.
          In Iowa, Many Republicans Stand By Trump Despite Recent Missteps         
Republican voters in Iowa weigh in on the failure of the health care repeal effort, the Russia investigations and the Trump administration's recent effort to limit immigration.
          Nurse forced to participate in abortion        

A nurse in New York has filed a lawsuit against Mt. Sinai Hospital in New York, after being forced to assist in a late second-trimester abortion.  The hospital knew of her objections and essentially told her she would be fired otherwise.  Specifically, she would be charged with "insubordination and patient abandonment", leading to a possible loss of her job and her license as a nurse.

The woman's attorney stated:

"We're seeing more and more cases where pro-life health workers are facing requirements to assist in abortions against their rights of conscience."

Of course, this comes against the backdrop of the Democrats' attempt to have the federal government take over much of the health care industry in America, which, by definition, includes the people who actually practice medicine.  What kind of protection will those individuals be afforded to avoid doing things that violate their conscious or religious beliefs?  Such as, in this case, abortion, or even doctor assisted suicide - or straight out Euthanasia?

The short answer seems to be little.  Obama himself promised a "robust conscious clause", but this is the same President who used his authority to rescind such protections for medical practitioners that was put in place buy the Bush administration.

And Congress has already had an opportunity to extends such protection as part of the ongoing heath care debate and chose not to.  Specifically, the House rejected an amendment which would have done just that.

It seems that religious conscious and liberty aren't so high on their list of priorities.

 


          White House getting religion on deficit?        

After almost a year of big, new spending proposals - to say nothing of the tab that will come along with government run health care - the White House is signaling that this year's one and a half trillion dollar deficit might be a political problem that needs to be dealt with after all. 

It's a good bet that what this really represents is their recognition of what's happening in elections in Virginia, New Jersey and New York - and their trying to inoculate themselves against similar political damage in the future.

From the Washington Times... 

Anxiety about the deficit has fueled the anger of the conservative "tea party" activists, riled by government spending and debt, and it has seeded reservations about the long-term price tags of signature items on the president's agenda...

A speech last week by Christina D. Romer, chairman of the president's Council of Economic Advisers, looked at the reasons for the deficit and at how it relates to health care reform. Treasury Secretary Timothy F. Geithner appeared on NBC's "Meet the Press" on Sunday to make clear that the administration recognizes the deficit is growing too large.

"Well, it's going to have to come down. Now it's too high, and I think everybody understands this," Mr. Geithner said. "The president's very committed to bring down these deficits."

Republicans have hammered the administration for government spending levels, and public polling for the first time is showing that the American public is losing confidence in the president's handling of the economic crisis. That shift occurred in the middle of last month, when a range of public surveys showed that more people (46.9 percent) disapproved of the president's handling of the economy than approved of it (45 percent), according to the Web site Pollster.com. ...

Mr. Orszag's speech will not contain any new proposals or policy solutions, but will attempt to lay a foundation for the conversations to come next year. ...

In other words, it's just words...  Oh, and they plan to continue to blame everything on Bush.

As his top aides try to make clear that they recognize the problem, Mr. Obama has added an element to his speeches: He reminds the public that he "wasn't sworn in yet" when the nation's economy took a nosedive.

So what do they plan to do?

The White House on Monday was noncommittal on one of the top political solutions under discussion: the creation of a bipartisan commission to study the problems of the long-term deficit and debt and to deliver recommendations to Congress for up or down votes that could not be amended.

White House press secretary Robert Gibbs said Monday that the idea will "be looked at."

Which likely means "no", because it would have to result in recommended reductions in entitlements...which liberals won't stomach.

So just what kind of deficit/debt are we looking at now?  The ten year forecast of deficits via Obama budgeting is nine trillion...which will be added to our current debt of almost twelve trillion - a number that's bigger than the entire annual US economy.

 


          Political news and nuggets: 10-9-09        

from 'round the sphere...

Democracy, shlemocracy...

Newt Gingrich points
out the undemocratic way the health care reform bill is being put
together...as in by just a few senators and their staff members.

Think about it: All of the power of the United States Senate to
transform one-sixth of our economy will be in the hands of three men
and their aides. It's government by staff, aided by lobbyists, for the
benefit of bureaucrats.

No wonder so many Democrats in Congress are so dead set against having
members read - and more importantly, allowing the American people to
read - bills before they vote on them. ...

Just 5 more days for that Specter refund

The Washington Examiner
notes that October 15th is the last day you can get a refund from Arlen
Specter if you happened to give him a campaign contribution before he
jumped ship and became a Democrat.  The Club for Growth has made the
generous effort of contacting all such Specter donors by mail (over 6,000 of them) and providing them with a form they can fill out and tell Specter they want their money back.

We're sure Specter appreciates their kind assistance.

Could Obamacare be repealed?

That's the question Stephen Spruiell is asking over at National Review Online.  He
points out that many of the "reforms" being considered under various
versions of health care reform have been tried at the state level in
places such as Kentucky and Vermont...and all with disastrous
consequences.  As in driving the costs of individual insurance through
the roof and causing the majority of insurers to leave those state
markets.  He then points out that a few states that made such mistakes,
(like Kentucky and Washington), have since repealed those "reforms". 
The question becomes, if it passes at the national level, could it be
repealed?

Time for Obama to make a decision on Afghanistan

Charles Krauthammer points out that Obama's dithering over whether to accept General McChrystal's report and go with a surge of 40,000 troops in Afghanistan just underlines the cynical nature of the Democrat's mantra of condemning the war in Iraq and lauding the war in Afghanistan as the "good war".

...championing victory in Afghanistan was a contrived and disingenuous
policy in which Democrats never seriously believed, a convenient
two-by-four with which to bash George Bush over Iraq -- while still
appearing warlike enough to fend off the soft-on-defense stereotype.
    
Brilliantly
crafted and perfectly cynical, the "Iraq War bad, Afghan War good"
posture worked. Democrats first won Congress, then the White House. But
now, unfortunately, they must govern. No more games. No more pretense.
    
So
what does their commander in chief do now with the war he once declared
had to be won but had been almost criminally under-resourced by Bush? ...

Less than two months ago -- Aug. 17 in front of an audience of veterans
-- the president declared Afghanistan to be "a war of necessity." Does
anything he says remain operative beyond the fading of the audience
applause?

Right now the answer doesn't look promising.


          New Coalition Poll: Your Main Concerns About Obamacare?        

Cast your vote in our latest poll...then add your comments.

What are your main concerns about recently proposed health care reforms?

Your options:

  • The costs
  • Potential rationing of health care
  • Public funding of abortion
  • Loss of personal liberty
  • The government run "public option" in general
  • All of the above
  • Other

 Click here to cast you vote and comment.

***

TAKE ACTION: contact your members of Congress and let them know how you feel.


          The Health Care Reform Act turmoil        

Opinions and concerns abound about this issue, sometimes to the point that the facts get obscured. Can I separate all the facts from the fiction? Nope, I can be duped and sucked in as easily as the next person. But I can tell you where to go to form your own opinions undiluted by anyone else with an agenda. Thomas from the Library of Congress is an excellent site for following legislation and the workings of Congress. As a matter of fact, Thomas has made it easy for people right now. You don't even have to search for the House's health care bill. They've put up a direct link on the very front of their website. From that link, you can then read a summary of the bill, see what Committees it's been referred to, see who is sponsoring it, and read the bill word for word yourself. Be warned, the bill's over 1,000 pages long and very dense to read! That doesn't mean I think it's not worth reading; I'm just saying don't expect to skim through it on your lunch hour unless you belong to Mensa. :)

You can also get some very useful links from Congressman Brad Ellsworth's "Online Office." He has the PDF of the full bill, just as Thomas does, but he additionally has links to the committee work being done on the bill.

And while we're talking Congressmen, if you want to share your opinion, do you know who to share yours with? Indiana's Senators are Evan Bayh and Richard Lugar, while Evansville's Congressman is Brad Ellsworth.

Lastly, here's on other place I like to go when I'm inundated with opinions, http://factcheck.org/. They appear non-partisan to me. They've debunked pro and con statements surrounding the health care debate. And, their website/services don't exist solely for the health care debate (it just looks that way right now :). Take a look at their Archives or Ask Factcheck to see some of the other political issues they address.


          My Wife Died Because Of The Conflict In Yemen        
Smoke billows behind a building following a reported air strike by the Saudi-led coalition in the Yemeni capital Sanaa on Jan. 22, 2017.

Yemen has suffered economic instability, political turmoil, civil unrest and conflicts for decades. But the beginning of the recent conflict in March 2015 was a stark turning point for the economic, social, and humanitarian destiny of this country.

As someone who was born and lived in Yemen, my life which revolved around work and family has now become a struggle for survival. I think back to that day when in a matter of minutes, the sky was flooded with bomber jets. As we realized what was happening, there was a mad rush to the shelter to protect ourselves from the bombs. In the days that followed, we were confined to our homes, curfews were imposed, while food, water, and basic supplies became scarce.

As of January, 10,000 civilians had been killed and 40,000 injured

The humanitarian situation has reached new depths.

The regular bombings and deliberate military tactics to shred the economy have destroyed public and private services, dragging an already weak and impoverished country to almost breakdown. If it weren't for international assistance, the country would have collapsed by now.

The majority of my fellow citizens have lost their jobs or their livelihoods and have depleted most of their savings. Their lives have been quite simply devastated by the conflict. Over twenty million people are in need of humanitarian aid to survive. That's more than in any other country in the world. The global humanitarian community is now faced with one of the most staggering man-made disasters in decades.

I have been working as an aid worker for Islamic Relief in Yemen since 2010. In the last two years our programme, including food aid, water and sanitation, health care, orphan and child welfare and vocational training for young people, has benefitted 4.6 million people. Most recently we have responded to the cholera epidemic by providing medical supplies and large tents to help the hospitals cope with the overcrowding.

I've put my heart and soul and all of my experience and expertise into making sure this life-saving aid is delivered where it is needed most, often in dangerous circumstances.

But as with every other Yemeni, the conflict has taken a huge toll on my personal and family life.

One bombing attack in mid-2015 close to my home marked the beginning of the physical and psychological horrors of war for my family.

The explosions were like something you could never imagine. The ground underneath shook as if we were experiencing an earthquake. Doors and windows were wrenched from the walls and glass was scattered everywhere. My children were terrified.

The impact was catastrophic. I had to move my family away from the violence. Within a year we were forced to move four times in a bid to find somewhere safe to live, but as the bombings became more and more frequent and widespread, this became impossible.

Throughout all of this, I continued with my humanitarian commitments to deliver aid to affected communities across the country. But I was aware of the physical and psychological impact the conflict was having on my family. My children were traumatized by the bombing attacks and were petrified when they heard the sounds of fighter jets in the air.

My wife was diagnosed with an autoimmune liver infection. We couldn't get adequate medical treatment because of the trade embargo on the country. She suffered for two years and then tragically passed away. I believe the stress and fear of the violence caused her health to deteriorate and ultimately led to her death.

She was a loving wife to me, and the perfect mother to our children. Her death has left a deep grief engraved in our hearts that will be there for the rest of my life.

The violence still continues as I write this. I have to be strong for my children and be strong for my community. My work with Islamic Relief is what keeps me going. When we are able to help a family or someone who is suffering, the relief I see in their eyes and the smile on their faces is what drives me to stay committed to my humanitarian work.

My country, Yemen, needs help. The violence needs to stop.

Salem Jaafar Baobaid is part of Islamic Relief Yemen's operations. He writes this from Yemen. For more information on Islamic Relief's Canada work in Yemen, click here.

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          It Seems Female Physicians Don't Factor Into Trudeau's Feminism        

Justin Trudeau frequently promotes himself as a feminist and supporter of women in the workplace. He tells us "we need women and girls to succeed because that's how we build stronger, more resilient communities." His recent budget hyped itself as the first ever application of gender-based analysis and he gives great advice to men who want to be allies: "don't interrupt women, and notice every time women get interrupted." (Hear hear!)

So perhaps when Finance Minister Bill Morneau announced the upcoming end to incorporation for certain small businesses, it was on the assumption there wouldn't be a gendered impact on the owners of health-care businesses. The shorter name for these business owners is "physicians," and they are up in arms over Morneau's suggestion that incorporated doctors are tax cheats.

I know this is difficult news

In spite of the well-worn image of a doctor as a grey-haired older man spending his free time on the golf course, a significant number of doctors are actually young to middle-aged moms, rushing straight home from the hospital or clinic to start their second shift with the kids. Fifty-two per cent of Canadian physicians under 45 are women, and this number is not static.Between 2011 and 2015, the number of female doctors grew three times faster than male doctors. In family medicine this change is even more pronounced, with women making up 59 per cent of the under 45 group and 65 per cent of the under 35 group. Yet despite Trudeau's many feminist-friendly statements lauding working women and their contributions, not a lot of us women in medicine feel that he supports us and our work.

That's why a petition was created a few days after Morneau's announcement, as physician moms nationwide looked at their finances and realized they were in danger of never retiring. Dr. Nadia Alam, president-elect of the OMA and a small-town family physician and anesthetist, writes that in addition to retirement planning, incorporation allows her to work demanding, irregular hours with four small kids and support her aging parents.

I have all the responsibilities and risks of a small business, yet the federal government doesn't think I should have any of the tax treatment.

Each woman in medicine is a female-owned small business that contributes to this country's heath-care infrastructure and economy. Physicians don't only provide their own labour, they fund other health-care staff, clinic space and medical equipment. A wide range of health-care infrastructure is paid for out of pocket by individual physicians, and a growing number of these physicians are women with young families like Dr. Alam and myself.

Later this month my son will celebrate his first birthday. I took six months off when he was born, although I would have liked to have taken more. Like other small business owners, I couldn't simply close up shop for my maternity leave. My patients still needed a doctor, the rent still needed to be paid and my staff still needed regular paycheques.

All of these costs were paid out by me (including paying the physician locum who covered my leave) and resulted in a tight financial squeeze during the months I was home with my son. I'm not complaining about my lack of maternity leave benefits, and certainly there are women in much more fragile financial positions who don't have maternity benefits, either. My point is that I have all the responsibilities and risks of a small business, yet the federal government doesn't think I should have any of the tax treatment available to other types of small businesses.

CANADA-BUDGET/

More unique to physicians is the deferral of saving for retirement because of the relatively late start to our careers. Another thing frequently deferred is starting a family, as is common for women who spend longer in school (doctors typically spend at least a decade in post-secondary studies). I had my first baby in residency, pushing back the start of my working life, as did many of my female colleagues. The lack of a pension or maternity benefits for most physician mothers presents a special challenge: having already delayed the start of your work life, what is the cost to your retirement savings if you want to have a baby? Last year, when I was a 36-year-old pregnant family physician, this question was frequently on my mind. And like many other female doctors, I'm the breadwinner in my family, and a breadwinner without maternity benefits can sometimes feel stuck between a rock and a hard place.

So when Trudeau calls himself a feminist, is he thinking about the women who fund health-care infrastructure in this country through their small businesses? I'm not sure he's aware how many of us are also the breadwinners for our family and how difficult a position that puts us in when we become mothers. It's obvious he isn't considering how being working moms in medicine disadvantages us in saving for retirement.

We're wondering why a prime minister who speaks glowingly about the societal contributions of working women can look right past us as if we don't exist.

Trudeau seems himself to have succumbed to the popular image of the older male physician on the golf course. This entrenched idea makes us hard-working "lady doctors" (yes, I have been called that MANY times) who are raising young families feel invisible, when what we really are is a major, growing demographic within health care. And since we also fund health-care infrastructure directly out of our female-owned small businesses, we're wondering why a prime minister who speaks glowingly about the societal contributions of working women can look right past us as if we don't exist.

Certainly the Liberal government doesn't want to be seen as the purveyor of empty feminist platitudes, however, that's already a well-establishedcriticism. The recent budget paid lip service to the idea of encouraging women to move into senior-level positions, yet medicine already is a key avenue for women to move into prominent positions in health care. Hamstringing the female physicians ready to do the hard work of health-care leadership can hardly be seen as supportive of working women. This policy will destabilize one of the few fields where women having been claiming the kind of success Trudeau waxes poetic about, and I don't see very much that's feminist about that.

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          On Balance        
"It’s not that simple,” Brian Burke said, voicing the minority opinion in front of a Toronto conference room filled with the most influential minds in hockey.

In the afterglow of the games once in a generation success at the 2010 Vancouver Winter Olympics, the overwhelming consensus at the Word Hockey Summit was that it is, in fact, that simple. The NHL should go to Sochi in 2014 with almost no reservations.

Overall the Summit appears to have been a success, bringing different perspectives from management, players, and media members into the same room to discuss the biggest issues in the game. Though, with much at stake and the perception amongst hockey’s mavens to be swung, it was not without its share of political theater, at times devolving into what appeared to be hockey’s “spin alley”.

Speaking on behalf of his Maple Leaf boss and the other 29 franchise owners who have yet to make a decision on participating in the games, Burke lends his well deserved creditability to the argument that while everyone is in favor of returning, the deal involves complexities that prevent the league and players association from rubber stamping it without further information. An argument that seems like a more than reasonable stance until said complexities are examined.

Perhaps too aware of the way millionaire owners would come across holding out of the Olympics for their own gain, Burke, who put together the silver medal Team USA squad in his first term as general manager, attempted to take the side of his players.

“They aren't paid,” he argued. Mentioning the airplane tickets and hotels the players had to pay for any friends of family that joined them for the events, as if the IOC should bend over backwards accommodating player entourages. But buried in his less than believable support for the players was the real point, the one thing ownership would have people walking away from the discussion remembering. The sticking point that has kept the NHL from enlisting for another Winter Olympics: “The IOC makes a fortune off this thing.”

Other arguments are moot. 15 of the 16 teams that make the NHL playoffs don’t pay the players for the experience either. Brilliant Red Wings GM Ken Holland argues a point of view that hemust be far too intelligent to actually believe. That the travel could affect players and in turn cost teams wins, and as we saw this past spring, even a single point can decide whether a team makes the postseason or not.

Imagine how criminal it would be
if a playoff spot was decided by
something as silly and outside the
sanctity of the game as traveling.
No, we know how these things
are supposed to be decided:
Breakaway contests.
But that argument rings a little hallow when the league itself will send teams to Helsinki, Stockholm, and Prague to start off the season as part of the NHL Premiere program, now in its fourth year.

And if the league is particularly interested in eliminating needless travel and interruptions in the schedule, perhaps they should start with nixing the now entirely pointless All-Star weekend.

Any reluctance to enlist for the Sochi games instead can be more accurately summed up in a single word for Deputy Commissioner Bill Daly when he referred to players simply as “assets”.

To the owners, most of which are extremely successful business men, that is what players are. They are something that they invest millions and millions of dollars into, and as a result they lure the top talents and allow them to play at their absolute peak. They are afforded the best equipment, coaching, training, facilities, and health care that money can buy.

And every four years these elite players take that talent, paid for and fostered by NHL owners, and play essentially for free for another organization that makes money hand over fist.

The IOC made nearly $400M in
Beijing in 2008. Or, based on his
contract negotiations with the
Devils, enough to lock up Ilya
Kovalchuk through 2067
.
While numbers from the 2010 games have yet to be reported, the IOC had a net revenue of $2.4 billion in 2008 from the Beijing games, off of which they made a cool $383.3 million in earnings. Meanwhile, based on a November report from Forbes magazine, 14 of the 30 NHL franchises operated at a loss last season.

When you ignore the fact that it is their very own CBA that is responsible for suffocating smaller revenue teams, it almost seems reasonable. Almost.

The IOC takes advantage of NHL assets, and in turn the NHL wants something back. Even if players, especially the leagues Russian talent, seem absolutely eager and willing to head back to the games again. Superstar Alexander Ovechkin has already stated that he intends to go either way. Yet owners are willing to play the “as long as you live in my house you’ll live by my rules” card.

See, if we look at statements made by the league’s own fearless leader, Commission Gary Bettman, this is really all about its broadcast . No one has called for the IOC to send a giant check to the NHL. No one has asked for the IOC to pick up the tab on 2 weeks of the NHL players contracts that it’ll tap.

“If we are going to disappear for the better part two weeks, we want to make sure it’s worth it,” Bettman said. “Particularly if the time zone puts you eight hours ahead of the east coast.”

As mind blowing as it might seem, this whole thing is apparently just the league posturing itself to promote the game better. Which, based on your perspective, is either the height of hypocrisy considering the leagues embarrassing exclusive cable contract with VS. Or for those particularly stubbornly “glass half full” people, a lesson learned, albeit five years too late.

The International Olympic Committee has yet to even award the US television rights to the Sochi games, pushing back bidding multiple times in an attempt to deal the rights in a more favorable economic environment. Without a broadcast partner decided, shouldn’t the league be hesitant to make any decision? Isn’t that the type of information the league needs to come to a decision?

The Globe and Mail's Bruce
Dowbiggin reported
that NBC
has prepared two contracts.
One if the league participates
in Sochi, one if they don't.
Perhaps, but with NBC’s $200+ million loss on the Vancouver games, and ice hockey being one of the Winter Olympics signature events, and with broadcast networks lining up with bids that rival African countries GDPs, I’m betting the TV side is arguing the reverse logic. How are networks supposed to deal for the TV rights without knowledge of whether or not the greatest ice hockey players in the world will be at the rinks in Sochi?

And make no mistake, even if the US TV rights haven’t been secured yet, no one is going to be hiding the coverage on a third rate network, like say, Versus. Alongside NBC, FOX and ESPN are lining up to bid on the US TV rights for the Sochi games.

In an understatement for the century, Bettman characterized the 2010 Vancouver games as being “on balance, good”. But, of course, not before first making it clear that “even when it’s very good, there are issues” and calling Olympic participation “a mixed bag”.

Now see, here is where I differ from the all mighty and powerful commission. If I was representing a group of owners, nearly half of whom lost money in 2009, I’d have another name for a national event like the USA v. Canada gold medal game that drew 27.6 million US viewers, the most that have watched a hockey game since Miracle on Ice. It would go something like, “The answer to all our prayers” or perhaps “eureka”.

There is too much to gain by participating. When the leagues marketing strategy can best be described as “preaching to the choir”, the Olympics succeed at doing something the league hasn’t, getting people who don’t watch hockey to watch hockey.

The question on everyone’s lips around the NHL was whether or not the game would get a “bump” based on the success of the Olympics. It was answered 3 months later when the 2010 Stanley Cup Finals became the highest viewed in 36 years.

But the issues taken with the broadcasting continue. Sure, Vancouver was the greatest thing to happen to the sport in the US since Al Michaels exclaimed that immortal phrase as the clock approach zeros in Lake Placid, but that kind of success could never be replicated outside of the continent, right? Definitely not if the broadcasts will be taking place between 4AM and 2PM EST.

If there is one sport
that hockey is ahead
of in the US peaking
order it's pro soccer.
Now here, Bettman might have a point … if three months ago ESPN didn’t take the South African hosted 2010 World Cup, broadcast it between 6 in the morning and 2 in the afternoon, and turn it into what can only be described as a national phenomenon. Ratings up 41% from 2006, and with the final match-up that set the record for US viewership of a men’s soccer game.

Or as Bettman would probably describe it, “being, on balance, good for soccer.”

So no matter what angle you try to take on the 2014 Sochi games, the NHL players are going to participate. Anything you hear between now and the point the deal is official that implies anything to say the contraire can only be summed up as political posturing.

And any person affiliated with the league or the players association who tell you anything besides “We love and are honored to participate in the Winter Olympics, we are working hard to come to an agreement with the IOC, and we fully expect to be back in 2014” is either playing you for a fool, or they themselves, “on balance”, are a complete and utter moron.

          Health care information,Health and Hygiene,FAQs,Major diseases,Minor diseases,First-Aid,Health Insur        
In this site,we will get all important information about health care.some important information about major diseases,minor diseases,its treatments&prevention etc.are discussed here.
          Pioneering Vascular Surgeon Researcher Health Care Educator Named as CEO        
Wake Forest Baptist Medical Center has named Julie Ann Freischlag, M.D., as its new chief executive officer (CEO). Freischlag joins the Medical Center on May 1 and succeeds CEO John D. McConnell, M.D., who last year announced that he would transition to a new position at the Medical Center, after leading it since 2008.   See the news coverage on CNBC, HealthLeaders Media, Becker’s Hospital Review, Sacramento Business Journal, Triad Business Journal, Winston-Salem Journal and Greensboro News and Record. Read the entire new release.
          Statement from UN Foundation President & CEO Kathy Calvin on New Restrictions of U.S. Foreign Assistance to Limit Women’s Access to Health Care Globally        

New restrictions jeopardize the health and well-being of the world's most vulnerable girls and women

(PRWeb January 23, 2017)

Read the full story at http://www.prweb.com/releases/2017/01/prweb14006959.htm


           Worried about your health care? Then don't let them cut EPA's budget.         
Thousands of Americans at this federal agency go to work every day to keep people out of the doctor’s office.
     

          COPD 9 Patient Education Workshop will Inform, Inspire and Empower Patients!        
Something very special will be happening in Chicago this June, and you’re invited. The international COPD9USA conference is a unique medical conference where top researchers, health care professionals, and patients, family members and caregivers not only co-exist in the same space, but are encouraged to interact – and even ask tough questions. COPD advocate Grace […]
          Health Care Volunteer Opportunities in Nepal Kathmandu        

Health Care Volunteer Opportunities:  Kathmandu, Nepal Ask someone to describe Nepal and you may hear them say exotic, mystical or enchanting.  Ask a local Nepali about their health care options and you’d likely hear the words insufficient or non- existent.  Nepal is one of the least developed Asian countries, with millions living in poverty with […]

The post Health Care Volunteer Opportunities in Nepal Kathmandu appeared first on Volunteer Abroad News.


          Poor People Don’t Need Good Health Care, They Just Need to Pray Harder        

Liberals are up in arms now that Congress is poised to pass the American Health Care Act. Just because 22 million people will be without access to a primary care doctor and prescriptions, liberal elites are pretending like all hope is loss. Scientific studies reveal the power of Christian prayer is just as effective as going to the doctor, especially for poor people.  Researchers found that a specific prayer technique called Proximal Intercessory Prayer unleashes a ‘divine healing’ upon the […]

The post Poor People Don’t Need Good Health Care, They Just Need to Pray Harder appeared first on ChristWire.


          India ranks 130th in Human Development Index: UNDP        

New Delhi: The United Nations Development Programme (UNDP) in its latest report has placed India`s Human Development Index (HDI) value for 2014 at 0.609, as the country climbed five spots to 130 in a list of 188 countries and territories.

Between 1980 and 2014, India`s HDI value increased from 0.326 to 0.609 -- an increase of 68.1 percent or an average annual increase of about 1.54 percent.

The HDI is a summary measure of assessing long-term progress in three basic dimensions of human development -- long and healthy life, access to knowledge and decent standard of living.

"India loses 28.6 percent HDI due to inequalities, largely due to inequalities in education (42.1 percent). Among BRICS, South Africa has the highest loss due to inequalities at 35 percent and lowest is for Russia at 10.5 percent," said a note circulated with the report.

On the Gender Inequality Index (GII), India ranks 130 out of 155 countries with a value of 0.563.

The GII reflects gender-based inequalities in three dimensions -- reproductive health, empowerment and economic activity.

The 2015 Global Human Development report by UNDP, named "Work for Human Development", was released on Monday in Ethiopia.

The report encourages governments to look beyond jobs to consider the many kinds of work such as unpaid care, voluntary or creative work that are important for human development.

As per the report, 2 billion people have moved out of low human development levels in the last 25 years.

The report shows that providing universal social protection in India could cost an estimate 4 percent of GDP.

Between 2000 and 2010, the number of direct jobs in information and communications technology in India jumped from 284,000 to more than 2 million.

As per the data provided in the report, only 39 percent of women in India were internet users compared to 61 percent of men in 2013.

The report cites that off-grid solar photovoltaic technologies will generate 90 direct and indirect jobs per megawatt in India.

For India, unpaid work, predominantly performed by women, is estimated at 39 percent of GDP.

It further stated that India`s workforce participation of women is declining -- from 35 percent in 1990 to 27 percent in 2013.

In 38 countries, including India, Pakistan, Mexico and Uganda, 80 percent women were unbanked.

Globally, 74 million youth were unemployed. In India, over 10 percent of youth were unemployed, the report says.

Haoliang Xu, assistant administrator and director of UNDP`s Regional Bureau for Asia and the Pacific, said: "The availability and quality of work are key for human development in Asia and the Pacific, a region that is home to two-thirds of the world`s working-age population.

"In order to ensure that the work-force is capable of adapting to rapidly changing demands, the governments need to make strategic investments into education and health care."

Commending the Indian government for its leadership role in the design and adoption of the Sustain Development Goals, Yuri Afansasiev, UN resident coordinator and UN resident representative in India, said: "With national development programmes like the National Rural Employment Guarantee Act, Skill India, Digital India, and Make in India in place, the government of India is on a strong footing for the SDGs.

"A greater focus on work, especially for women and youth will undoubtedly ensure success in the achievement of Agenda 2030."

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          As A Weight Administration Product, Nuratrim Functions!        

There are very few wellness related items that could claim duality.

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One connects to improving power levels, food digestion and metabolic process, while the other tackles and boosts, intestinal regularity.

To find out more Concerning Nuratrim Visit does nuratrim work

With greater power degrees, it is so much simpler to look at the inspiration to work out even more compared to ever, and thereby burn additional of those necessary extra calories.

While with boosted digestion additionally addressed, our system functions much more successfully at moderating the calories our physiques takes in from the meals we consume.

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Aided of course by its distinct mix of leading-edge, clinically shown, fat loss improving ingredients, it is gaining an excellent share of the fat burning supplement market.

So, what is in fact included in this mix that makes Nuratrim operates rather so effectively?

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Glucomannan: Attributes s wealthiest resource of soluble fiber and which promises to aid you discover your trick to wellness, physical fitness and vitality.

Licorice Extract: This not just reduces your physique fat, however it significantly removes physical body weight, physique mass index, and LDL cholesterol levels.

Eco-friendly Coffee: Baseding on an independent research, when utilized for an extended time, Environment-friendly coffee can lead to lower physique mass test amounts, and body fat deposits obviously, when compared to the use of typical instant coffee.

Capsicum Extract: Medical studies have actually also shown, that capsicum extract could aid burn approximately 278 more calories in the past, throughout and after working out on a treadmill for one hour.

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While several weighting loss tablet computers include amphetamines and guaranam, it has actually been shown that these stimulants have at the very least unpleasant negative effects that can, in some thoes, consist of, stress and anxiety, irritation and sleeping disorder.

Nuratrim, on the other hand, stays well clear of all fabricated ingredients, thus priding itself in being ONE HUNDRED per cent natural.

Nuratrim is simply taken daily, ideally in the morning with morning meal and a glass of water. Each container stands for a month s supply of 30 pills.

Even though Nuratrim is really highly regarded as a class-leading weight-loss item, it isn t for everyone.

Just like all weight loss products, Nuratrim really isn t advised for expectant women, or for children under the age of 18.

And once more, as prevails to all weight-loss products, it is recommended to first speak with your health care doctor before taking any kind of fat burning supplement.

The ingesting of any kind of caffeine-related item can at first have some affect on rest. Nonetheless, with Nuratrim, sleeping patterns are hardly ever also annoyed, just because of the very percentages of high levels of caffeine it contains.

Similar to any sort of item, potential customers will certainly always wish to know if the item that they are interested, in reasons any kind of harmful negative side effects. With Nuratrim, there are no such concerns, as it contains just ONE HUNDRED % natural ingredients.

However, we have to add this, that one of its natural active ingredients is a chilli remove, which naturally raises physique temperature level in order to burn fats better. This extract can, sometimes, offer some individuals, the feeling of exactly what us described by some as, moderate hot flushes, and undoubtedly, this has been mentioned by a quite little percentage of Nuratrim users.

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Nuratrim does appear as a result, to be among the best weight administration products on the open market, and without a doubt the majority of individuals concur, that there ought to be few bookings regarding utilizing it.

To find out more Regarding Nuratrim Visit nuratrim


          As A Weight Administration Product, Nuratrim Functions!        

There are very few wellness related items that could claim duality.

What do we suggest by that?

Well, Nuratrim takes on two distinct elements of weight administration.

One connects to improving power levels, food digestion and metabolic process, while the other tackles and boosts, intestinal regularity.

To find out more Concerning Nuratrim Visit does nuratrim work

With greater power degrees, it is so much simpler to look at the inspiration to work out even more compared to ever, and thereby burn additional of those necessary extra calories.

While with boosted digestion additionally addressed, our system functions much more successfully at moderating the calories our physiques takes in from the meals we consume.

Nuratrim s examine reduction product appears to have flawlessly satisfied BOTH of these duality criterion, and, not surprisingly, therefore, it has become one of the leading weight, health-related items on the marketplace today.

Aided of course by its distinct mix of leading-edge, clinically shown, fat loss improving ingredients, it is gaining an excellent share of the fat burning supplement market.

So, what is in fact included in this mix that makes Nuratrim operates rather so effectively?

Well, to begin with, let s have a look at the following, partial list, to see the perks that could be derived from Nuratrim:.

Glucomannan: Attributes s wealthiest resource of soluble fiber and which promises to aid you discover your trick to wellness, physical fitness and vitality.

Licorice Extract: This not just reduces your physique fat, however it significantly removes physical body weight, physique mass index, and LDL cholesterol levels.

Eco-friendly Coffee: Baseding on an independent research, when utilized for an extended time, Environment-friendly coffee can lead to lower physique mass test amounts, and body fat deposits obviously, when compared to the use of typical instant coffee.

Capsicum Extract: Medical studies have actually also shown, that capsicum extract could aid burn approximately 278 more calories in the past, throughout and after working out on a treadmill for one hour.

Thus, with this remarkable mix of active ingredients, it s little marvel that Nuratrim works so effectively in removing unwanted physique fat.

Nuratrim, created by Nuropharm Limited, is readily available throughout the world. While there are no high street stockists where you could buy Nuratrim, its creators are claiming that soon it will certainly be available.

While Nuratrim is not presently offered offline, it can of course be delivered right to your doorstep through internet stockists.

Judging from the forgoing, there are great deals of positives for Nuratrim. However, there are a couple of negatives.

One is, that however, Nuratrim is not appropriate for vegetarians and vegans. The item contains gelatin, something that all vegans and vegetarians purely stay clear of.

Nevertheless, others will be kindlied to understand that Nuratrim consists of a cocktail of proven, metabolic rate improving stimulants, that.

While several weighting loss tablet computers include amphetamines and guaranam, it has actually been shown that these stimulants have at the very least unpleasant negative effects that can, in some thoes, consist of, stress and anxiety, irritation and sleeping disorder.

Nuratrim, on the other hand, stays well clear of all fabricated ingredients, thus priding itself in being ONE HUNDRED per cent natural.

Nuratrim is simply taken daily, ideally in the morning with morning meal and a glass of water. Each container stands for a month s supply of 30 pills.

Even though Nuratrim is really highly regarded as a class-leading weight-loss item, it isn t for everyone.

Just like all weight loss products, Nuratrim really isn t advised for expectant women, or for children under the age of 18.

And once more, as prevails to all weight-loss products, it is recommended to first speak with your health care doctor before taking any kind of fat burning supplement.

The ingesting of any kind of caffeine-related item can at first have some affect on rest. Nonetheless, with Nuratrim, sleeping patterns are hardly ever also annoyed, just because of the very percentages of high levels of caffeine it contains.

Similar to any sort of item, potential customers will certainly always wish to know if the item that they are interested, in reasons any kind of harmful negative side effects. With Nuratrim, there are no such concerns, as it contains just ONE HUNDRED % natural ingredients.

However, we have to add this, that one of its natural active ingredients is a chilli remove, which naturally raises physique temperature level in order to burn fats better. This extract can, sometimes, offer some individuals, the feeling of exactly what us described by some as, moderate hot flushes, and undoubtedly, this has been mentioned by a quite little percentage of Nuratrim users.

But aside from that, it seems from all reports, that there is little else to bother with from ingesting Nuratrim.

Nuratrim does appear as a result, to be among the best weight administration products on the open market, and without a doubt the majority of individuals concur, that there ought to be few bookings regarding utilizing it.

To find out more Regarding Nuratrim Visit nuratrim


          Former Blackhawks Star Eddie Olczyk Diagnosed with Colon Cancer        

Former Stanley Cup champion and current NBC Sports analyst Eddie Olczyk is recovering from surgery after he was diagnosed with colon cancer.

"I have been diagnosed with a form of colon cancer and am currently undergoing treatment for the disease," Olczyk said in a statement released by the Chicago Blackhawks on Tuesday. "I have been working with outstanding health care professionals and expect to be back in the broadcast booth after I complete my treatment."

Blackhawks team physician Dr. Michael Terry added Olczyk "is recovering well from the procedure and will be undergoing further treatment in the coming weeks, including chemotherapy."

Olczyk, 50, spent 16 years in the NHL after he was selected third overall by the Blackhawks in the 1984 draft. 

By the time Olczyk retired in 2000, he had tallied 794 points on 342 goals and 452 assists. 

Since calling it quits, the 1994 Stanley Cup champion has served as the primary color commentator for NBC Sports' No. 1 hockey booth alongside Doc Emrick. 

Olczyk has also contributed to NBC Sports as a horse racing analyst, making regular appearances on the network's various television platforms during Triple Crown season. 

Read more NHL Central news on BleacherReport.com


          ObamaCare Repeal: Now Is the Time for Senate Republicans to Deliver        

Senate Majority Leader Mitch McConnell (R-Ky.) has indicated that he will bring an ObamaCare repeal bill to the floor early next week for a motion to proceed. For those not familiar with a motion to proceed, it's a procedural vote that allows the Senate to consider a piece of legislation on the floor.

Eventually, though, the Senate will vote on language similar to the 2015 ObamaCare repeal bill, the Restoring Americans’ Healthcare Freedom Reconciliation Act, which repealed much of the 2010 health insurance law and passed both chambers of Congress before being vetoed by President Barack Obama.

There are some uncertainties regarding what legislative language the motion to proceed will cover. Presumably, the motion to proceed will be based on the House-passed version of H.R. 1628, the American Health Care Act, and vote on the 2015-style repeal language as an amendment. The amendment would become the base text of H.R. 1628.

FreedomWorks has issued a key vote in support of the motion to proceed, which we will triple-weight on our 2017 Congressional Scorecard, to begin the amendment process, starting with the 2015 ObamaCare repeal bill as the base text.

Now, some may be wondering what the 2015 ObamaCare repeal bill entails. First, it must be noted that this bill can't be considered "full repeal" because it doesn't touch Title I of ObamaCare, which includes the costly mandates that are driving up the cost of health insurance premiums on the nongroup market. The bill, however, did repeal most of the other significant parts of ObamaCare.

Here are some of the major aspects of ObamaCare that the 2015 bill repealed or altered:

  • Premium tax credit (Section 202)
  • Cost-sharing subsidies (Section 202)
  • Small business tax credit (Section 203)
  • Individual mandate (Section 204)
  • Employer mandate (Section 205)
  • Medicaid expansion (Section 207)
  • Cadillac tax (Section 209)
  • Tax on health savings accounts (Section 211)
  • Prescription drug tax
  • Medical device tax (Section 214)
  • Health insurance tax (Section 215)
  • Tanning tax (Section 219)
  • Net investment tax (Section 220)

The full section-by-section of the 2015 ObamaCare repeal bill is available on the House Budget Committee website. There are a few things to note about the bill, though. The repeal of the reinsurance, risk corridor, and risk adjustment programs are no longer applicable, as these programs were transitional and expired at the beginning of 2017. Additionally, the individual and employer mandates weren't repealed, at least not in the true sense of the word. The penalties were zeroed out, though the mandates technically remained in statute.

At this point, there is a small group of moderates -- Sens. Shelly Moore Capito (R-W.Va.), Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), and Rob Portman (R-Ohio) -- who have gone on record saying that they would vote against a motion to proceed on a bill that repeals ObamaCare without a replacement. On December 3, 2015, Sens. Capito, Murkowski, and Portman voted to pass the Restoring Americans’ Healthcare Freedom Reconciliation Act, without a replacement. Sen. Collins, to no one's surprise, was one of two Republicans to vote against the bill. (There's a reason we have a press release template ready to go for when Sen. Collins votes against conservative priorities.)

From FreedomWorks perspective, and undoubtedly the minds of conservative grassroots activists, a vote against the motion to proceed is a vote to keep ObamaCare. There are no more excuses. With a Republican president urging the Senate to pass the 2015 ObamaCare repeal bill and pledging to sign it into law, we finally have the opportunity to accomplish a big victory. Don't let this moment pass.


          The CBO Reviews Trump's Budget        

The Congressional Budget Office (CBO) has released its analysis of the President’s Budget Proposal. In collaboration with the Joint Committee on Taxation (JCT), the CBO reviewed the President’s proposals to see what the likely impact would be were they implemented. What it found was a major reduction in spending that would reduce the deficit and promote economic growth.

President Trump has requested total discretionary appropriations of $1.15 trillion for 2018, but excluding the proposed net reduction the total comes to $1.17 trillion. Of that amount, defense spending will receive $668 billion which is a net increase of 5 percent from last year while nondefense spending will receive $499 billion which is a net decrease of 13 percent. Overall, that is 3 percent less than last year.

Between 2018 and 2027, the White House’s budget is projected to eliminate $3.3 trillion from the federal deficit. With these cuts in place, the amount of interest payments will be reduced by $300 billion. The totals to $4.2 trillion in its entirety, but there is a projected revenue decline of $900 brillion so that will result in the original reduction which is still a significant cut.

There are some other key reforms in the budget as well. Case and point, the proposal for “lowering the premiums paid by providers for medical liability insurance” and “reducing the use of health care services prescribed by providers when faced with less pressure from potential malpractice suits” would drive down costs by about $64 billion. Another part meanwhile would increase infrastructure spending by $200 billion. In addition, the largest savings will come from repealing Obamacare, which will total $1.25 trillion off the deficit. It also reduces subsidies for student loans which would save $100 billion and possibly drive down college costs as well.

It seems this would have an overall net positive impact on the economy. The percentage of the debt held by the public would total 80 percent by 2027, which is actually a decrease of 11 percent from the CBO’s current baseline. With that in mind, GDP growth would be higher as a result of the budget cuts by 0.2 percent than current projections in 2022 and 0.7 percent higher in 2027. That is a significant increase for economic productivity, though smaller GDP growth than the White House projected.

The new budget proposal significantly cuts spending. This would help spur economic growth which will be good for the country. The CBO highlights its positive impacts so this is definitely a step in the right direction.


          Abundance        

People who gush with hope and optimism about the future are few and far between. One of them is Peter Diamandis, a fifty-one year old aerospace engineer and medical doctor, who gives us an upbeat assessment in his book, Abundance: The Future Is Better Than You Think. (1) The key to a prosperous planetary future, according to Diamandis, is to "raise global standards of living," with special focus on the worst off, mainly Africans, whom he calls the "bottom billion." Abundance, he holds, starts with satisfying the basic needs of everyone on the planet, a goal toward which, he claims, significant progress has already begun. While Diamandis expects the developed nations and the U.N. to support the quest for abundance, he argues that three other ingredients are essential.

The first is Do-It-Yourself "maverick innovators" who relish a challenge and who work in small groups, usually independent of government and universities, to develop technological marvels. Since technology matures exponentially, he argues, it has a "staggering potential" to improve global standards of living. Diamandis gives dozens of examples of Do-It-Yourselfers who have changed the world. For instance, Dean Kamen built a device that purifies water with miniscule amounts of energy; Burt Rutan inaugurated private space travel; Chris Anderson invented the drone; and a small group of friends in California, who dubbed themselves the Homebrew Computer Club, spawned twenty-three companies, including Apple. (2)

The second is a new breed of wealthy and generous benefactors who are committed to improving the world. Most of them earned fortunes early in life, mainly in computers and mobile phones. He calls them techno-philanthropists. For instance, Bill Gates of Microsoft is spreading a vaccine around the world to combat malaria, and Jeff Skoal of e-Bay has awarded $250 million to eighty-one entrepreneurs working to improve life on five continents. (3)

The third is significant cash prizes, sponsored by techno-philanthropists, foundations, governments, and corporations, to induce competition among teams of Do-It-Yourselfers to tackle formidable global challenges. Diamandis cites many historical examples of the success of such prizes. For instance, the lure for Charles Lindbergh'sNew YorktoParisflight in 1927 was a $25,000 prize. Diamandis is convinced that such incentives can produce technological breakthroughs to bring the entire world safe water, abundant food, electricity, toilets and sewers, basic health care, housing, education, modern banking and transportation, and hundreds of low-cost products.

Diamandis's message is refreshing, even inspiring, but he may be written off as a

modern-day Dr. Pangloss, the pie-in-the-sky optimist in Voltaire's Candide, unless he overcomes a major hurdle - funding. Although his X PRIZE Foundation has attracted sponsors of cash prizes for six projects so far, it hopes to secure funding for more than eighty others. One wonders how much nations stricken with debts and deficits can help. Hopefully, many more of the world's wealthy, including the one-thousand billionaires, will step up to the plate.


 

  1. Free Press, 2012, 386 pages. Steven Kotler, a science journalist, assisted Diamandis with the book, and is listed as a co-author. Diamandis established theInternationalSpaceUniversityto promote space exploration, the X PRIZE Foundation to provide incentives for discoveries that can benefit millions of people, andSingularityUniversityto offer courses, degrees, and conferences about problems facing the world and their potential solutions. He took undergraduate and graduate engineering degrees from MIT and a M.D. from Harvard.
  2. Also, Tony Spear came up with the proposal to use air bags to cushion the landing of an unmanned rover on Mars, which worked, and Craig Venter fully sequenced the human genome in less that one year for less than $100 million. By contrast, the U.S. Government spent ten years and $1.5 billion to do this. Venter is now developing synthetic life that can manufacture ultra-low-cost fuels.
  3. Techno-philanthropists also subsidize dozens of organizations such as Camfed, led by Ann Cotton, which has educated over a quarter million girls in Africa, and the Acumen Fund, led by Jacqueline Novogratz, which has invested $75 million in seventy companies in South Asia andAfricato deliver affordable health care, water, housing, and energy to the poor.

© 2012 Tom Shipka


           A brief interactive training for health care professionals working with people affected by “female genital mutilation”: initial pilot evaluation with psychosexual therapists         
Elliott, Charmaine; Creighton, Sarah M.; Barker, Meg-John and Liao, Lih-Mei (2016). A brief interactive training for health care professionals working with people affected by “female genital mutilation”: initial pilot evaluation with psychosexual therapists. Sexual and Relationship Therapy, 31(1) pp. 70–82.
          The Ernest C. Manning Innovation Awards: The Strongest Families Institute        

Tackling the challenge of providing mental health care from a distance

The post The Ernest C. Manning Innovation Awards: The Strongest Families Institute appeared first on Macleans.ca.


          Is Socialism Coming?        

In the United States today health care reform is front and center. President Obama has stumped for reform in dozens of appearances across the nation, an address to the Congress, and no fewer than five televised news shows last Sunday. On a daily basis the media report the latest wrinkles in a spate of health care proposals under discussion in the Congress and speculate on the political prospects of the President's preferred "public option."

In the health care debate, as in the government bailout of failing banks and two major U.S. auto producers, some critics of the White House invoke the "S" word – socialism. They warn that America is abandoning its historic commitment to limited government, private ownership, and the free market in favor of a welfare state, public ownership, and a planned economy. Such critics, including those attending TEA (Taxed Enough Already) parties, seem to share Ronald Reagan's distrust of government. Government, they believe, is the problem, not the solution. Government, they tell us, is inept, it covets more and more power, it steals from producers to support parasites, it threatens our liberties, and it saddles future generations with enormous debt. (1) Setting aside the voices of dissent from the radical fringe - the birthers, the conspiracy theorists, those who vilify the President as a liar, and those who construe his pep talk to the nation's students as socialist propaganda - let's engage the central issue: Is the United States abandoning capitalism for socialism?

Let us understand that under socialism the government owns and administers the productive apparatus of society and provides all the goods and services, and by contrast, under capitalism individuals and companies own and administer the productive apparatus of society and provide all the goods and services with the possible exception of law enforcement and national defense. Now, where can we find examples of these two systems in practice? The fact is that we can't because the dominant economic system in the world today is a mixed one. A mixed economy incorporates elements of socialism and capitalism, although the mix differs from nation to nation. When a good or service is provided by a public source in a society, there is a socialist component; when a good or service is provided by a private source in a society, there is a capitalist component.

Thus, if you want to see socialist components in the United States, look no farther than the Grand Canyon National Park, Social Security, Head Start, Medicare, Medicaid, the U.S. Postal Service, food stamps, police and fire departments, Youngstown State University, the Canfield public schools, the Public Library of Youngstown and Mahoning County, and the Mill Creek Metroparks. (2) Similarly, if you want to see capitalist components in the United States, look no farther than Disney World, the stock market, McDonald's, Wal-Mart, Amazon.com, Microsoft, Omaha Steaks, UPS, ESPN, Grove City College, Farmers National Bank, the Exal Corporation, and Handel's Ice Cream.

It seems clear to me that the U.S. is not abandoning capitalism for socialism. Rather, it continues to blend elements of both systems. Although the specific jurisdictions of the public and private sectors in America will change in the future as they have in the past, our economic hybrid is here to stay for the foreseeable future.


  1. See, for instance, the recent statements of the Atlas Society, a group which seeks to perpetuate the ideas of Ayn Rand, an advocate of laissez-faire capitalism. See www.atlassociety.org.
  2. One of the ironies in recent weeks is a mother objecting to her child hearing a talk in his public school by President Obama because she wanted to shield him from "socialist propaganda." Public schools are a socialist component in America. If Americans were pure capitalists, there would be only private schools.

© 2009 Tom Shipka


          What's Next for Health Care After GOP Plan Failed?        
HHS Secy. Tom Price and Senator Susan Collins (R-ME) join Chuck to break down the latest on the GOP's health care plan after their failed vote. Plus, Corey Lewandowski joins to talk West Wing shake-ups.
          'Thousands of People Will Die:' Sanders on Health Care Bill        
Missed MTP? Catch highlights in this week's ComPRESSed.
          Faith Based Policies        

In 1899 the U.S. Supreme Court issued an important decision on whether government may constitutionally grant public funds to a religious organization. In Bradfield v. Roberts the Court ruled that the District of Columbia could pay a hospital in Washington operated by an order of Catholic nuns to provide a secular service to the poor health care. (1) Under this ruling, many religious groups received public funds without controversy year after year. Typically such groups did not seek to proselytize their clients, only to serve them, and used no religious test in hiring and firing. When George W. Bush was elected President, however, he created a White House Office of Faith-Based and Community Initiatives with the intent to distribute much more tax dollars to religious organizations and he issued executive orders which changed past practice. Now such groups could mix sectarian and secular activities and could use religious criteria to hire and fire. (2) Challenges to the Bush program in the courts were unsuccessful.

As a result, many who were opposed to President Bush's faith-based programs turned to candidate Barack Obama for hope and he seemed poised to deliver relief if elected. For instance, in a speech in Ohio on July 1, 2008, he said:

"First, if you get a federal grant, you can't use that money to proselytize to the people that you help and you can't discriminate against them or against the people you hire " on the basis of their religion. Second, federal dollars that gob directly to churches, temples, and mosques can only be used on secular programs. And we'll also ensure that taxpayer dollars only go to those programs that actually work." (3)

Based in part on these affirmations, Mr. Obama won solid support from civil libertarians and other supporters of separation of church and state, including millions who identify themselves as secular or non-religious. No fewer than 75 percent of the secular community voted for him. (4)

Since his election, however, Mr. Obama seems to have done a U-turn. He has left the Bush executive orders intact, he has retained the Bush White House Office of Faith-Based and Community Initiatives, and he has hired a 26-year old Pentecostal minister to run it. Seculars are disappointed and angry. For example, the current issue of Free Inquiry, a magazine that has a huge readership in the secular community, features no fewer than five articles critical of President Obama's early decisions on faith-based programs. (5) Seculars are not the only ones concerned. The Pew Research Center reports that 73 percent of Americans object to religious groups being allowed to discriminate in hiring and firing, and 61 percent oppose proselytizing of clients by religious groups who receive public funds. (6)

President Obama should either shut down the faith-based programs altogether or issue new rules to prevent proselytizing and discrimination in employment in them. He should also order that such programs be evaluated by the General Accounting Office or some other competent agency to determine their effectiveness. Only programs which successfully achieve their secular goals should be refunded.


 

  1. See Rob Boston, The Faith-Based Initiative 2.0: Can We Unplug It? Free Inquiry June/July 2009, p. 3.
  2. President Bush denied that he authorized proselytizing but his failure to require monitoring of expenditures permitted and encouraged sectarian activities.
  3. Quoted in Rob Boston, p. 34.
  4. Rob Boston, p. 34.
  5. See pp. 26-40, Free Inquiry June/July 2009. The authors are Daniel Horowitz and Ruth Mitchell, who present an official position paper of the Council for Secular Humanism; Rob Boston, a senior policy analyst at Americans United for Separation of Church and State; Susan Jacoby, a specialist in American intellectual history; D. J. Grothe, an associate editor of Free Inquiry; and Ronald A. Lindsay, a lawyer and bioethicist who is CEO of the Center for Inquiry/Transnational.
  6. Rob Boston, p. 34.

© 2009 Tom Shipka


          Ted Kennedy's Legacy        

A team of reporters and an editor from The Boston Globe have published a book entitled Last Lion: The Fall and Rise of Ted Kennedy which gives us a thorough, objective study of Joseph and Rose Kennedy's youngest child. (1)

The reader will find in the Last Lion much that is familiar. Ted was born into a family of wealth and privilege in 1932 when his mother was forty-one because, as a devout Catholic, she refused to use birth control. (p. 13) Joe was often away making money, courting women, including actress Gloria Swanson, or serving as FDR's ambassador to Great Britain. (p. 17) Rose agreed to ignore Joe's adultery in exchange for what some euphemistically called "retail therapy," that is, shopping to her heart's content in the United States and Europe. (p. 29) Also, Joe set up a $1 million trust fund for each of his children in the hope that lifetime financial security would free them to devote themselves to public service. (p. 17)

Further, we learn that as Ted grew up, unlike his siblings, he struggled in school. His parents transferred him so often that by age eleven he had attended ten schools. (p. 26) Despite his mediocre academic record, Ted followed his brothers Jack and Bobby to Harvard where he was suspended during his first year for cheating on a Spanish test. (p. 38) After a stint in the U.S. Army, he returned to Harvard, completed his degree, and, following the family tradition, enrolled in law school at the University of Virginia where he and his partner eventually won the moot court competition. (p. 53) We also learn that after the death of Jack and Bobby, Ted became a surrogate father to their children with mixed results. After his first marriage failed, Ted married Vicki Reggie, a divorcee with two children, with whom he built a stable marriage which thrives today. (p. 290) We also learn much about Chappaquiddick but we still get no credible explanation of why the Senator waited nine hours to report the fatal accident to the local police. (pp. 145-168)

The reader of the Last Lion will also find some new and surprising information about Senator Kennedy's legislative record. During his forty-seven years in the Senate, he has authored some 2,500 bills, three-hundred of which are law. (p. 396, p. 403) He has played a pivotal role in the passage of virtually every law in the past half century in civil rights, health care, immigration, and education. His achievements include the Americans with Disabilities Act; Head Start; the Women, Infants, and Children program; Health Maintenance Organizations; the No Child Left Behind Law; increases in financial aid for college students and for cancer research; the Immigration Act of 1965; the Ryan White Act for AIDS research; and hundreds of others. Understandably, Senator John McCain has described Ted as "the most effective member of the Senate." (p. 387) Other senators from both sides of the aisle have echoed this tribute, including Orrin Hatch of Utah. (pp. 322-337, p. 387) (2)

Although many will remember Ted Kennedy for his family's tragedies and his personal excesses, his enduring legacy to the nation is a remarkable legislative record built on his personal charm and political savvy, his intense study of proposed legislation, his readiness to reach across the aisle, and his belief that a half a loaf is better than none.


 

  1. Simon & Schuster, 2009. Senator John McCain's characterization of Kennedy as "the last lion in the Senate" accounts for the title of the book. The reporters are Bella English, Neil Swidey, Jenna Russell, Sam Allis, Joseph P. Kahn, Susan Milligan, and Don Aucoin and the editor is Peter S. Canellos.
  2. Hatch tells a story about a letter he received from a senior citizen in southern Utah which said: "Senator Hatch, when we heard you might run for office, we supported you. When you actually ran for office, we voted for you. And when we heard that you were friends with Senator Kennedy, we prayed for you." (p. 332.)

© 2009 Tom Shipka


          Health Care Defeat Proves Washington is Broken        
OMB Director Mulvaney said, “Washington was a lot more broken than Pres. Trump thought," based on health care defeat
          What Ever Happened to Jefferson and Madison?        

The most recent book of Pulitzer Prize-winning historian, Garry Wills, is Head and Heart: American Christianities. The chapters on religion during the Revolutionary Era show how far the USA today has drifted from the plan of our founders (1).
Wills explains that the founders believed that to build an enduring republic they would have to minimize the impact of religion on government. They were keenly aware of the blood that was spilled in the Crusades, the Inquisition, the persecution of the Jews, and the religious wars in Europe in the 16th and 17th centuries, and they saw first hand religious intolerance in the colonies. They also agreed with British philosopher, John Locke, (2) that human beings have a natural right to form their own beliefs on religion based on reason and conscience, that the duly-constituted government must possess a monopoly of power, that churches are subordinate to the State and its laws, and that churches may use only admonitions and exhortations, and never coercion, in dealing with their members or non-members.
Wills tells us that Jefferson and Madison led the battle to build a lasting new republic based on the separation of government and religion. Jefferson's insistence on this is found in his "Bill to Establish Religious Freedom" in Virginia, his Letter to the Danbury Baptists, and his behavior as President. The Virginia statute disestablished the Anglican Church and ended the practice of taxing Virginians to support it (3). In his Letter to the Danbury Baptists, Jefferson characterized the Virginia statute, and the Constitution, as erecting "a wall of separation between Church and state." During his presidency, he refused to issue prayer day proclamations (4). As for Madison, Father of the Constitution, the Constitution, his essay against compulsory taxation to support churches (5), the "Federalist Papers," and his behavior as President show his agreement with Jefferson. Madison insisted on religious liberty for all and required churches to tolerate one another. He also opposed a religious test for public office and government support for a particular church or for religion in general. Like Jefferson, he opposed prayer day proclamations (6). He also opposed paying chaplains with public funds, tax exemptions for churches, government-endorsement of religious charities, and allowing churches to acquire extensive wealth (7).
Thus, our founders were deeply fearful of sectarianism and they aimed to disentangle religion and government (8). Although contemporary political leaders pay lip service to Jefferson and Madison, few follow their lead. Today most politicians pander to religious groups and their leaders. The White House sends hundreds of millions of dollars to religious charities, the Justice Department hires only applicants who pass an evangelical litmus test, atheists or agnostics are unelectable to high office, pastors openly defy IRS rules about partisan political activity, forty states exempt parents who subscribe to faith-healing from prosecution for denying medical care to their sick children, embryonic stem cell research is halted, and Genesis myths trump science in many classrooms. The list goes on and on (9). Today, religion rules. Whatever happened to Jefferson and Madison?


 

  1. See "Part Two: Enlightened Religion," Chapters 7-14, pp. 121-249.
  2. Locke's writings had a powerful influence on our founders. The doctrines of natural rights, limited government, government by consent, majority rule, the separation of powers, the legitimacy of revolution or rebellion against an illegitimate government, the separation of church and state, and others, are found in his First Treatise of Government, Second Treatise of Government, and Letter Concerning Toleration.
  3. Jefferson's "Bill for Establishing Religious Freedom" provides, in part, that "...no man shall be compelled to frequent or support any religious worship, workplace, or ministry whatsoever, nor shall (he) be enforced, restrained, molested, or burthened in his body or goods, nor shall (he) otherwise suffer, on account of his religious opinions or belief; ...all men shall be free to profess, and by argument to maintain, their opinions in matters of religion, and the same shall in no wise diminish, enlarge, or affect their civil capacities." (Quoted in Wills, p. 196)
  4. Wills, p. 237.
  5. "Memorial and Remonstrance." See Wills, pp. 207-222.
  6. Madison reluctantly issued a prayer day proclamation during the War of 1812, a decision he later regretted.
  7. Wills, pp. 242-247. On the issue of church wealth, Madison was fearful that wealthy churches would attempt to exert political influence.
  8. Wills shares two "laments" with readers by individuals who recognized, and apparently regretted, the secular origins of our nation.
  9. a. In 1812 Timothy Wright wrote:
  10. "We formed our Constitution without any acknowledgement of God, without any recognition of His mercies to us as a people, of his government, or even of his existence. The Convention by which it was formed never asked, even once, his direction or his blessing upon their labors. Thus we commenced our national existence, under the present system, without God." (Quoted in Wills, p. 223)
  11. b. In 1813 Chancey Lee wrote:
  12. "Can we pause and reflect for a moment, with the mingled emotions of wonder and regret, that that public instrument which guarantees our political rights and freedom and independence - our Constitution of national government, framed by such an august, learned and able body of men, formally adopted by the solemn resolution of each state, and justly admired and celebrated for its consummate political wisdom - has not the impress of religion upon it, not the smallest recognition of the government or the being of God, or the dependence and accountability of men - be astonished, O Earth! - nothing by which a foreigner might certainly decide whether we believe in the one true God, or in any God." (Quoted in Wills, p. 223-224)
  13. Other examples include vouchers and other forms of government support of religious schools, displays of nativity scenes on public property, allowance of Christian proselytizing in the military academies, support of proselytizing by Christian ministries in jails and prisons, prayer breakfasts sponsored by public officials, legislative prayers, office holders and candidates closing speeches with "God bless you and God bless America" or a variation, newly-elected presidents utilizing a Bible during their oath and adding "So help me God" to the presidential oath provided in the Constitution, highly publicized efforts by office-holders to block the disconnection of life support systems from individuals in persistent vegetative states, such as Terri Schiavo, stacking boards of education with evangelicals, evangelical opposition to bills promoting children's rights, state referenda defining marriage as the bond between one man and one women, "In God We Trust" on currency, "One Nation Under God" in the Pledge of Allegiance, government "sex education" programs promoting abstinence only and ignoring condoms and the pill, the White House and others promoting the teaching of intelligent design alongside evolution, opposition to casino gambling by evangelicals and their political patrons in some states, the placing by the State of Utah of 12-feet crosses at the sites of state highway patrol officers who died in the line of duty, a 36-year old "Free Day Away" program at Fort Leonard Wood in Missouri where trainees may leave base provided that they participate in a religious program conducted by the Tabernacle Baptist Church of Lebanon, Missouri, incorporation of religion into the health care programs of the U.S. Department of Veterans Affairs, etc.

© 2008 Tom Shipka


          Know the Different Health Benefits of Wearing Hijab         

The term Hijab means “barrier” or “to cover.” Women wearing hijab possess more confidence and strength as they were less mindful of their appearance and physique. There are a number of health benefits of wearing hijab and some scientific studies recommend that hijab is the best choice for women.

Hygienic Purposes

For the hygienic purpose, head cover is used by doctors, nurses, health care providers, fast food workers, restaurant workers and servers, deli counter workers and much more. Even the public can use the hijab for hygiene purpose while driving two-wheelers to protect their hair and skin from dust.

Prevent Skin Diseases

It is scientifically proven that hijabs or head cover can prevent the cause of various skin diseases like Sunburn, Solar keratosis, Solar urticarial, etc.Since hijab can prevent direct sunlight on your skin, you can avoid many skin diseases caused due direct sunlight and dust.

Skin cancer is a result of direct exposure to the sun, particularly during 10 am to 4 pm. Scientists believe that UV rays from sunlight can damage DNA present in your skin cells which caused cancerous tumors. The possible areas of skin cancer are the face, arms, palms, and calves. The UV rays will damage the antibody cells that are present on the skin surface. As a result, the cancer tumor grows faster. These rays can also affect the beauty and health of your skin.

Psychological Balance

Women wearing hijab feel more comfortable and possess confidence during their interviews. Studies reveal that there is a connection between what they wear and their insights of how successful they will be in their interviews.


          Electronic Medical Billing Software Maintaing Privacy        
Medical billing software is used by a variety of health care providers on a daily basis to keep track of accounts and to determine the amount of how much has been paid in total and how much is left to still be paid through claims and invoices. Due to the many changes within the medical […]
          Black Salve feedback        
     …   The following are testimonials that have been emailed to me.  Always seek the advise of a qualified health care practitioner when using any health treatment.  There are many bogus salves on the market, if you can’t make your own, try http://BestOnEarthProducts.com …  This great product is now available in SA at […]
          Statement on American Health Care Act (AHCA)        
The South Carolina Autism Society has bee following the the proposed American Health Care Act (AHCA), and we share the concerns of our fellow advocates as to how these cuts will affect people with disabilities. The AHCA will cut an estimated $800 billion from Medicaid over the next 10 years.  If these cuts occur, what […]
          Ed Broadbent testifies to the House of Commons Finance Committee on income inequality        


*CHECK AGAINST DELIVERY*

Last September, the Broadbent Institute issued a major discussion paper Towards a More Equal Canada, which addressed the issue of rising economic inequality. For every $1 increase in national earnings over the past twenty years, more than 30 cents have gone to the top 1% of earners, while 70 cents have had to be shared among the bottom 99%.  Middle class incomes have now been stagnant for thirty years.

Today is the deadline for filing personal income tax returns. It is a day to remind ourselves that our tax system could move us to a more equal Canada if we made the system fairer, with a particular focus on expanding tax credits for low and middle income Canadians.  Canada’s poverty rate is, at 8.2% for children and 10.1% for working-age adults in 2010, far too high and could be reduced significantly through the targeted measures we propose.

Our discussion paper drew upon the work of many distinguished experts, examined the causes and consequences of the growth of economic inequality over the past thirty years, and set out a broad policy framework to reverse the trend and lead us back to a more equal Canada.

We have just released another paper “Union Communities, Healthy Communities” that highlights the importance of a strong labour movement in building a more equal Canada.  And we have also published more than twenty responses to our reports from a wide range of points of view, as well as the results of an independent poll of Canadians that revealed their opposition to the growth of inequality and their strong support for corrective measures.

Extreme economic inequality undermines democracy and the common good. Very unequal societies do much worse in terms of both social and economic performance, including in such fundamental terms as health and life expectancy, social mobility (equality of opportunity for children), crime levels, the quality of democracy, and levels of social trust.

The level of inequality in a nation is ultimately a matter of political choice. While it is true that rising inequality is due in significant part to fundamental economic changes such as globalization and technological change which are difficult to manage, it is equally true that some advanced industrial countries have been able to remain much more equal than others. Political choices matter. The empirical evidence – from Canada, the US, Europe and the OECD – is clear. 

The rise of extreme income inequality has been much greater in those countries which have most strongly embraced a fundamentalist so-called free market agenda, and much less in those countries which have continued to believe in the need for shared progress.

The Broadbent Institute believes that we must, as a society, strike a balance between the roles of the market and democratic government in determining the distribution of economic resources.

The market, properly regulated, is a useful tool for creating wealth. But democratic governments must ensure that that the needs of all citizens, such as access to health care and education as well as the means to secure a decent livelihood, are met regardless of the level of wealth and income acquired through the market. 

A very important goal of democratic governments should be to protect and promote not only political and civil rights but also to promote social and economic rights. This is essential to secure genuine equality of opportunity, and to ensure fair outcomes for citizens. It is why Canada signed on to the two UN covenants that include both categories of rights in the mid 1970s.

Research by the OECD and the Conference Board among others shows that Canada used to do quite well at striking a balance between having a growing market economy and securing a fair distribution of the fruits of economic growth. But cuts to social programs and public services as well as changes to transfers (income support programs) and the personal income tax system since the mid 1990s have compounded the rising inequality which has been delivered by the market economy

Growing inequality of market income has, as shown in our recent paper Union Communities, Healthy Communities, been driven in significant part by the decline in union density and bargaining power since the 1980s. Respect for labour rights by governments enables unions to ensure that the gains of a growing economy are equitably shared with workers, and collective bargaining has been shown to narrow pay differences, especially pay gaps between women and men. 

Another major part of the problem has been the increase in precarious employment, meaning that more than one third of working Canadians do not have permanent, full-time paid jobs. Many fall below the poverty line due to low hourly wages and/or not enough weeks of work. These issues have been highlighted in recent reports from the Law Commission of Ontario and the United Way. Yet we have failed to support these struggling workers and their families through the tax system and through improvements to basic employment standards.

As recognized in the Broadbent Institute discussion paper on inequality good jobs are the basic building block of successful societies, and a successful economy combined with strong labour rights is a major force for equality. It has been well documented that countries with strong trade union movements are much more equal in terms of the distribution of market income, and that such countries also tend to be prepared to invest more to promote greater equality through public services and social programs. Canada’s already acute inequality problem will become much worse if  Canada imports from the United States so called right to work laws, as well as legislation that limits the ability of the labour movement to act as political advocates for their members and all workers. Bill C-377, passed by the House of Commons and now before the Senate, singles out unions for highly onerous reporting requirements under tax law which do not apply to the activities of other associations, including business associations. 

Providing key services to citizens outside of the market mechanism is crucial to promoting the goal of greater equality. Our public health care system provides important rights, and these should be extended by ensuring that all citizens have a right to prescription drug coverage and to home and elder care as needed by reason of disability or old age. There is perhaps no more powerful tool for securing real equality of opportunity than major public investments in education, from child care and early learning through post secondary education and adult learning.

As requested by the Committee and spelled out in the motion, this brief will focus on the role of the tax/transfer system in promoting greater income equality. 

Providing a basic income-tested guarantee to all citizens through a fairer personal income tax system would be a powerful force for greater equality.

The tax/transfer system equalizes income in two important ways first, progressive income taxes mean that the affluent pay to governments a higher percentage of income earned in the market than do middle and low income earners. 

Second, these taxes help finance income transfer programs (such as public pensions, Employment Insurance, child benefits and refundable tax credits) which benefit those who have middle and low incomes more than those with high incomes. The result is that incomes after taxes and transfers are more equal than incomes earned in the market.

Statistics Canada data (CANSIM Table 202-0703) show that the top 20% of Canadian families receive 47.0% of all market income, but a lower 40.0% percent of all income after taxes and income transfers. The bottom 20% receive just 3.4% of all market income, but a higher 7.1% of all income after taxes and transfers. The middle class (the middle income quintile) has about the same share of market and after tax and transfer income (16.0% and 17.2% respectively).

The Centre for the Study of Living Standards calculate that the income tax/income transfer system reduces inequality as measured by the Gini co-efficient by 24%, with the transfer system having about twice as great an equalizing impact as the personal income tax system.

However, while our tax/transfer system remains modestly re-distributive, the fact remains that we still have a very unequal distribution of income after the impact of taxes and transfers has been taken into account. And, according to the OECD, the re-distributive impact of the system in Canada has been declining since the mid 1990s. 

The Centre for the Study of Living Standards has also shown that the inequality reducing role of the tax/transfer system in Canada has been falling, and is now 20% below the OECD average. The major reason for the decline in redistribution has been the cuts to social assistance and Employment Insurance programs of the mid 1990s combined with our failure to respond to the growth of more precarious and low paid work.

What major changes might we make to our tax/transfer system?

The Broadbent Institute believes that we should embrace the goal of a basic income guarantee sufficient to eliminate poverty and to help close the growing gap between low and higher income Canadians.  

This goal should be met by building incrementally on existing income support programs targeted to different age groups and by promoting greater tax fairness.

Step 1:  The Broadbent Institute supports the long-standing position of Campaign 2000, other anti poverty groups and research institutions that the maximum level of income-tested child benefits should be raised to cover the full cost of raising children. 

Canada has a basic income guarantee for children in the form of refundable federal child benefits (with additional contributions by some provinces.)  Child benefits are delivered through the income tax system and are “refundable”, meaning that they are paid even to tax filers who do not have a tax obligation. Benefits are paid on a regular basis and are changed as family income changes from year to year. 

Research by the Caledon Institute among others shows that Canada’s system of income-tested child benefits has been effective in reducing (though far from eliminating) child poverty, and still pays significant amounts to middle-class families to help meet the costs of raising children. The problem is that the maximum benefits paid by Canada Child Tax Benefit and the National Child Benefit Supplement fall well short of the costs of supporting children.

The cost of raising these child tax credits should be offset in part by eliminating the poorly targeted Universal Child Care Benefit.

Step 2:  We should significantly increase the federal Working Income Tax Benefit to support working poor individuals and families and to deal with the growing reality of low pay and precarious work.

The greatest gap in the current architecture of Canadian income support programs is for the working age population, especially the growing part of this population who are employed in precarious and low-paid jobs. The working poor and near poor -– those who move in and out of low paid jobs but often fail to attain a decent standard of living – is disproportionately made up of recent immigrants, especially those belonging to racial minorities, persons with disabilities, women single parents, the single near elderly, Aboriginal Canadians, and young people trying to get into secure employment.

Credit should be given to the present federal government for creating the Working Income Tax Benefit, a new form of benefit which has been shown in the US and elsewhere to reduce poverty while promoting employment as the best path out of poverty.

However, the current benefit is extremely modest (less than $1,000 for a single person and less than $1,800 for a family) and is lost completely at low levels of employment income ($18,000 for a single person and $27,000 for a family).  

The maximum benefit should be increased significantly and phased out more slowly as income rises so that recipients are always better off if they find more weeks and hours of work or find better-paid jobs. 

Increases to the Working Income Tax Benefit should be matched by incremental increases in minimum wages to raise incomes and also to ensure that income supplements for the working poor do not become subsidies to low wage employers. Minimum wages should be set at a level sufficient to ensure that a single person working full time for a full year does not live in poverty.

Improving conditions for low wage workers will also involve raising minimum employment standards covering issues such as hours of work, rights of part-time workers and pay and employment equity, pro actively enforcing such standards, facilitating access to unionization, and greatly expanding skills training programs for unemployed and under-employed workers. 

Canada ranks among the bottom of OECD countries in terms of adequate income support for the unemployed. Our Employment Insurance system currently fails to provide benefits to 60% of unemployed workers even though all workers and their employers pay into the system. We must reform EI so that we provide income security to all persons who experience temporary involuntary unemployment.

Step 3:  Eliminate poverty in old age. 

Canada already has a basic income guarantee for seniors in the form of the Guaranteed Income Supplement (GIS) to Old Age Security (OAS). The GIS is gradually phased out as income rises and is currently received by about one in four seniors. The fact that the OAS plus the maximum amount of GIS is very close to the poverty line means that very few seniors live in poverty. Indeed, the fact that Canada has the lowest poverty rate for seniors among the advanced industrial countries is evidence of a very successful public pensions policy dating back to the 1970s. However, the GIS does need to be raised to ensure that provides all Canadian seniors with an adequate standard of living, particularly single women seniors in large urban areas who are most likely to experience poverty.

Step 4:  As a long term goal – and this would clearly involve complex negotiations with the provinces –- we should abolish welfare as it currently exists and replace it with an income support program for working-age adults delivered through the tax system in the form of a negative income tax. This program would deliver regular benefits based on family income, phased-out as income from employment and other sources rises.  

Canada’s income security program of last resort, social assistance, paid for by the provinces, provides meagre and stigmatizing benefits which are, as shown in reports by the recently abolished National Council of Welfare, far below the poverty line for almost all family-types in all provinces.

The aim has been, as in the Victorian era Poor Laws, to ensure that even extremely low wage jobs will deliver more income than does welfare. Yet the evidence shows that the vast majority of recipients who are able to engage in paid work do, in fact, seek to work.

Social assistance is of no help to the working poor. A recipient must be unemployed, have no access to family income, and must have exhausted almost all assets in order to qualify. Benefits are cut off after only a very few days of work. At the same time, it is very difficult for many recipients, especially persons with disabilities and single parents of young children, to climb the “welfare wall” since leaving social assistance often also means giving up health and housing benefits and since the needed supports and services, such as affordable child care, are not in place.

The aim would be to ensure that working age adults with no or very low incomes from paid work, unemployment insurance, disability benefits and other sources receive a supplement which would be sufficient to secure an acceptable basic income. The supplement would be phased out with rising income rather than being turned off as soon as a person starts to receive employment income. Such a supplement could be partly financed by folding in some current tax credits such as the GST credit.

Such an alternative, a negative income tax, has been broadly championed across the political spectrum, including by Senator Hugh Segal in his published response to the Broadbent Institute paper on inequality, and by the late Tom Kent, the prime architect of Canada’s social reforms of the 1970s, who wrote the first paper published by the Institute. 

Without addressing the complex issues, there is also a pressing need for reform and improvement of disability benefits.

Step 5:  Improvements to income support programs could and should be financed by making our income tax system much fairer. 

The incomes of the top 1% have risen from 7% to 11% of the total income of Canadians since the early 1980s, while the incomes of middle-class and working Canadians have increased little in real terms. The rising share of the top 1% is the main reason why market income inequality in Canada increased so significantly from the early 1980s to 2009.

Recent Statistics Canada data show the effective income tax rate on the top 1% has fallen from 39.4 per cent to 33.3 per cent since 2000, and the effective income tax rate on the top 0.1 per cent of Canadians, whose incomes start from $685,000 and average $1,519,000, has fallen sharply from 41.6 percent to 35.4 per cent.  Thus, even as the income share of very high income earners has risen, their effective tax rate has fallen significantly. As we have said before, we should consider changes to top income tax rates.

We should also scale back special tax breaks that deliver huge benefits to the very well off, such as the exclusion of 50% of capital gains incomes from taxes and low tax rates on gains from stock options. (It is reasonable only to tax capital gains above inflation over the period for which assets were held.) We should also be cracking down on tax avoidance by the very rich through offshore tax havens and other means such as sheltering income and wealth within private companies and family trusts. It is time to crack down on the tax cheats who undermine government finances and public belief in the fairness of the tax system, and the present federal government should be commended for their 2013 Budget proposals in this area. Additional revenues can also be gained by more broadly applying the principle of “polluter pay.”  Our current tax system allows corporate polluters to offload risk and current and future payments for cleaning up their mess to individual taxpayers.  This isn’t fair, and needs to be changed.

There is much more to dealing with inequality than reforms to the tax/transfer system. However, changes in this area could narrow the widening gap between the very affluent and the middle class, and also lead us closer to the goal of eliminating poverty in Canada.

In summary, concrete steps can be taken to make our tax system a much more effective vehicle for closing the growing gap in Canada between the very rich on the one hand, and the middle class and the poor on the other. The priority should be to eliminate poverty by expanding refundable tax credits, especially for the working poor who fall through the cracks of our current income support system. Our tax system would also be much fairer if we closed special tax loopholes for the very affluent, ensured that corporations pay to clean up their own mess and cracked down on tax cheaters.


          Bill Crawford praises John McCain        
Recited the Pledge of Allegiance lately?

Once upon a time in America school children were required to stand, face the flag, and recite the pledge each morning.

Remember how it goes?

"I pledge allegiance to flag of the United States of America, and to the Republic for which it stands, one nation under God, indivisible, with Liberty and Justice for all."

Well, did you ever mean it when you said it?

The core of the pledge was written in 1892 by Baptist minister Francis Bellamy. In 1942 Congress officially adopted a slightly revised pledge. Then, in 1954, at the urging of the Knights of Columbus, Congress added the words “under God.”

Bellamy's job was to develop a flag salute as part of a celebration of the 400th Anniversary of the Discovery of America by Columbus. He sought to instill a love of country in America’s school children. President Benjamin Harrison proclaimed, “Let the national flag float over every schoolhouse in the country and the exercises be such as shall impress upon our youth the patriotic duties of American citizenship.” Thus, on celebration day, millions of school children first recited the pledge.

Love of country is supposed to be the tie that binds us into "one nation under God, indivisible." But, that hopeful, beautiful ideal appears gone with the wind.

A greed and power seeded sickness infects us, inflamed by swelling ill will toward one another. When political enmity pits brother against brother, family against family, church against church, and state against state there is nothing left to bind us into an "indivisible" nation.

Instead, we are fragmenting into a nation of conservatives vs. liberals, haves vs. have-nots, big business vs. common folks, straight vs. gay, black and brown vs. white, faithful vs. faithless, gun lovers vs. gun haters, and so on. We are so split into factions and antagonisms, personified by Republicans vs. Democrats, that our national government struggles to function, much less accomplish anything.

If there is to be a turn-around, courageous and forthright patriots must take the wheel.

One did so last month. Explaining his deciding vote on health care legislation, Sen. John McCain said, “We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people. We must do the hard work our citizens expect of us and deserve.”

All Americans who mean the Pledge of Allegiance when they say it, like Sen. McCain, must help.

In 1787 our pragmatic forefathers created the unique Republic we pledge allegiance to, carefully crafting it to overcome factions and antagonisms in order to serve “the people.” Elected representatives, three co-equal branches of government, and numerous checks and balances were established to force and forge mutually beneficial results, the assuaging balm essential for indivisibility.

Today, our spreading contagion contaminates the hearts and minds of too many government officials, elected and appointed, crippling support for the notion and necessity of “one nation.”

Take the wheel America and enable more John McCains!


Crawford is syndicated columnist from Meridian (crawfolk@gmail.com)

          House of Representatives Passes Bill to Repeal and Replace Obamacare        
The House of Representatives voted on Thursday in favor of the American Health Care Act, which would repeal and replace the Affordable Care Act, which is commonly known as Obamacare. Congressional Republicans took a step forward in their years-long quest to repeal the Obamacare, the 2010 law that reshaped the country's individual health insurance market. Continue reading…
          Macto, or How To Build a Prison        

image

The sample application that I am going to build is going to be a prison management application. I am going to take this post as a chance to talk about it a bit, discuss the domain and then I’ll talk about the overall architecture in more details.

The domain of a prison is actually fairly simple, you have an inmate, and the sole requirement is that you would keep him (it tend to be overwhelmingly him, rather than her) in lawful custody.

The term lawful custody has a lot of implications, which are, in more or less their order of importance:

  • The inmate is in custody, that is, he didn’t manage to run away.
  • Custody is lawful, that is, you have legal authorization to keep him in jail. Usually that means an order by a judge, or for the first 24 hours, by a police officer.
  • Lawful custody itself means that you:
    • keep the inmate fed
    • in reasonable conditions (sleeping quarters, sanitation, space)
    • access to medical facilities. Indeed, in most prisons the inmates get better health care, especially for emergencies, than the people living in most big cities.
    • ability to communicate with lawyers and family

The devil, however, is in the details. I am pretty sure that I could sit down and write about 250 pages of high level spec for things that are absolutely required for a system that run a prison and still not get everything right.

In practice, at least in the prisons I served at, we did stuff using paper, some VB6 apps & Access, and in one memorable occasion, an entire set of small prisons where running on what amounted to a full blown application written using Excel macros.

Anyway, what I think that I’ll do is start with a few modules in the system, not try to build a full blown system.

The modules that I‘ll start with would be:

  • Staff – Managing the prison’s staff. This is mostly for authentication & authorization for now.
  • Roster – Managing the roster of the prisoners, recording Countings, etc.
  • Legal – Managing the legal side of the prisoners, ensuring that there are authorizations for all the inmates, court dates, notifications, etc.
  • Escort – Responsible for actually taking the inmates out for court, medical evacs, releasing inmates, etc.

That is enough for now, for that matter, it is a huge workload already, but that is about the only way in which I can actually have a chance to show a big enough system and the interactions between all the parts.


          (USA-CA-MERCED) Staff Pharmacist-Ca        
877499BRReq ID:877499BRCompany Summary:What started small, with a single discount store and the simple idea of selling more for less, has grown over the last 50 years into the largest retailer in the world. Today, nearly 260 million customers visit our more than 11,500 stores under 72 banners in 28 countries and e-commerce sites in 11 countries each week. With fiscal year 2016 revenue of $482.1 billion, Walmart employs 2.3 million associates worldwide – 1.5 million in the U.S. alone. It’s all part of our unwavering commitment to creating opportunities and bringing value to customers and communities around the world.Job Title:Staff Pharmacist-CaEmployment Type:Full TimeCity:MERCEDState:CAPosition Description: + Demonstrates up-to-date expertise and applies this to the development, execution, and improvement of action plans + Ensures compliance with Company and legal policies, procedures, and regulations for assigned areas + Maintains confidential information, documentation, and assigned records as required + Models compliance with company policies and procedures and supports company standards of ethics and integrity + Models, enforces, and provides direction and guidance to Associates on proper Customer service approaches and techniques to ensure Customer needs, complaints, and issues are successfully resolved within Company guidelines and standards. + Provides and supports the implementation of business solutions + Provides comprehensive patient care to customers + Provides pharmaceutical care to Customers, including processing and accurately dispensing prescription orders, counseling Customers regarding health care and prescription medication needs, maintaining confidential information, maintaining controlled medication and required documentation. Minimum Qualifications: + Bachelor's Degree in Pharmacy or PharmD degree, or equivalent FPGE (NABP). + Completion of an ACPE Accredited Immunization training program (for example, APhA, Pharmacy School Curriculum, State Pharmacy Association sponsored). + Pharmacy license (by job entry date). Category:Healthcare - Pharmacy Hourly/Salary:HourlyRequisition Template:Health and Wellness
          (USA-CA-Merced) Licensed Vocational Nurse (Telehealth)        
Job Overview ## Job Overview ### Summary **Vacancy Identification Number (VIN):** 1991434 **OUR MISSION:** To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? The **Department of Veterans Affairs** (VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service. If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA. **The VA is committed to hiring Veterans.** The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission. The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families and other beneficiaries. The Values are** I**ntegrity, **C**ommitment, **A**dvocacy, **R**espect and **E**xcellence ("**I CARE**"). **America's Veterans need you!** To find out more, go to http://www.va.gov/jobs/. VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. **NOTE:** Current permanent VA Central CA Health Care System (VACCHCS) employee or current, permanent VA nationwide employee, you must apply under internal announcement number NP-17-AGC-1991438-BU. 1st Area of Consideration - Current permanent VA Central California Health Care System (VACCHCS)/CBOC employees; 2nd Area of Consideration - Current permanent VA Nationwide employees. This position does not require the filing of a financial disclosure report. A Recruitment/Relocation Incentive is not authorized. PCS/Relocation Allowances are not authorized. ### Duties This Licensed Vocational Nurse (LVN) position is located in our Community Based Outpatient Clinic (CBOC) with the VA Central California Healthcare System (VACCHCS), in Merced, CA. The Veterans Health Administration (VHA) expands the provision of patient care to various institutional and non-institutional settings, such as the Department of Veterans Affairs Medical Centers (VAMCs), Community-Based Outpatient Clinics (CBOCs), State Veteran Homes, Vet Centers, homeless shelters, Indian Health Services (IHS), Department of Defense (DOD) and other affiliated organizations by utilizing innovative telecommunication technologies to enhance care coordination, access to care, and to routinely and proactively manage diseases to prevent healthcare crises. These programs may include, but are not limited to, Video Conferencing, Learning Management System, My Health E Vet, Care Coordination Home Technology (CCHT), Clinical Video Telehealth (CVT) and Store and Forward (CCSF) technologies. The Telehealth Clinical LVN serves in a generalist role to support (but not limited to): *video conferencing and staff training *learning management systems *telehealth clinical encounters from the patient and provider locations and *the site Telehealth Clinical LVN for telehealth store and forward applications *CCHT technology support *clinical presenter/facilitator for real time telehealth events, including patient education activities, technical support, training, help desk, business processes, and scheduling support *other program duties as needed **Designated Drug Testing Position:** Applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Applicants will not be appointed to the position if a verified positive drug test result is received. **Work Schedule:** Monday through Friday, 8:00 am to 4:30 pm **Functional Statement Title:** GS-06 LVN (Telehealth Clinical) FS-023080 This position is not eligible for telework. ### Supervisory Status No ### Promotion Potential 06 ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… U.S. Citizens and current permanent Federal employees of other Agencies Questions? This job is open to 2 groups. Job Requirements ## Job Requirements ### Key Requirements * Must pass pre-employment examination * Must be proficient in written and spoken English * Designated and-or Random Drug Testing required * Background and-or Security Investigation required * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **Basic Requirements:** **Citizenship:** Citizen of the United States. Non-Citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. **Education:** Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. **Licensure:** Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. **English Language Proficiency:** Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). **Preferred Experience:** * Experience in Outpatient Clinic Care * Experience with Telehealth technology Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. **Grade Determinations:** **GS-6:** * Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. * Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. * Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. * Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. * Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. * Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. * Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. * Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. * Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. * Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. **References:** VA Handbook 5005, Part II, Appendix G13. This can be found in the local Human Resources Office. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **PLEASE NOTE:** Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html. All education claimed by applicants will be verified by the appointing agency accordingly. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **Physical Requirements:** Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Straight Pulling (7 to 8 hours); Pushing (7 to 8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (7 to 8 hours); Standing (1 hour); kneeling (1 hour); Repeated bending (7 to 8 hours); both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; far vision correctable in one eye to 20/20 and to 20/40 in the other; Hearing (aid permitted); emotional/ mental stability. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications. ### Security Clearance Other Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on "Application Status." For a more detailed update of your status, click on "more information." Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS **Receiving Service Credit for Earning Annual (Vacation) Leave:**Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. ### Other Information * It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. * This job opportunity announcement may be used to fill additional vacancies. * This position is in the Excepted Service and does not confer competitive status. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/475310200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-07-26 to 2017-08-15 *Salary:* $52,820 to $68,671 / per year *Pay scale & grade:* GS 06 *Series:* 0620 Practical Nurse *Appointment type:* Excepted Service Permanent *Work schedule:* Full Time *Job announcement number:* NP-17-AGC-1991434-BU *Control number:* 475310200
          (USA-CA-Merced) Licensed Vocational Nurse (Telehealth)        
Job Overview ## Job Overview ### Summary **Vacancy Identification Number (VIN):** 1991438 **OUR MISSION:** To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? The **Department of Veterans Affairs** (VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service. If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA. **The VA is committed to hiring Veterans.** The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission. The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families and other beneficiaries. The Values are** I**ntegrity, **C**ommitment, **A**dvocacy, **R**espect and **E**xcellence ("**I CARE**"). **America's Veterans need you!** To find out more, go to http://www.va.gov/jobs/. VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. **NOTE:** If you are not a current, permanent VA Central CA Health Care System (VACCHCS) employee or current, permanent VA nationwide employee, you must apply under external announcement NP-17-AGC-1991434-BU. **NOTE:** Fee Basis, WOC, Contract, Volunteer, Resident/Trainee, and Temporary personnel must apply to the external announcement in order to receive consideration.* This position does not require the filing of a financial disclosure report. A Recruitment/Relocation Incentive is not authorized. PCS/Relocation Allowances are not authorized. ### Duties This Licensed Vocational Nurse (LVN) position is located in our Community Based Outpatient Clinic (CBOC) with the VA Central California Healthcare System (VACCHCS), in Merced, CA. The Veterans Health Administration (VHA) expands the provision of patient care to various institutional and non-institutional settings, such as the Department of Veterans Affairs Medical Centers (VAMCs), Community-Based Outpatient Clinics (CBOCs), State Veteran Homes, Vet Centers, homeless shelters, Indian Health Services (IHS), Department of Defense (DOD) and other affiliated organizations by utilizing innovative telecommunication technologies to enhance care coordination, access to care, and to routinely and proactively manage diseases to prevent healthcare crises. These programs may include, but are not limited to, Video Conferencing, Learning Management System, My Health E Vet, Care Coordination Home Technology (CCHT), Clinical Video Telehealth (CVT) and Store and Forward (CCSF) technologies. The Telehealth Clinical LVN serves in a generalist role to support (but not limited to): *video conferencing and staff training *learning management systems *telehealth clinical encounters from the patient and provider locations and *the site Telehealth Clinical LVN for telehealth store and forward applications *CCHT technology support *clinical presenter/facilitator for real time telehealth events, including patient education activities, technical support, training, help desk, business processes, and scheduling support *other program duties as needed **Designated Drug Testing Position:** Applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Applicants will not be appointed to the position if a verified positive drug test result is received. **Work Schedule:** Monday through Friday, 8:00 am to 4:30 pm **Functional Statement Title:** GS-03 LVN (Telehealth Clinical) FS-023080 GS-04 LVN (Telehealth Clinical) FS-023270 GS-05 LVN (Telehealth Clinical) FS-023280 GS-06 LVN (Telehealth Clinical) FS-023080 ### Supervisory Status No ### Promotion Potential 06 ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… 1st Area of Consideration - Current permanent VA Central California Health Care System (VACCHCS)/CBOC employees; 2nd Area of Consideration - Current permanent VA Nationwide employees. Questions? This job is open to 3 groups. Job Requirements ## Job Requirements ### Key Requirements * Must pass pre-employment examination. * Must be proficient in written and spoken English. * Designated and-or Random Drug Testing required. * Background and-or Security Investigation required. * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **Basic Requirements:** **Citizenship:** Citizen of the United States. Noncitizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. **Education:** Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. **Licensure:** Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. **English Language Proficiency:** Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). **Preferred Experience:** * Experience in Outpatient Clinic Care * Experience with Telehealth technology Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. **Grade Determinations:** **GS-3:** * None beyond the basic requirements **GS-4:** * Six months of qualifying experience as an LPN or LVN; **OR** * Graduation from an approved school and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; **OR** * Graduation from an approved school of at least 24 months duration. **GS-5:** * Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. * Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. * Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. * Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. * Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest. * Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. * Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review. **GS-6:** * Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. * Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. * Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. * Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. * Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. * Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. * Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. * Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. * Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. * Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. **References:** VA Handbook 5005, Part II, Appendix G13. This can be found in the local Human Resources Office. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **PLEASE NOTE:** Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html. All education claimed by applicants will be verified by the appointing agency accordingly. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **Physical Requirements:** Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Straight Pulling (7 to 8 hours); Pushing (7 to 8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (7 to 8 hours); Standing (1 hour); kneeling (1 hour); Repeated bending (7 to 8 hours); both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; far vision correctable in one eye to 20/20 and to 20/40 in the other; Hearing (aid permitted); emotional/ mental stability. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications. ### Security Clearance Other Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on "Application Status." For a more detailed update of your status, click on "more information." Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS **Receiving Service Credit for Earning Annual (Vacation) Leave:**Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. ### Other Information * It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. * This job opportunity announcement may be used to fill additional vacancies. * This position is in the Excepted Service and does not confer competitive status. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/475305200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-07-26 to 2017-08-15 *Salary:* $37,727 to $68,671 / per year *Pay scale & grade:* GS 00 *Series:* 0620 Practical Nurse *Appointment type:* Agency Employees Only *Work schedule:* Full Time *Job announcement number:* NP-17-AGC-1991438-BU *Control number:* 475305200
          (USA-CA-Merced) Licensed Vocational Nurse (LVN)        
Licensed Vocational Nurse \(LVN\) Primary Location: United States\-CA\-CAMerced Function: Clinical Organization: Redwood _Everybody needs a job but only extraordinary people work here\._ Our team is fun, creative, and dedicated to making a difference every day in the lives of the people we serve\. The heart of what we do is support people with Intellectual and Developmental Disabilities of all ages\. Description As a **Licensed Vocational Nurse \(LVN\)** with Loyd's Liberty Homes, a partner of California MENTOR, you’ll be one of those extraordinary people\. This position supports adult individuals we serve in our group homes, under the Intermediate Care Facility \(ICF\) classification\. We seek a passionate individual who can provide consistent clinical care to persons with intellectual and developmental disabilities\. In this role you will utilize your license skills and knowledge to carry out each individual’s health care plan and providing direct care with the support of a Registered Nurse and QIDP \(Administrator\)\. Do you have nursing experience and are looking for a meaningful change in your work life? Leverage your education and skill set with California MENTOR to make an impact in people’s lives\. Join our dedicated, dynamic and fast growing team today\! Job Responsibilities: + Provides technical assistance and training to staff to ensure the effective implementation of medically related services + Administers medications and provides documentation according to established guidelines + Provides input regarding health care services to be included in each individual’s service plan + Monitors and ensures physicians orders are performed as prescribed + Accompanies individuals to routine and emergency medical visits + Responsible for following nursing care plans according to program requirements + Provide direct support to individuals we serve, such as the duties of our Direct Support Professional \- as needed
          (USA-CA-Merced) Director of HIM - Mercy Medical Center - Merced, CA - $5,000 SIGN ON BONUS!!        
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) Responsible for effectively leading and directing the work of assigned staff within the parameters of designated performance standards and metrics. The HIM Facility and/or CEO Director is expected to motivate staff to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service and financial performance. This position is key in delivering critical feedback and coaching to facility-based leadership, consistently improving the patient, employee and client experience. . This position is directly accountable for meeting performance metrics, key performance indicators established by both the client and Optum 360 to ensure accurate and timely patient health information management and coding. This role is also responsible for creating a patient centric culture while maintaining strong operational metrics and being financially fiscal. The HIM Facility and/or CEO Director interacts with other departments within the assigned client site(s), and serves as a representative of the O360 HIM Operations department. The incumbent attends managerial meetings as required and supports the core values of Optum360, which is an integral part of this position. The HIM Facility and/or CEO Director drives continuous improvements and tracks, monitors and trends performance to improve business objectives and to disrupt the status quo in order to exceed Service Level Agreement commitments. This position must maintain strong client relationships and represent Optum 360 in all aspects of its values. This HIM Facility and/or CEO Director will serve as a conduit to drive employee engagement, set and balance expectations and reward and recognize winning performance through accountability, performance management, and strong leadership. Although this position is primarily focused upon the provision of service at the Facility (Hospital and/or Clinics) and/or or within the HIM CEO, the position has frequent contact with the Regional HIM Directors, as well as facility-based clinical and administrative leadership. This is an office based position located in Merced, CA at the Mercy Medical Center Merced. Primary Responsibilities: Provides system level oversight for the development of processes and initiatives designed to improve Revenue Cycle performance in assigned areas which includes: SLA and MSA Compliance Audit Follow-up and Compliance Client Liaison (i.e., Relationship development, program coordination) Client/Customer Engagement Leads and monitors targeted customer engagement improvement initiatives Collaborates with and actively coach HIM/Coding leaders, managers, and frontline staff to implement evidence-based strategies to improve the client/customer experience Monitors and evaluates the results of various service / satisfaction surveys. Maintains reporting system including aggregation, correlation, and analysis of data to identify opportunities for operational improvements Evaluates progress, synthesizes feedback, and identifies barriers to success; collaborates with HIM/Coding senior leadership and client leaders to develop and implement interventions to mitigate / remove barriers and achieve positive experience goals Provides administrative oversight for related HIM/Coding initiatives Communications including but not limited to: scheduling and conducting regular individual, mgmt. and department meetings for the purposes of disseminating information, performance feedback and development. Department Status Report Compilation Other duties as assigned Provides system level oversight for Optum360 client improvement programs and initiatives related to assigned HIM/Coding activities, working within the functional HIM/Coding and Client leadership, as warranted. Effectively participates in HIM/Coding Quality Assurance, Patient Satisfaction, Client Satisfaction, Employee Engagement and Process Improvement activities; ensuring associate understanding and commitment, as well as expected process improvement outcomes. Leads by example: promotes teamwork and operational relationships by fostering a positive, transparent and focused working environment which achieves maximum results. Maintains and demonstrates expert knowledge of the application of HIM/Coding processes and best practices; drives the integration of Optum360 HIM/Coding related business objectives within the client environment. Knows, understands, incorporates, and demonstrates the Optum360 Mission, Vision, and Values in behaviors, practices, and decisions. Serves in a leadership role and promotes positive Human Capital Management skills: Interviews, selects and is accountable for the on-going development and evaluation of individuals within the area of responsibility Develops associate loyalty and retention through effective associate engagement, inclusion and participation; Proactively solicits, listens to and addresses associate suggestions; Promotes a professional environment that recognizes and respects diversity Develops or oversees the development of associate work schedules to ensure cost effective staffing that meets customer requirements, while promoting an economical, efficient workforce and considers associate work-life balance Establishes, implements and evaluates on-going performance improvement programs, utilizing an interdisciplinary approach; Escalates to the Regional Director any unfavorable trends or disciplinary actions; Provides managerial follow-up related to performance, up to and including disciplinary actions and termination Provides staff training and mentoring to promote growth and development of assigned resources Responsible for the financial and personnel management of assigned areas Provides leadership for departmental services through collaboration with customers, employees, physicians, clinics, other Optum360 / client departments and services, vendors, etc. Scope of job duties, include and are not limited to: Directly responsible for effectively managing the assigned HIM/Coding activities and staff members; recommend, design and implement procedures for compliance with regulations and standards Uses knowledge of HIM/Coding industry leading practices, performance metrics and monitors, and other documentation Responsible for distributing process updates regarding criteria changes, regulation changes, process and program changes to assigned staff, ensuring their understanding and future compliance Manages assigned staff in order to ensure steady workflow balance and high quality outcomes: Effectively directs and facilitates a multidisciplinary team to achieve its desired outcome Creates a culture supportive of personnel, fostering individual motivation, teamwork and high levels of performance and accountability, and staff retention Supports a collaborative, participative management style Fosters teamwork atmosphere between business and clinical stakeholders Maintains close business relationship with associates at the regional and local levels by ensuring onsite and virtual presence at regular intervals and during special events Educates client and organizational associates regarding assigned HIM/Coding requirements: Functions as a consultant to Regional and facility-based leadership, physicians, and others regarding assigned performance guidelines and standards for HIM/Coding services Identifies action plans to improve the quality of services in a cost efficient manner and facilitates plan implementation Prepares required reports using statistically sound information, displaying content in easily understandable format; escalates to the Regional Director any unfavorable trends Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general: Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas Develops and implements an annual plan of personal and professional development Demonstrates the competencies necessary to influence others’ behaviors toward a common dedication to the Optum360’s mission, goals, and objectives Participates in local, regional and national health care revenue activities and professionally represents Optum360 at these function Other duties as needed and assigned by the Regional Director or in coordination with other Optum360 HIM/Coding or Revenue Cycle Leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-functional resources, as required Subject Matter Expert of applicable federal, state, and local laws and regulations, Optum360’s Compliance, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior Required Qualifications: Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field Required Certifications include RHIT or RHIA CCS or AAPC for direct oversight of coding functions 5+ years in leadership role with experience in the management of supervisors / leaders Acute Care Facility HIM and / or Coding Department leadership experience, managing one or more functional areas of: HIM, Coding, or other management functions related to revenue cycle activities in a complex, multi - site environment Experience consulting and project management experience in revenue cycle design and optimization Technical Knowledge Experience leading or participating in HIM and / or Coding - related IT and / or Contact Center program implementation Requires proficiency with: Microsoft Excel, Word, Project, PowerPoint and SharePoint Prior experience with the major HIM and / or Coding technologies currently in use, and / or other “like” systems Preferred Qualifications: Excellent organizational skills (ability to multi - task, produce rapid turnaround, and effectively manage multiple projects) Exemplary level leadership and business driver skills (ability to make hard decisions focusing upon operational goals and business requirements) Experience working in a union environment Exemplary level ability to influence change and serve as primary change agent Demonstrated client service / account management orientation Strong program management skills with the ability to lead and manage multiple, concurrent running projects, prioritize tasks and adapt to frequent changes in departmental priorities. Ability to recognize necessary changes in priority of tasks and allocation of resources, and bring them to the attention of Optum360 leadership, as required. Demonstrated knowledge of process improvement techniques are essential to success, as is the ability to be a self - starter and work independently to move projects successfully forward Ability to work with a variety of individuals in executive, managerial and staff level positions. The incumbent frequently interacts with staff at the Corporate / National, Regional and Local organizations. May also interact with external parties, such as financial auditors, third party payer auditors, consultants, and various hospital associations Must be comfortable operating in a collaborative, shared leadership environment that encourages change engagement and participation, and open dialogue. Ability to work within the organization at all levels utilizing a very “hands - on” approach to creating value and buy - ins as the lead change facilitator Ability to attract, develop, deploy and retain a world - class revenue cycle team, capable of performing as a team and of evolving with the organization’s vision and with cutting - edge technologies Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Optum360 and our client organization(s) Operational knowledge of Federal and State regulations pertaining to patient admissions, as well as standards from regulatory agencies and accrediting organizations (DHS, HCFA, OSHA, TJC) Operational knowledge of Federal and State regulations pertaining to patient admissions, as well as standards from regulatory agencies and accrediting organizations (DHS, HCFA, OSHA, TJC) Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: RHIA, RHIT, Health Information Management, Merced, CA, California 83b265e0-6ee6-4958-9644-c83705ee9435 *Director of HIM - Mercy Medical Center - Merced, CA - $5,000 SIGN ON BONUS!!* *California-Merced* *723003*
          (USA-CA-Merced) Registered Nurse - New Grad Per Diem        
At Dignity Health Mercy Merced Medical Center, we deliver humankindness through serving the health care needs of the greater Merced Community. Our vision is to help the people of our community become physically, emotionally and spiritually healthy. As part of our team, you will provide clinical expertise; support and oversight that helps ensure our patients receive exceptional care. This is your opportunity to champion the charge by joining in our mission of healing through humankindness. *Job Summary*: Consistent with scope of licensure, parameters of the California Nurse Practice Act, and Mercy Medical Center (MMC) policy and procedure, this position renders direct and indirect nursing care to assigned patient populations; assesses patients for nursing needs, establishes and implements a problem oriented plan of nursing care, and evaluates the effectiveness of care provided and provides immediate direction to other members of the nursing care team to assure the appropriate provision of nursing services. Patient age populations served, and the specific competencies that comprise this job title may vary among nursing units. These specifics are found in the “Department / Unit Orientation and Initial Assessment of Competency” checklists for this unit/position, and –by reference – form a part of this job description. *Minimum Requirements*: * Must possess and maintain a current Registered Nurse (RN) license with the state of California. * Must possess and maintain a current Basic Life Support (BLS) certificate. * Must possess and maintain a current Advance Cardiac Life Support (ACLS) certificate or obtain one within 6 months of hire. * Must possess and maintain a current Pediatrics Advance Life Support (PALS) or Emergency Nurse Pediatrics Certified (ENPC) certificate at the time of employment. New Nurse Graduates must obtain one within 6 months of employment and or transfer. *Preferred Requirements*: * Current MICN or TNCC certification * Bilingual * Previous acute or emergency experience a plus * Certification for Emergency Nurse (CEN) Certificate Mercy Medical Centerhas been building a rich history of care in our community for more than 100 years. We have grown from a small one-story wooden structure into a major healthcare provider with a brand new 186-bed main campus, offering the latest in facility design and technology. Mercy also operates Outpatient Centers, a Cancer Center and several rural clinics. Wherever you work throughout our system, you will find faces of experience with dedication to high quality, personalized care. Joining our 1,300 employees, 230 physicians and many volunteers, you can help carry out our commitment to providing our community with the excellence they have come to associate with Mercy Medical Center. **Job:** **Emergency* **Organization:** **Mercy Medical Center Merced* **Title:** *Registered Nurse - New Grad Per Diem* **Location:** *California-Central California Service Area-Merced-Mercy Merced Community* **Requisition ID:** *1700012580* **Equal Opportunity** Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law.
          (USA-CA-Merced) Pharmacist - Staff        
**Position Summary:** Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on their path to better health—from advising on prescriptions to helping manage chronic and specialty conditions. As a Staff Pharmacist, you have a critical role at the forefront of delivering our purpose, modeling our values, and demonstrating genuine, authentic care for our patients. In addition to supporting the Pharmacy Manager in leading and directing your Pharmacy Technician Support Staff, you are accountable for supporting the management, oversight and operation of all aspects within your pharmacy. This includes: • Patient Safety • Pharmacy Professional Practice • Regulatory Requirements • Quality Assurance • Customer Service • Personnel Management • Inventory Management • Financial Profitability • Loss Prevention • Workflow Management A key component of the Staff Pharmacist role is keeping your customers and patients healthy through adoption and management of patient care programs. Additionally, you will: • Lead with Heart – display empathy and compassion for your patients, customers, caregivers and colleagues on your team • Motivate, inspire and develop your Pharmacy Support Staff by balancing assignments that maximize colleagues’ strengths, address development opportunities and decrease knowledge gaps • Identify critical business opportunities and contribute to the development of meaningful solutions to drive growth and improve performance in your pharmacy • Successfully implement those solutions by leading your team to achieve specified goals • Adapt to change and adjust plans to thrive in a dynamic community healthcare setting • Seek new ways to grow, collaborate with others and deliver better outcomes • Align others around purpose to gain support and commitment • Actively contribute to a ‘team’ culture that promotes caring, energy, enthusiasm and pride • Apply acquired knowledge to help drive healthy outcomes and differentiate CVS from competitors *The above represents a summary of the functions of a Staff Pharmacist. Additional functions and physical requirements are available on the full job description. **Required Qualifications:** Minimum Required Qualifications: • Active Pharmacy License in the state in which you are employed • Not on the DEA Excluded Parties List • Immunization Certification through an accredited organization (i.e. APhA)* • Free of pending felony charges or convictions for criminal offenses involving controlled substances **Education:** Bachelor of Science in Pharmacy or Pharm. D. degree **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health at mailto:AA_EEO@cvscaremark.com For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Pharmacist - Staff        
**Position Summary:** Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on their path to better health—from advising on prescriptions to helping manage chronic and specialty conditions. As a Staff Pharmacist, you have a critical role at the forefront of delivering our purpose, modeling our values, and demonstrating genuine, authentic care for our patients. In addition to supporting the Pharmacy Manager in leading and directing your Pharmacy Technician Support Staff, you are accountable for supporting the management, oversight and operation of all aspects within your pharmacy. This includes: • Patient Safety • Pharmacy Professional Practice • Regulatory Requirements • Quality Assurance • Customer Service • Personnel Management • Inventory Management • Financial Profitability • Loss Prevention • Workflow Management A key component of the Staff Pharmacist role is keeping your customers and patients healthy through adoption and management of patient care programs. Additionally, you will: • Lead with Heart – display empathy and compassion for your patients, customers, caregivers and colleagues on your team • Motivate, inspire and develop your Pharmacy Support Staff by balancing assignments that maximize colleagues’ strengths, address development opportunities and decrease knowledge gaps • Identify critical business opportunities and contribute to the development of meaningful solutions to drive growth and improve performance in your pharmacy • Successfully implement those solutions by leading your team to achieve specified goals • Adapt to change and adjust plans to thrive in a dynamic community healthcare setting • Seek new ways to grow, collaborate with others and deliver better outcomes • Align others around purpose to gain support and commitment • Actively contribute to a ‘team’ culture that promotes caring, energy, enthusiasm and pride • Apply acquired knowledge to help drive healthy outcomes and differentiate CVS from competitors *The above represents a summary of the functions of a Staff Pharmacist. Additional functions and physical requirements are available on the full job description. **Required Qualifications:** Minimum Required Qualifications: • Active Pharmacy License in the state in which you are employed • Not on the DEA Excluded Parties List • Immunization Certification through an accredited organization (i.e. APhA)* • Free of pending felony charges or convictions for criminal offenses involving controlled substances **Education:** Bachelor of Science in Pharmacy or Pharm. D. degree **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health at mailto:AA_EEO@cvscaremark.com For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Paramedic $5000 Sign-on bonus        
$5,000 Paramedic Sign-On Bonus Paramedic’s annual salary with benefits $63,438 - $77,814 * Competitive benefits with employer paid Group Life Insurance * 401(k) Profit Sharing Plan * Education & Training and more. RIGGS is the exclusive Advanced Life Support provider in Merced County and Accredited by the Commission on the Accreditation of Ambulance Services (CAAS). RIGGS is the only ALS responderin Merced County. Our dedicated professionals are committed to providing high quality patient care utilizing the most up to date equipment and resources. POSITION PURPOSE AND SUMMARY Under the supervisor, the ideal incumbent will perform duties associated with providing emergency medical care to the sick and injured in accordance with all applicable laws, regulations, and Company policies. ESSENTIAL DUTIES AND RESPONSIBILITIES General Responsibilities The incumbent must possess and apply knowledge and skills necessary to perform the duties of an Emergency Medical Technician and Emergency Medical Technician Paramedic, in a dignified and compassionate manner, including but not limited to: + Responding to an emergency efficiently and promptly; + Administering basic and advanced life support to patients at the scene, en route to the hospital, and in a pre-hospital setting, in accordance with federal, state, and local laws, regulations, and standards, and in accordance with Company policies and guidelines; + Assessing the nature and extent of injury or illness to establish and prioritize medical procedures to be followed; + Treating patients at the scene, en route to the hospital, and in a pre-hospital setting, in accordance with federal, state, and local laws, regulations, and standards, and in accordance with Company policies, rules, and guidelines; + Effectively communicating with professional medical personnel and treatment facilities to obtain instructions regarding further treatment and/or to arrange reception of patients to the appropriate center; + Maintaining order at scenes, including crowd dispersement and restraint of family and friends; + Completing patient care forms, insurance forms, evaluation forms, and all other forms in a competent and timely fashion; + Adhere to and follow all Policies and Procedures concerning safety and contamination by bloodborne pathogens; and + Educate and /or train squad personnel, EMS trainees and the public. Additional Obligations and Skills The incumbent must possess and apply knowledge and skills necessary to perform the duties of a driver of ambulance equipment, including but not limited to: + Promptly responding to instructions from a dispatcher and driving and operating specially equipped emergency vehicles to specified locations at a safe and controlled speed, in accordance with federal, state, and local laws, regulations and standards, and in accordance with Company policies, rules, and guidelines; + Assuring that vehicles are in good working condition at all times, are properly maintained and stocked, have all necessary equipment and that the equipment is in good working order at all times; + Cleaning, organizing and restocking vehicles in a ready condition after each transport; + Receiving and responding to requests for emergency ambulance service and other duties-related communication via two-way radio or other communication devices; + Maintaining accurate records of ambulance equipment and other emergency equipment and/or personnel dispatched to each emergency and non-emergency request and other operation and administrative data as required to maintain the operational continuity of the Company and as directed by superiors; + Properly document each transport on the approved Patient Care Report in accordance with Company Policies and Procedures; + Handling telephone communications professionally and efficiently with careful regard to the divulgence of information respecting confidentiality requests at all times; + Coordinating requests for non-emergency transports in accordance with the Company's non-emergency transport policies; + Monitoring communication equipment to maintain contact with the dispatcher; and + Maintaining apparatus and equipment in accordance with all policies, procedures and direction. The incumbent must perform routine tasks in and around the ambulance service building, including but not limited to: + Checking, restocking, inventorying and cleaning any apparatus operated by the Company; + Cleaning, doing dishes, emptying trash and other related duties in the station; + Washing and drying personal protective equipment in heavy duty washer and dryer; + Representing the ambulance service while on duty at public service functions, expositions, and other public events; and + Performing any other duty related to the Company as designated by the supervisor or manager. The incumbent must also: + Be a team player, as EMS is a team effort, and providers must provide necessary assistance to ensure system sanitation, readiness and adherence to quality assurance standards; + Be flexible, as emergency services operate on a 24-hour clock; the incumbent's assigned work shift schedule may vary and the incumbent should be available to respond immediately for a call during the assigned work period, and the start and shift times may vary due to the nature of the business; + Maintain a thorough working knowledge of local geography, which includes maps, streets, and grid book systems; + Maintain a thorough working knowledge of applicable current standards of care, including equipment functions and uses; + Assure that all certifications, licenses and registrations are up-to-date; and + Conduct him/herself in a courteous, helpful, dignified and professional manner at all times when dealing with patients, co-workers, supervisors and or the public. + Must be able to read, write and understand the English language. QUALIFICATIONS Educational Requirements The incumbent must have a minimum of either a high school diploma or a GED as evidence of completion of a high school education, and must have and maintain current emergency medical technician and/or paramedic certification. An incumbent must also maintain the required annual continuing medical education credits as set forth by the State EMS Office. Certificates, Licenses And Registrations The incumbent must possess and maintain a valid California driver's license, Paramedic certification, ACLS, American Red Cross CPR for the Professional Rescuer and/or American Heart Association BCLS certification, EVOC/EVDT certification, Hazardous Materials R & I, PHTLS, PEPP or PALS, Current Ambulance Drivers Certificate issued by the DMV, Current California Drivers License issued by the DMV, Current Medical Certificate issued by the DMV and other certifications as required. Minimum Experience, Abilities Required And Special Requirements This position requires one year of experience in the field of rescue and emergency medical services as an EMT. Additionally, the incumbent must possess basic working knowledge of an IBM-compatible computer, and be able to enter necessary data into a computer or PDA. PHYSICAL REQUIREMENTS OF THE POSITION The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. The position requires significant physical strength and dexterity and the ability to function in very adverse environments with exposure to numerous safety risks typically found at emergency scenes. The following guidelines are used to describe the frequency of activities in this position: Occasionally equals 1-33%; Frequently equals 34%-66%; and Continuously equals 67-100% of a typical work day. STANDING/WALKING: Frequently to continuously when responding to calls. Optional while at rest at the facility. This usually includes: going to and from the emergency vehicle, and getting patients from their locations, and rendering treatment. Most walking would be for short distances, as emergency vehicles are allowed to get as close to the location as possible. However, the incumbent must also be able to run these same distances, in case of an emergency where time is of the essence. Walking and running may vary, however, as the patient may be located inside a large, multi-floored facility. Standing, walking and running could be on all types of surfaces, including but not limited to: asphalt, cement, concrete, soft/packed dirt, linoleum, wood, hardwood floors, etc. The individual must be able to go up and down slight inclines or declines that may be found at roadsides, agricultural areas, etc. At a location, standing would occur more often than walking or running. Standing would occur on the wide variety of surfaces mentioned above. Standing could last from a few minutes to hours, depending on the situation. Standing could occur in the standard erect position, the kneeling or squatting position, etc. SITTING: Frequently when responding to a location, the individual will sit in the emergency vehicle. The emergency vehicles are equipped with a standard installed vehicle seat. The time performing the sitting activity on a call would depend upon the specific situation. The facility is equipped with a small lounge area that is furnished. LIFTING AND CARRYING: Frequently required to lift and carry weights ranging from a few pounds to ten pounds and above. Occasionally required to lift and carry weights in excess of 100 pounds or more. Incumbents will need to lift and carry with one team member adult patients, lifting them from various positions (such as a bed or a chair) onto various patient movement devices, such as an ambulance stretcher, a stair chair, long back boards, etc., and then efficiently move them into an ambulance. Other heavier objects in the high range category would be 5-foot tall, 10 inch diameter oxygen cylinders, and medical equipment boxes. The oxygen cylinders can be made of quarter-inch steel and weigh up to 113 pounds. The medical equipment boxes can weigh approximately fifty pounds or more. BENDING AND STOOPING: Frequently. Frequently throughout a work shift the individual will be required to bend in a range of 1 to 90 degrees. The average situation will require the individual to work in a range of 35 to 65 degree bends. This would involve: lifting a patient, lifting equipment, treating a patient at ground level, sitting on a bench located in the ambulance. This activity may be prolonged and last up to 30 minutes or more. During any given call, the provider may bend and/or stoop any number of times per incident. CROUCHING AND KNEELING: Frequently. Crouching and kneeling may be performed when on the scene picking up equipment or assisting patients. The actual number of times this is done depends on the particular incident. CLIMBING: Occasionally. This is required when climbing steps up and down with a patient on a cot or other device, and when entering or exiting the emergency vehicle. Generally, the climbing would require that the incumbent be lifting and carrying heavy objects such as a cot or other device with a patient on it. Balancing may be required when backing down staircases. REACHING: Frequently to continuously throughout the work shift in order to review monitoring equipment, operate communication equipment, administer oxygen, and operate equipment. The incumbent may also be required to reach in precarious positions, such as in a vehicle, which has been crushed in an accident, or in other confined spaces. If working inside the ambulance en route to a medical facility, the incumbent will need to reach to access the patient and supplies. Reaching will involve partial to full extension of the arms. PUSHING AND PULLING: Frequently. The activities that would require the most force in pushing and pulling is when removing or returning a gurney to the emergency vehicle, with and without a patient on the gurney. The weight required to push/pull will vary, depending on the weight on the gurney. Slight pushing will be required if the incumbent is performing CPR, which can require repetitive pushing and may range from a few minutes to hours. Pushing and pulling is required when operating and closing vehicle doors. HANDLING OR GRASPING: Continuously. While working at any given location, continual bilateral gross manipulation is performed in this position. This may be involved when: opening/closing doors; and using, handling, carrying and operating medical equipment boxes that may weigh approximately fifty pounds or more, stretcher rails, various handles attached to equipment, and tools. The arm and hand must be able to perform all types of positions, including supination and pronation. Hyperextension, extension and flexion of the fingers will be involved, ulnar and radial deviation, abduction and adduction of the hand and wrist will be required. A wide variety of grasping will be required, such as cylindrical grasping, palmer grasping, hook grasping, tip grasping, lateral grasping and spherical grasping. HAZARDS: The incumbent, when responding to emergency situations, may be exposed to dust, fumes, gases, fire, smoke, adverse weather conditions, and chemicals. There is also exposure to body substances that may contain infectious materials that could cause illness or death. There is potential for bodily harm or death from violent patients, bystanders, or other dangers. At all time the incumbent is expected to adhere to all applicable Policies and Procedures concerning safety and the prevention of contamination and infection due to bloodborne pathogens. OTHER PHYSICAL REQUIREMENTS + Maintain balance and strength in awkward positions; + Speak clearly under stressful circumstances; + Accurately communicate ideas orally and in writing in English; + Respond physically with speed; + Speak loudly; and + Get along well with others. MENTAL REQUIREMENTS OF THE POSITION + Handle a significant number of stressful situations, and be able to function calmly, coolly and collectedly under all types of stressful situations; + Get along well with diverse personalities; + Communicate with patients and others with empathy and respect; + Create and maintain a positive and cooperative working environment + In stressful situations; + Work smoothly and professionally in an environment where teamwork + Is essential; + Analyze and interpret difficult and complex patient care and personnel situations; + Work independently with minimum supervision for assigned tasks; + Exercise sound independent judgment within general Policy and procedural guidelines; + Anticipate and identify problems and take initiative to prevent or + Correct them; + Establish and maintain effective working relationships with all levels of personnel within the medical community, the Company, outside agencies, patients, and members of the community; + Understand and follow federal, state and local laws, and Company + Policies, procedures, and rules; + Establish and maintain effective working relationships with others; + Follow orders; + Remember and apply concepts, knowledge and principles; + Analyze and interpret situations; and + Appropriately deal with stress and maintain composure when encountering serious injuries or illnesses. JOB RESPONSIBILITIES RELATED TO PATIENT PRIVACY + The incumbent is expected to protect the privacy of all patient information in accordance with the Company’s privacy policies, procedures, and practices, as required by federal law, an in accordance with general principles of professionalism as a health care provider. Failure to comply with the Company’s policies and procedures on patient privacy may result in disciplinary action up to and including termination of employment. + The incumbent may access protected health information (PHI) and other patient information only to the extent that is necessary to complete your job duties. The incumbent may only share such information with those who have a need to know specific patient information you have in you possession to complete their job responsibilities related to treatment, payment or other company operations. + The incumbent is encouraged and expected to report, without the threat of retaliation, any concerns regarding the Company’s policies and procedures on patient privacy and any observed practices in violation of that policy to the designated Privacy Officer. + The incumbent is expected to actively participate in Company privacy training and is required to communicate privacy policy information to coworkers, students, patients and others in accordance with Company policy. PROTECTED HEALTH INFORMATION ROLE BASED ACCESS Access to PHI will be limited to those who need access to PHI to carry out their duties. The following describes the specific categories or types of PHI specific to this job description: Job Title Description of PHI to be accessed Conditions of Access to PHI Paramedic Patient Care Reports, Hospital face sheets, Dispatch run reports. May access only to the extent necessary to complete documentation/addendums.
          (USA-CA-Merced) Community Health Nurse        
This recruitment is for the California Childrenand#39;s Services Program and Clinical Services.Duties may include, but are not limited to the following:Provides nursing advice to patients; administers medications and performs assessments.May provide case management services and utilization review for programs including CCS, CHDP, MCAH, Outreach, Medi-Cal Targeted case management, Indigent Health Care and other programs.Will assist clients to gain access to needed medical, social, educational and other services.Promotes the control of communicable disease by early detection and preventive treatment.Records communicable diseases as prescribed by State and County laws and regulations.Makes home visits to follow up on identified at-risk mother and infants; teaches parenting skills.Functions as an On-Call nurse to give information and make appropriate referrals by telephone.Explains physicianand#39;s instructions and recommendations to patient and patientand#39;s families.Promotes preventative medicine by providing health education and conducting presentations.May provide grief counseling to parents in Sudden Infant Death Syndrome.Engage in outreach and other activities to enhance services to Medi-Cal beneficiaries.MINIMUM QUALIFICATIONSExperience:One (1) year of professional nursing experience. (Possession of a Bachelorand#39;s degree in Nursing, or a closely related field may be substituted for the one (1) year of required experience.)
          (USA-CA-Merced) Pharmacy (Pharmacist) Manager        
The primary purpose of this position is to oversee the daily activities of the Pharmacy department within a retail store. Additionally, to assist customers with their health care needs by filling prescriptions and providing excellent customer service. The incumbent is also required to perform all tasks in a safe manner consistent with corporate policies and state and federal laws. The associate is responsible for the functions below, in addition to other duties as assigned: • Ensure the accuracy and appropriateness of all prescriptions filled by completing Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of Pharmacy regulations. • Build profitable business and script growth through recommended clinical programs including appropriate immunization and when available MTM (Medication Therapy Management), DCS (Diabetes Care Specialist), and all ongoing other programs as identified. • Oversee the daily activities of the Pharmacy department. • Counsel customers with regard to medications filled at the pharmacy. • Ensure growth and profitability of Pharmacy Department. • Handle and resolve customer issues, complaints and questions to build customer trust and loyalty. • Comply with all federal and state laws and regulations. • Interact with physicians to gain additional information about customers and prescriptions to be filled. • Ensure excellent customer service by Pharmacy associates. • Maintain a clean and efficient Pharmacy department. • Provide leadership and development for associates by communicating career opportunities, providing regular performance feedback, and demonstrating RAPTAR (Recognition, Appreciation, Praise, Treat Associates Respectfully) behaviors. • Maintain appropriate security of the Pharmacy department. • Maintain reports for controlled, outdated, and recalled medications; and prescription and customer files. • Manage pharmacy inventory at acceptable levels to fulfill customer need. • Ensure compliance with all policies and procedures for controlled substance dispensing and record keeping. • Prioritize Pharmacy Department tasks and follow through to ensure all tasks are completed in a timely manner. Including, but not limited, to cycle counts, inventory management and will-calls to customers. The following qualities are required: -Minimum age of 21 years old meet education and experience requirements. -Ability to pass drug test. -Committed to providing customer service that makes both internal and external customers feel welcome, important, and appreciated. -Ability to preserve confidentiality of information. -Ability and willingness to move with purpose and a strong sense of urgency. -Ability to work weekends and extended days on a frequent basis. -Ability to work day, evening, and/or night shift. -Accuracy and attention to detail. -Ability to organize and prioritize a variety of tasks/projects. -Familiarity with industry/technical terms and processes. -Ability to work within strict time frames and resolute deadlines. -Excellent communication and customer service skills. -Ability to adapt to change quickly and frequently. -Ability to perform different tasks on different days as necessary. -Ability to respond to interruptions and then return seamlessly to task at hand -Ability to handle stressful situations while maintaining a sense of calm. -Ability to multi-task for extended periods of time. Bachelor's degree (BS), Doctoral degree (PHARM.D.), or equivalent in Pharmacy, and Immunization Certification through an accredited organization (i.e. APhA) plus a minimum of one(1) year experience as a licensed Pharmacist; or equivalent combination of education and experience. In addition, the associate should have experience in a retail environment. Position ID#: 78386 External Company Name: Rite Aid Hdqtrs. Corp. External Company URL: www.riteaid.com
          (USA-CA-Merced) Pharmacist        
The primary purpose of this position is to assist customers with their health care needs by filling prescriptions and providing excellent customer service and assisting with supervising Pharmacy associates. Frequent independent judgments are essential. The incumbent is also required to perform all tasks in a safe manner consistent with corporate policies and state and federal laws. The associate is responsible for the functions below, in addition to other duties as assigned: • Ensure the accuracy and appropriateness of all prescriptions filled by completing Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of Pharmacy regulations. • Build profitable business and script growth through recommended clinical programs including appropriate immunization and when available MTM (Medication Therapy Management), DCS (Diabetes Care Specialist), and all ongoing other programs as identified. • Provide excellent customer service by assisting customers with medical-related issues and providing healthcare counseling. • Supervise the work completed by Pharmacy Technicians and support staff while on duty. • Assist Pharmacy Manager to train, coach, and manage Pharmacy associates. • Assume management responsibility over the entire pharmacy in the absence of the Pharmacy Manager. • Maintain appropriate security of the Pharmacy department. • Comply with all federal and state laws and regulations. • Handle and resolve customer issues, complaints and questions to build customer trust and loyalty. • Interact with physicians and utilize reference material to gain information on customers and prescriptions and to resolve any issues that arise. • Assist with maintaining the Pharmacy department by keeping it clean and in order. • Prioritize Pharmacy Department tasks and follow through to ensure all tasks are completed in a timely manner. Including, but not limited, to cycle counts, inventory management and will-calls to customers. *All duties described in this document are to be performed in keeping with the core values and service attributes consistent with the Rite Aid brand and strategy. • Minimum age of 18 to meet education and experience requirements. • Ability to pass drug test. • Committed to providing customer service that makes both internal and external customers feel welcome, important, and appreciated. • Ability to preserve confidentiality of information. • Ability and willingness to move with purpose and a strong sense of urgency. • Ability to work weekends and extended days on a frequent basis. • Ability to work day, evening, and/or night shift. • Accuracy and attention to detail. • Ability to organize and prioritize a variety of tasks/projects. • Familiarity with industry/technical terms and processes. • Ability to work within strict time frames and resolute deadlines. • Excellent communication and customer service skills. • Ability to adapt to change quickly and frequently. • Ability to perform different tasks on different days as necessary. • Ability to respond to interruptions and then return seamlessly to task at hand • Ability to handle stressful situations while maintaining a sense of calm. • Ability to multi-task for extended periods of time. Bachelor's degree (BS), Doctoral degree (PHARM.D.), or equivalent in Pharmacy, and Immunization Certification through an accredited organization (i.e. APhA). Position ID#: 78384 External Company Name: Rite Aid Hdqtrs. Corp. External Company URL: www.riteaid.com
          (USA-CA-Merced) Public Health Nurse I/II        
EXAMPLES OF DUTIES This recruitment is for the California Childrenand#39;s Services Program Duties may include, but are not limited to the following: May provide case management services and utilization reviews for programs including California Children Services, Child Health and Disability Prevention Program, MCAH Outreach, Medi-Cal Targeted Case Management, Nurse Family Partnership, and Indigent Health Care Program.Investigate and interview parents; assess and screen at-risk individuals; Act as patient advocate.Instruct parents on child safety, growth, development; signs of abuse, poor nutrition and failure to thrive.May provide crisis assistance and participate in patient meetings for special needs children.May work directly in Immunization, STD, TB, and HIV Testing clinics. Administer tuberculosis medications, perform and read skin test for tuberculosis diagnosis.Search for unreported or missed cases of communicable diseases.Conduct home visits to collect and/or complete health forms related to communicable disease.Provides outreach and education by giving presentations and teaching classes to the public.Provide orientation and training to community providers to assure adherence to quality standards.Acts as on-call nurse to receive referrals and provide information.May develop in-service programs for care providers, provide Targeted Case Management services, and engage in outreach and other activities to enhance services to Medi-Cal beneficiaries.The Public Health Nurse II classification is the advanced journey level in the series and can act in a lead capacity and/or be assigned special projects as needed.
          (USA-CA-Merced) Shift Supervisor Management Trainee        
**Position Summary:** The Shift Supervisor Trainee role is an entry-level, short-term role that prepares an employee to perform a higher-level supervisory role, such as Operations Supervisor or Shift Supervisor. The Shift Supervisor Trainee performs work as directed in order to prepare for future supervisory responsibilities, completes basic operations and management skills training, and also learns about key aspects of the business (e.g., building customer loyalty through exceptional service) and CVS/pharmacy culture. Upon successful completion of the training program, Shift Supervisor Trainees are eligible to be considered for promotion to open Operations Supervisor or Shift Supervisor positions. These key leadership roles support the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager onsite, the Operations Supervisor or Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Function: 1. Management • Work effectively with store management and store crews • Supervise the store's crew through assigning, directing and following up of all activities • Effectively communicate information both to and from store management and crews 2. Customer Service • Assist customers with their questions, problems and complaints • Promote CVS customer service culture. (Greet, offer help, and thank) • Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers • Maintain customer/patient confidentiality **Required Qualifications:** • Deductive reasoning ability, analytical skills and computer skills. • Advanced communication skills • Ability to work a flexible schedule, including some early morning, overnight and weekend shifts, to work overtime as needed **Preferred Qualifications:** Experience in retail **Education:** High school diploma or equivalent required **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Shift Supervisor Management Trainee        
**Position Summary:** The Shift Supervisor Trainee role is an entry-level, short-term role that prepares an employee to perform a higher-level supervisory role, such as Operations Supervisor or Shift Supervisor. The Shift Supervisor Trainee performs work as directed in order to prepare for future supervisory responsibilities, completes basic operations and management skills training, and also learns about key aspects of the business (e.g., building customer loyalty through exceptional service) and CVS/pharmacy culture. Upon successful completion of the training program, Shift Supervisor Trainees are eligible to be considered for promotion to open Operations Supervisor or Shift Supervisor positions. These key leadership roles support the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager onsite, the Operations Supervisor or Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Function: 1. Management • Work effectively with store management and store crews • Supervise the store's crew through assigning, directing and following up of all activities • Effectively communicate information both to and from store management and crews 2. Customer Service • Assist customers with their questions, problems and complaints • Promote CVS customer service culture. (Greet, offer help, and thank) • Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers • Maintain customer/patient confidentiality **Required Qualifications:** • Deductive reasoning ability, analytical skills and computer skills. • Advanced communication skills • Ability to work a flexible schedule, including some early morning, overnight and weekend shifts, to work overtime as needed **Preferred Qualifications:** Experience in retail **Education:** High school diploma or equivalent required **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Registered Nurse        
At HealthCare California operational success comes from loyalty, teamwork and dedication of our employees to our patients. Our team consist of compassionate and confident individuals who strive for patient excellence providing quality home health care. Job Summary: The Registered Nurse is responsible for providing services based on the plan of care, prepares necessary items for treatment and procedures, implements and uses current standards to prevent spread of infection, instructs and may prepare medications as appropriate for the patient’s care and safety. Makes treatment recommendations based upon the patient’s acuity level and goal potential. Gives consideration to the immediate and long term effects of recommendations such as frequency, component of care and additional services as required for the patients recovery process. All nursing services will be performed according to compliance with state and local laws/ regulations, the Nurse Practice Act and all other healthcare accreditation standards. Requirements + Valid California Registered Nurse license + A minimum 1 year experience Acute Care nursing setting + Current CPR certification + Valid California Driver license and proof of auto insurance + The ability to inform and enforce information verbally and/or through presentation + Excellent communication skills; must be able to communicate in a manner that is understandable to the staff and general public verbally and in writing Benefits We offer competitive packages that include: + Flexible work environment + Ability to create and manage your own schedule + Point of Care System - iPads for documentation + Mileage reimbursement (Part- Time/Per- Diem) + Company vehicles for full-time equivalent clinicians + Medical, Dental, and Vision (Full-Time employees
          (USA-CA-Merced) Store Team Member        
**Position Summary:** Store Team Members play a meaningful role within the CVS Health family. At CVS Health, we’re shaping the future of health care for people, businesses, and communities. With your talents and expertise, you can help us play a more active and supportive role in each person’s unique healthcare needs. Join our team of thousands as we positively impact millions…one customer at a time. The Store Team Member position provides an opportunity, in a leading retail setting, to excel in a growing, high impact, customer focused role, working both independently and as a member of a team, to positively impact the lives of others. Essential Functions: • Providing differentiated customer service by anticipating customer needs, demonstrating compassion and care in all interactions, and actively identifying and resolving potential service issues • Focusing on the customer by giving a warm and friendly greeting, maintaining eye contact and offering help locating additional items, when needed • Accurately operating a cash register - handling cash, checks and credit card transactions with precision while following company policies and procedures • Maintaining the sales floor by restocking shelves, checking in vendors, updating pricing information and completing inventory management tasks as directed by store manager • Supporting opening and closing store activities, when needed • Providing customer support to all departments, including photo and beauty, ensuring departments are fully stocked and operational while remaining current with all updated services and tools • Assisting pharmacy personnel when needed, including working regular shifts in the pharmacy as part of opportunities for growth and career development •Embracing and advocating for new CVS services and loyalty programs that support our purpose of helping people on their path to better health **Required Qualifications:** • At least 16 years of age Physical Requirements: • Remaining upright on the feet, particularly for sustained periods of time • Lifting and exerting up to 35 lbs of force occasionally, up to 10 lbs of force frequently, and a negligible amount of force regularly to move objects to and from, including overhead lifting • Visual Acuity - Having close visual acuity to perform activities such as: viewing a computer terminal, reading, visual inspection involving small parts/details **Preferred Qualifications:** • Previous experience in a retail or customer service setting **Education:** • High School diploma or equivalent **Business Overview:** CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Caremark is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, color, gender, national origin, ancestry, religion, physical or mental disability, age, veteran status, sexual orientation, gender identity or expression, marital status, pregnancy, citizenship, or any other factor protected by anti-discrimination laws. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Caremark at mailto:AA_EEO@cvscaremark.com
          (USA-CA-Merced) Pharmacy Technician        
**Position Summary:** Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicians take important steps to ensure all medication needs and regulatory compliance standards are met for our patients and they demonstrate ethical conduct and maintain patient confidentiality at all times. Success for incumbents in this role includes being able to manage all assigned pharmacy workstations and tasks to support the team’s ability to promptly, safely and accurately fill patient prescriptions all while providing caring service that exceeds customer expectations. If you like working in fast-paced environments and demonstrating compassionate, genuine care for patients and customers, this job is for you! As a new Pharmacy Technician, you are required to complete an extensive CVS Pharmacy Technician Training Program as well as satisfy all registration, licensing and certification requirements according to your State’s Board of Pharmacy guidelines. Your Pharmacy Technician duties will be restricted by your manager at first until you complete all necessary requirements. Once you satisfy all requirements and expand your Pharmacy Technician duties, you have the opportunity to continue to build your clinical, technical and insurance knowledge and expertise by leveraging available tools and training to build your pharmacy career. Are you ready to help people on their path to better health? We are ready to have you join our team and help you on your career path to achieve your goals! Please note in select markets the collective bargaining agreement rules regarding the Pharmacy Technician would apply. DISCLAIMER: The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. **Required Qualifications:** • Must be at least 16 years of age • Licensure requirements vary by state • Attention and Focus o The ability to concentrate on a task over a period of time without being distracted • Customer Service Orientation o Actively look for ways to help people, and do so in a friendly manner o Notice and understand customers’ reactions, and respond appropriately • Communication Skills o Use and understand verbal and written communication to interact with customers and colleagues o Actively listening by giving full attention to what others are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times • Mathematical Reasoning o The ability to use math to solve a problem, such as calculating day’s supply of a prescription • Problem Resolution o Is able to judge when something is wrong or is likely to go wrong; recognizing there is a problem o Choosing the best course of action when faced with a complex situation with several available options PHYSICAL DEMANDS: • Remaining upright on the feet, particularly for sustained periods of time • Moving about on foot to accomplish tasks, particularly for moving from one work area to another • Picking, pinching, typing or otherwise working primarily with fingers rather than whole hand or arm • Extending hand(s) and arm(s) in any direction • Bending body downward and forward by bending spine at the waist • Stooping to a considerable degree and requiring full use of the lower extremities and back muscles • Expressing or exchanging ideas by means of spoken word; those activities where detailed or important spoken instructions must be conveyed accurately • Perceiving the nature of sounds at normal speaking levels with or without correction, and having the ability to receive detailed information through oral communication • Visual Acuity: o The worker is required to have close visual acuity to perform activities such as: transcribing, viewing a computer terminal, reading, visual inspection involving small parts • Occasional lifting of up to 30 lbs; exerting up to 30 lbs of force occasionally and/or up to 10 lbs of force frequently, and/or a negligible amount of force constantly to move objects **Preferred Qualifications:** • Previous experience in a pharmacy, retail, medical, or customer service setting • Previous experience as a Pharmacy Technician • PTCB National Certification **Education:** • High School diploma or equivalent (preferred) **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health at mailto:AA_EEO@cvscaremark.com For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Pharmacy Technician        
**Position Summary:** Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicians take important steps to ensure all medication needs and regulatory compliance standards are met for our patients and they demonstrate ethical conduct and maintain patient confidentiality at all times. Success for incumbents in this role includes being able to manage all assigned pharmacy workstations and tasks to support the team’s ability to promptly, safely and accurately fill patient prescriptions all while providing caring service that exceeds customer expectations. If you like working in fast-paced environments and demonstrating compassionate, genuine care for patients and customers, this job is for you! As a new Pharmacy Technician, you are required to complete an extensive CVS Pharmacy Technician Training Program as well as satisfy all registration, licensing and certification requirements according to your State’s Board of Pharmacy guidelines. Your Pharmacy Technician duties will be restricted by your manager at first until you complete all necessary requirements. Once you satisfy all requirements and expand your Pharmacy Technician duties, you have the opportunity to continue to build your clinical, technical and insurance knowledge and expertise by leveraging available tools and training to build your pharmacy career. Are you ready to help people on their path to better health? We are ready to have you join our team and help you on your career path to achieve your goals! Please note in select markets the collective bargaining agreement rules regarding the Pharmacy Technician would apply. DISCLAIMER: The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. **Required Qualifications:** • Must be at least 16 years of age • Licensure requirements vary by state • Attention and Focus o The ability to concentrate on a task over a period of time without being distracted • Customer Service Orientation o Actively look for ways to help people, and do so in a friendly manner o Notice and understand customers’ reactions, and respond appropriately • Communication Skills o Use and understand verbal and written communication to interact with customers and colleagues o Actively listening by giving full attention to what others are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times • Mathematical Reasoning o The ability to use math to solve a problem, such as calculating day’s supply of a prescription • Problem Resolution o Is able to judge when something is wrong or is likely to go wrong; recognizing there is a problem o Choosing the best course of action when faced with a complex situation with several available options PHYSICAL DEMANDS: • Remaining upright on the feet, particularly for sustained periods of time • Moving about on foot to accomplish tasks, particularly for moving from one work area to another • Picking, pinching, typing or otherwise working primarily with fingers rather than whole hand or arm • Extending hand(s) and arm(s) in any direction • Bending body downward and forward by bending spine at the waist • Stooping to a considerable degree and requiring full use of the lower extremities and back muscles • Expressing or exchanging ideas by means of spoken word; those activities where detailed or important spoken instructions must be conveyed accurately • Perceiving the nature of sounds at normal speaking levels with or without correction, and having the ability to receive detailed information through oral communication • Visual Acuity: o The worker is required to have close visual acuity to perform activities such as: transcribing, viewing a computer terminal, reading, visual inspection involving small parts • Occasional lifting of up to 30 lbs; exerting up to 30 lbs of force occasionally and/or up to 10 lbs of force frequently, and/or a negligible amount of force constantly to move objects **Preferred Qualifications:** • Previous experience in a pharmacy, retail, medical, or customer service setting • Previous experience as a Pharmacy Technician • PTCB National Certification **Education:** • High School diploma or equivalent (preferred) **Business Overview:** CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health at mailto:AA_EEO@cvscaremark.com For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
          (USA-CA-Merced) Store Team Member        
**Position Summary:** Store Team Members play a meaningful role within the CVS Health family. At CVS Health, we’re shaping the future of health care for people, businesses, and communities. With your talents and expertise, you can help us play a more active and supportive role in each person’s unique healthcare needs. Join our team of thousands as we positively impact millions…one customer at a time. The Store Team Member position provides an opportunity, in a leading retail setting, to excel in a growing, high impact, customer focused role, working both independently and as a member of a team, to positively impact the lives of others. Essential Functions: • Providing differentiated customer service by anticipating customer needs, demonstrating compassion and care in all interactions, and actively identifying and resolving potential service issues • Focusing on the customer by giving a warm and friendly greeting, maintaining eye contact and offering help locating additional items, when needed • Accurately operating a cash register - handling cash, checks and credit card transactions with precision while following company policies and procedures • Maintaining the sales floor by restocking shelves, checking in vendors, updating pricing information and completing inventory management tasks as directed by store manager • Supporting opening and closing store activities, when needed • Providing customer support to all departments, including photo and beauty, ensuring departments are fully stocked and operational while remaining current with all updated services and tools • Assisting pharmacy personnel when needed, including working regular shifts in the pharmacy as part of opportunities for growth and career development •Embracing and advocating for new CVS services and loyalty programs that support our purpose of helping people on their path to better health **Required Qualifications:** • At least 16 years of age Physical Requirements: • Remaining upright on the feet, particularly for sustained periods of time • Lifting and exerting up to 35 lbs of force occasionally, up to 10 lbs of force frequently, and a negligible amount of force regularly to move objects to and from, including overhead lifting • Visual Acuity - Having close visual acuity to perform activities such as: viewing a computer terminal, reading, visual inspection involving small parts/details **Preferred Qualifications:** • Previous experience in a retail or customer service setting **Education:** • High School diploma or equivalent **Business Overview:** CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers. CVS Caremark is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, color, gender, national origin, ancestry, religion, physical or mental disability, age, veteran status, sexual orientation, gender identity or expression, marital status, pregnancy, citizenship, or any other factor protected by anti-discrimination laws. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Caremark at mailto:AA_EEO@cvscaremark.com
          PT Intensive Medicare        
PT Intensive Medicare, established in 2002, is the first health care consultancy and services company in Indonesia which provides the most complete health care services to the clients, such as employee health benefits consultancy; health insurance consultancy; managed care; third party administration; medical evacuation and repatriation and other assistance services; health care providers network (doctors, clinics, hospitals, pharmacies, clinical laboratory, optics, ambulances) and other services.

Our vision, mission and commitment have attracted talented professionals to share their unique capabilities and competency in delivering superb quality health care services.With various background and lots of experience in specific areas of service, our people have delicately build "BLUE DOT" as

Staf Analis Klaim
(Jakarta Raya)

Responsibilities:
• Melakukan analisa klaim, menginput data ke system, Administrasi Klaim
Requirements:
• Pendidikan min SMF (Sekolah Menengah Farmasi) / D3 (Perawat) / S1 Kedokteran / Apoteker
• Wanita / Pria, usia 23-30 tahun
• Memiliki pengetahuan tentang obat-obatan
• Mau bekerja keras dan mandiri
• Memiliki sifat yang jujur, tegas. lugas dan bertanggungjawab dalam melaksanakan pekerjaannya
• Dapat bekerja dengan baik dalam team
• Dapat mengoperasikan Microsoft Office dengan baik
• Berkomitmen tinggi

For registered JobStreet.com users, to apply online or via sms
JSA(spasi)APPLY(spasi)EHMFT
Send to 9333



          1st International Diabetes Expert Conclave (IDEC) 2017        
Last week I was an invited plenary speaker at the 1st International Diabetes Expert Conclave (IDEC2017) held in Pune, India. This 3-day event, organised by Drs. Neeta Deshpande (Belgaum), Sanjay Agrawal (Pune) and colleagues, brought together well over 900 physicians from across India for a jam-packed program that covered everything from diabetic food disease and neuropathy to the latest in insulin pumps and devices – all in a uniquely Indian context. I, of course, was there to speak on obesity, which featured prominently in the program. Topics on obesity ranged from the potential role of gut bugs to bariatric surgery. While Dr. Allison Goldfine, former Director of Clinical Research at the Joslin Diabetes Center in Boston spoke on the latest developments in anti-obesity pharmacotherapy (delivering her talk via Skype), I spoke about obesity as a chronic disease and the need to redefine obesity based on actual indicators of health rather than BMI. During my visit in Pune, I also had the opportunity to visit with my friend and colleague Dr. Shashank Shah, whose bariatric surgical center in Pune alone performs about 75 to 100 bariatric operations per month – a remarkable number by any standards. Of course, the overwhelming number of talks were given by Indian faculty (there being only a handful of select invited international faculty at the meeting), and I did come away most impressed by the breadth and depth of knowledge presented by the local speakers. Diabetes care certainly appears to be in good hands although the sheer number of patients with diabetes (estimated at about 70 million, which I assume to be a rather conservative assessment), would provide a challenge to any health care system. On the obesity front, things are a lot less rosy, given that (as everywhere else) obesity has yet to receive the same level of professional attention and expertise afforded to diabetes or other chronic diseases. Thanks again to the organisers for inviting me to this exciting meeting and congratulations on an excellent event that bodes well for the 2nd Conclave planned for 2018. @DrSharma Edmonton, AB
          Herbal Appetite Suppressant        

Herbal Appetite Suppressant

If your you make a capsule, as illustrious proof of their appetite the fat and loss ingredient is for health care. Is it depends on the vast majority are great is a great product before taking a natural appetite suppressant: to take? Just being investigated for losing your fait in the group was that Hoodia to have found that sun people have successfully been eating mid brain and very powerful than the stave off hunger and organic with its major effects from the Hoodia does Hoodia Gordonii is about it then, harvested when you Hoodia.

For two weeks or have taken the prove the harsh south capability of Hoodia. If your stomach is proven with your metabolic rate, of the western cape conservation authority. When they are advise the Hoodia Gordonii might have been eating Hoodia also controls the day: lose weight loss and deforestation, threatening the medical discovery of this product is its bitterness, and flora cites, which includes species Hoodia herbal ingredients. The Hoodia Gordonii Absolute work?


          Tackling obesity: Foundations and nonprofits go local for greater impact