Thursday, July 30, 2009

New Poll Finds Growing Unease on Health Plan

Stephen Crowley/The New York Times

President Obama took his appeal for support of a health care overhaul on the road Wednesday, speaking (and snacking) at a Kroger grocery store in Bristol, Va.

Published: July 29, 2009

President Obama’s ability to shape the debate on health care appears to be eroding as opponents aggressively portray his overhaul plan as a government takeover that could limit Americans’ ability to choose their doctors and course of treatment, according to the latest New York Times/CBS News poll.

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Related

Texas Hospital Flexing Muscle in Health Fight (July 30, 2009)

House Democrats End Impasse on Health Bill (July 30, 2009)

Pick Up in Produce: Obama Makes His Health Pitch (July 30, 2009)

How the Poll Was Conducted (July 30, 2009)

Times Topics: Health Care Reform

Selling Health Care Reform to Voters

Room for DebateWhat President Barack Obama needs to do -- and avoid doing -- to get the public on board.

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The latest on President Obama, the new administration and other news from Washington and around the nation. Join the discussion.

Stephen Crowley/The New York Times

Protesters and supporters lined Mr. Obama’s route in Raleigh, N.C. A poll shows concern about the effect of an overhaul.

Americans are concerned that revamping the health care system would reduce the quality of their care, increase their out-of-pocket health costs and tax bills, and limit their options in choosing doctors, treatments and tests, the poll found. The percentage who describe health care costs as a serious threat to the American economy — a central argument made by Mr. Obama — has dropped over the past month.

Mr. Obama continues to benefit from strong support for the basic goal of revamping the health care system, and he is seen as far more likely than Congressional Republicans to have the best ideas to accomplish that. But reflecting a problem that has hindered efforts to bring major changes to health care for decades, Americans expressed considerable unease about what the end result would mean for them individually.

“We need to fix health care,” Mary Bevering, a Democrat from Fort Madison, Iowa, said in a follow-up interview, “but if the government creates the system, I’m afraid the quality of care will go down and costs will go up: We will pay more taxes.”

“It’s going to come down to regulation,” Ms. Bevering said. “What also worries me is whether we will be told what physician we can have.”

The poll was taken at a moment of extreme fluidity, both in terms of the complicated negotiations in the House and the Senate as lawmakers and the administration sort out the substance and politics of competing proposals, and in the efforts by both sides to define the stakes of the health care debate for the public.

With Congress now almost certain to recess until after Labor Day without floor votes on any specific plan, a vigorous advertising and grass-roots effort to shift public opinion is likely in the next month or two. The poll offers hope to both sides.

The changes in the public’s attitude over the past month, even if not huge, suggest one reason Mr. Obama sought so hard to get Congress to vote on some version of an overhaul before heading home.

Opponents of the proposed health care overhaul have already spent $9 million on television advertisements raising concerns about it, said Evan Tracey, the chief operating officer of Campaign Media Analysis Group, which tracks political advertising. The advertisements are financed by the Republican National Committee and aimed at constituents of wavering lawmakers. The committee is also running radio spots.

Officials said the advertising would accelerate as the legislators returned home for the summer. The advertisements present the overhaul as a risky experiment, or a government takeover of health care that would prevent people from choosing their own doctors.

Mr. Obama is making an intense effort to rebut those claims. On Wednesday, he flew to Raleigh, N.C., for a town-hall-style meeting to address the kinds of public concerns reflected in the poll results.

“First of all,” Mr. Obama said, “nobody is talking about some government takeover of health care. I’m tired of hearing that. I have been as clear as I can be. Under the reform I’ve proposed, if you like your doctor, you keep your doctor; if you like your health care plan, you keep your health care plan. These folks need to stop scaring everybody, you know?”

Mr. Obama sought in particular to reassure people who already have health insurance and whom the overhaul plans under consideration in Congress would benefit by preventing insurers from dropping them or diluting their coverage if they become ill, while also bringing rapidly rising costs under control. And he sought to stoke a sense of urgency for getting a bill signed this year.

“If we do nothing, I can almost guarantee you your premiums will double over the next 10 years, because that’s what they did over the last 10 years,” Mr. Obama said. “It will eat into the possibility of you getting a raise on your job because your employer is going to be looking and saying, ‘I can’t afford to give you a raise because my health care costs just went up 10, 20, 30 percent.’ ”

The national poll was conducted by telephone starting on Friday and ending on Tuesday. It involved 1,050 adults, and has a margin of sampling error of plus or minus three percentage points.

Mr. Obama’s job approval rating has dropped 10 points, to 58 percent, from a high point in April.

And despite his efforts — in speeches, news conferences, town-hall-style meetings and other forums — to address public misgivings, 69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.

Still, Mr. Obama remains the dominant figure in the debate, both because he continues to enjoy relatively high levels of public support even after seeing his approval ratings dip, and because there appears to be a strong desire to get something done: 49 percent said they supported fundamental changes, and 33 percent said the health care system needed to be completely rebuilt.

The poll found 66 percent of respondents were concerned that they might eventually lose their insurance if the government did not create a new health care system, and 80 percent said they were concerned that the percentage of Americans without health care would continue to rise if Congress did not act.

By 55 percent to 26 percent, respondents said Mr. Obama had better ideas about how to change health care than Republicans in Congress did.

There is overwhelming support for a bipartisan agreement on health care, and here again, Mr. Obama appears in the stronger position: 59 percent said that he was making an effort to work with Congressional Republicans, while just 33 percent said Republicans were trying to work with him on the issue.

Over all, the poll portrays a nation torn by conflicting impulses and confusion.

In one finding, 75 percent of respondents said they were concerned that the cost of their own health care would eventually go up if the government did not create a system of providing health care for all Americans. But in another finding, 77 percent said they were concerned that the cost of health care would go up if the government did create such a system.

Helene Cooper, Marina Stefan and Dalia Sussman contributed reporting.

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Wednesday, July 29, 2009

The plant-milk businesses in the industrialized nations of the world, as well as the developing nations, make non-dairy milks which we in dairy-obsessed regions tend to call "alternatives to cows’ milk", where children in school cafeterias around the countries (as in the US) are routinely given cows milk. Growing incidence of lactose intolerance and other health and supporting reasons for NOT consuming cow's milk make these plant-milk businesses particularly PROMISING financial investments - IF the market for volume feeding is grown or expanded. Volume feeding outlets include all "total institutions" (school and company cafeterias, prisons, hospitals, worksites) and anywhere milk or coffee creamers are served (did you know that nondairy coffee creamers made of soy are now available and distributed in the same supply chain as dairy cream?).


Don’t Schoolchildren Deserve the Option of Healthy Alternatives to Cows’ Milk?

This year, Congress is reauthorizing the Child Nutrition Act, providing us with a tremendous opportunity to make non-dairy alternatives to cows’ milk available as an option for children in school cafeterias around the country.

Currently, virtually all children participating in the National School Lunch Program (NSLP) are automatically served cows’ milk, despite the fact that as many as eight million schoolchildren are lactose intolerant, and countless others avoid cows’ milk for health, environmental and ethical reasons.

Contact your congresspersons today and urge them to support amendments to the Child Nutrition Act that would make non-dairy alternatives to cows’ milk readily available to all schoolchildren.

Thank you for your compassion,

Gene Baur
President and Co-founder
Farm Sanctuary


Farm Sanctuary, PO Box 150, Watkins Glen, NY 14891

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I am just overwhelmed by the work I have to do at home, at HMS, and at HSPH - and my very best friend will be here this weekend.

I ask all my friends, acquaintances, and would-be friends to 'friend' me on all OTHER social media UNTIL Facebook increases total allowable connections beyond 5000 (I have maxed out with the TOTAL number of friends, groups, contacts, fanning, etc = 5000) and to READ MY BLOGS here and all the others, all linked at http://Maynard.Clark.GooglePages.com

Oddly, I'm taking a day off from work to sleep. Is being tired a result of feeling overwhelmed?



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Tuesday, July 28, 2009

Daily Herald
Wheaton College ranked second-most sober school in nation
By Elisabeth Mistretta | Daily Herald Staff
Published: 7/28/2009 3:30 PM

Whether Wheaton College's latest distinction is a good or not-so-good thing depends a lot on what you're looking for.

When The Princeton Review released results of its annual college rankings this week, the Christian institution in Wheaton was second in the nation in the Stone Cold Sober Schools category, right behind Brigham Young University in Utah.

BYU has held the top spot for 12 years and Wheaton is "a usual suspect" in that category, said Robert Franek, author of "The Best 371 Colleges, 2010 Edition."

The rankings are based on surveys of 122,000 college students, and any student with a college e-mail address can participate in the annual surveys at princetonreview.com.

Wheaton College officials say the ranking is a positive mark because it fits the school's moral philosophy.

"Part of our campus environment and goal is to cultivate an atmosphere that stimulates moral and intellectual growth," spokeswoman LaTonya Taylor said.

Wheaton College encourages all students to agree to a Community Covenant, which cites the school's Christian values and discourages behaviors officials believe are at odds with their religion and scripture, such as excessive alcohol consumption, any use of illegal drugs or anything deemed pornographic.

Taylor said many students are looking for such guidelines to help keep them true to their beliefs.

"The students who come to Wheaton are interested in growing their faith, as well as for challenging academics," she said.

In addition to being a the second-most sober school in the country, Wheaton also ranked in several other categories: first, Alternative Lifestyle Not an Alternative (low acceptance of gay community); second, Got Milk? (low beer consumption); second, Scotch & Soda, Hold the Scotch (low hard liquor consumption); third, Most Religious Students; fourth, Future Rotarians and Daughters of the American Revolution; fifth, Town-Gown Relations are Great (good relationship with Wheaton residents); sixth, Don't Inhale (low marijuana use); eighth, Most Conservative Students, 13th, Best Campus Food.

Last year the college was said to have the best food in the nation. This year it moved from fifth to first place for low acceptance of the gay community. Franek said the rankings vary from year to year based on the changing student body.

"Each list is an incredible resource because it reports so much information from primary sources, which is college students themselves," he said.

He added that there is no such thing as a bad ranking in the book. Instead, the categories are created simply to help prospective students make the best decisions.

"If you're a young, gay kid thinking of applying to any school, you want to know what the campus climate is," Franek said. "If the tolerance is low, you would at least want to understand that and prepare some questions. It doesn't mean you should stop your research there, but you should let that make your research that much more savvy. I don't want people to cross a school off their list simply because of our rankings."


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Harvard University Green Tip of the Month - July 2009

A nice green tip from the Office for Sustainability...
----- Original Message -----
This is the campus-wide Harvard University Green Tip of the Month.
Having trouble reading this newsletter? Click here to see it in your browser.
Harvard University Green Tip of the Month


Eat Less Meat!

Industrial meat production, especially beef, accounts for 18% of the world's greenhouse gas emissions* (from the entire meat production cycle).

Pick up some vegetarian ingredients at a local farmer's market, including three near Harvard:

  1. Science Center market: Tuesdays 12:30-6pm, until October 27th
  2. Allston market: Fridays, 3-7pm
  3. Charles Hotel market: Fridays, 12-6pm & Sundays, 11-3pm
  4. Restaurant Associates weekly farmer's markets at HMS: Wednesdays, all day, Courtyard Cafe and Elements Cafe (alternating weeks)
  5. Mission Hill market: Thursdays, 11am-6pm at Brigham's Cricle (*near HSPH)

Or find a market near you: http://www.massfarmersmarkets.org

* United Nations (September 2008) "Livestock production alone contributes to 18 percent of the global warming effect - more than the emissions from every single car, train, and plane on the planet. Though livestock production only contributes 9 percent of carbon dioxide emissions, the sector is responsible for 37 percent of methane and 65 percent of nitrous oxide, both potent greenhouse gases." http://www.fao.org/docrep/010/a0701e/a0701e00.htm


Setting the Record Straight

July Green Tip

It is healthy to be vegetarian.

Studies have shown that vegetarians (who follow a well-balanced, low-fat, high-fiber diet) often have lower incidences of coronary artery disease, hypertension, obesity and some forms of cancer.


Your Actions Add Up!

If every Harvard affiliate replaced one average daily diet containing meat with one vegetarian meal a week, we would

Prevent 14 million pounds of CO2 from entering the atmosphere.

That's like taking 1,280 cars off the road!


Resources







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Monday, July 27, 2009

Brighter Green Logo

Stella Zhou Joins Brighter Green as an Associate 7/20/2009

Harvard Public Health graduate student Stella Zhou becomes a Brighter Green Associate. Stella's interests include population-level bioethics, animal rights, and the relationship between public health and diet. A Chinese citizen, Stella hopes to use her degree to reinvigorate the bioethics curricula used in Chinese Universities. Brighter Green looks forward to working with Stella and gaining from her fresh insights.

China: Animal Welfare on the Legal Docket

July 26, 2009 8:58pm
Filed under:
Cats in cages

In future, a different destiny?

China has drafted it first Animal Protection Law. At present, Chinese animal law covers wildlife only. A team of experts headed by Chang Jiwen, director of the Chinese Academy of Social Sciences’ Social Law Research Department, is looking to change this. On June 15, 2009, state media reported that the team finished drafting China’s first Animal Protection Law. According to the draft, severe cases of animal abuse, such as the hauling of cats from all over China to Guangdong Province for a Cantonese delicacy of shui zhu huo mao or water-boiled live cats, can result in the jailing of violators. Lighter punishments include fines of up to 6,000 yuan ($877.50) and detention periods of 15 days or less. The draft also proposes implanting data chips in pets as a means of controlling stray populations, and improving farm animal welfare through the adoption of humane breeding, transportation, and slaughter practices.

In August, the draft law will be published to solicit public opinion and will be submitted to various government departments by year-end. Repeated accounts of animal abuse reported by the Chinese media have spurred on the legal drafting team’s work. In 2002 for example, a student from Tsinghua University poured sulphuric acid into the mouths of Beijing zoo’s black bears. In 2005, a graduate student from Fudan University abused 30 stray cats, gouging out their eyes and eventually killing them. More recently, in 2006, a group of teenage girls in high heels trampled a number of cats to death, supposedly for fun. An Internet uproar ensued and the events sparked off heated ethical debates.

While China’s animal lovers responded eagerly to news of the draft law, critical voices were also heard. “We’re unable even to take care of the numerous poor, let alone animals. Let’s talk about human rights first!” was a common public response. Some went further, accusing the scholars and activists of blindly emulating the West and pointing out the hypocrisy of “animal welfare,” as the animals are ultimately killed regardless of how humane the slaughter.

In an interview with CCTV, Professor Chang, head of the drafting team, responded to such criticisms. He stressed that the team sought to craft the law in accord with the actual conditions for animals in China, with anti-abuse (that is, punishing the infliction of unnecessary pain on nonhuman animals) forming the basis of the law. Professor Chang admitted that it while it is currently unrealistic for China to mirror Western standards of animal welfare, he detailed step-by-step measures to improve Chinese animal welfare that can be implemented within the next two decades.

A final version of the draft law will have to go through the State Council, China's highest executive organ, and undergo three readings at the National People’s Congress (China's national legislature) before taking effect. Every change in life presents its own set of challenges. Such difficulties are inevitable, but are never reason enough to avoid action. This draft presents the Chinese people with a plan detailing not only better animal treatment, but also reforms to industrial animal agriculture systems and rural labor. The "humane" path will encounter roadblocks in China, but it is an important route to the future.

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Sunday, July 26, 2009

Forget Who Pays Medical Bills,
It’s Who Sets the Cost
(and it's not preventing any problems, anyway!)


By DAVID LEONHARDT Published: July 25, 2009

Related
Political Memo: Partisan or Not, a Tough Course on Health Care (July 26, 2009)
Obama Defends Proposed Health Office
(July 26, 2009)
Obama Moves to Reclaim the Debate on Health Care (July 23, 2009)
Times Topics: Health Care Reform

WASHINGTON — Every fight over health care reform is different, and every fight over health care reform is the same.

In 1929, Michael Shadid, a doctor in western Oklahoma, proposed an idea for making medical care affordable to farmers. Rather than pay piecemeal for treatments, farmers would each contribute $50 a year to a cooperative. Dr. Shadid and his colleagues would pay their own salaries and expenses with the aggregate sum, and no farmer’s annual bill for family medical care would exceed $50.

Horrified by the plan, other Oklahoma doctors tried to revoke Dr. Shadid’s license. The conflict was soon duplicated across the country; cooperatives sprang up, and the American Medical Association tried to beat them back. The A.M.A.’s members, as the historian Paul Starr has written, felt threatened because the cooperatives “subjected doctors’ incomes and working conditions to direct control by their clients.”

The issue was clear: Who controls the doctor-patient relationship? That question has been at the core of every big subsequent battle over health care. Should doctors determine not only their patients’ treatment but also their own pay, through the fee-for-service system that has survived since the 1920s? Or should patients have more power in the relationship? And who could claim to act on patients’ behalf, monitoring treatments and bargaining with doctors?

A succession of presidents — from Harry S. Truman to Richard M. Nixon to Bill Clinton — volunteered the government for the role of patients’ advocate, and their grand efforts all failed. Now it is President Obama’s turn to try to remake America’s medical system.

Last week’s back and forth, when Congressional Democrats squabbled and Mr. Obama took his case to the public, highlighted how difficult his task will be. Reform of health care has the potential to threaten profits and incomes that make up one-sixth of the economy. More daunting, perhaps, Americans seem to have great trust in their doctors — more, certainly, than they trust the government on medical matters.

More than three in four Americans are “very satisfied” or “somewhat satisfied” with their own care, according to the latest New York Times/CBS News poll. But a substantial majority also say that the health care system needs fundamental change and that rising costs are a serious threat to the economy — a view that economists strongly share.

Thus the political challenge facing any effort at an overhaul: Americans say they want change, but they also want to preserve their own status quo.

The disconnect can be explained partly by the peculiar economics of health care. Because third parties — the government or a private insurer — typically pay the bill, many people miss the fact that the money originally comes from them. They see the benefits of medical care without seeing the costs.

But trust in doctors is a factor as well. Even when doctors order costly treatments with serious side effects and little evidence of their being effective, as studies find is common, patients are loath to question the decision. Instead of blaming such treatments for the rising cost of medicine, many people are inclined to blame forces that health economists say are far less important, like greedy insurance companies or onerous malpractice laws.

Mr. Obama is well aware of the public perception. This is why he directs his criticism not at doctors but at insurers and drug companies. In his news conference on Wednesday night, he advocated creating a government panel with the power to begin moving Medicare away from its fee-for-service model and emphasize outcomes instead. But he described it in doctor-friendly terms — as “an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency.”

His rhetorical choices highlight one of the least discussed but most important conflicts in the current health care debate. The fight isn’t just a matter of Democrats vs. Republicans, Blue Dogs vs. liberals or patients vs. insurers. It is also doctors vs. doctors.

That’s the same as in Oklahoma in 1929. And what has happened to Dr. Shadid’s model? It has survived. He built a team of doctors who collaborated closely and were not paid based on how many procedures they performed. Today, this description fits the Mayo Clinic and the Cleveland Clinic (which Mr. Obama visited on Thursday), as well as less-known groups around the country.

Medicare data shows that these groups generally provide less expensive care and appear to deliver better results. Armed with this data, the doctors who run the groups have been lobbying Congress to make their model a bigger part of health reform. Two weeks ago, 13 such groups released a letter saying that recent versions of proposed legislation did not control costs enough.

Their goal is to weaken the fee-for-service system. In its place, doctors might receive a lump-sum payment to treat a patient with a certain condition, based on average costs elsewhere and on what scientific evidence had found to be effective. Hospitals with especially good outcomes might earn bonuses.

Advocates say such a system could ultimately give doctors more control. Rather than having to organize their schedules around the tests and procedures that insurers agree to reimburse, doctors could opt for the treatments they deem most effective. “It’s a lot more accountability, which is why it’s scary for physicians,” said Dr. Mark McClellan, a former head of Medicare under George W. Bush. “But in some ways it’s also more autonomy.”

On Tuesday, doctors and hospital executives from 10 cities with below-average cost growth gathered in Washington for a conference called, “How Do They Do That?” They were a diverse lot, only some of whom hailed from providers resembling the Mayo Clinic. While crediting a range of factors for their success, they generally agreed about what ails American medicine.

When Dr. McClellan, who helped organize the conference, asked how many people thought the fee-for-service system was “archaic and fundamentally at odds” with good practice, most hands shot up. In effect, they were siding with Dr. Shadid and against a system that provides incentives for more and more care, regardless of its benefit.

“There are no consequences right now to over-utilization,” Dr. Anthony F. Oliva, chief medical officer of the Guthrie Healthcare System, in northeast Pennsylvania, said later. “If you don’t have consequences, you won’t change the culture. If you don’t have consequences, the people that are killing themselves to control cost are going to say, ‘Why am I doing this?’”

It is a message, of course, that a doctor can deliver more easily than anyone else.

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Is the verb 'friend' related to 'befriend'?

I argued, during my Friday mid-afternoon (10 July) co-presentation with Vance 'Joy of Soy' and 'EarthtoPhilly' Lehmkuhl on social media at the 35th Annual NAVS Vegetarian Summerfest, that these two verbs are too similar to be unrelated. An audience member disagreed with me, but Toronto's Lauren Corman of Animal Voices Podcast seems to agree because during her most recent podcast she asked listeners to 'befriend' them on Facebook.

Listen and subscribe here:
http://www.learnoutloud.com/Podcast-Directory/Sports-and-Hobbies/Pets/Animal-Voices-Podcast/6803

Wednesday, July 22, 2009

Summerfest Presentation: What IS Social Media? What ARE Social Media?

What IS Social Media?

http://en.wikipedia.org/wiki/Social_media

Social media is online content created by people using highly accessible and scalable publishing technologies. Social media is a shift in how people discover, read and share news, information and content; it's a fusion of sociology and technology, transforming monologues (one to many) into dialogues (many to many) and is the democratization of information, transforming people from content readers into publishers. Social media has become extremely popular because it allows people to connect in the online world to form relationships for personal, political and business use. Businesses also refer to social media as user-generated content (UGC) or consumer-generated media (CGM).
Information outputs and human interaction

Primarily, social media depend on interactions between people as the discussion and integration of words to build shared-meaning, using technology as a conduit.

Social media utilities create opportunities for the use of both inductive and deductive logic by their users. Claims or warrants are quickly transitioned into generalizations due to the manner in which shared statements are posted and viewed by all. The speed of communication, breadth, and depth, and ability to see how the words build a case solicits the use of rhetoric. Induction is frequently used as a means to validate or authenticate different users' statements and words. Rhetoric is an important part of today’s language in social media.

Social media are not finite: there is not a set number of pages or hours. The audience can participate in social media by adding comments, instant messaging or even editing the stories themselves.


Examples

Social media can take many different forms, including Internet forums, weblogs, social blogs, wikis, podcasts, pictures and video. Technologies include: blogs, picture-sharing, vlogs, wall-postings, email, instant messaging, music-sharing, crowdsourcing, and voice over IP, to name a few. Examples of social media applications are Google Groups (reference, social networking), Wikipedia (reference), MySpace (social networking), Facebook (social networking), MouthShut.com yelp.com (product reviews), Youmeo (social network aggregation), Last.fm (personal music), YouTube (social networking and video sharing), Avatars United (social networking), Second Life (virtual reality), Flickr (photo sharing), Twitter (social networking and microblogging), Open Diary (blogging), and other microblogs such as Jaiku. Many of these social media services can be integrated via social network aggregation platforms like Mybloglog and Plaxo.





Social media: a categorization

Examples of social media software applications include:

Communication

Collaboration

Multimedia

Reviews and Opinions

Entertainment

Social Media is online content created by people using highly accessible and scalable publishing technologies. Social media is a shift in how people discover, read and share news, information and content; it's a fusion of sociology and technology, transforming monologues (one to many) into dialogues (many to many) and is the democratization of information, transforming people from content readers into publishers. Social media has become extremely popular because it allows people to connect in the online world to form relationships for personal, political and business use. Businesses also refer to social media as user-generated content (UGC) or consumer-generated media (CGM).