Saturday, February 7, 2009
nauseating subject
What is truly nauseating is the way city officials have wasted HUNDREDS of THOUSANDS of our tax dollars in EACH and EVERY city construction project over the past four years! They do it with NO apology, embarrassment, or sense of shame. THAT is truly nauseating in its scope and arrogance. we need change. NOW.
commentary
Is it possible that it is my opponent asking me to stop writing about things they dont understand - like variances? That would be completely understandable in view of his almost total lack of participation and involvement in City affairs for the past two years. Anybody wanting to become a Council person should have a pretty good grasp of such things, unless they just plan to have the Mayor explain it to them and regurgitate those words anyway. Of course having the Mayor explain anything, or be utilized as a source of knowledge, is a scary concept in its own right, but I am sure there will be a meeting of the minds somewhere, such as it is. Not being a proctologist, that pain in your butt could easily be a symptom of a longterm, lifelong, chronic hemmorhoidal condition that can effect the people around you even more than yourself. There is currently no cure for that malady, unfortunately, but it might be worth a trip to your physician. Dr. Mel P. Johnson
commentary
George Lob has been to TWO Council meetings in the past TWO YEARS! He knows NOTHING about the issues facing our community and would be just another YES man and lap dog for Billy. Garcia backed out because SAID he needed to spend more time with his family, yet he is seen all over town campaigning hard and often for their slate! What happened to all that quality time he was supposed to be spending with his family? Makes you wonder why he REALLY backed out, doesnt it?
another example
Is it more a problem that Dotson asked for shuttle ridership five times, OR that he got NO ANSWER five times? Was ANYBODY else concerned with the ridership? NO. Did anybody else ask ANY questions about the shuttle? Who IS the concerned one that is interested in the city operations? He probably could be more forceful and demand answers but its just another example of the lack of cooperation and communication that exists from the City Manager.
Friday, February 6, 2009
read the script
Is the Optimist guy going to run on a platform of ANY issues? Or is he just going to go with the issues and dialog that Billy and Garcia give him? IE We somehow, NEED this expensive gym so that the contractors can buy a new car! Price is NO object! Its immaterial! IRRELEVANT! We will pay whatever the contractor wants - 300%, 400% or more in profits, no problem! DOZENS of change orders almost guaranteed because we have NO CLUE about planning ahead of time! We couldn't even figure out that bathrooms might need water, sewer, and electric hookups! The forgotten possibilities and change orders on the new gym are ENDLESS! Parking and height problems? NO PROBLEM, as we will just give our self variances that wouldn't even be seriously considered for the average residents! Its not a problem (for us) because when our funds get low, we will just raise the residents taxes and fees! NO real PROBLEM! The residents MIGHT get cranky when we hose them repeatedly, but they are manageable if we just continue to dazzle them with BS! Simple. All Mr Lob has to do is recite the script!
forgotten details
The point is being made that there are parking problems NOW on those TWO DAYS a week that the gym is fully utilized. Is there anybody who is suggesting that a new gym will bring in LESS people? Of course not, it will bring in MORE people and make the parking problems there EVEN WORSE! More thought needs to be given to the parking situation and a solution found. Off-site parking is NOT the answer to everyday parking problems that already exist, and will get WORSE woith a new gym and more activities. It is generally a good thing to get more residents involved in the gym activities but it DOES place an undue burden on the residents who live in that area on a daily basis already, and it will only get worse if better planning is not done. This parking problem sounds a lot like the FORGOTTEN bathroom hookups, a detail that wasnt anticipated or planned for very well in advance, or even handled adequately once it WAS realized to be a necessity for the functioning of the facility and a problem.
parking problems
When jazzercise and a basketball game are being done at the same time the front parking lot is packed, along with the swales on both sides back to, and into, the back lot. Go any Teusday or Thursday and see for yourself. Its good that the residents are using the facility those couple days a week but DOES place a burden on the residents in that area who have cars parked in their swales and sometimes driveways, due to insufficient parking spots. During the one year, minimum, construction time to build a new gym, where are those people going to park? At the Optimist Club? Lions Club? There will be staging in the back parking lot and construction materials and equipment in the front lot!
Thursday, February 5, 2009
zoning rules clarified
Any of you residents wanting to upgrade, update, or enhance your properties and need a 10% variance are out of luck. We will righteously claim that it changes the character of the neighborhood, affects property values, etc etc. However, when WE, the city, want a 26% zoning variance, NO PROBLEM, because WE are the ultimate authority on zoning matters and WE CAN. Sure, it like having the fox guard the hen house, but HEY! Sure, we have a vested interest in giving the variance because we WANT it badly to pass. We can even claim that the community will be harmed if it isnt passed in the humongous form we want. A slightly smaller one would deprive... uh... well....perhaps.... maybe a few kids... well, anyway, just remember- the zoning rules apply ONLY to the residents. The City can get variances for ANYTHING we want to build! Adequate parking and height requirements are NOT A PROBLEM (for us)- just you guys.
interplanetary communication
New jobless claims soared to a more than 26-year high in the latest week and a record number of Americans are receiving jobless benefits, according to government data released Thursday. Meanwhile, productivity soared at the end of last year as companies cut the number of hours worked faster than output declined, a reflection of the massive number of layoffs. And factory orders dropped for a fifth straight month in December, closing out the weakest year since 2002. Earth to Mayor and Council- we HAVE a problem and NO, it doesnt just apply to everyone else! What planet ARE you guys on? Everyone on THIS planet is affected! They are cutting costs, consolidating, and tightening their belts. Why are YOU GUYS not doing the same?
Wednesday, February 4, 2009
no basis in fact
Is it possible that the Optimist president doesnt know what is in the Pistorino report? Is it possible he doesnt even know it EXISTS? If he had actually read it- new roof, floors, walls, fire sprinklers, and structural supports, documented and itemized estimates by an eminently qualified structural engineer, confirming that the gym can be renovated for 1.6-1.8 million to a like-new condition - he would NEVER have said that its "like putting lipstick on a pig". Its a interesting turn of phrase but unfortunately has NO basis in reality. IF he had actually READ the Pistorino report, how could he make such a ridiculous statement? If hes going to present himself as a source of more-or-LESS rational opinion in public, he should do some homework first, or he will embarrass himself, again.
monitoring
One of the reasons I check this site on a daily basis is to insure that my name is NOT ascribed to any comments or positions I have not made. If it should happen I will set the record straight ASAP. It would seem to be a simple matter for the webmaster to determine if the comment came from my web address or not. There are some people who will not sign their names for their own reasons ie fear of retribution by the City, for the most part, and those fears are not unfounded. I will continue to monitor this site on at least a daily basis and post as I see fit. Dr. Mel Johnson
clarification
Let me clear the air. Whoever says they have it good authority that I rarely post on this site has NEVER spoken with me about it, because its patently NOT TRUE. Although I have another blog at GreenGuy1700 at blogspot, I check this site at least daily, and post using my name. The Gazette editor made the remark that, since my letters and everyone elses letters to the Gazette editor, are signed, he suggested that all posts be signed. It sounded reasonable so I have taken the lead, and started signing my posts. Lead by example is my motto, so I am trying this approach out to see if it catches on. I believe it will stop, or at least slow down, the personal insults and attacks that are sometimes posted here, if everyone signs their names and takes responsibility for their comments. Your comments are welcomed. Dr. Mel Johnson
corrections ?
IF there are errors in anything I have posted, feel free to correct them and add the information you feel is correct, along with the explanation of where my error was and why your explanation is better. I make no claims of being a typist. Thanks. Dr. Mel Johnson
let the debates begin !
Letters to the Editor, addressing the Council, and this forum are just some of the ways ones opinions and the supporting rationale can be presented and discussed. It will be interesting to see the opinions and rationale being presented by all the candidates here, and by other means. I welcome debate and discussion regarding my positions, as it is the foundation and basis of American democracy in action. BTW, letters to the Editor are SIGNED too. Dr. Mel Johnson
public explanation needed
While community activism is not always pretty and the positive effects that are intended do not always happen, at the very least it shows a passion and caring for this community and an ability and willingness to become involved. How can somebody who has attended two Council meetings in TWO years say they have a handle on any of the issues that face our community? They have been phoning it in? As good as the Optimists have been for our community over the years, they are really only involved with one area of our City- athletics. Well, two, if you count that very possibly contrived story about having a connection with the pool and putting money in their account to avoid sales tax! Cant wait to see the explanation about that! Why doesnt Mr Lob just make that explanation public?
Tuesday, February 3, 2009
slept thru it?
Its hard to believe that somebody would vote for a candidate who only attended two Council meetings in TWO years. How many times did they address the Council? How many letters to the Editor did they publish? Are they on any volunteer Boards? All of these things are indications of being up to date and INVOLVED in the issues that face our community TODAY. Of course its possible that somebody watched the Council proceedings on Comcast- its just as likely they didnt bother, or slept thru it, no? The best way to figure out a candidate and what they stand for is in a debate. Ask him, or her. It will be easy to tell who is up-to-date and who isnt; who is regurgitating a party line, and who isnt.
still waiting
No word yet on the FOI request regarding the Optimist connection to the pool. It was supposedly written by Mr. Lob and explains in detail what the connection is, has been in the past, and how it works. It is assumed that verified bank statements and deposit slips are included as documentation of that relationship. How long does it usually take to have a FOI request acted on? What time frame would be considered TIMELY. Dr. Mel Johnson
in memoriam
Dr. James was an excellent physician and friend to many in the Springs. He loved our little town dearly and was a strong voice and advocate of, and for, our community. A memorial service will be held Wednesday at the Country Club 6-7pm. Miami Springs has lost one of its pillars, and he will be deeply missed by many. Dr. Mel Johnson
debates are needed now
Rumor has it that Mr Lob is running for Group 3. GREAT. Everybody should have an opponent so that they can explain their positions on various issues and their rationale behind it. Debates should be the perfect place to do that, and should be scheduled immediately. Has anybody actually seen him at ANY Council meeting in the past TWO YEARS? Other than the one where he spoke in favor of the new gym, at any cost?
principle is the same
I have lived here for fifty years, have no kids at the Rec center, and dont mind paying for OUR kids to play and enjoy themselves here. I DO have a problem when I am expected to pay for EVERYBODY else's kids TOO, from outside the Springs! I do not golf either but I dont mind paying the bond because it is a convenience for our golfers AND preserves the green space for the next generation of kids. I also do not mind if outsiders come to play our course, as long as they pay the going standard rate. Ditto the pool. I WOULD have a problem if we gave the outside golfers a 60% discount, while we are losing 190k per year. Same goes with the pool, as the principle is the same. While a steep discount doesnt appear to be happening at the golf course now, it DOES appear to be happening at the pool. How can that be justified? Dr. Mel Johnson
Lack of political will?
Op-Ed Columnist
By BOB HERBERT
Published: February 2, 2009
I wonder what it will take to get this country serious about repairing and rebuilding its crumbling and increasingly obsolete infrastructure.
The catastrophe in New Orleans didn’t do it. Yes, that was an infrastructure tragedy. As the historian Douglas Brinkley wrote in his remarkable book, “The Great Deluge”:
“What people didn’t yet fully comprehend was that the overall disaster, the sinking of New Orleans, was a man-made debacle, resulting from poorly designed levees and floodwalls.”
And the spectacular rush-hour collapse of the Interstate 35W bridge over the Mississippi River in Minneapolis, which killed 13 people, was not enough to get us serious.
Not even the terrible economic downturn that has gripped the country — a downturn that could be eased by a truly big-time surge of infrastructure investment — has been enough to get the leaders of the country to do the right thing.
We’re rushing to bail out the banking industry for what? What kind of country will we have once the bankers are fat and happy again? The U.S. will still be a nation with a pathetic mid-20th-century infrastructure struggling to make it in a dynamic 21st-century world. It’s a blueprint for sustained national decline.
The reason to seize this particular moment to move with a laserlike focus on the infrastructure is because of the desperate need to stop the advancing rot, and because rebuilding the infrastructure is a phenomenal source of employment.
The American Society of Civil Engineers, in a report released last week, essentially described the state of American infrastructure as dreadful. More than a quarter of the nation’s bridges were rated structurally deficient or functionally obsolete. Public transportation systems and the nation’s dams and levees are generally in sorry shape, many of them more than a half-century old.
Listen to what the report had to say about the water we drink:
“America’s drinking water systems face an annual shortfall of at least $11 billion to replace aging facilities that are near the end of their useful life and to comply with existing and future federal water regulations. This does not account for growth in the demand for drinking water over the next 20 years. Leaking pipes lose an estimated seven billion gallons of clean drinking water a day.”
The society gave the nation’s infrastructure an overall grade of D and said it would require an investment of $2.2 trillion over five years to get it back into decent shape.
When you juxtapose this tremendous national need with the wholesale destruction of employment that has occurred over the past several months (and that is expected to continue for some time), you have to wonder why President Obama and Congressional leaders are not moving with extraordinary quickness to put together an infrastructure investment program that is both vast and visionary.
Instead, 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.
Among those who have expressed their concerns publicly is Gov. Ed Rendell of Pennsylvania, a Democrat and persistent advocate of infrastructure investment. Just prior to President Obama’s inauguration, Mr. Rendell said of the stimulus package being considered by the House: “Anybody who thinks — if the president-elect thinks, or the team thinks — that this is the answer to America’s infrastructure needs is in a different universe.”
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.
By BOB HERBERT
Published: February 2, 2009
I wonder what it will take to get this country serious about repairing and rebuilding its crumbling and increasingly obsolete infrastructure.
The catastrophe in New Orleans didn’t do it. Yes, that was an infrastructure tragedy. As the historian Douglas Brinkley wrote in his remarkable book, “The Great Deluge”:
“What people didn’t yet fully comprehend was that the overall disaster, the sinking of New Orleans, was a man-made debacle, resulting from poorly designed levees and floodwalls.”
And the spectacular rush-hour collapse of the Interstate 35W bridge over the Mississippi River in Minneapolis, which killed 13 people, was not enough to get us serious.
Not even the terrible economic downturn that has gripped the country — a downturn that could be eased by a truly big-time surge of infrastructure investment — has been enough to get the leaders of the country to do the right thing.
We’re rushing to bail out the banking industry for what? What kind of country will we have once the bankers are fat and happy again? The U.S. will still be a nation with a pathetic mid-20th-century infrastructure struggling to make it in a dynamic 21st-century world. It’s a blueprint for sustained national decline.
The reason to seize this particular moment to move with a laserlike focus on the infrastructure is because of the desperate need to stop the advancing rot, and because rebuilding the infrastructure is a phenomenal source of employment.
The American Society of Civil Engineers, in a report released last week, essentially described the state of American infrastructure as dreadful. More than a quarter of the nation’s bridges were rated structurally deficient or functionally obsolete. Public transportation systems and the nation’s dams and levees are generally in sorry shape, many of them more than a half-century old.
Listen to what the report had to say about the water we drink:
“America’s drinking water systems face an annual shortfall of at least $11 billion to replace aging facilities that are near the end of their useful life and to comply with existing and future federal water regulations. This does not account for growth in the demand for drinking water over the next 20 years. Leaking pipes lose an estimated seven billion gallons of clean drinking water a day.”
The society gave the nation’s infrastructure an overall grade of D and said it would require an investment of $2.2 trillion over five years to get it back into decent shape.
When you juxtapose this tremendous national need with the wholesale destruction of employment that has occurred over the past several months (and that is expected to continue for some time), you have to wonder why President Obama and Congressional leaders are not moving with extraordinary quickness to put together an infrastructure investment program that is both vast and visionary.
Instead, 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.
Among those who have expressed their concerns publicly is Gov. Ed Rendell of Pennsylvania, a Democrat and persistent advocate of infrastructure investment. Just prior to President Obama’s inauguration, Mr. Rendell said of the stimulus package being considered by the House: “Anybody who thinks — if the president-elect thinks, or the team thinks — that this is the answer to America’s infrastructure needs is in a different universe.”
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.
Monday, February 2, 2009
New medical paradigm needed
Unboxed
Disruptive Innovation, Applied to Health Care
Noah Berger for The New York Times.Ann O’Brien of Kaiser Permanente uses a touch-screen tablet computer in San Leandro, Calif.
By JANET RAE-DUPREE
Published: January 31, 2009
THE health care system in America is on life support. It costs too much and saps economic vitality, achieves far too little return on investment and isn’t distributed equitably. As the Obama administration tries to diagnose and treat what ails the system, however, reformers shouldn’t be worried only about how to pay for it.
Noah Berger for The New York Times
Dr. Yan Chow, a pediatrician with Kaiser, demonstrates a videoconferencing system that would allow doctors to speak with patients in their homes.
Noah Berger for The New York Times
A laser keyboard could be used in spaces too small for a conventional one and might help prevent the spread of infection among hospital workers.
Instead, the country needs to innovate its way toward a new health care business model — one that reduces costs yet improves both quality and accessibility.
Two main causes of the system’s ills are century-old business models, for the general hospital and the physician’s practice, both of which are based on treating illness, not promoting wellness. Hospitals and doctors are paid by insurers and the government for the health care equivalent of piecework: hospitals profit from full beds and doctors profit from repeat visits. There is no financial incentive to keep patients healthy.
“The business models were all created decades ago, and acute disease drove those costs at the time,” says Steve Wunker, a senior partner at the consulting firm Innosight. “Most businesses in this industry are looking at their business model as entirely immutable. They’re looking for innovative offerings that fit this frozen model.”
Advances in technology and medical research are making it possible to envision an entirely new health care system that provides more individualized care without necessarily increasing costs, some health care experts say.
For instance, genetic breakthroughs have helped reveal time and again that what we thought was one disease — Type 2 diabetes, for instance — actually represents a score or more of distinct illnesses, each of which responds best to a different type of therapy, according to medical professionals.
As researchers develop ways to define diagnoses more precisely, more effective treatments can be prescribed, says Matthew Holt, founder of the Health Care Blog and co-founder of the biannual conference Health 2.0. Ultimately, those therapies can be administered by nurse practitioners or others trained to handle routine ailments. The expensive “intuitive medicine” practiced by doctors trained to wade through a thicket of mysterious symptoms in search of an accurate diagnosis can then focus on those cases that truly require their services.
Using innovation management models previously applied to other industries, Clayton M. Christensen, a Harvard Business School professor, argues in “The Innovator’s Prescription” that the concepts behind “disruptive innovation” can reinvent health care. The term “disruptive innovation,” which he introduced in 2003, refers to an unexpected new offering that through price or quality improvements turns a market on its head.
Disruptive innovators in health care aim to shape a new system that provides a continuum of care focused on each individual patient’s needs, instead of focusing on crises. Mr. Christensen and his co-authors argue that by putting the financial interests of hospitals and doctors at the center, the current system gives routine illnesses with proven therapies the same intensive and costly specialized care that more complicated cases require.
“Health care hasn’t become affordable,” he said in an interview, “because it hasn’t yet gone through disruptive decentralization.”
It’s coming, though. Some health care suppliers have set up fixed-fee integrated systems, and accept monthly payments from members in exchange for a promise of cradle-to-grave health care. Each usually also charges a small co-payment for treatment. Routine cases are handled through lower-cost facilities, leaving more complicated cases to higher-cost hospitals and specialists. Such systems include Kaiser Permanente, Intermountain Healthcare in Utah, the Mayo Clinic, the Geisinger Health System in Pennsylvania and the Veterans Health Administration.
By creating a continuum of care that follows patients wherever they go within an integrated system, says the Princeton University economist Uwe Reinhardt, care providers can stay on top of what preventive measures and therapies are most effective. Tests aren’t needlessly duplicated, competing medications aren’t prescribed by different doctors, and everyone knows what therapies a patient has received. As a result, integrated systems like Kaiser’s provide 22 percent greater cost efficiency than competing systems, according to a 2007 study by Hewitt Associates.
Kaiser’s system, in particular, has proved the benefits of an integrated system, Mr. Reinhardt says. “It is much cheaper than pay-for-service systems, because they have absolutely no incentive to overtreat you, but they have every incentive to keep you healthy,” he says. “Kaiser still makes mistakes — any large system does — but their facilities always come out ahead in every service quality survey I’ve reviewed.”
At Kaiser, experimentation with new technologies and business models occurs at the Sidney R. Garfield Health Care Innovation Center in San Leandro, Calif. Kaiser opened the facility in 2006 to test such new technologies as a videoconferencing system linking health care professionals to patients in their homes. Another is a laser-projected keyboard to prevent the spread of germs via computer equipment.
The Stanford economist Alain C. Enthoven, who has been studying the nation’s health care system for more than 30 years, said integrated systems “are the disruptive innovation we need to turn loose on the rest of America.” In a recent report for the Committee for Economic Development, Mr. Enthoven advocates letting consumers choose between traditional fee-for-service plans and less expensive integrated systems, then letting consumers pocket the difference in premiums. “Medicine is a complicated team sport,” he notes. “It takes an integrated system to keep the patient at the center of it.”
DR. JOHN H. COCHRAN, who as executive director of the Permanente Foundation is the highest-ranking physician among Kaiser’s 14,000-plus doctors, says information technology will play a crucial role in revolutionizing the country’s health care system.
“There’s a mythology that I.T. decreases the personal relationship between the physician and the patient,” he said. “In point of fact, it enhances it.”
Bringing business school concepts to bear on health care simply makes sense, Dr. Cochran says.
“We have a financial, macroeconomic, multinational crisis right now that can be paralytic or catalytic,” he said. “Let’s make sure we’re a catalyst.”
Janet Rae-Dupree writes about science and emerging technology in Silicon Valley. E-mail: unboxed @nytimes.com.
Disruptive Innovation, Applied to Health Care
Noah Berger for The New York Times.Ann O’Brien of Kaiser Permanente uses a touch-screen tablet computer in San Leandro, Calif.
By JANET RAE-DUPREE
Published: January 31, 2009
THE health care system in America is on life support. It costs too much and saps economic vitality, achieves far too little return on investment and isn’t distributed equitably. As the Obama administration tries to diagnose and treat what ails the system, however, reformers shouldn’t be worried only about how to pay for it.
Noah Berger for The New York Times
Dr. Yan Chow, a pediatrician with Kaiser, demonstrates a videoconferencing system that would allow doctors to speak with patients in their homes.
Noah Berger for The New York Times
A laser keyboard could be used in spaces too small for a conventional one and might help prevent the spread of infection among hospital workers.
Instead, the country needs to innovate its way toward a new health care business model — one that reduces costs yet improves both quality and accessibility.
Two main causes of the system’s ills are century-old business models, for the general hospital and the physician’s practice, both of which are based on treating illness, not promoting wellness. Hospitals and doctors are paid by insurers and the government for the health care equivalent of piecework: hospitals profit from full beds and doctors profit from repeat visits. There is no financial incentive to keep patients healthy.
“The business models were all created decades ago, and acute disease drove those costs at the time,” says Steve Wunker, a senior partner at the consulting firm Innosight. “Most businesses in this industry are looking at their business model as entirely immutable. They’re looking for innovative offerings that fit this frozen model.”
Advances in technology and medical research are making it possible to envision an entirely new health care system that provides more individualized care without necessarily increasing costs, some health care experts say.
For instance, genetic breakthroughs have helped reveal time and again that what we thought was one disease — Type 2 diabetes, for instance — actually represents a score or more of distinct illnesses, each of which responds best to a different type of therapy, according to medical professionals.
As researchers develop ways to define diagnoses more precisely, more effective treatments can be prescribed, says Matthew Holt, founder of the Health Care Blog and co-founder of the biannual conference Health 2.0. Ultimately, those therapies can be administered by nurse practitioners or others trained to handle routine ailments. The expensive “intuitive medicine” practiced by doctors trained to wade through a thicket of mysterious symptoms in search of an accurate diagnosis can then focus on those cases that truly require their services.
Using innovation management models previously applied to other industries, Clayton M. Christensen, a Harvard Business School professor, argues in “The Innovator’s Prescription” that the concepts behind “disruptive innovation” can reinvent health care. The term “disruptive innovation,” which he introduced in 2003, refers to an unexpected new offering that through price or quality improvements turns a market on its head.
Disruptive innovators in health care aim to shape a new system that provides a continuum of care focused on each individual patient’s needs, instead of focusing on crises. Mr. Christensen and his co-authors argue that by putting the financial interests of hospitals and doctors at the center, the current system gives routine illnesses with proven therapies the same intensive and costly specialized care that more complicated cases require.
“Health care hasn’t become affordable,” he said in an interview, “because it hasn’t yet gone through disruptive decentralization.”
It’s coming, though. Some health care suppliers have set up fixed-fee integrated systems, and accept monthly payments from members in exchange for a promise of cradle-to-grave health care. Each usually also charges a small co-payment for treatment. Routine cases are handled through lower-cost facilities, leaving more complicated cases to higher-cost hospitals and specialists. Such systems include Kaiser Permanente, Intermountain Healthcare in Utah, the Mayo Clinic, the Geisinger Health System in Pennsylvania and the Veterans Health Administration.
By creating a continuum of care that follows patients wherever they go within an integrated system, says the Princeton University economist Uwe Reinhardt, care providers can stay on top of what preventive measures and therapies are most effective. Tests aren’t needlessly duplicated, competing medications aren’t prescribed by different doctors, and everyone knows what therapies a patient has received. As a result, integrated systems like Kaiser’s provide 22 percent greater cost efficiency than competing systems, according to a 2007 study by Hewitt Associates.
Kaiser’s system, in particular, has proved the benefits of an integrated system, Mr. Reinhardt says. “It is much cheaper than pay-for-service systems, because they have absolutely no incentive to overtreat you, but they have every incentive to keep you healthy,” he says. “Kaiser still makes mistakes — any large system does — but their facilities always come out ahead in every service quality survey I’ve reviewed.”
At Kaiser, experimentation with new technologies and business models occurs at the Sidney R. Garfield Health Care Innovation Center in San Leandro, Calif. Kaiser opened the facility in 2006 to test such new technologies as a videoconferencing system linking health care professionals to patients in their homes. Another is a laser-projected keyboard to prevent the spread of germs via computer equipment.
The Stanford economist Alain C. Enthoven, who has been studying the nation’s health care system for more than 30 years, said integrated systems “are the disruptive innovation we need to turn loose on the rest of America.” In a recent report for the Committee for Economic Development, Mr. Enthoven advocates letting consumers choose between traditional fee-for-service plans and less expensive integrated systems, then letting consumers pocket the difference in premiums. “Medicine is a complicated team sport,” he notes. “It takes an integrated system to keep the patient at the center of it.”
DR. JOHN H. COCHRAN, who as executive director of the Permanente Foundation is the highest-ranking physician among Kaiser’s 14,000-plus doctors, says information technology will play a crucial role in revolutionizing the country’s health care system.
“There’s a mythology that I.T. decreases the personal relationship between the physician and the patient,” he said. “In point of fact, it enhances it.”
Bringing business school concepts to bear on health care simply makes sense, Dr. Cochran says.
“We have a financial, macroeconomic, multinational crisis right now that can be paralytic or catalytic,” he said. “Let’s make sure we’re a catalyst.”
Janet Rae-Dupree writes about science and emerging technology in Silicon Valley. E-mail: unboxed @nytimes.com.
special medication delivery
..Novelties
‘Fantastic Voyage,’ Revisited: The Pill That Navigates
Philips ResearchAn opened iPill: The reservoir, left, can deposit medicine at specific spots in the body. The rest of the capsule houses sensors and other technology.
By ANNE EISENBERG
Published: January 31, 2009
THE doctor’s advice to “take two aspirin and call me in the morning” may one day be updated to “take this pill, and it will call me in the morning.”
Philips Research in Eindhoven, the Netherlands, has developed a prototype for a pill that can be programmed to navigate toward a specific trouble spot in the body and deposit its medicine there, radioing dispatches to the doctor as it travels.
The technology, now being tested in animals but not yet in humans, may one day be used to treat digestive tract disorders like colitis and Crohn’s disease, said Dr. Peter van der Schaar, a gastroenterologist in Heerlen, also in the Netherlands. He worked with Philips in developing the device, which is officially named the Intelligent Pill and which Philips calls the iPill for short.
The iPill, a plastic capsule that is to be taken with food or water, is intended to travel through the digestive system naturally, typically within about 24 hours, dispensing its medicine at specific locations along the way, Dr. van der Schaar said.
Localized drug delivery has advantages: it can mean smaller doses of a drug, as well as fewer problems than when the drug travels through the body in the bloodstream. “The drugs might have fewer side effects while having a higher therapeutic value,” he said.
About the size of a plump multivitamin, the iPill is one-third medicine and two-thirds microprocessor, battery, antenna and other miniaturized equipment. The pill can send data to a control station about temperature, for example, and the time that has elapsed since it was swallowed. And the medical staff can then respond.
“If a doctor sees an adverse reaction,” said Steve Klink, a senior communications manager at Philips Research, a signal could be sent “to override the iPill and not distribute any more of the drug.”
Michael J. Cima , a professor of materials science and engineering at the Massachusetts Institute of Technology and an investigator at the Koch Institute for Integrative Cancer Research there, said that electronic systems for localized drug delivery were already being used in clinical testing of pharmaceutical products. For example, a volunteer swallows a pill that is tracked with X-rays and programmed to release its medicine at a specific spot in the gastrointestinal tract — for instance, in the colon.
The pills aren’t yet in use in the general population. But Philips Research, an arm of Philips Electronics, may be well placed to bridge that gap, Mr. Cima said. “Those folks are in consumer electronics,” he noted.
Basic to the iPill’s successful journey is a sensor within it that detects the acidity, as measured by the pH value, in the gastrointestinal tract. This varies from the high acidity of the stomach to the less acidic intestines to the more acidic colon. “We can program the pill to do a certain mode of action based on this change of pH,” Dr. van der Schaar said.
The medication is packed into a reservoir within the pill and can be released all at once or in bursts as it travels along, Mr. Klink of Philips said. A tiny pump inside the pill releases the drugs. The pump, made up of a motor and piston driven by a screw rod, is commanded by the microprocessor. A silver oxide battery in the pill lasts about two days, twice the time it usually takes for the pill to travel naturally through the body.
The device is being tested at the Philips Research laboratories in Briarcliff Manor, N.Y., said Jeff Shimizu, a senior scientist. Researchers are using an aquarium as a stand-in for the watery medium of the human body, testing the propagation of the iPill’s radio waves as they make their way from the tank to the receiving station.
“It’s working out pretty well,” Mr. Shimizu said.
Another company that has developed technology to deliver drugs to specific regions of the gastrointestinal tract is Pharmaceutical Profiles Ltd. of Ruddington, England. It specializes in clinical trials for pharmaceutical and biotechnology customers. More than 3,500 capsules packed with drugs, an antenna, electronics, and other materials have been ingested by volunteers using the Pharmaceutical Profiles technology, called Enterion, since 2002, said Dr. Mark Egerton, managing director. Dr. Cima of M.I.T. said that one day, localized electronic drug delivery might play an important role in patient care.
“You could put a drug to treat colon cancer or irritable bowel syndrome at a select location in the G.I. tract with great fidelity,” he said. “It could be the next step in therapy.”
‘Fantastic Voyage,’ Revisited: The Pill That Navigates
Philips ResearchAn opened iPill: The reservoir, left, can deposit medicine at specific spots in the body. The rest of the capsule houses sensors and other technology.
By ANNE EISENBERG
Published: January 31, 2009
THE doctor’s advice to “take two aspirin and call me in the morning” may one day be updated to “take this pill, and it will call me in the morning.”
Philips Research in Eindhoven, the Netherlands, has developed a prototype for a pill that can be programmed to navigate toward a specific trouble spot in the body and deposit its medicine there, radioing dispatches to the doctor as it travels.
The technology, now being tested in animals but not yet in humans, may one day be used to treat digestive tract disorders like colitis and Crohn’s disease, said Dr. Peter van der Schaar, a gastroenterologist in Heerlen, also in the Netherlands. He worked with Philips in developing the device, which is officially named the Intelligent Pill and which Philips calls the iPill for short.
The iPill, a plastic capsule that is to be taken with food or water, is intended to travel through the digestive system naturally, typically within about 24 hours, dispensing its medicine at specific locations along the way, Dr. van der Schaar said.
Localized drug delivery has advantages: it can mean smaller doses of a drug, as well as fewer problems than when the drug travels through the body in the bloodstream. “The drugs might have fewer side effects while having a higher therapeutic value,” he said.
About the size of a plump multivitamin, the iPill is one-third medicine and two-thirds microprocessor, battery, antenna and other miniaturized equipment. The pill can send data to a control station about temperature, for example, and the time that has elapsed since it was swallowed. And the medical staff can then respond.
“If a doctor sees an adverse reaction,” said Steve Klink, a senior communications manager at Philips Research, a signal could be sent “to override the iPill and not distribute any more of the drug.”
Michael J. Cima , a professor of materials science and engineering at the Massachusetts Institute of Technology and an investigator at the Koch Institute for Integrative Cancer Research there, said that electronic systems for localized drug delivery were already being used in clinical testing of pharmaceutical products. For example, a volunteer swallows a pill that is tracked with X-rays and programmed to release its medicine at a specific spot in the gastrointestinal tract — for instance, in the colon.
The pills aren’t yet in use in the general population. But Philips Research, an arm of Philips Electronics, may be well placed to bridge that gap, Mr. Cima said. “Those folks are in consumer electronics,” he noted.
Basic to the iPill’s successful journey is a sensor within it that detects the acidity, as measured by the pH value, in the gastrointestinal tract. This varies from the high acidity of the stomach to the less acidic intestines to the more acidic colon. “We can program the pill to do a certain mode of action based on this change of pH,” Dr. van der Schaar said.
The medication is packed into a reservoir within the pill and can be released all at once or in bursts as it travels along, Mr. Klink of Philips said. A tiny pump inside the pill releases the drugs. The pump, made up of a motor and piston driven by a screw rod, is commanded by the microprocessor. A silver oxide battery in the pill lasts about two days, twice the time it usually takes for the pill to travel naturally through the body.
The device is being tested at the Philips Research laboratories in Briarcliff Manor, N.Y., said Jeff Shimizu, a senior scientist. Researchers are using an aquarium as a stand-in for the watery medium of the human body, testing the propagation of the iPill’s radio waves as they make their way from the tank to the receiving station.
“It’s working out pretty well,” Mr. Shimizu said.
Another company that has developed technology to deliver drugs to specific regions of the gastrointestinal tract is Pharmaceutical Profiles Ltd. of Ruddington, England. It specializes in clinical trials for pharmaceutical and biotechnology customers. More than 3,500 capsules packed with drugs, an antenna, electronics, and other materials have been ingested by volunteers using the Pharmaceutical Profiles technology, called Enterion, since 2002, said Dr. Mark Egerton, managing director. Dr. Cima of M.I.T. said that one day, localized electronic drug delivery might play an important role in patient care.
“You could put a drug to treat colon cancer or irritable bowel syndrome at a select location in the G.I. tract with great fidelity,” he said. “It could be the next step in therapy.”
securing your USB drive
Search All NYTimes.com
Tuesday, February 3, 2009
Personal TechWorld
February 2, 2009, 10:10 am
Q & A: Locking a Keychain Drive
By J.D. BiersdorferI have a U.S.B. drive, but am worried about keeping the data on it private. Is it possible to password-protect a U.S.B. drive?
If you already have the drive, an encryption utility program will let you lock it up. Many of these programs are designed for the needs of business users who need to protect sensitive corporate information; check out pgp.com to get an idea of the software offered for sale. Companies that make antivirus and security software may also have drive-encryption options for sale.
If the price is too high, consider shareware from a reputable site or a free open-source solution like TrueCrypt. TrueCrypt, with versions available to download for Windows XP and Vista, Mac OS X and Linux, can encrypt the entire U.S.B. drive. Although some open-source software projects tend to get a little technical for new users, the TrueCrypt site has an illustrated beginner’s tutorial and a lengthy section devoted to Frequently Asked Questions.
If you are shopping for a new U.S.B. drive, several companies make models that have security measures built right in. Kingston, Verbatim and SanDisk all have their own variations on the secure U.S.B. drive; prices will probably be higher than those for regular U.S.B. drives. For the deeply security-minded, IronKey even makes waterproof, tamperproof U.S.B. drives with military-grade encryption software; the 1-gigabyte “personal” model costs $79.
ComputerWorld reviewed seven different brands of secure U.S.B. drives last year and has a head-to-head assessment if you want some in-depth opinions
Tuesday, February 3, 2009
Personal TechWorld
February 2, 2009, 10:10 am
Q & A: Locking a Keychain Drive
By J.D. BiersdorferI have a U.S.B. drive, but am worried about keeping the data on it private. Is it possible to password-protect a U.S.B. drive?
If you already have the drive, an encryption utility program will let you lock it up. Many of these programs are designed for the needs of business users who need to protect sensitive corporate information; check out pgp.com to get an idea of the software offered for sale. Companies that make antivirus and security software may also have drive-encryption options for sale.
If the price is too high, consider shareware from a reputable site or a free open-source solution like TrueCrypt. TrueCrypt, with versions available to download for Windows XP and Vista, Mac OS X and Linux, can encrypt the entire U.S.B. drive. Although some open-source software projects tend to get a little technical for new users, the TrueCrypt site has an illustrated beginner’s tutorial and a lengthy section devoted to Frequently Asked Questions.
If you are shopping for a new U.S.B. drive, several companies make models that have security measures built right in. Kingston, Verbatim and SanDisk all have their own variations on the secure U.S.B. drive; prices will probably be higher than those for regular U.S.B. drives. For the deeply security-minded, IronKey even makes waterproof, tamperproof U.S.B. drives with military-grade encryption software; the 1-gigabyte “personal” model costs $79.
ComputerWorld reviewed seven different brands of secure U.S.B. drives last year and has a head-to-head assessment if you want some in-depth opinions
bailouts for bunglers
Op-Ed Columnist
Bailouts for Bunglers
By PAUL KRUGMAN
Published: February 1, 2009
Question: what happens if you lose vast amounts of other people’s money? Answer: you get a big gift from the federal government — but the president says some very harsh things about you before forking over the cash.
Fred R. Conrad/The New York Times
Paul Krugman
Am I being unfair? I hope so. But right now that’s what seems to be happening.
Just to be clear, I’m not talking about the Obama administration’s plan to support jobs and output with a large, temporary rise in federal spending, which is very much the right thing to do. I’m talking, instead, about the administration’s plans for a banking system rescue — plans that are shaping up as a classic exercise in “lemon socialism”: taxpayers bear the cost if things go wrong, but stockholders and executives get the benefits if things go right.
When I read recent remarks on financial policy by top Obama administration officials, I feel as if I’ve entered a time warp — as if it’s still 2005, Alan Greenspan is still the Maestro, and bankers are still heroes of capitalism.
“We have a financial system that is run by private shareholders, managed by private institutions, and we’d like to do our best to preserve that system,” says Timothy Geithner, the Treasury secretary — as he prepares to put taxpayers on the hook for that system’s immense losses.
Meanwhile, a Washington Post report based on administration sources says that Mr. Geithner and Lawrence Summers, President Obama’s top economic adviser, “think governments make poor bank managers” — as opposed, presumably, to the private-sector geniuses who managed to lose more than a trillion dollars in the space of a few years.
And this prejudice in favor of private control, even when the government is putting up all the money, seems to be warping the administration’s response to the financial crisis.
Now, something must be done to shore up the financial system. The chaos after Lehman Brothers failed showed that letting major financial institutions collapse can be very bad for the economy’s health. And a number of major institutions are dangerously close to the edge.
So banks need more capital. In normal times, banks raise capital by selling stock to private investors, who receive a share in the bank’s ownership in return. You might think, then, that if banks currently can’t or won’t raise enough capital from private investors, the government should do what a private investor would: provide capital in return for partial ownership.
But bank stocks are worth so little these days — Citigroup and Bank of America have a combined market value of only $52 billion — that the ownership wouldn’t be partial: pumping in enough taxpayer money to make the banks sound would, in effect, turn them into publicly owned enterprises.
My response to this prospect is: so? If taxpayers are footing the bill for rescuing the banks, why shouldn’t they get ownership, at least until private buyers can be found? But the Obama administration appears to be tying itself in knots to avoid this outcome.
If news reports are right, the bank rescue plan will contain two main elements: government purchases of some troubled bank assets and guarantees against losses on other assets. The guarantees would represent a big gift to bank stockholders; the purchases might not, if the price was fair — but prices would, The Financial Times reports, probably be based on “valuation models” rather than market prices, suggesting that the government would be making a big gift here, too.
And in return for what is likely to be a huge subsidy to stockholders, taxpayers will get, well, nothing.
Will there at least be limits on executive compensation, to prevent more of the rip-offs that have enraged the public? President Obama denounced Wall Street bonuses in his latest weekly address — but according to The Washington Post, “the administration is likely to refrain from imposing tougher restrictions on executive compensation at most firms receiving government aid” because “harsh limits could discourage some firms from asking for aid.” This suggests that Mr. Obama’s tough talk is just for show.(If they dont want oversight, let them fail- MJ)
Meanwhile, Wall Street’s culture of excess seems to have been barely dented by the crisis. “Say I’m a banker and I created $30 million. I should get a part of that,” one banker told The New York Times. And if you’re a banker and you destroyed $30 billion? Uncle Sam to the rescue!
There’s more at stake here than fairness, although that matters too. Saving the economy is going to be very expensive: that $800 billion stimulus plan is probably just a down payment, and rescuing the financial system, even if it’s done right, is going to cost hundreds of billions more. We can’t afford to squander money giving huge windfalls to banks and their executives, merely to preserve the illusion of private ownership.
Bailouts for Bunglers
By PAUL KRUGMAN
Published: February 1, 2009
Question: what happens if you lose vast amounts of other people’s money? Answer: you get a big gift from the federal government — but the president says some very harsh things about you before forking over the cash.
Fred R. Conrad/The New York Times
Paul Krugman
Am I being unfair? I hope so. But right now that’s what seems to be happening.
Just to be clear, I’m not talking about the Obama administration’s plan to support jobs and output with a large, temporary rise in federal spending, which is very much the right thing to do. I’m talking, instead, about the administration’s plans for a banking system rescue — plans that are shaping up as a classic exercise in “lemon socialism”: taxpayers bear the cost if things go wrong, but stockholders and executives get the benefits if things go right.
When I read recent remarks on financial policy by top Obama administration officials, I feel as if I’ve entered a time warp — as if it’s still 2005, Alan Greenspan is still the Maestro, and bankers are still heroes of capitalism.
“We have a financial system that is run by private shareholders, managed by private institutions, and we’d like to do our best to preserve that system,” says Timothy Geithner, the Treasury secretary — as he prepares to put taxpayers on the hook for that system’s immense losses.
Meanwhile, a Washington Post report based on administration sources says that Mr. Geithner and Lawrence Summers, President Obama’s top economic adviser, “think governments make poor bank managers” — as opposed, presumably, to the private-sector geniuses who managed to lose more than a trillion dollars in the space of a few years.
And this prejudice in favor of private control, even when the government is putting up all the money, seems to be warping the administration’s response to the financial crisis.
Now, something must be done to shore up the financial system. The chaos after Lehman Brothers failed showed that letting major financial institutions collapse can be very bad for the economy’s health. And a number of major institutions are dangerously close to the edge.
So banks need more capital. In normal times, banks raise capital by selling stock to private investors, who receive a share in the bank’s ownership in return. You might think, then, that if banks currently can’t or won’t raise enough capital from private investors, the government should do what a private investor would: provide capital in return for partial ownership.
But bank stocks are worth so little these days — Citigroup and Bank of America have a combined market value of only $52 billion — that the ownership wouldn’t be partial: pumping in enough taxpayer money to make the banks sound would, in effect, turn them into publicly owned enterprises.
My response to this prospect is: so? If taxpayers are footing the bill for rescuing the banks, why shouldn’t they get ownership, at least until private buyers can be found? But the Obama administration appears to be tying itself in knots to avoid this outcome.
If news reports are right, the bank rescue plan will contain two main elements: government purchases of some troubled bank assets and guarantees against losses on other assets. The guarantees would represent a big gift to bank stockholders; the purchases might not, if the price was fair — but prices would, The Financial Times reports, probably be based on “valuation models” rather than market prices, suggesting that the government would be making a big gift here, too.
And in return for what is likely to be a huge subsidy to stockholders, taxpayers will get, well, nothing.
Will there at least be limits on executive compensation, to prevent more of the rip-offs that have enraged the public? President Obama denounced Wall Street bonuses in his latest weekly address — but according to The Washington Post, “the administration is likely to refrain from imposing tougher restrictions on executive compensation at most firms receiving government aid” because “harsh limits could discourage some firms from asking for aid.” This suggests that Mr. Obama’s tough talk is just for show.(If they dont want oversight, let them fail- MJ)
Meanwhile, Wall Street’s culture of excess seems to have been barely dented by the crisis. “Say I’m a banker and I created $30 million. I should get a part of that,” one banker told The New York Times. And if you’re a banker and you destroyed $30 billion? Uncle Sam to the rescue!
There’s more at stake here than fairness, although that matters too. Saving the economy is going to be very expensive: that $800 billion stimulus plan is probably just a down payment, and rescuing the financial system, even if it’s done right, is going to cost hundreds of billions more. We can’t afford to squander money giving huge windfalls to banks and their executives, merely to preserve the illusion of private ownership.
unmarried mothers
IN 1960, UNMARRIED MOTHERS accounted for about 5 percent of births in the United States. Now they are having almost 40 percent of the country’s babies. About half of these women are on their own, and the other half are living with a man at the time of the birth, according to Pamela Smock, a sociology professor at the University of Michigan, Ann Arbor. The stock characters of the explosion of out-of-wedlock births are feckless fathers and hapless young mothers. It’s true that most unmarried mothers are still in their 20s — and less often in their teens — and have no more than a high-school education.
welfare and the economy
(Page 2 of 2)
The data collected by The Times is the most recent available for every state and includes some similar programs financed solely by states, to give the broadest picture of cash aid. In a year when 1.1 million jobs disappeared, 18 states cut the rolls, 20 states expanded them, and caseloads in 12 states remained essentially flat, fluctuating less than 3 percent. (In addition, caseloads in the District of Columbia rose by nearly 5 percent.)
The rolls rose 7 percent in the West, stayed flat in the South, and fell in the Northeast by 4 percent and Midwest by 5 percent.
Seven states increased their rolls by double digits. Five states, including Texas and Michigan, made double-digit reductions. Of the 10 states with the highest child poverty rates, eight kept caseloads level or further reduced the rolls.
“This is evidence of a strikingly unresponsive system,” said Mark H. Greenberg, co-director of a poverty institute at the Georgetown University law school. Some administrators disagree.
“We’re still putting people to work,” said Larry Temple, who runs the job placement program for welfare recipients in Texas, where the rolls dropped 15 percent. “A lot of the occupations that historically we’ve been able to put the welfare people in are still hiring. Home health is a big one.”
Though some welfare recipients continue to find jobs, nationally their prospects have worsened. Joblessness among women ages 20 to 24 without a high school degree rose to 23.9 percent last year, from 17.9 percent the year before, according to the Bureau of Labor Statistics.
Some analysts offer a different reason for the Texas caseload declines: a policy that quickly halts all cash aid to recipients who fail to attend work programs.
“We’re really just pushing families off the program,” said Celia Hagert of the Center for Public Policy Priorities, a research and advocacy group in Austin, Tex.
Some officials predict the rolls will yet rise. “There’s typically a one- to two-year lag between an economic downturn and an uptick in the welfare rolls,” said David Hansell, who oversees the program in New York State, where the rolls fell 4 percent.
Indeed, as the recession has worsened in recent months, some states’ rolls have just started to grow. Georgia’s caseload fell until July 2008, but has since risen 5 percent. Still, as of October the national caseloads remained down 70 percent from their peak in the early 1990s under the predecessor program, Aid to Families with Dependent Children.
Nationally, caseloads fell every year from 1994 to 2007, to about 4.1 million people, a level last seen in 1964. The federal total for 2008 has not been published, but the Times analysis of state data suggests they remained essentially flat.
Some recent caseload reduction has been driven by a 2006 law that required states to place more recipients in work programs, which can be costly and difficult to run. It threatened states with stiff fines but eased the targets for states that simply cut the rolls.
“Some states decided they had to get tougher,” said Sharon Parrott of the Center for Budget and Policy Priorities, a Washington research and advocacy group.
Rhode Island was among them. Previously, the state had reduced but not eliminated grants to families in which an adult had hit a 60-month limit. Last year, it closed those cases, removing 2,200 children from the rolls.
Under the new federal accounting rules, that made it easier to meet statistical goals and protected the state from fines.
Michigan also imposed new restrictions, forcing applicants to spend a month in a job-search program before collecting benefits. Critics say the up-front requirement poses obstacles to the neediest applicants, like those with physical or mental illnesses.
“I think that’s a legitimate complaint,” said Ismael Ahmed, director of the Michigan Department of Human Services, though he blamed the federal rules. The program “was drawn for an economy that is not the economy most states are in.”
While food stamps usually grow faster than cash aid during recessions, the current contrast is stark. Many officials see cash aid in a negative light, as a form of dependency, while encouraging the use of food stamps and calling them nutritional support.
“Food assistance is not considered welfare,” said Donalda Carlson, a Rhode Island welfare administrator.
Nationally, the temporary assistance program gives states $16.8 billion a year — the same amount they received in the early 1990s, when caseloads were more than three times as high as they are now. Mr. Haskins, the program’s architect, said that obliged them to ensure the needy could return to the rolls. “States have plenty of money,” he said.
But most states have shifted the money into other programs — including child care and child welfare — and say they cannot shift it back without causing other problems.
Oregon expanded its cash caseload 19 percent last year, so far without major backlash. “That’s the purpose of the program — to be there for that need,” said Vic Todd, a senior state official. But California officials expressed ambivalence about a 6 percent rise in the cash welfare rolls in that state when it is facing a $40 billion deficit. “There’s some fine tuning of the program that needs to occur, to incentivize work,” said John Wagner, the state director of social services.
Among those sanguine about current caseload trends is Robert Rector, an analyst at the Heritage Foundation in Washington who is influential with conservative policy makers. He said the program had “reduced poverty beyond anyone’s expectations” and efforts to dilute its rigor would only harm the poor.
“We need to continue with the principle that you give assistance willingly, but you require the individual to prepare for self-sufficiency,” he said.
The data collected by The Times is the most recent available for every state and includes some similar programs financed solely by states, to give the broadest picture of cash aid. In a year when 1.1 million jobs disappeared, 18 states cut the rolls, 20 states expanded them, and caseloads in 12 states remained essentially flat, fluctuating less than 3 percent. (In addition, caseloads in the District of Columbia rose by nearly 5 percent.)
The rolls rose 7 percent in the West, stayed flat in the South, and fell in the Northeast by 4 percent and Midwest by 5 percent.
Seven states increased their rolls by double digits. Five states, including Texas and Michigan, made double-digit reductions. Of the 10 states with the highest child poverty rates, eight kept caseloads level or further reduced the rolls.
“This is evidence of a strikingly unresponsive system,” said Mark H. Greenberg, co-director of a poverty institute at the Georgetown University law school. Some administrators disagree.
“We’re still putting people to work,” said Larry Temple, who runs the job placement program for welfare recipients in Texas, where the rolls dropped 15 percent. “A lot of the occupations that historically we’ve been able to put the welfare people in are still hiring. Home health is a big one.”
Though some welfare recipients continue to find jobs, nationally their prospects have worsened. Joblessness among women ages 20 to 24 without a high school degree rose to 23.9 percent last year, from 17.9 percent the year before, according to the Bureau of Labor Statistics.
Some analysts offer a different reason for the Texas caseload declines: a policy that quickly halts all cash aid to recipients who fail to attend work programs.
“We’re really just pushing families off the program,” said Celia Hagert of the Center for Public Policy Priorities, a research and advocacy group in Austin, Tex.
Some officials predict the rolls will yet rise. “There’s typically a one- to two-year lag between an economic downturn and an uptick in the welfare rolls,” said David Hansell, who oversees the program in New York State, where the rolls fell 4 percent.
Indeed, as the recession has worsened in recent months, some states’ rolls have just started to grow. Georgia’s caseload fell until July 2008, but has since risen 5 percent. Still, as of October the national caseloads remained down 70 percent from their peak in the early 1990s under the predecessor program, Aid to Families with Dependent Children.
Nationally, caseloads fell every year from 1994 to 2007, to about 4.1 million people, a level last seen in 1964. The federal total for 2008 has not been published, but the Times analysis of state data suggests they remained essentially flat.
Some recent caseload reduction has been driven by a 2006 law that required states to place more recipients in work programs, which can be costly and difficult to run. It threatened states with stiff fines but eased the targets for states that simply cut the rolls.
“Some states decided they had to get tougher,” said Sharon Parrott of the Center for Budget and Policy Priorities, a Washington research and advocacy group.
Rhode Island was among them. Previously, the state had reduced but not eliminated grants to families in which an adult had hit a 60-month limit. Last year, it closed those cases, removing 2,200 children from the rolls.
Under the new federal accounting rules, that made it easier to meet statistical goals and protected the state from fines.
Michigan also imposed new restrictions, forcing applicants to spend a month in a job-search program before collecting benefits. Critics say the up-front requirement poses obstacles to the neediest applicants, like those with physical or mental illnesses.
“I think that’s a legitimate complaint,” said Ismael Ahmed, director of the Michigan Department of Human Services, though he blamed the federal rules. The program “was drawn for an economy that is not the economy most states are in.”
While food stamps usually grow faster than cash aid during recessions, the current contrast is stark. Many officials see cash aid in a negative light, as a form of dependency, while encouraging the use of food stamps and calling them nutritional support.
“Food assistance is not considered welfare,” said Donalda Carlson, a Rhode Island welfare administrator.
Nationally, the temporary assistance program gives states $16.8 billion a year — the same amount they received in the early 1990s, when caseloads were more than three times as high as they are now. Mr. Haskins, the program’s architect, said that obliged them to ensure the needy could return to the rolls. “States have plenty of money,” he said.
But most states have shifted the money into other programs — including child care and child welfare — and say they cannot shift it back without causing other problems.
Oregon expanded its cash caseload 19 percent last year, so far without major backlash. “That’s the purpose of the program — to be there for that need,” said Vic Todd, a senior state official. But California officials expressed ambivalence about a 6 percent rise in the cash welfare rolls in that state when it is facing a $40 billion deficit. “There’s some fine tuning of the program that needs to occur, to incentivize work,” said John Wagner, the state director of social services.
Among those sanguine about current caseload trends is Robert Rector, an analyst at the Heritage Foundation in Washington who is influential with conservative policy makers. He said the program had “reduced poverty beyond anyone’s expectations” and efforts to dilute its rigor would only harm the poor.
“We need to continue with the principle that you give assistance willingly, but you require the individual to prepare for self-sufficiency,” he said.
Quote
QUOTATION OF THE DAY
"To date, the banks have stuck their heads in the sand and demanded that they be paid the price of good apples for bad apples."
LYNN E. TURNER, a former chief accountant for the Securities and Exchange Commission, on setting a value on assets the United States might buy in its banking rescue plan.
"To date, the banks have stuck their heads in the sand and demanded that they be paid the price of good apples for bad apples."
LYNN E. TURNER, a former chief accountant for the Securities and Exchange Commission, on setting a value on assets the United States might buy in its banking rescue plan.
a response
This IS Dr. Mel Johnson. I have NO problem signing my name if the pathetic pukes who are making personal attacks will sign their real names. I have spent the greater part of the past 28 years trying to understand the angry, hostile, and ignorant people who cannot make a rational or logical explanation for their actions or behaviors. When they are exposed they become threatened and strike out to divert attention from their failures. They are trying to provoke me with their personal attacks, but they will not succeed. They are more to be pitied for their pettiness, paucity of intellect, and lack of character. Dr. Mel P. Johnson
Dotson is the ONLY one who understands the budget, and how much trouble we will be in NEXT year when the full impact of this deepening recession hit. He is the only one to ask probing and pertinent questions about the golf course during the budget process. NOBODY has asked any questions about the pool until recently and it was only put on the agenda for discussion when Paul requested it. If Dr. Johnson is elected there WILL BE further scrutiny and inquiry at the pool and Rec center.
Leadership starts at the top!
Billy is not a puppet? Hes the LEADER of the Rubber Stamp regime! Whatever you want, Gymbo! Dotson was the only one really prepared during the budget hearings AND the only one to ask tough questions of the City Manager all along! He KNOWS NUMBERS! It IS his area of expertise! He has 40+ years of experience dealing with finances and budgets- EXACTLY what we need to lead us in this recession! He WILL trim the fat, consolidate, and do what needs to be done for our financial health and survival. Billy has none of these skills, background, training, or experience. The choice is clear.
Denial is not a river
Personal bankruptcies surged to more than 1 million filings in the United States in 2008 -- the most since a rewrite of bankruptcy laws went into effect in 2005. Filings of Chapter 7 and Chapter 13 bankruptcies rose 33% in 2008 as the economy worsened, according to data from U.S. bankruptcy courts and compiled by bankruptcy data firm Automated Access to Court Electronic Records. Chapter 13 bankruptcy allows people to pay off debts under a three- to five-year plan; Chapter 7 bankruptcy allows for a discharge of all debts. In 2007, there were 819,115 such filings in the 50 states and Washington, D.C. The number rose to 1,086,130 in 2008 as the recession took hold. That's nowhere near the record of 2.1 million filings in 2005, as consumers rushed to file before a federal bankruptcy reform law went into effect and made filings more difficult and expensive, but it's still a significant leap. The pain of bankruptcy was spread unevenly, but it was everywhere. Not one jurisdiction showed a decrease in filings, whether measured on a per capita basis or by the raw numbers of filings. (AP) when will our city officials realize that the country, the state, and the cities are in BIG financial trouble? When, if ever, will they start tightening their municipal belts? We have been in a recession for OVER a year officially, and we are acting like it has NO effect here! Denial is NOT a river in Egypt.
grants
I have heard that the grant writer makes 50k and brought in 100k in grants last year. One was for a rain detection system for the golf course, so that when it rains, the sprinklers dont come on, saving water. 2:1 sounds like a pretty good deal, no?
commentary
What is an "e" slate? is it like email? Does anybody know what the new candidates positions are? It would be helpful in making the decision as to who to vote for if there was an official depiction of the voting records of all the incumbents. Who would have that information? Would it require an FOI? Signs starting to pop up around town.
middle school maintenance
Heard from a teacher at the middle school that the fighting and other disruptions are way down this year, with the new principal. Budget cuts however, have caused the maintenance schedules (painting, cleaning, fixing,etc) to fall behind. Anyody have any ideas as to how that could be remedied?
Sunday, February 1, 2009
focus and concentration needed here
The vote was 3-2 to hire a contractor, any contractor, to build a new gym. The vote may have been 5-0 for LINK, as they had the best presentation of the contractors that bid, far and away. FOCUS here... concentrate...there were TWO different votes.
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