Saturday, March 28, 2009
put up or shut up
Exactly WHAT BS information are you talking about? Are you referring to the 415k that we spent on the bathrooms? That came from a Freedom of Information request, from City Hall. Are you referring to the $125 a square foot and 140k that those bathrooms SHOULD have cost? That comes from a licensed General Contractor with over 25 years of construction experience, in addition to my insurance company. Ask ANY insurance company OR experienced General Contractor what the usual and customary construction costs are for new construction in S Fla. Ask Skip Reed, the City's GC. IF you want a detailed, line-by-line explanation of the costs involved in the bathrooms, when you see me in the street just ask to see it. I will be happy to oblige, as I have shown DOZENS of residents, including other contractors. Is there ANY doubt the numbers quoted are accurate and current? If so, lets see your numbers and your rationale behind them. Put up, or shut up. Dr. Mel P. Johnson
spending wisely
Having more money is almost always a good thing. Spending wisely and judiciously is the problem. If we continue to throw away our money like we did with the CC addition and the bathrooms it will be gone before we know it. We need acountability and transparency in city operations and we need it now. There are those in the construction community who believe the new gym can be built for less than three million bucks. Does anybody have any further information on this? Dr. Mel P. Johnson
double standard
I am merely agreeing with the posters opinion of his views. He said that "in a sick kind of way" he wants me to win. Those are his words, not mine. It is interesting to me that those who complain that the people who post here, but dont sign their names, are cowards. Yet somehow, IF that was true, it doesnt apply to THEM, when THEY dont sign their names! Dr. Mel P. Johnson
Friday, March 27, 2009
sick desires require haldol
Acknowledging that you are sick and have sick desires is half the battle to getting better. I am glad that guy has acknowledged he has sick desires. Now if he can only get some Haldol and a couple years of psychotherapy perhaps he could become a productive member of society. I have dealt with the mentally unbalanced for a large part of my adult life and am not overly concerned about a mentally unbalanced person commenting on me. I just wish he would finally make some sense occasionally, and grow a pair so he could sign his name so we would know who this brave poster is. Dr. Mel P. Johnson
Rain Barrels
abendwolke - I typed (55 gallon drums) into the Craigslist search and found over a half dozen ads. You could also post a wanted ad in the farm & garden section and let those with the barrels email you. Thats what I did. At least four people with drums available responded.
Rain Barrels
msmarion, I don't know if you have a rain barrel yet or not. After Michelle posted about her rain barrel I stopped by the UF Yards & Neighborhoods Program in Martin County (288-5654). If you attend a 40 minute program they give you a rain barrel. The coordinator expects to have a class within 30 days. The last class was held at the T.C. Mall a week or so ago. She'll send you a notice if you provide your address for the wait list.
Its worth a visit to the extension office if you're in Stuart someday: very friendly people, great info from UF and some nice plants from area Master Gardeners.
Its worth a visit to the extension office if you're in Stuart someday: very friendly people, great info from UF and some nice plants from area Master Gardeners.
commentary
At the Senior Center today Bob Best asked how many, of the over 100 present, had ever taken a ride on the free bee shuttle. TWO hands were raised. Isnt there a better way to spend $120,000 a year? Also, most seniors are retired and on fixed incomes so they have great difficulty when the City keeps raising their taxes and fees. Is there anybody who doesnt believe the city will raise taxes and fees AGAIN this year to make up for the 1.3 million deficit that Gym has warned about? Gym, I can tell you where at least 630k disappeared to. If he could retrieve THAT money the deficit would be cut in HALF! What do you say, Gym? Dr. Mel P. Johnson
clarification
"Well Mel, you have actually just described your synthoms." What "synthoms" would that be? I would welcome any communication from the Dept of Health regarding my academic qualifications. My degree is actually a Doctor of Psychology (PsyD) and not a Doctor of Philosophy (PhD). Both are Doctorates, just in different areas. My internship was one year in duration and approved by the American Psychological Association (APA). Any further questions? Dr. Mel P. Johnson
commentary
She did SORRY she, she, she,,got it. THIS is a SENTENCE? This is supposed to make sense? These are two things the poster did not, or can not, do. Arguing with idiots is a waste of time usually and this just proves it. I heard nowhere in the speeches where more money is on the way. WHEN did that happen? WHO said that? Having more money is no guarantee that the City cant, and wont, find a way to pay the contractors TRIPLE (or more) than it actually costs, just like they did with the bathrooms AND the CC enclosure. Never underestimate the Citys ability to disappear our tax dollars! Past behavior is the best predictor of future behavior, and in the past the City Manager has been in charge of two projects, at least, that have cost us AT LEAST TRIPLE, what they should have. That much is clear. Lets see what he does with THIS project. Let the constant change orders and cost overruns begin! Dr. Mel P. Johnson
Thursday, March 26, 2009
NY TIMES
Doctors Raise Doubts on Digital Health Data
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By STEVE LOHR
Published: March 25, 2009
Now that the federal government plans to spend $19 billion to spur the use of computerized patient records, the challenge of adopting the technology widely and wisely is becoming increasingly apparent.
Two articles, to be published on Thursday in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs.
One article reports that only 9 percent of the nation’s hospitals have electronic health records, based on a survey of nearly 3,000 hospitals. The study, financed by the federal government and the Robert Wood Johnson Foundation, is the most definitive measure to date of the use of computerized patient records by hospitals. The government-backed study found a far lower level of use than some earlier, less rigorous surveys.
The study, the authors said, measured only the adoption of digital patient records. The survey did not ask whether the electronic records were used to advance the health policy goals of the federal plan, like tracking the quality of care and communicating effectively with outside specialists and clinics to coordinate a patient’s care.
“We have a long way to go,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health who was the article’s lead author. “And we did not measure effective use. Even if a hospital does have electronic health records, it does not mean it is sharing information with other hospitals and doctors down the road.”
In a second article in the journal, two experts in health information technology at Children’s Hospital Boston assert that spending billions of dollars of federal funds to stimulate the adoption of existing forms of health record software would be a costly policy mistake.
In the article, identified as a “perspective,” Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane portray the current health record suppliers as offering pre-Internet era software — costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements.
Instead of stimulating use of such software, they say, the government should be a rule-setting referee to encourage the development of an open software platform on which innovators could write electronic health record applications. As analogies, they point to other such software platforms — whether the Web or Apple’s iPhone software, which the company has opened to outside developers.
In the Mandl-Kohane model, a software developer with a new idea for health record features like drug allergy alerts or care guidelines could write an application, and those could be added or substituted for a similar feature.
Such an approach, they say, would open the door to competition, flexibility and lower costs — and thus, better health care in the long run. “If the government’s money goes to cement the current technology in place,” Dr. Mandl said in an interview, “we will have a very hard time innovating in health care reform.”
To justify spending taxpayers’ money, the government program must expand digital records beyond routine tasks like billing to focus on “how the technology will be used to improve clinical performance,” said Herbert S. Lin, a senior scientist the National Academy of Sciences, an advisory group to the government.
The Obama administration’s health technology plan, which is part of the economic recovery package, includes incentive payments for adopting electronic health records — more than $40,000 per physician and up to several million dollars for hospitals. The payments are spread over a few years and are based on “meaningful use” of “certified” records, although Congress left defining those terms to the Department of Health and Human Services.
The incentive payments, industry experts say, are enough to greatly accelerate the adoption of electronic health records. In the new survey of hospitals, the cost of digital record systems was cited as the single largest obstacle to adoption.
Dr. David Blumenthal, a professor at the Harvard Medical School, oversaw the hospital study. Last week he was named the national coordinator for health information technology in the Obama administration. In a conference call to discuss the study, Dr. Blumenthal declined to talk about his plans in detail.
But clearly, he sees electronic health records as a tool to reform health care, and the Obama administration intends to shift Medicare and Medicaid reimbursement toward paying for better health outcomes, which will be measured and monitored using technology.
“The goals are quality and efficiency, instead of just putting machinery in offices,” Dr. Blumenthal said. “If we encourage better performance, then physicians are going to find ways to improve performance. And health information technology is one crucial way to do that.”
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Permalink
By STEVE LOHR
Published: March 25, 2009
Now that the federal government plans to spend $19 billion to spur the use of computerized patient records, the challenge of adopting the technology widely and wisely is becoming increasingly apparent.
Two articles, to be published on Thursday in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs.
One article reports that only 9 percent of the nation’s hospitals have electronic health records, based on a survey of nearly 3,000 hospitals. The study, financed by the federal government and the Robert Wood Johnson Foundation, is the most definitive measure to date of the use of computerized patient records by hospitals. The government-backed study found a far lower level of use than some earlier, less rigorous surveys.
The study, the authors said, measured only the adoption of digital patient records. The survey did not ask whether the electronic records were used to advance the health policy goals of the federal plan, like tracking the quality of care and communicating effectively with outside specialists and clinics to coordinate a patient’s care.
“We have a long way to go,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health who was the article’s lead author. “And we did not measure effective use. Even if a hospital does have electronic health records, it does not mean it is sharing information with other hospitals and doctors down the road.”
In a second article in the journal, two experts in health information technology at Children’s Hospital Boston assert that spending billions of dollars of federal funds to stimulate the adoption of existing forms of health record software would be a costly policy mistake.
In the article, identified as a “perspective,” Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane portray the current health record suppliers as offering pre-Internet era software — costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements.
Instead of stimulating use of such software, they say, the government should be a rule-setting referee to encourage the development of an open software platform on which innovators could write electronic health record applications. As analogies, they point to other such software platforms — whether the Web or Apple’s iPhone software, which the company has opened to outside developers.
In the Mandl-Kohane model, a software developer with a new idea for health record features like drug allergy alerts or care guidelines could write an application, and those could be added or substituted for a similar feature.
Such an approach, they say, would open the door to competition, flexibility and lower costs — and thus, better health care in the long run. “If the government’s money goes to cement the current technology in place,” Dr. Mandl said in an interview, “we will have a very hard time innovating in health care reform.”
To justify spending taxpayers’ money, the government program must expand digital records beyond routine tasks like billing to focus on “how the technology will be used to improve clinical performance,” said Herbert S. Lin, a senior scientist the National Academy of Sciences, an advisory group to the government.
The Obama administration’s health technology plan, which is part of the economic recovery package, includes incentive payments for adopting electronic health records — more than $40,000 per physician and up to several million dollars for hospitals. The payments are spread over a few years and are based on “meaningful use” of “certified” records, although Congress left defining those terms to the Department of Health and Human Services.
The incentive payments, industry experts say, are enough to greatly accelerate the adoption of electronic health records. In the new survey of hospitals, the cost of digital record systems was cited as the single largest obstacle to adoption.
Dr. David Blumenthal, a professor at the Harvard Medical School, oversaw the hospital study. Last week he was named the national coordinator for health information technology in the Obama administration. In a conference call to discuss the study, Dr. Blumenthal declined to talk about his plans in detail.
But clearly, he sees electronic health records as a tool to reform health care, and the Obama administration intends to shift Medicare and Medicaid reimbursement toward paying for better health outcomes, which will be measured and monitored using technology.
“The goals are quality and efficiency, instead of just putting machinery in offices,” Dr. Blumenthal said. “If we encourage better performance, then physicians are going to find ways to improve performance. And health information technology is one crucial way to do that.”
staged theater
" You said show me the money and see did????????I have always believed basic sentence structure, spelling, and literacy to be good things that can enhance communication when used properly. Some of the posters should try it sometime. The activity tonight was open to the public. I am part of the public. I went to see how many people would show up. The 150 people there were mainly city workers, contractors, Pelican Players, the MSSH band, and people who were curious, like me. It was hardly a groundswell of support, 150 out of 13,500 residents of Miami Springs. It was staged theater and the fact that it happened a week before the elections was not a coincidence either. In any case, it is done and we can move on to elect a new Council. I am hopeful the residents will vote for change. I KNOW I will. DR. Mel P. Johnson
clarification
Mental illness is such a difficult problem to address because of the lack of logic and rationality inherent in the disease. It makes sense to THEM in their head, but not to anybody else. WHEN did I say show me the money? There was some question in some peoples minds but a rational person or politician wouldnt make a statement like that with NO means to back it up, as it would create doubts regarding credibility. Yes, I am an Advanced Nurse Practitioner in Psychiatry. I also have an earned Doctorate in Clinical Psychology from the Miami Institue of Psychology. Look it up. I also completed an American Psychology Association internship at N Miami Mental Health off of 95th street. Look that up too. Dr. Mel P. Johnson
commentary
Its true that I HATED the disappearance of 280k on the bathrooms! I also HATED having at least 350k disappear on the CC enclosure. I severely disliked having the water, electric, and sewer hookups FORGOTTEN to the bathrooms, and then paying outrageous sums when they finally WERE done! I am also not very happy when the people in charge of these disasters are NOT accountable and provide NO transparency. I am also not crazy about the fact that WE did NOT get a vote on the new gym. We are AMERICANS and should vote on the BIG issues! We voted on the gold course issue in the past and to limit highrises in our town to three stories. BOTH of those were BIG issues that have MAJOR effects on our town, and we voted. We SHOULD have voted on the new gym. This Mayor and Council wouldnt have allowed us to vote on annexation if we hadnt DEMANDED to vote, by having a petition with 1371 signatures! We are AMERICANS, and as such we have the right to vote. We should exercise that right on BIG issues. Dr. Mel P. Johnson
commentary
John Rivera is the President of the Police Benevolent Association, the union for police officers. He says in the Gazette "Peter Newman has devoted his life to serving the community as a law enforcement officer" That is a verbatim quote. Is there anybody out there who believes that the PBA President doesnt know what a law enforcement officer IS? is there anybody out there who believes that the PBA President would have any reason to make a public statement that wasnt true? To say otherwise is just ridiculous, of course. Its just another case of innuendo and half-truths being used in this campaign to create doubts in the minds of the residents. It happens to me here all the time and I understand its just a dark side of petty politics in a small town, like signs being stolen, knocked down, or defaced. But it doesnt make it right. Dr. Mel P. Johnson
commentary
Well, learning that 275k of our tax monies DISAPPEARED, over and above the actual costs, was pretty traumatic to me, that is true. When I learned that another 350k also DISAPPEARED with the Country Club enclosure, that was also pretty traumatic. Even more traumatic was the effects on our city finances, as we could use that 630k+ now in light of the 1.3 million deficit that Gym says we will have next year! Those who are happy with the bathrooms AND the CC enclosure must be those who received that extra 630k out of the taxpayers pockets. The TAXPAYERS surely arent happy. While I have NO experience in elected office, I also have NO experience disappearing taxpayers monies by the truckloads either. Neither of my opponents have any experience as elected officials either. Dr. Mel P. Johnson
Questions surround e-health record billions
Questions surround e-health record billions
Government will spend $19 billion, but few docs have joined digital age
Health care & costs, by the numbers
What's Obama's policy on health insurance? See if he's keeping his word, and vote on his progress during the first 100 days.
updated 4:19 p.m. ET, Mon., March. 23, 2009
WASHINGTON - Here's the best-case scenario for the government's plans to spend $19 billion on computerized medical records: seamless communication among doctors and patients, and far fewer mistakes.
And the worst-case: $19 billion goes down the drain.
The medical industry is hoping for the first outcome, even while some fear the second, as the Health and Human Services Department tries to get hundreds of thousands of doctors to quit using paper files and join the digital age.
The money for the massive undertaking is in the economic stimulus bill that President Barack Obama signed into law last month.
"We need to get this right," said Dr. David Kibbe, a senior adviser at the American Academy of Family Physicians. "Adoption of information technology for its own sake really is not the end game."
The end game, Kibbe and others say, is for doctors' offices and hospitals to be able to easily share patient information, something the vast majority can't do today. That would cut down on mistaken and unnecessary procedures and give doctors faster access to more accurate information about patients' medical histories and drug regimens.
Text reminders to take meds
The goals get even more ambitious. A forum on Capitol Hill Monday focused on making medical information not just digital but wireless. Patients could be reminded via mobile devices to take their medications, and send back details like weight and blood sugar level.
Medical costs for chronic conditions like diabetes are driven up dramatically because patients don't adhere to their medical regimens; wireless technology could help.
"The promise of these applications is that we can improve the health and productivity of people with chronic disease," Gregory Seiler, a vice president at BeWell Mobile Technology, Inc., said at the forum sponsored by the New America Foundation and the wireless industry trade group CTIA.
The government's history of undertaking major technological upgrades isn't entirely encouraging.
The FBI spent four years and $170 million trying to modernize its paper-based case system, only to kill the project in 2005. Before that, the Federal Aviation Administration wasted more than $1 billion trying to overhaul the air traffic control system.
For advocates of the health technology transformation, the biggest fear is that the money could pay just for making paper records electronic, without giving doctors and hospitals much greater ability to connect.
"It's not going to improve the decisions that either providers of care or patients make unless we get that information to move from the existing stovepipes," said Zoe Baird, president of the Markle Foundation, which works to improve health care and national security.
Few U.S. doctors use electronic records
The U.S. lags behind many other countries in adoption of electronic health records. A report in the New England Journal of Medicine, based on surveys from 2007 and 2008, found that 4 percent of physicians had extensive, fully functional electronic records systems, while 13 percent had more basic systems.
Track President Barack Obama's promises
Explore and track the president's campaign pledges. See if Obama keeps his word, and vote on his progress during the first 100 days.
Typically, many systems aren't connected to other physicians or hospitals. Dozens of vendors compete to sell proprietary systems that often cannot communicate with each other. Installation costs are prohibitively expensive for some doctors, particularly those in small practices.
Lawmakers and the Obama administration hope the stimulus legislation can begin to solve such problems. The bill envisions new standards to drive development of systems that are better able to communicate, and requires doctors and hospitals to show they're going to be able to put those systems to "meaningful use."
Computerizing records will "save money, improve the quality of care for patients and make our health care system more efficient," HHS spokesman Nick Papas said.
'Devils are in the details'
But important details are missing from the legislation. Plus, a health secretary is not yet on the job, and just Friday the administration named a national coordinator for health information technology — Dr. David Blumenthal, a former Harvard Medical School professor who advised Obama during the presidential campaign and once worked for Sen. Ted Kennedy, D-Mass., chair of the Senate's health committee.
The stimulus bill directs $17 billion in incentives through Medicare and Medicaid to nudge doctors and hospitals toward electronic record-keeping beginning in 2011. In 2015, financial penalties will start for doctors and hospitals if they haven't done so.
What systems will be deemed acceptable? How will doctors and hospitals be able to show they will put such systems to meaningful use? Those questions remain largely unanswered.
Preliminary technological standards are due at the end of this year. That doesn't give doctors, hospitals or technology companies much time to get up and running by 2011.
E-prescribing expected to soar in next 5 years
Judge orders FDA to let 17-year-olds use Plan B
Health care for detained immigrants bashed
The bill also contains $2 billion for items such as health technology grants, training initiatives and state programs. The uncertainty surrounding this money has touched off heavy lobbying from interest groups hoping for a piece.
"The devils are in the details and we don't know the details," said Janet Marchibroda, head of the nonprofit advocacy group eHealth Initiative.
Still, many health care professionals foresee a more connected health care system ahead.
"It will take time to get there," said Tom Romeo, IBM's vice president for government health care. "But everything's in place to really make a huge jump forward now like it never has been before."
Government will spend $19 billion, but few docs have joined digital age
Health care & costs, by the numbers
What's Obama's policy on health insurance? See if he's keeping his word, and vote on his progress during the first 100 days.
updated 4:19 p.m. ET, Mon., March. 23, 2009
WASHINGTON - Here's the best-case scenario for the government's plans to spend $19 billion on computerized medical records: seamless communication among doctors and patients, and far fewer mistakes.
And the worst-case: $19 billion goes down the drain.
The medical industry is hoping for the first outcome, even while some fear the second, as the Health and Human Services Department tries to get hundreds of thousands of doctors to quit using paper files and join the digital age.
The money for the massive undertaking is in the economic stimulus bill that President Barack Obama signed into law last month.
"We need to get this right," said Dr. David Kibbe, a senior adviser at the American Academy of Family Physicians. "Adoption of information technology for its own sake really is not the end game."
The end game, Kibbe and others say, is for doctors' offices and hospitals to be able to easily share patient information, something the vast majority can't do today. That would cut down on mistaken and unnecessary procedures and give doctors faster access to more accurate information about patients' medical histories and drug regimens.
Text reminders to take meds
The goals get even more ambitious. A forum on Capitol Hill Monday focused on making medical information not just digital but wireless. Patients could be reminded via mobile devices to take their medications, and send back details like weight and blood sugar level.
Medical costs for chronic conditions like diabetes are driven up dramatically because patients don't adhere to their medical regimens; wireless technology could help.
"The promise of these applications is that we can improve the health and productivity of people with chronic disease," Gregory Seiler, a vice president at BeWell Mobile Technology, Inc., said at the forum sponsored by the New America Foundation and the wireless industry trade group CTIA.
The government's history of undertaking major technological upgrades isn't entirely encouraging.
The FBI spent four years and $170 million trying to modernize its paper-based case system, only to kill the project in 2005. Before that, the Federal Aviation Administration wasted more than $1 billion trying to overhaul the air traffic control system.
For advocates of the health technology transformation, the biggest fear is that the money could pay just for making paper records electronic, without giving doctors and hospitals much greater ability to connect.
"It's not going to improve the decisions that either providers of care or patients make unless we get that information to move from the existing stovepipes," said Zoe Baird, president of the Markle Foundation, which works to improve health care and national security.
Few U.S. doctors use electronic records
The U.S. lags behind many other countries in adoption of electronic health records. A report in the New England Journal of Medicine, based on surveys from 2007 and 2008, found that 4 percent of physicians had extensive, fully functional electronic records systems, while 13 percent had more basic systems.
Track President Barack Obama's promises
Explore and track the president's campaign pledges. See if Obama keeps his word, and vote on his progress during the first 100 days.
Typically, many systems aren't connected to other physicians or hospitals. Dozens of vendors compete to sell proprietary systems that often cannot communicate with each other. Installation costs are prohibitively expensive for some doctors, particularly those in small practices.
Lawmakers and the Obama administration hope the stimulus legislation can begin to solve such problems. The bill envisions new standards to drive development of systems that are better able to communicate, and requires doctors and hospitals to show they're going to be able to put those systems to "meaningful use."
Computerizing records will "save money, improve the quality of care for patients and make our health care system more efficient," HHS spokesman Nick Papas said.
'Devils are in the details'
But important details are missing from the legislation. Plus, a health secretary is not yet on the job, and just Friday the administration named a national coordinator for health information technology — Dr. David Blumenthal, a former Harvard Medical School professor who advised Obama during the presidential campaign and once worked for Sen. Ted Kennedy, D-Mass., chair of the Senate's health committee.
The stimulus bill directs $17 billion in incentives through Medicare and Medicaid to nudge doctors and hospitals toward electronic record-keeping beginning in 2011. In 2015, financial penalties will start for doctors and hospitals if they haven't done so.
What systems will be deemed acceptable? How will doctors and hospitals be able to show they will put such systems to meaningful use? Those questions remain largely unanswered.
Preliminary technological standards are due at the end of this year. That doesn't give doctors, hospitals or technology companies much time to get up and running by 2011.
E-prescribing expected to soar in next 5 years
Judge orders FDA to let 17-year-olds use Plan B
Health care for detained immigrants bashed
The bill also contains $2 billion for items such as health technology grants, training initiatives and state programs. The uncertainty surrounding this money has touched off heavy lobbying from interest groups hoping for a piece.
"The devils are in the details and we don't know the details," said Janet Marchibroda, head of the nonprofit advocacy group eHealth Initiative.
Still, many health care professionals foresee a more connected health care system ahead.
"It will take time to get there," said Tom Romeo, IBM's vice president for government health care. "But everything's in place to really make a huge jump forward now like it never has been before."
Miami clonoscopies
Unsterile equipment used on Miami veterans
More than 3,000 who had colonoscopies at VA hospital told to get HIV tests
INTERACTIVE
Fact file
Health care & costs, by the numbers
Most popular
• Most viewed • Top rated • Most e-mailed
Is ‘people food’ ever OK? 7 pet myths debunked
AIG exec turns in resignation ... in NY Times
Octuplet mom once worked as a stripper
Geithner to propose massive regulatory reform
It's fear that keeps Baghdad's peace
Most viewed on msnbc.com
Fireman dresses as Spider-Man to rescue boy
Parrot gets award for warning about choking tot
Mean dogs, few escapes at Idaho prison
Rare hand transplant performed on Marine
Beer kegs help keep zoo animals happy
Most viewed on msnbc.com
What's Obama's policy on health insurance? See if he's keeping his word, and vote on his progress during the first 100 days.
updated 5:53 p.m. ET, Mon., March. 23, 2009
MIAMI - Officials say more than 3,000 patients at a Veterans Affairs hospital in Miami had colonoscopies with equipment that wasn’t properly sterilized
They’ve been told they should be tested for HIV and other diseases.
The VA insists the risk of infection is minimal and only involved tubing on equipment, not any device that actually touched a patient. But it’s the second recent announcement of errors during colonoscopies at VA facilities.
Last month, more than 6,000 patients at a clinic in Tennessee were told they may have been exposed to infectious body fluids during colonoscopies.
The VA also said 1,800 veterans treated at an ear, nose and throat clinic in Augusta, Ga., were alerted they could have been exposed to an infection due to improper disinfection of an instrument.
More than 3,000 who had colonoscopies at VA hospital told to get HIV tests
INTERACTIVE
Fact file
Health care & costs, by the numbers
Most popular
• Most viewed • Top rated • Most e-mailed
Is ‘people food’ ever OK? 7 pet myths debunked
AIG exec turns in resignation ... in NY Times
Octuplet mom once worked as a stripper
Geithner to propose massive regulatory reform
It's fear that keeps Baghdad's peace
Most viewed on msnbc.com
Fireman dresses as Spider-Man to rescue boy
Parrot gets award for warning about choking tot
Mean dogs, few escapes at Idaho prison
Rare hand transplant performed on Marine
Beer kegs help keep zoo animals happy
Most viewed on msnbc.com
What's Obama's policy on health insurance? See if he's keeping his word, and vote on his progress during the first 100 days.
updated 5:53 p.m. ET, Mon., March. 23, 2009
MIAMI - Officials say more than 3,000 patients at a Veterans Affairs hospital in Miami had colonoscopies with equipment that wasn’t properly sterilized
They’ve been told they should be tested for HIV and other diseases.
The VA insists the risk of infection is minimal and only involved tubing on equipment, not any device that actually touched a patient. But it’s the second recent announcement of errors during colonoscopies at VA facilities.
Last month, more than 6,000 patients at a clinic in Tennessee were told they may have been exposed to infectious body fluids during colonoscopies.
The VA also said 1,800 veterans treated at an ear, nose and throat clinic in Augusta, Ga., were alerted they could have been exposed to an infection due to improper disinfection of an instrument.
Wednesday, March 25, 2009
vote for change
IF spending 275k in our taxes OVER AND ABOVE the actual costs of the new bathrooms disturbs you, vote for change. If you believe that we should exercise our rights as Americans to vote on the BIG issues, vote for change. If spending 500k on a CC project that should have cost 100k bothers you, vote for change. Dr. Mel P. Johnson
commentary
Is there ANYBODY who believes that Lob is NOT a puppet of Billy? Lob is a one-issue candidate- the gym- which JUST HAPPENS to be Billy's legacy project. What a coincidence! On WHAT issue does Lob differ from Billy? When and where did I put a knife in anybodys back? I have been against costly projects that waste the taxpayers monies from the outset. I also strongly disapprove of those who make those mishaps happen on a regular basis, and have been from the outset. No surprises there either. Dr. Mel P. Johnson
Billy is CONSISTENT
Billy is CONSISTENT. He has consistently voted for each and every motion that brings his legacy project into being, whether we need it, want it, or can afford it. When Billy says that due diligence was done in deciding on a new gym is he being misleading, disingenuous, or dishonest? Possibly all three? At which meeting was the Pistorino option discussed and debated in any depth or thoroughness? I would like a verbatim recording of THAT discussion, along with the date and time, IF it ever happened. So, while its true that Billy may have NO regrets about any of his votes, the PEOPLE who will have to pay for his LEGACY project do! Dr. Mel P. Johnson
commentary
To those hapless and miserable souls who continue to suggest I havent told the truth, I say NAME ONCE. Provide your figures and a rationale behind them. Put up or shut up. Are you saying the bathrooms CANT be built for 140k? I have a written, detailed, line-by-line estimate by a guy with 25 years+ in construction that says otherwise. Are they saying we DIDNT pay 415k for the bathrooms? I have a FOI that indicates otherwise. Are they saying that the water, sewer, and electric hookups werent left out on the bathrooms? Are they saying the City didnt pay OUTRAGEOUS prices to have the sewer connected? the bathrooms elevated? If they have a question about ANY of those preposterously expensive projects I will be glad to help them straighten out their thinking with facts. What part of RIPOFF dont they understand? Dr. Mel P. Johnson
'Watchful Waiting' Safe With Low-Risk Prostate Cancers
Study suggests close monitoring offers some men better quality of life
Posted March 16, 2009
MONDAY, March 16 (HealthDay News) -- Refusing immediate treatment can be safe for men with low-risk prostate cancer if they're closely monitored, new research finds.
The multi-center study of American and Canadian patients was conducted between 1991 and 2007.
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"When or if to treat men with low-risk prostate cancer has always been a challenging question that faces patients and urologists," study author Dr. Scott Eggener, an assistant professor of surgery at the University of Chicago Medial Center, said in a news release from the university. "Some men may be rushing into treatment that won't necessarily benefit them, prevent problems or prolong life. Close observation in certain patients may provide and maintain quality of life without increasing the chances of the cancer spreading."
Between 20 percent and 50 percent of American men diagnosed with prostate cancer will eventually die from a cause other than their prostate cancer, he noted. This shows that a large number of patients don't benefit from treatment for their prostate cancer.
The 262 men in this study who decided on "watchful waiting" instead of immediate treatment met the following criteria: under age 75; prostate specific antigen (PSA) below 10 ng/ml; clinical stage T1-T2a; Gleason score 6 or below; and three or fewer positive cores at diagnostic biopsy. The patients underwent a restaging biopsy and had no treatment for six months following the repeat biopsy. They then had physical exams and PSA tests every six months with biopsies recommended every one to two years.
Of the men in the study, 43 eventually decided to have treatment or had evidence of cancer progression that prompted a doctor's recommendation to begin treatment. Following radiation or surgery, all but one of those 43 patients were cured of their prostate cancer. The remaining 219 patients remained on watchful waiting without evidence of cancer progression.
"Active surveillance with delayed treatment, if necessary, for select patients appears to be safe and associated with a low risk of metastatic spread," the researchers concluded.
The study was published in the March 16 issue of Urology.
"Active surveillance is not a total disregard for patients with prostate cancer. Instead, it identifies men unlikely to be affected by their cancer and encourages frequent monitoring, and then starting therapy at a later appropriate time if needed. Cure rates appear to be identical when these men choose immediate treatment or delayed treatment when prompted by new information about their condition," Eggener said.
Study suggests close monitoring offers some men better quality of life
Posted March 16, 2009
MONDAY, March 16 (HealthDay News) -- Refusing immediate treatment can be safe for men with low-risk prostate cancer if they're closely monitored, new research finds.
The multi-center study of American and Canadian patients was conducted between 1991 and 2007.
People Who Read This Also Read
'Male Lumpectomy' May Help Some With Prostate Cancer 22884078
Study Questions Screening for Leg Vessel Blockages 23053294
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11 Things to Know About Prostate Cancer 20260613
"When or if to treat men with low-risk prostate cancer has always been a challenging question that faces patients and urologists," study author Dr. Scott Eggener, an assistant professor of surgery at the University of Chicago Medial Center, said in a news release from the university. "Some men may be rushing into treatment that won't necessarily benefit them, prevent problems or prolong life. Close observation in certain patients may provide and maintain quality of life without increasing the chances of the cancer spreading."
Between 20 percent and 50 percent of American men diagnosed with prostate cancer will eventually die from a cause other than their prostate cancer, he noted. This shows that a large number of patients don't benefit from treatment for their prostate cancer.
The 262 men in this study who decided on "watchful waiting" instead of immediate treatment met the following criteria: under age 75; prostate specific antigen (PSA) below 10 ng/ml; clinical stage T1-T2a; Gleason score 6 or below; and three or fewer positive cores at diagnostic biopsy. The patients underwent a restaging biopsy and had no treatment for six months following the repeat biopsy. They then had physical exams and PSA tests every six months with biopsies recommended every one to two years.
Of the men in the study, 43 eventually decided to have treatment or had evidence of cancer progression that prompted a doctor's recommendation to begin treatment. Following radiation or surgery, all but one of those 43 patients were cured of their prostate cancer. The remaining 219 patients remained on watchful waiting without evidence of cancer progression.
"Active surveillance with delayed treatment, if necessary, for select patients appears to be safe and associated with a low risk of metastatic spread," the researchers concluded.
The study was published in the March 16 issue of Urology.
"Active surveillance is not a total disregard for patients with prostate cancer. Instead, it identifies men unlikely to be affected by their cancer and encourages frequent monitoring, and then starting therapy at a later appropriate time if needed. Cure rates appear to be identical when these men choose immediate treatment or delayed treatment when prompted by new information about their condition," Eggener said.
What to Make of the Prostate Cancer Screening Studies
What to Make of the Prostate Cancer Screening Studies
March 23, 2009 02:05 PM ET | Bernadine Healy, M.D. | Permanent Link | Print By Bernadine Healy
Two ongoing prostate screening studies, one in the United States and the other in Europe, provide an early peek at mortality information. The studies, discussed in the just released issue of The New England Journal of Medicine, have caused a storm of confusion, since they seem to conflict. Actually, the studies are complementary, both make a lot of sense, and they are certain to influence medical practice even before they are completed.
For background, U.S. health policymakers are concerned that too many people get screened with the prostate-specific antigen test, which can identify prostate cancer long before symptoms develop. For this slow-growing tumor, that can mean before it needs to be detected, leading to unnecessary treatment, side effects, and cost. Thus, many think PSAs should be reined in. In contrast, in Europe, where PSAs are not routinely available to screen healthy men for disease, prostate cancer mortality is higher, leading some to believe that the reins on the test should be loosened up.
The two major randomized, controlled trials, begun in the early 1990s, offer a peek after roughly 10 years of monitoring and seem to affirm both views: The European study shows a mortality benefit from screening, while the American study, in which half of those in the control group (supposed to be unscreened) were unwilling to give up their PSAs, showed no benefit.
Though some pundits might dismiss one or the other of these studies from both sides of the pond, the two together provide powerful insights. Inderbir Gill, chairman of the University of Southern California Institute of Urology, believes that the studies are a huge step forward in understanding PSA screening. And "they surely serve as a moment of pause and reflection for those who might be too aggressive in treatment," he adds.
The original plan for both studies was a head-to-head comparison of groups of healthy men who were or were not screened with PSAs. What has emerged are two very different trials highly influenced by the varied European and American medical practices. In Europe, PSA screening of healthy men is not recommended routinely, and the mortality rate for prostate cancer is generally higher than in the United States. The men in the control group in the European study did not have the ready option of getting PSA tests from their community doctor outside of the study. And in the screening group, the Europeans found almost twice as many cases of prostate cancers as compared with the control group.
The European results show that picking up cancers before they produce symptoms brings a 20 percent improvement in mortality, and if the analysis is done including only those people who actually got screened (some signed on but did not get tested), the benefit was 28 percent. Based on bone scans, the screened group was 40 percent less likely to have cancer that spread to bone, the favored site for prostate cancer metastasis.
However, the benefit came with a lot of overtreatment if one looks only at the first-decade mortality figures: To save one life, the European study tested more than 1,000 men and treated close to 50 of them. That's sobering, considering the cost and side effects of treatment—unless, of course, you're that one man.
In the American trial, the background of medical enthusiasm for routine, yearly PSA screening had great influence. The health-conscious men who usually sign up for a research study had trouble giving up their regular PSAs.
To start with, almost half of the men entering the trial had been getting PSAs before joining, and those who did had a 25 percent lower mortality rate at the 10-year mark than the other men who joined the trial without prior testing. Once in the trial, more than half of the men in the "control" group continued to get their PSAs as part of their routine medical care outside of the study. So what the American trial is really comparing is a more intensely screened group in which 85 percent of men get their PSAs (some men in the screening group never got tested) with a moderately screened group where only 52 percent do. No surprise that in the control group nearly as many cancers were detected as in the so-called screened group.
It is also not surprising that the American study shows, so far during the first decade, no mortality difference between groups. From this, one could conclude that leaving the choice of whether to be screened up to men comes at no peril to public health. There is no need to try to force mass screening when moderate screening may work as well, particularly since the treatment of the disease comes with harm that many men are unwilling to accept.
In the meantime, practice continues to change. PSA screening has improved since the trials began and will get better yet. Doctors have come to recognize that watchful waiting is a sound option when a prostate cancer is small and slow growing. And regardless of their views on early screening, most urologists in the United States today agree that the decision to detect and treat prostate cancer needs to be personalized, and ultimately made by the patient.
March 23, 2009 02:05 PM ET | Bernadine Healy, M.D. | Permanent Link | Print By Bernadine Healy
Two ongoing prostate screening studies, one in the United States and the other in Europe, provide an early peek at mortality information. The studies, discussed in the just released issue of The New England Journal of Medicine, have caused a storm of confusion, since they seem to conflict. Actually, the studies are complementary, both make a lot of sense, and they are certain to influence medical practice even before they are completed.
For background, U.S. health policymakers are concerned that too many people get screened with the prostate-specific antigen test, which can identify prostate cancer long before symptoms develop. For this slow-growing tumor, that can mean before it needs to be detected, leading to unnecessary treatment, side effects, and cost. Thus, many think PSAs should be reined in. In contrast, in Europe, where PSAs are not routinely available to screen healthy men for disease, prostate cancer mortality is higher, leading some to believe that the reins on the test should be loosened up.
The two major randomized, controlled trials, begun in the early 1990s, offer a peek after roughly 10 years of monitoring and seem to affirm both views: The European study shows a mortality benefit from screening, while the American study, in which half of those in the control group (supposed to be unscreened) were unwilling to give up their PSAs, showed no benefit.
Though some pundits might dismiss one or the other of these studies from both sides of the pond, the two together provide powerful insights. Inderbir Gill, chairman of the University of Southern California Institute of Urology, believes that the studies are a huge step forward in understanding PSA screening. And "they surely serve as a moment of pause and reflection for those who might be too aggressive in treatment," he adds.
The original plan for both studies was a head-to-head comparison of groups of healthy men who were or were not screened with PSAs. What has emerged are two very different trials highly influenced by the varied European and American medical practices. In Europe, PSA screening of healthy men is not recommended routinely, and the mortality rate for prostate cancer is generally higher than in the United States. The men in the control group in the European study did not have the ready option of getting PSA tests from their community doctor outside of the study. And in the screening group, the Europeans found almost twice as many cases of prostate cancers as compared with the control group.
The European results show that picking up cancers before they produce symptoms brings a 20 percent improvement in mortality, and if the analysis is done including only those people who actually got screened (some signed on but did not get tested), the benefit was 28 percent. Based on bone scans, the screened group was 40 percent less likely to have cancer that spread to bone, the favored site for prostate cancer metastasis.
However, the benefit came with a lot of overtreatment if one looks only at the first-decade mortality figures: To save one life, the European study tested more than 1,000 men and treated close to 50 of them. That's sobering, considering the cost and side effects of treatment—unless, of course, you're that one man.
In the American trial, the background of medical enthusiasm for routine, yearly PSA screening had great influence. The health-conscious men who usually sign up for a research study had trouble giving up their regular PSAs.
To start with, almost half of the men entering the trial had been getting PSAs before joining, and those who did had a 25 percent lower mortality rate at the 10-year mark than the other men who joined the trial without prior testing. Once in the trial, more than half of the men in the "control" group continued to get their PSAs as part of their routine medical care outside of the study. So what the American trial is really comparing is a more intensely screened group in which 85 percent of men get their PSAs (some men in the screening group never got tested) with a moderately screened group where only 52 percent do. No surprise that in the control group nearly as many cancers were detected as in the so-called screened group.
It is also not surprising that the American study shows, so far during the first decade, no mortality difference between groups. From this, one could conclude that leaving the choice of whether to be screened up to men comes at no peril to public health. There is no need to try to force mass screening when moderate screening may work as well, particularly since the treatment of the disease comes with harm that many men are unwilling to accept.
In the meantime, practice continues to change. PSA screening has improved since the trials began and will get better yet. Doctors have come to recognize that watchful waiting is a sound option when a prostate cancer is small and slow growing. And regardless of their views on early screening, most urologists in the United States today agree that the decision to detect and treat prostate cancer needs to be personalized, and ultimately made by the patient.
Tuesday, March 24, 2009
villains or voters?
I have recently seen Fred Suco about town wearing his police homicide shirt. He is wearing it to canvass the Springs. Is he canvassing for villains or voters? Has their been homicides all over town that he is investigating? It is certainly a political statement and shouldnt be allowed by law. I thought he was retired. Can he wear his official police shirt while out seeking votes? I doubt seriously that the County or the PBA would approve of this behavior. I have asked the City Clerk to investigate this, and she has assured me she will get back to me soon. Dr. Mel P. Johnson
astounding and miraculous terms
A neighbor has taken issue with my statement that Billys term has been unremarkable. He finds those terms to be astounding and miraculous. Astounding in its lack of vision, common sense, and oversight by the Council. Miraculous in the fact that nobody has been indicted yet for any felonies and that we are STILL solvent, in spite of Billy and Gym. He HAS a point, or three. Dr. Mel P. Johnson
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Illegal Immigration Costs California Over Ten Billion Annually
State's "cheap labor" costs average household $1,183 a year
By Robert Longley, About.com
Immigration History
Dateline: December, 2004
In hosting America's largest population of illegal immigrants, California bears a huge cost to provide basic human services for this fast growing, low-income segment of its population. A new study from the Federation for American Immigration Reform (FAIR) examines the costs of education, health care and incarceration of illegal aliens, and concludes that the costs to Californians is $10.5 billion per year.
Among the key finding of the report are that the state's already struggling K-12 education system spends approximately $7.7 billion a year to school the children of illegal aliens who now constitute 15 percent of the student body. Another $1.4 billion of the taxpayers' money goes toward providing health care to illegal aliens and their families, the same amount that is spent incarcerating illegal aliens criminals.
"California's addiction to 'cheap' illegal alien labor is bankrupting the state and posing enormous burdens on the state's shrinking middle class tax base," stated Dan Stein, President of FAIR. "Most Californians, who have seen their taxes increase while public services deteriorate, already know the impact that mass illegal immigration is having on their communities, but even they may be shocked when they learn just how much of a drain illegal immigration has become."
The Costs of Illegal Immigration to Californians focuses on three specific program areas because those were the costs examined by researchers from the Urban Institute in 1994. Looking at the costs of education, health care and incarceration for illegal aliens in 1994, the Urban Institute estimated that California was subsidizing illegal immigrants to the tune of about $1.1 billion. The enormous rise in the costs of illegal immigrants over the intervening ten years is due to the rapid growth in illegal residents. It is reasonable to expect those costs to continue to soar if action is not taken to turn the tide.
"Nineteen ninety-four was the same year that California voters rebelled and overwhelmingly passed Proposition 187, which sought to limit liability for mass illegal immigration. Since then, state and local governments have blatantly ignored the wishes of the voters and continued to shell out publicly financed benefits on illegal aliens," said Stein. "Predictably, the costs of illegal immigration have grown geometrically, while the state has spiraled into a fiscal crisis that has brought it near bankruptcy.
"Nothing could more starkly illustrate the very high costs of ‘cheap labor' than California's current situation," continued Stein. "A small number of powerful interests in the state reap the benefits, while the average native-born family in California gets handed a nearly $1,200 a year bill."
The Federation for American Immigration Reform is a nonprofit, public-interest, membership organization advocating immigration policy reforms that would tighten border security and prevent illegal immigration, while reducing legal immigration levels from about 1.1 million persons per year to 300,000 per year.
Illegal Immigration Costs California Over Ten Billion Annually
State's "cheap labor" costs average household $1,183 a year
By Robert Longley, About.com
Immigration History
Dateline: December, 2004
In hosting America's largest population of illegal immigrants, California bears a huge cost to provide basic human services for this fast growing, low-income segment of its population. A new study from the Federation for American Immigration Reform (FAIR) examines the costs of education, health care and incarceration of illegal aliens, and concludes that the costs to Californians is $10.5 billion per year.
Among the key finding of the report are that the state's already struggling K-12 education system spends approximately $7.7 billion a year to school the children of illegal aliens who now constitute 15 percent of the student body. Another $1.4 billion of the taxpayers' money goes toward providing health care to illegal aliens and their families, the same amount that is spent incarcerating illegal aliens criminals.
"California's addiction to 'cheap' illegal alien labor is bankrupting the state and posing enormous burdens on the state's shrinking middle class tax base," stated Dan Stein, President of FAIR. "Most Californians, who have seen their taxes increase while public services deteriorate, already know the impact that mass illegal immigration is having on their communities, but even they may be shocked when they learn just how much of a drain illegal immigration has become."
The Costs of Illegal Immigration to Californians focuses on three specific program areas because those were the costs examined by researchers from the Urban Institute in 1994. Looking at the costs of education, health care and incarceration for illegal aliens in 1994, the Urban Institute estimated that California was subsidizing illegal immigrants to the tune of about $1.1 billion. The enormous rise in the costs of illegal immigrants over the intervening ten years is due to the rapid growth in illegal residents. It is reasonable to expect those costs to continue to soar if action is not taken to turn the tide.
"Nineteen ninety-four was the same year that California voters rebelled and overwhelmingly passed Proposition 187, which sought to limit liability for mass illegal immigration. Since then, state and local governments have blatantly ignored the wishes of the voters and continued to shell out publicly financed benefits on illegal aliens," said Stein. "Predictably, the costs of illegal immigration have grown geometrically, while the state has spiraled into a fiscal crisis that has brought it near bankruptcy.
"Nothing could more starkly illustrate the very high costs of ‘cheap labor' than California's current situation," continued Stein. "A small number of powerful interests in the state reap the benefits, while the average native-born family in California gets handed a nearly $1,200 a year bill."
The Federation for American Immigration Reform is a nonprofit, public-interest, membership organization advocating immigration policy reforms that would tighten border security and prevent illegal immigration, while reducing legal immigration levels from about 1.1 million persons per year to 300,000 per year.
The High Cost of Cheap Labor
The High Cost of Cheap Labor
Illegal Immigration and the Federal Budget
Executive Summary
--------------------------------------------------------------------------------
This study is one of the first to estimate the total impact of illegal immigration on the federal budget. Most previous studies have focused on the state and local level and have examined only costs or tax payments, but not both. Based on Census Bureau data, this study finds that, when all taxes paid (direct and indirect) and all costs are considered, illegal households created a net fiscal deficit at the federal level of more than $10 billion in 2002. We also estimate that, if there was an amnesty for illegal aliens, the net fiscal deficit would grow to nearly $29 billion.
Among the findings:
Households headed by illegal aliens imposed more than $26.3 billion in costs on the federal government in 2002 and paid only $16 billion in taxes, creating a net fiscal deficit of almost $10.4 billion, or $2,700 per illegal household.
Among the largest costs are Medicaid ($2.5 billion); treatment for the uninsured ($2.2 billion); food assistance programs such as food stamps, WIC, and free school lunches ($1.9 billion); the federal prison and court systems ($1.6 billion); and federal aid to schools ($1.4 billion).
With nearly two-thirds of illegal aliens lacking a high school degree, the primary reason they create a fiscal deficit is their low education levels and resulting low incomes and tax payments, not their legal status or heavy use of most social services.
On average, the costs that illegal households impose on federal coffers are less than half that of other households, but their tax payments are only one-fourth that of other households.
Many of the costs associated with illegals are due to their American-born children, who are awarded U.S. citizenship at birth. Thus, greater efforts at barring illegals from federal programs will not reduce costs because their citizen children can continue to access them.
If illegal aliens were given amnesty and began to pay taxes and use services like households headed by legal immigrants with the same education levels, the estimated annual net fiscal deficit would increase from $2,700 per household to nearly $7,700, for a total net cost of $29 billion.
Costs increase dramatically because unskilled immigrants with legal status -- what most illegal aliens would become -- can access government programs, but still tend to make very modest tax payments.
Although legalization would increase average tax payments by 77 percent, average costs would rise by 118 percent.
The fact that legal immigrants with few years of schooling are a large fiscal drain does not mean that legal immigrants overall are a net drain -- many legal immigrants are highly skilled.
The vast majority of illegals hold jobs. Thus the fiscal deficit they create for the federal government is not the result of an unwillingness to work.
The results of this study are consistent with a 1997 study by the National Research Council, which also found that immigrants' education level is a key determinant of their fiscal impact.
A Complex Fiscal Picture
Welfare use. Our findings show that many of the preconceived notions about the fiscal impact of illegal households turn out to be inaccurate. In terms of welfare use, receipt of cash assistance programs tends to be very low, while Medicaid use, though significant, is still less than for other households. Only use of food assistance programs is significantly higher than that of the rest of the population. Also, contrary to the perceptions that illegal aliens don't pay payroll taxes, we estimate that more than half of illegals work "on the books." On average, illegal households pay more than $4,200 a year in all forms of federal taxes. Unfortunately, they impose costs of $6,950 per household.
Social Security and Medicare. Although we find that the net effect of illegal households is negative at the federal level, the same is not true for Social Security and Medicare. We estimate that illegal households create a combined net benefit for these two programs in excess of $7 billion a year, accounting for about 4 percent of the total annual surplus in these two programs. However, they create a net deficit of $17.4 billion in the rest of the budget, for a total net loss of $10.4 billion. Nonetheless, their impact on Social Security and Medicare is unambiguously positive. Of course, if the Social Security totalization agreement with Mexico signed in June goes into effect, allowing illegals to collect Social Security, these calculations would change.
The Impact of Amnesty. Finally, our estimates show that amnesty would significantly increase tax revenue. Because both their income and tax compliance would rise, we estimate that under the most likely scenario the average illegal alien household would pay 77 percent ($3,200) more a year in federal taxes once legalized. While not enough to offset the 118 percent ($8,200) per household increase in costs that would come with legalization, amnesty would significantly increase both the average income and tax payments of illegal aliens.
What's Different About Today's Immigration. Many native-born Americans observe that their ancestors came to America and did not place great demands on government services. Perhaps this is true, but the size and scope of government were dramatically smaller during the last great wave of immigration. Not just means-tested programs, but expenditures on everything from public schools to roads were only a fraction of what they are today. Thus, the arrival of unskilled immigrants in the past did not have the negative fiscal implications that it does today. Moreover, the American economy has changed profoundly since the last great wave of immigration, with education now the key determinant of economic success. The costs that unskilled immigrants impose simply reflect the nature of the modern American economy and welfare state. It is doubtful that the fiscal costs can be avoided if our immigration policies remain unchanged.
Policy Implications
The negative impact on the federal budget need not be the only or even the primary consideration when deciding what to do about illegal immigration. But assuming that the fiscal status quo is unacceptable, there are three main changes in policy that might reduce or eliminate the fiscal costs of illegal immigration. One set of options is to allow illegal aliens to remain in the country, but attempt to reduce the costs they impose. A second set of options would be to grant them legal status as a way of increasing the taxes they pay. A third option would be to enforce the law and reduce the size of the illegal population and with it the costs of illegal immigration.
Reducing the Cost Side of the Equation. Reducing the costs illegals impose would probably be the most difficult of the three options because illegal households already impose only about 46 percent as much in costs on the federal government as other households. Thus, the amount of money that can be saved by curtailing their use of public services even further is probably quite limited. Moreover, the fact that benefits are often received on behalf of their U.S.-citizen children means that it is very difficult to prevent illegal households from accessing the programs they do. And many of the programs illegals use most extensively are likely to be politically very difficult to cut, such as the Women Infants and Children (WIC) nutrition program. Other costs, such as incarcerating illegals who have been convicted of crimes are unavoidable. It seems almost certain that if illegals are allowed to remain in the country, the fiscal deficit will persist.
Increasing Tax Revenue by Granting Amnesty. As discussed above, our research shows that granting illegal aliens amnesty would dramatically increase tax revenue. Unfortunately, we find that costs would increase even more. Costs would rise dramatically because illegals would be able to access many programs that are currently off limits to them. Moreover, even if legalized illegal aliens continued to be barred from using some means-tested programs, they would still be much more likely to sign their U.S.-citizen children up for them because they would lose whatever fear they had of the government. We know this because immigrants with legal status, who have the same education levels and resulting low incomes as illegal aliens, sign their U.S.-citizen children up for programs like Medicaid at higher rates than illegal aliens with U.S.-citizen children. In addition, direct costs for programs like the Earned Income Tax Credit would also grow dramatically with legalization. Right now, illegals need a Social Security number and have to file a tax return to get the credit. As a result, relatively few actually get it. We estimate that once legalized, payments to illegals under this program would grow more than ten-fold.
From a purely fiscal point of view, the main problem with legalization is that illegals would, for the most part, become unskilled legal immigrants. And unskilled legal immigrants create much larger fiscal costs than unskilled illegal aliens. Legalization will not change the low education levels of illegal aliens or the fact that the American labor market offers very limited opportunities to such workers, whatever their legal status. Nor will it change the basic fact that the United States, like all industrialized democracies, has a well-developed welfare state that provides assistance to low-income workers. Large fiscal costs are simply an unavoidable outcome of unskilled immigration given the economic and fiscal realities of America today.
Enforcing Immigration Laws. If we are serious about avoiding the fiscal costs of illegal immigration, the only real option is to enforce the law and reduce the number of illegal aliens in the country. First, this would entail much greater efforts to police the nation's land and sea borders. At present, less than 2,000 agents are on duty at any one time on the Mexican and Canadian borders. Second, much greater effort must be made to ensure that those allowed into the country on a temporary basis, such as tourists and guest workers, are not likely to stay in the country permanently. Third, the centerpiece of any enforcement effort would be to enforce the ban on hiring illegal aliens. At present, the law is completely unenforced. Enforcement would require using existing databases to ensure that all new hires are authorized to work in the United States and levying heavy fines on businesses that knowingly employ illegal aliens. Finally, a clear message from policymakers, especially senior members of the administration, that enforcement of the law is valued and vitally important to the nation, would dramatically increase the extremely low morale of those who enforce immigration laws.
Policing the border, enforcing the ban on hiring illegal aliens, denying temporary visas to those likely to remain permanently, and all the other things necessary to reduce illegal immigration will take time and cost money. However, since the cost of illegal immigration to the federal government alone is estimated at over $10 billion a year, significant resources could be devoted to enforcement efforts and still leave taxpayers with significant net savings. Enforcement not only has the advantage of reducing the costs of illegal immigration, it also is very popular with the general public. Nonetheless, policymakers can expect strong opposition from special interest groups, especially ethnic advocacy groups and those elements of the business community that do not want to invest in labor-saving devices and techniques or pay better salaries, but instead want access to large numbers of cheap, unskilled workers. If we choose to continue to not enforce the law or to grant illegals amnesty, both the public and policymakers have to understand that there will be significant long-term costs for taxpayers.
Summary Methodology
Overall Approach. To estimate the impact of households headed by illegal aliens, we rely heavily on the National Research Council's (NRC) 1997 study, "The New Americans." Like that study, we use the March Current Population Survey (CPS) and the decennial Census, both collected by the Census Bureau. We use the March 2003 CPS, which asks questions about income, household structure, and use of public services in the calendar year prior to the survey. We control total federal expenditures and tax receipts by category to reflect actual expenditures and tax payments. Like the NRC, we assume that immigrants have no impact on defense-related expenditures and therefore assign those costs only to native-headed households. Like the NRC, we define a household as persons living together who are related. Individuals living alone or with persons to whom they are unrelated are treated as their own households. As the NRC study points out, a "household is the primary unit through which public services are consumed and taxes paid." Following the NRC's example of using households, many of which include U.S.-citizen children, as the unit of analysis makes sense because the presence of these children and the costs they create are a direct result of their parents having been allowed to enter and remain in country. Thus, counting services used by these children allows for a full accounting of the costs of illegal immigration.
Identifying Illegal Aliens in Census Bureau Data. While the CPS does not ask respondents if they are illegal aliens, the Urban Institute, the former Immigration and Naturalization Service (INS), and the Census Bureau have used socio-demographic characteristics in the data to estimate the size and characteristics of the illegal population. To identify illegal aliens in the survey, we used citizenship status, year of arrival in the United States, age, country of birth, educational attainment, sex, receipt of welfare programs, receipt of Social Security, veteran status, and marital status. This method is based on some very well-established facts about the characteristics of the illegal population. In some cases, we assume that individuals have zero chance of being an illegal alien, such as naturalized citizens, veterans, and individuals who report that they personally receive Social Security benefits or cash assistance from a welfare program or those who are enrolled in Medicaid. However, other members of a household, mainly the U.S.-born children of illegal aliens, can and do receive these programs. We estimate that there were 8.7 million illegal aliens included in the March 2003 CPS. By design, our estimates for the size and characteristics of the illegal population are very similar to those prepared by the Census Bureau, the INS, and the Urban Institute.
Estimating the Impact of Amnesty. We assume that any amnesty that passes Congress will have Lawful Permanent Residence (LPR) as a component. Even though the President's amnesty proposal in January seems to envision "temporary" worker status, every major legalization bill in Congress, including those sponsored by Republican legislators, provides illegal aliens with LPR status at some point in the process. Moreover, Democratic presidential nominee John Kerry has indicated his strong desire to give LPR status to illegal aliens.
To estimate the likely impact of legalization, we run two different simulations. In our first simulation, we assume that legalized illegal aliens would use services and pay taxes like all households headed by legal immigrants with the same characteristics. In this simulation, we control for the education level of the household head and whether the head is from Mexico. The first simulation shows that the net fiscal deficit grows from about $2,700 to more than $6,000 per household. In the second simulation, we again control for education and whether the household head is Mexican and also assume that illegals would become like post-1986 legal immigrants, excluding refugees. Because illegals are much more like recently arrived non-refugees than legal immigrants in general, the second simulation is the more plausible. The second simulation shows that the net fiscal deficit per household would climb to $7,700.
Results Similar to Other Studies. Our overall conclusion that education level is the primary determinant of tax payments made and services used is very similar to the conclusion of the 1997 National Research Council report, "The New Americans." The results of our study also closely match the findings of a 1998 Urban Institute study, which examined tax payments by illegal aliens in New York State. In order to test our results we ran separate estimates for federal taxes and found that, when adjusted for inflation, our estimated federal taxes are almost identical to those of the Urban Institute. The results of this study are also buttressed by an analysis of illegal alien tax returns done by the Inspector General's Office of the Department of Treasury in 2004, which found that about half of illegals had no federal income tax liability, very similar to our finding of 45 percent.
Illegal Immigration and the Federal Budget
Executive Summary
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This study is one of the first to estimate the total impact of illegal immigration on the federal budget. Most previous studies have focused on the state and local level and have examined only costs or tax payments, but not both. Based on Census Bureau data, this study finds that, when all taxes paid (direct and indirect) and all costs are considered, illegal households created a net fiscal deficit at the federal level of more than $10 billion in 2002. We also estimate that, if there was an amnesty for illegal aliens, the net fiscal deficit would grow to nearly $29 billion.
Among the findings:
Households headed by illegal aliens imposed more than $26.3 billion in costs on the federal government in 2002 and paid only $16 billion in taxes, creating a net fiscal deficit of almost $10.4 billion, or $2,700 per illegal household.
Among the largest costs are Medicaid ($2.5 billion); treatment for the uninsured ($2.2 billion); food assistance programs such as food stamps, WIC, and free school lunches ($1.9 billion); the federal prison and court systems ($1.6 billion); and federal aid to schools ($1.4 billion).
With nearly two-thirds of illegal aliens lacking a high school degree, the primary reason they create a fiscal deficit is their low education levels and resulting low incomes and tax payments, not their legal status or heavy use of most social services.
On average, the costs that illegal households impose on federal coffers are less than half that of other households, but their tax payments are only one-fourth that of other households.
Many of the costs associated with illegals are due to their American-born children, who are awarded U.S. citizenship at birth. Thus, greater efforts at barring illegals from federal programs will not reduce costs because their citizen children can continue to access them.
If illegal aliens were given amnesty and began to pay taxes and use services like households headed by legal immigrants with the same education levels, the estimated annual net fiscal deficit would increase from $2,700 per household to nearly $7,700, for a total net cost of $29 billion.
Costs increase dramatically because unskilled immigrants with legal status -- what most illegal aliens would become -- can access government programs, but still tend to make very modest tax payments.
Although legalization would increase average tax payments by 77 percent, average costs would rise by 118 percent.
The fact that legal immigrants with few years of schooling are a large fiscal drain does not mean that legal immigrants overall are a net drain -- many legal immigrants are highly skilled.
The vast majority of illegals hold jobs. Thus the fiscal deficit they create for the federal government is not the result of an unwillingness to work.
The results of this study are consistent with a 1997 study by the National Research Council, which also found that immigrants' education level is a key determinant of their fiscal impact.
A Complex Fiscal Picture
Welfare use. Our findings show that many of the preconceived notions about the fiscal impact of illegal households turn out to be inaccurate. In terms of welfare use, receipt of cash assistance programs tends to be very low, while Medicaid use, though significant, is still less than for other households. Only use of food assistance programs is significantly higher than that of the rest of the population. Also, contrary to the perceptions that illegal aliens don't pay payroll taxes, we estimate that more than half of illegals work "on the books." On average, illegal households pay more than $4,200 a year in all forms of federal taxes. Unfortunately, they impose costs of $6,950 per household.
Social Security and Medicare. Although we find that the net effect of illegal households is negative at the federal level, the same is not true for Social Security and Medicare. We estimate that illegal households create a combined net benefit for these two programs in excess of $7 billion a year, accounting for about 4 percent of the total annual surplus in these two programs. However, they create a net deficit of $17.4 billion in the rest of the budget, for a total net loss of $10.4 billion. Nonetheless, their impact on Social Security and Medicare is unambiguously positive. Of course, if the Social Security totalization agreement with Mexico signed in June goes into effect, allowing illegals to collect Social Security, these calculations would change.
The Impact of Amnesty. Finally, our estimates show that amnesty would significantly increase tax revenue. Because both their income and tax compliance would rise, we estimate that under the most likely scenario the average illegal alien household would pay 77 percent ($3,200) more a year in federal taxes once legalized. While not enough to offset the 118 percent ($8,200) per household increase in costs that would come with legalization, amnesty would significantly increase both the average income and tax payments of illegal aliens.
What's Different About Today's Immigration. Many native-born Americans observe that their ancestors came to America and did not place great demands on government services. Perhaps this is true, but the size and scope of government were dramatically smaller during the last great wave of immigration. Not just means-tested programs, but expenditures on everything from public schools to roads were only a fraction of what they are today. Thus, the arrival of unskilled immigrants in the past did not have the negative fiscal implications that it does today. Moreover, the American economy has changed profoundly since the last great wave of immigration, with education now the key determinant of economic success. The costs that unskilled immigrants impose simply reflect the nature of the modern American economy and welfare state. It is doubtful that the fiscal costs can be avoided if our immigration policies remain unchanged.
Policy Implications
The negative impact on the federal budget need not be the only or even the primary consideration when deciding what to do about illegal immigration. But assuming that the fiscal status quo is unacceptable, there are three main changes in policy that might reduce or eliminate the fiscal costs of illegal immigration. One set of options is to allow illegal aliens to remain in the country, but attempt to reduce the costs they impose. A second set of options would be to grant them legal status as a way of increasing the taxes they pay. A third option would be to enforce the law and reduce the size of the illegal population and with it the costs of illegal immigration.
Reducing the Cost Side of the Equation. Reducing the costs illegals impose would probably be the most difficult of the three options because illegal households already impose only about 46 percent as much in costs on the federal government as other households. Thus, the amount of money that can be saved by curtailing their use of public services even further is probably quite limited. Moreover, the fact that benefits are often received on behalf of their U.S.-citizen children means that it is very difficult to prevent illegal households from accessing the programs they do. And many of the programs illegals use most extensively are likely to be politically very difficult to cut, such as the Women Infants and Children (WIC) nutrition program. Other costs, such as incarcerating illegals who have been convicted of crimes are unavoidable. It seems almost certain that if illegals are allowed to remain in the country, the fiscal deficit will persist.
Increasing Tax Revenue by Granting Amnesty. As discussed above, our research shows that granting illegal aliens amnesty would dramatically increase tax revenue. Unfortunately, we find that costs would increase even more. Costs would rise dramatically because illegals would be able to access many programs that are currently off limits to them. Moreover, even if legalized illegal aliens continued to be barred from using some means-tested programs, they would still be much more likely to sign their U.S.-citizen children up for them because they would lose whatever fear they had of the government. We know this because immigrants with legal status, who have the same education levels and resulting low incomes as illegal aliens, sign their U.S.-citizen children up for programs like Medicaid at higher rates than illegal aliens with U.S.-citizen children. In addition, direct costs for programs like the Earned Income Tax Credit would also grow dramatically with legalization. Right now, illegals need a Social Security number and have to file a tax return to get the credit. As a result, relatively few actually get it. We estimate that once legalized, payments to illegals under this program would grow more than ten-fold.
From a purely fiscal point of view, the main problem with legalization is that illegals would, for the most part, become unskilled legal immigrants. And unskilled legal immigrants create much larger fiscal costs than unskilled illegal aliens. Legalization will not change the low education levels of illegal aliens or the fact that the American labor market offers very limited opportunities to such workers, whatever their legal status. Nor will it change the basic fact that the United States, like all industrialized democracies, has a well-developed welfare state that provides assistance to low-income workers. Large fiscal costs are simply an unavoidable outcome of unskilled immigration given the economic and fiscal realities of America today.
Enforcing Immigration Laws. If we are serious about avoiding the fiscal costs of illegal immigration, the only real option is to enforce the law and reduce the number of illegal aliens in the country. First, this would entail much greater efforts to police the nation's land and sea borders. At present, less than 2,000 agents are on duty at any one time on the Mexican and Canadian borders. Second, much greater effort must be made to ensure that those allowed into the country on a temporary basis, such as tourists and guest workers, are not likely to stay in the country permanently. Third, the centerpiece of any enforcement effort would be to enforce the ban on hiring illegal aliens. At present, the law is completely unenforced. Enforcement would require using existing databases to ensure that all new hires are authorized to work in the United States and levying heavy fines on businesses that knowingly employ illegal aliens. Finally, a clear message from policymakers, especially senior members of the administration, that enforcement of the law is valued and vitally important to the nation, would dramatically increase the extremely low morale of those who enforce immigration laws.
Policing the border, enforcing the ban on hiring illegal aliens, denying temporary visas to those likely to remain permanently, and all the other things necessary to reduce illegal immigration will take time and cost money. However, since the cost of illegal immigration to the federal government alone is estimated at over $10 billion a year, significant resources could be devoted to enforcement efforts and still leave taxpayers with significant net savings. Enforcement not only has the advantage of reducing the costs of illegal immigration, it also is very popular with the general public. Nonetheless, policymakers can expect strong opposition from special interest groups, especially ethnic advocacy groups and those elements of the business community that do not want to invest in labor-saving devices and techniques or pay better salaries, but instead want access to large numbers of cheap, unskilled workers. If we choose to continue to not enforce the law or to grant illegals amnesty, both the public and policymakers have to understand that there will be significant long-term costs for taxpayers.
Summary Methodology
Overall Approach. To estimate the impact of households headed by illegal aliens, we rely heavily on the National Research Council's (NRC) 1997 study, "The New Americans." Like that study, we use the March Current Population Survey (CPS) and the decennial Census, both collected by the Census Bureau. We use the March 2003 CPS, which asks questions about income, household structure, and use of public services in the calendar year prior to the survey. We control total federal expenditures and tax receipts by category to reflect actual expenditures and tax payments. Like the NRC, we assume that immigrants have no impact on defense-related expenditures and therefore assign those costs only to native-headed households. Like the NRC, we define a household as persons living together who are related. Individuals living alone or with persons to whom they are unrelated are treated as their own households. As the NRC study points out, a "household is the primary unit through which public services are consumed and taxes paid." Following the NRC's example of using households, many of which include U.S.-citizen children, as the unit of analysis makes sense because the presence of these children and the costs they create are a direct result of their parents having been allowed to enter and remain in country. Thus, counting services used by these children allows for a full accounting of the costs of illegal immigration.
Identifying Illegal Aliens in Census Bureau Data. While the CPS does not ask respondents if they are illegal aliens, the Urban Institute, the former Immigration and Naturalization Service (INS), and the Census Bureau have used socio-demographic characteristics in the data to estimate the size and characteristics of the illegal population. To identify illegal aliens in the survey, we used citizenship status, year of arrival in the United States, age, country of birth, educational attainment, sex, receipt of welfare programs, receipt of Social Security, veteran status, and marital status. This method is based on some very well-established facts about the characteristics of the illegal population. In some cases, we assume that individuals have zero chance of being an illegal alien, such as naturalized citizens, veterans, and individuals who report that they personally receive Social Security benefits or cash assistance from a welfare program or those who are enrolled in Medicaid. However, other members of a household, mainly the U.S.-born children of illegal aliens, can and do receive these programs. We estimate that there were 8.7 million illegal aliens included in the March 2003 CPS. By design, our estimates for the size and characteristics of the illegal population are very similar to those prepared by the Census Bureau, the INS, and the Urban Institute.
Estimating the Impact of Amnesty. We assume that any amnesty that passes Congress will have Lawful Permanent Residence (LPR) as a component. Even though the President's amnesty proposal in January seems to envision "temporary" worker status, every major legalization bill in Congress, including those sponsored by Republican legislators, provides illegal aliens with LPR status at some point in the process. Moreover, Democratic presidential nominee John Kerry has indicated his strong desire to give LPR status to illegal aliens.
To estimate the likely impact of legalization, we run two different simulations. In our first simulation, we assume that legalized illegal aliens would use services and pay taxes like all households headed by legal immigrants with the same characteristics. In this simulation, we control for the education level of the household head and whether the head is from Mexico. The first simulation shows that the net fiscal deficit grows from about $2,700 to more than $6,000 per household. In the second simulation, we again control for education and whether the household head is Mexican and also assume that illegals would become like post-1986 legal immigrants, excluding refugees. Because illegals are much more like recently arrived non-refugees than legal immigrants in general, the second simulation is the more plausible. The second simulation shows that the net fiscal deficit per household would climb to $7,700.
Results Similar to Other Studies. Our overall conclusion that education level is the primary determinant of tax payments made and services used is very similar to the conclusion of the 1997 National Research Council report, "The New Americans." The results of our study also closely match the findings of a 1998 Urban Institute study, which examined tax payments by illegal aliens in New York State. In order to test our results we ran separate estimates for federal taxes and found that, when adjusted for inflation, our estimated federal taxes are almost identical to those of the Urban Institute. The results of this study are also buttressed by an analysis of illegal alien tax returns done by the Inspector General's Office of the Department of Treasury in 2004, which found that about half of illegals had no federal income tax liability, very similar to our finding of 45 percent.
The Immigration Debate - WSJ
Illegal immigration has been painted as a costly problem, an economic necessity and a political football as the debate surrounding it has gathered steam.
The Wall Street Journal Online asked economists Gordon Hanson of the University of California, San Diego, and Philip Martin, of the University of California, Davis, to discuss the underlying causes of immigration (both legal and illegal), its historical roots and the nature of the current political uproar over the issue.
What do you think? Share your thoughts on our discussion board.
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.Gordon Hanson writes: For all the heat that the debate about immigration has generated, the net economic impact of immigration on the U.S. economy appears to be remarkably small. First, some thoughts on legal immigration, before we address illegal immigrants.
By bringing new workers into the economy, immigration allows existing U.S. capital, land, and technology to be used more efficiently. Also on the plus side, immigrants pay property taxes, sales taxes, Social Security taxes, and income taxes.
About the Participants
Gordon Hanson obtained his bachelor's in economics from Occidental College in 1986 and his doctorate from the Massachusetts Institute of Technology in 1992. Before joining UCSD in 2001, he was on the economics faculty at the University of Michigan and at the University of Texas. He has written more than 50 publications in academic journals and other academic volumes. His current research focuses on causes and consequences of Mexican migration to the U.S., how and why multinational firms globalize their production activities and the factors that shape countries' export capabilities. His most recent book is "Why Does Immigration Divide America? Public Finance and Political Opposition to Open Borders."
Philip Martin is a professor of agriculture and resource economics at the University of California, Davis. He also chairs the University of California's Comparative Immigration & Integration Program and edits the monthly immigration newsletter, Migration News. He studied labor economics and agricultural economics at the University of Wisconsin, Madison, where he earned a Ph.D. in 1975. His research focuses on farm labor, labor migration, economic development, and immigration issues, and has testified before Congress and state and local agencies numerous times on these issues. His most recent book is "Managing Labor Migration in the Twenty-First Century."
.In the negative column, immigrants use public services in the form of public education, fire and police protection, government assistance, etc. Add the positive and negative elements together and you get what looks like a very small number.
We can calculate the gain to U.S. GDP due to immigration, known in econ parlance as the immigration surplus, using a simple formula that is a function of three things:
■The importance of labor to the U.S. economy
■The size of the immigrant labor inflow
■The change in U.S. wages due to immigration
Whether legal or illegal, immigration generates a gain in national income by making U.S. business more productive. George Borjas and Larry Katz have examined the specific consequences of immigration from Mexico for U.S. wages.
But illegal immigration differs from legal immigration in several important respects. First, illegal immigrants tend to have low skill levels, which means they end up in jobs in agriculture, construction, household services, landscaping, low-end manufacturing, or restaurants and lodging. Employers in these industries (and consumers of the goods these industries produce) are primarily the ones who benefit from illegal immigration. In a recent study, Patricia Cortes, a graduate student at MIT, finds that U.S. cities that have higher larger immigrant inflows have lower prices for housekeeping, gardening, and other labor intensive services. Ten percent more immigration lowers prices for these services by about 1.3%.
Second, illegal immigrants, by virtue of their low income levels and their tenuous attachment to the legal economy, don't pay all that much in taxes. Yet their kids still attend school and their U.S.-born kids still get access to Medicare. What does this mean for the net fiscal consequences of illegal immigration? The Center for Immigration Studies, an anti-immigration think tank, estimates that the short-run net fiscal impact of illegal immigration is negative, on the order of $10 billion in 2002, or 0.09% of U.S. GDP in that year. This is not a big number.
As with immigration overall, what upsets people is not the aggregate impact of illegal immigration, which, as with legal immigration, seems to be more or less a wash. It is that the benefits of illegal immigration are enjoyed by one group -- the employers who hire them (and the consumers of their services) -- while the costs are incurred by other groups -- low-skilled workers and taxpayers in states where illegal immigrants reside.
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.Philip Martin writes: Gordon is right: Immigration, whether legal or illegal, adds workers, most of whom get jobs, which makes the U.S. economy larger. If there are economies of scale, as when producing more lowers the cost of production, the prices of some goods fall, benefiting those who buy those goods at home and abroad.
Most of the benefits of immigration go to the immigrants who earn higher wages in the U.S. than they would at home. In the standard triangle analysis, there are no net economic benefits to the U.S. economy (the triangle in the Hanson and Borjas papers above, as well as in my book "Promise Unfulfilled: Unions, Immigration, and Farm Workers") if wages do not fall with the addition of immigrant workers.
It has been very hard to agree on how much wages declined because of immigration, but the 3% estimate of Borjas is reasonable.
With migrants getting most of the gain from immigration in their wages, and owners of capital and land getting most of the rest in higher profits and rents, the surplus triangle is 1/10 of 1% of GDP. Pro-immigration people stress that immigration is positive, a net economic benefit, and in a $13 trillion economy, 1% is $13 billion. Anti-immigrant people stress that immigration adds $13 billion, or about two weeks' growth in an economy growing 2.5% a year.
Economists agree that the immigration generates a small net economic benefit for the U.S. and in doing so redistributes income from workers to owners of capital and land. Perhaps this is why immigration is such a political hot potato; it's mostly a distribution issue and, for governments that are in the business of redistributing income via taxes and subsidies, regulating immigration is another redistribution tool.
How many, from where and in what status are the core questions of immigration policy. Could the U.S. get a larger economic benefit if changed the mix of immigrants arriving?
The National Research Council data suggest the answer is yes. Making often heroic assumptions about how well immigrants and their children will fare in the U.S., the NRC calculated the present value of a typical immigrant arriving in the U.S. in the mid-1990s to be $89,000, that is, taking into account the taxes paid of immigrants and assuming that their children and grandchildren are like their U.S.-born counterparts, the NRC estimated that the present value of the taxes paid will exceed tax-supported benefits consumed by $89,000 over the next 50+ years.
However, the same study emphasized that the key to the benefits of immigration for the U.S. are their level of education. Those with more than a high-school education had a net present value of almost $200,000, while those with less than a high-school education had a net present value of negative $13,000.
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.Gordon writes: I think few would argue with the statement that we are living through an unprecedented moment of immigration from Mexico and Latin America. Where disagreements might arise is over what brought this moment about and how long it might last.
If you go back to the middle of the 20th century, immigration from Mexico just wasn't a big deal. The share of Mexican immigrants in the U.S. labor force actually fell from the 1920s to the 1960s. Now, these numbers don't include temporary immigrants that entered the U.S. under the Bracero program from 1942 to 1964, but I think the importance of that program is easy to exaggerate. Since braceros had to return home at the end of each year, the program represented a one-time increase in the U.S. labor force of just a few hundred thousand workers. Even at its height in the late 1950s, when over 400,000 Braceros entered the U.S., these workers represented less than half a percent of the U.S. labor force.
Today, however, the scale is entirely different. Mexican immigrants now account for about 5% of the U.S. labor force (and 35% of the immigrant labor force), up from less than 1% in 1970. What happened?
I would cite two events. Since 1982, Mexico has had several major economic contractions and has been unable to string together more than a few years of solid growth. As a result, per capita income in Mexico has steadily fallen relative to per capita income in the U.S. Why stay in Mexico when incomes are rising faster in the U.S.?
Compounding migration pressures has been the entry of Mexico's baby boom into the labor force. While fertility rates in Mexico have dropped sharply in the last three decades (from five kids per woman in 1970 to three kids per woman in 2000), it wasn't that long ago that the typical Mexican woman had nearly a half dozen children. Mexico's high fertility years produced a demographic bulge, the members of which in the last 20 years have come of age and started to look for work. As luck would have it, Mexico's baby boom entered the labor force during Mexico's two decades of dismal economic performance and decidedly lackluster growth in labor demand. The result has been the surge in Mexican immigration that we have been witnessing.
What makes the current surge in Mexico-to-U.S. migration hard to slow is that today's generation of Mexican young people do not have a memory of good economic times in Mexico. Many may have lost faith in Mexico's ability to provide them with a decent future. Such a change in expectations is a powerful force because it implies that Mexico would have to produce unexpectedly strong economic growth for a sustained period to get Mexican workers to believe in the Mexican economy, again. In the meantime, Mexican labor will keep heading north.
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.Philip writes: Gordon has nicely laid out the failure of Mexico to create jobs for its baby-boom generation and the challenge of generating stay-at-home development after repeated disappointments in Mexican economic development. I think that the Bracero experience has relevance for today's policy debate, in which both the House and Senate agree on more border and interior enforcement, and both seem to favor guest workers, but only the Senate offers a path to legal status.
The Bracero ("strong arm") program was very important in setting Mexico-U.S. migration in motion. There were actually two periods of programs, between 1917 and 1921 and again between 1942 and 1964. The second period was important for several reasons: It gave Mexicans experience migrating legally and illegally to the U.S., made farmers familiar with Mexican workers, and introduced the nemeses of guest-worker programs everywhere: distortion and dependence.
Opening legal channels for guest workers doesn't necessarily curb illegal immigration. Between 1942 and 1964, some 4.6 million Mexicans were admitted to do farm work; many Mexicans returned year after year, but between one million and two million gained legal U.S. work experience.
The Bracero program is another example of the maxim that there is nothing more permanent than temporary workers. The economic decisions of U.S. farmers became distorted as they made investment decisions that assumed Braceros would continue to be available. There was no need to raise the piece-rate wages that most Braceros earned, so it became profitable to plant orange and apple trees in remote areas. If the Bracero program were ended, these plantings would be unprofitable, explaining why farmers argued that they would go out of business without migrants. The program was nonetheless ended at the behest of President Kennedy, who believed that Braceros were "adversely affecting the wages, working conditions, and employment opportunities of our own agricultural workers."
Today, 75% of U.S. hired workers on crop farms were born in Mexico, and more than half are unauthorized. If we substitute "unauthorized Mexican farm worker" for "Bracero," we get the same debate as we had in the early 1960s and the early 1980s, before IRCA was enacted.
Perhaps the best way to minimize the distortion inherent in guest-worker programs is to charge employers for the privilege of employing legal migrants, and to use the taxes or levies collected to help them to mechanize and restructure jobs. In agriculture and many other U.S. industries that hire Mexican workers, it can be hard for an individual employer to mechanize, since, e.g., the crop must be packed or processed in a facility that is set up to handle machine-picked or hand-picked produce, but not both.
The other issue is the dependence of some areas of Mexico on the U.S. labor market. Economic theory suggests that areas sending and receiving migrants should see convergence in wages, but this anticipates higher wages in areas losing workers. Wages have risen in Mexico, but many of the rural areas from which most migrants come have been described as filled with nurseries and nursing homes, reflecting the fact that working-age adults are in the U.S. Remittances can lead to better housing and spending that generates multipliers and helps nonmigrants, too, but may not lead to the economic development that would keep young Mexicans seeking a brighter future at home.
The Bracero program sowed the seeds for subsequent Mexico-U.S. migration, which makes me cautious about beginning another large-scale guest-worker program. Second, if a new guest-worker program does not deal with the distortion that invariably creeps into the decision making of guest-worker dependent employers, there will be future "I will go out of business without migrant" protests. Third, if Mexico cannot absorb its labor force entrants in good or formal sector jobs, there will continue to be strong incentives to cross the border.
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.Gordon writes: Where do we go from here? Congress is battling over how to manage illegal immigration, with a plan to expand a guest-worker program being the most popular current policy option. In a nutshell, the idea would be to convert illegal immigrants into guest workers, which the U.S. government could regulate.
A guest-worker program, at least how it is envisioned by Congress, would be a disaster. For as maligned as illegal immigration is, it has some attractive features in terms of economic efficiency. Illegal immigration delivers U.S. business the types of workers they need (low-skilled labor, which is increasingly in short supply), when they need them (during times when the U.S. economy is expanding), and where they need them (in regions where job growth is strong).
A guest-worker program would have none of these properties. Given the snail's pace at which the Department of Homeland Security operates, U.S. employers would likely have to apply for guest workers long in advance of when they actually need them. The flexibility and adaptability of current illegal inflows would be lost. In response, many employers would probably go back to what they are doing now, which is hiring illegal workers.
Successful policy reform would require rethinking both illegal and legal immigration in the U.S. Why not convert most family-sponsored immigration visas into visas awarded on the basis of skill? Why not make the number of immigrants awarded visas conditional on U.S. economic conditions? Why not have the price of a U.S. immigration visa be determined by market conditions? These are questions that in the current debate should be asked but sadly are not.
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.Philip writes: I hate to think that illegal migration, with migrants dying in the desert and sometimes subject to unscrupulous employers, is the best we can do. I think the first priority is to agree that hiring unauthorized workers is a serious offense and devote the resources needed to change the behavior of employers and migrants. We can do this; we have done it for child labor, and we can make hiring unauthorized migrants just as unacceptable, as is true in northern Europe and Germany.
After 1986, both U.S. employers and Mexican migrants thought for a short time that the U.S. government was taking unauthorized migrants as seriously as child labor. But they soon realized that it wasn't, and they went back to hiring the unauthorized workers who showed up seeking jobs. There was also a layering in the labor market, with many employers turning to labor contractors to hire crews of workers on separate payrolls, cutting the link that allowed for some earlier Horatio Alger stories of ambitious workers climbing the ladder within a corporation when discovered by the right manager.
Labor migration is a process to be managed, not a problem to be solved. An effective migration-management process is one that uses economic incentives and disincentives to encourage employers and migrants to obey government-set rules, since we will never have enough enforcers to get compliance that goes against economic interests. In guest-worker programs, these economic incentives and disincentives involve payroll taxes; in general legal immigration, we have to answer the question whose interest migration is to solve.
If migration is to benefit natives, the key is to select immigrants most likely to be successful: young, healthy, well-educated English speakers. If migration is to allow the world's "huddled masses" to breathe free, there will be different selection criteria. The inability of policy makers to answer these questions may reflect American ambivalence about immigration.
The Wall Street Journal Online asked economists Gordon Hanson of the University of California, San Diego, and Philip Martin, of the University of California, Davis, to discuss the underlying causes of immigration (both legal and illegal), its historical roots and the nature of the current political uproar over the issue.
What do you think? Share your thoughts on our discussion board.
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.Gordon Hanson writes: For all the heat that the debate about immigration has generated, the net economic impact of immigration on the U.S. economy appears to be remarkably small. First, some thoughts on legal immigration, before we address illegal immigrants.
By bringing new workers into the economy, immigration allows existing U.S. capital, land, and technology to be used more efficiently. Also on the plus side, immigrants pay property taxes, sales taxes, Social Security taxes, and income taxes.
About the Participants
Gordon Hanson obtained his bachelor's in economics from Occidental College in 1986 and his doctorate from the Massachusetts Institute of Technology in 1992. Before joining UCSD in 2001, he was on the economics faculty at the University of Michigan and at the University of Texas. He has written more than 50 publications in academic journals and other academic volumes. His current research focuses on causes and consequences of Mexican migration to the U.S., how and why multinational firms globalize their production activities and the factors that shape countries' export capabilities. His most recent book is "Why Does Immigration Divide America? Public Finance and Political Opposition to Open Borders."
Philip Martin is a professor of agriculture and resource economics at the University of California, Davis. He also chairs the University of California's Comparative Immigration & Integration Program and edits the monthly immigration newsletter, Migration News. He studied labor economics and agricultural economics at the University of Wisconsin, Madison, where he earned a Ph.D. in 1975. His research focuses on farm labor, labor migration, economic development, and immigration issues, and has testified before Congress and state and local agencies numerous times on these issues. His most recent book is "Managing Labor Migration in the Twenty-First Century."
.In the negative column, immigrants use public services in the form of public education, fire and police protection, government assistance, etc. Add the positive and negative elements together and you get what looks like a very small number.
We can calculate the gain to U.S. GDP due to immigration, known in econ parlance as the immigration surplus, using a simple formula that is a function of three things:
■The importance of labor to the U.S. economy
■The size of the immigrant labor inflow
■The change in U.S. wages due to immigration
Whether legal or illegal, immigration generates a gain in national income by making U.S. business more productive. George Borjas and Larry Katz have examined the specific consequences of immigration from Mexico for U.S. wages.
But illegal immigration differs from legal immigration in several important respects. First, illegal immigrants tend to have low skill levels, which means they end up in jobs in agriculture, construction, household services, landscaping, low-end manufacturing, or restaurants and lodging. Employers in these industries (and consumers of the goods these industries produce) are primarily the ones who benefit from illegal immigration. In a recent study, Patricia Cortes, a graduate student at MIT, finds that U.S. cities that have higher larger immigrant inflows have lower prices for housekeeping, gardening, and other labor intensive services. Ten percent more immigration lowers prices for these services by about 1.3%.
Second, illegal immigrants, by virtue of their low income levels and their tenuous attachment to the legal economy, don't pay all that much in taxes. Yet their kids still attend school and their U.S.-born kids still get access to Medicare. What does this mean for the net fiscal consequences of illegal immigration? The Center for Immigration Studies, an anti-immigration think tank, estimates that the short-run net fiscal impact of illegal immigration is negative, on the order of $10 billion in 2002, or 0.09% of U.S. GDP in that year. This is not a big number.
As with immigration overall, what upsets people is not the aggregate impact of illegal immigration, which, as with legal immigration, seems to be more or less a wash. It is that the benefits of illegal immigration are enjoyed by one group -- the employers who hire them (and the consumers of their services) -- while the costs are incurred by other groups -- low-skilled workers and taxpayers in states where illegal immigrants reside.
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.Philip Martin writes: Gordon is right: Immigration, whether legal or illegal, adds workers, most of whom get jobs, which makes the U.S. economy larger. If there are economies of scale, as when producing more lowers the cost of production, the prices of some goods fall, benefiting those who buy those goods at home and abroad.
Most of the benefits of immigration go to the immigrants who earn higher wages in the U.S. than they would at home. In the standard triangle analysis, there are no net economic benefits to the U.S. economy (the triangle in the Hanson and Borjas papers above, as well as in my book "Promise Unfulfilled: Unions, Immigration, and Farm Workers") if wages do not fall with the addition of immigrant workers.
It has been very hard to agree on how much wages declined because of immigration, but the 3% estimate of Borjas is reasonable.
With migrants getting most of the gain from immigration in their wages, and owners of capital and land getting most of the rest in higher profits and rents, the surplus triangle is 1/10 of 1% of GDP. Pro-immigration people stress that immigration is positive, a net economic benefit, and in a $13 trillion economy, 1% is $13 billion. Anti-immigrant people stress that immigration adds $13 billion, or about two weeks' growth in an economy growing 2.5% a year.
Economists agree that the immigration generates a small net economic benefit for the U.S. and in doing so redistributes income from workers to owners of capital and land. Perhaps this is why immigration is such a political hot potato; it's mostly a distribution issue and, for governments that are in the business of redistributing income via taxes and subsidies, regulating immigration is another redistribution tool.
How many, from where and in what status are the core questions of immigration policy. Could the U.S. get a larger economic benefit if changed the mix of immigrants arriving?
The National Research Council data suggest the answer is yes. Making often heroic assumptions about how well immigrants and their children will fare in the U.S., the NRC calculated the present value of a typical immigrant arriving in the U.S. in the mid-1990s to be $89,000, that is, taking into account the taxes paid of immigrants and assuming that their children and grandchildren are like their U.S.-born counterparts, the NRC estimated that the present value of the taxes paid will exceed tax-supported benefits consumed by $89,000 over the next 50+ years.
However, the same study emphasized that the key to the benefits of immigration for the U.S. are their level of education. Those with more than a high-school education had a net present value of almost $200,000, while those with less than a high-school education had a net present value of negative $13,000.
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.Gordon writes: I think few would argue with the statement that we are living through an unprecedented moment of immigration from Mexico and Latin America. Where disagreements might arise is over what brought this moment about and how long it might last.
If you go back to the middle of the 20th century, immigration from Mexico just wasn't a big deal. The share of Mexican immigrants in the U.S. labor force actually fell from the 1920s to the 1960s. Now, these numbers don't include temporary immigrants that entered the U.S. under the Bracero program from 1942 to 1964, but I think the importance of that program is easy to exaggerate. Since braceros had to return home at the end of each year, the program represented a one-time increase in the U.S. labor force of just a few hundred thousand workers. Even at its height in the late 1950s, when over 400,000 Braceros entered the U.S., these workers represented less than half a percent of the U.S. labor force.
Today, however, the scale is entirely different. Mexican immigrants now account for about 5% of the U.S. labor force (and 35% of the immigrant labor force), up from less than 1% in 1970. What happened?
I would cite two events. Since 1982, Mexico has had several major economic contractions and has been unable to string together more than a few years of solid growth. As a result, per capita income in Mexico has steadily fallen relative to per capita income in the U.S. Why stay in Mexico when incomes are rising faster in the U.S.?
Compounding migration pressures has been the entry of Mexico's baby boom into the labor force. While fertility rates in Mexico have dropped sharply in the last three decades (from five kids per woman in 1970 to three kids per woman in 2000), it wasn't that long ago that the typical Mexican woman had nearly a half dozen children. Mexico's high fertility years produced a demographic bulge, the members of which in the last 20 years have come of age and started to look for work. As luck would have it, Mexico's baby boom entered the labor force during Mexico's two decades of dismal economic performance and decidedly lackluster growth in labor demand. The result has been the surge in Mexican immigration that we have been witnessing.
What makes the current surge in Mexico-to-U.S. migration hard to slow is that today's generation of Mexican young people do not have a memory of good economic times in Mexico. Many may have lost faith in Mexico's ability to provide them with a decent future. Such a change in expectations is a powerful force because it implies that Mexico would have to produce unexpectedly strong economic growth for a sustained period to get Mexican workers to believe in the Mexican economy, again. In the meantime, Mexican labor will keep heading north.
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.Philip writes: Gordon has nicely laid out the failure of Mexico to create jobs for its baby-boom generation and the challenge of generating stay-at-home development after repeated disappointments in Mexican economic development. I think that the Bracero experience has relevance for today's policy debate, in which both the House and Senate agree on more border and interior enforcement, and both seem to favor guest workers, but only the Senate offers a path to legal status.
The Bracero ("strong arm") program was very important in setting Mexico-U.S. migration in motion. There were actually two periods of programs, between 1917 and 1921 and again between 1942 and 1964. The second period was important for several reasons: It gave Mexicans experience migrating legally and illegally to the U.S., made farmers familiar with Mexican workers, and introduced the nemeses of guest-worker programs everywhere: distortion and dependence.
Opening legal channels for guest workers doesn't necessarily curb illegal immigration. Between 1942 and 1964, some 4.6 million Mexicans were admitted to do farm work; many Mexicans returned year after year, but between one million and two million gained legal U.S. work experience.
The Bracero program is another example of the maxim that there is nothing more permanent than temporary workers. The economic decisions of U.S. farmers became distorted as they made investment decisions that assumed Braceros would continue to be available. There was no need to raise the piece-rate wages that most Braceros earned, so it became profitable to plant orange and apple trees in remote areas. If the Bracero program were ended, these plantings would be unprofitable, explaining why farmers argued that they would go out of business without migrants. The program was nonetheless ended at the behest of President Kennedy, who believed that Braceros were "adversely affecting the wages, working conditions, and employment opportunities of our own agricultural workers."
Today, 75% of U.S. hired workers on crop farms were born in Mexico, and more than half are unauthorized. If we substitute "unauthorized Mexican farm worker" for "Bracero," we get the same debate as we had in the early 1960s and the early 1980s, before IRCA was enacted.
Perhaps the best way to minimize the distortion inherent in guest-worker programs is to charge employers for the privilege of employing legal migrants, and to use the taxes or levies collected to help them to mechanize and restructure jobs. In agriculture and many other U.S. industries that hire Mexican workers, it can be hard for an individual employer to mechanize, since, e.g., the crop must be packed or processed in a facility that is set up to handle machine-picked or hand-picked produce, but not both.
The other issue is the dependence of some areas of Mexico on the U.S. labor market. Economic theory suggests that areas sending and receiving migrants should see convergence in wages, but this anticipates higher wages in areas losing workers. Wages have risen in Mexico, but many of the rural areas from which most migrants come have been described as filled with nurseries and nursing homes, reflecting the fact that working-age adults are in the U.S. Remittances can lead to better housing and spending that generates multipliers and helps nonmigrants, too, but may not lead to the economic development that would keep young Mexicans seeking a brighter future at home.
The Bracero program sowed the seeds for subsequent Mexico-U.S. migration, which makes me cautious about beginning another large-scale guest-worker program. Second, if a new guest-worker program does not deal with the distortion that invariably creeps into the decision making of guest-worker dependent employers, there will be future "I will go out of business without migrant" protests. Third, if Mexico cannot absorb its labor force entrants in good or formal sector jobs, there will continue to be strong incentives to cross the border.
* * *
.Gordon writes: Where do we go from here? Congress is battling over how to manage illegal immigration, with a plan to expand a guest-worker program being the most popular current policy option. In a nutshell, the idea would be to convert illegal immigrants into guest workers, which the U.S. government could regulate.
A guest-worker program, at least how it is envisioned by Congress, would be a disaster. For as maligned as illegal immigration is, it has some attractive features in terms of economic efficiency. Illegal immigration delivers U.S. business the types of workers they need (low-skilled labor, which is increasingly in short supply), when they need them (during times when the U.S. economy is expanding), and where they need them (in regions where job growth is strong).
A guest-worker program would have none of these properties. Given the snail's pace at which the Department of Homeland Security operates, U.S. employers would likely have to apply for guest workers long in advance of when they actually need them. The flexibility and adaptability of current illegal inflows would be lost. In response, many employers would probably go back to what they are doing now, which is hiring illegal workers.
Successful policy reform would require rethinking both illegal and legal immigration in the U.S. Why not convert most family-sponsored immigration visas into visas awarded on the basis of skill? Why not make the number of immigrants awarded visas conditional on U.S. economic conditions? Why not have the price of a U.S. immigration visa be determined by market conditions? These are questions that in the current debate should be asked but sadly are not.
* * *
.Philip writes: I hate to think that illegal migration, with migrants dying in the desert and sometimes subject to unscrupulous employers, is the best we can do. I think the first priority is to agree that hiring unauthorized workers is a serious offense and devote the resources needed to change the behavior of employers and migrants. We can do this; we have done it for child labor, and we can make hiring unauthorized migrants just as unacceptable, as is true in northern Europe and Germany.
After 1986, both U.S. employers and Mexican migrants thought for a short time that the U.S. government was taking unauthorized migrants as seriously as child labor. But they soon realized that it wasn't, and they went back to hiring the unauthorized workers who showed up seeking jobs. There was also a layering in the labor market, with many employers turning to labor contractors to hire crews of workers on separate payrolls, cutting the link that allowed for some earlier Horatio Alger stories of ambitious workers climbing the ladder within a corporation when discovered by the right manager.
Labor migration is a process to be managed, not a problem to be solved. An effective migration-management process is one that uses economic incentives and disincentives to encourage employers and migrants to obey government-set rules, since we will never have enough enforcers to get compliance that goes against economic interests. In guest-worker programs, these economic incentives and disincentives involve payroll taxes; in general legal immigration, we have to answer the question whose interest migration is to solve.
If migration is to benefit natives, the key is to select immigrants most likely to be successful: young, healthy, well-educated English speakers. If migration is to allow the world's "huddled masses" to breathe free, there will be different selection criteria. The inability of policy makers to answer these questions may reflect American ambivalence about immigration.
Monday, March 23, 2009
commentary
Financials lead a huge rally as the Geithner plan to buy banks' toxic assets wins cheers. Techs and energy shares also jump. The S&P 500 may rally to 900; March could be the best month for the index since 1987. Existing-home sales unexpectedly rise. Nobody is saying the economy will not have occasional rallies on the way down. The news that energy stocks are up because energy prices are going back up is GOOD NEWS? Not to the consumers. Dr. Mel P. Johnson
total agreement
Billy has been taking lessons at the Dubya School of Public Speaking again. He said tonight that his experience as Mayor over the past 6 years has been "unremarkable". I couldnt agree more. See, there ARE times I agree with Billy. This is one of those times. Dr. Mel P. Johnson
sign her up !
I wasnt sure it was Margie spewing forth her own special brand of venom until tonight. Now I am sure. C'mon Margie, if you are going to poison this site with your senseless invective, at least have the guts to sign your name! I do. Dr. Mel P. Johnson
DERM shows up
DERM finally showed up tonight and verified that there are 27 sites identified at this point being remediated or monitored at this point. They also said that 9 of those sites have State funds available if cleanup should be needed. Stuff NOT mentioned was HOW MUCH state monies might be available for those cleanups. The State is hurting for money too. Will there be enough money to do an adequate cleanup? If not, will the County chip in to make up the difference? DERM says they are the ones to enforce the pollution laws but didnt say what might happen if 30 years of defunct companies are traced back but NONE have a desire, or the funds, to actually do a cleanup? When I called DERM they said they would need an addrees and site before they could give an opinion on any potential pollution sites. I will try again tomorrow, but until I have an agreement in writing that the County or State will be responsible for any cleanups needed in the proposed areas to be annexed I cannot be sure its a good deal for us, and would have a hard time agreeing to this annexation proposal. Dr. Mel P. Johnson
Municipal Money Magically Disappears
All I know for sure is that an experienced local contractor can build the bathrooms for 140k and that includes a fat 25% profit for him. The City paid an ADDITIONAL 280k for the very same bathrooms! We KNOW it costs 140k to build- where did that additional money go? IF the City Manager had a rational response he would have offered it LONG AGO. He doesnt. The City Manager should be embarrassed and ashamed to have thrown away our hard-earned tax monies like that! If he's embarrassed, as he SHOULD be, then its only because he has done it to himself with that shameful exhibit of municipal malfeasance, if not worse. I am just the observer who points out that the Emperor has... been exposed. The Mayor and Council should also be embarrassed and ashamed for approving those expenditures without any discussion or rational debate. Rubber Stamp R Us could be their slogan. Pitiful. Pathetic. Problematic. Preposterously exPensive. Dr. Mel P. Johnson
commentary
I have NO IDEA why the City would pay 280k more than it cost to build those bathrooms. I only know that the money disappeared! Poof! Gone with the wind! 280k of OUR tax dollars disappeared! And another 350k+ disappeared on the CC project! Where did THAT money go? The City Manager was in charge of BOTH projects and he has NO rational explanation. NONE. ZERO. We KNOW what the actual costs were- 140k. Where did that additional 280k go? We are not talking nickels and dimes here. We are talking about at least $630,000+ in our hard-earned tax dollars going POOF! GONE. Disappearing. We NEED that money now, as we look into a potential 1.3 million dollar deficit next year! WHERE did it go? Dr. Mel P. Johnson
commentary
If you dont believe my GC friend, ask any Fla insurance company what the usual and customary charges are for new construction in S Fla are. My insurance company says $125 a square foot. Can it be that the past-middle-age chunky real estate female is back and spewing her senseless and shameless venom again on this site? To suggest that I am writing the baseless, tasteless, and fictitious comments about myself is absurd, of course, and would be amusing if it wasnt so pathetically presented and pursued. It pleases me to know that people like that are NOT associated with MY campaign. Dr. Mel P. Johnson
Sunday, March 22, 2009
the choices are clear
Between Suco and Lob I dont believe you could get a dozen Council meetings attended over the past TWO YEARS. Lob wants whatever Billy tells him to want. Suco apparently thinks Gym is doing a fine job and should continue in that capacity for the next couple years until he retires. I disagree with both of them, as I believe that this new costly gym is a mistake in this economic environment and the City Managers performance has been horrible for the past couple years, especially on the city comstruction projects. So there are clear differences in our beliefs for the voters to contemplate and decide. Suco doesnt believe that pollution is an issue for the annexation properties- I disagree. When, or IF, the county puts it into writing that THEY will be responsible for any further cleanups, then I would be okay with that part of annexation. The choices are clear- Lob if you want a Billy clone; Suco if you want to allow the City Manager to continue as he has been doing; and me, who disagrees strongly with both of them on multiple points. Dr. Mel P. Johnson
the truth shall set you free
I will be glad to talk to anybody about our tax base, and anything else they want to talk about. The PEOPLE stated VERY clearly they didnt want any highrises over 3 stories, not me. End of that story. I do not believe I have made any untrue statements. Those who believe I have, need to give their numbers and rationale behind them. All I hear is broad accusations with NO numbers or rationale by ANONYMOUS posters! At least they should sign their names, like I do, or risk being thought of as one of the cojone-less cowards they accuse others of being! Dr. Mel P. Johnson
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