Every am put some coins in left pocket. When happy transfer a coin to right.Give away to Not You end of day! http://www.freedomOK.net/wordpress
Aptos psychologist: In England, 50% of persons with autism fall through cracks…www.freedomOK.net/wordpress
“Eight out of 10 doctors need more training to spot the signs of autism, according to a new report.
The study, from the National Audit Office (NAO), also found that around half of the estimated 400,000 adults in England with autism may be falling through the gaps due to a lack of services.
This is because they do not have a learning disability and services are mostly set up for people with illness, physical or learning disabilities, and mental health problems.
A poll of 1,000 GPs for the report found 80% thought they needed additional guidance and training to identify and manage those with autism more effectively. Many did not know where to refer people with autism due to a lack of specific services.
The study said: “In our survey of GPs, 64% told us that they referred adults with suspected high-functioning autism to adult mental health services, and 19% to learning disability services.
“(A total of) 12% were not sure where they should refer such patients, and only 10% reported that they would refer them to a specialised autism diagnostic service.”
The NAO found that most NHS organisations and local authorities do not know how many people with autism live in their area, something it said should change. It also called for specialist support services.
The study – called Supporting People with Autism through Adulthood – said: “Providing specialised support could improve outcomes for this group of people and their carers, and potentially enhance value for money, as the costs of establishing such support could be outweighed over time by overall savings.”
Tim Burr, spokesman for the NAO, added: “Greater awareness of the numbers of people with autism, as well as better understanding of autism amongst those providing health, social care, benefits, education and employment services, would lead to improved quality of life for those on the autistic spectrum.”Mark Lever, chief executive of the National Autistic Society (NAS), said: “Neither the Government, people with autism nor the taxpayer are getting value for money from existing autism services and support, leaving those affected by the condition feeling isolated, ignored and often at breaking point. This is simply unacceptable.”
Aptos psychologist: mothers know that rewarding bad behavior results in MORE bad behavior. Are we rewarding bad behavior by North Korea? www.freedomOK.net/wordpress
Good parents know that it’s best to nip bad behavior early on. So why did the US for years reward North Korea’s bad behavior? Why didn’t we cut off their credit so they could not buy the nuclear materials they wanted? The government needs good mothers runnning foreign policy!
The Wall Street Journal Sat. June 6:
Once again the Dear Leader has defied the international communiy with a nuclear test
Aptos Ferenzie sage: Hispanic is a meaningless term. www.freedomOK.net/wordpress
Homogenizing ‘Hispanics’ from American Thinker
J.C. Arenas
To liberals, those of us with origins in Spanish-speaking cultures are a voting block or interest group. They aren’t interested in celebrating our real diversity, only in mobilizing political power to support their policies. The bigger the group, the bigger the clout, so create an imaginary identity like “Hispanic” or “Latina” with no cultural roots or authenticity.
Case in point: Ruth Marcus published an article the other day entitled Souter with a Salsa Beat that goes to the heart of liberals’ racial profiling and stereotyping.
The title of her article serves as no surprise to me, after all the liberal think tank of Hollywood, perpetrates this behavior all the time.
How often do we see in movies some Latin heartthrob enter into the scene and a track of Spanish music is cued in the background?
I am going to give Marcus the benefit of the doubt and assume that she chose a “salsa beat” because salsa is popular amongst Puerto Ricans. However, if she had really wanted to demonstrate some level of knowledge, she would have chosen a reggaeton beat, a popular Spanish mixture of hip-hop and reggae that originated in Puerto Rico–Cubans are credited with the origination of salsa.
Marcus’s circumscribed view of Latinos allows her to attribute a “salsa beat” to a Puerto Rican nominee to the highest court in the land and exemplifies the problem with the “Hispanic” classification.
The Latin American culture is one that should be celebrated for its inherent multiracial, multinational, and multicultural nature. To assemble all of us under the same umbrella rationalizes ignorance to the fact that we embrace and represent our own individual nationalities. Our multifarious appearances, uses of the language, and tastes in food and music — just to name a few — are clearly unrecognized by the Left.
Why many of us have embraced their discriminatory philosophy and brethren whom fail to recognize even the basic variability amongst our various nationalities is beyond me.
Do we want to be taken seriously as a distinct faction of American society or do we just want to be pandered to for votes with chants of “Si, se puede”?
The political party that realizes they should do the former will have our allegiance and the latter can walk off in defeat to a salsa beat.
For more, go to: American Thinker
Aptos psychologist: How much HIGH DENSITY housing is FAIR for one small corner of Aptos? www.freedomOK.net/wordpress
How much wood would a woodchuck chuck if a woodchuck could chuck wood? That’s a tongue twister. It has no real meaning. Just something we teach young children.
Here’s a society tongue “twister”: How much high density, taxpayer paid for housing can one small corner in Aptos be forced to absorb?
Answer: Plenty! And maybe even more! The Board of Supervisors will decide in early June the fate of Poor Clare’s property. That is the Catholic owned property near the entrance to Sea Cliff beach which currently houses Aptos Four Square Church located at 280 State Park Drive. And what organizations with clout support even more low income, high density housing on the Catholic owned property? COPA is one.
But is it FAIR to jam so many families together without any family resources? No park coming soon! No family resource building planned! No basketball courts or skate park! No sandbox and slides for small children!
Right by the freeway in Aptos, there will be 5 acres of high density family housing with no resources for those families. And now the Board of Supervisors may decide to allow even more high desity housing. And maybe a hotel.
Is COPA a pivotal force behind the scenes influencing government? COPA stands for Community Organized for Relational Power in Action. Locally about 30 + organizations and churches participate. It is based on Saul Alinsky’s social theories. It is my understanding that COPA supports even MORE low cost housing at 280 State Park Dr.
The Episcopal Church of St. John’s will soon occupy a 2 1/2 acre parcel next to the 5 acres of high density low income housing. The church opens its Aptos doors in June, 2009. Just to open its Aptos doors has cost the church roughly $3 million. The existing church structure will be a large area for both worship and community gathering. St. John’s wants to be a “good neighbor”. Is St. John’s acting as a “good neighbor” by seeking even more high density, low income housing on the Poor Clare property?
It is my understanding that COPA – of which the Episcopal Church of St. John’s, Temple Beth El and Resurection Catholic Church are members – supports MORE high density, low cost housing on the Catholic property. I would like to know more who funds COPA and who really “runs” the organizaton.
I wonder if COPA, who ever they are, has thought through the implications. Is it FAIR to crowd so many low income families into one small area of Aptos? Driving by the existing parcel of jammed together, high density housing, you can see teenagers bouncing basket balls on their stairs with no place to go. There is no park for youth within walking distance. The area that was to be a park is walled off.
To qualify for low cost housing, families have less money. They have fewer resources. Why jam even more low income families together in an area LACKING family resources? There is no plan to put in a family resource center such as Live Oak has. There are no parks for mothers with young children such as the Blue Ball park next to Soquel High School.
What if instead of low income families only clean and sober homes were located on those 5 acres next to the freeway in Aptos? Or what if only severely disabled persons could inhabit that area?
It is simply better that we encourage a diverse neighborhood. Before jamming more families into one tiny area of Aptos, the County of Santa Cruz needs to step up to the plate and create parks, tennis courts and family resource centers. And no, just because the beach is close by is not equivalent to a REAL park and REAL resource centers. And REAL basketball courts. All families need resources that allow youth to engage in healthy activities.
It would not be healthy to have one corner of the Santa Cruz County where all the clean and sober homes were located. Nor would society benefit were all the disabled housing located in one tiny area. And it is not healthy to educate largely autistic children in one school classroom. Likewise, it is not healthy to locate huge numbers of low income families jammed together in high density housing. Without family resources. All in one tiny corner of Aptos.
How best to use the Poor Clare property? Let the County buy it and develop it into a resource for the existing 5 acres of high density, low income families. And as a resource for all the families in Aptos, Seacliff and nearby areas. With a REAL park like the BLUE BALL park in Soquel. And basketball courts. How about a public swimming pool! And a skateboard park. And real, organic vegetables growing. And the sound of woodchucks chucking wood! Yes, how much wood can a woodchuck chuck if a woodchuck could chuck wood? Answer: Lots of wood!
written by Cameron Jackson cameronjacks@gmail.com 831 688-6002
Twitter Updates for 2009-05-31
- Obama’s credit card reform is a sellout to credit card companies. Their URSURY rates offiensive. #
Powered by Twitter Tools.
Aptos, CA:Easter Seals shows parents how to PLAY & ENGAGE their autistic child.www.freedomOK.net/wordpress
From Aptos psychologist Dr. Jackson 831 688-6002
Easter Seals offers P.L.A.Y., a method that is softer and more gentle than Applied Behavior Analysis (ABA). Parents need to educate themselves about the different techniques available for assisting children with Autistic Spectrum Disorders. Parents need to be in the driver’s seat as to what kind of therapy they think will be best for their child.
There are “squishy” softer methods such as P.L.A.Y. and FloorTime. And there are “prickly”, harsher methods in my opinon such as Applied Behavior Analyisis (ABA). Different methods for different severities and kinds of autistic symptoms. Each child is unique. Parents who have educated themselves will make the best decisions.
Call EASTER SEALS in Aptos for informantion about how to PLAYFULLY engage with children with social and communication delays. Go: Easter Seals
Education in Santa Cruz County: Pacifica Collegiate is our only GREAT school. Parents need CHOICE through tax credits and scholarships so middle and low income families have same goal: good education. Let PARENTS choose!! Pajaro Valley Unified LAGS way behind. www.freedomOK.net/wordpress
PVUSD zone system debated
By DONNA JONES
WATSONVILLE — “A proposed revision of Pajaro Valley Unified School District’s management structure is meeting with resistance.
Superintendent Dorma Baker presented the plan to reduce the number of assistant superintendents from four to three and manage the district by grade levels rather than the current geographic zones Wednesday.
Though the plan eliminates district office oversight of zones, Baker said she hoped to keep the concept alive in the community.
“There has been lots of conversation and concern about zones,” Baker said, adding she had been flooded with e-mail about the plan. “We need to listen to those voices so we don’t have people standing outside.”
The zone system, established in 2000 in the wake of an unsuccessful attempt by Aptos parents to split the district along north-south lines, is in trouble due to a fiscal crisis.
As district leaders hacked $14 million from next year’s spending, critics called for more administrative cuts. When Catherine Hatch, assistant superintendent for the central zone, subsequently announced her retirement, Baker and school board President Leslie De Rose recommended freezing the position.
But Baker’s plan to put 16 elementary schools under one assistant superintendent has raised concerns.
Trustee Willie Yahiro, who has served on the board for more than 16 years, worried that academic progress would be stymied by such a large grouping of schools with disparate needs as evidenced by widely divergent levels of achievement.
“When I first came on the board, everyone said everything is fine,'” Yahiro said. “When the first state tests came out, it was shocking to find the south zone was so far behind. This was the system we used.”
Assistant Superintendent Ylda Nogueda said a lot had changed since then. The state not only implemented a new testing scheme about the time the zones were established, it has since developed academic standards and textbooks to support them.
“In the 1980s, the state did not have curriculum defined. All of that is in place now,” Nogueda said. “With that you will see student achievement continuing to go up.”
Trustee Kim Turley said though the plan was created on the assumption that Hatch’s job would not be filled, trustees had yet to vote on the freeze.
“Parents right now, as they go through the system, have one person they deal with whether elementary, middle school or high school,” Turley said. “With this that is going to shift.”
Baker stressed that her plan was a draft, and there likely would be changes during and after implementation to get the bugs out.
Trustee Doug Keegan called the plan “bold” and “creative.”
“The people on whom the burden of this new plan will fall are among the most dedicated and talented people,” Keegan said. “That gives me confidence.”
De Rose urged parents to attend an all zone meeting set for Monday at Pajaro Valley to discuss the plan.”This is going to be a yea or nay to it,” De Rose said. “If you have a strong opinion, show up.”
PVUSD zone system debated
By DONNA JONES
Posted: 05/29/2009 01:30:41 AM PDT
WATSONVILLE — A proposed revision of Pajaro Valley Unified School District’s management structure is meeting with resistance.
Superintendent Dorma Baker presented the plan to reduce the number of assistant superintendents from four to three and manage the district by grade levels rather than the current geographic zones Wednesday.
Though the plan eliminates district office oversight of zones, Baker said she hoped to keep the concept alive in the community.
“There has been lots of conversation and concern about zones,” Baker said, adding she had been flooded with e-mail about the plan. “We need to listen to those voices so we don’t have people standing outside.”
The zone system, established in 2000 in the wake of an unsuccessful attempt by Aptos parents to split the district along north-south lines, is in trouble due to a fiscal crisis.
As district leaders hacked $14 million from next year’s spending, critics called for more administrative cuts. When Catherine Hatch, assistant superintendent for the central zone, subsequently announced her retirement, Baker and school board President Leslie De Rose recommended freezing the position.
But Baker’s plan to put 16 elementary schools under one assistant superintendent has raised concerns.
Trustee Willie Yahiro, who has served on the board for more than 16 years, worried that academic progress would be stymied by such a large grouping of schools with disparate needs as evidenced by
——————————————————————————–
Advertisement
——————————————————————————–
widely divergent levels of achievement.
“When I first came on the board, everyone said everything is fine,'” Yahiro said. “When the first state tests came out, it was shocking to find the south zone was so far behind. This was the system we used.”
Assistant Superintendent Ylda Nogueda said a lot had changed since then. The state not only implemented a new testing scheme about the time the zones were established, it has since developed academic standards and textbooks to support them.
“In the 1980s, the state did not have curriculum defined. All of that is in place now,” Nogueda said. “With that you will see student achievement continuing to go up.”
Trustee Kim Turley said though the plan was created on the assumption that Hatch’s job would not be filled, trustees had yet to vote on the freeze.
“Parents right now, as they go through the system, have one person they deal with whether elementary, middle school or high school,” Turley said. “With this that is going to shift.”
Baker stressed that her plan was a draft, and there likely would be changes during and after implementation to get the bugs out.
Trustee Doug Keegan called the plan “bold” and “creative.”
“The people on whom the burden of this new plan will fall are among the most dedicated and talented people,” Keegan said. “That gives me confidence.”
De Rose urged parents to attend an all zone meeting set for Monday at Pajaro Valley to discuss the plan.”This is going to be a yea or nay to it,” De Rose said. “If you have a strong opinion, show up.”
ReprintPrint Email Font ResizeReturn to Top
CommentsWe are pleased to let readers post comments about an article. Please increase the credibility of your post by including your full name and city in the body of your comment.
FAQ: Article commenting how-tos and tips
Recent Comments
Be the first to post a comment.
Post Your Comment
Log in to forums to post a comment.
Sorry, no items are currently available.
PVUSD zone system debated
By DONNA JONES
Posted: 05/29/2009 01:30:41 AM PDT
WATSONVILLE — A proposed revision of Pajaro Valley Unified School District’s management structure is meeting with resistance.
Superintendent Dorma Baker presented the plan to reduce the number of assistant superintendents from four to three and manage the district by grade levels rather than the current geographic zones Wednesday.
Though the plan eliminates district office oversight of zones, Baker said she hoped to keep the concept alive in the community.
“There has been lots of conversation and concern about zones,” Baker said, adding she had been flooded with e-mail about the plan. “We need to listen to those voices so we don’t have people standing outside.”
The zone system, established in 2000 in the wake of an unsuccessful attempt by Aptos parents to split the district along north-south lines, is in trouble due to a fiscal crisis.
As district leaders hacked $14 million from next year’s spending, critics called for more administrative cuts. When Catherine Hatch, assistant superintendent for the central zone, subsequently announced her retirement, Baker and school board President Leslie De Rose recommended freezing the position.
But Baker’s plan to put 16 elementary schools under one assistant superintendent has raised concerns.
Trustee Willie Yahiro, who has served on the board for more than 16 years, worried that academic progress would be stymied by such a large grouping of schools with disparate needs as evidenced by
——————————————————————————–
Advertisement
——————————————————————————–
widely divergent levels of achievement.
“When I first came on the board, everyone said everything is fine,'” Yahiro said. “When the first state tests came out, it was shocking to find the south zone was so far behind. This was the system we used.”
Assistant Superintendent Ylda Nogueda said a lot had changed since then. The state not only implemented a new testing scheme about the time the zones were established, it has since developed academic standards and textbooks to support them.
“In the 1980s, the state did not have curriculum defined. All of that is in place now,” Nogueda said. “With that you will see student achievement continuing to go up.”
Trustee Kim Turley said though the plan was created on the assumption that Hatch’s job would not be filled, trustees had yet to vote on the freeze.
“Parents right now, as they go through the system, have one person they deal with whether elementary, middle school or high school,” Turley said. “With this that is going to shift.”
Baker stressed that her plan was a draft, and there likely would be changes during and after implementation to get the bugs out.
Trustee Doug Keegan called the plan “bold” and “creative.”
“The people on whom the burden of this new plan will fall are among the most dedicated and talented people,” Keegan said. “That gives me confidence.”
De Rose urged parents to attend an all zone meeting set for Monday at Pajaro Valley to discuss the plan.”This is going to be a yea or nay to it,” De Rose said. “If you have a strong opinion, show up.”
ReprintPrint Email Font ResizeReturn to Top
PVUSD zone system debated
By DONNA JONES with comments by Cameron Jackson in brackets
WATSONVILLE — A proposed revision of Pajaro Valley Unified School District’s management structure is meeting with resistance.
“Superintendent Dorma Baker presented the plan to reduce the number of assistant superintendents from four to three and manage the district by grade levels rather than the current geographic zones Wednesday.
Though the plan eliminates district office oversight of zones, Baker said she hoped to keep the concept alive in the community.
“There has been lots of conversation and concern about zones,” Baker said, adding she had been flooded with e-mail about the plan. “We need to listen to those voices so we don’t have people standing outside.”
The zone system, established in 2000 in the wake of an unsuccessful attempt by Aptos parents to split the district along north-south lines, is in trouble due to a fiscal crisis.
As district leaders hacked $14 million from next year’s spending, critics called for more administrative cuts. When Catherine Hatch, assistant superintendent for the central zone, subsequently announced her retirement, Baker and school board President Leslie De Rose recommended freezing the position.
But Baker’s plan to put 16 elementary schools under one assistant superintendent has raised concerns.
Trustee Willie Yahiro, who has served on the board for more than 16 years, worried that academic progress would be stymied by such a large grouping of schools with disparate needs as evidenced by
widely divergent levels of achievement.
“When I first came on the board, everyone said everything is fine,'” Yahiro said. “When the first state tests came out, it was shocking to find the south zone was so far behind. This was the system we used.”
Assistant Superintendent Ylda Nogueda said a lot had changed since then. The state not only implemented a new testing scheme about the time the zones were established, it has since developed academic standards and textbooks to support them.
“In the 1980s, the state did not have curriculum defined. All of that is in place now,” Nogueda said. “With that you will see student achievement continuing to go up.”
Trustee Kim Turley said though the plan was created on the assumption that Hatch’s job would not be filled, trustees had yet to vote on the freeze.
“Parents right now, as they go through the system, have one person they deal with whether elementary, middle school or high school,” Turley said. “With this that is going to shift.”
Baker stressed that her plan was a draft, and there likely would be changes during and after implementation to get the bugs out.
Trustee Doug Keegan called the plan “bold” and “creative.” (Oh reallly?)“The people on whom the burden of this new plan will fall are among the most dedicated and talented people,” Keegan said. “That gives me confidence.”
De Rose urged parents to attend an all zone meeting set for Monday at Pajaro Valley to discuss the plan.”This is going to be a yea or nay to it,” De Rose said. “If you have a strong opinion, show up.”
hhhhh
Once keyed in, electronic medical records are rarely checked for accuracy. Many more mis-diagnosis with electronic compared to paper diagnosis. www.freedomOK.net/wordpress
By JEROME GROOPMAN and PAMELA HARTZBAND
“Last week, President Barack Obama convened a health-care summit in Washington to identify programs that would improve quality and restrain burgeoning costs. He stated that all his policies would be based on rigorous scientific evidence of benefit.
The flagship proposal presented by the president at this gathering was the national adoption of electronic medical records — a computer-based system that would contain every patient’s clinical history, laboratory results, and treatments. This, he said, would save some $80 billion a year, safeguard against medical errors, reduce malpractice lawsuits, and greatly facilitate both preventive care and ongoing therapy of the chronically ill.
Following his announcement, we spoke with fellow physicians at the Harvard teaching hospitals, where electronic medical records have been in use for years. All of us were dumbfounded, wondering how such dramatic claims of cost-saving and quality improvement could be true.
The basis for the president’s proposal is a theoretical study published in 2005 by the RAND Corporation, funded by companies including Hewlett-Packard and Xerox that stand to financially benefit from such an electronic system. And, as the RAND policy analysts readily admit in their report, there was no compelling evidence at the time to support their theoretical claims. Moreover, in the four years since the report, considerable data have been obtained that undermine their claims. The RAND study and the Obama proposal it spawned appear to be an elegant exercise in wishful thinking.
To be sure, there are real benefits from electronic medical records. Physicians and nurses can readily access all the information on their patients from a single site. Particularly helpful are alerts in the system that warn of potential dangers in the prescribing of a certain drug for a patient on other therapies that could result in toxicity. But do these benefits translate into $80 billion annually in cost-savings? The cost-savings from avoiding medication errors are relatively small, amounting at most to a few billion dollars yearly, as the RAND consultants admit.
Other potential cost-savings are far from certain. The impact of medication errors on malpractice costs is likely to be minimal, since the vast majority of lawsuits arise not from technical mistakes like incorrect prescriptions but from diagnostic errors, where the physician makes a misdiagnosis and the correct therapy is delayed or never delivered. There is no evidence that electronic medical records lower the chances of diagnostic error.
All of us are conditioned to respect the printed word, particularly when it appears repeatedly on a hospital computer screen, and once a misdiagnosis enters into the electronic record, it is rapidly and virally propagated. A study of orthopedic surgeons, comparing handheld PDA electronic records to paper records, showed an increase in wrong and redundant diagnoses using the computer — 48 compared to seven in the paper-based cohort.
But the propagation of mistakes is not restricted to misdiagnoses. Once data are keyed in, they are rarely rechecked with respect to accuracy. For example, entering a patient’s weight incorrectly will result in a drug dose that is too low or too high, and the computer has no way to respond to such human error.
Throughout their report, the RAND researchers essentially ignore downsides to electronic medical records. Rather, they base their cost calculations on 100% compliance with the computer programs “adopted widely and used effectively.” The real-world use of electronic medical records is quite different from such an idealized vision.
Where do the RAND policy analysts posit major cost-savings? They imagine that the computer will guide doctors to deliver higher quality care, and that patients will better adhere to quality recommendations embedded in the computer programs. This would apply to both preventive interventions like vaccines and weight reduction, and to therapy of costly chronic maladies like diabetes and congestive heart failure. Over 15 years, the RAND analysts assert, more than $350 billion would be saved on inpatient care and nearly $150 billion on outpatient care. Unfortunately, data to support such an appealing scenario are lacking.
A 2008 study published in Circulation, a premier cardiology journal, assessed the influence of electronic medical records on the quality of care of more than 15,000 patients with heart failure. It concluded that “current use of electronic health records results in little improvement in the quality of heart failure care compared with paper-based systems.” Similarly, researchers from the Brigham and Women’s Hospital and Harvard Medical School, with colleagues from Stanford University, published an analysis in 2007 of some 1.8 billion ambulatory care visits. These experts concluded, “As implemented, electronic health records were not associated with better quality ambulatory care.” And just this past January, a group of Canadian researchers reviewed more than 3,700 published papers on the use of electronic medical records in primary care delivered in seven countries. They found no solid evidence of either benefits or drawbacks accruing to patients. This gap in knowledge, they concluded, “should be of concern to adopters, payers, and jurisdictions.”
What is clear is that electronic medical records facilitate documentation of services rendered by physicians and hospitals, which is used to justify billing. Doctors in particular are burdened with checking off scores of boxes on the computer screen to satisfy insurance requirements, so called “pay for performance.” But again, there are no compelling data to demonstrate that such voluminous documentation translates into better outcomes for their sick patients.
Even before these new data, there were studies casting doubt on the benefits of electronic medical records. In response, the RAND researchers boldly stated, “We choose to interpret reported evidence of negative or no effect of health information technology as likely being attributable to ineffective or not-yet-effective implementation.” This flies in the face of the scientific method, where an initial hypothesis needs to be modified or abandoned in the face of contradictory results. Rather than wrestle with contrary information, the report invokes the successes of computer-based systems in saving money in industries like banking, securities trading, and merchandizing, using ATM machines, online brokerage and bar-coded checkouts. Medical care of human beings — treatment of acute and chronic illnesses and the even more complex process of effecting lifestyle changes like smoking cessation and weight loss to prevent disease — is not analogous to buying bar-coded groceries and checking-account balances online.
Some have speculated that the patient data collected by the Obama administration in national electronic health records will be mined for research purposes to assess the cost effectiveness of different treatments. This analysis will then be used to dictate which drugs and devices doctors can provide to their patients in federally funded programs like Medicare.
Private insurers often follow the lead of the government in such payments. If this is part of the administration’s agenda, then it needs to be frankly stated as such. And Americans should decide whether they want to participate in such a national experiment only after learning about the nature of the analysis of their records and who will apply the results to their health care.
All agree skyrocketing health-care costs are a dangerous weight on the economic welfare of the nation. Much of the growing expense is due to the proliferation of new technology and costly treatments. Significant monies are spent for administrative overhead related to insurance billing and payments. The burden of the uninsured who use emergency rooms as their primary care providers, and extensive utilization of intensive care units at the end of life, further escalate costs.
The president and his health-care team have yet to address these difficult and pressing issues. Our culture adores technology, so it is not surprising that the electronic medical record has been touted as the first important step in curing the ills of our health-care system. But it is an overly simplistic and unsubstantiated part of the solution.
We both voted for President Obama, in part because of his pragmatic approach to problems, belief in empirical data, and openness to changing his mind when those data contradict his initial approach to a problem. We need the president to apply real scientific rigor to fix our health-care system rather than rely on elegant exercises in wishful thinking.
Drs. Groopman and Hartzband are on the staff of Beth Israel Deaconess Medical Center in Boston and on the faculty of Harvard Medical School.
Thousands of miles from Aptos, California, naval operations in Afganistan. www.freedomOK.net/wordpress
Naval Ops in Afghanistan
Hello everyone,
I just wanted to send out another update to everyone to let you know how things are going out here on the good ship Eisenhower.
We are into our seventh week of deployment and have 108 days to go.
We began combat operations back on March 21st and have been flying over the beach almost everyday since then.
This is the most flying that I’ve done in all my 17 years.
Naval Aviators are limited by instruction to 30 flight hours a month and in order to go over that you must have a written waiver by the Flight Surgeon.
As of today I have 65 hours in the last 29 days.
Our missions are regularly 6 hours long. Its an hour transit to and from the ship just to get on station in southern Afghanistan.
All the air traffic travels up a common air route that we call the boulevard that traverses Pakistan and crosses the border into Afghanistan.
All the traffic on the boulevard is either Naval aircraft from our ship or Air Force tankers coming from Qatar.
Most of our missions thus far have been in southern Afghanistan near the city of Kandahar.
That is where a lot of the poppy harvest is taking place right now and that is where a lot of the enemy forces have dug in. On a typical mission we check in with a JTAC (Joint Tactical Air Controller) on the ground who is part of a ground unit.
The JTAC is trained to be able to communicate with aircraft and if necessary call in for air support in case some shooting starts. They used to be called Forward Air Controllers.
Thus far I have worked with American Special Forces, British Forces, Australian and Danish Forces.
It is very interesting to see the mix of troops on the ground. But its nice to see that all the procedures are very standardized no matter what nationality that you are supporting.
On most of our missions we provide Armed Reconnaissance, which has us watching over a friendly ground patrol, in vehicle or on foot, and looking ahead of their route of travel to try and find enemy fighters or potential spotting positions.
A few days ago I was watching over an Army Special Forces unit that were about 15 to 20 guys all riding four wheelers in the hills over looking a small village.
We do most of our searching using our FLIR camera which is an infrared camera that has the ability to zoom in pretty close.
The JTACS on the ground can also link up with our FLIR camera and see what we are seeing on their laptop computer. We look for bad guys in groups digging or potentially placing road side bombs. A lot of times the JTACS give us coordinates of known bad guy locations and have us watch for movement or activity.
A few nights ago I was talking to a JTAC and I could hear the gunfire over the radio and he calmly said they were taking fire from an unknown locations and wanted us to scan the hills surrounding them for any activity. On average our Airwing drops four or five bombs a day or conducts a few strafing runs on enemy positions. We also do a lot of Show’s of Force which is simply a high speed low altitude pass over an enemy position to get them to stop shooting or even run.
Although I haven’t yet gotten a chance to drop a bomb I can say that I’m not in a rush. My time will come. I did have a wing man that conducted a strafing run on two individuals who were digging at a roadside intersection. It was at night so the complexity if shooting bullets from an aircraft moving 500mph at a small moving target in the dark is absolutely amazing.
I enjoy working with the guys on the ground. I think its a comforting feeling for them to know that we are over head and can deliver a devastatingly accurate blow within seconds of asking for it. Even if we don’t find bad guys I feel a lot of job satisfaction just being up there and talking to the guys on the ground. These guys are pretty amazing. I will hear them say something like, “We are taking fire from an unknown location so we are going to get out of our vehicles and move into the open so that we can try an locate where the fire is coming from.” Amazing bravery.
Our team is killing a lot of bad guys right now.
Some of the most harrowing parts of our mission is refueling. Particularly in the dark or in bad weather. On a typical 6 hour mission we refuel off of big wing Air Force tankers three times.
There is a point on the boulevard that once I cross it I know that if I have a problem with my tanker, that I do not have enough fuel to get back to the carrier and would have to divert to one of the three occupied airfields in the country. The tankers all hold at specific points and altitudes around the country. I know before I launch what my tanker’s call sign is, what point he will be at, what time I’m supposed to be there, what altitude he will be at and what frequency I will talk to him on. There is an overarching control agency that runs the tanker plan and it is constantly changing usually based on the fight that is going on the ground. A lot of times tankers get pushed over an area where there is fighting so that the airborne assets don’t waste time trying to get to their tanker and back to the fight. Once one tanker moves it starts a domino effect that effects almost everyone. Its like a shell game. They are constantly shuffling tankers around. I don’t think I’ve launched on a single mission and hit all my tankers that I was originally scheduled for. I have tanked off American and British Air Force tankers. Two days ago I was on a tanker and two French Rafael fighters were waiting in line with me at 22000 feet for their gas.
When the mission is over we hit the tanker one last time before exiting the country and fly the boulevard south and the hour flight back to the carrier.
When its all done then I get to look forward to that night carrier landing.
Luckily the North Arabian Sea is calm and the weather has been good. No pitching deck out here so far. By the end of the mission I’m usually starving. I try and take food and water with me in the cockpit and typically I get a chance to eat and drink something on the trip back to the carrier at the end of the mission. But you don’t want to drink too much because that presents a whole new problem for a single seat cockpit. Thank goodness for altitude hold.
The cockpit gets pretty crowded with all of our extra gear. We have our standard issue gear for going in country which includes our pistol and two magazine clips, our blood chit which is basically a piece a paper that we use in case we find ourselves on the ground that is written in several different native languages and basically says “I’m an American and you will be paid if you help me return to friendly American forces.” We carry a camel back full of water that is sewn into our flight vest. On every mission we go on, we have a stack of papers that have coordinates and radio frequencies. I also have my new helmet mounted targeting system which is a new visor that clips to the regular helmet and projects vital information on my visor (I’ve attached a picture of me wearing that helmet in the cockpit.) It looks like a Martian helmet, but it is honestly the best piece of gear that I carry with me. I can type in the coordinate for a friendly unit on the ground and then look outside the cockpit and diamond will be projected on my visor directly over the position of that unit on the ground. Its I very useful in locating things on the ground, but it also helps me find things in the air. Yesterday I saw my tanker from 28 miles away because my helmet puts a box around the radar contact that I have locked up so I know exactly where to look. Pretty cool.
I also take a pair of NVGs on every flight. Night Vision goggles are absolutely necessary once the sun goes down.
The ground units use a lot of infrared lights to help mark their positions or the positions of enemy units and I can see all of that from 20000 feet with my NVG’s on.
Well I’ve written way more than I should have. I hope I haven’t bored you. I know many of you have asked what I’m doing over here.
This e-mail was to try to help you understand what I’ve been doing. It in no way is meant to be tooting my own horn.
The guys on the ground are the real hero’s. I’m simply a supporting element to the fight.
I want to say thank you to all of you that have sent care packages. They were very much appreciated by me and all my ready room.
Keep watching the news. If you hear about air strikes in Southern Afghanistan there is a good chance it came from my air wing.
I’ve attached three photos with this email. The first is of me in the cockpit and my large Martian helmet. The weapon that is out on the right wing of the aircraft is a 500 lbs laser guided bomb.
On the other wing that you can’t see is a 500 lbs gps guide bomb. That is our standard load out on these missions.
(pictures not available from e-mail.)