As we ponder modern politics, it is becoming increasingly evident that the Internet will offer yet another opportunity for a great leap in communications, bringing a customized one-on-one dialogue into the home of each voter. Instead of the one-size-fits-all television campaigns that dominate our politics, the Internet in general – and e-mail in particular – will make possible a conversation between each voter and each candidate about issues and ideas. The interactivity of the Web means the end to “I talk, you listen” politics, and the beginning of a two-way discussion as the basis of political communication. Some feel this is long overdue.
Dick Morris, Power Plays: Win or Lose – How History’s Great Political Leaders Play the Game, Regan Books, 2002
As part of the administration’s efforts to tee off a movement toward legislative action on health care, it also set up a new Web site, healthreform.gov.
Kate Phillips, “White House Plans Regional Health Care Forum,” New York Times, March 5, 2009
The world is moving on Internet time. This reality has seemingly dawned on the whole world at once. It is the factor leading to the wide-spread belief that a interoperable, all-purpose, all-reaching, all-the-time available, on-line system holds the key to improving access and quality of our health care system.
President Obama and his advisors believe this. And for good reason. The Internet is an efficient, instantaneous, and inexpensive way of reaching millions with a click on the keyboard.
One tactic Obama used successfully to win the presidency was mobilizing support and money over the Internet. He raised a record $750 million and kept e-mail addresses of millions who contributed to this campaign over a two year period. Now Obama has became an e-health reform organizer, an extension of his knowledge gained from Internet fundraising and his community organizes efforts. This includes you, the patient, who can access the Obama administration’s multiple website, to see his thoughts for the day and his progress on multiple health care fronts.
Current E-Reform Efforts
President Obama is an engaged in an extensive Internet campaign promising to provide universal coverage by the end of his first term. The dimensions of this e-campaign are becoming evident and include.
1. The Obama-Biden website which says.
- Obama will make affordable and accessible health care for all
- Obama will lower health premiums by $2500 per year per family
- Obama will promote public health
In addition, the web site asks for comments (it claims to already have over 10,000 citizens suggesting and offering free access clicks to Obama videos on health care.)
2. Regular Obama Facebooks, with videos featuring Obama talking health care
basic promises.
3. Virtual Online Townhalls – On March 25, President Obama held what promises to be first of a series of virtual townhalls. In this first online townhall, he responded directly to six questions winnowed from more than 100.000 submitted directed by emails from citizens. The media dutifully televised the event. It also appeared on online video, and was broadcast it to the nation on mainstream and cable television.
Clicking Away
Through these instantly accessible e-sites, Obama can efficiently click away again and again at his basic promises and premises.
- Savings through prevention, EMRs, chronic disease management, medical homes
- Expanding coverage through private and government-run health plans
- Making large businesses cover employees or pay a fine
- Mandating that health plans accept those with pre-existing illnesses
- Having government negotiate Medicare drug prices
- Reforming health care as an integral part of his economic salvage plan
Prospects for Success
Given his election margin (53% vs. 47%), large Democratic majorities in the House and Senate, his successful Internet deployment during the presidential run, his cache of millions of email addresses from supporters, the presence of personal computers in 80% of American homes, and his promise of $2500 premium savings for the typical American family, Obama’s electronic mobilizing tactics for health reform may succeed.
President Obama has a simultaneous top-down, i.e. daily dominating the national radio, mainstream and cable television, and Internet media, and a bottom-up strategy, i.e, while at the same time soliciting and responding to hundreds of thousands, indeed, millions of emails.
In his book Power Plays, Dick Morris asks and answers, ”Will the new techniques and strategies improve our political process? Likely they will. Each development seems to move in the same direction – greater direct democracy and more public participation. Certainly the Internet and the two-way political dialogue it fosters will tend to make our democracy more direct and citizen involvement more consuming.”
As with any political development, there may be a darker side. Rush Limbaugh, the conservative radio talk show host, believes the Obama daily dominance of all media has Orwellian, Big Brother overtones, and may lead to totalitarian tyranny of our minds. I would not go that far. I give President Obama his due. It is a brilliant ongoing political communication strategy, transforms politics, and will have to be countered by his political opponents.
I would not bet against significant incremental health reform. What might prevent Obama-style health reform are the economy, the soaring federal budget deficit, and the Department of Health and Human Services current $708 billion budget, 25% of federal spending and Medicare on brink of bankruptcy, but Obama is not one to let billions, even trillions of dollars, stand in his way. He will persist, and he will let the government printing presses roll.
Summary
Barack Obama is our first Internet President, which is altogether without precedent. The President uses the Web to issue a daily report and to mobilize wider political support. That e-tools help his agenda is evident. For Obama, Internet politics is good. For all of us that fact has to be understood. Obama Internet supporters helped get him where he is today and elevated him above the ordinary political fray. For Obama the Internet was the little Engine that could. Say about Obama’s Internet strategy what you will. Say that it’s shows the mark of remarkable political skill. Say that it smacks of George Orwell’s Big Brother. Say that it brings all media under one giant cover. Say what you will: The Internet is now routine grist for the political and health care mill.
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Career Degree with Education and Training Programs Dreaming is easy, anyone can do it. And while it’s a start in the right direction to finding the right career, achieving career success requires much more than just a dream. But with today’s busy schedule, who has time to further their education? We at Career Search City know it’s a daunting thought and it’s not going to be easy, but taking a look into it is the first step. The following career education directory is designed to help aspiring career professionals like yourself, to find flexible, reputable, and accredited career education programs designed to be completed in the evenings, on weekends, or online via distance learning. It’s easier than ever. The best investment you can make is in yourself so take that first step. Simply select a program which interest you, then fill out a personal information form so that a representative can send you more information on that career education program. There is absolutely no obligation and the cost like everything here at Career Search City is free of charge.
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Self Detoxification
You have probably heard of detoxification clinics that performs effective detoxification procedures for overall health and to help reduce cellulite. You can however safely come up with your own detoxification program as a home remedy for cellulite.
Detoxification is simply getting rid of body toxin and limiting the entry of more toxins. This is crucial in any home remedy for cellulite since cellulite may be caused to some extent by toxin build up.
A good detoxification home remedy for cellulite would be to simply keep away from junk food, processed food and high fat food. You could also set a few days or weeks aside as a time for you to increase water, fruits and vegetable intake. These substances have high nutrient and antioxidant contents that can help your body both flush out toxins and rejuvenate your system.
Exercise
A full exercise program that includes the aerobic, muscular and flexibility elements is recommended for most people. If you are not a person though who does not have extensive experience with a rigid exercise regimen, you would do well to start slowly. Pick a basic aerobic exercise like jogging as your first home remedy for cellulite. Jog for at least 15 minutes three times a week until your body can adjust to a stricter exercise schedule.
An aerobic exercise is especially good as a home remedy for cellulite since it can both increase oxygen intake and use in the body and improve blood circulation. Proper blood circulation is especially needed for the proper elimination of toxins and excess fats.
Self-Massage
There are also some known massage techniques that can help break down fat deposits and therefore assist in excess fat elimination. You can easily have your own massage home remedy for cellulite by using a soft brush or bathing mitt on damp cellulite areas. Massaging cellulite cream on affected areas is also a recommended home remedy for cellulite. Pick a massage cream with natural ingredients for optimum results and to reduce the risk of harmful side effects.
Ground Coffee
One other home remedy for cellulite that is growing in popularity is the use of caffeinated ground coffee. Topical applications of cellulite creams with coffee can break down fat deposits and increase blood flow.
You can easily replicate this through your own coffee home remedy for cellulite. Get a warm scoop of used ground coffee and mix with a lotion or some olive oil. Apply the mixture on cellulite areas and wrap with the areas with plastic. Wash off the coffee after 20 to 30 minutes. Perform this procedure a couple of times a week for best results.
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Another big myth presents the U.S. health care system as totally private, or almost. It is true that most health care establishments are private – either for profit or non-profit – and that private health insurance systems generally run on a forprofit basis (apart from Blue Cross and Blue Shield). But it is incorrect to suggest that public health care spending is low or that no public health insurance system exists in the United
States. The U.S. very clearly has public health insurance systems, Medicare and Medicaid. Heavy public spending also goes toward various areas such as public hospitals or Department of Veterans Affairs facilities.
With everything taken into account, public health care spending in the United States is higher than in most other large western countries (see Figure 1). Public health care spending as a proportion of GDP is 6.6% in the U.S., putting it ninth among the 30 OECD countries. It should be noted that the U.S. comes just after Canada, where public health care spending accounts for 6.7% of GDP. Moreover, per capita government spending is higher in the U.S. than in Canada – $2,364 compared to $2,048 at purchasing power parity, based on OECD data.
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The corollary of this myth is that the health care market in the United States is completely free and that unbridled capitalism runs rampant. In fact, the U.S. health care market is highly regulated at several levels, leading to distortions in the use and supply of care. This explains in part the difficulty that millions of Americans face in paying for private insurance. Standards set by state governments and by federal authorities are ubiquitous in the insurance field, limiting the introduction of cheaper, more accessible policies. Regulations specify, for example, which medical procedures an insurance policy must cover. Private
health care supply is also tightly regulated, both by the medical profession and in the management and financing of health care establishments.
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Conclusion
Contrary to myths that have been going around, only a small minority of Americans are involuntarily uninsured on a long-term basis, and even these people generally have access to free health care. Public health care spending is higher in the United States than in most other OECD countries, and the U.S. has sizable public health insurance systems.
The problems of the U.S. health care system largely result not from its private character but rather from the heavy regulation to which it is subjected and from the way the insurance system functions. The tax treatment of insurance and the very low degree of direct involvement by policyholders in controlling health care costs are partly responsible for bloated insurance premiums and for the presence of a certain proportion of uninsured people. As with public financing, when the payer is a third party, costs tend to run wild. In this regard, it is not very surprising to see that the most innovative solutions proposed for reforming the U.S. health care system resemble those suggested for dealing with problems in the Canadian system. These solutions involve the assumption of greater responsibility by patients receiving care and a liberalization of supply mechanisms, whether in terms of care or its financing. One highly promising suggestion involves health savings accounts, established in 2003 with slightly over a million accountholders across the United States by March 2005. These accounts enable individuals to build tax-free savings for coverage of health care costs while purchasing insurance policies with fairly high deductibles but lower premiums. Be that as it may, a more realistic perspective of the advantages and flaws of the U.S. health care system would lead to a more pertinent debate than the repetition of unfounded myths.
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President Obamas odds of enacting major healthcare reform this year are worse than winning at blackjack, despite the fact that its his game, at his table, and with his dealer.
Democrats are going to stumble under the weight of their own unwillingness to compromise on some key policy prescriptions: ideas that make their plan unnecessarily costly and politically vulnerable. This starts with an insistence on erecting a public insurance option, modeled off Medicare, to compete with private health plans -- a proposal that at once is both a budget buster and a killjoy to bipartisan compromise.
Then there are the plans for a federal health board and a new agency devoted to patient centered healthcare research (gone is the phrase comparative effectiveness research -- apparently the White House found it didnt poll well). These latter two proposals invoke images of Canadian style cost controls, wait times for new knees, and faceless bureaucrats adjudicating who gets access to medical treatments according to Congressional rather than clinical prerogatives.
Now its true that, so far, no policy arguments are even bumps in the road to the Democratic plans. But the over-reach of Washington control of individual medical decisions by scary sounding new agencies (it took real genius to name it the health board ) is eventually going to resonate badly with regular voters.
In the end, the real flaw in Obamacare is the underlying premise that to trim costs we need to expand government control over healthcare. Our problems exist not in spite of government intervention but precisely because of it. As the biggest purchaser of healthcare, Medicare overpays for commodity products (wheelchairs) and underpays for essential services (disease management). A remote and largely clinically deficient entity, Medicare has no ability to match spending to incentives that actually improve care delivery -- creating misalignments that permeate through our entire system.
The Congressional Budget Office will soon speak. The costs will be astronomical. Once Rahm Emanuel sees the poll numbers on healthcare reform decline -- taking with it whats left of the Presidents standing on matters fiscal -- Democrats will concede some political ground. They will roll into one bill whatever health legislation they can get done this year (a fix to the doctor fee schedule, expansions in Medicaid, follow on biologics, comparative effectiveness research, etc). They will proclaim it health reform. But it wont be what they started out to pass. Because in the end, they will have tried to deal Americans a bad hand.
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IAN G. PARR, the Special Agent-in-Charge of the New York Field Office of the United States Secret Service (), announced the filing yesterday of a six-count Indictment against LAVETTE M. BILLS, KIRK LACEY, OMAR HENRY, and PETER CHEVERE, charging them with perpetrating a mortgage fraud scheme involving loans totaling over $3 million on at least six different residences. BILLS, 36, of Briarcliff Manor, New York, and LACEY, 36, of Pembroke Pines, Florida, were previously charged in a criminal Complaint filed in Manhattan federal court on March 17, 2009. HENRY, 26, of the Bronx, New York, and CHEVERE, 21, also of the Bronx, New York, surrendered to authorities this morning and are expected to be presented later today in Manhattan federal court.
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She added that she arranges for the pregnant women to receive future health care for their children and additional support from HIV/AIDS service organizations. I become the string that draws it all together. I will see her prenatally, try and normalize her pregnancy for her because shes thrilled to be pregnant, but shes going to find people all the way through who, if they knew she was positive, would be horrified, MacGillivray said.
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People in DC would argue that doing anything about personal behavior is virtually impossible, so why bother, but McKinsey’s case on this one is pretty compelling. In fact, McKinsey argues that the whole “40% of individual health care expenses occur in the last year of life”is no longer true - primarily due to the rise in costs associated with managing chronic conditions. Quote - “…our findings suggest that the management of chronic disease outside of acute-care environments accounts for at least 20 percent of total U.S. health care spending, perhaps more. That level of expenditure, compounded over decades in many cases, dwarfs the cost of end-of-life care…” They indicate that end-of-life health carespending - on average -for people who pass away between the ages of 65 and 95 represents less than 10% of the total amount of money they spend onhealth care during their lifetimes.
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In the same week that the Obama Administration has stated its commitment to overhauling the health care system, the FRESH-Thinking Capstone Conference adjourned yesterday morning to discuss next steps in health care reform. The event is a cross-section of health care experts—academics, practitioners, economists, industry insiders—devoted to fixing the health care system.
The morning began with Stanford Health Policy core faculty member Victor Fuchs welcoming the hundred plus attendees. Fuchs is co-director of the FRESH-Thinking Project with Ezekiel Emanuel. Emanuel stepped down from the Project to join the Obama Administration earlier this year. The Project has spent the past years considering all aspects of health care reform, and this conference is the capstone event of the groups findings. The morning talks look at the cost side of reform.
The first morning speaker was John B. Shoven, Director of the Stanford Institute for Economic Policy Research (SIEPR), who queried the crowd is it possible to put health care on a diet? Shovens focus was on universal coverage and how it can be paid for. After discussing the logistics of who the uninsured are and the current taxation approach, he disavowed the crowd of two giant universal health care reform myths: shared responsibility and the middle class not having to shoulder health care costs. Shovens take aways were s not necessarily that we should have new value added tax. Its that we should have a dedicated tax ... We should not separate the benefits from the costs.
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Terms Of Reference:
Administration Coordinator
for the Inter-agency Working group (IAWG) on Disaster Preparedness for Central and Eastern Africa
Background
The Inter-agency Working group (IAWG) on Disaster Preparedness for Central and Eastern Africa was established following to OCHA Regional Contingency Planning Exercise in June 2002 and the regional CAP Process for 2003. The geographical coverage of the IAWG includes Great Lakes, East and Horn of Africa.
The emphasis of the IAWG is inter-agency information exchange, coordination in order to prepare and respond to disasters in a more cost and time efficient manner, and to better support country counterparts. This has helped to increase common understanding of the partner organization to regional threats and challenges facing humanitarian work. The IAWG has improved coordination among humanitarian organizations and partnership between UN agencies and NGOs.
In order to allow more in-depth discussions and tackling important humanitarian issues; five sub-working groups were established. It is recognized that coordination among the sub-groups is increasingly time consuming given the voluntarily commitments made by the members who are often travelling in the region. An Administration Coordinator position of the IAWG was established to reduce time pressure on key members of the IAWG and to facilitate the daily routine business of the five sub groups, core/executive committee. Accordingly, the post holder will be required to provide administrative support to the different sub groups and IAWG as a whole.
Main Objective of the Administration Coordinator
To follow up on IAWG routine functions, information is shared among the relevant organizations and individuals in a timely manner and to ensure that assigned tasks are completed within an agreed timeframe.
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The ANSI/RESNA wheelchair standards: sample evaluation and guide to interpreting test data for prescribing power wheelchairs
This study is a joint project of ECRI and the National Rehabilitation Hospital, supported by a grant from the National Institute on Disability and Rehabilitation Research (NIDRR, U.S. Department of Education, Agreement No. H133E80016). ECRI is the first independent laboratory to test power wheelchairs and power wheelchairs according to the standards of the Rehabilitation Engineering Society of North America (RESNA), now known as the Association for the Advancement of Rehabilitation and Assistive Technology (AART); these standards will ultimately be distributed by the American National Standards Institute (ANSI). We tested 10 power wheelchairs, which are similar in size and configuration, from seven manufacturers; all units are intended for adult use. Our testing showed that none of the sample wheelchairs are ideal for all environments in which these devices are typically needed. Each unit has advantages that should be carefully considered when specifying a power wheelchair. Numerous factors are involved in prescribing power wheelchairs, and learning the subtle differences in features and performance of a particular model and how they will affect the user is difficult. In addition, acquiring objective information about power wheelchairs from manufacturers is not typically easy. Considering these factors, and because the standards on which we based our testing do not generally provide criteria for passing or failing models under test, we did not rate the units. The purpose of this article is to present the data collected in our study, using wheelchair performance characteristics based on some parts of the ANSI/RESNA wheelchair standards, as an example of what prescribers can expect to receive from manufacturers and to provide guidance in interpreting and applying the data in writing power wheelchair prescriptions. Thus, this article provides an overview of the types of problems faced by those who specify power wheelchairs for users, the problems faced by the users themselves, and the components that are most susceptible to damage during use.
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You will be able to learn something about the right treatment for dry skin if you pay close attention to your eating habits and everyday routines. Is it your habit to eat enough veggies and fruits? Do you have enough hydration? Do you like quick showers or long baths? What makeup type do you use? Do you get enough sleep at night? You may even search on the Internet and see for yourself which are the reasons that evoke skin dryness in order to fight against them. To address just one of the above questions: hydration is determined through the skins condition.
Drinking enough liquids will help flush the toxins out of your system and the tissues also stay fresh and moist: taking too little water will dry your skin. Therefore, moisturizing on the outside, but hydrating on the inside: this should be the primary rule for a treatment for dry skin. Avoid drinking alcohol because it can contribute to dry skin as it accelerates dehydration. The body requires a lot of water as it eliminates ingested alcohol. Take note that theres a lot of homemade recipes that support a basic weekly treatment for skin dryness.
Herbs, honey, cold-pressed oils, fruits, veggies and yogurt can easily be made into the right ingredients for such a treatment for dry skin.
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In addition to payment rate changes, the Proposed Rule also seeks to clarify and revise existing requirements for pre-admission screening, post-admission evaluations, and individualized treatment planning. CMS will make conformingdraft revisions to the Medicare Benefit Policy Manual (MBPM), which will be released forpublic comment. For more information on these proposed changes, see the CMS Fact Sheet entitled Proposals to Clarify Inpatient Rehabilitation Facility Coverage Requirements.
CMS is expected published the Proposed Rule in the Federal Register on May 6, 2009 and reports that it will be accepting public comments until June 29, 2009. See the Proposed Rule for instructions regarding the submission of comments.CMS reports that comments on the draft MBPM revisions should be submitted through a link that will be supplied on the CMS website.
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Global Finance delivers the full story; corporate finance, joint ventures and MA, country profiles, capital markets, investor relations, currencies, banking, risk management, custody, direct investment, money management and all the rest-specifically tailored for corporate readers around the world.
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For travel, third parties include Orbitz, Travelocity and other intermediaries operating mostly on the vendor side of the marketplace. They wouldnt have to stay there, of course. They could become instruments of customers as well. There can be blurring between third and fourth parties.
But, as customers get more power, fourth parties are bound to flourish — and not just because theyre located on the side of the customer and his or her money. Fourth parties will flourish because they will help more intelligence flow into the marketplace, and help the customer both manage and apply that intelligence.
Fourth party business will bloom for every company that wishes to be user-driven and customer-driven. This will include countless new companies, of course. But there will also be fresh work for existing companies that already side with the individual in some way. This group includes banks, real estate agents, travel agents, insurance companies any business that wants to side with free customers, because they know in their bones that free customers are more valuable than captive ones.
Even traditionally locked-down monopolies, such as phone and cable companies, are in good positions to provide, or help provide, fourth party services — simply because these companies already have relationships with millions of customers. (Not to mention old and in some cases dying core businesses.)
What will keep fourth parties from turning on customers, and becoming essentially third parties for the big silo-maintaining vendors — in other words, wolves in sheeps clothing?
The only answer is native individual power. This is why it is critical to provide individuals with tools that enable their independence. A tool such as PayChoices pricing gun cannot be something provided by only one company. It has to belong to nobody and therefore to everybody, just like the existing suite of native Internet protocols. In fact, these native capabilities should enlarge the roster of protocols and other enablements that comprise the Internets suite of benefits for everybody.
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ORONO, Maine - Citing concerns over student access to health care as well as budgetary issues, the University of Maine this week announced it will turn over operation of the campus clinic, Cutler Health Center, to a private health care provider. The plan calls for expanded hours at the health center, more payment options for students, and a higher-profile role for health professionals on campus.
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There has been considerable discussion lately about whether or not the stimulus legislation (ARRA) extends HIPAA coverage to commercial vendors of personal health records (PHRs) any time they contract with entities already covered by HIPAA like hospitals, health plans or physicians groups. (For those of you who dont know, HIPAA is the Health Insurance Portability and Accountability Act of 1996. The HIPAA privacy and security regulations form our national health privacy and security rules.)
The provision in question (Section 13408) states that each vendor that contracts with a covered entity to allow that covered entity to offer a personal health record to patients as part of its electronic health record is required to enter into a business associate agreement with the covered entity. Under ARRA, business associates must comply with key provisions of the HIPAA privacy and security regulations.
In this post, I argue that PHR vendors should be covered under HIPAA only under certain circumstances. PHRs should be governed by a comprehensive framework of privacy and security protections, but HIPAA would provide inadequate privacy protection for people using these tools (at least as the HIPAA rules are currently structured). As a result, I argue that this provision in ARRA should not be read to require the automatic application of HIPAA to PHR vendors any time they contract with covered entities to offer a PHR. Instead, I suggest that HIPAA should cover a PHR vendors activities when the nature of the relationship between the vendor and the covered entity (hospital, health plan, physician office) primarily concerns the vendor performing a service for the covered entity.
However, where the contractual relationship is primarily about improving the value of the PHR to the consumer, HIPAA should not apply. (I know, not an easy line to draw - but I do suggest some factors that should influence the decision.)
Finally, I urge the prompt adoption of separate, targeted privacy provisions to protect consumers using PHRs so that the choice is not HIPAA or limited protections under other federal laws.
Why Not HIPAA - Isnt it Better Than Nothing? Continue reading Privacy Law Showdown.
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During NAB 2009, ENENSYS showcase advance solution for Mobile DTV, Digital Terrestrial TV, and its innovative digital TV Test Measurement products
ENENSYS will be present at NAB Show and will unveil its latest digital TV offering: Complete and multi-standard Broadcast Mobile TV solution, End-to-end Single Frequency Network solution, Latest IP gateway, and its innovative Digital TV test and monitoring products. With special demonstration on ENENSYS DVB-T2 LabMod and a participation of Broadcast Engineering Conference with Laurent Roul.
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