Posts Tagged ‘health’

Morning Read: Sunmount whistleblower says more protections needed

May 16th, 2012 by Brian Mann

The Associated Press is reporting that former government whistle blowers, including a former official at Sunmount in Tupper Lake, want even tougher oversight programs than the one Governor Andrew Cuomo is proposing to protect people with disabilities in state care.

Susan McLaughlin, who was a consumer advocate for the former state Office of Mental Retardation and Developmental Disabilities, recalled a disabled client at the Sunmount facility in the Adirondacks who in 2004 had his fingernails cut so short that all his fingers bled.

She wrote top agency officials in 2005 attempting to report 15 specific cases of illness, injury or death of disabled people in state care and what she described then as "systemic problems." She later sued after she was terminated following 35 years with the state.

"They should take the top third of the administration right off the top," McLaughlin said, adding she got many anonymous calls from direct care staff who feared losing their jobs, so she would report it. "And you need to bring in new people with a different philosophy."

Read the full article here.

One scientist's vision for Trudeau Institute's future

May 14th, 2012 by Brian Mann

Dr. Stephen Smiley (Source: Trudeau Institute)

Last week, NCPR and the Adirondack Daily Enterprise reported on the internal debate over the future of Trudeau Institute, the  immunology laboratory in Saranac Lake.

Among the comments to the In Box was the following essay, written by Dr. Stephen Smiley, who joined Trudeau's faculty in 2000 and has served as the Institute's director of corporate relations.

I'm reposting Dr. Smiley's perspectives, because I think they warrant wider attention.

I have been a scientist at the Trudeau Institute for 12 years. I love the Institute and I love the community it resides within. The following words reflect my personal opinion, not the official positions of Trudeau management.

To my knowledge, the Trudeau Institute has never sustained itself on NIH grants alone. One can argue about whether it might be more successful obtaining NIH grants if it was located elsewhere but that does not change the fact that NIH grants alone are unlikely to suffice. Institutes like ours do not exist on NIH funds alone.

Our other funds historically came from the Institute's endowment. When Bob North was director, he built that endowment to nearly $40M. At that level, one can expect ~$2M per year (presuming a 5% return) in extra income. Those extra funds are essential for covering the cost of operating expenses that NIH grants do not cover. With the Board's approval, the Institute's subsequent directors used more than $2M per year of the endowment year after year. They built programs and built buildings that improved the science and helped to make Trudeau the world-renowned institution it is today. In the process, they also eroded the endowment and created substantial new expenses, such as loan/bond repayments.

The original plan was to rebuild the endowment and pay off loans/bonds with philanthropy, but that never occurred. Then, in recent years, the Institute experienced increased competition for NIH funding, an ailing economy, the loss of its director and several (funded) investigators partly as a result of the relocation debate, and a continued failure to raise the necessary amounts of philanthropic funding. These circumstances all contributed to the current crisis.

What is needed is a plan to pay off our debt and rebuild the endowment – quickly. Then, the scientists can return to their work, return to bringing in grant funds to cover most expenses, and know that the $2M revenue from the endowment is there to cover the shortfall. I believe the "translational problem" can be addressed by partnering with nearby institutes with clinical facilities (e.g. Univ of Vermont, SUNY Upstate) who value our stellar reputation and scientific strength in basic infectious disease research. In fact, Trudeau will announce new grant awards over the next few weeks that demonstrate our ability to perform translational studies by partnering with others. However, I think it highly unlikely that partnering will suffice to overcome our revenue shortfall – most businesses are struggling in the current economy and I don't think any partner will commit to providing Trudeau with the extra $2M per year in operating funds that we need.

So I urge the community to help us rebuild the endowment. I am a scientist. I don't know how to raise an endowment. Our Board doesn't seem to know how to either. If there are people in the community who care and truly have the capacity to help, then I urge you to get involved now. How? I'm not sure. We may need a grass roots effort to figure out how. Or maybe there are a few key "champions" in our community who can come to the rescue philanthropically, or take the lead on a vigorous fundraising campaign.

Why should you care? First of all, Trudeau Institute has brought $138M in revenue to Saranac Lake over the past 10 years. Those funds come mostly from NIH grants. A very large percentage of the dollars we obtain from NIH are spent paying the wages and benefits of the 100+ people employed by Trudeau who live and work in this community. On average, we infuse the local economy with more than $6M per year. Our employees spend much of that money locally – they eat in the local restaurants, shop at the local stores, pay local taxes, contribute philanthropically to local efforts, etc.

Second, the community should be proud of this jewel of an institute and use it as a means to sustain and build our regional economy. As our mayor is trying to do, we should use it as an example of the kind of future this region can look forward to. This is a wonderful place to live, work, and raise a family. In a modern economy, rural locations like Saranac Lake should have less trouble competing, not more. We have a good infrastructure – we can communicate with anyone instantly by internet and we can get supplies delivered overnight. It is far easier to work here now than in the days when Frank Trudeau originally set the Institute here. I applaud Mayor Rabideau's efforts and I believe wholeheartedly that, with a strong sustaining endowment, Trudeau can stabilize and help to anchor the growth of a high tech economy in this region.

But I think Trudeau's future is currently dependent on the good will of this community. Trudeau needs substantial philanthropic assistance now. It needs to rebuild its endowment very quickly. I hope my contribution to this blog will help to turn the conversation away from a rehash of who is to blame for what. Certainly with hindsight we can identify past mistakes by well intentioned individuals, including myself. But what we need now is a discussion of how a community that cares about Trudeau Institute can help to ensure it survival for another 127 years.

Five questions for Trudeau's leadership

May 11th, 2012 by Brian Mann

The last couple of weeks, I've been poring over internal documents leaked by former employees at Trudeau Institute, including more memos and studies provided this week to NCPR and the Adirondack Daily Enterprise.

They provide new detail and clarity on the turmoil and lingering uncertainty at the biomedical research laboratory, which employs about 100 people in Saranac Lake.

It appears that for the last half decade, the lab's leadership has been painfully divided, with some board members and staff secretly pursuing a plan to relocate some or all of the institute without buy-in from other board members.

When the relocation plan was vetoed by the full board in January 2011, the organization entered into a period of unprecedented disruption, losing key administrators and faculty.

Trudeau's national reputation has clearly suffered.  Eighteen months after the decision was made to stay, the institute still lacks a permanent director, and the community has no clear understanding of what the new plan is for moving forward.

Trudeau is a private institution.  But it is also a vital part of the North Country's economy, culture and history, and it relies for the lion's share of its funding on taxpayer dollars.

Saranac Lake has staked a significant part of its future on emerging as a biomedical research cluster, with Trudeau at its heart.  It appears that state and Federal officials are willing to help by investing significant funds in that vision.

So as the public discussion moves forward — and it appears that the timeline for solving some of Trudeau's "structural" problems will need to be fairly swift — here are the questions Trudeau's leadership needs to answer.

1.  In simple terms, what is the plan?  Has the board accepted that Trudeau can no longer serve the mission of conducting fundamental research into the human immune system, as it has done for half a century?  If so, what's next?

2.  Whatever the plan is, how much money do you need?  Trudeau executives hoped to garner roughly $88 million in subsidies, grants and philanthropic donations to relocate to Florida.  What kind of public support is needed to sustain your vision in Saranac Lake?

3.  Is the current board of trustees up to the task of guiding this institution, or does there need to be a substantial change?  A survey conducted of Trudeau staff and faculty in April 2011 revealed a lot of fear, anxiety and distrust.  Is it time for a shake-up at the top?

4.  Is there a way to better engage and communicate with the community?  Trudeau Institute relies on public support for its operations, but the organization often operates invisibly.  The result has been deep distrust between some local leaders and Trudeau executives, and a remarkable level of detachment and apathy among the public.  Do you think that needs to be fixed and if so how?

5.  Exactly what is the situation now?  How much money is left in Trudeau's endowment?  What are the most pressing, short-term needs, financial and otherwise, that will keep Trudeau afloat while bigger questions are answered?  And why has it taken so long to hire a permanent new director?

Trudeau chairman Benjamin Brewster declined to be interviewed on tape for our reporting. And he didn't return phone calls after the most recent Trudeau board meeting last Friday.

But in the absence of a permanent director at the lab, someone needs to step forward soon to speak bluntly about the institute's next steps.

Why rehash Trudeau Institute's travails now?

May 10th, 2012 by Brian Mann

Today, NCPR and the Adirondack Daily Enterprise launch a two-day investigative report on the behind-the-scenes debate over the future of Trudeau Institute, the bio-research and immunology laboratory in Saranac Lake.

We've known since the autumn of 2010 that there was a "strategic planning" effort that included the possibility of moving the facility out of state.  So why we revisit the controversy now?

Sources have been saying off the record to reporters for months that the situation at Trudeau remains fragile, with deep divisions over the future of the institute, which still employs roughly 100 people.

Documents leaked recently by a former staffer gave new insight into the policy differences that sparked those rifts, and the leadership decisions that shaped events behind the scenes.

Memos and other documents indicated that some staff and board members engaged in a concerted effort to keep the effort to move the laboratory to Florida secret for months and even years.

Even after executives traveled to Florida and submitted a formal application for more than $88 million in incentives from officials in Port St. Lucie Florida, it appears that some board members were still kept in the dark.

Those documents also suggest that troubling questions remain about Trudeau's future.  At stake are dozens of high paying jobs an a facility that anchors Saranac Lake's fledgling "biotech cluster."

But Trudeau is also an essential part of the village's culture.  Founder E.L. Trudeau served as Saranac Lake's first mayor in the 1800s.

Tomorrow, Chris Knight takes the story forward, looking at the options being considered for Trudeau as the lab works to recover from months of turmoil, budget cuts and internal divisions.

Is it time to blow the whistle on American football?

April 9th, 2012 by Brian Mann

Going down hard during the 2006 Pro Bowl. Photo: Cpl. Michelle M. Dickson

Over the last year, I've written a couple of times about the deep shame of collegiate sports in America.

From the plantation-style economics of modern NCAA athletics to the broken moral compass of programs like Penn State, there's something rotten in a culture that was supposed to teach fitness, teamwork and healthy competition.

It's hard to imagine those stories being eclipsed by behavior even more reprehensible — even more apparently criminal — but the NFL has managed to pull it off.

News broke weeks ago that former New Orlenas Saints defensive coordinator Gregg Williams allegedly paid his athletes to deliberately injure players on opposing teams.

An audio recording has now emerged of Williams instructing his players to target other players' heads.  "Kill the head and the body will die," Gregg instructed, offering cash rewards to any player who carried out the hit-job.

He also instructs his players to destroy another player's knee.  "He becomes human when we (expletive) take out that outside ACL," Gregg argued, according to a report in USA Today.

Americans have always liked our sports rough-and-tumble; and my own tastes are hardly cricket-and-croquet.  I was a high school wrestler, I love football, and have been an on-again-off-again fan of mixed martial arts.

But there are moments when even a pass-time as central to our national sensibility as football warrants a good, no-holds-barred fresh look.

In order to clear the air, the sport needs to do three things.

First, the NCAA has to address the inequities in the college game, where (mostly white) coaches, administrators and media executives rake in huge bucks.

Meanwhile (mostly black) players are denied even the most basic professional compensation and protection, while they expose themselves to astonishing physical risk.

Secondly, the NFL needs to turn over all evidence of injury-for-hire schemes, like the one in New Orleans, to criminal investigators.  This is, at long last, a job fo rthe police.

Last time I checked, it was illegal for anyone in the US to pay cash to a hit-man to deliberately injure or cripple someone.

The fact that this conspiracy allegedly occurred on a gridiron should not cause the proper authorities to hesitate in taking over this probe.

Finally, the medical profession needs to independently investigate growing evidence that football — at the high school, collegiate, and professional level — is severely damaging the brains of far too many athletes.

While this investigation is underway, the parents of young children who take up football should be warned far more clearly and explicitly that their kids can expect to suffer hundreds of potentially debilitating head injuries each season.

This from an article last year in Slate magazine:

[R]esearchers aren't exactly sure what is happening to these players. But they believe that what we call concussions are only one of several kinds of head injury that affect players' verbal ability, memory, and "vestibular system," which controls spatial orientation and balance.

Many of the hits that produce "shell-shock" concussions involve blows to the side of the head, as happens with helmet-to-helmet collisions in the open field. The new group of injured players—the ones without visible injury—had suffered damage to the frontal lobe, the part of the brain that controls high-end "executive functioning."

In the end, we may find that the overt brutality of alleged bad actors like Gregg Williams is a much smaller piece of the moral quandary that faces football.

The bigger dilemma may be that so many of us are prospering from, and being thrilled by, a spectacle of violence that really is as destructive as it looks.

Does American healthcare need Henry Fielding?

March 30th, 2012 by Brian Mann

Ironically, I've been stuck at home sick much of the week, while the healthcare debate has been unfolding at the Supreme Court in Washington.

I've followed those developments closely, but I've also been reading about another fascinating chapter in the long evolution of democratic governments in the West.

It turns out the idea of having a professional, government-operated police force is a relatively late concept.

The first formal police force organized in London was created – weirdly enough – by Henry Fielding, author of the classic novel "Tom Jones."

Prior to Fielding's organization of the Bow Street Runners, you basically had two choices when it came to protecting yourself from crime, both involving what libertarians might describe as elements of the free market.

You went about with your own armed gang, which was a common practice for the aristocracy and wealthier merchants, or you hired a vigilante known as a "thief-taker" to try to capture any criminal who had already done you wrong.

When Fielding tried to organize a force of actual beat cops, paid for by Parliament, the idea was initially dismissed and derided as a dangerous expansion of big government, an infringement on liberty.

People literally worried about the emergence of a "police state."

But those ideas were soon swamped by the simple reality that London — one of the most prosperous cities on earth — was growing into a Somalia-style war zone, governed by bandit-leaders and their incredibly violent gangs.

The vast majority of average citizens couldn't afford the "free market" forms of security that protected wealthier citizens.  Murder, rape and kidnapping were as common in the city of King George as they are now in lawless corners of Africa.

Thinking about that moment in the mid-1700s, I couldn't help but ponder the analogy to our modern healthcare debate.

A lot of Americans think it represents a dangerous expansion of the government's power if we move toward an arrangement where we citizens are required by law to purchase insurance coverage.

The "police" state concerns of the past have been replaced with the "nanny" state concerns of today.

But I wonder if those ideological concerns can withstand the new simple reality:

Tens of millions of Americans now lack healthcare and, as a result, we're seeing more and more "third world" style crises in our communities, including shamefully high infant mortality rates, and people dying from treatable ailments.

Obviously, the free market offers healthcare solutions to anyone with the money to pay for them.

But just as police protection was viewed as a luxury in the 1700s, for many of our neighbors proper healthcare is now a kind of out-of-reach pipe dream.

The last time the World Health Organization ranked national healthcare systems, ours had fallen to number 37, trailing Costa Rica and Morocco.

For their part, Londoners in the Georgian age didn't accept a police force and set aside their libertarian instincts out of altruism, in order to protect their more vulnerable neighbors.

They did so because the alternative to "big government" was a kind of gridlock of fear, a city of chaos in which free enterprise and prosperity were being stifled by crime.

I wonder if the same eventual evolution won't occur in America.  We will resist the notion of government-organized healthcare until the alternatives are simply too gruesome, and too disruptive.

I suspect that only when enough Americans have died prematurely, or when our prosperity is seriously threatened by a healthcare system that is too costly and unwieldy, will we finally reach a consensus that some government fix is required.

Does this mean that we will have taken another step along the slippery slope toward despotism?  Maybe.

But a lot of us are now quite comfortable with the idea of having policemen on the beat at night, just as we have grown satisfied with having a government-run education system.

Yes, it is important to maintain proper checks on the size and strength of government.  But it turns out that having a healthy, safe, and educated population is no less important for the maintenance of liberty.

On healthcare, Republicans earn deep skepticism

March 23rd, 2012 by Brian Mann

Allow me to bury the lead by beginning with a couple of the usual caveats:

I think it's perfectly reasonable for people to debate the design, implementation, cost and philosophical principles underlying the Democrats' Healthcare Reform Act.

A lot of legitimate questions remain about how the program will be paid for long-term, how many people it will actually help, and whether better, less complicated and less intrusive alternatives might be found.

And now for the punch-line:  As they seek to score political points on "Obamacare," Republicans have largely blown their own credibility as the party with the right ideas to answer those questions.

Indeed, GOP leaders have earned for themselves a deep reservoir of skepticism.

The first blunder, of course, is that top Republicans have adamantly refused to offer alternatives, or talk about how they would approach this differently.

Nor have they adequately explained the fact that during the years when Republicans controlled Washington, they ballooned the public costs of healthcare (pushing through a huge, budget-busting prescription drug entitlement for seniors) without addressing the tens of millions of Americans with no insurance coverage.

So when Republicans say their message in 2012 will be "repeal and replace," journalists like myself and voters like you should be asking for specifics:  Replace with what?  How will you get it right this time?

The other reason the GOP has drifted into "pants on fire" territory on this issue is that so many of their most adamant claims about the Democratic plan have turned out to be flimsy, exaggerated or downright false.

Just this morning on our airwaves, New York state Republican leader Dean Skelos argued that a new Congressional Budget Office accounting of Obamacare suggests that it will cost twice as much as originally predicted.

This is a widely parroted theme among conservatives and it is, simply and factually, false.  Here's what the non-partisan website FactCheck.org found when they looked at this issue:

Several readers asked us about Republican comments and news reports saying that a new Congressional Budget Office report had found that the federal health care law would cost double the original estimate. But that’s not what CBO’s report said. Instead, the report shows that the gross yearly costs of the new health care law are likely to be 8.6 percent higher than originally estimated.

Politifact — another non-partisan fact-checking team — reached the same conclusion, calling conservative claims bluntly "false."

Politifact also investigated conservative claims, echoed by presidential candidate Mitt Romney, that the Healthcare Reform Act would somehow ration or deny certain Medicare treatments received by elderly Americans.

Their probe concluded that the assertions were "pants on fire" lies, saying that the a new political ad about the issue "isn’t just wrong. It’s also ridiculous."

So what's up with that?  If Obamacare really is so toxic, why does the GOP have to keep trotting out full-blown whoppers to attack it?  If the truth about the program is ugly, hit us with the truth.

And then there's the complicated issue of whether or not the GOP's top candidate, Mitt Romney, actually some of the most controversial policy provisions of Obamacare, while serving as the governor of Massachusetts and while campaigning in 2008.

The Washington Post's Factchecker site concluded that Romney embraced the idea of personal mandates, insisting as recently as 2008 that "mandates work."

But Romney never embraced a national mandate requiring that all Americans purchase health insurance.

That's an important distinction, but it still leaves a lot of of unanswered questions.  If mandates work but we don't want them in national policy, what are the alternatives?

How does the GOP leadership plan to confront the complex, thorny problems posed by uninsured Americans, both those who can't afford coverage and those who carelessly choose not to buy protection, thus ballooning costs for the rest of us?

As Republicans campaign this summer, these are the questions that they should be answering.  And to win the high ground on this issue, they should make sure that their answers are based in fact.

What journalists talk about when we talk about sex

March 17th, 2012 by Brian Mann

Over the last week, a lot of newspapers around the US decided not to run Gary Trudeau's "Doonesbury" cartoon as it delved into the flame-hot issues of sexuality and politics that have emerged in the 2012 presidential season.

The editorial board of the Plattsburgh Press-Republican argued in an essay that the "six 'Doonesbury' installments just struck us as too offensive," and so the strip was shelved for a week.

NCPR has also wrestled with this question:  How do we talk about sex — especially the politicized, polarized aspects of human sexuality now being debated — without being "offensive."

When our reporter Sarah Harris interviewed Erica Macilintal, a Roman Catholic woman at SUNY Plattsburgh struggling to live within the constraints of her Church's teaching, we took a deep breath and plunged ahead.

"Are you sexually active?" Harris asked.  "I know that's a really weird question to ask you, but I'm kind of curious because a lot of people, you know, can believe something and practice another.”

Weird, yes.  Awkward, yes. Borderline offensive, even, by any traditional rules of social decorum.

Polite people just don't ask other people publicly about their sex lives.

But as Harris's lead editor on this project, I made it clear that I didn't think we had a choice.  We had to 'go there.'

Here's why.  As a journalist, I've reached the conclusion that we have to set aside our squeamishness and address these issues head-on.

If lawmakers are going to force women who are choosing to have legal abortions in the US to have ultra-sounds that include the insertion of medical devices into their vaginas, journalists and pundits need to talk about that stuff honestly, not obliquely.

We need to accept that the politics of sexuality require us to open our airwaves, news pages, and editorial space to frank discussions that might, in some quarters, be viewed as "offensive."

What, after all, is the alternative?  Should we not speak bluntly and factually about the very issues that are defining much of our politics?

In this culture war era, politicians have marched boldly into our bedrooms, into the treatment rooms of our gynecologists and family physicians, and into the moral decisions that Americans (not just women) make about their sexuality.

They have also hoisted their flags over that fractious, bitter terrain that lies at the intersection of religious faith and human intimacy.

For better or worse, journalists have to follow them.

This isn't to say that Mr. Trudeau gets it "right."  His argument that the government-mandated insertion of a medical device into a woman's vagina is "rape" is clearly only one possible point of view.

Others have argued that requiring these ultrasounds is a way to ensure that women have all necessary medical information "before making such a critical decision."

This is the debate we need to treat accurately and unblushingly, even when it makes us uncomfortable.

Trudeau's Doonesbury tackles abortion law, goes viral

March 16th, 2012 by Sarah Harris

North Country native Garry Trudeau's Doonesbury comic strip went viral this week. The provocative cartoon about Texas' new law mandating that abortion seekers receive a transvaginal ultrasound has been pulled from at least 60 newspapers and caused a fair amount of controversy.

Doonesbury cartoonist Gary Trudeau in 1999 at Tufts University. Photo: 48states

But Trudeau stands by his choice, telling the Washington Post's Comic Riffs blog that

"to ignore it would have been comedy malpractice."

He elaborates in a further interview with Slate Magazine.

"The systematic dismantling of reproductive rights, much like the takedown of collective bargaining, has been taking place in full view. All I'm trying to do is cut through a little of the complacency and lay out in some detail what's at stake."

Trudeau's gotten a lot a lot of feedback about the strip–not all of it complimentary. But there's one compliment he's happiest about:

"The comment that pleased me the most this week came in an email from my daughter: 'You're a good friend to the ladies, Dad.' I used to self-identify as a feminist, simply as a matter of principle. But now I'm also a father and a husband. This is about the health and rights of people I love."

Is it "war on women" or a fight for religious liberty?

February 28th, 2012 by Brian Mann

This morning, NCPR begins several days of conversation with people in the North Country wrestling with moral and political questions surrounding social and family planning issues, as well as religious freedom.

We begin with an in-depth conversation with Bishop Terry LaValley, head of the Diocese of Ogdensburg, which you can hear here.

This issue sparks a lot of really thorny, tangled questions.

Is it fair, appropriate or constitutional for the Federal government to require faith groups to provide insurance coverage for care that some churches disapprove of, including contraception, vasectomies, and so-called "morning after" birth control pills?

Should existing state laws in New York be overturned?
Is it fair for faith groups to deny those insurance services to employees — including non-believers — thus denying them the right to make their own individual moral choices?

And what about the social services that faith groups provide, often with taxpayer support?  Should those be shaped by religious conviction, even when the services are provided to people of other faiths, or to people of no faith at all?

Do you feel that religion is "under attack" in America?  Or do you feel that religious groups are trying to shape laws that will force you to adopt their moral codes?

These are the questions that we're exploring this week and I'm interested for your views.  This is difficult stuff, not exactly water cooler conversation.  So please chime in, but keep it thoughtful and civil and respectful.