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Most ‘sentinel events’ caused by poor communication

LOS ANGELES—I’m on the west coast now, first for the  USC Body Computing Conference here Friday, and then for the annual Health 2.0 conference up in San Francisco Monday and Tuesday.

Friday there was a lot of talk of healthcare reform. One interesting — and plausible — idea I heard for the first time is that the new Medicare policy of denying reimbursements for preventable readmissions within 30 days of discharge for patients with heart attack, heart failure or pneumonia might have an unintended consequence: We’ll start seeing a lot of readmissions on or after Day 31.

The new policy is one of the many aspects of true reform in the Patient Protection and Affordable Care Act beyond the controversial insurance expansion. And there seems to be a loophole that you can be sure  a lot of hospitals will seek to exploit. Even if they don’t, it is hard to change patient behavior, so it’s likely many will come back to the hospital for the same condition, even if it’s not within 30 days.

More importantly, I heard some statistics presented by Stanford dermatology resident Michelle Longmire, M.D., about medical errors: 7o percent of all sentinel events in U.S. healthcare facilities — and there were 8,859 such events voluntarily reported to the Joint Commission between 1995 and the first quarter of 2012, meaning that many times more probably occurred —result from breakdowns in communication. Half occur during patient handoffs such as shift changes, specialist consultations and transfers to other wards or facilities, Longmire said.

I am convinced all the buffoonery that took place while my dad was hospitalized prior to his death was due to communication problems, poorly designed work processes and a culture of covering one’s posterior in an error-prone organization.

This happens far too often, yet some politicians who want to repeal “Obamacare” keep trying to convince the ignorant masses that American healthcare is just in need of a few tweaks.

At the Republican National Convention in August, New Jersey Gov. Chris Christie said the following: “”Mitt Romney will tell us the hard truths we need to hear to end the debacle of putting the world’s greatest healthcare system in the hands of federal bureaucrats and putting those bureaucrats between an American citizen and her doctor.” PolitiFact.com generously rated this as “half true.” However, PolitFact itself noted that the World Health Organization rated U.S. healthcare as 37th of 191 countries in terms of “overall performance.” The Organization for Economic Cooperation and Development says we spend more on healthcare as a share of gross domestic product than any of the other 33 OECD countries. If that’s the “world’s greatest,” I’d sure hate to be worst.

Last week, during the first presidential debate, former Massachusetts Gov. Mitt Romney, the very same Gov. Romney who championed near-universal health insurance coverage with an individual mandate in his home state — a plan first hatched by the conservative Heritage Foundation as an alternative to the Clinton healthcare reform proposal in 1993 — said this:

Look, the right course for — for America’s government — we were talking about the role of government — is not to become the economic player picking winners and losers, telling people what kind of health treatment they can receive, taking over the healthcare system that — that has existed in this country for — for a long, long time and has produced the best health records in the world.

Without getting into what the role of government should or should not do, our health records suck, Our record on producing healthier people is not so wonderful, either. So no matter what Romney meant by “best health records in the world,” he was lying.

I couldn’t help thinking he was playing to this crowd:

 

Now, this cartoon makes it seem like Obamacare is so wonderful. It’s not. As I’ve said before, having insurance does not mean you will get good care. Having “good” insurance that requires very little out-of-pocket for the patient doesn’t guarantee good care, either, nor does being a VIP. Recall the case of James Tyree, who died from a medical error at a prestigious teaching hospital he was on the board of. The late Rep. John Murtha (D-Pa.) suffered a similar fate despite having “Cadillac” insurance coverage.

I’m going to repeat what is fast becoming my mantra: It’s quality, stupid.

UPDATE, Oct.8: Here’s a summary of what actually is in the Affordable Care Act, and when each provision takes effect, courtesy of the Kaiser Family Foundation.

 

October 7, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

ACA decision is a beginning, not an end, to health reform

I’ve spent a lot of time on social media since Thursday morning debating the meaning of the Supreme Court’s rather stunning decision on the Patient Protection and Affordable Care Act. It was stunning in that Chief Justice John Roberts, a George W. Bush appointee, sided with the four liberal-minded justices, but also stunning in that the court went against conventional wisdom by upholding the individual mandate on the grounds that it was a legal exercise of Congress’ constitutional right to levy taxes.

I had to remind a lot of people that this decision neither solves the crisis, as supporters have claimed, or turns us into the Soviet Union, as some on the lunatic fringe have suggested. Expanding insurance only throws more money at the same problem. This was my first tweet after I learned of the decision:

Breaking news: American #healthcare still sucks. It's quality, stupid. #ACA #hcr #SCOTUS #Obamacare
@nversel
Neil Versel

The cynic in me likes to point out that the individual mandate was an idea first conceived by the conservative Heritage Foundation and championed in Massachusetts by Mitt Romney. Both somehow now oppose the idea. The law that ultimately passed Congress was written by Liz Fowler, a top legal counsel to Max Baucus’ Senate Finance Committee who previously was a lobbyist for WellPoint. Her reward for doing the bidding of the insurance industry was for Obama to appoint her deputy director of the Office of Consumer Information and Oversight at HHS. This was insider dealing at its finest, as much a gift to insurers as the 2003 Medicare Prescription Drug, Improvement and Modernization Act was a gift to Big Pharma.

Of course, I initially was misinformed about the Supreme Court ruling because CNN jumped the gun (as did Fox News) and erroneously reported that the court had struck down the individual mandate on the grounds that it violated the Interstate Commerce clause of the Constitution. But so were millions of others.

I suppose that was fitting, since the national media have for more than two years been misinforming the public about what is really in the law. There are small but real elements of actual care reform — not just an insurance expansion — in there, but very few have been reported. The actual reform has been drowned out by ideologues on both sides. Here’s a handy explanation of most of what’s really there (it’s a good list but not exhaustive). The insurance expansion, the only thing people are talking about, really is just throwing more money at the problem. There is a lot more work to be done to fix our broken system.

What I consider real reform in the ACA includes accountable care organizations and the creation of the Center for Medicare and Medicaid Innovation. Along with the innovation center, CMS also gets the power to expand pilot programs that are successful at saving money or producing better outcomes. In the past, successful “demonstrations” would need specific authorization from Congress, which could take years.

Notice that there isn’t a whole lot specific to IT. That’s because the “meaningful use” incentive program for EHRs was authorized by the 2009 American Recovery and Reinvestment Act. Another key element of real reform that also is not part of the ACA is Medicare’s new policy of not reimbursing for certain preventable hospital readmissions within 30 days of discharge.

We need more attention to quality of care. Many have argued that tort reform needs to be part of the equation, too, because defensive medicine leads to duplicative and often unnecessary care. Perhaps, but lawsuits are a small issue compared to the problem of medical errors. Cut down on mistakes and you cut down on malpractice suits. Properly implemented EHRs and health information exchange — and I do mean properly implemented — will help by improving communication between providers so everybody involved with a patient’s care knows exactly what’s going on at all times.

All of these facts lead me to conclude that true healthcare reform hasn’t really happened yet. Look at this Supreme Court ruling as a beginning, not an end, to reform.

 

June 29, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Yes, you do have a right to your health records

Lest anyone forget — including the American Hospital Association, which wants to take 30 days post-discharge to supply copies of medical records to patients — HIPAA explicitly gives patients the right to access their own records. This is not new. The HIPAA privacy rules have been in force since 2002. Yet, far too many patients have no idea of this right and far too many providers don’t inform patients of this right or do what they can to prevent access.

Fortunately, the HHS Office for Civil Rights, which enforces HIPAA privacy and security standards, is trying to change that with an outreach campaign, including this video.

 

Unfortunately, the video has been viewed just 556 times as of this writing. Equally unfortunately, the video directs viewers to visit HHS.gov/OCR. But the real information you need is at http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html. I found that page using Google, not by trying to navigate the menu, which is not very intuitive, even for someone who knows the healthcare industry. I can’t imagine the average consumer finding that page without help or plain old dumb luck.

Various HHS agencies are trying hard to disseminate messages to the public. I think of AHRQ’s Questions are the Answer campaign. I’ve seen poster-size ads around Chicago telling people to visit ahrq.gov for a list of questions they should be asking their healthcare providers, but the better link, not mentioned in the ads, is ahrq.gov/questions.

For that matter — and I mentioned this to one of the AHRQ higher-ups at the HIMSS conference a few months ago — how many people really know what the Agency for Healthcare Research and Quality is? Wouldn’t it be better to have a more memorable URL? The Obama administration is good at setting up URLs for programs it wants to promote for political reasons — think recovery.gov and even the consumer-friendly healthcare.gov — but the less-politicized divisions such as AHRQ (remember, Director Dr. Carolyn Clancy is a career professional who has run AHRQ for two presidents since 2003) and OCR haven’t done so. They need to come up with easy-to-remember URLs that the general public can remember. Bureaucrat-speak just isn’t getting the job done.

Meantime, physicians need to become more patient-friendly, too. I invite you to check out this Salon article from a few weeks ago entitled, “Listen up, doctors: Here’s how to talk to your patients.” Please share with family, friends and, yes, your doctors. Share the OCR video, too. If OCR can’t make the information easy to find, I will.

 

June 12, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Facebook community for reporting patient harm

Kudos to investigative journalism organization ProPublica (yes, some journalists still have integrity today) — and a hat tip to HealthLeaders for bringing it to my attention — for setting up a Facebook community for people to report stories of patient harm. I’ve just shared the story of my dad’s torturous final month. I’m glad that a news organization with wide reach beyond the healthcare and technology industries cares about real stories, not distractions related to insurance coverage and partisan politics.

The group now has 661 members. There really should be 1,000 times as many. Please join and share your own stories, then help get the word out about the poor state of U.S. hospital care. (Note that I only accept Facebook friend requests from people I know personally.)

June 1, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Sen. Whitehouse, make some more noise, please

I have railed more often than I can count against politicians and the national media for misleading or at least failing to inform the public on what health reform is all about. For me, it was quite refreshing to see an interview in the Washington Post with Sen. Sheldon Whitehouse (D-R.I.), attempting to shed some light on the parts of reform that have nothing to do with insurance.

“The Affordable Care Act is mostly known as an insurance expansion, expected to extend coverage to more than 30 million Americans,” started the post by Sarah Kliff. “But … a big chunk of the law is dedicated something arguably more ambitious: an overhaul of the American business model for medicine. ‘This is a very significant piece of the bill that has received virtually no attention because it’s so non-controversial,’ Sen. Sheldon Whitehouse (D-R.I.) told me in a recent interview.”

On Thursday, Whitehouse released a 52-page document outlining what he sees as the 47 changes the Patient Protection and Affordable Care Act is making to how care is delivered. That doesn’t even count the reforms in the HITECH section of the American Recovery and Reinvestment Act from a year earlier, by the way.

Health IT, of course, is a big part of reform.”The HITECH Act took important steps to restructure financial incentives to shift the pattern of health IT adoption. The HITECH Act’s Medicare and Medicaid incentive payments are encouraging doctors and hospitals to adopt and “meaningfully use” certified
electronic health records,” Whitehouse noted.

Also from that report:

Health information technology (IT) will radically transform the health care industry, and is the essential, underlying framework for health care delivery system reform. The ACA’s payment reforms, pilot projects, and other delivery system reforms are built with the expectation of having IT-enabled providers. In particular, the shift to new models of care, like ACOs, will rely heavily on information exchange and reporting quality outcomes. Indeed, the formation of ACOs is contingent on having providers “online” to transfer information and patient records, and report quality measures.

Whitehouse did discuss ACOs with the Washington Post, but there’s a reason why the interview appears on a page called the WonkBlog. This stuff is too complicated and wonky for the average person.

What isn’t complicated is explaining that throwing more money at a broken system, as the insurance expansion does, will not lower the cost of care. It also isn’t complicated to explain that tens of thousands of Americans needlessly die each year due to medical errors or low-quality care. Yet, more than a few defenders of the ACA have said that the insurance mandate would help guarantee “quality care” for millions.

Wrong!

The insurance expansion guarantees insurance coverage. It does not guarantee quality care. Whoever wins Friday’s Mega Millions drawing wouldn’t necessarily be able to buy quality care, either. Nor would Bill Gates, for that matter. You can’t get quality care unless you’re willing to address the causes of errors and adverse events. Period.

Sen. Whitehouse seems to understand that. I doubt too many other members of Congress do, despite the fact that a former colleague, the late Rep. John Murtha (D-Pa.), who had the “Cadillac” coverage so many people covet, died as a result of a medical error.

March 30, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Berwick, after the fact

The tragedy of Dr. Don Berwick’s short tenure as head of the Centers for Medicare and Medicaid Services has been well-documented, including right here on this blog. Berwick got in by a controversial recess appointment because President Obama didn’t have the political courage to fight for his nominee and allow Berwick to face the Democratic-controlled Senate. Berwick, of course, quit late last year when it became clear Obama would not renominate Berwick for the job he is uniquely qualified for.

There have been a number of postmortems in the press, where Berwick discussed his experience running CMS, including the challenges of implementing both the HITECH Act and the Patient Protection and Affordable Care Act and his. continuing efforts to improve the quality of care in this country. But I haven’t seen one quite as good as what Dan Rather just produced.

The former CBS News anchor has been toiling in relative obscurity at HDNet, a hard-to-find cable network run by billionaire Mark Cuban. Fortunately, Rather took to the far more popular Huffington Post this week to share his thoughts on a recent interview he conducted with Berwick.

“Dr. Don Berwick, a pediatrician by training, came to Washington with a sterling reputation among people who actually know something about health care. He had helped pioneer the Institute for Healthcare Improvement, which may sound like another pointy-headed D.C. think tank, but really is a Cambridge, Massachusetts-based organization lauded the world over for helping make health care systems better. For example, they have worked with hospitals on common sense techniques to reduce hospital infections. These are serious people who are welcomed in hospitals and clinics across the country and around the world,” Rather wrote on HuffPo.

That’s right, Rather understood Berwick’s background, unlike, say Dr. Scott Barbour of a crackpot group called  Docs4PatientCare. “Utilizing quotes from Dr. Berwick, Dr. Barbour exposed that, ‘He is not interested in better health care. He is only concerned about implementing his socialist agenda,’” read a pitch I received from that organization last year.

I’ve been over this before. Berwick has probably done more to improve the quality of care and save lives than anybody else on the planet today. Some of the people who publicly opposed his nomination privately knew this, as Rather’s interview with Berwick demonstrates:


Yes, most of the opposition was an elaborate lie perpetrated for political gain. In today’s Washington, is anybody surprised? The losers once again are the American people and anybody who comes to this country for healthcare.

February 16, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Gingrich on EHRs in the 2009 stimulus

I don’t like to get political on this blog, but I’ve been thinking a lot about how the Newt Gingrich we’ve seen on the campaign trail of late is quite different from the Newt Gingrich who was a tireless advocate for health IT and EHRs from about 2004 to 2009.

Lately, Gingrich has, as primary candidates are wont to do, been pandering toward the more ideologically pure elements of his party, not addressing the center, as will be necessary during a general election. Notably, Gingrich has jumped on the “repeal Obamacare” bandwagon, essentially making the ridiculous argument that America does not need healthcare reform. That’s interesting, because Gingrich, after he left Congress, founded the Center for Health Transformation to push for technology-enabled health system improvement.

Back in 2004, Gingrich joined with strange bedfellow Hillary Clinton to advocate for a national, government-funded strategy to support adoption of health IT. That idea eventually morphed into the HITECH Act section of the 2009 American Recovery and Reinvestment Act, President Obama’s $787 billion stimulus legislation. Gingrich, like most Republicans, opposed the bulk of the stimulus, but he was an ardent supporter of HITECH. Here’s the proof: Read more..

January 29, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Help free Warren Weinstein

As you may know, Warren Weinstein, the American kidnapped in Pakistan in August, is a family friend. I posted about him shortly after the kidnapping, but took the post down at the request of the Weinstein family. Now, with the chilling news that he is in the hands of Al-Qaeda, I am being encouraged to spread the word to put pressure on the U.S. government and others who might be able to save him.

Please:

1. Forward this message to your friends who can influence others.
2. Send letters to the editor of influential publications.
3. Write to your government and legislators.

The following is a note from my uncle, to whom Warren is a close friend and mentor:

 

Dear Friend,

A very dear friend of ours, Dr. Warren Weinstein, was brutally kidnapped from his house in Lahore, Pakistan on August 13, 2011, just a few weeks after celebrating his 70th birthday with his family back in Maryland, and just two weeks before he left Pakistan for good. Warren is an exceptionally talented and devoted man and during the five or so years that he was in Pakistan, he did a phenomenal amount of good for the people with whom he worked. Among other things, he used his extensive networking skills to open up new markets for Pakistan’s jewelers and to help increase value-added for Pakistani dairy producers. He spoke Urdu, the language of the people and he fit in to the society, exactly the way an excellent development worker should do. He was all about delivering good things to the people of Pakistan – to the best of his considerable ability.

That he was grabbed from his home – at 3 am during Ramadan, the holy month of fasting (which Warren, an observant Jew who respected others’ religious beliefs, probably was keeping in solidarity with his co-workers) was certainly a callous, cold-blooded and cowardly, if not infidel, act. Given that violence was (apparently) used upon him and his guards also underscores the brutal nature of his abductors. The Pakistani police were and have continued to be impotent in following through on Warren’s kidnapping. The Pakistani government has been absent.

And now, after four long difficult months of waiting, not hearing anything, the cowardly caliph of Al Qaeda comes forward with a valiant declaration, victoriously claiming that he and his henchmen are holding a good and righteous 70 year old man who has dared to try to help others less fortunate than he during his entire career, in fact his entire lifetime. As an American, and as a Jew, Warren believed strongly that by helping others he was doing what was right, and he always did it very well. Accusing Warren of the venal crime of working for USAID, Al-Zawahiri wants the West to give back all the Al Qaeda loyalists in return for Warren.

For those Al Qaeda loyalists, whose work is to destroy, to explode, to obliterate, to assassinate innocent men, women and children, of whatever creed or belief, simply to terrorize, they – so we are told – believe that they do this all in the name of Allah… How can that same Allah condone the work of Warren and the work of the Al Qaida contingent? I suppose that’s why Allah is indeed so wondrous…

In the few days following Al-Zawahiri’s announcement, I have seen NO official US government reaction. That is shameful, given that Warren was doing everything in his power to do good works so that America and USAID would be better-viewed by Pakistanis. Warren and his team were successful at expanding opportunities for Pakistanis’ businesses, using US taxpayers’ money. Perhaps there is some secret mission underway to bring Warren home, but the lack of even basic appreciation for what Warren has done is shocking. The Department of State released some benign diplomatic drivel to suggest that they had communicated with the Government of Pakistan….with whom we have very complex and rapidly deteriorating “relations”…and that they were working to get the hostage freed, or something to that effect. Is that it? Is that all one gets when one has devoted years of service and has the misfortune to be placed in grievous circumstances?

In an earlier incident, a redneck CIA hack who shot Pakistanis to death in some sort of traffic accident which ended in an altercation, claimed self-defense or some such thing, got wonderful treatment and laser-focus from the US government. He was subsequently released and repatriated to the US where he could get into trouble in his own country, and if I recall correctly, did indeed. US funds were used to pay blood money to the victims’ families. But for Warren, a contractor – not a US government direct-hire employee, since the US does not negotiate with terrorists (or so the tale goes), what will the US do for him????

I do not usually agree with the forum that I have cited below this appeal letter. In this case, the author is at least venturing something other than inaction, an alternative to doing nothing or benign business-as-usual phrases.

I ask you to think about Warren and his family and share this with others so that he may brought home as quickly as possible. He has beautiful grandchildren and daughters and a wife who all miss him like he most definitely misses them. And he has friends…lots of friends all over the world, from dozens of countries and with whom he communicates in their languages. If you would be so kind as to ask your Congressional representatives and Senators to get involved, maybe we can break through some of the bureaucratic malaise and get Warren home with his family.

This is a season of hope. Perhaps we can dare to hope that Warren can be set free as quickly as possible.

Thank you for reading this. Help free Warren Weinstein.

Best wishes,
Malcolm Versel

 

from: Family Security Matters
http://www.familysecuritymatters.org/publications/id.10971/pub_detail.asp
December 6, 2011
How Should the U.S. React to the Kidnapping of Warren Weinstein?

Ryan Mauro

On August 13, a 70-year old Jewish-American named Warren Weinstein was kidnapped from his home in Pakistan. Ayman al-Zawahiri has released a tape claiming he is in Al-Qaeda’s custody and his fate will be decided by whether the U.S. gives into his demands. He’s believed to be under the control of Pakistani Taliban commander Tariq Afridi, who operates out of the tribal town of Darra Adam Khel near Peshawar, but there are reportedly no credible leads on Weinstein’s exact location. What is the United States to do?

The first thing the U.S. must do is inform Pakistan that it will be held responsible for Weinstein’s fate. This would not have happened if Pakistan lived up to the same responsibilities that all of the world’s countries are expected to. If there is any intelligence service that can find Weinstein, it’s Pakistan’s ISI intelligence service. Should it fail to do so, Pakistan should receive just as much blame as Al-Qaeda and the Taliban. There are specific, long overdue punishments that Pakistan must face if Weinstein’s life is lost.

The second action that must be taken is to ideologically pressure Al-Qaeda, the Taliban and Pakistan. This is an opportunity to bring attention to the goodness of America and the evil of the Islamist terrorists. Weinstein is not an enemy combatant. He is not even near the age to become a combatant if he wished. He is an aid worker who has devoted his life to helping others, especially Pakistanis. He set up scholarships for students in the tribal areas to study the gem trade. He’s helped improve the dairy market. His job was to develop Pakistan. His story should become known to all Pakistanis as an example of how America is helping them and the terrorists are hurting them.

The U.S. must also use the kidnapping to embarrass Al-Qaeda and the Taliban and to stop them from using it to try to appear strong. The U.S. and its allies must emphasize how cowardly of an act this is and depict it as an act of weakness. The fact that Al-Qaeda and the Taliban has to resort to kidnapping 70-year old aid workers should be used against them.

Muslim governments that covet their ties to the U.S. should be asked to pressure their imams to condemn the act. Again, Weinstein is not an enemy combatant and even some anti-American Islamists will view his kidnapping as uncalled for. Although I do not agree with all of his suggestions, former Egyptian terrorist Tawfik Hamid makes a wise recommendation. He says that Islamic scripture should be used to condemn Weinstein’s captors. It is important that the U.S. do everything it can to stir debate within the Islamic world about such events.

Unfortunately, the odds are not high that Weinstein’s life will be saved and so a response must be prepared should the terrorists kill him.

The U.S. must steal the headline from Al-Qaeda and the Taliban. The world’s headlines should not read, “Al-Qaeda Kills American Hostage.” They must read, “Al-Qaeda Kills American Hostage; U.S. Launches Massive Strikes on Terror Havens.”

When President Obama came into office, he was given a list of 150 terrorist camps inside Pakistan. Some have since been destroyed but plenty remain, along with safehouses, front businesses and other terrorist entities. The U.S. must immediately respond to the announcement of Weinstein’s death with military action that demonstrates our strength, makes terrorists (and those who do business with them, such as the kidnappers who may have sold Weinstein) second-guess the wisdom of their actions and raises the cost to Pakistan for taking the enemy’s side. By doing this, Al-Qaeda will be prevented from having any boost in morale or prestige. His death must be remembered as something that brought misery to Al-Qaeda and its allies, not joy.

The U.S. should also have a strategy that becomes incrementally more aggressive towards Pakistan. If there is any information indicating that Pakistan is protecting Zawahiri or Commander Afridi, it should be released. If a specific ISI operative is tied to them, his assets should be frozen. Further cuts in aid to Pakistan must happen. The target list for the drone campaign should be expanded and U.S. troops in Afghanistan should be permitted to return fire across the border. Our troops deserve to have the threat to their lives minimized and sites used to kill them should not have immunity.

If Pakistan’s behavior does not immediately change, the State Department should reverse its decision to not include the country on its list of “Countries of Particular Concern” for violations of religious freedom. The case of Asia Bibi, a mother who has been sentenced to death for criticizing Islam after converting to Christianity, should be taken up. There should be open discussion in Congress about designating the ISI as a terrorist group, as was done with the Iranian Revolutionary Guards, or at least its S-Wing that is most involved.

Richard Miniter offers some additional ideas. He suggests eliminating our dependency on Pakistan by building a supply route to Afghanistan through India, preferably in secret. Allies in central Asia should be used to airlift supplies. The U.S. can also insist that AT&T and other companies change their business arrangements with Pakistan in order to financially punish the country.

The hard truth is that the U.S. isn’t doing everything in its power to save Warren Weinstein or our soldiers in Afghanistan. Pakistan must be forced to do everything it can to find him and if his life is taken, he deserves to be honored with more than condolences.

Ryan Mauro is the National Security Analyst for Family Security Matters. He is the Founde rof WorldThreats.com, a national security analyst at Christian Action Network, a Strategic Analyst for Wikistrat and a national security commentator for FOX News.

 

Thank you for your attention. And now, back to health IT.

 

December 9, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Does Berwick *really* sound like a radical commie?

While people continue to demonize CMS Administrator Dr. Donald Berwick and President Obama essentially throws Berwick under the political bus, far too many are missing the message. Wouldn’t “radical communist thugs” like one commenter on this YouTube page labeled the Obama administration really want to dehumanize patient care?

Watch this short video of Berwick speaking in Berlin in 2009 (yes, socialist Europe). He talks about how patient care already has been dehumanized and how healthcare professionals and organizations routinely ignore the wishes of patients. Speaking of a friend who couldn’t get mammogram results over the phone, Berwick said, “Their choice trumps her choice. Period. And that’s what scares me. It scares me to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, or to be alone when I need to hold my wife’s hand, or to eat what I do not wish to eat, or to be named what I do not wish to be named, or to be told when I wish to be asked, or to be awoken when I wish to sleep.”

Does that sound like a “radical communist thug” or someone genuinely committed to improving the quality of care and actually humanizing the patient experience?


 

June 19, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Is it even possible to seem unbiased when mentioning politics?

Is it even possible anymore to seem unbiased when reporting on politics or the workings of government? As hard as I try sometimes, there’s always someone who thinks I’m taking a particular side.

The latest example came today in a story I wrote for InformationWeek about the Obama administration’s new White House Rural Council. Created by executive order last week, the council “will focus on actions to better coordinate and streamline federal program efforts in rural America, and to better leverage federal investments,” according to USDA Secretary Tom Vilsack, chair of the council.

That’s obviously the Obama administration’s line. Yet within a couple of hours of the story being posted, someone offered this comment:

Okay, let me see if I got the right? The government is spending more money than ever before, the economy is lagging, and a recession is hanging over our heads and won’t go away. What would the most intelligent man in the world do about this? Spend more money to take better heathcare to rural areas. Wow, were is the logic is this? This whole thing smells fishy, it doesn’t pass the smell test to me.

Thanks for the ‘I love Obama’ speech buddy, but I ain’t buyin’ it. Let’s see how many do come November.

Huh? How is a news story an “I love Obama” speech? All I did was report what the administration said, and included a short, unspecific comment from one of the few interest groups, the National Rural Health Association, that has said anything at all related to the healthcare aspects of this executive order. I don’t see any editorializing there.

Take issue with the administration’s plan all you want, though at least get your facts right. The White House has been pretty vague about the council to this point, but nobody has said anything about spending more money beyond what’s already been allocated for other programs. But don’t call a straightforward, fairly bare-bones news story an “‘I love Obama’ speech.”

I think it’s fair to say that some news organizations are thinly veiled cheering sections for certain political viewpoints. InformationWeek is not one of them. Has our political culture become so poisoned that it’s impossible to come off as objective anymore?

 

June 15, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.