How many are even aware of the societal crisis in America?
I've been watching all of this since I was in the seventh grade. It is all interconnected. I read, over on the "six questions" thread, how many of you <h2>do not</h2>
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...believe that part of the role of taxation is to redistribute resources more equally.....
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You know who you are....the ones most likely not even to read what is in this post:
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http://www.guardian.co.uk/elsewhere/...312004,00.html
Los Angeles Dispatch
Civil wrongs
Decades after the Watts riots, life for the people of South Central Los Angeles is as tough as ever - and now they are losing their only good medical facility, reports Dan Glaister
Friday September 24, 2004
Guardian Unlimited
Next year sees the 40th anniversary of the Watts riots - or rebellion, depending on your politics. Among the hottest points of the civil rights struggles of the 1960s, the riots were condemned by the white establishment at the time as one of the largest outbreaks of mass looting ever seen, involving an estimated 50,000 people.
Almost 40,000 police and national guard officers confronted the rebels/rioters as the authorities reacted belatedly and heavy handedly. Of the 34 people who died during the six days of unrest, 28 were African-American.
After the event, despite the tepid recommendations of the official McCone commission, orthodoxy swung behind the more liberal interpretation of events: the Watts riots had been a "rebellion of rising expectations" fuelled by poverty, racial injustice, a lack of services and the awareness that Watts, Willowbrook and Compton, predominantly African-American areas of Los Angeles that were later renamed South Central, were being left behind.
The McCone commission, while largely dismissed as a whitewash, did produce one legacy, a legacy that has returned Watts and the events of almost 40 years ago to the news this week.
Three years after the riots and just six days after the assassination of Martin Luther King Jr, work began on the construction of what came to be called the King/Drew medical centre, a response to the catastrophic lack of services for the local community. The 500-bed hospital, serving 1.5 million people, opened in March 1972.
Since then the proud hopes of the King/Drew medical centre have given way to less edifying stories of mismanagement, corruption, and inefficiency.
Yet a beacon shone out of the rubble of the hospital's original aims. The pride of the medical centre was its trauma unit. The unit, additional to the emergency room, specialised in the treatment of violent injuries such as gunshot wounds, stabbings and car accidents. It treated 2,150 patients last year and was the busiest and best trauma unit in the country.
However, at a press conference last week hospital officials announced that the trauma centre was to be shut down as part of an attempt to rationalise the chaotic state of the institution and prevent the closure of the entire facility....
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A teaching hospital with 537 beds, reduced to 233 beds, then to 42 beds, and three months ago...to zero beds...and an elimination of:
Hospital killed by racial/economic segregation driven dysfunction:
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http://en.wikipedia.org/wiki/Martin_...forces_closure
Martin Luther King Jr.-Harbor Hospital (MLK-Harbor), formerly known as Martin Luther King Jr./Drew Medical Center (King/Drew), is a public hospital in Willowbrook, an unincorporated section of Los Angeles County, California, north of the city of Compton and south of the Watts neighborhood of Los Angeles.
MLK-Harbor is operated by the Los Angeles County Department of Health Services (DHS) and has 48 beds. In recent years, widely publicized problems related to incompetence and mismanagement caused the hospital to undergo a radical overhaul: <h3>bringing the number of beds down to 42 from 233.[1]</h3> Since 2004, 260 hospital staffers, including 41 doctors, had been fired or had resigned as a result of disciplinary proceedings. It currently has 1,400 employees. To alleviate the impact on the community of the large loss of capacity, The Los Angeles County Medical Alert Center (MAC) contracts ambulances take approximately 250 patients per month to other local hospitals. [1]
<h3>At the turn of the 21st century and before its crisis, MLK-Harbor (then MLK/Drew) had 537 beds</h3>, was the teaching hospital of the adjacent Charles R. Drew University of Medicine and Science, and spread over a 38.5-acre site that includes a dormitory for medical residents; with 2,238 full-time employees, and in 2004 treated 11,000 inpatients and 167,000 outpatients. Located near areas of high crime, the hospital has a very active trauma unit. <h3>In 2003, it handled 2,150 gunshot wounds and other life-threatening injuries.....</h3>
....Federal funding termination forces closure
On August 10, 2007, after the hospital failed a comprehensive review by the U.S. Centers for Medicare and Medicaid Services, federal officials decided to revoke $200 million in funding.[21] Inspectors concluded that there was no functioning quality improvement plan at the hospital.[22] Los Angeles County health director Dr. Bruce Chernof moved quickly to notify the county Board of Supervisors of his decision to begin shutting down the facility. The emergency room was closed by 7 p.m. that day and ambulances were diverted to other area hospitals, the rest of the hospital was closed by August 27, 2007.[21] Some of King-Harbor's 1 600 employees would likely be reassigned to jobs at other county facilities.[21]
On August 13, at a specially convened board meeting, LA County supervisors voted unanimously to shut inpatient services and promised to pay up to $16.3 million to nearby private hospitals and doctors bracing for a deluge of patients from the closed facility.[22] They also released the 124-page report by federal inspectors that detailed dozens of errors and failures by the hospital during their final make-or-break review; the citations included improperly sterilized medical equipment, nurses who could not rapidly find medication, a nurse who did not know how to mix medication in an emergency, and a patient who complained of severe chest pain but was not given pain medication for 4.5 hours.[22]
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Hospital imperiled by racial/economic segregation driven dysfunction:
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http://www.ajc.com/shared-gen/conten...cxntlid=inform
http://news.google.com/news?hl=en&q=...-8&sa=N&tab=wn
Atlanta Hospital in Grave Condition
By ERRIN HAINES
Associated Press Writer
ATLANTA — For generations, Grady Memorial Hospital has treated the poorest of the poor, victims of stabbings and shootings, and motorists grievously injured in Atlanta's murderous rush-hour traffic.
Now, Grady itself is in grave condition.
Staggering under a deficit projected at $55 million, the city's only public hospital could close at the end of the year, leaving Atlanta without a major trauma center and foisting thousands of poor people onto emergency rooms at other hospitals for their routine medical care.
"I don't have the words to describe the onslaught of health care needs that will hit the region if Grady were to close," said Dr. Katherine Heilpern, chief of emergency medicine at the Emory University medical school, which uses Grady as a teaching hospital and supplies many of its physicians. "This is a huge deal. We may literally have people's lives at stake if the Grady Health System fails and spirals down into financial insolvency."
Grady Memorial Hospital's board of trustees on Monday unanimously agreed to establish a nonprofit governing board intended to attract $300 million in immediate and long-term funding from the city's business, philanthropic and government communities as well as from the state.
Dozens of activists, doctors, clergy members, lawmakers and citizens packed an auditorium across from Grady and demanded to be heard before the board voted.
"Y'all ought to be ready to stay here all night," said state Sen. Vincent Fort, who was involved in a scuffle with hospital security guards shortly before the meeting. "The fight ain't over. If some of us have to go to jail, so be it."
Founded in 1892, Grady has struggled financially for years. But now it has reached a crisis because of rising health care costs, dwindling government aid, a lack of paying customers and years of neglect — a situation not uncommon among urban hospitals like Grady that primarily serve the needy.
In addition to losing money on patient care, Grady needs an estimated $300 million to repair and modernize its buildings and acquire new equipment such as CT scanners and an up-to-date computer system.
The loss of Grady would be unconscionable to many political and civic leaders in this booming metropolitan area of 5 million people. The overwhelming majority of the 900,000 patients treated at Grady each year are poor and black, and the institution is considered a vital part of Atlanta's black community.
But some fear that after the switch to a nonprofit governing board the hospital will be less committed to the poor, and that the board will go from mostly black to mostly white. Grady has been run by a governing board whose members are appointed by politicians in Fulton and Dekalb counties.
Fort, a black Democrat from Atlanta, said earlier that Grady is "absolutely critical" to the city's black poor. And he charged that Atlanta's "white power structure" — including the business leaders and politicians who are pushing for the nonprofit board — is trying to orchestrate a takeover.
"To the extent that you have African American doctors, nurses and other professionals operating a big-city hospital and taking care of black people, that is a source of pride in the black community," Fort said. "So there is a great deal of skepticism that the Chamber of Commerce is interested in Grady. There are some of us who believe that is a self-interest."
<h2>With 953 beds and 5,000 employees, Grady is an anchor of Atlanta's downtown and accepts all patients, without regard to their ability to pay.
Only 7 percent of Grady's patients have private insurance, and 75 percent are on Medicaid. Because they lack insurance and have no family doctor, many go to Grady's emergency room even when they don't have an emergency. The ER ends up treating sore throats and other ordinary aches and pains.</h2>
Besides Atlanta's poor, Grady's patients include tourists passing through on their way south to Walt Disney World and victims of auto accidents, since Grady is the only hospital in a 100-mile radius of Atlanta that has a Level 1 trauma center, capable of treating the most serious injuries. (A popular bumper sticker seen on cars along Atlanta-area highways reads: "If I'm in a car crash, take me to Grady.")...
...."Quite frankly, that would've overwhelmed any other system in the city," Heilpern said. "That was sort of all in a day's work for us."
<h3>Grady also has the state's only poison control center, obstetrics intensive care unit and comprehensive sickle cell center. And the city's emergency command center for handling plane crashes and terrorist attacks is based at Grady.</h3>
If Grady were to close, poor people would probably swamp other hospitals' ERs with everything from ordinary colds to genuine medical emergencies.
"It will be a sad day for Atlanta if Grady closes. If people realized the benefits Grady provides, closure would not be on the table," said Dr. Marsha Regenstein, a health policy professor at George Washington University in the nation's capital.
Doctors, activists, lawmakers, business leaders and the hospital leadership are scrambling to find a fix for Grady, which gets most of its funding from Medicare, Medicaid and Fulton and Dekalb counties.
In July, a 17-member task force of business leaders recommended the shift to a nonprofit board. Some of Atlanta's major corporations have said they would contribute to Grady if it were run by a nonprofit board because it would manage the hospital more efficiently.....
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http://www.pewtrusts.org/our_work.aspx?category=428
<h3>Economic Mobility of Black and White Families</h3>
Nov 13, 2007
The dream that one can rise up from humble beginnings and achieve a comfortable middle-class living, if not attain great wealth, transcends racial lines. But is this a reality for black and white families alike?
This report, by Julia Isaacs of The Brookings Institution, reviews overall income trends based on Census Bureau data and provides an intergenerational analysis based on a longitudinal data set that allows a direct match of the family income of parents in the late 1960s to their children’s family income in the late 1990s to early 2000s.
In brief, trends show that median family incomes have risen for both black and white families, but less so for black families. Moreover, the intergenerational analysis reveals a significant difference in the extent to which parents are able to pass their economic advantages onto their children. Whereas children of white middle-income parents tend to exceed their parents in income, a majority of black children of middle-income parents fall below their parents in income and economic status. These findings are provided in more detail below....
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http://www.nytimes.com/2006/03/20/na...=1&oref=slogin
Plight Deepens for Black Men, Studies Warn
Published: March 20, 2006
BALTIMORE — Black men in the United States face a far more dire situation than is portrayed by common employment and education statistics, a flurry of new scholarly studies warn, and it has worsened in recent years even as an economic boom and a welfare overhaul have brought gains to black women and other groups.....
...Although the problems afflicting poor black men have been known for decades, the new data paint a more extensive and sobering picture of the challenges they face.
"There's something very different happening with young black men, and it's something we can no longer ignore," said Ronald B. Mincy, professor of social work at Columbia University and editor of "Black Males Left Behind" (Urban Institute Press, 2006).
"Over the last two decades, the economy did great," Mr. Mincy said, "and low-skilled women, helped by public policy, latched onto it. But young black men were falling farther back."
Many of the new studies go beyond the traditional approaches to looking at the plight of black men, especially when it comes to determining the scope of joblessness. For example, official unemployment rates can be misleading because they do not include those not seeking work or incarcerated.
"If you look at the numbers, the 1990's was a bad decade for young black men, even though it had the best labor market in 30 years," said Harry J. Holzer, an economist at Georgetown University and co-author, with Peter Edelman and Paul Offner, of "Reconnecting Disadvantaged Young Men" (Urban Institute Press, 2006).
In response to the worsening situation for young black men, a growing number of programs are placing as much importance on teaching life skills — like parenting, conflict resolution and character building — as they are on teaching job skills.
These were among the recent findings:
¶The share of young black men without jobs has climbed relentlessly, with only a slight pause during the economic peak of the late 1990's. In 2000, 65 percent of black male high school dropouts in their 20's were jobless — that is, unable to find work, not seeking it or incarcerated. By 2004, the share had grown to 72 percent, compared with 34 percent of white and 19 percent of Hispanic dropouts. Even when high school graduates were included, half of black men in their 20's were jobless in 2004, up from 46 percent in 2000.
¶Incarceration rates climbed in the 1990's and reached historic highs in the past few years. In 1995, 16 percent of black men in their 20's who did not attend college were in jail or prison; by 2004, 21 percent were incarcerated. By their mid-30's, 6 in 10 black men who had dropped out of school had spent time in prison.
¶In the inner cities, more than half of all black men do not finish high school.
None of the litany of problems that young black men face was news to a group of men from the airless neighborhoods of Baltimore who recently described their experiences.....
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The POTUS and former Texas governor, left this legacy when he left Texas, for Washington:
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http://www.npr.org/templates/story/s...oryId=15822844
All Things Considered, October 31, 2007 · The Texas juvenile corrections system is in a deep crisis.
Nation
Crisis-Prone Texas Juvenile Facilities Look to Reform
by Jason Beaubien
Listen Now [4 min 45 sec] add to playlist
This is the second report in a two-part series.
.....Texas Seeking Alternatives
For those residents who can't maintain control, there is an isolation area called the Security Unit where as many as 30 people are kept in isolation cells. All the cells are occupied. In one cell, a 13-year-old near the door screams profanities and bangs on his cell walls. Assistant Superintendent Gonzales says teens can be held in this isolation unit — at times just until they calm down — or for as long as 90 days.
<h3>By comparison, in Missouri, there are only nine isolation cells in the entire state for a system serving 1,000 youth offenders. Evins, along with the rest of the facilities run by the Texas Youth Commission, is attempting to change and to become a bit more like Missouri, where the focus is on small, treatment-orientated group homes.</h3>
Missouri has reaped the benefits of an alternative system. Tim Decker, the director of the Missouri Division of Youth Services, says Missouri's recidivism rate is less than 10 percent. According to the Texas Youth Commission report, the recidivism rate in Texas tops 50 percent.
Evins is shutting down one of its large dorms and building individual cells. It also offers education and counseling for its residents, but in this isolated corner of the state, it's often difficult to attract and keep professional staff. Will Harrell, who earlier this year was appointed as the ombudsman for the Texas Youth Commission, credits Missouri with offering a model for reform, <h2>but he says whatever changes are adopted in Texas will be unique to the state and will take time.</h2>
"It's a transition and a difficult one at that," Harrell says, "but everyone needs to understand that <h3>it took many years to get to the crisis that imploded the agency earlier this year, and it's going to take a while to stabilize the agency and move forward.".....</h3>
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Read the last few sentences in the preceding quote box; these are kids, they don't "have time"....while Texas juvie takes fucking forever to emulate what is in place, and known to work well in Missouri.
I've been aware of all of this for more than forty years. Not only do we have to solve these problems if we are going to have vibrant city centers with performing arts, orchestras, and advanced teaching and research medical centers, expecially with $5.00 gas "a'comin" to slow suburban sprawl, but the rest of us have to drag some of you along, "kickin and screamin", as you vote to sabotage the relief that can only come from government driven and managed solutions. Piecemeal doesn't work, turning whole cities into ghettos entered only to receive trauma care in dire emergencies, isn't working, and private health insurance sure as hell is not working.
Why are we torturing juvenile detainees in Texas, and why are we incarcerating so many blacks not convicted of violent crimes?
You can keep voting for Bush, for Paul, and you can pay much more later if the problems are not dealt with now. The choice is living in gated communities with increasingly heavy security needed when you want to leave your "GREEN ZONED" world.
Nothing will change while you refuse to even see the problems, then, accept that they are your problems, and you look around to see who is able to pay to fix them, besides you.
Trauma medicine is not state of the art because of what doctors have learned at the Mayo clinic in Rochester, Minn...it is because of the experience gained in the practice of emergency medicine at the teaching hospitals in the centers of old, run down, American cities.
Either the wealthiest pay a disproportionate share to help bring everyone else up to a higher quality of life with government managed and subsidized, "single payer" healthcare, as in the rest of the indusrtialized and post industrialized world, or the entropy currently weighing on American society will pull everyone down with it.
Let's stop talking BS like, "it's the tort lawyers and their malpractice lawsuits". It isn't coherent, IMO, to claim that private malpractice insurance for doctors is broken, so government must pass laws to stop those who cannot afford upfront legal fees from suing on a contingency basis, while simultaneously claiming that private medical insurance is a hunky dory status quo solution for the American healthcare crisis. It is the opposite....the lawsuits are driven by the high cost of longterm care for people who are rendered uninsurable after botched medical care that leaves them with expensive to treat, "pre-existing conditions" that are excluded from future medical insurance coverage.
I'm not a medical practitioner, but even I'm sharp enough to evaluate how ludicrous the idea that medical malpractice lawsuits are a significant cause of "the problem", and not merely another symptom of a broken system that can only be mitigated by a single payer solution. <h3>It is obvious that there is no way to keep "have nots" in the current private payer system, from using emergency and trauma centers as clinics of last resort, without reform that provides them equal and routine access to neighborhood clinical and preventive medical treatment.</h3> |
