The Buffalo News - Viewpoint http://www.buffalonews.com Latest stories from The Buffalo News en-us Fri, 24 May 2013 04:05:26 -0400 Fri, 24 May 2013 04:05:26 -0400 <![CDATA[ Businesses can learn from the demise of Your Host ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130519/OPINION/130519222/1122
Your Host started life as a hot dog stand in 1944 and from this humble beginning Alfred Durrenberger Jr. and Ross Wesson grew the fledgling enterprise to 40 locations. Calling Your Host a restaurant makes it seem more upscale than it actually was. In reality, it was a diner along the lines of both the fabled Route 66 diners and mythical small-town diners of the Eisenhower era. If Edward Hopper had chosen to base his iconic painting “Nighthawks” in Buffalo, he would have used Your Host as the model.

The food was a step above McDonald’s and Red Barn (another casualty of the fast-food/diner wars) and Your Host eventually outlasted its main local competitor, Deco Restaurants, which went out of business in 1979. Any teenager with a car, or who had a friend with a car, knew the nearest Your Host location. On Friday nights and weekends in the 1960s and 1970s, when the drinking age was 18 and bars stayed open until 4 a.m., they were drawn like the proverbial moth to the flame to Cleve-Hill Plaza, the Hamburg Shopping Center and even to Dunkirk and Rochester. Once crammed into the tiny booths, the crowds of semi-sober young people scarfed down greasy burgers and french fries soaked in ketchup or gravy.

Times change, and in many ways Your Host failed to change with them, but the seminal reasons for the restaurant’s demise are eerily similar to what many local businesses face today. Some of the reasons in 1993 for the closure of Your Host were a faltering economy, escalating costs, a failure to modernize and update its stores and an increase in competition from national chains. Small businesses still face these same challenges in 2013.

Although the economy has recovered somewhat since it went into a free-fall in 2008, the unemployment rate and the number of workers who have given up looking for work remains remarkably high. Household income has flat-lined and consumer confidence is low. These factors have stunted the growth of small business, and it does not appear the economy will fully recover in the near term.

Small businesses are particularly impacted whenever government issues new mandates. Costs of the new health care law, called Obamacare by many, are gradually coming into focus and are not good news for small businesses. They may have to lay off full-time workers and replace them with part-time workers to prevent paying insurance costs they can’t afford. The increase in the minimum wage that New York State recently passed will not only hurt small businesses’s ability to survive but may also cause higher unemployment among teens and minorities. In New York City, billionaire Mayor Michael Bloomberg’s strangely Orwellian attempt at social engineering is driving up costs for small business.

Sears and Kmart are examples of what happens to companies with poor business plans and older, run-down stores. The mom-and-pop operations in your village or down the street need to remember that first impressions are most often the only impression customers will remember. Clean and welcoming stores make customers want to come back. Run-down and dirty stores cause them to flee.

The competitive environment has become more treacherous as national chains such as Walmart, Denny’s and McDonald’s expand into smaller and smaller geographic areas. Online tax-free purchases hurt local brick-and-mortar stores by stealing their customers or squeezing their profit margins. Locally Tops has taken a preventative step by opening Orchard Fresh in Orchard Park. This store, which specializes in upscale, gourmet foods and sundries, is partially an effort to stop other chains from competing in Western New York.

Like the television show “Cheers,” at Your Host it seemed everybody knew your name. Your Host was local people serving and supporting local people. While there are memories left behind by Your Host there are also business lessons. Small business needs less government interference and fewer mandates. What it needs from government is less of the economic illiteracy we see from the current state and federal administration and a more pro-growth agenda. Small businesses need to continue to evolve, adapt, modernize and adopt new technology in the face of ever-growing competition, both nationally and online. Ultimately, small local businesses desperately need our support.



Remy C. Orffeo, a resident of Orchard Park, is a professor of business administration at Erie Community College South Campus and a freelance writer who has published business case studies in “Decision Making in Business.” ]]> Fri, 17 May 2013 10:56:17 -0400 By Remy C. Orffeo

Special to The News

]]> <![CDATA[ America is in trouble: Economy peaked 40 years ago, and we’ve been living off borrowing and bubbles ever since ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130519/OPINION/130519223/1122
President Obama held this year’s State of the Union address on Abraham Lincoln’s birthday. While Obama is hardly facing the same problems as Lincoln, the state of the union in 2013 is still troubled. I hate to bring more bad news to a country facing lingering unemployment and record deficits, but the fact is we haven’t created much long-term real wealth since the early 1970s. We’ve just been treading water economically, while getting deeper and deeper into debt. While I believe these were mostly problems Obama inherited, the state of the union is simply not good and we’re likely facing a massive rebuilding effort.

Data from the Bureau of Labor Statistics shows that the U.S. economy peaked sometime between 1967 and 1973, and we’ve been struggling to get back on track ever since the OPEC oil embargo in late 1973 that sparked the first energy crisis. The percentage of Americans under age 62 not working has remained at roughly 15 percent for the last five years, the worst run since the Great Depression. Only 64 percent of Americans are participating in the labor force (i.e., working or actively looking), which means that nearly 100 million Americans are not working.

The average hourly wages of ordinary workers adjusted for inflation are now 5 percent lower than they were in 1973, according to the bureau, $9.26 per hour in 1973 compared to $8.74 in 2012. The minimum wage reached its purchasing peak in 1967, the same year wages peaked for American men. (Women, on the other hand, have greatly improved their educational status and earnings). Our standard of living has simply declined on a quantitative basis.

How could this be when everyone has more of everything: more cars, more big-screen TVs, more cellphones, more home computers and bigger houses? The answer is that most of those goods were bought with borrowed money. Total personal debt reached an all-time record level of $12 trillion in the last five years, or roughly equal to the nation’s yearly output. Household debt as a percentage of disposable income peaked during the financial crisis of 2007-09 at more than 100 percent of family income.

High-tech workers, professionals and government employees are also important in the rising Gross Domestic Product. They have all done much better economically than private sector blue-collar workers over the last generation. For example, most of the business growth in the 1970s and 1980s came from corporate mergers, which made lawyers, investment bankers, brokers and executives richer, but didn’t do a lot for the average worker.

The other reason we’ve been able to keep consuming more is most families now have two parents working. In 1990, just as a recession was starting, Chicago Tribune columnist Joan Beck wrote that the main thing keeping the economy going was the work of “superwomen.” She had an excellent point. In the 1950 Census, less than half of American women worked outside the home, and women earned on average less than half of men. In the 21st century, there are more women than men in college. With wages for men stagnant since about 1967, every dollar of family income added since the 1970s has come from spouses (mainly wives) going to work outside the home. But even with the higher incomes from both parents working, are we really better off than our parents were a generation ago?

Ten years ago, Harvard Law professor Elizabeth Warren and her daughter Amelia wrote a book answering that question titled, “The Two-Income Trap: Why Middle-Class Mothers and Fathers Are Going Broke.” Their simple answer was no, on average, we are not better off than the single-income families of the 1940s, 1950s and 1960s.

They wrote: “The average two-income family earns far more today than did the single-breadwinner family of a generation ago. And yet, once they have paid the mortgage, the car payments, the taxes, the health insurance, and the day-care bills, today’s dual-income families have less discretionary – and less money to put away for a rainy day – than the single-income family of a generation ago.”

Big-ticket items, especially housing prices, health care, college costs and local taxes, have simply outpaced most families’ incomes – even with both parents working. There was a satirical bumper sticker from the ’80s that read: “I owe, I owe, so off to work I go.” It is no longer a joke.

In 2009, Paul Krugman said that “we’ve spent the last 20 years lurching from bubble to bubble. … The excesses that got us to this point are ready to do it to us again even if we get out of this current trap.”

The bubbles Krugman was referring to include the defense spending/real estate/stock market bubble of the mid-to-late-1980s under President Ronald Reagan, the high tech/stock market bubble of the 1990s under President Bill Clinton, and the real estate/stock market bubble of the last decade under President George W. Bush. All three resulted in quick, but spectacular, booms. However, all three failed to create long-term sustainable growth and ended with serious recessions. They essentially papered over the nation’s long-term stagnation while producing only short-lived boosts.

This fundamental economic slowdown since the late ’60s explains why our politics has been so volatile, why racial frictions have been exacerbated, why the two parties are so polarized and engaged in chronic trench warfare, why family life is so strained and why people generally keep saying they believe the nation is on the wrong track. In the last Gallup Poll on the subject, 68 percent of Americans were dissatisfied with the country’s condition.

Americans are clearly correct when they say something is wrong with the state of the nation. Most of us have been struggling to just keep up for the past generation. These economic struggles also explain why our politics has seemed so negative. Simply put, when the economic pie isn’t growing, people fight even harder to keep their share.

So, the problems are massive and real. How can we get a start on solving them? To oversimplify greatly, economic growth generally results from one of two factors. The first is development of natural resources: water, gold, silver, oil, natural gas, soil, minerals and so on. North America was blessed with abundant natural resources and we became the richest continent exploiting them. But there are limits to resources, as we discovered in the last generation. The second is a new technology that vastly increases worker productivity. Classic examples would be the steam engine, cars, telephones, airplanes and computers. We’ve certainly had our share of inventors and innovators: Thomas Edison, Henry Ford, the Wright Brothers and Bill Gates, to name a few. Walter Meade Russell was surely right when he wrote that we’re all waiting for the “next American upgrade.” The difficulty with new inventions is that we now have so many efficient competitors in Asia and Europe. Even if some young American genius invented, say, an engine that ran on water, there’s no guarantee that it would be made in Detroit.

With the highest long-term unemployment since the Depression, it is now imperative that both parties come up with a plan to restore real growth. Obama hoped to create new industries in the field of alternative energy, but the technology hasn’t appeared yet. The high-tech industry continues to create dazzling new products, but it may also be a “mature” industry in that families can only buy so many new gadgets.

Republicans can greatly help themselves win in 2016 by offering jobs and hope. In the past, wealth has been created through “mining, manufacturing and farming.” Manufacturing has been in decline for years and farming is stable, that leaves the “mining” of energy sources.

Perhaps the best chance for Russell’s “upgrade” would be the development of natural resources, particularly natural gas. And that would be in the Republican Party’s traditions: after abolishing slavery and preserving the Union, Lincoln’s next biggest achievement was opening up the American West, mainly via the transcontinental railroad, which was completed after his death. This “growth plan” turned out to be both good policy (the West provided jobs and wealth) and good politics (the Mountain West and Farm Belt often voted Republican). Western farmers, ranchers, small businessmen and oil and gas workers (outside the South) were usually a good source of votes and contributions to the Republicans.

The guess here is that the “fracking” revolution in the oil and natural gas fields is the Republican Party’s best chance to restore real growth. According to the International Energy Agency, North American energy supplies and production could easily surpass Saudi Arabia as the world’s largest source by 2030. We may be on the edge of what the IEA calls “the Golden Age of Gas.”

But is fracking environmentally safe? Could injecting a mixture of hot water and chemicals into the earth permanently, fatally damage the water supply? Those are the $20 trillion questions.

Since I’m not a scientist, I can’t answer those questions. But if it turns out to be safe, the natural gas revolution could get the nation back on track. Massive exports of oil and gas to Asia and Europe would go a long way toward creating numerous jobs, putting revenue into coffers and reducing our trade deficits. The oil boom of the 19th century coincided with Republican dominance of national elections after the Civil War. Might history repeat itself?

Incidentally, Warren will now have a more direct chance to raise the incomes of ordinary Americans: In November 2012, she was elected to the U.S. Senate from Massachusetts. We should all wish her well in this goal, because with the nation going sideways economically for last four decades, the task is going to be Herculean.



Patrick Reddy is a Democratic political consultant in California. He is the co-author of “California After Arnold” and the author of the forthcoming “21st Century America,” a study of national politics. ]]> Fri, 17 May 2013 10:56:03 -0400 By Patrick Reddy // Special to the News

]]> <![CDATA[ 150 years ago, Nelson Baker answered his country’s call ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130512/OPINION/130519983/1122 Nelson Baker is a name that is universally recognized throughout Western New York. Now that he is called “venerable” by the Catholic Church in recognition of his path to sainthood, knowledge of this holy man has widened. Even before his death in 1936, people had a strong connection with Father Baker. Well-known are the stories of his devotion to orphans, the poor, the homeless and the downtrodden. The institutions that this “apostle of charity” founded are vibrant and integral in service to the community to this very day. His devotion to the Blessed Mother and his determination to honor her with a shrine is known worldwide, as is his service and devotion to others. It is his legacy.

Perhaps less well-known and another example of service attributed to Baker is his patriotism and military service. Prior to his ordination as a priest, Baker enlisted at the age of 21 during the Civil War. He joined the 74th New York Militia Regiment, Company A (part of the New York National Guard) as an infantryman – not as a drummer boy, as some have alleged – most likely in 1862. The regiment had been organized in Buffalo in 1854. In response to the request of U.S. Secretary of War Edwin Stanton to New York Gov. Horatio Seymour for 20,000 new troops, the 74th was called to active duty in June 1863, the third summer of the war.

Confederate States Gen. Robert E. Lee had raised apprehensions in the North by moving his Army of Northern Virginia into Pennsylvania. His target appeared to be Harrisburg, the state capital and a transportation hub. The strategy of Lee’s second invasion of the North was to relieve pressure on Virginia, where most of the fighting had been so far, and in addition to win a significant victory on Northern soil. Such a victory would, Lee hoped, lead to official recognition of the Confederate States by several European nations, and also leave Washington, D.C., open to attack. (Lee’s first invasion of the North at Antietam Creek, Md., was blunted by Union forces, and ended with a Confederate withdrawal to Virginia.) As Lee’s army advanced, Union forces rushed to meet the challenge. The two armies clashed at Gettysburg, Pa., on July 1, 1863, precipitating the largest and bloodiest battle ever on American soil.

Unfortunately, Private Baker kept no diary that we know of until 1866. However, the Official Records of the War of the Rebellion, officer reports from the 74th Regiment and material from the Father Baker Archives provide a clear picture of where he went and what he saw. Departing Buffalo on June 19, the 74th arrived in Harrisburg, Pa., the next afternoon. After being supplied, the troops were deployed to Mount Union, Pa., (some 80 miles from Harrisburg) on June 27, to be placed on picket duty protecting the strategic Pennsylvania Railroad right of way through the mountains, as well as two significant railroad bridges and the locks of the Pennsylvania Canal. It was “all quiet” at Mount Union until July 3. As America’s bloodiest battle raged at Gettysburg to the south, 500 Rebel cavalry from Brig. Gen. John D. Imboden’s brigade appeared at the Mill Creek railroad bridge apparently with intent to destroy it. After reconnoitering, the outnumbered Rebels withdrew without attacking the well-defended bridge. On July 5, as Lee’s army withdrew into Virginia and Maryland, Baker’s regiment joined others in pursuit. Much to the dismay of President Abraham Lincoln, Lee got away again, but official reports show that the 74th exchanged fire with retreating Rebels at Clear Springs, Md., on July 10. No casualties were reported.

The Gettysburg Campaign had ended, but before Baker and his fellow soldiers could return to Buffalo, the 74th and other units were ordered to report “with all haste to New York City.” Serious, destructive and bloody riots had broken out on July 13. The New York Draft Riots had a number of complex social and economic causes that simmered below the surface, but when a new Federal Conscription Act allowed the procuring of substitutes (usually for $300) for those drafted, anger and frustration exploded among working-class New Yorkers, many of whom were ethnic Irish. “Rich man’s war, poor man’s fight” became an epithet. It took days to suppress the disturbances. The death toll and property destruction were shocking. Black New Yorkers seemed to be a particular target of the rioters.

The 74th arrived on July 17 to assist in “mop up” and stabilizing efforts as the riots waned. Without leaving too much to speculation, it is clear that Baker and his comrades were witnesses to the horrors of this incident. This, in addition to a nerve-wracking stint on the periphery of the clash at Gettysburg. Fortunately, the 74th suffered no casualties. According to a regimental history, only one soldier died (of disease) during active duty. The regiment returned to Buffalo on July 24. Yet Baker’s Civil War duty was not over. On Nov. 16, 1863, the 74th was reactivated to protect Buffalo from an impending Confederate invasion. It seems that Stanton had received intelligence that Buffalo was to be destroyed in the attack. The invasion never materialized, however, and Baker’s call to service had ended.

Baker was among many thousands of individuals who answered the call of their nation to serve. It reveals a strength of character and bravery, for no one who serves in the “crucible of war” can predict if he will return. No one who has ever written or spoken of being in war has described it as enjoyable. It does leave an impression. In fact, Baker rarely, if ever, spoke of his military experiences. He was an infantryman in Company A. No doubt he experienced the fear of engagement and boredom of camp life (incidentally, he may have contracted a severe skin disease, erysipelas, from unsanitary camp conditions). It became an element of his life experience.

Patriotism and service to country is one component in the character of the humble Buffalonian of Irish and German descent. Coupled with his intense spiritual devotion and concern for others, this former soldier became known as “The Apostle of Charity.” He may someday be known as Saint Nelson Baker.



Timothy Ellis is a retired history teacher from Hamburg. ]]> Thu, 9 May 2013 14:52:16 -0400 By Timothy Ellis

Special to The News

]]> <![CDATA[ Look before you leap: Society will bear substantial costs if state legalizes marijuana ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130505/OPINION/130509839/1122
Colorado and Washington now have laws that permit adults to openly grow, sell and possess marijuana; no other jurisdictions in the world have implemented this level of tolerance.

The success has come in part by emphasizing potential benefits of marijuana and minimizing likely risks.

Therefore, before New York State jumps on the bandwagon, it is essential that the full picture of risks and benefits is discussed and incorporated into wise policy making.

Three types of arguments have been put forth to support legalizing marijuana: health, economic and legal.First, “marijuana has proven health benefits and is safe.” Typically, stories report on individuals who believe that smoking marijuana has helped their chronic pain or spasms. While important, the experience of isolated cases may not generalize what will happen to others: benefit or risk.

To date, no large-scale and systematic studies have shown major benefits of smoked marijuana. In fact, benefits are often limited by a significant incidence of central nervous system side effects, such as hallucinations and uncoordination. A doctor cannot recommend smoked marijuana based on the strength of medical studies documenting reasonable medical benefit with reasonable side effect risks, as there are no such studies.

Advocates often repeat their belief that marijuana has been available for thousands of years and is known to be safe. In fact, the rest of the story, based on a growing body of scientific literature, proves otherwise. In short-term use, it impairs coordination, impairing driving and other complex tasks. Several studies have shown that it is a significant contributor to automobile accidents, the rate of which has risen in Colorado since the state has promulgated medical marijuana.

With long-term use, marijuana can be physically addicting in some people. One in 10 adults who try it will go on to develop patterns of compulsive use, inability to limit their use and significant negative life events. Potential effects in teens are more troublesome, where the likelihood of dependency increases to one in six. Frequent smoking has been shown to affect rates of psychosis, depression, anxiety, lung function, school and work performance and newborn weight. The statement that marijuana is safer than alcohol or tobacco may be partly true; but circulating via the lungs several hundred chemicals, many of known toxic potential, most of unknown effects, cannot be safe.

Most reports of the benefits of marijuana focus on severe debilitating conditions such as end-stage cancer or unremitting pain and hope to focus our compassion so that we will make this “magic medicine” marijuana particularly accessible to those who have no other treatment hope. In such cases, even modest benefit would seem to outweigh nearly all risks. In fact, in areas that have reported their experience, the vast majority of people who are authorized to possess medical marijuana do not have these types of conditions. In fact, in states that approve medical marijuana, folks believe that marijuana has improved almost everything from ADHD to insomnia, leaving the risk-benefit balance unclear. Thus it seems apparent that proposing to use marijuana as a medicine opens the door to nearly any problem, making nearly everyone eligible.

More importantly, underreporting of risk will likely contribute to use by people who have no health problems. It has been shown that perceived risk is an important contributor to the decision to use; if the risk is minimal, why not? While firm data are not yet available from medical marijuana areas, it seems reasonable that more people will use marijuana and be exposed to its associated risks.

Recently, The Buffalo News reported that the director of a national marijuana advocacy group is promoting that marijuana should be regulated like other herbs, which are only superficially monitored. However, no other herb has such known health risks. This proposal highlights the advocates’ goal of providing the least possible restrictions on marijuana regulation. No doubt commercialization of distribution of marijuana will magnify that trend.The second group of justifications often raised in support of expanded marijuana use is that it will improve the economy through new jobs and taxes. The RAND research group raised a number of critical economic questions undermining the credibility of these assertions. For example, how expensive will it be to create the required extensive regulatory structure needed to support new tax collectors, safety monitoring and health side effects? Many of the new jobs will be relatively low paying and unskilled and therefore not likely to add much to our economic progress. While long-term economic projections for marijuana are difficult, it is well-established that the revenues generated to governments from the sale of alcohol and tobacco do not support the billions of additional costs to society that result from the sale of these substances.

It is also said that by removing the profits of illegal marijuana sales and distribution, the costs of enforcement against drug cartels and police interdiction will go down. These benefits may not be substantial either, since it is estimated that only a small percentage of the profits to the cartels comes from marijuana. If they dropped out of the marijuana business completely, it seems likely they would find other ways to maintain their bottom line. Also, it is possible that expanded marijuana use will also expand other legal problems that police will need to deal with, such as an increase in driving under the influence of drugs. Thus, for marijuana, it seems reasonable to expect that while some entrepreneurs may end up making large profits, the costs to the rest of society will be substantial.A third set of justifications related to the impact of implementing current marijuana laws relates to civil rights and the criminal justice system. Advocacy groups often report on large numbers of people convicted and incarcerated for simply possessing marijuana, again oversimplifying a complex problem.

For example, in New York State, an individual who possesses moderate amounts of marijuana for personal use in a civil violation is subject to fines, but not incarceration. Those who are in jail for marijuana-related crimes are there either for sales or other crimes, but not the simple possession of marijuana. Unique to our state, high rates of “stop and frisk,” especially in New York City, appear to impact minorities disproportionately. This is an area of concern and should be subjected to further legal review. Having a punishment that is appropriate to the crime should remain a cornerstone.

Advocates say widespread use of marijuana in contradiction to laws undermines public support for the legal system. But the vast majority of people do not smoke marijuana. By overstating prevalence of use, they are supporting teen misinformation; “everyone does it, so why can’t I?”

Advocates also state that the choice to use marijuana, like other individual decisions, should be purely personal, not subject to governmental restraints. Most of us would agree that government should interfere with personal behavior only by exception. However, when such individual behavior affects us all, such as driving while under the influence, as a society we have a right to attempt to modify individual behavior. Further, we are all affected by unnecessary health care costs of marijuana abuse.

It is also stated that making marijuana illegal has not reduced levels of marijuana use. “Prohibition of alcohol failed, and so it has with pot.” In fact, alcohol prohibition did reduce alcohol abuse and health consequences of drinking, such as cirrhosis. It was repealed, however, due to lack of strong public support and impact on other criminal activity.

Since it is well-documented that availability, societal attitudes and perceived levels of risk of abusable substances predict levels of use, it seems likely that the efforts of marijuana advocates will increase use of marijuana. An extensive body of studies has shown that the number of people who use mood-altering substances is closely related to the interaction of several identifiable individual and social factors. These include price, availability, perceived risk and the generally held public view of the substance. Current proposals – potentially decreasing the price, making marijuana more readily available and enhancing societal acceptance of it – reduce the protective factors. These effects are especially important for vulnerable populations: teens and those with mental health issues and/or behavioral problems.

Admittedly, our current societal response to marijuana oversight is not optimal either. The past 10 years of rising rates of marijuana use have undermined the prior 20 years of major decline of use. The strong emphasis and expense of supply reduction has not been sufficiently successful. However, radically changing laws, regulations and how they are implemented is not the right direction.

Have we forgotten the advice that parents and others have given us? Just because everyone else does it, doesn’t mean it is a good idea for us. However, knowledge gained from prior experience does provide a path to improvement. For example:

• Expand a public health campaign to accurately inform, in culturally and age-appropriate ways, the risks of marijuana use and abuse.

• Expand relevant research to identify likely benefits of chemical components of marijuana, resulting in products of known safety, dosage, routes of delivery and side effects.

• Expand the use of appropriate interventions, coordinated with legal sanctions, for those with impairment related to sustained marijuana use, such as via drug courts.

• Re-evaluate the role and scope of demand reduction efforts to make them more effective and less intrusive.



Robert Whitney, M.D., is the former medical director for the Addictions Unit at Erie County Medical Center. He has been a board member for the Erie County Council for the Prevention of Alcohol and Substance Abuse since 2005 and the public policy committee chairman for several years. ]]> Thu, 2 May 2013 14:39:44 -0400 By Robert Whitney, M.D.

Special to The News

]]> <![CDATA[ New York’s small businesses and workers will benefit fom Affordable Care Act ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130428/OPINION/130429413/1122
But because of the Affordable Care Act, New York’s small businesses and their employees are getting better choices, starting with new protections that limit the outrageous rate hikes many small business owners faced in the past.

Insurance companies must now publicly justify every rate increase of 10 percent or more, which has led to a sharp decline in double-digit rate hikes. Starting in 2014, insurers will have to justify every proposed rate increase, even if it’s a 1 percent bump.

Additional rules require insurers to spend at least 80 percent of small employer premium dollars on employees’ actual health benefits, instead of the insurer’s own administrative costs. These limits have already resulted in more than $1 billion being returned to small business owners and other consumers.

The law has also begun to slow rising costs across the system by reducing waste and fraud and promoting higher quality care that emphasizes coordination and prevention. These changes in care delivery have contributed to the slowest sustained national health spending growth in 50 years.

Small businesses are the backbone of New York’s economy. Across the state, nearly 349,000 businesses employ 25 or fewer workers. They are also seeing savings thanks to new tax credits available to help them cover their employees. Many of them have already received a tax credit of up to 35 percent of their health insurance costs. And beginning in 2014, this tax credit will go up to 50 percent.

And, in an economy where small businesses create two-thirds of jobs, owners and employees deserve a health insurance market with fairer prices, better choices and greater certainty. Thanks to the Affordable Care Act, that market is on its way.

Beginning in 2014, New York small business owners will have access to a new Health Insurance Marketplace – the New York Benefit Health Exchange, which opens for enrollment on Oct. 1 – that will allow them to make side-by-side comparisons to find a plan that fits their budget and that’s right for their businesses and employees. Each Marketplace will operate a Small Business Health Options Program, or SHOP, focused just on small businesses.

And while many small business owners have questions about the employer responsibility provision, it is important to note that businesses with fewer than 50 employees – that’s 96 percent of small businesses – are not required to purchase insurance. Of the remaining 4 percent of small businesses with more than 50 employees, most already provide insurance. So the number of businesses that will have to begin offering employee health insurance or pay a penalty is very small.

No business owner wants to drop coverage for his employees. For many, the employees are like a family. For others, offering health insurance is critical to attracting the kind of workers they need to succeed.

By making the health insurance market work better for New York small businesses, the law is letting them focus on what they do best: delivering great products and services, creating jobs and growing our economy.

For more information, visit www.sba.gov/healthcare or healthcare.gov or contact your local SBA or Health and Human Services office.



Jaime R. Torres, M.D., is regional director of U.S. Health and Human Services. Bernard Paprocki is acting regional administrator of the U.S. Small Business Administration. ]]> Thu, 25 Apr 2013 17:06:04 -0400 By Jaime R. Torres, M.D., and Bernard Paprocki

Special to The News

]]> <![CDATA[ Women’s Equality Agenda allows doctors to be doctors ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130428/OPINION/130429414/1122
In the coming weeks, the New York State Legislature will consider Gov. Andrew M. Cuomo’s Women’s Equality Agenda, a ground-breaking piece of legislation that will address many serious issues from achieving pay equity, to eradicating workplace sexual harassment, to ensuring safety for victims of domestic violence. It also contains a critical provision to protect reproductive health decisions, which has everything to do with how I care for my patients, and how I address emergencies.

Most everyone has heard of Roe v. Wade, the 1973 Supreme Court decision that legalized abortion. New York was a national leader, providing women with safe, legal abortions three years before Roe. However, we haven’t updated our state laws regarding abortion in 40 years, and we lack a provision that allows later abortion in order to save a woman’s health.

The Women’s Equality Agenda will align our law with federal law and current medical practice, ensuring that a woman’s health is front and center in every decision that a health care professional makes. Additionally, the agenda clarifies and affirms that New York already regulates health care providers and sets up-to-date standards for what medical professionals can and cannot do in our state.

Federal law says I can perform a later abortion to save a woman’s health; New York law does not. This leads to confusion. Confusion that could have had disastrous consequences for my patients, like one I saw just this month whom I’ll call Janet.

Janet came to me with a wanted pregnancy in the 23rd week, but her health was rapidly declining due to complications. Nothing was going well and, in consultation with me, Janet and her husband decided to make the heartbreaking decision to end the pregnancy to save her health. Before this could happen, however, her condition worsened dramatically. I needed to make a medical decision and I needed to make it fast. Janet was so sick that she might not have survived a cesarean. Abortion was our only safe option.

I performed the abortion, and within hours, Janet’s condition completely turned around and she was soon back in good health. I understood federal protections allowed me to move forward with that medical directive. A less-seasoned physician may not have known this – jeopardizing a patient’s health and well-being because of fear of criminal prosecution.

Let me ask you this: If someone you loved were in my operating room, would you want me to wait and consult with a hospital lawyer about the nuances of state and federal law before providing desperately needed care? Would you want me to be guided by fear of prosecution or by experience and medical judgment along with public health laws?

This should matter not only to medical professionals, but to all New Yorkers. It is my sincere hope that no family needs to face a life- or health-threatening situation. But if people do, I want their doctor to be able to do everything possible for that family and that patient.

The Women’s Equality Agenda does many things to improve women’s lives, from safer workplaces to better pay, but it also lets doctors be doctors. It allows us to save lives, protect women’s health and support families.



Anne Davis, M.D., M.P.H., is an associate professor of clinical obstetrics and gynecology at Columbia University Medical Center in New York City and director of the Kenneth Ryan Family Planning Fellowship. She served on the board of Physicians for Reproductive Health from 2002 to 2008 and is now its consulting medical director. ]]> Thu, 25 Apr 2013 17:06:01 -0400 By Anne Davis, M.D.

Special to The News

]]> <![CDATA[ Americans must remain vigilant; Community, family members who witness extremist behavior have a duty to alert authorities ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130428/OPINION/130429415/1122 WASHINGTON – Three years ago, al-Qaida’s magazine, Inspire, published an article titled, “Make a bomb in the kitchen of your Mom.” The article explained how to build a pressure cooker device like the ones that blew up at the Boston Marathon. But the recipe left out the most important ingredient. To make a bomb in your mom’s kitchen, the first thing you need is an inattentive mom.

That’s what Tamerlan and Dzhokhar Tsarnaev had. We don’t yet know where or when they made the bombs they’re accused of planting at the marathon. But we do know that their father, Anzor Tsarnaev, and their mother, Zubeidat Tsarnaeva, had plenty of warnings that Tamerlan was becoming dangerous. Tamerlan was a human pressure cooker loaded with zeal, violence and destructive ideology. His parents, blinded by adoration and excuses, refused to see it.

Most people who met or knew Tamerlan, including family members, say he was a jerk. His dad, however, insists Tamerlan was “kind” and “very nice.”

Anzor “lost control over that family quite a time ago,” says his brother Ruslan Tsarni.

In every interview, Anzor claims to know exactly what his kids have been up to, though he hasn’t seen them since he moved back to Dagestan a year ago. He also claims, falsely, that Tamerlan “was never out of my sight” during the young man’s visit to Dagestan last year.

According to Anzor, Tamerlan was such a boxing stud that “in the U.S. everyone knows he is a celebrity.” When Anzor left Boston, he asked Tamerlan to keep an eye on Dzhokhar. He thinks the elder brother has been keeping the younger one away from bad influences.

Tamerlan’s mother is just as deluded. She swears Tamerlan and Dzhokhar couldn’t be involved in a bomb plot because “my sons would never keep a secret.” Instead of correcting Tamerlan’s conspiracy theories, she swallowed them.

According to one of her spa clients, Zubeidat recently called the 9/11 attacks a U.S. plot to stoke hatred of Muslims. “My son knows all about it,” she allegedly told the client. Zubeidat also says the FBI has been watching her family constantly for years, which the FBI denies. Last year, she was arrested, but apparently never prosecuted, for shoplifting $1,600 worth of clothes.

Anzor and Zubeidat were given several warnings that Tamerlan was headed for trouble. Sometime between 2007 and 2009, Tamerlan and Zubeidat turned to religion. Zubeidat became observant, but Tamerlan became intolerant and hostile. He pushed his strict views on the rest of the family, causing tensions. When his sister married a non-Muslim, Tamerlan didn’t accept the man.

Tamerlan’s uncle perceived a change in his nephew’s personality. Tsarni says a family friend told him in 2009 that a Muslim convert had “brainwashed” Tamerlan.

The tension exploded when Tamerlan, in a conversation during that period, called Tsarni an “infidel.” Tamerlan also challenged another uncle, Alvi Tsarni, to a fight. No one in the family has explained what words ensued between the parents and the uncles, but both uncles cut off contact with the Tsarnaevs. Ruslan Tsarni says his beef was with “the way they were bringing the children up.”

Anzor, unchastened even by the marathon bombings, says the uncles don’t really know his kids. “They are just blabbing what they know nothing about,” he told the New York Times.

Around that time, Tamerlan was arrested and charged with domestic violence for hitting his girlfriend. “Yes, I slapped her,” he told police. The case was eventually dismissed, and Anzor brushed it off. “He hit her lightly,” Anzor told the Times. “There was jealousy … In America you can’t touch a woman.”

In early 2011, two FBI agents, provoked by an alert from Russian intelligence, came to the Tsarnaevs’ apartment to speak to the family about Tamerlan. Zubeidat says the agents explained that Tamerlan was visiting “extremist sites” and that “they were afraid of him.” She says Tamerlan answered the agents defiantly, “I am in a country that gives me the right to read whatever I want and watch whatever I want.”

Anzor shrugged off the warning: “I knew what he was doing, where he was going. I raised my children right.” Zubeidat says the agents investigated Tamerlan only because “he loved Islam.”

So the warnings passed. When the marathon bombs exploded, and videos implicated Tamerlan and Dzhokhar, the uncles acknowledged the evidence, but the parents didn’t. They didn’t just stammer, as many parents would, that their sons couldn’t have done it. They declared that the young men had been “set up,” and they hurled conspiracy theories at the authorities.

“The police are to blame,” said Anzor. “Being cowards, they shot the boy dead. There are cops like this.” He denounced the pursuit of his sons by law enforcement as “a provocation of the special services who went after them because my sons are Muslims and don’t have anyone in America to protect them.”

Zubeidat said the authorities “wanted to eliminate [Tamerlan] as a threat because he was in love with Islam.”

Anzor’s sister, Maret Tsarnaeva, echoed these self-deceptions. “Growing up, within the family, everything was perfect,” she told reporters. Her nephews had no motive to bomb anyone, she insisted: “For what beliefs? I don’t know them to have any strong beliefs.” She concluded that “our boys were framed.” When reporters showed her video evidence implicating them, she replied: “The picture was staged.”

Neighbors and congregants at Tamerlan’s mosque had warnings, too. In November 2012, he angrily rebuked a merchant in Cambridge for advertising Thanksgiving turkeys, which Tamerlan viewed as an affront to Islamic law. At Friday prayers, he disrupted and criticized a sermon that defended the celebration of Thanksgiving and July 4.

Two months later, he interrupted an imam who suggested that Martin Luther King Jr., like the Prophet Mohammed, was worthy of emulation. Tamerlan protested that King was “not a Muslim,” and he called the imam a “Kafir,” or non-believer. Some of the congregants threatened to expel Tamerlan, but apparently, none of them reported him to the authorities, since, as far as they knew, he hadn’t preached or committed any violence.

You can’t expect witnesses to report every fanatical outburst to the FBI. But when family members are repeatedly exposed to signs that a loved one is drifting into the vortex of violent extremism, they have a duty to intervene, or at least to alert someone. If they don’t, and the fanatic becomes a killer, they bear an awful responsibility. If they deny that responsibility by accusing the police and the government of anti-Islamic conspiracies, they forfeit our sympathy, our respect and our trust.

Police your family. Police your congregation. Police your community. If you don’t, the rest of us will do it for you.



William Saletan covers science, technology and politics for Slate. ]]> Thu, 25 Apr 2013 17:05:57 -0400 By William Saletan

Slate

]]> <![CDATA[ Earth is at risk: Unless we change our ways, future generations will inherit a hostile planet ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130421/OPINION/130429976/1122 Earthrise is one of the best-known photographs of the 20th century. It was taken by Apollo 8 astronauts on Christmas Eve, 1968. It shows the incredible beauty of the Earth. At the same time, it hints at the planet’s fragility and smallness in the emptiness of space. Earth has provided us with everything we have. However, the Earth, and we as its inhabitants, are paying a steep price because of what we have done to it and what is likely to happen.

The first Earth Day was celebrated on April 22, 1970. That same year, Congress established the Environmental Protection Agency and passed the Clean Air Act. The EPA’s mission is “to protect human health and the environment.” The act required the EPA to identify the most dangerous and common air pollutants and establish air quality standards for each. These are known as National Ambient Air Quality Standards or NAAQS. They are designed to protect everyone. They emphasize those who are the most vulnerable to these pollutants, such as asthmatics, children and the elderly.

There are six of these criteria pollutants: lead, oxides of nitrogen, carbon monoxide, oxides of sulfur, ground-level ozone and particulate matter. The smallest particulates are the deadliest. They measure 2.5 millionths of a meter in diameter or less and are known as PM2.5. Typical hairs measure about 70 millionths of a meter in diameter. Ozone is formed from oxides of nitrogen in chemical reactions powered by sunlight, so emission data can’t be compiled.

Counties where there is a persistent failure to meet NAAQS standards are known as non-attainment areas. In 2012, Erie, Niagara, Orleans and Genesee counties failed to meet standards for one pollutant. Chautauqua County failed to meet two. Across the nation, 158 million Americans live in non-attainment areas.

The EPA monitors the amount of carbon monoxide, oxides of sulfur, ground-level ozone and PM2.5 at more than 1,000 sites. These data become the Air Quality Index. This index can be found at the EPA website known as Enviroflash, apps for smartphones and the Buffalo News weather forecast. The index ranges between 0 and 500, and is a predictor of how likely your air will cause a health problem, such as an asthma attack, in the relatively near future. An index of 50 or less indicates good air. Anything above 300 warns of an immediate serious health hazard. However, there is no completely safe level for any of these pollutants.

Numerous studies published by leading scientists, doctors and epidemiologists in top-tier medical journals have provided unequivocal evidence linking criteria pollutants to the top four causes of death in the United States. These are, in order, heart disease, cancers of all types, diseases of the lungs and respiratory system, and stroke.

The newest data from the Centers for Disease Control and Prevention attributed almost 1.5 million deaths to these diseases in 2008. Many of these deaths and associated serious and minor illnesses can be prevented by making our air cleaner and safer to breathe.Investigators in Taiwan and Korea have linked small particles, carbon monoxide, oxides of nitrogen and oxides of sulfur with an increased risk for stroke. These studies were reinforced by results from the Women’s Health Initiative, which included research done at the University at Buffalo. They found a significant link between increases in small particles and heart attacks, strokes and the need for coronary artery bypass surgery.

Other studies using the Medicare database showed links between PM2.5 concentrations and hospitalization rates for heart failure, abnormal heart rhythms and cardiovascular disease. More recently, transient increases in the concentration of small particles that do not exceed the EPA criteria increase the risk of a stroke by about 10 percent. The list of other studies is very long.

As health care research has advanced, air pollution has been tied increasingly to the severity of disease, the numbers of patients affected and the number of diseases involved. Preliminary studies suggest that air pollution may increase the risk for developing Alzheimer’s disease and Type II diabetes.But there is good news amidst the bad. The Clean Air Act Acid Rain Program has led to dramatic reductions in the emissions of oxides of sulfur and nitrogen. As a result, we have healthier air to breathe, and lakes in New York and elsewhere are coming back to life. Small particle concentrations have fallen.

Buffalo is a big winner in this regard. In a study of 51 metropolitan areas between the years 1978 and 1982, the Erie County life expectancy was 73.5 years when the average PM2.5 concentration was 26.5 micrograms per cubic meter of air. By 1999 and 2000, life expectancy had risen by 3.4 years. A good deal of that increase was due to a reduction in the PM2.5 concentration of just over 50 percent.

An EPA report to Congress predicts that by 2020, the Clean Air Act will prevent 230,000 premature deaths and result in about 2.4 million fewer asthma attacks, 17 million fewer lost days at work, 200,000 fewer heart attacks and many other health benefits. Associated health care savings are expected to be around $2 trillion per year, at a cost to industry of around $65 billion – a 30 to 1 return. This is a win-win-win situation. Americans enjoy better health, we curb health care costs and reduced federal and state expenses provide debt relief.There is a dark cloud on the horizon – global warming. As a result of expanding economies and the need for more energy, we inject trillions of tons of carbon dioxide into the air each year. From measurements of concentrations in air bubbles trapped in ancient ice, we know that atmospheric carbon dioxide levels are higher now than at any other time in the past 435,000 years. The concentration of other global warming gases such as methane and nitrous oxide are also rising.

Four independent studies conclude that current global temperatures have risen by about 1.4 degrees Fahrenheit compared to a 1950 to 1970 baseline. Multiple lines of evidence show that the rise in carbon dioxide and increasing temperatures are the result of human activity – mainly, burning fossil fuels such as coal, oil and natural gas.

We can see the health consequences of global warming in the form of heat-related deaths and illnesses, worsening epidemics of diseases such as West Nile encephalitis and dengue, or break-bone fever, malaria and others. Severe weather events, such as droughts and superstorm Sandy, are becoming more frequent, causing deaths, injuries and refugees. Rising ocean waters are likely to displace 8 million people by 2050 as low-lying deltas flood.

According to the World Bank, last summer’s droughts caused a 10 percent increase in world food prices in July 2012 alone. This will worsen childhood malnutrition that already nears 50 percent in many Third World nations, according to another World Bank report. Climate scientists tell us that unless we curtail greenhouse gas emissions very soon, global temperatures will reach what they call the tipping point – the point of no return.The EPA has classified carbon dioxide as a pollutant and is taking steps to curtail its emissions. Courts have upheld these actions, declaring that “the agency was unambiguously correct” and “this is how science works.”

A recent report by Stanford University and Cornell University professors shows how New York can lead the way in combating climate change by using wind, water and solar energy to supply all of the energy used for virtually all purposes by 2030. Installing about 16,000 wind turbines, rooftop solar cells on homes, governmental and commercial buildings, and taking better advantage of geothermal, hydroelectric and tide energy could meet the demand. Energy efficiency would increase.

And once generators are in place, fuel prices would drop to zero along with the emission of the worst pollutants. Most of New York’s energy jobs are out-of-state, so their plan creates more in-state jobs than would be lost. They estimate that pollution reductions would save New Yorkers about 4,000 lives per year and $33 billion in morbidity-mortality costs.

In medical school, we grew bacteria in petri dishes. When there were only a few, they grew rapidly in the seemingly inexhaustible food supply. With time, food was depleted and metabolic wastes halted their growth. They died. We humans on Earth are a bit like the bacteria – the resources of the Earth once seemed infinite, but they are not. The Earthrise photograph puts this in perspective, and Earth Day should remind us of Earth’s bounty and peril. Our activities have placed us and our planet at risk. Unless we change our ways, our children and grandchildren will inherit a very different and much more hostile planet.

As a neurologist, I know how magnificent our brains are and what they can do. The question is whether we have the wisdom that matches our potential.



Alan H. Lockwood, M.D., F.A.A.N., is emeritus professor of neurology and nuclear medicine at the University at Buffalo and director and co-chairman of the Environment and Health Committee for Physicians for Social Responsibility. ]]> Thu, 18 Apr 2013 17:32:04 -0400 By Alan Lockwood, M.D.

Special to The News

]]> <![CDATA[ South Koreans don’t bat an eye in response to threats ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130421/OPINION/130429977/1122
Eating toast, eggs and oatmeal, winking away at our coffee, my wife and I listened to the news as calmly as if we were back home in Olean. For almost two years, we’ve been working as public school teachers in Asan, a 40-minute high-speed train ride from Seoul, which North Korean dictator Kim Jong Un has said he intends to ignite into a “sea of fire.”

One would be hard-pressed to have called us foolhardy that morning, though. You would have a better case calling it group-think.

None of my co-workers was buzzing about anything – despite the newspapers with pictures of the B-2 stacked in the teachers’ room. We had the same reaction when Kim Jong Il died last year. People at home talked about his passing more than anyone in the hermit country did. Some teachers mentioned it during lunch. My colleague’s firefighter husband told her they were on higher alert. That was it.

Does this seem odd to you? A Communist dictator claims he’s going to incinerate the capital of America’s “puppet state,” and no one bats an eye.

I often drink coffee and watch the kids play during my lunch break. It’s not uncommon to hear a thudding in the air. I look up from their soccer game to see a two-pronged military chopper flying around. It makes me think of home. I used to look up and see Mercy Flight helicopters whirring over my house. Not exactly the same. I look back down – the kids don’t even notice. They’re usually chasing their soccer ball after it bounces off the goal post.

We chat on Skype with my mother on Sunday evenings. No matter what I say, she always tells me how good it will be to have us safe on U.S. soil again.

“We’re fine,” I tell her. “Nobody’s worried here. It’s business as usual.”

Is that what they thought in 1950? In the beginning of the Korean War, North Korean troops stormed through South Korean territory in a veritable blitzkrieg. They captured Seoul in three days, and weren’t stopped until Busan, the very southern end of the peninsula.

Later in the summer, reinforced American, U.N. and South Korean troops began sprinting north as resistance crumbled. When they neared the border with China, Chinese forces intervened and pushed them back down. At the end of the Forgotten War, the border was reinstated where it had been to begin with. Since then, the two Korean brothers have lived at a stand-off. Sort of.

In 1976, U.S. and South Korean soldiers attempted to cut down a tree obstructing strategic vision in the Demilitarized Zone. In rebuttal, North Korean soldiers attacked with axes. In less than four minutes, two U.S. soldiers were killed and eight others (four U.S., four South Korean) were wounded. North Korean infiltration tunnels have been found as recently as 1990. Although the Armistice was signed in 1953, it’s claimed the tunnels weren’t started until 1972. This is not so very long ago.

And yet, maybe the most tragic part about the Korean War is that despite its brutality, people don’t even remember it’s still technically going on.

I met a man in an Olean bank before we expatriated. He asked if we were going to North Korea. Another person did not even realize there was more than one Korea. The Forgotten War. There are still people breathing who fought it.

The next generation of South Koreans doesn’t seem much better. Known as one of the most wired countries in the world, I have seen its kindergarten children sending text messages on smartphones before class begins. They whine and scream when they can’t play Angry Birds. Buses and subways are filled with the digital glow of smartphones, never more than inches from their owners’ faces. Just past the DMZ, people are starving.

What a different land these children will grow up in than the Korea of their parents and grandparents, whose country was so ravaged by war that a current staple soup, called budae jjigae, was born out of scraps from U.S. soldiers. Street corners abound with private academies for piano, English and dance lessons. Cosmetics stores fill in the gaps, mingled with McDonald’s, KT cellphone stores and the designer handbags to put it all in.

Look at it this way: the two most prevalent Korean figures in international headlines this year have been Psy and Kim Jong Un. These are the two Koreas: one is a warmonger, and the other can’t hear over the horse-dance clatter.



Western New York native John Loyd is a former reporter for the Olean Times Herald, now living in South Korea. He was a contributor for the book “Minutes to Midnight.” ]]> Thu, 18 Apr 2013 17:31:56 -0400 By John Loyd

Special to The News

]]> <![CDATA[ Focus on commonalities to improve schools, hospitals ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130407/OPINION/130409631/1122
Since 2000, hospital bills have increased at an annual average rate of 10 percent. Surveys show most Americans think that health care costs seriously threaten the economy. Issues of access and quality complicate the picture. Health care is gobbling up 20 percent of the Gross Domestic Product.

Meanwhile, funding cutbacks are distressing K-12 schools. More than half the states are spending less per student this year compared to last. As thousands of teachers are laid off, school boards and superintendents are reverting to bare-bones core academic programs and nervously depleting fund balances.

Schools and hospitals have many similarities. These include for-profit and nonprofit types, boards of directors and CEOs, differentiated patient or pupil treatments, stringent confidentiality of records, specialized and licensed staff, extensive professional development, substantial physical plants and technology, and diverse business functions. Schools and hospitals are communities as well as bureaucracies.

Hospitals depend on individual plans for each patient. They keep detailed records regarding what intervention has been tried, which ones have succeeded or failed and for what length of time. They must measure change carefully because lives depend on it. At least for the non-disabled students, schools are less conscientious about individual plans for children.

Schools should take the cue from hospitals and strive toward complete, flexible plans for all students. Thereby, interventions can be applied consistently and for the right length of time. Special education has helped schools build bridges between themselves and the medical world. Like medical professionals, school staffs have adopted the use of response to intervention (RTI). Teachers vary the time, frequency and duration of an intervention to meet individual needs, assess and compare data regarding its effects and then, if necessary, utilize an alternative intervention. RTI gets at problems before the child fails dismally and has to be remediated. Educators should expand and refine this model, along with other medical inspirations like brain-based learning, doing group rounds, inquiry-based learning, action research, scientifically valid practices (a federal Race to the Top priority), referrals and preventive counseling.

Teachers hope to be publicly respected like doctors. This will not happen unless school boards empower teachers to exercise more discretion to generate students’ individual plans. Joint accountability for results would be a must, but teachers and children would benefit from more responsive and tailored support.

Teachers and doctors alike are grappling with an explosion of Internet-based information and new technology. Educators are encouraged to coach or guide students to self-directed learning, while doctors and other medical staff are exploring telemedicine, and rehabilitation in home settings. The key is to use technology more creatively, not as a convenient substitute for the status quo.

A warning: as technology redefines relationships, shoddy education or physical damage can occur as individuals self-diagnose or take intellectual shortcuts over the Internet. Technology must reinforce rather than substitute for licensed professional expertise, solid thinking and good judgment.

The intersection of medicine and education could be called health. Public schools struggle to combine core academic subjects with learning about mental, emotional and physical health. By the same token, hospitals and doctors are challenged to reach out to their surrounding communities in ways that could definitely strengthen health services. By promoting healthy communities, schools and hospitals could better serve the public at lower cost.

For many years, I have served on the board of a nonprofit network called the Healthy Community Alliance in rural Western New York. Largely state grant-funded with six full-time employees, the network provides or coordinates programs that address chronic disease awareness and prevention, youth mental health, parent education and management, including physical activity and nutrition.

The alliance takes advantage of emerging health and lifestyle priorities for both young and older populations. It maintains an impressive list of partnerships and affiliations, but relationships with both hospitals and school districts are hampered by apathy or uneasiness because “silo thinking” lingers. School and hospital executives should prioritize alliances with regional health networks to close community service gaps more efficiently and cost effectively.

Funding is a minefield for both schools and hospitals. However, public schools operate in a comparatively controlled fiscal environment. Elected school boards, annual public budget or tax rate referenda, property tax caps and mandated reporting requirements keep schools more accountable to their constituencies than most hospitals are accountable to theirs.

Hospital charges depend on a confusing combination of costs derived from different sources. Hospitals do not publicize standardized fees for specific services. Usually patients are not in any position to make informed choices.

In a recent Time magazine special report, Stephen Brill urges significantly lowering the eligibility age for Medicare to 40 so that insurance limits can be extended on certain expensive tests, drugs and services. Medicare controls costs by reimbursement based on certain standards for treatment. The standards are published, specific, measurable and reasonably scientific. Connecting performance standards to cost reimbursements seems to hold promise not just for medicine, but as well for schools where politics often override educational performance. Medicare may have big flaws, but it also saves big money.

Everyone wants measurable results to assure performance quality and bang for the buck. School and hospital leaders should make time to discuss their commonalities. By climbing out of their boxes, these two institutions could reconnect cost with quality and multiply productivity.



Jeffrey M. Bowen, of Delevan, has served as superintendent of the Yorkshire Pioneer Central School District, research director for the New York State School Boards Association and supervisor of on-the-job training in an Air Force hospital. He is a founding member and vice president of the Healthy Community Alliance in Gowanda. ]]> Thu, 4 Apr 2013 16:17:44 -0400 By Jeffrey M. Bowen

Special to The News

]]> <![CDATA[ Mental illness is common thread in mass shootings ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130407/OPINION/130409632/1122 WASHINGTON – In recent days, investigators in Arizona and Connecticut have released thousands of pages of documents about the Tucson and Sandy Hook massacres. The documents, coupled with investigative leaks and with testimony about the movie theater shooting in Aurora, Colo., paint a clearer picture of what caused these tragedies. It isn’t just high-capacity magazines or defenseless victims. It’s a failure to link firearms access to mental health information.

On Sept. 29, 2010, Pima Community College told the parents of a troubled student, Jared Loughner, that he was being suspended for a raving video he had made. College officials stipulated that before returning to campus, he would have to “obtain a mental health clearance indicating [that], in the opinion of a mental health professional, his presence at the college does not present a danger to himself or others.”

The officials advised Loughner’s parents, with whom he was living, to remove any firearms he might use. So Loughner’s dad took away the shotgun his son had bought from a local store in 2008. As compensation, the father gave his son money to cover part of what the gun had cost.

What did Loughner do with the money? He went back to the same store and bought a Glock pistol. The clerks at the store had no idea anything crucial about Loughner had changed. They made him sign the same form (ATF Form 4473) and go through the same background check, with the same result: He passed. After the shooting, they handed over his forms to the police, proudly explaining their strict protocol for verifying each customer’s identity. Mental fitness wasn’t part of the protocol.

On Dec. 6, a week after the Glock purchase and a month before the shooting, Loughner put two spent cartridge casings from the gun in an envelope, with a note describing them as proof that he had “planned my assassination.” Police later found the envelope, along with “The Anarchist Cookbook,” in a safe in his room. Apparently, his parents hadn’t looked inside it.

Three weeks before the shooting, Loughner showed the Glock to a friend. It had an extended clip full of rounds. The friend later told police that Loughner had failed to give a satisfactory answer to his question: “Why the hell do you have this?” Noting that Loughner had “crazy thoughts” about the government, the friend assured investigators that when Loughner showed up with the gun, “I kicked him out of my house.” Fat lot of good that did.

Three hours before the shooting, Loughner tried to buy ammunition at a Walmart. The clerk, uneasy about Loughner’s agitation, told him the ammo wasn’t in stock. The press called the clerk a hero: “Tucson ammo seller lied to make Loughner go away.” So what did Loughner do? He went to the next Walmart and bought the same ammo 23 minutes later. Warnings don’t get passed, even between Walmarts.

A year after the Tucson shooting, James Holmes, a neuroscience student at the University of Colorado, began to unravel. Lynne Fenton, a psychiatrist at the university, has testified that she met with Holmes on June 11, 2012, and subsequently contacted a campus police officer in part “to communicate my concerns” about him. Reports from Denver, citing sources close to the investigation, say that Fenton requested a criminal background check on Holmes and contacted colleagues on the university’s behavioral evaluation and threat assessment team because Holmes was fantasizing about killing “a lot of people.”

What did Fenton and her colleagues do about this menace? Nothing, apparently. Holmes was already in the process of leaving the school. He had dropped out of the neuroscience program on June 10. By June 12, he no longer had access to campus facilities that required security clearance. He wasn’t the university’s problem anymore. So Fenton and the threat assessment team dropped the case. University officials never reported it to police in Aurora, where Holmes lived.

Over the next month, Holmes bought an arsenal of weapons and military gear from merchants who knew nothing about his condition. The Bureau of Alcohol, Tobacco and Firearms lists eight local and online purchases from June 13 to July 14, providing Holmes with a Glock, several 30-round magazines, a 100-round drum magazine, two laser sights, body armor and chemicals for making bombs. He eventually stockpiled four guns and more than 6,000 rounds of ammunition, which he used on July 20 to kill 12 people and injure 58 more.

Adam Lanza’s atrocity came five months later, but the warning signs began years earlier. A New York Times article found by police at his home describes a shooting spree at Northern Illinois University that killed five people and injured more than 20 others. The date on the article, Feb. 18, 2008, doesn’t quite match the Times’ online archive, which probably means Lanza clipped it from the print edition.

The Hartford Courant says Lanza also kept articles about the 2011 mass shooting in Norway. The New York Daily News, citing a Connecticut State Police colonel, says Lanza had a “spreadsheet 7 feet long and 4 feet wide” that compared body counts and weaponry from so many mass killings “it had to have taken years” to compile. (Last month, prosecutors called the Daily News story a “disclosure” and didn’t dispute it.) Police records also mention the discovery of three photos at Lanza’s home depicting “a deceased human covered with … what appears to be blood,” as well as a “digital image print of a child and various firearms.” That comports with the Daily News account of a 2-year-old picture showing Lanza “strapped with weapons, posing with a pistol to his head.”

You’d think that Lanza’s mother, who lived alone with him, might have stumbled across one of these clues. Even if she never found any of the photos or the giant spreadsheet – how did he print it without her help? – she told friends more than a year ago that he was burning himself with a lighter. Yet she continued to buy him deadly weapons and train him in their use.

All three guns Lanza brought into Sandy Hook Elementary School – a Glock, a Sig Sauer and a Bushmaster – were registered to his mother. In addition to these and the shotgun in his car, a search of their home turned up two rifles, 10 knives (four of them with blades at least 9 inches long), three Samurai swords, a spear, a bayonet and more than 1,700 rounds of ammunition. Police also found a holiday card with a check Mrs. Lanza had made out to her son for another handgun.

Every detail suggests that this woman, in her blind folly, armed her son for mayhem. She bought four of her guns between 2010 and 2012, as he was deteriorating. Records suggest two of them were purchased in October and December 2011. She took him to shooting ranges to practice. He showed up at Sandy Hook with 10 high-capacity magazines, each with 30 rounds, and fired more than half the 300 bullets in less than five minutes. When police entered her house and found her dead – apparently having been shot before she could get up – her gun locker was open, with no signs it had been broken into. The weapons were there for the taking.

The more we learn about these cases, the more they complicate the gun debate. Loughner, with a handgun, fired at a faster rate than Holmes or Lanza did with their rifles. Holmes’ giant drum magazine didn’t help him; it jammed his weapon. The cops in Connecticut think Lanza picked an elementary school because it was an easy target, just as the National Rifle Association says. And these guys were nuts, not crooks. Criminal background checks wouldn’t have stopped them.

When I look at all the documents, the common thread is mental illness. Worries and warnings about it weren’t heeded or shared. Loughner couldn’t go back to class, but he could buy a Glock. He couldn’t get ammo at one Walmart, but he could get it at another. Holmes merited an alert to a college threat assessment team, but not to the dealers who sold him 6,000 rounds. Lanza’s mother, lost in denial, failed to recognize that he shouldn’t be anywhere near a firearm.

Disclosing mental health problems makes all of us uneasy. We don’t want to live in a country where every therapy session is public information. Many of us don’t want to live in a country where guns are confiscated over gossip. I can’t tell you how to link weapon sales to behavioral assessment in a way that avoids those scenarios. But I can tell you this: Until we do, there will be more carnage.



William Saletan covers science, technology and politics for Slate. ]]> Thu, 4 Apr 2013 16:17:40 -0400 By William Saletan

Slate

]]> <![CDATA[ Strengthening family dairy farms will revive upstate economy ]]> http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130331/OPINION/130339974/1122
This windfall? New construction and serious expansion of dozens of yogurt processing plants all across upstate New York. Several of these plants have potentially massive production capacity. This trend has brought construction jobs and massive purchases of building materials. It eventually will produce several thousand more good manufacturing jobs. All that will be needed will be copious amounts of additional milk.

The reaction of the Cuomo administration has been wholly predictable: wild enthusiasm and somewhat sophomoric ideas as to what is appropriate. On Aug. 15, 2012, the governor hosted the first New York State Yogurt Summit in Albany. Attendance was tightly controlled; all major yogurt processors were in attendance and the governor’s office even courageously included three hand-picked token dairy farmers, properly neutered and holding the appropriate opinion, of course.

An issue that surfaced at the summit was the regulatory exemption limit of 200 cows per farm in the official definition of a concentrated animal feeding operation (CAFO). Any farm with more than 200 cows has to undergo a prohibitively expensive environmental vetting process allowing it to operate above the 200-cow threshold. Hearing this, the governor sprang into action. Leaving the summit room for a brief period, he returned triumphant to announce he was going to amend the CAFO exemption to include farms up to 300 cows. Too bad he overlooked the fact that any decisions regarding CAFOs are under the authority of the U.S. Environmental Protection Agency, rather than state jurisdiction.

Undaunted, Cuomo forged ahead with two new initiatives. Under the auspices of the New York State Energy Research and Development Authority, the state is doubling a state incentive grant from $1 million to $2 million per farm for installation of anaerobic manure digesters. These facilities convert cow manure to methane gas used to generate on-farm electricity.

The second initiative throws a modest $450,000 of state cash at the Dairy Acceleration Program to dole out up to $5,000 grants to farms wishing to increase cow numbers and to provide aid for financial analysis, strategic planning, executing business expansion plans or adopting best management practices, engineering and/or design projects.

Yogurt, depending on the type, uses 1 to 3 pounds of raw milk to produce 1 pound of finished product. The rising star of yogurts, strained, (or Greek-style) uses 3 pounds of milk per pound of finished product. Taking stock of the milk requirements of these new or expanding yogurt facilities, the official mouthpiece of the region’s dairy processors, the Northeast Dairy Foods Association, estimates the increased amount of milk required at an additional 4 billion pounds per year. This is an increase equal to 20 percent of New York’s current yearly milk production; the output of, not the paltry 25,000 cows Cuomo’s 200-cow to 300-cow CAFO tinkering would render, but an additional 180,000 dairy cows!

Instead of pushing 200-cow farms to 300 cows, wouldn’t upstate New York’s overall economy benefit far more from the revitalization of 1,000 or more of the multitude of decommissioned dairy farms over the length and breadth of upstate New York? These new operations could be easily peopled with the skilled offspring of New York’s dairy farm families. Smaller, family farms are noted for spending their milk checks close to home in their local communities, stimulating all the other businesses necessary to the upstate economy. Likewise, they are noted for their long tradition of effort in outstanding environmental stewardship.

Why not invest the $2 million per farm the governor is willing to throw at large farms through NYSERDA grants and channel it into helping young farm families rebuild sustainable, family-size dairy farms, thus benefiting a far larger economic segment of upstate New York? This would be an economic stimulus that would last not just a year or two, but a lifetime.

Cuomo should be considering how New York’s dairy farms can be returned to their former viability and become, once again, economically sustainable. Done properly, the state’s dairy industry can grow responsibly, thrive and become a robust economic engine helping pull the entire upstate economy back into prosperity.

An excellent starting point would be for the governor, other politicians and concerned citizens to give voice and political support to an initiative to reform the U.S. Department of Agriculture farm milk price formula. There is a compelling public interest in the need to create farm milk pay prices that return dairy farmers’ production costs, plus a fair profit to cover the farm family’s living expenses. Accomplish that and the rest of this supposedly thorny problem will resolve itself, with a dynamic, resurgent upstate New York general economy as a worthy consequence.



Nate Wilson, of Sinclairville, is retired from 40 years of dairy farming on a small, grassland hill farm in New York’s beautiful Chautauqua County. ]]> Thu, 28 Mar 2013 17:07:52 -0400