Guest Post: Health Care Panel Report

Guest post by Mrs. sco

Last week, The Boston Foundation held a panel to discuss the release of its health care report, The Boston Paradox: Lots of Health Care, Not Enough Health. TBF President Paul Grogan began by sounding a warning bell: he forecast a long-term decline in health due to skyrocketing costs, an aging workforce, and a rise in chronic illness.

Wendy Everett, President of New England Healthcare Institute, presented the report. She started out by describing Boston as a healthcare paradise – lots of jobs in the industry, lots of doctors and world-class institutions, average life expectancy of just under eighty years. But she pointed to signs of trouble in paradise, including increases in healthcare costs outpacing income, a decrease in fitness, and an obesity rate of over 20%. (The obesity statistics were the most alarming part of her presentation – go look at the CDC's PowerPoint presentation, which shows the fattening of America from 1985 to 2005. There is currently no state in the Union where less than 15% of the population is obese. 46 states have an obesity rate of 20% or more.)

The rest of the discussion was devoted to ideas for improving the bleak outlook. All of the panelists emphasized public health. Public health spending has dropped by 12.5% over the past six years, while healthcare spending has risen by 25%. Meanwhile, within healthcare spending, we spend 88% of our budget on access to care when only 10% of our health is influenced by access to care. We spend 7% of our budget on behavior and environment, which accounts for 50% of our level of health.

The common theme was that public health isn't just about improving access; it's about improving environment and behavior. And not just in ways that you might think, encouraging people to get preventative medical care and to be physically active.

In fact, Dr. Judy Ann Bigby, the Secretary of Health and Human Services for the Commonwealth, discussed gun violence, the lack of grocery stores in low-income communities, and the impact of race on health outcomes. (Dr. Bigby's alarming statistic: a college-educated black woman with regular prenatal care is likely to have a worse outcome than a high-school educated white woman with minimal prenatal care.) Judith Kurland, Mayor Menino’s Chief on Staff, picked up on some of these points. She talked about programs like urban gardens, bringing farmer's markets to low-income neighborhoods, encouraging use of food stamps – which wouldn't cost Massachusetts a dime because it's federally funded – and making school lunches palatable for kids. She also discussed Mayor Menino's initiative to plant 100,000 trees (actually, she corrected herself and said he would "cause them to be planted") in Boston. That appears to be an environmental issue, but dig just a tiny bit deeper and it's a public health issue too – the rate of asthma has risen dramatically in the past decade or two. Similarly, Dr. Barry Zuckerman, Chief of Pediatrics at Boston Medical Center, talked about a medical-legal partnership that, among other things, helped people resolve disputes with their landlords. Again, it doesn't seem to be related, but if you're living in a dangerous environment because your landlord won't fix the broken window or the rusty water pipes, your health will suffer.

The takeaway message for me was: racial and socioeconomic disparities, environmental problems, issues with public housing, education, and even bureaucracy are obstacles to health. Containing costs is important, but investing now to address all the interrelated issues may pay off more in the future.

Guest Post: Thoughts on Foreclosure Plan

Guest post by Mrs. sco

On Wednesday the Patrick administration announced its plan to stop mortgage fraud and help homeowners at risk of foreclosure. The plan adopts the recommendations of the Mortgage Summit convened last November. It aims to stop deceptive practices, increase oversight and regulation of mortgage providers, and educate consumers. If it works, it will be a huge win for vulnerable homeowners in Massachusetts.

Last fall I had the opportunity to work as a student advocate in the Predatory Lending unit of the Hale and Dorr Legal Services Center in Jamaica Plain. I heard the same story over and over: Unscrupulous lender targets homeowner with lots of debt. Lender feeds owner a story about how convenient it will be to pay off all their other debts and just get a single bill each month. Owner mortgages the house, misses a payment, and the bank forecloses. There are variations – the illness, death, divorce, or job loss that caused the missed payment; the sky-high interest rates, undecipherable payment plan, or bizarre insurance fees added to the mortgage (does anyone in the Boston metro area really need earthquake insurance?) – but it’s basically the same story.

There are two problems here: the circumstances that cause people to get into this mess in the first place, and the difficulty of remedying the situation. The first problem is impossible to resolve completely. There’s no way to ensure that everyone has enough money, luck, responsibility, and financial literacy to avoid debt or an unfair loan. But the administration does try to address this by providing a hotline for people to call when they start having trouble making payments. The hotline information will include referrals to reputable lenders and credit counselors vetted by the government. Crucially, the plan also includes an education initiative. The details aren’t fleshed out yet, but if buyers are given this information at the mortgage closing and also reminded periodically through public education campaigns, the program could be effective.

Of course, as I learned from my time at Legal Services, most people don’t seek help in advance – they keep holding out hope that they’ll dig themselves out of debt until the day they receive that foreclosure notice. At that point, they could still rely on laws like the Truth In Lending Act or the Massachusetts Consumer Credit Cost Disclosure Act to invalidate a deceptive or unfair mortgage. Here’s where the second problem comes in: if you can’t make a mortgage payment, you probably can’t afford to pay a lawyer. The few attorneys in the state who focus on pro bono foreclosure cases are so overburdened that they probably can’t help you either. And here, in my opinion, is the real strength of the administration’s plan: it increases regulatory fees for mortgage lenders and uses the money to create a mortgage fraud unit, so people who have been exploited by subprime lenders can actually take advantage of the recourse that the law already provides.

We’ll have to wait and see how the implementation of the new plan goes, but the very fact that the government is paying attention to this problem and not just leaving homebuyers to their own devices bodes well. Maybe it will force lenders to stop deceptive practices and start dealing with even uneducated consumers fairly, and the reforms will be so successful that they’ll eventually extend to all forms of consumer protection and not just mortgages . . . a girl can dream.

Depression is Treatable

Guest Post by Susan Falkoff

Seven weeks after announcing she was being treated for exhaustion and depression, Diane Patrick is ready to return to public life. Hmm, 4-8 weeks is how long they say it takes most anti-depressants to take effect. They also say that situational depressions like Diane’s are highly responsive to the right medication. Impossible to fault Diane: weren’t we all a little depressed by how things were going for the first few weeks of the administration?

Can’t give medication, though. Who wouldn’t be glad to have an attentive, respectful, committed husband like Diane’s, who walks the walk about putting you first? The Globe ran a photo of Diane and Deval at the movies last weekend. I had two reactions: 1) how sweet! and 2) who was there interrupting their date with a camera? I guess we don’t see more date photos because usually governors/presidents either don’t like their spouse, don’t bother with dates, or they only attend private showings so they won’t have to talk to anyone or have a picture of their date in the Globe the next day.

Mitt Romney seemed to have been elected on the strength of an ad that talked about his lying to his father to sneak out on a date with his wife. Lying to your father is a reason to elect someone? I didn’t get it. What I do get is that what the Patricks have is the real thing. Welcome back, Diane!

A Wise Hire

Guest Post by Susan Falkoff

Here’s some good news in what someone at bluemassgroup.com described as “a very [expletive deleted in deference to Steve] week”:

The Massachusetts Executive Office of Energy and Environmental Affairs has hired Marc Breslow of the Massachusetts Climate Action Network (MCAN) to develop state policies for reducing greenhouse gas emissions from transportation and buildings.
For those of us concerned about global warming – and who isn’t? – this is wonderful news. If you haven’t encountered Marc, you haven’t been active on this issue in Massachusetts. No one knows more, has done more, has spurred others on to do more, than Marc. He said, “I've had a great time being part of our growing movement, and am happy that I can continue doing so with a state administration that really wants to address the issue.” Congratulations to Marc and to Gov. Patrick’s administration for making a very wise hire. Check out massclimateaction.org for more information about MCAN and information about what’s happening in your town to reduce greenhouse gas emissions.

A Man Went Into a Bar

Guest Post by Susan Falkoff, sco will return Sunday


What happened to all the good old bar jokes? My father told this one, repeatedly: “A man goes into a bar. He orders crab and asks that the crab be boiled alive. The chef storms out of the kitchen, horrified at the cruel request. ‘But you do it to lobsters all the time,’ says the patron. ‘Lobsters are used to it!’ replies the chef.”

America, myself included, gasps at the horrifying massacre of 33 people at Virginia Tech. For those of us who are students, or former students, or the parents of a student, this hits close to home. Yet, I recognize with some embarrassment that neither I nor the media is able to sustain this level of outrage and attention to for daily life in Iraq, where 33 might be the civilian death toll on a slow day. From today’s NY Times: “Bombs ravaged Baghdad in five horrific explosions aimed mainly at Shiite crowds on Wednesday, killing at least 171 people in the deadliest day in the capital since the American-led security plan for the city took effect two months ago.” If we could, as a nation, acknowledge this reality, would it make a difference? Or would we just conclude that lobsters are used to it?

Parallel Universes and the Military

Guest Post by Susan Falkoff

An interesting controversy erupted in the Watertown TAB this week. Last week’s paper featured a first person account by Capt Stephanie Cooper, a soldier who had the “opportunity” to participate in a team that was sent to cordon and search an Iraqi home, a possible “high value target.” Capt. Cooper’s role was to frisk the women as they emerged from their house in the middle of the night and then “comfort the frightened women and children and keep them out of the way” while the scouts dealt with the men. To Capt. Cooper, including women on this combat team demonstrates “a higher level of cultural sensitivity to the Iraqi people.” When Ms Cooper returned to her room after a miserable boat trip, she was proud of her physical stamina and thought this operation was “the most fun I’ve had since landing in Iraq.”
http://www.townonline.com/watertown/local_news/x1290303071

This week, the TAB printed five letters that saw in Capt. Cooper’s story heartlessness, not courage. http://www.townonline.com/watertown/opinion. These writers contrast the “memories and stories” Capt. Cooper believes will last her a lifetime to the nightmares, sorrow and trauma experienced by the Iraqi people.

The TAB’s editor was startled by the vigorous response. I agree with him that this story became a vehicle for people to project their pre-existing feelings about Iraq.

I think there are two totally separate universes of thought about the military. Universe One is represented by the slogan “Support our Troops.” People in this universe tend to believe that if someone is serving in the US Armed Forces, the purpose and conduct of the mission is basically irrelevant. This universe was created three or four wars ago and, unfortunately, exists in a time warp where it is easy to tell the good guys from the bad. Universe One is well integrated into our town government with a full-time Veteran’s Agent and official events on Memorial Day and Veteran’s Day to remember and honor our veterans and those who gave their lives serving the country. I became more acquainted with this universe while serving on the Town Council.

Universe Two is peopled by those who do not see it as unpatriotic or disrespectful to question what this occupation is all about. One letter asks: What is an “enemy” in Iraq? Who is an “insurgent?” Is it “someone who opposes another group in their own country, or opposes us?” In the opinion of many people in Universe Two, the best way to support the troops is to bring them back home.
One letter writer fears that Capt Cooper will be dehumanized by her experiences. This is certainly possible. She may well join the thousands of other veterans who have served in Iraq or Afghanistan, suffer from Post Traumatic Stress Disorder and are not finding it easy to get their lives back on track. I suspect that many people in Universe One got their start in life with the help of the WWII GI Bill. Survivors of today’s conflict will not be so lucky. Benefits are being cut, not expanded. As we read this week, injured troops can barely get any medical care much less the long-term psychiatric support they will need. I won’t be surprised if next week there is a flurry of letters and/or Speakout comments

Eyewitness Account of Markey Office Occupation

Guest post by Susan Falkoff.

Below are excerpts from a report by “mlc” (distributed by United for Justice with Peace on the Sit-in at Congressman Ed Markey’s Medford office that was organized by Veterans for Peace, in which Congresman Markey explains why he intends to vote for Bush’s supplemental budget request with conditions instead of defeating the request outright:

“2/21/07 Today was the second day of the occupation of Rep. Markey's office in Medford. Again, there were several Veterans for Peace and supporters outside, on the street, with banners and signs asking the Congressman to sign the Pledge to Vote Against 2007 Supplemental Funding For The Iraq War. And, again, several people sat all day inside Markey's office suite reading the names of all the US soldiers killed in Iraq, state by state. Today was the day that Markey had agreed to meet with the Veterans for Peace, their supporters, and his constituents who favor his signing the Pledge.

“…Nate Goldshlag, one of the organizers,… asked if he could read the names of those soldiers killed in Iraq who were from Massachusetts. After reading each name, another veteran for peace struck a small bell chime. Then Nate set out the intention of our meeting with the congressman, specifically urging him to sign the Pledge stating that he would vote against the supplemental spending measure that President Bush will seek in 2007 to fund the ongoing occupation and war on Iraq; and to take leadership in getting others to vote against it. Markey initially said he was 100% with us, and that he had already signed the pledge…Then he began an explanation of his position, which he was to repeat many times throughout the long meeting:

“That he intended to vote for a Murtha-style supplemental bill—which would approve supplemental funding for the ongoing occupation with conditions attached regarding troop safety equipment, extension of leave time between successive deployments, etc. Markey told us repeatedly that he believes there would never be more than 190 Representatives willing to vote against Bush's supplemental. That 218 Representatives would be required to stop its passage. Therefore, rather than take a principled but losing stand, he would prefer to vote for the supplemental (which, he says, will pass anyway) with the Murtha “amendment.”

“…Several of the Veterans for Peace continued to argue that they would prefer Markey took a principled stand and voted against the supplemental, especially since he believed it would pass anyway. Nate Goldshlag pointed out that Markey could vote with the majority in favor of the Murtha amendment to take care of the troops, and then vote against the final supplemental spending bill. However, it was clear that Markey had made up his mind to vote for the supplemental with the Murtha conditions attached. He insisted this was being ‘politically smart.’

“… [Markey] has decided he wants to be seen as on the side “protecting the troops”---knowing , as he admitted, that at least 1000 more US soldiers will be killed (and tens of thousands of Iraqi civilians) over the next year in Iraq--- rather than invite his fellow Democrats and moderate Republicans to stand with him against the continuation of funding for this illegal, immoral occupation. The whole event was very peaceful, cordial, and the Congressman and staff provided donuts, coffee, and bagels.”

Guest Post: Deval’s Damask

Guest Post by Susan Falkoff. I just wanted to also note that the failure of Watertown delegates to get reminders about this year's caucus should fall squarely on my shoulders, and not Deval Patrick's. If his citizen's network is going to be successful, he needs the leaders of the campaign to be the driving forces making this happen. I should have been more vigilant. --sco

Deval, Deval what are you doing to us? I cut you slack on the Cadillac but the curtains – it’s so – Nancy Reagan.

I read these stories about ostentatious consumerism with this in mind: I am not generally active in Democratic Party politics so I wasn’t paying attention to the caucuses to choose delegates for this year’s state convention. When someone mentioned in passing that the caucus was that day, I was startled that, as a Deval Patrick delegate to last year’s convention, I hadn’t heard anything at all about the caucus from the Deval Patrick email network. I don’t expect the mountainous volume of email I received during the campaign but getting nothing at all is far less than I’d anticipated. Wasting the progressive base you’ve laboriously created is, in my opinion, a much more egregious failing even than bad taste in curtains.

Unlike a writer to today’s Globe who voted for Deval Patrick and now feels "hopelessly used," I haven’t give up hope for change. The state budget is still to come and there is plenty of time to demonstrate a commitment to conservation and energy efficiency with future state vehicle choices. But I am getting antsy and wonder what happened to the active and engaged citizenry that we were promised during the campaign.

Guest Post: Deval's DeVille

Guest post by Susan Falkoff.

I was interested to catch up with Blue Mass Group today and learn that the consensus there is that the fuss over Deval’s new Cadillac is the result of partisan bickering. Among my acquaintances, the issue seemed to have more traction than on BMG. A former Grace Ross supporter wrote (as though I am Deval’s scheduler or personal assistant, which I’m not): “Pleeze give Deval a ride home soon in your sweet little hybrid... Does it make sense for the Guvner to be driven to work & back home in such a notorious gas guzzler, traffic hog, and ‘gangsta cah’?” I was definitely more disturbed by my friend’s crass use of racist stereotypes than by Deval’s choice of car but it bothered me when another leftie made a similar, if more gracefully phrased, comment today. It was reminiscent of when Deval took a hit among my acquaintances (some with significant personal wealth) over building a lavish second home in the Berkshires.

Personally, I agree with those on BMG who believe that the governor needs a presentable vehicle but I was surprised that BMG posts weren’t more concerned about mileage. I’d feel a lot better if I knew that mileage was at least one of the factors that were considered in the vehicle selection. Was a hybrid SUV even a contender? This is not an area where I would expect creative thinking from the state police. Did it even occur to anyone to run (no pun intended) this past the administration’s energy and environment people? Let Deval keep his Deville but I’ll be looking for the administration to demonstrate significant leadership and creativity around energy efficiency in lots of other ways.

Guest Post: Black Mark for Black Road Policy

Guest post by Susan Falkoff

Out-of-towners frequently comment on how, entering Watertown, they are delighted there is not a bit of snow on any of the roads. Our DPW Superintendent is proud of his “Black Road Policy” and he is often praised by locals, too, for doing a great job of clearing the roads.

While I hope that there are black roads today all the way from Steve's .08 acres to the hospital where his wife will soon deliver a baby (DPW take note!), heavy use of road salts visibly damages vegetation and also corrodes concrete and steel and harms beneficial soil organisms, birds, and aquatic life. Watertown spends a lot of money planting street trees and then allowing salting practices that make it impossible for them to thrive.

New Hampshire did an experiment several years ago and treated test sections of road with half the usual amount of salt on low-volume highways. Poorer driving conditions were noted on the test sections but safety was not significantly compromised. NH DOT concluded that reduced salt programs make sense where a highway is relatively flat, without hills and curves, and in a low speed/low volume section. Compared to country roads in New Hampshire, there must be a lot of those in Watertown. There’s more information about this study at http://www.des.state.nh.us/factsheets/wmb/wmb-4.htm.

Guest Post: The Blame Game and DSS

Guest post by Susan Falkoff. Susan will be helping me out with occasional posts over the next few weeks for reasons that will be more obvious in a few days (I hope!). -- sco

While Steve was struck by dueling columnists commenting this week on Sen. Scott Brown's use of profanity, my attention was caught by diametrically opposed columns on the subject of the latest DSS tragedy. Commissioner Harry Spence was excoriated by Eileen McNamara on Sunday and exonerated by Adrian Walker on Monday for the death of 4-year-old Rebecca Riley due to an apparent overdose of prescription medication.

Seems to me that Walker got it just about right. DSS gets a report of a child who is possibly overmedicated. A social worker investigates, and is reassured by the doctor that the medication prescribed is appropriate. It would be absurd for DSS to assume the doctor was wrong. The parents administer the medication inappropriately. What I can’t tell from the press reports is how much of the problem was medication that was poorly prescribed by a licensed medical professional, or medication that was poorly administered by a very troubled parent. In either case, how on earth could Harry Spence be responsible for the girl's death?

Guest Post: Moving Forward to a Standstill along the Charles River

Guest post by former (and future?) Watertown Town Councilor Susan Falkoff. For more information on development along the Charles River on Pleasant St, check out yesterday's article in Globe West or the discussion on H2OTown.

Pleasant Street, Watertown – a rutted road with aging industrial buildings, auto body shops, older single family homes and small apartment buildings plunked down at random. Hidden behind it is the Charles River and a much-loved naturalistic multi-use path that is marred at several points by vistas of crumbling buildings and heavy industrial equipment. Pleasant Street is a fixer-upper -- and its catching on. A Lowe’s is planned for Waltham, with a corner of its parking lot jutting into Watertown. Next to that, a 300+ unit apartment complex is going up and its scale has startled and alarmed some. In my opinion, that project is well-designed and appropriate for the location, but only if future development isn’t higgledy-piggledy all around it.

Town Councilor Jonathan Hecht gets much credit for initiating the common sense idea that the town could plan for future development instead of approving projects piecemeal. Last week, the council wisely approved funding in the range of $40,000 - $55,000 for a six-month planning study. On Sunday, the Globe reported this shocking fact about the funding: in 1993, Stop and Shop agreed to pay the town $35,000 toward a similar study. “The study was never conducted, and town officials say they don't think the company ever paid up.” How often, one wonders, does a developer promise linkage and never deliver? I know of one similar example when, decades later, the Conservation Commission realized that promised plantings were never installed in the Watertown Mall parking lot. Does the town even have a mechanism to track linkage obligations?

The State Convention: A Layperson's Perspective

[Guest Post by Mrs. sco]

I'm not nearly as involved in politics as my illustrious husband, but I went to the state Democratic convention out of curiosity. I pictured a bunch of people sitting around tables, debating issues, and voting on the platform. It turned out that the issues and platform were decided long before; the convention consisted of lots of speeches.

We got to Lowell early. We spent an hour or two waiting around for Ted Kennedy while chewing on tough bagels and listening to all the speakers who were trotted out to fill up time. They ranged from Howard Dean to a teenage girl who announced how excited she was to be at the convention. Several of the candidates for governor and lieutenant governor put in appearances. Deval Patrick and Tom Reilly, who would have the floor later, made pro-Democrat speeches. Deb Goldberg and Andrea Silbert took advantage of their brief time at the microphone to talk themselves up and repeatedly ask the crowd for our support (and, in Silbert's case, to admonish us for not paying close enough attention). Finally, Kennedy ("the greatest senator in history!", as we kept hearing all day) showed up and... well, I can't remember what he said, but I remember everyone cheering a lot.

On the convention floor, there were more exhortatory speeches. The three candidates for governor all spoke briefly. I had heard the candidates' names, but I didn't know much about any of them. Like sco, I liked what Bill Galvin had to say about businesses moving out of Massachusetts and the recent United Airlines pension debacle. Deval Patrick talked about his own background as well as his ideas. He said that he had worked in a corporate boardroom, but had also operated a lathe in a machine shop; he had counseled President Clinton on civil rights issues in the Oval Office, and then had trouble hailing a cab after the meeting. I'm sure this is a standard part of his speech, but it resonated with me as a minority and a relative newcomer to the state. I feel like there's a sense of entitlement with entrenched party insiders like Galvin and Reilly.

After all the big speakers in the morning, the afternoon was a letdown. A procession of speakers read out the party platform, which we had printed in the newsletter we received several weeks before the convention. Yawn.

In the last half hour or so of the convention, we voted on amendments to the charter. Well, sort of. As sco mentioned, it was an all-or-nothing vote; we had to accept all of the amendments or none of them. It was clear that many of the delegates were not happy about some of the proposed changes, but they did not have an opportunity to voice their concerns. Finally, several resolutions where accepted with an "aye" vote... but nobody ever asked for a "no" vote. The convention ended and we all filed out. I was still a little confused. What had just happened? There must be a flaw in the rules if they prevented debate over the amendments, right? But I learned that I was just being naive. The party leadership didn't want to encourage debate; they wanted to push through their changes, and they bent the rules a little in order to succeed. After all the talk of party unity and local involvement and the politics of hope, that display of power left a bad taste in my mouth.

All in all, I'm glad we went; it was good to hear Democratic state and national leaders talking about the issues and riling up the crowds. But I was a little disillusioned by the end of the convention.