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显示标签为“Health care”的博文。显示所有博文

2008年9月27日星期六

Cafe society takes on health care

GOOD, a do-gooder media company “serving people who want to live well and do good” and Starbucks are partnering to provide “The GOOD Sheet,” a weekly page that explores key political topics. It’s an exclusive arrangement, so you won’t see these sheets at Peet’s. For 11 weeks leading up to and following the US presidential election, GOOD Sheets will be produced and distributed on specific topics, including gas prices, voter turnout and the environment.
Health care is the topic for the second Sheet. You can see a reproduction here in case you miss it at Starbucks. It includes quite a bit of interesting information such as:
“A look at what’s wrong”
Spending breakdowns
International comparisons of costs and outcomes
A matrix of “how to health the system,” which lays out various alternatives (like single payer), compares them on key dimensions, and notes which aspects Obama or McCain have endorsed
Along the bottom is a timeline of “how we got into this mess,” covering key events and trends over the past couple hundred years
I like the idea of the GOOD Sheet. It presents useful, relevant information in a visually compelling way without dumbing down the issue or taking too strong a stance in favor of a particular outcome. I can imagine the Sheet elevating the discussion about health care to a level where arguments are productive and informed.
The next topic is immigration, which is another area where it would be beneficial to elevate the conversation.
Although I’m not a frequenter of Starbucks –I don’t drink coffee and don’t like the atmoshphere– GOOD Sheets might just get me to go.
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Posted in Policy and politics

Army Can Boost Mission Success by Better Managing Environmental Considerations

By better managing environmental issues during deployments, U.S. Army units can gain tactical and strategic advantages that will help in combat and post-conflict operations, and boost overall mission success, according to a RAND Corporation study issued today.
The study finds that commanders have not usually given environmental concerns high priority during planning, despite the effect environmental conditions can have on troop health, safety and security, and the importance they have for the local population.
Researchers recommend that Army leaders give more weight to strategic, operational and tactical aspects of environmental considerations during planning and operations, and develop comprehensive standards and best practices to address environmental issues during contingencies.
This is consistent with the Army's new counterinsurgency doctrine, which highlights the importance of environmental improvements (especially sewage, water and trash) to gain support of the local population.
U.S. experience in Iraq suggests that providing clean water, electricity, sewage and trash management can tip the balance between the local residents supporting the U.S. mission or the insurgency, according to the study. Public opinion surveys suggest that Iraqis care about these issues almost as much as security.
Environmental considerations encompass anything related to the environment that affects the planning and execution of military operations or is affected by those operations. They include (but are not limited to) clean water, sewage-related infrastructure, soldier health, compliance with environmental laws, sustainability, protection of historical and cultural sites, and management of agricultural and natural resources.
“Perhaps the most underappreciated aspect of environmental considerations is the role that they can play in achieving U.S. national objectives in counterinsurgency and stability operations,” said report co-author David Mosher, a researcher at RAND, a non-profit research organization.
In countries where environmental conditions and infrastructure are severely degraded, clean drinking water, effective sewage and trash systems, and viable farmland are crucial to local inhabitants. Providing these things can influence whether inhabitants support the local government and U.S. goals and objectives.
“Commanders and planners can take steps in the combat phase to preserve existing environmental infrastructure and resources that will be vital once combat has ended,” Mosher said. “Determining what to preserve will demand that leaders and planners take a strategic view of the operation, including what the end result ought to be.”
The Army also can have a positive influence on the environment. In operations in Afghanistan, Iraq and the Balkans, U.S. soldiers have helped to build wells, sewage treatment plants and other water infrastructure systems, which were beneficial to both U.S. soldiers and local communities, said report co-author Beth Lachman.
In Iraq, the U.S. Army Corps of Engineers is helping to restore the Mesopotamian Marshlands that are significant to both regional and migratory bird species, and the local economy.
Environmental issues can also affect soldier health and safety, the costs of an operation, the logistical burden of supporting forces, and diplomatic relations. The study finds that long deployments and extended post-conflict operations like those in Iraq, Afghanistan, and the Balkans expose U.S. forces to a variety of environmental problems. At one base camp in Afghanistan, legacy pollution problems caused short-term respiratory illnesses for U.S. soldiers until the problem was identified and addressed.
The relationship between the Army and the environment is a two-way street, according to the study. On the one hand, soldiers and operations affect the environment; on the other, the environment affects soldiers and operations, especially because many contingency operations are often conducted in locations that have significant legacy pollution and other environmental problems.
The study finds that base camps raise a host of environmental issues. In most contingencies over the last 20 years, U.S. forces have remained in theater much longer than expected. As a result, base camps that were hastily constructed for temporary use are occupied for many years and often have inadequate environmental systems and procedures, such as insufficient waste management.
Pollution from base camps can affect relations with locals, cause health problems for soldiers, and require costly cleanup efforts. The authors state that Army leaders should anticipate longer stays and design and build base camps accordingly.
Operations that require less fuel, water and other resources, and produce less waste, will reduce the logistics burden. A well-designed, efficient base camp can reduce the resources required to sustain it and free logistics assets to support U.S. troops or reduce the number of convoys that must travel along dangerous roads, the report finds.
Environmental conditions can also extend beyond national borders because air and water pollution may travel great distances, affecting diplomatic relations with countries that could be crucial to the mission's success.
The authors make several recommendations:
Improve policy and guidance for environmental considerations in contingency operations. Work with the Department of Defense to develop guidance that would clarify the need to anticipate and address environmental issues in contingency operations.
Encourage an environmental ethic throughout the Army that extends to contingency operations.
Better incorporate environmental considerations into planning, particularly those that relate to achieving U.S. strategic objectives and to base camps.
Improve pre-deployment and field environmental training so that soldiers and leaders understand the importance of the environment in contingency operations and techniques for reducing the Army's impact.
Invest more in environmental resources and good environmental practices for field operations, including training for base camp managers and unit environmental personnel, developing efficient base camp designs, and creating new technologies to manage and reduce the environmental effects of Army operations.
Use a “sustainability” model for planning for and managing environmental issues during contingency operations to reduce the logistic burdens and costs of base camps, decrease waste streams and lessen the need for cleanup.
Other authors of the study are Michael D. Greenberg, Tiffany Nichols, Brian Rosen, Henry H. Willis. The report, “Green Warriors: Environmental Considerations in Army Contingency Operations,” is available at www.rand.org.
The study was prepared by the RAND Arroyo Center, which provides objective analytic research on major policy concerns to leadership of the U.S. Army, with an emphasis on mid- to long-term policy issues intended to improve effectiveness and efficiency. The center also provides the Army with short-term assistance on urgent problems and acts as a catalyst for needed change.

A Government Takeover of Health Care? If Only!

"I want families making decisions about health care, not the federal government."
This, of course, is John McCain's--and every conservative's--favorite line about proposals for universal health care. So in case anybody is visiting this site for the first time, and perhaps hasn't followed this debate, here are the essential points.
1. Obama has not proposed to have the federal government take over health insurance. He would set standards for what private insurance must provide--and how private insurance carriers must sell their policies. That means making sure everybody gets benefits as good as what members of Congress gets and making sure everybody can get coverage. Most Americans think those are good things--and they are right.
2. Obama would create a public health plan, something that looks like Medicare, into which anybody can enroll. One reason for doing this is to provide a safety check on private plans: If private insurers know they must compete with a public plan, they can't play the same games--that is, they can't try to exclude people with serious medical conditions or short-change beneficiaries. Private insurers have been known to do these things. It's possible everybody could end up in the public plan--but, if so, that would only be because everybody wanted to join. (What Obama is proposing looks a lot like this.)
3. For the record, if we did have a government-controlled health care system in this country, we'd probably be better off. The most popular insurance program in America is Medicare, a government-run health care system. Most experts will tell you that the most efficient, high-quality health care in this country comes from the Veterans Administration (thanks mostly to its high-tech patient information system). That's as close to socialized medicine as you'll find in this country. But nothing Obama has proposed would come close to putting everybody into a VA-like system. (Also, for what it's worth,sSome of the best health care systems in the world--namely the systems in France and Taiwan--are truly government-run.)
4. Nobody should know the benefits of govenrment-run health care better than McCain, who over the years has benefitted from eligibility in the VA system, the Federal Employees Health Benefits Plan, and Medicare.
5. McCain's health plan would not make health insurance more affordable and accessible. More likely, it will lead to people losing good coveage. And the impact will be felt most by those with pre-existing medical conditions--that is, the people who need insurance the most. More on that here and here and here.