HealthCommentary

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“Eric Garner’s Death Highlights America’s Empathy Gap”

Posted on | December 17, 2014 | No Comments

 

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Michael Magee,
CEO, Mayoral Academies

I have been struggling to put into words the range of emotions set off by the death of Eric Garner and others in the recent past. What is there left to say? Then this morning, I read an editorial in the Providence Journal written by my son, Michael, which perfectly captures the challenge we face as a civil society.

It’s title, “Eric Garner’s death highlights America’s empathy gap”, directs the focus of all caring Americans, and most especially those of us who have pledged our lives to caring for others.

In the body of the article, Michael says, “ It is easier to harm other human beings when you believe their lives have less value than your own, and easiest when you don’t consider them human beings at all. In a nation profoundly and increasingly segregated by race and class, we have the conditions for precisely this sort of dehumanization and concomitant violence. Institutions have grown up with it and around it and have perpetuated it.”

“Just as there is no ‘separate but equal’ there is no ‘separate but empathetic.’ There are many ways for human beings to develop empathy and understanding, to disabuse themselves of the inherited tribal suspicions that cause them to act like fools and devils. The experience of literature and art and great oratory can be a transformative window into the lives and perspectives of people whose cultural experiences have been very different from our own. But by far the greatest mother of empathy is social familiarity, or what we might just call friendship or community. To put it bluntly, public servants are less likely to put their friends and neighbors in choke holds.”

Near the end of the piece, he focuses on the role of education, an area he is more than familiar with as CEO of the Rhode Island Mayoral Academies. He correctly sees our public education as essential to meaningful change. As he says, “ Highly restrictive neighborhood schools, their gerrymandered enrollment zones guided by the invisible hand of property value, should be opened to a broad cross-section of children that reflect the diversity of entire states. Given the unlikelihood of mandated desegregation, we should accomplish this through an expansion of racial and economically diverse public schools of choice. Those would be good places to start. We’ve got to start somewhere and we had better start now.”

Each of us has a role to play. As a starting point, I highly recommend that you take a few moments to read Michael Magee’s piece. You will find it HERE.

For Health Commentary, I’m Mike Magee.

COSTCO, Adam Smith, and Healing America.

Posted on | December 10, 2014 | 3 Comments

Mike Magee

Today, on CNBC, highest cudos went to COSTCO’s, not simply for exceeding expectations with a 7% year-over-year growth, but for having the lowest employee turnover of any major retail business in the United States.

COSTCO’s founder was well known for saying he purposefully paid his employees way above a living wage (because it was only right) and was still a billionaire. He wasn’t fudging. In fact, according to Bloomberg Businessweek in June, 2013, current CEO Craig Jelinek confirmed that the average hourly worker at COSTCO made $20.89 an hour, not including overtime, and received great health benefits to boot.

Compare that with the famous, flag-waving, nickle and dime leadership of Walmart which weighs in with skimpy benefits and an average hourly wage of $12.67. But the CNBC analysts noticed one thing more about COSTCO – it feels better to shop there because the workers are happy, healthy, helpful and productive.

Now none of this is exactly break-through thinking or revelatory knowledge. However, it caught my eye because I’ve  been reading Eli Ginzberg’s “The House of Adam Smith”. The legendary “maverick health economist” earned his PhD at Columbia in 1934 at the age of 23 with a dissertation that explored the sociopolitical factors shaping Adam Smith’s classic “The Wealth of Nations”.

Years later, Ginzberg recalled, “I could not possibly reconstruct the sense of excitement that I experienced as I read the book for the first time. Nor could I reconstruct the intensity of my feelings as I saw the possibility of correcting a major historic misinterpretation and revealing Adam Smith for what he was, a liberal reformer, instead of as so many wished him to be, a rigid defender of free enterprise.”

Eli taught over 10,000 students in his 53 years at Columbia. His last class occurred on December 3, 2002. That was one week before he died, just short of his 92nd birthday. I am not certain what he taught that day, but I am absolutely convinced from my conversations with him over the years that Adam Smith was close at hand and near the surface.

According to his good friend and Business School colleague, James W. Kuhn, “Smith’s approach to economics would become Eli’s own”, specifically, “…the habit of evaluating policies by their contributions to peoples lives, a natural preoccupation for Smith who was best known during his lifetime as a moral philosopher.”

Adam Smith was born June 16, 1723, in Kirkcaldy, Scotland, forty miles from Edinburgh. Eli Ginzberg was born on April 30, 1911 in New York City.

What does Eli (and therefore Adam Smith) in his “House of Adam Smith”, have to say about our current environment, the 99.9%, productivity and justice? Here are a few excerpts:

On corporate appeals to government, off-shore wealth, and cloaking oneself  in patriotism:

“The confusion was tremendous. The babble of special pleadings became most disconcerting to the quiet student. But a few skeptics were able to see the forest for the trees. The people were bewitched by the word liberty. All crimes could be committed under its aegis. All is fair in love and war and in the struggle for liberty…Adam Smith listened to the trading interest but was not greatly impressed with its plea. He was convinced that merchants were not citizens of any country and was therefore amused by their appeal for public support on the basis of patriotism.”

On productivity:

“Smith was not the first to advance the theory that all wealth is derived from labor. Smith however broke new ground in building the complete system of economic thought around the concept of productive labor….The history of the world was in his opinion the history of the increasing efficiency of labor.”

On the attitudes of rulers toward the 99.9%:

“The rulers of the state despised the populace, and, except in times of crisis when man power became important, ignored it completely. During normal periods the commonalty had to labor hard, pay high taxes, and behave itself. Art, politics, and learning were the vested interests of the rich and powerful.”

On Corrosive Government Policies; (note: the Settlement Acts sought to assign management of the growing poor population to the geographic locality of birth or residency – thus restricting mobility and opportunity; and the Apprenticeship Acts required 7 years of servitude labor before hanging a shingle – which rarely followed.)

“The Settlement and Apprenticeship Acts interfered with both the supply of labor and the conditions of labor…Corporations with exclusive privileges were established better to enforce the apprenticeship regulations…. The apprenticeship regulations were undoubtedly a great boon to the masters…. Masters were frequently permitted to establish rules and regulations for the conduct of their business. In most cases the charter members of the corporation limited the number of people who might engage in their trade….Novices upon the payment of an entrance fee receive free board and lodging in return for 14 hours worked per day….An apprenticeship after seven years of service became a journeyman. He didn’t receive wages for his labor and secured a modicum of independence. In theory, but not in practice, a journeyman might become a master after several years additional service. Without wealthy relatives one could never hope to become the head of a trade for often a capital of several hundred or even thousand pounds was required.”

On Congressional Inaction: Cost-Of-Living/Minimum Wage/Trickle Down Economics:

“The government viewed with favor the apprenticeship and corporation laws for it believed that the public benefited from the regularization of industry. However it really was an impertinent affectation to maintain that any good could result from legislative measures which trampled upon the most sacred property of man – his labor.”

On Unintended Outcomes (Think Kansas tax policy; Ferguson, MO, militarization of police; Staten Island, NY police policy- 2014):

“During the second decade of the 18th century, one estimate placed the number of unprofitable poor at 1,500,000. The care of the poor developed into England’s most important industry. The burden was especially severe upon the landowners. The land tax was very high….The great increase of robberies which took place during the middle of the century could be explained only by the desperate condition of the poor.”

On Fear Post- 9/11 and Torture:

“The liberties of Englishmen have been severely curtailed in an attempt to solve this perplexing problem….The various regulations violated natural liberty and justice without achieving any practical results. Unfortunately, the common man, after suffering from these oppressions for more than a hundred years, had not yet rebelled.”

On the Economics of Justice:

“When piece work is well rewarded, laborers frequently overstrain themselves in their desire to improve their position.”

In studying Adam Smith, Eli executed  his own conversion from Economist to Moral Philosopher. Shortly after completing his initial field studies, in 1939, he laid out the truisms that would be his “touch posts” for the next 6+ decades. He said that economic policies should “seek equity; that a self-regulatory economy is an oxymoron; that government played a critical role in regulating the economy; that racism was an unsolved problem; that our continental dimensions had an important impact; and finally that we could no longer be an island unto ourselves.”

For Health Commentary, I’m Mike Magee.

My Father’s 100th Birthday: Why I Love Him.

Posted on | December 3, 2014 | 17 Comments

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Mike Magee

My father was born on December 5, 1914. Today is his 100th Birthday. And although he died on September 15, 1998, and my mother some three years earlier while caring for him, there is rarely a day that goes by that I do not think of them.
What do I love about my father?
First and foremost, he loved my mother, and everything flowed from that.
We kids understood that we were an extension of their love.
I loved his physical presence – that he was big and strong, that he embraced us, held us tight.
I liked that he taught me to whistle, which remains a useful skill.
I was proud that he took care of people as a job, and that the people who he took care of loved him so much.
I liked that every Christmas our dining table was full of baked goods that his patients gave him to thank him for his many kindnesses – giving them time, having open office hours day and night, making house calls when they were scared or worried.
I loved that he was honest, that he didn’t cheat or fudge, that he believed your name had to stand for something.
I loved that he was a gentleman and a gentle man.
I liked that he liked to build things, that he owned tools he rarely got to use, and that he’d get upset because we were always messing with his stuff.
I liked that he liked clothes, especially shoes. He liked to look good, and he wore clothes well.
I liked that he always had lots of change in his pockets.
I liked that he knew the owners of the local stores across the street by their first names.
I liked that he was patriotic and courageous. I learned after his death that he earned a Bronze Star on May 9, 1945. We never saw that medal or ever heard him talk about that day, ever.
I like that he was modest. He didn’t brag. He didn’t have to. I liked that.
I liked that he delegated. He and my mother expected us kids (there were 12 of us) to help teach each other skills like bike riding, and catching a ball, and climbing a tree.
I liked that he took risks, and wanted us to take risks as well – even though a few of those risks turned out to be unwise and too costly.
I liked that he wasn’t perfect – it meant we didn’t have to be perfect, but we did have to try, and we did have to be independent.
I liked that he was often watching in the background, a last stop before disaster, and that his intervention was usually at the direction of our mother.
I loved that the two of them were a team – and that we kids were the players.
I liked that he could take a hit, that he would never fall apart, no matter how bad things were, he would get up the next morning. Our father was reliable, consistent, upright, sturdy, alive.
I thought he was handsome. Others thought so too.
I loved that he was a family man.
I liked that he had a spiritual core – not because of his religious belief system, because his values were secure with or without religion. And not for any punitive conceit – hell rarely made it into our family’s consciousness. No, I liked his spiritual core because it signaled respect for a greater good, a directing hand, the capacity to endure, a reason to try to reach for the stars.
I love my father. He was such a good man. I have tried in some ways to be like him.
When I think of him, I always remember one evening, arriving home from college, coming through the door, and being greeted by him. He enveloped me in a big hug that night – tight, long – and kissed me on the cheek, and said my name. He was smiling. His eyes were alive and happy. I can smell him. I can feel his presence.

 

Why I Thank Presidents Nixon, Bush(41) and Obama This Thanksgiving Day.

Posted on | November 27, 2014 | No Comments

Mike Magee

Last evening, the night before Thanksgiving Day, I went to sleep shaking my head. I had just watched the 1974 documentary, “Hearts and Minds”, which documented the behaviors of five American presidents from Eisenhower to Nixon, as they distorted the truth and led our country into a disastrous war.

Of the many images that refused to disappear as I drifted off to sleep, there were two, juxtaposed that were front and foremost. The first was a distraught and weeping 8 year old Vietnamese boy, holding a picture of his handsome father, as he refused to let go of his flag-draped father’s coffin being lowered into the ground. His full fledged grief, his defiance, his honest and human reaction to the shock and inhumanity of it all, reminded me of my own four children at this age. In his grief, he expressed  love and honored his father’s memory forever.

The image was then starkly followed by a matter of fact interview, again in 1974, of the seersucker suit draped William Westmoreland who explained that “Well, the Oriental doesn’t put the same high price on life as the Westerner. And as the philosophy of the Orient expresses it, life is not important.”

Thinking of him and those years again, which in many ways I’d sooner forget, and realizing that to some extent, we have managed to repeat our mistakes, and embrace the same types of biases, in our actions in Iraq and Afghanistan, well, you can understand why I sighed a bit for the human race last evening.

But this morning, I came across Coral Davenport’s report in the New York Times, which seemed sent to deliver a Thanksgiving message that said, “Yes, but…” It make me offer thanks to Presidents Nixon, Bush(41), and Obama. And here’s why.

1. In 1970, the Senate passed the Clean Air Act 73-0, and President Nixon, who had created the EPA, signed the bill into law. This landmark legislation was intentionally writ large to allow the head of the EPA broad latitude in addressing future needs.

2. In 1990, another Republican president, George Bush, signed legislation that further strengthened the law after 89 senators, including Mitch McConnell supported the changes. Of this action, our new incoming Majority Leader, who has recently decried actions of the EPA as attempts to destroy “Big Coal”, has stated, “I had to choose between cleaner air and the status quo. I chose cleaner air.” President Bush’s action allowed the EPA to first begin to measure levels of ozone and mercury in our air.

3. Finally, faced with an inability to sign on to any new legislation, President Obama has made the most of the gifts that his two predecessors have provided him, and focused on mining the full potential of that far reaching, now nearly half-century old act. Most notably, it has become the leading edge of an attack on global warming. It’s chief instruments? Significant tightening of standards on coal-fired power plants to take effect next year and a new fuel-economy standard of 54.5 miles per gallon on automobiles by the year 2025. This last step alone helps explain why hybrid and electric technology is on a tear, and why Canadian tar sand and cross-territorial pipelines are really so “old school”.

So this Thanksgiving, I choose to see the world for what it is, endless shades of grey, imperfect, and yet hopeful. And I thank Presidents Nixon, and Bush, and Obama, for these wise actions, and for the good they continue to provide for each of us, wherever we are, and for our planetary patient.

Happy Thanksgiving!

Parent Alert: Graco Stollers Recalled Due to Baby Fingertip Amputations

Posted on | November 21, 2014 | 1 Comment

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Parent Alert: Baby products giant Graco has recalled 5 million strollers like those above after babies have lost fingertips in the framing. To check whether your stroller is safe, contact Graco Children’s Products at (800) 345-4109 or online at gracobaby.com.

Arsenic and Rice: Why Rice Cereal For Babies Is Not A Good Choice.

Posted on | November 19, 2014 | No Comments

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Mike Magee

Thanks to Consumer Reports, most Americans are at least somewhat aware that there are issues with rice – specifically arsenic. Their initial report from 2012 has just been updated with a 2014 Report with hundreds of measurements and testing of alternate grains as well. What do you need to know?

The Basics:

Arsenic is a naturally occurring toxic metallic element found in soil and water. In large enough concentrations in its’ inorganic form, it’s a proven carcinogenic substance. Arsenic concentrates differently in varied plants. One of the foods that concentrates arsenic at the highest levels is rice. The use of  “arsenic-based pesticides, drugs and rice byproducts in agricultural production” has artificially elevated the concentration of arsenic in food and water in parts of the U.S. This, in turn, has continued to elevate arsenic levels in rice plants from some areas of our country. Brown rice, which naturally retains the grains outer sheath covering and has nutritional advantages compared to white rice, is higher in arsenic than white rice which has had the sheath removed. This is because the outer coverings of rice absorb arsenic at the highest levels. Rice is not only a popular food for adults in America but also extensively used in processed baby cereals, crackers and rice cakes, and as a milk alternative in childhood beverages. Babies and young children are especially vulnerable to arsenic.

The Findings/Recommendations:

1. “Children (up to 70 pounds) should rarely eat hot rice cereals or rice pastas. Those products all had some of the highest measured levels of total inorganic arsenic.” According to Consumer Reports: “The FDA should immediately address the risk for children consuming rice and commonly consumed rice-based foods, including rice cereals, pastas, and beverages, by setting standards for inorganic arsenic in those food.”

2. “Rice labeled as from the U.S. or from Arkansas, Louisiana, or Texas …has the highest levels of total inorganic arsenic compared with rice from elsewhere.” This contrasts with rice from California which generally has much lower levels of arsenic.

3. Brown rice has higher levels than white rice, but also some nutritional advantages. Specifically, brown Basmati rice from California, India and Pakistan, and sushi rice from the U.S. had the lowest levels of arsenic of all varieties tested. Amaranth, millet, and quinoa are also safer alternatives.

CRM_Arsenic_Chart_Page-42_01-15-1The Point System:

In lieu of FDA action, Consumer Reports has created a point system to help guide consumer choice and behavior. Each product was assigned a number of points with differentiation of children and adults. Over a course of one week, CR recommends that neither child nor adult exceed 7 points.

The Full Report is available HERE.

For Health Commentary, I’m Mike Magee.

 

 

Why There Is No Surgeon General Today.

Posted on | November 13, 2014 | No Comments

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Mike Magee

The New England Journal of Medicine asks this week, “Where is the Surgeon General?”

In their words: “As an unchecked Ebola epidemic moves out of West Africa to touch the United States and the rest of the world, we should rightfully ask, ‘Where is the Surgeon General?’ The answer is, quite simply, that we do not have one. We face a growing crisis of confidence in our ability to protect patients and health care workers, and the position of the chief public health officer of the United States remains unfilled. How did this happen?”

In 2007, Health Commentary asked , “Do Americans know there is (or ever was) a Surgeon General, and do they care? Do they recall specific Surgeons General and what are their opinions (favorable and unfavorable) regarding those individuals? Are younger generations as aware of this position as older Americans?”

To answer these questions, a nationwide study with Yankelovich in September 2006 was commissioned – involving more than 1,000 Americans — that addressed these issues. The findings:

1. Most Americans, 71%, said they did know whether or not the United States had a Surgeon General.

2. At the same time, only one in three (32%) was able to recall unaided the name of any particular Surgeon General.

3. C. Everett Koop was by far the most commonly recalled Surgeon General, with 28% volunteering his name on an unaided basis, and an additional 24% recalling him when aided. This was especially remarkable since he had been out of the office for 17 years.

4. Jocelyn Elders, perhaps based on her highly publisized comments on masturbation, was the next highest at 3% unaided, and 33% aided.

5. Knowledge and awareness of Surgeons General was highest among older Americans. Younger Americans – those under 35 years of age – were generally unaware of any Surgeon General.

6. Men were more aware than were women.

In 2001, I interviewed a large number of Christian Conservatives (nearly 20), including Pat Robertson, about the Surgeon General position. To my surprise, they universally viewed the disposition of this position as among their most important issues. The primary take-aways were:

1. They continued to harbor deep anger and resentment toward C. Everett Koop, a well known fundamentalist Christian pediatric surgeon from the University of Pennsylvania, who they felt had betrayed their trust. These feelings were connected  to Koop’s refusal to state that abortion carried with it substantial physical and psychological risk to women, as well as his activist promotion of condoms and the distribution of his HIV/AIDS Report by mail to American households. Koop had produced and distributed tens of thousands of copies of the report, which included the recommendation that AIDS education “be started at the earliest grade possible”, without prior clearance from the Reagan White House. He also refused to support mandatory testing for HIV which conservatives like Bill Bennett and Phyllis Schafly we’re pushing with a vengeance.

2. In the wake of these “betrayals”, their top preference regarding the position was that President Bush dissolve it or at least leave it unfilled.

3. Their second choice, if it had to be filled, was that it be done with a candidate who would be dormant and inactive in that position – ceremonial only.

In this week’s article, the editors of the Journal list a number of highly qualified candidates from the ranks of academia, public health, and government, urging the President to act now. As they say in their final sentence, “We urge the President to nominate and the Senate to confirm a strong leader and trusted voice as the nation’s next Surgeon General.”

While this is sound advise, I believe that, were I to interview the same individuals today that I did in 2001, I would find that their views were unchanged, and their passion for elimination or deliberate vacancy of the position would be even more entrenched and passionate today than it was back then.

For Health Commentary, I’m Mike Magee

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