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Will Your Community Lose Its Hospital?
By Anna Kirsch and Jim Anderson, AlterNet. Posted October 17, 2007.

Why community hospitals are closing all across the United States and yours could be next.

All across the country, a new epidemic is threatening people's health -- the culprit is the closure of community hospitals and those most at risk are low-income and people of color.

"This is the hospital that I take my 94-year-old mother to. This is the hospital that I was born in ... this is the hospital that I take my nieces and nephews to, the hospital where most everyone in my community goes and where all my loved ones and family members have been and still get treated," said Jim Anderson, describing the Erie County Medical Center in Buffalo, N.Y., just one of many community hospitals across the nation that are slated to be shut down within the next year.

"This hospital is located in the heart of the black community here, and it serves any and everybody ... it has its problems, but the answer is not to shut it down," said Anderson, a New York correspondent for Poor Magazine and the PoorNewsNetwork (PNN), a grassroots media organization based in San Francisco dedicated to reframing the news and views around issues of racism and poverty.

I first heard Anderson speak in one of Poor Magazine's community newsroom meetings at the United States Social Forum in Atlanta this June, where he talked about the struggle he has faced in getting any sort of healthcare as a poor African-descendent man in this country.

As he spoke to crowd of folks struggling with poverty, racism and disability about the hospital closure crisis facing poor communities of color across the entire state of New York, one hand after another shot up in the air.

"The same thing is happening in ... New Orleans ... Nashville ... Philadelphia ... Los Angeles ... right here in Atlanta with Grady Memorial Hospital," folks from all over chimed in to share stories about their struggle to keep their community hospitals open.

Grady Memorial Hospital, which is the largest publicly funded hospital in the state of Georgia, was located just a few miles away from our meeting that day in Atlanta and is often referred to as the "only hospital that treats poor people."

Rev. Calvin E. Peterson, a formerly houseless, disabled man who was born at Grady Hospital in 1948 and also worked with the hospital on their accessibility plan, said that the entire poor, black community would be in an uproar if the state closed it down.

The hospital is facing mounting financial problems and could be closed by the end of the year if an agreement is not reached. This could leave thousands, such as Peterson, suffering and without a place to receive care.

Although Grady has been criticized by many for its inadequate services, if the state hospital could receive the much-needed funding -- that is currently being denied -- it could hire the necessary staff and make improvements.

Other folks expressed similar concerns for their own low-income communities all across the nation. Where would these people go for emergency treatment? What would happen to the hospital staff that had become an integral part of the community it served? Why couldn't a state-run "public" hospital get the necessary funding to treat residents?

As a person living without health insurance, I, like so many in this country, live in fear of facing any serious illness or accident, one that would put me in lifelong debt. Like Anderson and his family, I too am dependent on these community hospitals, and even though they are plagued with problems -- they are all we have.

Connecting the dots in Atlanta

"In Buffalo, some people are mistakenly thinking that this issue isn't touching anyone else, but in Atlanta I learned that this is not an isolated incident," said Anderson who explained that he believed the nationwide closure of hospitals serving communities of color is not a coincidence, but rather a calculated effort by the government to get rid of what it's calling a "surplus of unused hospital beds."

State governments all across the country are conducting "studies" largely behind closed doors to "restructure" healthcare facilities, which has resulted in numerous plans for closures and forced mergers.

For example, in New York, the Commission on Health Care Facilities in the 21st Century was created by the governor and is made up of 54 members, each appointed by either the governor, the senate or the speaker of the assembly. The commission was left with the task of "restructuring and rightsizing the healthcare industry" in the state and held most of tits meetings in secret -- a fact that has caused an uproar in local communities and caused two hospitals to sue.

With hardly any input from the community that would be the most affected by its decisions, such as the hospital workers themselves, the commission released dozens of recommendations in 2006 ultimately affecting the entire public hospital and nursing home system in New York. (The commission's full report can be read online.) In the Buffalo area alone, six hospitals -- almost all of which serve high needs communities of color, low-income people, disabled persons and seniors -- are slated for closure.

"Shutting down these hospitals will destabilize whole communities," said Anderson. "Smaller clinics are going to have to absorb the drop-off and they just don't have the resources to do so," he added.

Erie County Medical Center, like so many others facing possible closure in the country, definitely has its problems, including a serious lack of funding and staff. But changes, not forced closures and forced mergers, need to be made, said Anderson. The hospital has long been addressing health problems largely faced by the black community, like the high rate of heart disease, Anderson added, and has the best heart surgery survival rates in Western New York.

Hardly anyone would argue with the commission report's claim that the "healthcare system is broken and needs repair," however in the past, hospital mergers have created chaos and disastrous results in New York and other states. It's also interesting to note that the hospitals run by New York City's Health and Hospitals Corp. didn't face any closures or forced mergers under the commission's recommendations; the majority of hospitals that did are public, nonprofit providers.

Information from Health Care that Works reported that in New York City, "New Yorkers who live in predominantly minority communities face greater geographic barriers to accessing a hospital than those who live in predominantly white communities. These problems were made worse by the fact that six of the eight hospitals that closed between 1995 and 2005 were located in or near communities of color."

Most of these public hospitals are considered "safety net" hospitals, meaning they provide treatment to those who are uninsured and cannot afford to pay the full cost -- people like Anderson's family and mine. As more and more of these safety net hospitals, like Erie County Medical Center, close, it is less likely that people without insurance will be able to access any sort of medical care.

As a recent study conducted by a committee of interns, residents and directors of the Health Reform Program at Boston noted, "Hospital closings have harmed access to care -- particularly in underserved areas and communities of color ... the effects of hospital closings on access to care have been poorly studied and systematically downplayed by advocates of closing."

This is a fact that Anderson and other community members know all too well. When a financial crisis occurs in any industry, the poor are the first to face cuts in services. In America's longstanding trend of privatizing services that were once considered public, healthcare is the next in line. More and more, the truth is becoming that if you don't have the money, you don't get the treatment.

A nationwide epidemic

The story is the same all over the nation -- the most recent crisis occurring in South Central L.A., where the Martin Luther King Harbor Hospital will be closed. This historic hospital, which is predominately staffed by and serves African descendent folks, used to be a place of pride in the community, but has recently -- like Grady Memorial and Erie County Medical Center -- come under intense scrutiny for its care.

Now the emergency department at King has been shut down and the entire hospital is soon to follow. As Earl Ofari Hutchinson wrote for the L.A. Times:

The currently downsized King treats at least 100 emergency patients daily, nearly 1,000 in a week ... It has one of the highest emergency patient loads of any urban hospital. At one point, King provided sustained care for more than 10,000 patients, and it treated nearly 170,000 as outpatients. That equals the population of a small city. The U.S. Centers for Medicare and Medicaid Services, which cited King for deficiencies, has never stated that King was a threat to patients' lives.

Who are these patients the hospital serves? They are mainly African-Americans and Latinos who have a per capita income below the federal poverty rate. Many lack adequate private transportation. King is not one of the few options they have for medical care; it's their only option.

King served over 47,000 patients last year, now these patients will be forced to travel farther distances in life-threatening situations and overwhelm other already understaffed hospitals.

And where would these people go? Hutchinson writes:

In 2005, University of California researchers looked at hospital closures in L.A. County between 1997 and 2002. They found that the closures overwhelmed staff and facilities at the county's four general hospitals, which included King. The closures triggered a stampede of patients to doctor's offices, clinics and emergency rooms. They increased the time and distance that patients had to travel to get to a healthcare provider.
That meant that fewer patients saw doctors, fewer children had checkups, patients were less likely to seek and get preventive care, and there was a jump in the number of deaths from injuries and heart attacks. This virtually guaranteed that the number of people who suffered from acute illnesses would climb. These ailments are more costly to treat. In the case of King, there are even more deadly consequences. It treats more victims of life-threatening gunshot wounds than any other area hospital.

Across the country, the story is much the same. The hospital where I was born in Norfolk, Va., is facing serious downsizing and possible closure. Depaul Hospital, a nonprofit Catholic hospital run by the Bon Secours Health System that has been a fixture in my own community for over 150 years, is the latest target in the attack on community hospitals.

Now, in Virginia, just as in New York, a private advisory board called the Eastern Virginia Health Systems Agency, which was set up years ago, is about to release a set of recommendations early this month. The results could be disastrous for the local community, just like in Buffalo and Los Angeles.

Also similarly, the state is claiming this hospital must close or downsize to save money, yet it has been proven over and over again, by numerous researchers at places such as Boston University, that closing hospitals does in fact not save money. This fact seems to have been ignored by state governments all across the nation, as "financial reasons" is the claim most often stated by proponents of the closures.

Again, the solution does not seem to be to simply close this hospital's door, but rather provide better funding and develop more staff to meet the health needs of our citizens. As Anderson said, "We need to use these hospitals to train our own community members how to be culturally sensitive in their treatment and care of patients ... the opportunity for these hospitals to be successful exists if only we provide what's necessary. We are capable of doing our own analysis, our own studies, because in the end it's our loved ones who have been and will continue to be mis-served and underserved."

Anderson has a vision of not just preventing hospital closures but seeing a better community healthcare model.

"Imagine culturally sensitive, inclusive hospitals that are really capable of addressing healthcare needs by providing equitable quality care, diverse staffing, preventive healthcare and real community services," he said.

The possibility to save these hospitals does exist if only we, the community, refuse to be silenced and together create a vision for the future. These hospitals are meant to be for us and our communities, and we have all got to demand that the doors stay open and the facilities receive the proper and necessary funding to provide real care and service for people of all income levels.

"The real question to the public is: 'What are you prepared to do to stop these closures?' said Anderson. "We need people to share stories about what's happening in their hometowns with their own community hospital ... we need people to pay attention to reports and actions occurring in other communities, and people must challenge state and national political office holders to address this issue," he added.

It's time to demand a stop to the closures of community hospitals and, along with it, to demand a real cure for our hospitals and our healthcare system.

If a hospital is closing in your community, and you are interested in nationally organizing please email Anna (anna@poormagazine.org) or Jim (aqejim@aol.com). Poor Magazine is an online news service dedicated to providing media access to communities of color struggling with poverty locally and globally, as well as scholarship on issues of poverty, racism, disability, immigration and youth justice from people who struggle with and resist these positions of oppression every day.
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Steep decline in oil production brings risk of war and unrest, says new study
· Output peaked in 2006 and will fall 7% a year
· Decline in gas, coal and uranium also predicted
Ashley Seager
Monday October 22, 2007

World oil production has already peaked and will fall by half as soon as 2030, according to a report which also warns that extreme shortages of fossil fuels will lead to wars and social breakdown.

The German-based Energy Watch Group will release its study in London today saying that global oil production peaked in 2006 - much earlier than most experts had expected. The report, which predicts that production will now fall by 7% a year, comes after oil prices set new records almost every day last week, on Friday hitting more than $90 (£44) a barrel.

"The world soon will not be able to produce all the oil it needs as demand is rising while supply is falling. This is a huge problem for the world economy," said Hans-Josef Fell, EWG's founder and the German MP behind the country's successful support system for renewable energy.

The report's author, Joerg Schindler, said its most alarming finding was the steep decline in oil production after its peak, which he says is now behind us.

The results are in contrast to projections from the International Energy Agency, which says there is little reason to worry about oil supplies at the moment.

However, the EWG study relies more on actual oil production data which, it says, are more reliable than estimates of reserves still in the ground. The group says official industry estimates put global reserves at about 1.255 gigabarrels - equivalent to 42 years' supply at current consumption rates. But it thinks the figure is only about two thirds of that.

Global oil production is currently about 81m barrels a day - EWG expects that to fall to 39m by 2030. It also predicts significant falls in gas, coal and uranium production as those energy sources are used up.

Britain's oil production peaked in 1999 and has already dropped by half to about 1.6 million barrels a day.

The report presents a bleak view of the future unless a radically different approach is adopted. It quotes the British energy economist David Fleming as saying: "Anticipated supply shortages could lead easily to disturbing scenes of mass unrest as witnessed in Burma this month. For government, industry and the wider public, just muddling through is not an option any more as this situation could spin out of control and turn into a complete meltdown of society."

Mr Schindler comes to a similar conclusion. "The world is at the beginning of a structural change of its economic system. This change will be triggered by declining fossil fuel supplies and will influence almost all aspects of our daily life."

Jeremy Leggett, one of Britain's leading environmentalists and the author of Half Gone, a book about "peak oil" - defined as the moment when maximum production is reached, said that both the UK government and the energy industry were in "institutionalised denial" and that action should have been taken sooner.

"When I was an adviser to government, I proposed that we set up a taskforce to look at how fast the UK could mobilise alternative energy technologies in extremis, come the peak," he said. "Other industry advisers supported that. But the government prefers to sleep on without even doing a contingency study. For those of us who know that premature peak oil is a clear and present danger, it is impossible to understand such complacency."

Mr Fell said that the world had to move quickly towards the massive deployment of renewable energy and to a dramatic increase in energy efficiency, both as a way to combat climate change and to ensure that the lights stayed on. "If we did all this we may not have an energy crisis."

He accused the British government of hypocrisy. "Tony Blair and Gordon Brown have talked a lot about climate change but have not brought in proper policies to drive up the use of renewables," he said. "This is why they are left talking about nuclear and carbon capture and storage. "

Yesterday, a spokesman for the Department of Business and Enterprise said: "Over the next few years global oil production and refining capacity is expected to increase faster than demand. The world's oil resources are sufficient to sustain economic growth for the foreseeable future. The challenge will be to bring these resources to market in a way that ensures sustainable, timely, reliable and affordable supplies of energy."

The German policy, which guarantees above-market payments to producers of renewable power, is being adopted in many countries - but not Britain, where renewables generate about 4% of the country's electricity and 2% of its overall energy needs.
http://tinyurl.com/23gojh

Clinton bucks the trend and rakes in cash from the US weapons industry
By Leonard Doyle in Washington
Published: 19 October 2007

The US arms industry is backing Hillary Clinton for President and has all but abandoned its traditional allies in the Republican party. Mrs Clinton has also emerged as Wall Street's favourite. Investment bankers have opened their wallets in unprecedented numbers for the New York senator over the past three months and, in the process, dumped their earlier favourite, Barack Obama.

Mrs Clinton's wooing of the defence industry is all the more remarkable given the frosty relations between Bill Clinton and the military during his presidency. An analysis of campaign contributions shows senior defence industry employees are pouring money into her war chest in the belief that their generosity will be repaid many times over with future defence contracts.

Employees of the top five US arms manufacturers – Lockheed Martin, Boeing, Northrop-Grumman, General Dynamics and Raytheon – gave Democratic presidential candidates $103,900, with only $86,800 going to the Republicans. "The contributions clearly suggest the arms industry has reached the conclusion that Democratic prospects for 2008 are very good indeed," said Thomas Edsall, an academic at Columbia University in New York.

Republican administrations are by tradition much stronger supporters of US armaments programmes and Pentagon spending plans than Democratic governments. Relations between the arms industry and Bill Clinton soured when he slimmed down the military after the end of the Cold War. His wife, however, has been careful not to make the same mistake.

After her election to the Senate, she became the first New York senator on the armed services committee, where she revealed her hawkish tendencies by supporting the invasion of Iraq. Although she now favours a withdrawal of US troops, her position on Iran is among the most warlike of all the candidates – Democrat or Republican.

This week, she said that, if elected president, she would not rule out military strikes to destroy Tehran's nuclear weapons facilities. While on the armed services committee, Mrs Clinton has befriended key generals and has won the endorsement of General Wesley Clarke, who ran Nato's war in Kosovo. A former presidential candidate himself, he is spoken of as a potential vice-presidential running mate.

Mrs Clinton has been a regular visitor to Iraq and Afghanistan and is careful to focus her criticisms of the Iraq war on President Bush, rather than the military. The arms industry has duly taken note.

So far, Mrs Clinton has received $52,600 in contributions from individual arms industry employees. That is more than half the sum given to all Democrats and 60 per cent of the total going to Republican candidates. Election fundraising laws ban individuals from donating more than $4,600 but contributions are often "bundled" to obtain influence over a candidate.

The arms industry has even deserted the biggest supporter of the Iraq war, Senator John McCain, who is also a member of the armed services committee and a decorated Vietnam War veteran. He has been only $19,200. Weapons-makers are equally unimpressed by the former New York mayor Rudolph Giuliani. Despite a campaign built largely around the need for an aggressive US military and a determination to stay the course in Iraq, he is behind Mrs Clinton in the affections of arms executives. Mr Giuliani may be suffering because of his strong association with the failed policies of President Bush and the fact he is he is known as a social liberal.

Mrs Clinton's closest competitor in raising cash from the arms industry is the former Massachusetts governor Mitt Romney, who raised just $32,000.

"Arms industry profits are so heavily dependent on government contracts that companies in this field want to be sure they do not have hostile relations with the White House," added Mr Edsall.

The industry's strong support for Mrs Clinton indicates that she is their firm favourite to win the Democratic nomination in the spring and the presidential election in November 2008. In the last presidential race, George Bush raised more than $800,000 – twice the sum collected by his Democratic rival John Kerry.

Mr Edsall's analysis of the figures reveals that, over the past 10 years, the defence industry has favoured Republicans over Democrats by a 3-2 margin, making Mrs Clinton's position even more remarkable.
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Dragonfly or Insect Spy? Scientists at Work on Robobugs.
By Rick Weiss
Tuesday, October 9

Vanessa Alarcon saw them while working at an antiwar rally in Lafayette Square last month.

"I heard someone say, 'Oh my god, look at those,' " the college senior from New York recalled. "I look up and I'm like, 'What the hell is that?' They looked kind of like dragonflies or little helicopters. But I mean, those are not insects."



Out in the crowd, Bernard Crane saw them, too.

"I'd never seen anything like it in my life," the Washington lawyer said. "They were large for dragonflies. I thought, 'Is that mechanical, or is that alive?' "

That is just one of the questions hovering over a handful of similar sightings at political events in Washington and New York. Some suspect the insectlike drones are high-tech surveillance tools, perhaps deployed by the Department of Homeland Security.

Others think they are, well, dragonflies -- an ancient order of insects that even biologists concede look about as robotic as a living creature can look.

No agency admits to having deployed insect-size spy drones. But a number of U.S. government and private entities acknowledge they are trying. Some federally funded teams are even growing live insects with computer chips in them, with the goal of mounting spyware on their bodies and controlling their flight muscles remotely.

The robobugs could follow suspects, guide missiles to targets or navigate the crannies of collapsed buildings to find survivors.

The technical challenges of creating robotic insects are daunting, and most experts doubt that fully working models exist yet.

"If you find something, let me know," said Gary Anderson of the Defense Department's Rapid Reaction Technology Office.

But the CIA secretly developed a simple dragonfly snooper as long ago as the 1970s. And given recent advances, even skeptics say there is always a chance that some agency has quietly managed to make something operational.

"America can be pretty sneaky," said Tom Ehrhard, a retired Air Force colonel and expert in unmanned aerial vehicles who is now at the Center for Strategic and Budgetary Assessments, a nonprofit Washington-based research institute.

Robotic fliers have been used by the military since World War II, but in the past decade their numbers and level of sophistication have increased enormously. Defense Department documents describe nearly 100 different models in use today, some as tiny as birds, and some the size of small planes.

All told, the nation's fleet of flying robots logged more than 160,000 flight hours last year -- a more than fourfold increase since 2003. A recent report by the U.S. Army Command and General Staff College warned that if traffic rules are not clarified soon, the glut of unmanned vehicles "could render military airspace chaotic and potentially dangerous."

But getting from bird size to bug size is not a simple matter of making everything smaller.

"You can't make a conventional robot of metal and ball bearings and just shrink the design down," said Ronald Fearing, a roboticist at the University of California at Berkeley. For one thing, the rules of aerodynamics change at very tiny scales and require wings that flap in precise ways -- a huge engineering challenge.

Only recently have scientists come to understand how insects fly -- a biomechanical feat that, despite the evidence before scientists' eyes, was for decades deemed "theoretically impossible." Just last month, researchers at Cornell University published a physics paper clarifying how dragonflies adjust the relative motions of their front and rear wings to save energy while hovering.

That kind of finding is important to roboticists because flapping fliers tend to be energy hogs, and batteries are heavy.

The CIA was among the earliest to tackle the problem. The "insectothopter," developed by the agency's Office of Research and Development 30 years ago, looked just like a dragonfly and contained a tiny gasoline engine to make the four wings flap. It flew but was ultimately declared a failure because it could not handle crosswinds.

Agency spokesman George Little said he could not talk about what the CIA may have done since then. The Office of the Director of National Intelligence, the Department of Homeland Security and the Secret Service also declined to discuss the topic.

Only the FBI offered a declarative denial. "We don't have anything like that," a spokesman said.

The Defense Department is trying, though.

In one approach, researchers funded by the Defense Advanced Research Projects Agency (DARPA) are inserting computer chips into moth pupae -- the intermediate stage between a caterpillar and a flying adult -- and hatching them into healthy "cyborg moths."

The Hybrid Insect Micro-Electro-Mechanical Systems project aims to create literal shutterbugs -- camera-toting insects whose nerves have grown into their internal silicon chip so that wranglers can control their activities. DARPA researchers are also raising cyborg beetles with power for various instruments to be generated by their muscles.

"You might recall that Gandalf the friendly wizard in the recent classic 'Lord of the Rings' used a moth to call in air support," DARPA program manager Amit Lal said at a symposium in August. Today, he said, "this science fiction vision is within the realm of reality."

A DARPA spokeswoman denied a reporter's request to interview Lal or others on the project.

The cyborg insect project has its share of doubters.

"I'll be seriously dead before that program deploys," said vice admiral Joe Dyer, former commander of the Naval Air Systems Command, now at iRobot in Burlington, Mass., which makes household and military robots.

By contrast, fully mechanical micro-fliers are advancing quickly.

Researchers at the California Institute of Technology have made a "microbat ornithopter" that flies freely and fits in the palm of one's hand. A Vanderbilt University team has made a similar device.

With their sail-like wings, neither of those would be mistaken for insects. In July, however, a Harvard University team got a truly fly-like robot airborne, its synthetic wings buzzing at 120 beats per second.

"It showed that we can manufacture the articulated, high-speed structures that you need to re-create the complex wing motions that insects produce," said team leader Robert Wood.

The fly's vanishingly thin materials were machined with lasers, then folded into three-dimensional form "like a micro-origami," he said. Alternating electric fields make the wings flap. The whole thing weighs just 65 milligrams, or a little more than the plastic head of a push pin.

Still, it can fly only while attached to a threadlike tether that supplies power, evidence that significant hurdles remain.

In August, at the International Symposium on Flying Insects and Robots, held in Switzerland, Japanese researchers introduced radio-controlled fliers with four-inch wingspans that resemble hawk moths. Those who watch them fly, its creator wrote in the program, "feel something of 'living souls.' "

Others, taking a tip from the CIA, are making fliers that run on chemical fuels instead of batteries. The "entomopter," in early stages of development at the Georgia Institute of Technology and resembling a toy plane more than a bug, converts liquid fuel into a hot gas, which powers four flapping wings and ancillary equipment.

"You can get more energy out of a drop of gasoline than out of a battery the size of a drop of gasoline," said team leader Robert Michelson.

Even if the technical hurdles are overcome, insect-size fliers will always be risky investments.

"They can get eaten by a bird, they can get caught in a spider web," said Fearing of Berkeley. "No matter how smart you are -- you can put a Pentium in there -- if a bird comes at you at 30 miles per hour there's nothing you can do about it."

Protesters might even nab one with a net -- one of many reasons why Ehrhard, the former Air Force colonel, and other experts said they doubted that the hovering bugs spotted in Washington were spies.

So what was seen by Crane, Alarcon and a handful of others at the D.C. march -- and as far back as 2004, during the Republican National Convention in New York, when one observant but perhaps paranoid peace-march participant described on the Web "a jet-black dragonfly hovering about 10 feet off the ground, precisely in the middle of 7th avenue . . . watching us"?

They probably saw dragonflies, said Jerry Louton, an entomologist at the National Museum of Natural History. Washington is home to some large, spectacularly adorned dragonflies that "can knock your socks off," he said.

At the same time, he added, some details do not make sense. Three people at the D.C. event independently described a row of spheres, the size of small berries, attached along the tails of the big dragonflies -- an accoutrement that Louton could not explain. And all reported seeing at least three maneuvering in unison.

"Dragonflies never fly in a pack," he said.

Mara Verheyden-Hilliard of the Partnership for Civil Justice said her group is investigating witness reports and has filed Freedom of Information Act requests with several federal agencies. If such devices are being used to spy on political activists, she said, "it would be a significant violation of people's civil rights."

For many roboticists still struggling to get off the ground, however, that concern -- and their technology's potential role -- seems superfluous.

"I don't want people to get paranoid, but what can I say?" Fearing said. "Cellphone cameras are already everywhere. It's not that much different."
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