Category: USA

California/Environment/Lifestyle/Money/New York/seniors/USA
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Grim outlook for public transportation

by Fran Johns
Muni-Bus-Market-street-San-Francisco
Image via Wikipedia

Can we have a functional, effective transportation system in the U.S.? Can we afford not to? Those were the questions addressed by former Secretary of Transportation Norman Mineta and a panel of experts at a full-house 9 AM event at San Francisco’s Commonwealth Club Friday. Oh — and how are we going to pay for it all? The program was titled “Funding the Transportation System of the Future.”

“Within the next two decades,” Mineta said in his introductory remarks, “the Census Bureau estimates that the U.S. population will increase by as many as 50 million people. This population growth, combined with a growing backlog of overdue maintenance work on roads and transit systems, creates a need for significantly expanded transportation revenues. However, the current political climate is generally unfavorable to tax increases.”

The ensuing discussion continually returned to two general points: first, that our parents and grandparents funded the transit infrastructures and systems we now enjoy and it is incumbent upon us to do the same for our children and grandchildren; and second, as Mineta and others repeatedly said, that there is no political will anywhere to do the latter. One illustration of the first point was cited by panelist William Millar, president of the American Public Transportation Association, who observed that “the New York subway system was built 106 years ago for $35 million — and you couldn’t get a feasibility study today for $35 million.”

Given the fact that most cities and counties could spend $35 million on overdue maintenance alone, most panelist comments and audience questions concerned the issue of finding funds at a time when tax increases are not very popular. “Creative funding” solutions appear to be the answer, even if there is currently far more creativity around than funds.

Asha Weinstein Agrawal, Director of the Mineta Transportation Institute‘s National Transportation Finance Center, cited a public opinion poll released yesterday (“one of those phone calls at dinner time…”) that surveyed 1500 people in English and Spanish to test receptiveness to eight variations of a possible gasoline tax. In general, opposition to such a tax is high, she said, but acceptance increases in proportion to benefits which individuals can see: tie the tax to emissions per vehicle and thus reduce greenhouse gases, for example. Agrawal recommended consideration of taxes linked to environmental effects.

Panelist John Horsley, Executive Director of the American Association of State Highway and Transportation Officials, said that because of funding cuts and declining revenues (from road usage fees etc), the U.S. Highway Fund will be insolvent some time between August and October of 2011, with the resultant loss of approximately 1 million jobs. He cited a few bright spots such as several states going ahead with high speed rail projects, “four states have actually raised gas taxes, Kansas has increased the sales tax, and New Hampshire sold itself a bridge” (which will get paid off through tolls.) High occupancy toll lanes were another potential funding source Horsley said could help until “fiscal sanity returns: investing in something good (rather than) borrowing forever.”

The consensus was aptly covered in one summation by California Senator Alan Lowenthal: “It’s a very difficult time for transportation.”

Whereupon this reporter got back on the #1 California Muni bus (catch a back seat, work on your computer for 30 minutes, no parking fee, no traffic hassle) and went home.

California/Health/Lifestyle/Medicine/New York/seniors/USA/Women
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Life: does longevity trump quality?

by Fran Johns

“We have to get out of the way,” she said; “make room for other, new people on the planet.” Accomplished author/editor Cyra McFadden, at a recent dinner party, was talking about a group of women scientist friends’ excitement over discoveries they have made which show promise of extending life a fraction longer. Cyra was in fierce, though silent, disagreement.

It may be time for those of us who disagree with the rampant prolong-life-at-all-costs theories  to stop being silent.

Americans are, in fact (as reported in Epoch Times below, and elsewhere) living longer all the time. Sometimes that’s just fine, especially if we’re in reasonable health. But what if we’re not? What if we’d just as soon be getting on with whatever follows this temporary time on earth? Millions and millions of people are living for hours, days or extended months and years in circumstances they would not choose simply because we have created a culture that says we must be kept alive no matter what.

Average life expectancy continues to increase, and today’s older Americans enjoy better health and financial security than any previous generation. Key trends are reported in “Older Americans 2008: Key Indicators of Well-Being,” a unique, comprehensive look at aging in the United States from the Federal Interagency Forum on Aging-Related Statistics.

“This report comes at a critical time,” according to Edward Sondik, Ph.D., director of the National Center for Health Statistics. “As the baby boomers age and America’s older population grows larger and more diverse, community leaders, policymakers, and researchers have an even greater need for reliable data to understand where older Americans stand today and what they may face tomorrow.”

Where do we stand right now? Well, the same source that says we’re living longer and enjoying better health and financial security (hmmmm on the financial security business) reveals that Americans are “engaging in regular leisure time physical activity” on these levels: ages 45-64: 30%; ages 75-84: 20%; geezers 85 and over: 10%. Hello? Better health and financial security, just no leisure time physical activity? Could it bear some relationship to obesity factors in the same data: 30+% for men, 40+% for women?

Does living well need to be assessed in the compulsion to live long? Why not? Everyone should have the right to live at whatever weight and whatever level of inaction he or she chooses. But the system is weighted toward keeping us alive under all conditions, and bucking the system is not easy. A poignant, wrenching tale of her father’s slow decline and death — and her mother’s refusal to go down that same path — was recently told by California writer/teacher Katy Butler in the New York Times Sunday Magazine.

Almost without their consent, Butler’s gifted, educated parents had their late years altered to match the system’s preferences:

They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Given the limitless sources of victimization floating around, we should not have to add just-try-to-keep-them-alive-forever health care to the list.

My husband and I, having long ago signed advance directives with additional specific issues sheets (“If this happens, do that; if that happens, don’t do this,” etc) recently got them out and talked things over again, a very good thing to do for EVERYbody over 18. We will add dementia provisions to the existing documents while we can remember to do that (the closest you can come to avoid being warehoused in a memory-loss facility for umpteen years.) We are clear, and our friends and family understand, about having no interest in hanging onto life in a greatly diminished state if such an opportunity presents itself; for increasing thousands, it presents itself every day.

All this being said, there’s still a reasonable chance that I’ll be out of town one day when I’m in my 80s (which aren’t that far off), get wiped out by a speeding cyclist and picked up in a seriously mangled state by the paramedics, taken to a hospital that’s not Kaiser (which has all my directives on file,) miraculously brought into some heavily-sedated state of being because the hospital doesn’t consult Kaiser or the living will registry (which also has my directives) and kept alive by assorted mechanisms. By the time my husband or children get there to insist everything be unplugged — which of course will involve long hours and possibly court action — hundreds of thousands of dollars will have been needlessly spent.

I consider myself a highly valuable member of society, and my life a gift from God. But would those dollars not be better spent on a few kids needing specialized care?

Epoch Times – Americans Are Living Longer, According to Federal Report.

California/Environment/Health/Lifestyle/Media/USA
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Cell phone radiation danger: true or false?

by Fran Johns
from Grandview Park in San Francisco
Image via Wikipedia

Head-zaps, otherwise known as cell phone radiation levels, messing with your brain? Nobody knows. What we do know is that cell phones emit radiation, just as radio and TV stations do at somewhat higher levels. What we also know is that nobody cares much. The back-and-forth going on between legislators and cell phone industry lobbyists suggests that a few people do care… but it’s a long road from caring to understanding to any kind of meaningful action.

In California, where local and state efforts to increase information made available to consumers have met with mixed results, an explanation in the Letters section of today’s San Francisco Chronicle offers some interesting perspectives. To understand them, it helps to know about the city’s Sutro Tower (above), a looming structure completed in 1973 and now furnishing transmissions for 11 TV stations, 4 FM radio stations and about 20 wireless communication services.

Local electrical engineer Bill Choisser has this to say:

The power of radio waves falls off as the square of the distance. This means one watt an inch from your head (typical for a cell phone) has the same effect as 1 million watts 1,000 inches from your head. The strongest TV signals on Sutro Tower run i million watts. A thousand inches is about 83 feet. Whether putting your head 83 feet from Sutro Tower every time you talk on the phone bothers you, is up to you.

San Francisco’s board of supervisor’s voted last week to require disclosure of the measure of cell phone radiation next to sales displays, something unlikely to make the tiniest bit of difference to sellers, buyers or anyone else. The FCC has a similar requirement likely to make even less difference.

CNET’s Christina Jewett, on her California Watch blog, summed up some of the action at the state level, where Sen. Mark Leno‘s bill to make radiation level information more accessible recently died. Leno emphasizes, in a statement on his website that there’s no definitive evidence that cell phone radiation causes cancer or other illnesses. Supporters argue that there are potential health effects dangerous enough to warrant making more information available, Jewett explains, while opponents termed the whole business expensive and unnecessary.

When the bill was a going concern, it did little to slow the never-ending party that lobbyists for AT&T Inc., one of its chief opponents, tend to host at Arco Arena. The firm spent about $535,000 on lobbying during the first quarter of this year. From Kings games to Disney Stars on Ice to a Valentine’s Super Love Jam, legislative staffers continued to enjoy the hospitality. (Details below).

Whether the lobbying effort led to the bill’s demise may never be known. But the debate at least is bringing out more information on the issue, one that regulators and scientists pledge to keep watching.

Given the number of Americans walking around (or sitting, or standing in place) with cell phones plastered to their ears, I for one am happy that somebody is watching… and that Bill Choisser is explaining.

State hangs up on expansion of San Francisco phone law | California Watch.

California/Health/Lifestyle/seniors/USA/Women
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Robo-seals invade U.S. nursing homes — perhaps a gadget too far?

by Fran Johns
Stuffed seal
Image by matsuyuki via Flickr

What with human affection so hard to come by these days, wouldn’t Granny be happy with a fuzzy mechanical toy? That, presumably, was the reasoning behind Japanese inventor Takanori Shabata’s idea for the nursing home’s new best friend, Paro the robo-seal. $15 million dollars later, Paro had hummed and buzzed his (her?) way into the hearts and homes of some 1300 Japanese adults who don’t want the hassle of real, live pets. Now cleared as a Class 2 medical device — a category enjoyed by his brethren the motorized wheelchair and similar less-cuddly items — Paro’s newest destination is U.S. nursing homes.

“Some of our residents need more than we as human beings can provide,” says Marleen Dean, activities manager at Vincentian Home, one of four facilities run by Pittsburgh-based Vincentian Collaborative System. Vincentian Collaborative recently used a $55,000 grant to purchase eight Paros and finds them especially comforting to patients with dementia. “We’ve tried soft teddy bears that talk and move. But they don’t have the same effect.”

Bill Thomas thinks it’s inhumane to entrust the task of emotional support to a gadget.

“If you give me a robot that helps perform mundane tasks associated with caregiving, such as vacuuming or doing the dishes, I’m all for that,” says Dr. Thomas, founder of the Green House Project, a campaign to make nursing homes smaller and more like regular houses. But “if we wind up with nursing homes full of baby-seal robots, the robots will be trying to fulfill the relationship piece of caregiving, while the humans are running around changing the beds and cooking the food.”

This space sides with Bill Thomas. At $6,000 per robo-seal, it just seems that some less anti-bacterial real creature could be found to serve the same purpose. But Paro has made believers in several U.S. nursing homes such as one in which a dementia unit resident is quoted as whispering to it, “I know you’re not real, but somehow, I don’t know, I love you.”   The question of whether offering Paro for love and affection (and often just for calming down the agitated folks who tend to populate nursing homes) is ethical and proper is stirring debate both here and in Denmark, where more than 100 Paros have found homes.

Sherry Turkle, a professor in the Science, Technology and Society program at the Massachusetts Institute of Technology, acknowledges Paro’s potential as a communication aid, but warns against regarding it as a companion. “Why are we so willing to provide our parents, then ourselves, with faux relationships?” she asks.

Danish filmmaker Phie Ambo, who spotlighted Paro in her 2007 documentary on interactive robots, “Mechanical Love,” dismisses such concerns. “When I came into nursing homes and found people sitting in rocking chairs with dolls, no one lifted an eyebrow.”

DTI (European distributor Danish Technological Institute) requires caregivers to attend Paro seminars, where they discuss such issues as whether it’s OK to leave an elderly person alone with a Paro, and whether patients must be told it’s a robot. Don’t allow someone to “escape into a strange seal robot’s universe,” cautions Lone Gaedt, senior consultant at DTI.

Admittedly, we carry on with perfect strangers in the parallel worlds of cyberspacial social networks. But somewhere, somehow, a few lines of human interaction might be better off left un-blurred.

What do you think?

Paro the Robo-Seal Aims to Comfort Elderly, but Is It Ethical? – WSJ.com.

California/Health/Lifestyle/seniors/USA
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Latest boomer gadget: tombstone microchips

by Fran Johns
Microchip e microciop
Image by Un ragazzo chiamato Bi via Flickr

This may be one step farther than some of us want to go. But for those seeking to live, somehow, forever, the Canwest News Service reports on a new e-gimmick on the market and apparently targeting the boomer generation. There are several more paragraphs in writer Misty Harris‘ report, but this space suggests that the following, and particularly the last sentence, cover everything you really need to know.

Ensuring virtual life after death, new microchip-enabled headstones allow the Me Generation to share their stories from the grave, with passersby simply swiping markers with a cellphone to retrieve biographical details — everything from the deceased’s political beliefs to their favourite recipes.

“My wife and I had just lost relatives and found it so underwhelming, in a sense, to know that these people had contributed so much and yet their lives were being summed up with just names and dates,” says John Bottorff, founder of Objecs, the Arizona company behind the RosettaStone grave markers.

The palm-sized tablets can be mounted to existing headstones or installed on new ones. Each is engraved with custom symbols representing the deceased’s life — an Rx for a pharmacist, for example, or a sheriff’s star for a police officer — and contains a Near Field Communications radio-frequency identification tag, which allows biographical data to be loaded onto any NFC-enabled phone with the wave of a hand (NFC is expected to be standard on new mobile phones in North America by 2012).

A unique web ID is also engraved so people without NFC can raise the dead — or at least their personal histories — on any computer.

As early as 2015, seniors will outnumber children for the first time in Canadian history, while the number of centenarians is projected to triple — perhaps even quadruple — by 2036.

For end-trepreneurs, this represents a killer opportunity.

Microchip tombstones latest boomer gadget.

California/Health/Law/Lifestyle/Politics & Causes/seniors/teens/USA/Women
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Marriage = procreation, Prop 8 backers say

by Fran Johns

It’s all about procreation, the Proposition 8 lawyers said; marriage between a man and a woman who produce babies to be raised by their biological parents, and thus insure the survival of the human race. Those arguments were the closing of an historic case that went to a federal judge in San Francisco yesterday.

During more than two hours of intense and sometimes skeptical questioning by Chief U.S. District Judge Vaughn Walker, attorney Charles Cooper maintained that society is entitled to reserve its approval of marriage for those who can naturally conceive children.”The marital relationship is fundamental to the existence and survival of the race,” Cooper said in closing arguments before a packed San Francisco courtroom. The reason the state regulates marriage, he said, is to steer “procreative sexual relationships” into a stable family environment so that children can be raised by their biological parents.

It’s an argument that has worked before, but supporters of same-sex marriage hope this time might be different.

Walker, who presided over the nation’s first federal trial on the issue, sounded dubious. He noted that the state allows couples unable or unwilling to have children to marry, suggesting that the institution has a broader purpose that same-sex partners might equally fulfill.

“Marriage is a right which extends fundamentally to all persons, whether they’re capable of producing children, incarcerated or behind in their child-support payments,” Walker said, citing Supreme Court rulings that allow people in all those situations to marry.

People marry not to benefit the state, but because they believe that “I’m going to get a life partner, who I’m going to share my life with and maybe have children,” the judge said. “Why don’t those same values apply to gay couples and lesbian couples loving one another?”

Cooper replied that same-sex couples are incapable of “irresponsible procreation,” which he said marriage laws are designed to discourage.

He also said California has provided equal treatment for all couples in its domestic-partner laws. But even a discriminatory marriage law would be valid, Cooper said, because the U.S. Constitution offers no special protection to gays and lesbians and “we don’t have to submit evidence” to justify treating them differently.Theodore Olson, lawyer for two same-sex couples who sued for the right to marry, responded indignantly. Prop. 8, he said, “takes a group of people who have been victims of discrimination” historically and prevents them from “participating in the most fundamental relationship in life.”

Gays and lesbians, Olson said, seek to wed for the same reasons as everyone else, to be in a committed, socially accepted family relationship with the one they love. “Tell me how it helps the rest of the citizens of California to keep them out of the club,” he said.

Walker’s decision, in whichever direction, is certain to be appealed.

Prop. 8 backers: Marriage promotes procreation.

California/Lifestyle/Politics & Causes/Religion/seniors/USA/Women
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When fear & hatred go viral

by Fran Johns

Illegal aliens threaten, Muslims are murderers, we should be Very Afraid. Or perhaps, like the author of these points, just Very Tired.

A super-patriot message (re)circulating in cyberspace could serve as a blueprint for how to spread hatred and fear across the land. It purports to spread Republican virtues, having been written (with apologies to someone else’s earlier blog in the same style) by retired military/public servant Robert A. Hall. Originally floated in a blog dated February 19, 2009, it has recently been picked up and dusted off for recycling. This writer has gotten it three times; though I am not on a lot of right wing Favorites lists I try to listen and understand messages received from friends with whom I disagree.

Hall, now a resident of Illinois but not an admirer of its current native son President, apparently served honorably in the U.S. Marines and the Massachusetts state senate. This space hereby commends him for his public service, accepts his right to whatever political beliefs he chooses, and takes very strong exception to his blog. It is the incendiary passage below that needs to be refuted:

I’m  tired of  being told that Islam is a “Religion of Peace,” when every day I can  read dozens of stories of Muslim men killing their sisters,  wives and daughters for their family “honor”; of Muslims  rioting over some slight offense; of Muslims  murdering Christian and Jews because they aren’t  “believers”; of Muslims burning schools for girls; of Muslims stoning  teenage rape victims to death for “adultery”; of Muslims mutilating  the genitals of little girls; all in the name of Allah, because the  Qur’an and Shari’a law tells them  to.

I have not read the Qur’an, though I doubt that’s what it says. Iftekhar Hai has.  Co-founder and director of interfaith relations for United Muslims of America, Hai understands what the Qur’an has to say far better than do Hall or I. Here are a few clarifications — if only they could circulate as widely as is the above screed:

Whatever faith you are born in, you are in God’s image. The message is the same, but people keep adding on and that’s what messes things up. Diversity is part of Islamic belief.”

The Qur’an does not condone the killing of non-believers. Religious leaders cannot decide who is a non-believer. Islam is not exclusive, and extremists are wrong to judge others.”

As to the status of women in Muslim countries, Hai says inequality for women has no basis in the Qur’an, but is a cultural matter (as in the wearing of the burqa by women in Afghanistan. Only 18% of Muslims, he says, live in Arab countries, with the majority in India, Pakistan and Bangladesh; he is quick to point out women leaders in those countries and in Indonesia.

It seems superfluous, but still appropriate, to mention that Christians have done a lot of killing “in God’s name,” as have people of just about every other faith, and that assorted acts of mayhem and violence are caused every day under every conceivable banner.

Iftekhar Hai, like millions of his fellow Muslims here and abroad, is a man of peace. He serves on the board of the San Francisco Interfaith Council and works with other organizations such as United Religions Initiative to promote understanding, cooperation and peace among all faiths. Wouldn’t less fear and hatred, and more peace and understanding be a good idea at this point in world history?

California/Education/Environment/Health/Lifestyle/Medicine/seniors/USA/Women
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Your doctor's in shape… but may just be getting in shape to retire

by Fran Johns

U.S. doctors as a group are “leaner, fitter and live longer than average Americans… male physicians keep their cholesterol and blood pressure lower… women doctors are more likely to use hormone-replacement therapy than their patients,” according to several recent surveys.

That’s the good news.

The bad news is that they are taking all this health and fitness into early retirement. And thanks to the hordes of baby boomers hanging up their stethoscopes for good, finding enough doctors in any shape at all is going to be a challenge, particularly in light of the numbers of newly insured.

Nearly 40 percent of doctors are 55 or older, according to the Center for Workforce Studies of the Association of American Medical Colleges. Included in that group are doctors whose specialties will be the pillars of providing care in 2014, when the overhaul kicks in; family medicine and general practitioners (37 percent); general surgeons (42 percent); pediatrics (33 percent), and internal medicine and pediatrics (35 percent).

About a third of the much larger nursing workforce is 50 or older, and about 55 percent expressed an intention to retire in the next 10 years, according to a Nursing Management Aging Workforce Survey by the Bernard Hodes Group. New registered nurses are flowing from colleges, but not enough to replace the number planning to leave the profession.

“Moving into the future, we see a very large shortage of nurses, about 300,000,” said Peter Buerhaus, a nurse and health-care economist and a professor at Vanderbilt University. “That number does not account for the demand created by reform. That’s a knockout number. It knocks the system down. It stops it.”

According to the census, baby boomers include the 66 million Americans born between 1946 and 1964.

In an article for the Journal of the American Medical Association, Buerhaus and colleagues Douglas Staiger and David Auerbach predicted that there will be at least 100,000 fewer doctors in the workplace than the 1.1 million the federal government projects will be needed in 2020 under the health-care overhaul.

“There’s a much more rapid retirement of physicians,” Buerhaus said. “What does this retirement mean? This will mean at least 100,000 fewer doctors in the workplace in 2020.”He said the article does not estimate the change in demand or the level of recruitment by medical colleges, which is being beefed up significantly under the health-care law.

Although current studies involve more than a little conjecture — Will professions in the medical field continue to be as attractive as other areas? Will doctors and nurses work longer if truly needed? — there is no doubt about the coming shortage.

Lori Heim, president of the American Association of Family Practitioners, said someone might soon have to replace her. “My age group is looking at when we are going to retire,” said Heim, who is 54. “More physicians are changing their practice, doing things that have less calls. They want administrative roles.”

Heim said her statement is based on an impression. “I haven’t seen any numbers on this.” But, she said, her association is among the many that for years have pointed out the shortage of primary care doctors and nurses to the White House and Congress.

Staying healthy might be the best defense.

Retirements by baby-boomer doctors, nurses could strain overhaul.

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