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	<title>Center for Justice &#187; Kitchen Table</title>
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		<title>A Soldier&#8217;s Story</title>
		<link>http://www.cforjustice.org/2013/06/15/a-soldiers-story/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=a-soldiers-story</link>
		<comments>http://www.cforjustice.org/2013/06/15/a-soldiers-story/#comments</comments>
		<pubDate>Sun, 16 Jun 2013 06:14:52 +0000</pubDate>
		<dc:creator>tim</dc:creator>
				<category><![CDATA[Kitchen Table]]></category>

		<guid isPermaLink="false">http://www.cforjustice.org/?p=18755</guid>
		<description><![CDATA[Larry Shook comes home.]]></description>
				<content:encoded><![CDATA[<h3>Larry Shook is finally coming home from Vietnam.</h3>
<p>On a day that seems like a lifetime ago I stepped off the elevator onto the third floor of the Peyton Building and, within minutes, met Larry Shook.</p>
<div id="attachment_18756" class="wp-caption alignright" style="width: 360px"><a href="http://www.cforjustice.org/wp-content/uploads/2013/06/Larrysmu.jpg"><img class="size-full wp-image-18756" alt="Larry Shook delivering his Memorial Day sermon." src="http://www.cforjustice.org/wp-content/uploads/2013/06/Larrysmu.jpg" width="350" height="390" /></a><p class="wp-caption-text">Larry Shook delivering his Memorial Day sermon.</p></div>
<p>It was late June 1980. I was a very young reporter, and Larry was then the publisher of <em>Spokane Magazine</em>, a fine publication that hosted terrific writers including Patrick McManus, William Stimson, Karen Dorn Steele, and C.R. Roberts. Larry was movie-star handsome with a well-coiffed shock of black hair, starched white shirt with a dark tie flowing from a buttoned down collar. He was smart, and witty, and passionate about journalism.</p>
<p>I’d left a newspaper job in central Washington the month before because the publisher lacked the nerve to run hard-hitting stories I’d developed as a police reporter. What I soon learned working as a staff writer at <em>Spokane Magazine</em> is that Larry had as much courage as anyone I’d ever met.</p>
<p><em>Spokane Magazine</em> was a victim of the recession of the early 1980s. But, through our work, Larry and I had become good friends. Over the ensuing twenty five years, we collaborated on several major reporting projects, beginning with a grant-funded newspaper series looking at secrecy and the history of radiation releases from Hanford’s plutonium plants. We became <a href="http://www.cforjustice.org/programs/cases/accountability/">clients</a> of the Center for Justice in 2000 shortly after we teamed up to<a href="http://www.camasmagazine.com/"> report</a> on the veins of fraud that ran through the City of Spokane’s public/private partnership with the Cowles family real estate subsidiaries.</p>
<p>It’s only been in recent years that Larry began to share with me his experience in Vietnam. That sharing came in bits and pieces, and mostly in the form of anecdotes about the comrades he’d served with. Yet, he also told me he regarded the Vietnam war as a crime and that he was struggling, deeply, with what he’d been a part of, and what he’d witnessed.  Mostly, though, we talked about other things, quite a bit of which wound up in our journalism.</p>
<p>Last fall, though, Larry’s life took a dramatic turn. The two of us had gone to visit an old friend—retired Unitarian minister Bill Houff—following the passing of Bill’s wife. It turned out to be a warm and uplifting visit under the circumstances, but as we got to the parking lot to leave, Larry suddenly began trembling. He was convulsed in emotional anguish.</p>
<p>What I didn’t know then is that a month earlier, driving at dusk on a back road returning from Idaho, he’d struck a deer that was crossing the highway. He and his passenger were uninjured, but the bloodshed from the strike was gruesome and, within 24 hours, it triggered a vicious spasm of post-traumatic stress disorder (PTSD).</p>
<p>I can’t well describe the daily struggles that ensued for him in the weeks and months that followed. In order to begin to heal, he had both to confront and talk about his darkest memories from Vietnam. Not only has he done that but, as you can see from the video embedded in this post, Larry recognized that his story was part of a much larger saga.</p>
<p><iframe src="http://www.youtube.com/embed/mmZsVEZLCCA?rel=0" height="360" width="640" allowfullscreen="" frameborder="0"></iframe></p>
<p>On one level it is about the grievous injuries to the soul that are inflicted upon soldiers who survive combat. Those injuries are reflected in the <a href="http://www.nydailynews.com/news/national/u-s-vets-commit-suicide-alarming-rate-study-article-1.1253900">grim facts</a> that more than twenty U.S. veterans take their lives every day, and that among active duty soldiers, more die from suicide than are killed by enemy fire.</p>
<p>On a deeper level, Larry sees his experience, and those of his comrades in Vietnam, as a tragic lesson about the cost of American militarism.</p>
<p>It is the whole of it—the intimate toll on the soldiers, and the collective loss and costs for the rest of us—that Larry composed for the sermon he was invited to give on Memorial Day weekend at the Unitarian church in Spokane. Larry entitled his sermon, <em>“Grace and Me: A Forbidden Tale of War.”</em> He gave the sermon twice on May 26th and then, again, on May 30th. The sermons were filmed by Spokane videographer Don Hamilton, whose team at <a href="http://www.hamiltonstudio.com/">Hamilton Studios</a> has been working to document Larry’s story.</p>
<p>Judging by the reception he’s received, Larry’s message is resonating far beyond Spokane. This coming week he’s been invited and will be attending the Warrior’s Song retreat in Philadelphia. The<a href="http://www.warriorsongs.org/fr_home.cfm"><em> Warrior’s Song</em> project</a> was founded by Iraq war veteran and musician Jason Moon for the purpose of using music and other creative arts to aid in the healing of combat veterans. Larry is also at work on a memoir encompassing his Vietnam experience and his struggle with PTSD.</p>
<p>Given how our life journeys have been intertwined for three decades (I think of Larry as my older brother) I can’t possibly explain how I felt on May 26th, watching this brave, dear friend and colleague bare his soul before his community. As you’ll see, it wasn’t easy for him. Nor was it easy for his audience. People were in tears all around me. I  remember thinking that it was so important that this story get told. I can’t imagine anybody better to tell it.</p>
<p><em>—Tim Connor</em></p>
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		<title>How to Look at a Coal Train</title>
		<link>http://www.cforjustice.org/2013/06/01/how-to-look-at-a-coal-train/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=how-to-look-at-a-coal-train</link>
		<comments>http://www.cforjustice.org/2013/06/01/how-to-look-at-a-coal-train/#comments</comments>
		<pubDate>Sat, 01 Jun 2013 15:28:13 +0000</pubDate>
		<dc:creator>tim</dc:creator>
				<category><![CDATA[Kitchen Table]]></category>
		<category><![CDATA[coal]]></category>
		<category><![CDATA[Featured]]></category>
		<category><![CDATA[Global Climate Change]]></category>

		<guid isPermaLink="false">http://www.cforjustice.org/?p=18731</guid>
		<description><![CDATA[Opinion by Tim Connor]]></description>
				<content:encoded><![CDATA[<p><em>Opinion by Tim Connor</em></p>
<p>Having struggled with asthma much of my life, I don’t understand why people smoke. But I do understand why they sometimes set themselves on fire. There’s nothing quite like self-immolation to get peoples’ attention.</p>
<p>In June 1963 a Buddhist monk, Thich Quang Duc, torched himself in Saigon. His flaming image, captured in a wire photo, was a searing act of defiance that symbolized the deep moral objections to the corrupt, U.S.-backed South Vietnamese government that was doomed to fall. Likewise, when the Tunisian street vendor Tarek al-Tayeb Mohamed Bouazizi set himself on fire in December 2010, his fatal act ignited the “Arab Spring” uprisings that led to the fall of governments not only in Tunisia but in Yemen, Egypt and Libya.</p>
<p>I’ve been thinking, lately, of Quang Duc and Bouazizi. It’s not because my mind welcomes images of people engulfed in flame. It’s only because I’m part of a growing cohort of people who are increasingly restless, if not outwardly desperate, to imagine what it will ultimately take for us to act to avert the looming tragedies of global climate change.</p>
<p>As tragedies go, this one is as surreal as it is soporific. I’m folding my towels at a laundromat, a stone’s throw from the tracks at Latah Junction in west Spokane. I look up to see a steady stream of weather-beaten, uncovered rail cars, brimming with Wyoming coal, heading west. The long train could as easily be moving small mountains of grain to feed people.</p>
<p>But this cargo is planet lethal. The burning of coal accounts <a href="http://www.c2es.org/energy/source/coal">for over 40%</a> of greenhouse gas emissions world-wide. The short of it is that when we burn coal, we burn the future. Whatever warmth or hum of electricity comes from igniting the coal loaded onto this lumbering train, it also takes us inexorably closer to more calamities like Katrina and “Superstorm” Sandy which ravaged the mid-Atlantic coast last fall. And even these tragedies pale in comparison to the foreseeable destruction caused by sea-level rise, desertification, and increasing ocean acidity that is already chewing away at coral reefs throughout the tropics.</p>
<p>The mechanisms for this havoc are as well understood as the process by which you warm your coffee in a microwave oven. But we are still told to look away, or at least to not see what we know to be true. Trains are romantic. Yes. If you have to ship coal, it’s more energy efficient to ship by rail than by truck. True. Spokane should be proud of its railroading heritage, and grateful for the railroads’ “economic impact.” Of course.</p>
<p>“The issue is not whether the trains will come, but where they will go, and who will get the economic benefits,” <a href="http://www.spokesman.com/stories/2012/dec/09/editorial-coal-train-impact-study-should-have/">says the opinion page</a> of the <em>Spokesman-Review</em>. So, please, think locally and leave the planet to others. If you’re anxious, look down with a “tight focus” to the fistful of dollars in our hands today, and let someone else fuss over our children’s stormy tomorrows.</p>
<p>“We need to deal with the facts of the matter,” says Spokane County Sheriff Ozzie Knezovich, “not the emotions from coal.”</p>
<p>I gather the sheriff means we’re not supposed to consider all of what we know to be true when we see a coal train heading west into the sunset from Sunset Junction. Who needs Zoloft to buffer our emotions when a good mind-washing of denial will do the trick?</p>
<p>I have a better idea. Let’s look squarely, instead of looking away. Let’s listen to what the earth and the vast majority of scientists <a href="http://www.cforjustice.org/2013/01/06/truth-on-ice/">are telling us</a>. Let’s give our energy and our coinage to support <a href="http://onpoint.wbur.org/2013/03/11/environmentalism">the work of spirited young activists</a>, including our <a href="http://www.cforjustice.org/2013/04/01/new-waterkeeper-alliance-magazine-climate-wars/">Spokane Riverkeeper Bart Mihailovich</a>,  and <a href="http://www.energyactioncoalition.org/">Maura Cowley of Energy Action Coaltion</a>.</p>
<blockquote><p>When we burn coal, we burn the future. Whatever warmth or hum of electricity comes from igniting the coal loaded onto this lumbering train, it also takes us inexorably closer to more calamities like Katrina and “Superstorm” Sandy which ravaged the mid-Atlantic coast last fall. And even these tragedies pale in comparison to the foreseeable destruction caused by sea-level rise, desertification, and increasing ocean acidity that is already chewing away at coral reefs throughout the tropics.</p>
<div id="attachment_18732" class="wp-caption alignright" style="width: 301px"><a href="http://www.cforjustice.org/wp-content/uploads/2013/06/coal.jpg"><img class="size-full wp-image-18732" alt="Coal train leaving Latah Junction." src="http://www.cforjustice.org/wp-content/uploads/2013/06/coal.jpg" width="291" height="307" /></a><p class="wp-caption-text">Coal train leaving Latah Junction.</p></div></blockquote>
<p>Time is not on our side.</p>
<p>Earlier this month, a <em>New York Times</em> headline read: <a href="http://www.nytimes.com/2013/05/11/science/earth/carbon-dioxide-level-passes-long-feared-milestone.html?pagewanted=all&amp;_r=0">“Heat-trapping Gas Passes Milestone, Raising Fears.”</a>  What the article reported is that, for the first time in millions of years, the measured concentration of carbon dioxide in the earth’s lower atmosphere (as averaged over 24 hours) surpassed 400 parts per million.</p>
<p>This was not a milestone that a person could detect with any of the human senses. CO2 at 400 ppm is not going to burn the eyes like tear gas, pound the ear drums with a sonic boom, or darken the sky like a solar eclipse at noon. But if you know just enough to connect that number to the litany of earth science about the consequences of such high CO2 levels, and what this means for our children and grandchildren, then you may just know enough to be sick to your stomach.</p>
<p>The scale of the changes  beginning to unfold is almost as compelling as our indifference to them. If you want to observe what a disappearing polar ice cap looks like in its swirling death throes, you can see that here at one minute into this <a href="http://www.youtube.com/watch?v=splKGWuErnM">video presentation</a> by a fast-talking Al Gore. It will take you only a few seconds to visualize, on a grand scale, what’s happening in the environment.</p>
<p>On the other hand, if want to witness just how assiduously we are now moving, as a society, to address this gravest of all problems, it may take more than a few seconds to hear the sound of almost nothing. You could start by going to video replays of the 2012 Presidential debates and hearing not a word about climate change. Sorry <a href="http://www.youtube.com/watch?v=dgwzcXBgriU">“all you climate people”</a>  said debate moderator Candy Crowley, after she chose not to call on a citizen questioner who wanted to ask Barack Obama and Mitt Romney about global warming.</p>
<p>So much else to talk about. So little time.</p>
<p>Candy Crowley is a good political reporter. But her casual brush-off of the topic was wrong even when measured in pure political terms. Voters care more than she acknowledged, and especially voters in Republican primaries. This is where the American political landscape gets shaped and where denial and obstructionism are so deeply rooted. Between the ideologues and the buckets of money from oil and coal interests, climate change has become so politicized that honest leaders like Rep. Bob Inglis—a once popular Republican Congressman from South Carolina—are removed from office if they admit to what the science has so clearly revealed. Inglis lost his seat in the Republican primary of 2010.</p>
<p>“The most enduring heresy that I committed was saying the climate change is real,” <a href=" http://www.pbs.org/wgbh/pages/frontline/environment/climate-of-doubt/bob-inglis-climate-change-and-the-republican-party/">he told</a> PBS’s <em>Frontlines</em>.</p>
<div id="attachment_18735" class="wp-caption alignright" style="width: 360px"><a href="http://www.cforjustice.org/wp-content/uploads/2013/06/Bartcoalu.jpg"><img class="size-full wp-image-18735" alt="Spokane Riverkeeper Bart Mihailovich with a coal train in the distance." src="http://www.cforjustice.org/wp-content/uploads/2013/06/Bartcoalu.jpg" width="350" height="381" /></a><p class="wp-caption-text">Spokane Riverkeeper Bart Mihailovich with a coal train in the distance.</p></div>
<p>Crowley’s brush off and Inglis’s political demise bring to my mind a tragedy my father witnessed as a young boy. It was the explosion and fiery crash of the passenger zeppelin, the Hindenburg, in 1937, as it arrived on the East coast after crossing the Atlantic with 97 people aboard.</p>
<p>“Oh the humanity,” sobbed Herb Morrison, the WLS radio announcer who was broadcasting live at the time of the tragic explosion at Lakehurst, New Jersey. In the haunting recording of his broadcast, you can still hear Morrison’s voice, drenched in grief, as he finally apologizes to his audience for having to look away in order to compose himself after witnessing “the worst thing I’ve ever seen.”</p>
<p>What we, with collective indifference and denial, are inflicting upon our children is so much worse than the tragedy that brought Herb Morrison to tears.</p>
<p>When I look up from my laundry and see a coal train rolling through Latah Junction, I hear Herb Morrison’s voice.</p>
<p>“Oh, the humanity.”</p>
<p><em>Tim Connor&#8217;s essays do not necessarily reflect the view of the Center for Justice.</em></p>
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		<title>“The Center Did the Work&#8221;</title>
		<link>http://www.cforjustice.org/2013/05/14/the-center-did-the-work/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=the-center-did-the-work</link>
		<comments>http://www.cforjustice.org/2013/05/14/the-center-did-the-work/#comments</comments>
		<pubDate>Wed, 15 May 2013 03:02:04 +0000</pubDate>
		<dc:creator>tim</dc:creator>
				<category><![CDATA[Kitchen Table]]></category>

		<guid isPermaLink="false">http://www.cforjustice.org/?p=18626</guid>
		<description><![CDATA[The Spokesman-Review's Shawn Vestal reflects on the Center for Justice, and the Otto Zehm case.]]></description>
				<content:encoded><![CDATA[<h3>S-R Columnist Shawn Vestal talks about the Center for Justice and the Otto Zehm case.</h3>
<p><em>Jazzed for Justice, Hamilton Studio, May 9, 2013</em></p>
<p>A lot of the time, when our institutions fail us, their failures are accompanied by a more widespread public failure: the failure to care enough, the failure to insist on being better.<br />
In a democracy, this can have devastating consequences. Because it’s hard to actually make things better – it’s easy to get outraged, and then to spend that outrage very quickly – to post something, tweet something, to write a letter. To write a column. But that initial expenditure of outrage is often followed by … nothing. Or, even worse, by a sense of accomplishment and a desire to move on.</p>
<div id="attachment_18627" class="wp-caption alignright" style="width: 510px"><a href="http://www.cforjustice.org/wp-content/uploads/2013/05/Sv-smu.jpg"><img class="size-full wp-image-18627" alt="Shawn Vestal at Jazzed for Justice" src="http://www.cforjustice.org/wp-content/uploads/2013/05/Sv-smu.jpg" width="500" height="525" /></a><p class="wp-caption-text">Shawn Vestal at Jazzed for Justice</p></div>
<p>We’re very, very good at outrage. And very, very bad at follow-through.</p>
<p>That’s why we need the people and organizations who are dedicated to the long view. Who are willing to do the work that remains, once everyone’s done shouting. I can think of no better recent example of this than the Center for Justice’s work on the Otto Zehm case – work that has been steady and steadfast as the public’s interest waxed and waned, and as our institutions fumbled and flailed. It’s work that is bearing fruit for the community, even now.</p>
<blockquote><p>Shouldn’t we all be more outraged by this? I wanted to pose this question as a columnist, and I was, in part, posing it to myself. Shouldn’t I have been more outraged by this?</p></blockquote>
<p>When I refer to the failure to care – or the failure to care enough – I don’t mean only to point the finger at others. I was working the night Zehm was beaten in that Zip Trip. I was the Saturday reporter, and I remember heading over to the scene, at an editor’s behest, with the same kind of attitude I might have had toward any weekend news that breaking relatively late in the shift: Which is to say, less enthusiasm, less energy and less give-a-damn than I should have. That night, I stood outside the police tape and took down what Jim Nicks had to say, and asked a few questions, and returned to the office and filed a short item.</p>
<p>I have often thought about that night since then – about how detached I was able to feel from the events that happened just inside that store. About how concerned I was over getting to whatever Saturday night fun I had planned, and how little I understood or tried to discover what had happened in there.</p>
<p>Several years passed before I had any further professional attachment to the story. I followed it in the news coverage, and found myself periodically outraged anew. And yet, I had fallen into the same attitude that I suspect many of us shared, from time to time, in the Zehm case. A sense of weariness from the barrage of headlines. A desire to wrap it up, to find closure, to heal, which was probably more of a desire that the whole thing simply go away.</p>
<blockquote><p>in representing Zehm’s estate, the Center represented all of us – all of our interest in a better police department, in accountable public institutions, and a more just community.</p></blockquote>
<p>When I became a columnist at the newspaper, the federal case against Karl Thompson was proceeding to trial. I decided to become more deeply informed about the case, and as I read through mountains of court records, I became ashamed of the way I had come to feel about this case. About my sense of fatigue over it. Everywhere I turned – on seemingly every page filed in the criminal and civil cases – was another cause for deep, grave concern over the functioning of our local government.</p>
<p>Shouldn’t we all be more outraged by this? I wanted to pose this question as a columnist, and I was, in part, posing it to myself. Shouldn’t I have been more outraged by this?<br />
I think I should have. And I think all of us should have. And to the degree that we were, it has helped to drive some change, I believe. And yet, all that being said, outrage is fleeting and fickle. It does not do, finally, what needs to be done. The largest part of changing things for the better comes from those who work within the system – the slow, compromised, limited system – with patience and tenacity.</p>
<p>The Center for Justice was involved with this case almost immediately, and its efforts spanned six years. The Center sued the city on behalf of Otto Zehm’s estate in 2009 and settled it last year. Among the settlement’s achievements is the Zehm memorial – a physical insistence that his memory not be subsumed in a rush to move forward.<br />
Also, though, in representing Zehm’s estate, the Center represented all of us – all of our interest in a better police department, in accountable public institutions, and a more just community. A lot of us talked about it. The Center did the work.</p>
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		<title>Mercy</title>
		<link>http://www.cforjustice.org/2013/03/10/mercy-2/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=mercy-2</link>
		<comments>http://www.cforjustice.org/2013/03/10/mercy-2/#comments</comments>
		<pubDate>Mon, 11 Mar 2013 04:02:57 +0000</pubDate>
		<dc:creator>tim</dc:creator>
				<category><![CDATA[Kitchen Table]]></category>

		<guid isPermaLink="false">http://www.cforjustice.org/?p=18238</guid>
		<description><![CDATA[Steve Brill's master work on injustice in the American health care system.]]></description>
				<content:encoded><![CDATA[<h3>Steve Brill and Time’s master work on the ingrained greed and injustice in the American health care system.</h3>
<p>Here’s some irony for you.</p>
<p>In this age of Twitter and Facebook photo and perpetual phone text messaging, my fourteen year-old son sits on his grandparents’ sofa in east Spokane and starts reading a magazine. It is March 2nd, a Saturday, and the magazine he’s holding in his hands is <em>Time’s</em> March 4th issue. I am across the room, visiting with my mother.</p>
<p>Before long, my son starts hissing, and then whistling, and then hissing some more.</p>
<p>“Dad,” he finally says, “you’ve got to read this.”</p>
<p><a href="http://www.cforjustice.org/wp-content/uploads/2013/03/Timecover.jpg"><img class="alignright size-full wp-image-18239" alt="Timecover" src="http://www.cforjustice.org/wp-content/uploads/2013/03/Timecover.jpg" width="366" height="402" /></a>And I did. In fact, as of today, I’ve read it twice, which is no small feat given that Steven Brill’s article,<a href="http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/"><em> Bitter Pill</em></a>, is over 24,000 words long. News magazines are not supposed to run stories that are 24,000 words long, let alone 3,000 words long.</p>
<p>Regardless of your politics, Brill’s article is crazy-making material. It is built upon one carefully examined case after another of ordinary people entering the nation’s health care system under physical duress and leaving under mountains of debt, pursued by collection agencies. All of them have health insurance, but not nearly enough to pay their astronomical hospital and doctors’ bills. The documented price-gouging inflicted by hospitals (most of them run by ostensibly “non-profit” organizations) is shocking.</p>
<p>•$84 for a bag saline that can be purchased on-line for five bucks and change.<br />
•$1.50 for a single acetaminophen pill that retails for less then 1.5 cents.<br />
•$18 for a diabetic test strip that Amazon sells for 56 cents each.</p>
<blockquote><p>Obamacare will address at least some of the problems revealed in Brill’s reporting, such as the annual caps on what insurance companies will pay out for most kinds of health care. But Brill’s caution is that it doesn’t really touch the rampant inflation and price-gouging that drug companies and hospitals engage in.</p></blockquote>
<p>One of the cases that Brill uses to bring this blood-sucking toll into focus is in that of patient “Steve H.” who’d gone to Mercy Hospital in Oklahoma City complaining of a back ache. The cure, he was told, would be a surgically-implanted stimulator that could be installed in a day. With $45,181 remaining beneath the cap on his union-sponsored health insurance plan, “Steve H.” could be forgiven for not asking whether he had ample insurance. As Brill posits: How much could a day at Mercy cost?</p>
<p>Actually quite a bit when you consider some of these examples from Steve H’s hospital bill.</p>
<p>•$3 for the re-usable pen used to mark his back for the incision.</p>
<p>•$31 for the re-useable strap to hold him to the operating table.</p>
<p>•$32 for the blanket used to keep him warm during surgery.</p>
<p>•$39 for the $6 surgeon’s gown.</p>
<p>•$108 for bacitracin.</p>
<p>•and finally, $49,237 for the stimulator whose list price is less than $20,000.</p>
<p>His total Mercy bill for the one day procedure/implant was $87,000, not including doctor’s charges. Steve H. exhausted his insurance and wound up owing over $40,000.</p>
<p>Mercy Hospital is part of a chain of 31 hospitals and 300 clinics in the Midwest, Brill reports, and it is owned by an organization under the umbrella of the Catholic Church called Sisters of Mercy. “It’s mission, as described in its latest filing with the IRS as a tax-exempt charity, is ‘to carry out the healing ministry of Jesus by promoting health and wellness.’”</p>
<p>Mercy? Or money? Brill is merciless in diving into the hair-raising salaries that non-profit hospitals pay their CEOs and management staffs. In Mercy’s case its $784,000 for a regional president, and $438,000 to the hospital president. And these are typical. Also typical from Brill’s reporting is the stiff-arm he got when he asked hospitals to explain bills like Steve H.’s. They all refused to make top executives available to defend hospital charges claiming that the patient privacy provisions of the federal Health Insurance Portability and Accountability Act (HIPAA) bars them from saying anything about items on patients bills.</p>
<p>There’s no doubt that the effects of the profiteering and price-gouging that Brill reports on is a sprawling and deeply painful problem in America. Nearly two-thirds of personal bankruptcies in the U.S. are related to medical bills or illness. Nearly 70% of those experiencing medical-related bankruptcy were insured at the time they filed. If you’re not trapped in the brutal world that Brill writes about, chances are you know several people who are.</p>
<blockquote><p>Regardless of your politics, Brill’s article is crazy-making material. It is built upon one carefully examined case after another of ordinary people entering the nation’s health care system under physical duress and leaving under mountains of debt, pursued by collection agencies.</p></blockquote>
<p>My son’s hissing reaction to this epic work of journalism was to the cruelty and injustice inflicted on people who, by definition, were hurting at the time they sought medical care. But I was just as disturbed by Brill’s reporting on how far removed our politics are from this life-crushing phenomenon.</p>
<p>You may be asking, how can this be? Didn’t our political system groan at every seam and weld with the passage of the Affordable Care Act, a.k.a. Obamacare?</p>
<p>True, and Obamacare will address at least some of the problems revealed in Brill’s reporting, such as the annual caps on what insurance companies will pay out for most kinds of health care. But Brill’s caution is that it doesn’t really touch the rampant inflation and price-gouging that drug companies and hospitals engage in. The main problem he sees, and documents, is a profound lack of competition and accountability in the American health care system.</p>
<p>That’s a compelling finding and what it confirms is that the epic food fight over Obamacare was about politics, not about the best way to control health care costs.   Early on, in the futile effort to win bipartisan support, Obama took both the single-payer and public option (in which the government would offer a competing health insurance plan) off the table. Thus, the insurance reforms left the current system pretty much intact, albeit with new controls on how insurance companies can behave.</p>
<p>But as Brill emphasizes, the Obamacare insurance reforms don’t do much, at all, to deal with the dire problem of runaway health care costs. In 2013, these costs will approach $3 trillion. Brill points out that this is $750 billion more (27%) than if the U.S. spent the same, per person, on health care as other developed nations.</p>
<p>If there’s a crippling myth to our politics on health care reform it is that Americans get wondrous care because of free enterprise and competition within our private system. Actually, to the extent we get wondrous care, it is care that millions of Americans, including those with insurance, can’t afford because of a <em>lack</em> of competition.</p>
<p>Remember all the rhetoric from the right about how the Clintons and then Obama would ruin the free enterprise market in American health care?</p>
<p>The golden irony in Brill’s reporting is that really the only thing bringing competition to health care pricing is the government’s single-payer system for older Americans, otherwise known as Medicare.</p>
<p>Throughout his reporting, Brill constantly compares what hospitals charge those covered (or not covered) by private insurance, to what they charge those covered by Medicare.</p>
<p>For example:</p>
<p>•A heartburn patient charged $199.50 for a test that Medicare pays the same hospital $13.94.</p>
<p>•A stress test charged at nearly $8,000, where Medicare would pay the same hospital $554.</p>
<p>•Oxygen “supervision” charged at $134 a day where Medicare pays less than $18 per day.</p>
<p>And so on, and so on.</p>
<p>And this is despite the fact that—in order to keep drug companies happy—Congress limits Medicare’s capacity to lower costs even further by preventing it from negotiating prices on prescription drugs and looking at comparable effectiveness when it comes to purchasing decisions on medical equipment.</p>
<p>There’s also this poignant news clip for phlegmatic conservatives who would have you believe “government” is a synonym for “waste.” Comparing Medicare’s administrative and management costs with Aetna, a large private insurer, Brill found that Medicare’s cost were under $4, whereas Aetna’s were about $30 per claim.</p>
<p>Moreover, Brill reported, “the only players in the private sector who seem to operate efficiently are the private contractors working—dare I say it?—under the government’s supervision.”</p>
<p>Brill points that than in areas of the U.S. where Medicare has been allowed to conduct pilot programs on competitive billing, it has been able to produce savings of 40%. But those pilot projects are a mere 3% of the Medicare market.</p>
<p>“Unless you are protected by Medicare,” Brill concludes, “the health care market is not a market at all. It’s a crapshoot.”</p>
<p><em>—Tim Connor</em></p>
<p><em>(Tim Connor’s commentaries do not necessarily represent the views of the Center for Justice.)</em></p>
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		<title>Unbound is Unwise</title>
		<link>http://www.cforjustice.org/2013/02/22/unbound-is-unwise/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=unbound-is-unwise</link>
		<comments>http://www.cforjustice.org/2013/02/22/unbound-is-unwise/#comments</comments>
		<pubDate>Sat, 23 Feb 2013 05:00:28 +0000</pubDate>
		<dc:creator>tim</dc:creator>
				<category><![CDATA[Kitchen Table]]></category>
		<category><![CDATA[Featured]]></category>

		<guid isPermaLink="false">http://www.cforjustice.org/?p=18055</guid>
		<description><![CDATA[Defacing a beautiful county with soul-deadening urban sprawl is neither acceptable nor inevitable. ]]></description>
				<content:encoded><![CDATA[<h3>Defacing a beautiful county with soul-deadening urban sprawl is neither acceptable nor inevitable.</h3>
<p><em><strong>Update:</strong> Read Daniel Walters&#8217;s followup <a href="http://www.inlander.com/spokane/blog-8046-spokane-county-really-screwed-up-its-urban-growth-.html">story</a> in the Inlander 3/12/13</em></p>
<p>Ten minutes from downtown Spokane you can still take a left turn off a thoroughfare and find yourself not only in nature, but with views of something other than <em>noveau riche</em> housing developments and freeways. One of my favorite places that fits these directions is above and beyond a high wall of basalt palisades, opening to meadows of balsamroot, camas, and serviceberry, with a horizon of pines in two directions, mountains in a third.</p>
<div id="attachment_18056" class="wp-caption alignright" style="width: 310px"><a href="http://www.cforjustice.org/wp-content/uploads/2013/02/balsmu.jpg"><img class="size-full wp-image-18056" alt="Meadow in the palisades of west Spokane." src="http://www.cforjustice.org/wp-content/uploads/2013/02/balsmu.jpg" width="300" height="290" /></a><p class="wp-caption-text">Meadow in the palisades of west Spokane.</p></div>
<p>I can’t help you measure this experience in cash. But I think I can help you evaluate it, or at least comprehend it, in terms of what is truly precious. My doctor would say it lowers my troublesome blood pressure. But beyond such intimate physiology, there’s just a spiritual richness that comes with living in a place that’s not only aesthetically beautiful, but beautiful within the reach of our daily lives. It’s a form of being in love, and I write that knowing of the genuine heartbreak that comes in witnessing places that we treasure being gouged by bulldozers and then paved over for the sake of “progress” and “growth.” Five Mile Prairie isn’t a prairie anymore, and though some are materially richer because of it, something of greater value was lost.</p>
<p>For at least a decade, now, Spokane County has endured something akin to governmental bi-polar disorder when it comes to growth. “Near Nature, Near Perfect” is an economic development mantra. It’s a catch-phrase to market the Spokane area to people who really want what we’ve got, which is a rare combination of urban amenities leaning casually against a rural wilderness, and the remarkable recreation this affords. But politically we don’t have much of a commitment, at least not yet, to the nature part. Mostly, we want to make developers and land-owners happy and rich. It’s both sad and senseless to sell out the public interest this way. In the long run, we’ll all be poorer for it.</p>
<p>As I reported five years ago, the Center for Justice (led by the efforts of our current executive director, Rick Eichstaedt) became <a href="http://www.cforjustice.org/2008/05/30/moot-court/">deeply involved</a> in a high stakes legal battle against <a href="http://www.cforjustice.org/2012/03/20/the-high-cost-of-an-epic-coverup/">a corrupt county government</a> that openly defied the state’s Growth Management Act (GMA) and public records law. The raw purpose of this defiance was to serve the interests of developers who’d supported the Republican troika on the County Commission at the time. Our clients  were individuals and neighborhood organizations trying to preserve the rural nature of areas, like the beautiful palisades tract in west Spokane, and protect them from development.</p>
<p><a href="http://www.cforjustice.org/wp-content/uploads/2013/02/Nearsmu.jpg"><img class="alignright size-full wp-image-18057" alt="Nearsmu" src="http://www.cforjustice.org/wp-content/uploads/2013/02/Nearsmu.jpg" width="316" height="272" /></a>County government is discernibly less corrupt than it was in the mid-2000s, but the pressures and nature of the political dynamics hasn’t much changed. Next week the Commission will conduct a hearing to consider well over a dozen “study areas” and “individual requests” to expand the county’s urban growth area (UGA) beyond its current boundaries.</p>
<p>There are compelling, nitty-gritty economic arguments against the sprawl that the proposed expansions to the UGA would accommodate. The state-wide group <a href="http://futurewise.org/spokane/index_html"><em>Futurewise </em></a>does a terrific job pointing out that these proposed expansions are notorious for thrusting new costs on to taxpayers because of the expense of extending public infrastructure to serve the new developments.</p>
<p>But there really is a simple show-stopper here that should settle the issue, not just now, but for the foreseeable future. The simple truth is this—the existing urban growth area for Spokane County is not bursting at the seams. There is plenty of room inside the existing UGA boundaries to accommodate new development. So this idea that we need to expand the UGA to accommodate new populations and economic activity is just a canard.</p>
<p>If this piece of news seems familiar to you, it’s probably because it came up two years ago when the County was trying to <a href="http://www.cforjustice.org/2011/03/20/land-use-lockdown/">push through</a> an emergency UGA expansion to grease the skids for a rural grab land out on the West Plains to site a new jail. With the Center’s help, the jail proposal was quickly withdrawn after it became clear it couldn’t withstand land use scrutiny.</p>
<p>The same is true for the expansion proposals that will come up for a hearing next week.</p>
<p>Here’s what the county’s Planning Technical Advisory Committee <a href="http://www.spokanecounty.org/data/buildingandplanning/lrp/uga_update/8-PTAC%20recommendation%20report.pdf">reported</a> a year ago:</p>
<p><strong><em>The Regional Land Quantity Analysis for Spokane County, published October 2010 and revised in May of 2011 (the “LQA”), concludes that the existing UGA has the capacity to accommodate an additional 117,800 people, 4,259 more than the forecasted increase of 113,541. The LQA also concludes that the current UGA has a sufficient amount of commercial and industrial zoned property to accommodate the 2031 demand, with a surplus commercial land supply of 4,828 acres and a surplus industrial land supply of 3,087 acres.</em></strong></p>
<p>Of course the best thing for us to do, in the long run, is elect County Commissioners who are committed to upholding not just the Growth Management Act, but the County’s own comprehensive land use plans. In the short run, though, groups like <em>Futurewise</em> and the Neighborhood Alliance need our help and voices to preserve the essential nature of Spokane County. You can register your voice  by attending the hearing on Wednesday the 27th, or by calling or emailing your commissioner, or by <a href="http://be.futurewise.org/p/dia/action/public/?action_KEY=12926">going here</a> to sign this petition being circulated by<em> Futurewise</em>.</p>
<p><em>&#8211;Tim Connor</em></p>
<p><em>(Tim Connor’s commentaries do not necessarily reflect the views of the Center for Justice.</em>)<br />
<em>The public hearing on expansion of Spokane County’s urban growth area is set for Feb. 27 at 5:30 p.m. in the commissioners’ assembly room in the lower level of the county Public Works Building, 1036 W. Broadway Ave.</em></p>
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