USA Senate Republicans have a long history of Domestic Civil Rights and Human Rights Abuses as well as International.

...First of all, the amount of money that insurance companies (click title to entry - thank you) and drug companies put into defeating any change to the status quo is unreal. Where does all this money come from?

Shouldn't that say something about the insurance industry?

Next we have Senator Max Baucus (D) of Montana to add to the list of people to blame for how reform is currently going. Senator Baucus has been in Congress for years (long enough for me to have voted for him when I was 18 and still growing up in Montana). So I feel somewhat responsible for this and betrayed by a fellow democrat....

The Senate Health Care Bill has doubled in size and dwarfs the House Bill by 500 pages in its new 'edition.'

The Original Bill (click here)

And the ? Updated ? Bill (click here)

I'll read the Senate Health Care LUDICROSITY.

I want to briefly look them over before beginning. When I mean briefly, it is to be sure any of the first bill actually made it into the second.

I am taking a break first.

Kindly pay attention to 'the threat' to the Amazon, its biotic content and its people and write your legislators regarding this atrosity by American Oil Companies we will all be sorry for. A healthy and sustainable Amazon means healthy and sustainable people.

Currently, the 'slick' American lawyers working for the companies are using the American Courts to delay a decision and people are dying.

Thank you.

Chevron Oil needs to compensate the people of Ecuador NOW! They have been postponing their responsiblity through litigation for 15 years.

The damage to South American countries by American Oil Companies along the Amazon and the indigenous people of the Amazon have yet to be measured.

The DAMAGE done to South American is yet to be measured. The focus is on the 'immediate' damage of the people and land of Ecuador. The DUMPING of the American Oil Companies at the HEADWATERS of the Amazon go beyond the borders of Ecuador.

The people of Ecuador and the Amazon Basin need the support of the International Community and the benefit of the United Nations and their Human Rights Organizations to stop this hideous exploitation of both the people and the Legal system of all countries involved.

...The Amazon basin of Ecuador, known as the ‘Oriente’ (click here), consists of more than 40 million hectares of tropical rainforest lying at the headwaters of the Amazon river network. The region contains one of the most diverse collections of plant and animal life in the world.1...



Results
(The table below is explicit in the higher cancer rates in Ecuador at ALL oil sites). The table and this epidemological study shows conclusively the people of Ecuador have suffered horribly from the American Oil Company exploitation of the naivity of the Ecaudor government. The litigation cothat es for ONE reason and that is to put more and more distance and doubt between the 'acts' of all the American oil companies that are guilty of exploiting the nation of Ecuador and killing their people. They are guilty of human rights violations while the Ecuador government cannot afford the kind of 'state of the art' technology needed for their people and THEIR LAND.)

In all, 473 cancer cases (39.1% in males) were identified in exposed counties and 512 (40.2% in males) in non-exposed counties. An increased incidence for all sites combined by age was observed in both men and women (Figure 2). The RR of all cancer sites combined was significantly elevated in both men (RR = 1.40; 95% CI: 1.15–1.71) and women (RR = 1.63; 95% CI: 1.39–1.91) in exposed counties (Table 1). Significantly elevated RR were observed for cancers of the stomach (RR = 2.51; 95% CI: 1.60–2.94), rectum (RR = 10.40; 95% CI: 1.16–12.98), skin melanoma (RR = 10.15; 95% CI: 2.91–46.97), soft tissue (RR = 15.59; 95% CI: 1.74–139.30) and kidney (RR = 9.2; 95% CI: 1.03–82.20) in men and for cancers of the cervix (RR = 4.01; 95% CI: 2.97–5.41) and lymph nodes (RR = 4.74; 95% CI: 1.89–11.88) in women. Four cases of larynx cancer were found in males in exposed counties but none in the non-exposed countries (Table 1).



...Although several studies have focused on residents exposed to major oil spillages,13–15 epidemiological studies of communities exposed to oil pollutants near oil fields are scarce.10 Few studies have been conducted in petroleum exploration and producing workers. In one of two case-control studies, an excess risk for testicular cancer was observed among petroleum and natural gas extraction workers.16 No such excess was found in the other study.17 In a case-control study of cancer at many sites, an association was observed between exposure to crude oil and rectal and lung cancer, however the association was based on small numbers.18 A study carried out in producing and pipeline workers in the US did not find significant differences for any major cause of death.19 Sathiakumar et al.20 conducted an epidemiological study in oil and gas field workers in the US which showed a positive association between work and acute myelogenous leukaemia. A study from China has also reported increased incidences of leukaemia in oil-field workers.21 A recent update of a study of crude oil production workers showed a lower mortality risk for these employees compared with the general US population (perhaps a reflection of the ‘healthy worker effect’). An increased mortality from acute myelogenous leukaemia was found in those people who were first employed before 1940 and who were employed in the production of crude oil for more than 30 years.22 ...

'
Fifteen years of getting away with murder ! The longer they can postpone 'the truth' the more people die and the more the reputuation of the USA suffers. They ADMIT they worked in a consortium of oil companies that are GUILTY of polluting the lands of Ecuador, destroying the forests and killing people. They participated in "W"rongful practices and reeped profits that cost people of Ecuador their lives.

It has been 15 years since a group of Ecuadorian indigenous people filed a lawsuit against Texaco for oil contamination, resulting from 26 years of substandard oil extraction efforts. In those years, Texaco —acquired by Chevron in 2001—consistently has denied responsibility, delayed justice, and defamed the Ecuadorian people who need help the most. In other words, the oil giant has acted like most people expect Big Oil companies to act — like bullies — instead of the good corporate citizens that Chevron’s advertising campaigns like to portray.
Meanwhile, the Ecuadorians living in Texaco’s former dumping ground suffer every day. Texaco released over 18 billion gallons of oil and toxic water into the rainforest from 1964 to 1990. Experts indicate that over 1,000 people have died from cancer. Spontaneous abortions are two to three times more likely to occur in the concession area than in other parts of Ecuador. It’s almost impossible to find a family not touched by the illnesses.
Until you see the extent of the contamination, it is hard to believe. Almost 1,000 pits the size of large swimming pools scar an area the size of Rhode Island. Texaco built the pits to dump the remaining oil and toxic water after drilling. To reduce costs, Texaco violated standard industry practice and never lined the pits. As a result, the toxins have flowed directly into the streams and underground water supply. Texaco eventually covered the pits with dirt—as if hiding the pollution would make it go away — but never took any real steps to clean up the area. Some people even built their houses on top of the covered pits, thinking that the pits were safe.
Chevron has done almost nothing to help people or restore clean drinking water. The company has never conducted a single health impact study, probably because the corporation doesn’t want to create any evidence of its wrongdoing. You can view photos of some of the families here and more photos of the contamination here.
--Chevron has denied responsibility with misleading statements and arguments that insult the intelligence. For example:
--The soil in Ecuador is naturally toxic. (This claim despite the incredibly rich ecological diversity native to the rainforest.)
--The people in Ecuador are sick because they have poor personal hygiene. (This argument, replete with imperialist and racist undertones, is simply factually incorrect.)
--Fecal coliform bacteria in the water gave the Ecuadorians cancer. (This argument ignores the absolute fact that coliforms do not cause cancer.)
--Oil is good for you, so don’t worry about it being in the water. (This claim despite the numerous chemicals in oil that are known to cause human health problems, including benzyne, a known carcinogen.)
Each of these statements can be sourced directly to Texaco or Chevron....

The well established and knowledgable American companies NEVER 'bothered' to bring 'state of the art' CONCERN and Technology to Ecuador. They would rather 'blame' a government of Ecuador that exhibited weak laws in demanding the type of technology from these companies. The Ecuadorian government allowed the companies the right to take the oil, they never bargained for HUMAN RIGHTS abuses by American Oil Companies. That is, however, exactly what they got ! The American companies are guilty and they have admitted it, but, try to displace their guilt on the Ecuadorian government. The United Nations Human Rights Commission needs to chime in the violations of these lucrative companies.

Go back into your cave, Dick. It is hard for him to believe. but, he is irrelevant

As Pakistan continues its war against the Taliban militants in South Waziristan (click here), it is being aided by "Pro Government" fighters who say that the current insurgency is not in the national interest. (Photos: Shoaib Hasan)

We can begin the 'critique' of Bush the Commander and Chief and Puppet of Cheney with the realization they backed a coupe government in Pakistan. It would seem with President Obama, a President with backbone, as Commander and Chief and a new and freely elected President of Pakistan, President Zardari, another President with backbone, the people of Pakistan are willingly becoming allies to their own military.

I am really pleased Dick decided to 'come out of his closet' at Halloween. It is more than appropriate.

The eight years the Bush Administration oversaw Afghansitan. The years Bush was Commander and Chief saw the reconsitution of the Taliban and the continued influence of al Qaeda. I mean, does he really want to go here?

The Bush/Cheney administration abused the people of the USA in venue possible, lost the war in Afghanistan, allowed corruption to overtake the Karzai government and the Afghan people while the Taliban grew into a ferious 'entity' in both Pakistan and Afghanistan threatening the entire region.

They disregarded the National Security of the USA and diverted our war effort after the attacks of September 11, 2001 into Iraq, a country already disarmed, allowed NATO to 'attempt' to carry the burden of Afghanistan alone, while using out of control private contractors to rape the people of Iraq of their dignity, permitting Halliburton the run of the country of Iraq and requiring no accountability for their work or their exploitation of the USA Treasury and creating the largests SCAMS the world has ever seen in every venue of government.

Does Cheney want to open his own Pandora's Box, then we can have it !

How is your health, Dick? Kill many Quail these days? Maybe that is the issue, you haven't killed enough Quail lately.

The American People 'in majority' want a Health Care Bill with a public option, NOW !!!

President Obama's holding the line at an even division in public views on health care reform, boosted by support for two key elements -- a personal mandate and a public option -- and aided by continued weakness in the opposition party.(ABC News Photo Illustration)

POLL: Obama Holds Steady on Health Reform (click title to entry - thank you)
ABC News-Washington Post Poll: 57 Percent Support Public Option
ANALYSIS By GARY LANGER
Oct. 19, 2009
...Americans divide about evenly on the reform plan and Obama's handling of health care alike – neither better nor worse for him since summer. But 57 percent support one of the plan's most contentious elements, a government-sponsored insurance option, and that soars to 76 percent if it's limited to those who can't get affordable private insurance....

PDF of Survey (click here)

There is a series of upper tropospheric vortices crossing the North American continent. Don't expect a break in the weather pattern soon.

The first nor'easter of the season hit the Shore hard. In Sea Isle City, students including sisters Julia, Jessica, and Josie Manno had to be rescued by EMTs and police when their bus got stuck in water.

Storms in Pennsylvania, N.Y., and N.J. (click here)
By Edward Colimore and Jacqueline L. Urgo
Inquirer Staff Writers
Back-to-back nor'easters - the first two of the season - brought heavy rains, winds, and flooding to the Shore while soaking Philadelphia and dropping snow across higher elevations in New Jersey, Pennsylvania, and New York.
The first storm left yesterday as the second bore down this weekend with more precipitation. It is expected to head out to sea late tomorrow night.
Some sun should return by Monday and temperatures will rise into the high 50s, forecasters said....


Mike Dirks/NYT Regional Media Group
People walk along a closed part of the Blue Ridge Parkway on Sunday after the area received its first snow of the season. Most areas above 3,500 feet received at least one inch of snow. Forecasters predict an unusually cold, wet winter for the mountains and Piedmont.

I wish the weather services, especially in the South, would get out of the 'old jargon' of using El Nino for EVERY WINTER that passes. This is Climate Change as facilitated by Human Induced Global Warming. There are some television stations and internet sites that use the 'idea' of Climate issues when they state the weather to the public. I saw a station in Chicago using very innovative language and methods to illustrate the dynamics of the weather patterns. I was impressed.

But, El Nino 'over the course' of recorded meterology doesn't happen all the time and that is the 'key' to debunking denial of Human Induced Global Warming. Human Induced Global Warming has 'stimulated' every 'climate and weather manifestation' Earth has to redistribute heat.

The 'mechanism' that is delivering the upper tropospheric vortices across the North American continent 'originate' as a phenomena known as 'The Arctic Oscillation.' How often does anyone hear that? Never. Yet, it is a fact. Why doesn't the public hear it, because, that would actually confirm 'The Arctic' was involved. It is easy to remain focused on 'Pacific Storms' as a source of 'heat' from the sun rather than 'politically' addressing the manifestation of not only The Arctic Oscillaion, but, the North Atlantic Oscillation AND in frequent reliability within the last two months that I noted, the South Atlantic Oscillation off Brazil.

In Earth's history, all these 'upper tropospheric vortices' manifested from time to time. They are a 'geophysical phenomena' that directs heat from the troposphere to the ice formations and 'thus' keeps the Climate within the range where life occurs on Earth. They are fascinating mechanisms.

BUT.

Those mechanisms have never before in recorded meterological history ever manifested AT THE SAME TIME and FOR PROLONGED periods of time. The reason they are manifesting all the time is because it takes that many 'heat driven' mechanisms to 'handle' the heat humans are throwing into the troposphere. The heat doesn't come from outer space. The heat is 'infrared' heat that 'converts' solar sunlight into infrared rays. It is the 'heat trapping' gases that makes Earth livable and when there is too much it makes Earth volitile and dangerous for human life.

Not only that, but, when all the tipping points are reached, Earth won't be habitable for humans and the majority of fauna that exists today. We are engaged in the Sixth Extinction with thousands of species being lost on a regular basis.

It is imprudent and negligent to treat the public as if they are a 'management' issue and not people that have a right to know what is going on with their own 'home,' Earth. This is NOT 'simply' El Nino at work on Earth in the year 2009!!!!!

Get over it !

..."It's going to be very stormy," said John Cessarich, chief meteorologist at WYFF 4.
Even though the National Weather Service is predicting highs in the 70s for much of the rest of the week, the long-term forecast from December through March promises to be harsher.
"El Nino in the central and eastern equatorial Pacific Ocean is expected to be a dominant climate factor that will influence the December through February winter weather in the United States," according to the Weather Service 2009 winter outlook....



October 19, 2009
2130z
UNISYS North and West Hemisphere Water Vapor Satellite (click here for 12 hour loop)

In the loop noted above there is a 'dissipating' of the middle vortex as it moves over the continent. That is simply it adjusting to higher temperatures in its traverse. The dynamics don't really change, the direction of 'the air mass' remains the same and the velocity doesn't change and it is still bringing Arctic Air from the North Pole and Arctic Ocean across North America. What changes is the 'heat exchange' between the 'air mass' and the 'land mass.'

Hard to keep a good man down. President Karzai loves his people and worries about their future and legitimate elections.

I like him. He came forward to lead Afghanistan after the USA's retaliation from September 11, 2001. He didn't have to return to that country, but, he did.

He has dedicated himself to helping the people of Afghanistan through a time when other leaders would have quite. You can't tell me the corruption that overran Afghanistan AFTER the USA turned its efforts toward Iraq, didn't break his heart.

I do not believe for one minute that President Karzai accepts or encourages the corruption. It occurred because the Taliban began to overrun the country and Pakistan was already dominated by them under Musharraf. He didn't have a dedicated military with enough men to fight back or even hold their own and the Taliban instituted the economy of corruption to control the people. It wasn't just 'religion' that was going to hold them in servitude, it was creating an economy they were all dependant upon. People had no choice and in the case of President Karzai it was everything he could do to maintain 'order' and keep the country operating within the definitions of its new Constitution.

Today, Pakistan has new leadership and the USA a far better President and the NATO allies a new hope while dedicating more troops to the Afghan effort. It is turning around, ever so carefully it is turning around.

The victory of Abdullah Abdullah in the elections earlier this year to force a run off vote, is a victory for President Karzai as well. He maintained the Constitution's 'integrity' during very difficult times. Without his dedication to his country and people we would be looking at a very different scenario in Afghanistan.

I look forward to the run off election between two of the most dedicated men I have ever witnessed in a country so very neglected for so long. Both men are eminently qualified and will serve their people well. I wish them both luck and to President Karzai, be proud of the Constitution you protected and the ability of the people of Afghanistan to 'choose' leadership rather than have it impossed.

Afghanistan Electoral Complaints Commission (click here)

The Afgan ECC carried out research to substantiate their findings. It was important they conducted a good investigation to uphold the Afghan Constitution.

From the "Guardian":

...Still with us? These are the categories used by the EEC (here's the official explanation) for their sample search:
• A1 Polling stations in which 600 or more valid votes were cast. 545 stations, 55 sampled• B1 Polling stations with more than 100 votes in which one candidate received 95 percent or more of the total votes cast. 1270 stations, 124 sampled
C1 Polling stations in which 600 or more valid votes were cast AND in which one candidate received 95% or more of the total votes cast. 741 stations, 82 sampled
A2 Polling stations in which 600 or more total votes were cast, except those already covered in A1. 299 stations, 30 sampled
B2 Polling stations in which one candidate received 95 percent or more of the total valid votes cast, except those already covered in B1. 401 stations, 40 sampled
C2 Polling stations in which 600 or more total votes were cast AND in which one candidate received 95% or more of the valid votes. 121 stations, 14 sampled
You can go through the full results, and their locations on the google spreadsheet below. Can you visualise the data?

Spreadsheet Data (click here)

The Afghan ECC did a great job. Congratulations !

Example of their work, 'on the spreadsheet' is Polling Station ECC Number 80101301, Category A1 states, "50% uniform markings, 100 or more ballots marked with felt marker; missing materials."

Can't argue with that, it is corruption of the Election Method in that district. Time for a change in the 'infrastructure' in that polling district.

You can explain away the violence if you want to, but, extremists are sometimes viewed as 'favorable' by a people that want to change their government

This was a big kill for ANY of the revolutionaries in Iran. The Iranian government needs to be sure they have the right people and they don't know that. Why do they need to be careful? Because if they 'get it wrong' or 'scapegoat' anyone then they haven't solved the problem.

If the President of Iran DECIDES to assassinate people to simply lay blame and move on in hopes it will terrify the people to stop their revolution, it will only serve to enhance it. The more innocent people the President of Iran kills, the worse the streets will become !


Jundullah have been blamed for attacks aiming at destabilising Iran (click title to entry - thank you)
By Roger Hardy
BBC Middle East analyst
The Iranian authorities have accused a shadowy group called Jundullah - the Soldiers of God - of carrying out a suicide bombing in mid-October which killed six commanders of the Iranian Revolutionary Guards. But what is Jundullah, what does it want - and who is behind it?
It was founded in 2002 to defend the Baluchi minority in the poor, remote and lawless region of south-east Iran.
Its leader, Abdolmalek Rigi, denies the group has either foreign links or a separatist agenda.
In an interview in October 2008, he said the group - also known as the People's Resistance Movement - was not interested in trying to break away from Iran.
It simply wanted the state to respect the human rights, culture and faith of the Baluchis....

President Ahmadinejad must have a question to whom could carry out this violence. It may very well be al Qaeda or an al Qaeda backed rebel group. Iran has problems. Iran needs to stop escalating nuclear armament to threaten global stability and seek to solve their internal problems.

He is asking Pakistan to arrest terrorists and rebels. I do believe the Pakistanis are doing exactly that, so Mahmoud needs to 'rethink' whom is out to take over the government by coup. Iran will not 'back' the Taliban in Pakistan either. They need to focus on the 'unrest' and 'neglect' of the people of the country.

Ahmadinejad calls on Pakistan to help arrest terrorists, rebels (click here)
www.chinaview.cn

2009-10-19 19:27:25

TEHRAN, Oct. 19 (Xinhua) -- In a telephone conversation with Pakistani counterpart on Monday, Iran's President Mahmoud Ahmadinejad called on the Pakistani government to help arrest the terrorists and rebels and bring them to justice, the official IRNA news agency reported....

...Early on Sunday, a deadly bomb attack occurred in Iran's southeastern province of Sistan-Baluchestan near Iran's border with Pakistan, killing some 45 people, including a number of Islamic Revolution Guards Corps (IRGC) commanders, and wounded dozens others.
The Sunni rebel group Jundallah (God's soldiers) has claimed responsibility for the deadly suicide attack.

Oh, well, I've always wanted to live in a manmade cave, haven't you?

The grapes of Afghanistan. Where is the vino, babe? I love a man with a beard and a turban. Hubba-hubba. The Afghans need to 'sex up' their economy and put their children's future first!
These folks are not having fun and the reason for that is the Taliban. Barbers anyone?


It is called "status." What kind of goats to you raise? These are Angora Goats and their wool is used for Angora sweaters. Now, in my opinion, a goat is a goat is a goat and they all eat and drink about the same food and water. The question is do Afghan farmers want to continue subsistence farming or do they want to export 'high end' sweaters to Fifth Avenue?

Hello?


A United States Army soldier and a Marine searched the home and compound of an Afghan farmer in Khan Neshin. American officials are debating whether cracking down on the drug trade will anger farmers dependent on it for their livelihood.

This is more than a little silly and why there needs to be a REFORMER elected in Afghanistan in the Presidential Runoff Elections.

By allowing the current 'dysfunctional' drug economy to exist there are several things that are going to make this war difficult and hideous.

1. The USA should not be intimidated into being a drug warlord and throw in the society.

2. The Afghan people do not want to live under Taliban oppression.

3. The Afghan people are in the circumstances they are now because of the Taliban. They oppressed democracy and economic reform and the people of Afghanistan are only allowed to have an economy that services al Qaeda while causing problems in Advanced Societies.

4. The poppy fields have to go!

Only a very small share of Afghanistan's land (about 15 percent), (click here) mostly in scattered valleys, is suitable for farming; about 6 percent of the land is actually cultivated. At least two-thirds of this farmland requires irrigation. Water is drawn from springs and rivers and is distributed through surface ditches and through underground channels, or tunnels, which are excavated and maintained by a series of vertical shafts. Such a tunnel is known as a karez or qanat. In 1987 about 26,600 sq km (10,300 sq mi) of farmland were irrigated.
Wheat is the most important crop, followed by barley, corn, and rice. Cotton is another important and widely cultivated crop. Fruit and nuts are among Afghanistan's most important exports. Afghanistan is noted for its unusually sweet grapes and melons, grown mostly in the southwest, north of the Hindu Kush, and in the fertile regions around Herat. Raisins are also an important export. Other important fruits are apricots, cherries, figs, mulberries, and pomegranates....

Texas' soldier-farmers seek to remake Afghan farming (click here)

Monday, August 25, 2009

By Chris Vaughn

Fort Worth Star-Telegram
In uniform, they look like any other soldier.
But the heart of Lt. Col. Stan Poe’s unit of Texas National Guard troops is radically different than most combat outfits in Afghanistan, answering to the sounds of agriculture and the sight of crops.
Soldier-farmers, one might call them.
The Texas soldiers, agricultural experts who come from Aledo to Weslaco, are on the forefront of a new National Guard initiative to bring Afghan farming out of the 19th century, in a place where decades of war have destroyed infrastructure, wrecked government capabilities and provided a favorable environment for illicit poppy production....

Summary (click here)
Agriculture’s share of total economic activity – as measured by gross domestic
product (GDP) – is significant in seven countries located in Central and South Asia:
Afghanistan, Iran, Kyrgyzstan, Pakistan, Tajikistan, Turkmenistan, and Uzbekistan.
Its share ranges from about one fifth in Tajikistan to more than one half in
Afghanistan. Those employed in the agricultural sector account for a large portion
of the entire labor force in all seven countries. Agricultural workers account for
almost one-third of all employment in Iran; in Afghanistan, farmers and related
workers represent more than two-thirds of the labor force.
Large desert regions and extreme mountainous terrain limit the amount of arable
land in most of these countries. Irrigation systems are vital in most countries in
directing limited water supplies to agricultural producing areas.
All seven countries are net food importers, meaning they do not produce enough
to cover all their food needs....

The Afghan government needs to build 'strengths' when it comes to economics. They have to develop a service economy and a manufacturing economy. Sheep, goats can provide wool for weaving, leading to clothing, draperies, etc. Therefore, there is an industry for designers and marketing. The problem is that the food for the animals will inhibit the ability to propagate that economy.

From there they need to develop craftsmen and craftswomen, build REAL homes, hospitals and schools, educate teachers, doctors and nurses and provide public services. They need to have a fire department so their homes are made of something more than stone and plaster and they need to develop 'central plumbing' and find water sources along with sewage treatment.

A change in 'quality of life of these people' will develop an economy that is servicable through taxes from wages, no different than the USA economy. Police, trash removal and a transportation department that provides for tourism. Conservation and park quality viewing. Don't tell me it doesn't exist in Afghanistan because there are plenty of incredible vistas,

So.

The next President needs to set 'standards' for the people to live by and they need to organize themselves around a mayor and council and not the strength of warlords that can kill them if they are not obedient.

I mean honestly !

The President of the United States just signed a bill sending gobs of money to 'rehabilitate' Afghanistan. That includes drug treatment centers and monies to improve the infrastructure. THAT does not mean that the infrastructure is going to SEVICE al Qaeda. No. No. There is 'change' due the USA people in Afghanistan and we want it now!

The Senate Finance Committee is in the MINORITY of Senators that want to kill reform.

The best venue at this point, is for the House and Senate to be prepared for Reconciliation (click title of entry - thank you) of the Health Care Insurance Reform Bill. The reference to the title of this entry indicates the Insurance Industry is doing more than anticipating change, they are attempting to fight it.

From the "National Underwriter"...By packaging the bill as a budget bill, House leaders might be able to use a process called the “reconciliation” process to get a health reform bill through the Senate with just 51 votes, rather than 60 votes normally required....

Rep. Charles Rangle was under attack for ethics issues that failed. Why? Because he was leading the charge for Reconciliation. The ethics charges are baseless. I am not a fan of Rep. Rangel as he feels manditory military service should be a part of the citizenship of the USA, but, either charges are valid or not and in his case there was no wrong doing. He was attacked by the Republicans because of his power in Ways and Means and their cronies are getting nervous.

...Republican members of the House (click here) last week attempted to oust Rangel from his powerful chairmanship of the House Ways & Means Committee for the duration of a House Ethics Committee investigation into alleged ethical misconduct surrounding his real estate investments and dubious personal financial disclosure reports....

Considering the contentious measure has come from the Finance Committee and the House is sending their's to Budget, there is every indication we will have a Health Care Insurance Reform Bill within the next month or so. The American People can't wait any longer and the Republicans are 'set' on serving their cronies well and 'saving face' to their electorate. The Republicans are desperate for the lack of members since the 2006 elections and are spending all their political capital on the 2010 elections. It is an impossible environment in the Legislature. Reconciliation might be the only tool left to stop this hideous debate as there are other issues pressing, including, Climate Change and Immigration.

It goes like this. The Republicans in the House and Senate want to 'appear' to cooperate with the President, after all come November 2010 if they are sequestered in their own little GOP world it might cost them votes.

So, the Senate FINANCE Committee decided to 'set aside' all animosities and work for their cronies to pass a bill they can vote for; it would give everyone 'the face of success' including President Obama and the Democrats. Everyone that is, except, the American people in the majority.

Now that the Senate Finance Committee, acting against their colleagues and stabbing them in the back, has placed a stamp of approval on the Technologies Spending Bill (AKA The Health Care Reform Bill, or should I say Formerley Known As) the Republicans are attempting to place a 'wedge' issue into their strategy and turn the tables stating the Democrats don't know how to be bipartisan.

It's corruption through and through. What occurred in the Senate Finance Committee was the undermining of health care reform. It was during the media circus following the Committee's ? Work ? that the health care insurance INDUSTRY came out against the Democratic Majority and their bills. It is more obvious than ever and quite frankly the Senate Finance Bill is the last ditch effort for the Health Care Industry to stop a Public Option and provide for lining their coffers.

On CUE, case in point, still yet another version of a Republican lead charge, dissing the Baucus Bill, against the American people. What is the cry "Too much money." So what else is new from a Republican?

Health reform: Bipartisan plan will help all Americans (click here)

By Peter J. Pitts
October 18, 2009

Congressman Bill Cassidy, R-La., recently broke some news that could turn the health care debate on its head. During a radio interview, he revealed that Blue Dog Democrats have been quietly reaching out to Republicans to draft an alternative health reform bill.

This isn't surprising. After all, neither Republicans nor centrist Democrats nor the majority of Americans approve of the clumsy hodgepodge of big-government policies that make up Sen. Max Baucus' health care bill.

Fortunately, an alliance between Republicans and moderate Democrats could give Americans the reform package they're looking for — one aimed at lowering costs while promoting competition....

The next section of the House Bill which begins on page 931 with a title concerns itself with Health and Wellness, which is where billions are appropriated and that isn't because spending is a choice by Democrats, it is because it costs more than a dollar per person to be sure 300 million Americans are receiving COST SAVING Preventative Care.

Page 932 (the second page with the title to the section), lines 1 through 8:

‘‘TITLE XXXI—PREVENTION AND WELLNESS
‘‘Subtitle A—Prevention and Wellness Trust
‘‘SEC. 3111. PREVENTION AND WELLNESS TRUST.
‘‘(a) DEPOSITS INTO TRUST.—There is established a Prevention and Wellness Trust. There are authorized to be appropriated to the Trust—

This section of the bill is lengthy, sets up 'The Trust Fund' for the provision and is NOT outrageously expensive considering the 'per person' expenditure. The monies come from appropriated funds in the Health Investment Fund. All these monies by the way are 'housed' in the USA Treasury. So, when Paulson drained the Treasury to bail himself out of his incompetency as a CEO, he was acting with disregard to the priorities of the people of this nation. He didn't care if every other dollar in the Treasury appropriated for the well being of the nation went bankrupt.

One has to consider when making the observation that TODAY, Wall Street is zipping right along while there are still failing banks in the USA and high rates of unemployment in the face of stimulus. Paulson could not care less what was the outcome of his bailout. He didn't care if the American economy imploded and people were impoverished and living on the street or worse.

The reason that reality is not ours today, although there are people living on the street, is because we elected a moral man in the White House and a majority of Democrats to the House and Senate that passed a stimulus plan the began to turn things around. Otherwise, the 'domestic' condition of the nation would be very different than it is today.

Page 932, lines 12 through 14:

‘‘(2) in addition, out of any monies in the Public Health Investment Fund—
‘‘(A) for fiscal year 2010, $2,400,000,000;

Page 933, lines 11 through 13:

‘‘(2) for carrying out subtitle D (Prevention and Wellness Research)—
‘‘(A) for fiscal year 2010, $100,000,000;

Page 933, lines 24 and 25 and page 934, line 1:

‘‘(3) for carrying out subtitle E (Delivery of Community Preventive and Wellness Services)—
‘‘(A) for fiscal year 2010, $1,100,000,000;

Page 934, lines 12 through 15:

‘‘(4) for carrying out section 3161 (Core Public Health Infrastructure and Activities for State and Local Health Departments)— ‘‘(A) for fiscal year 2010, $800,000,000;

Page 935 begins the 'particulars' of the definition and focus of Preventive and Wellness provision:
Page 935, lines 7 through 18:

‘‘Subtitle B—National Prevention and Wellness Strategy
‘‘SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRATEGY.
‘‘(a) IN GENERAL.—The Secretary shall submit to the Congress within one year after the date of the enactment of this section, and at least every 2 years thereafter, a national strategy that is designed to improve the Nation’s health through evidence-based clinical and community prevention and wellness activities (in this section referred to as ‘prevention and wellness activities’), including core public health infrastructure improvement activities.

The provision continues in mapping the National Strategy in Health Care. It tells the Secretary where to concentrate efforts. It does not give the Secretary of Health and Human Services open uncontrolled power to 'be the decider' on what path to take for the nation's health. That would be incompetency in the Legislature if that occurred. The powers of the Executive Branch are to come from the Legislation and it is why the bills have to pass through the House and Senate.

Page 935, lines 19 thorugh 23:

‘‘(b) CONTENTS.—The strategy under subsection (a) shall include each of the following:
‘‘(1) Identification of specific national goals and objectives in prevention and wellness activities that take into account appropriate public health measures...

Page 936, lines 1 though 13:

(the) ...standards (including Healthy People and National Public Health Performance Standards).
‘‘(2) Establishment of national priorities for prevention and wellness, taking into account unmet prevention and wellness needs.
‘‘(3) Establishment of national priorities for research on prevention and wellness, taking into account unanswered research questions on prevention and wellness.
‘‘(4) Identification of health disparities in prevention and wellness.
‘‘(5) A plan for addressing and implementing paragraphs (1) through (4).

Those specific priorities 'keep' the focus of the provision from being undermined anytime in the future. It directs emphasis on UNMET needs. It would be easy to undermine the Health Care Reform Bill's initiatives if there wasn't strong language directly its focus. In other words, let's say Bush's Brownie were in the Secretary's seat and figured the 'unmet' needs are simply not needed at all by a minority of the people that don't vote in his direction anyway, so why do it. Brownie would simply focus on the accomplishments 'to date' of the American Health Care System and cut budgets in some areas and reappropriate in the direction of cronies. The bill prevents it. The UNMET needs of the nation has to take a priority, too.

The bill goes further to direct the Secretary in seeking 'consult' from specific 'agencies:'

Page 936, lines 15 through 21:

...strategy under subsection (a), the Secretary shall consult with the following:
‘‘(1) The heads of appropriate health agencies and offices in the Department, including the Office
of the Surgeon General of the Public Health Service, the Office of Minority Health, and the Office on Women’s Health.

Page 937, lines 6 through 14:

‘‘Subtitle C—Prevention Task Forces
‘‘SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERVICES.
‘‘(a) IN GENERAL.—The Secretary, acting through the Director of the Agency for Healthcare Research and Quality, shall establish a permanent task force to be known as the Task Force on Clinical Preventive Services (in this section referred to as the ‘Task Force’).

This provides for the 'expertise' of the Federal government to make all consults and recommendations focused on Prevention and Wellness. It is a dedicated Task Force because with Prevention and Wellness being a national priority the cost of any health care program, be it public or private will come down. This isn't just a 'Pie in the Sky' idea, it is a well accepted precept noted in the Private Health Care Insurance Industy that to bring down costs, offer Wellness programs.

The Secretary is responsible for appointing the 30 member Task Force. A little scary when considering this is probably the place where Republicans would seek to undermine 'the system.' So, the provision takes things a little further to insure 'quality control:'

Page 940, lines 11 through 19:

‘‘(4) REPRESENTATION.—In appointing members of the Task Force, the Secretary shall ensure that—
‘‘(A) all areas of expertise described in paragraph (3) are represented; and
‘‘(B) the members of the Task Force include practitioners who, collectively, have significant experience treating racially and ethnically diverse populations.

Page 941, lines 1 through 10:

‘‘(f) CLINICAL PREVENTION STAKEHOLDERS BOARD.—
‘‘(1) IN GENERAL.—The Task Force shall convene a clinical prevention stakeholders board composed of representatives of appropriate public and private entities with an interest in clinical preventive services to advise the Task Force on developing, updating, publishing, and disseminating evidence-based recommendations on the use of clinical preventive services.

The bill, being Constitutionally Correct, does not stop at the totality of government power and also includes a 'shareholders' group of public and private entities. This is somewhat standard for really good lawmaking. As example, "The Clean Air Act" provides for 'The New Source Review' every five years, I believe it is.

The New Source Review is exactly what the words imply, it is an opportunity for public and private sectors to report 'changes' in the 'nature' of air quality to the government. In these 'shareholder' groups ARE the interests of the public and private sector. It is our chance to tell the government about the issue as it relates to topic.

These are important aspects of any legislation and what 'empowers' the public to practice Democary.

The Treasury Department of the USA does not have these venues that I am aware of, it is sort of left up to the Federal Reserve.

Sorta.

If there were shareholders groups at the Federal level assisting the direction of policy we might be seeing a far different outcome to our society. The 'bailout' probably would not have happened, as citizens would have been screaming at the government at least by early 2007 and the warning signs would have been on record before 2008.

THEN, responsiblity could have been assigned for ignoring the reporting of the citizens of the USA to err on the side of negligence that served to bailout Goldman Sachs.

It really wasn't AIG's issue, except, the insurance to investment firms should never be trusted to a private entity, the only entity able to insure such ventures is a sovereign power and it is NOT in the best interest of the country to 'gamble.' The investment banks should have taken out policies with Lloyds of London. They probably tried. They were most likely rejected.

I believe some of the 'experimenting' that went on at AIG to try to build enough resources to cover such expensive policy holders was a direct result of a private insurer that was out on a limb. AIG was a dreamscape that should have never happened. It was never reasonable.

To return to health care policy, the bill requires 'health care consumers' to be members of the 'shareholder' group.

This bill also does not GROW the size of government, it ALLOWS for participation as a Democracy is required to do. Page 943, lines 5 through 11:

‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— Members of the Task Force or the clinical prevention stakeholders board shall not receive any pay for service on the Task Force, but may receive travel expenses, including a per diem, in accordance with applicable provisions of subchapter I of chapter 57 of title 5, United States Code.

A Personal Note: When it came to rasing my sons to be healthy and having a wonderful Pediatrician to count on, the operative word is 'Vitamins.' I took special vitamins when I was expecting and that continued after they were born. There was not a day that went by the boys forgot to take their vitamins. And it was fun, Flintstone vitamins and stuff like that. As a matter of fact one of the first 'adult health care decisions' my young men made was the choice of an appropriate adult vitamin. Where did they go? You guessed it, GNC.

The House bill is very fluid. It provides for 'thinkers' to be engaging the health care and health insurance issues of the American people. There is little 'control' in the path this legislation is taking, EXCEPT, to demand of all its government participants to improve the health of the American people. There is very little I object to within the language of this bill or its appropriations.

Page 947, lines 11 through 20:

‘‘(f) COMMUNITY PREVENTION STAKEHOLDERS BOARD.—
‘‘(1) IN GENERAL.—The Task Force shall convene a community prevention stakeholders board composed of representatives of appropriate public and private entities with an interest in community preventive services to advise the Task Force on developing, updating, publishing, and disseminating evidence-based recommendations on the use of community preventive services.

Page 950, lines 5 through 18:

‘‘Subtitle D—Prevention and Wellness Research
‘‘SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIVITY COORDINATION.
‘‘In conducting or supporting research on prevention and wellness, the Director of the Centers for Disease Control and Prevention, the Director of the National Institutes of Health, and the heads of other agencies within the Department of Health and Human Services conducting or supporting such research, shall take into consideration the national strategy under section 3121 and the recommendations of the Task Force on Clinical Preventive Services under section 3131 and the Task Force on Community Preventive Services under section 3132.

The House Bill provides for a lot of research. This is a quality control issue. The agencies mentioned in this provision are not small potatoes. The CDC is vital to any such Prevention and Wellness program as they are knowledgeable to the trends of disease in the nation. The NIH has to be a player/shareholder in this provision, it has a vested interest in the well being of the people of this nation. So, although some of this seems redundant, it isn't. The 'shareholders' change through many of the paragraphs and are empowered to act with 'equity' to any of the findings that impact the nation's health. It is important legislation. Truly.

Page 951, lines 14 through 22:

‘‘Subtitle E—Delivery of Community Prevention and Wellness Services
‘‘SEC. 3151. COMMUNITY PREVENTION AND WELLNESS SERVICES GRANTS.
‘‘(a) IN GENERAL.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a program for the delivery of community preventive and wellness services consisting of awarding grants to eligible entities—

All these measures aren't important without 'health care delivery.' These are necessary words. The House Bill is 'standard' good law. The bill goes on to define the delivery system across the spectrum of the USA including tribal heath departments. It uses the language "Core Public Health Infrastructure" and it is defined. It is huge. It is our health care delivery system and through this legislation it is now law as to the form that infrastructure. It cannot be dissolved at the whim of some maniac that wants to cut the federal government to the bone.

Page 960, lines 9 through 15:

‘‘(1) The term ‘core public health infrastructure’ includes workforce capacity and competency; laboratory systems; health information, health information systems, and health information analysis; communications; financing; other relevant components of organizational capacity; and other related activities.

The Republicans protestation of how Democrats GROW 'Big Government' is such a joke. The following provision CONSOLIDATES assets of the people of this nation to streamline decision making and facilitate the expediant care of the people.

Page 961, lines 9 through 22:

(1) FUNCTIONS, PERSONNEL, ASSETS, LIABILITIES, AND ADMINISTRATIVE ACTIONS.—All functions, personnel, assets, and liabilities of, and administrative actions applicable to, the Preventive Services Task Force convened under section 915(a) of the Public Health Service Act and the Task Force on Community Preventive Services (as such section and Task Forces were in existence on the day before the date of the enactment of this Act) shall be transferred to the Task Force on Clinical Preventive Services and the Task Force on Community Preventive Services, respectively, established under sections 3121 and 3122 of the Public Health Service Act, as added by subsection (a).

There are pages of 'Best Practice' statues, identifying existing, developing new, evaluation of, implementation and transparency to the public. How careful can the House be?

Page 972, lines 1 through 6:

(4) OBSTETRICS.—Improving the provision of obstetrical and neonatal care, including the identification of interventions that are effective in reducing the risk of preterm and premature labor and the implementation of best practices for labor and delivery care.

This particular statute addresses the Mother, Infant Death Rates in the USA. Those death rates, also may be considered 'survival' rates receive plenty of criticism by the Global Community. The USA does not have the best track record.

This is from the CIA World Factbook and the USA ranks 44th in Infant Mortality Rates. (click here) The chart is recorded from highest death rate to lowest and the USA is 44th from the 'least' infant morality rate. 6.26 infant deaths per 1000 births in current 2009 statistics with Singapore the lowest at 2.31.

Something I want to focus on is the GDP per capita. Singapore has the fourth largest GDP 'per capita' of any country on Earth. It is third on the list of the World Bank and fourth on the IMF (International Monetary Fund) and seventh on the CIA list. The USA is ranked below Singapore in its GDP per capita on all lists. The USA is ranked fourth by the World Bank, fifth by the IMF and eighth by the CIA list.

It is a way of looking at 'how' the USA is spending its money per person. How much the USA earns and how outsourcing and the lack of manufacturing effects the people of this nation.

Page 981, lines 12 through 19:

TITLE V—OTHER PROVISIONS
Subtitle A—Drug Discount for Rural and Other Hospitals
SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM.
(a) EXPANSION OF COVERED ENTITIES RECEIVING DISCOUNTED PRICES.—Section 340B(a)(4) (42 U.S.C. 256b(a)(4)) is amended by adding at the end the following:

This is not a subsidy provision, it lifts restrictions on hosptials to participate in group purchase, including generic substitution, of pharmaceuticals to bring down the cost of health care.

Page 993, lines 1 through 12 and Pages 21 through 25:

Subtitle B—School-Based Health Clinics
SEC. 2511. SCHOOL-BASED HEALTH CLINICS.
(a) IN GENERAL.—Part Q of title III (42 U.S.C. 280h et seq.) is amended by adding at the end the following:
‘‘SEC. 399Z–1. SCHOOL-BASED HEALTH CLINICS.
‘‘(a) PROGRAM.—The Secretary shall establish a school-based health clinic program consisting of awarding grants to eligible entities to support the operation of school-based health clinics (referred to in this section as ‘SBHCs’)....
...‘‘(A) evidence that the applicant meets all criteria necessary to be designated as an SBHC;
‘‘(B) evidence of local need for the services to be provided by the SBHC;...

I don't want to hear from Right Wing political extremists how the government is going to be handing out condoms to children. It is the most outrageous idea I have ever heard. The House bill provides for the establishment of School Based Health Clinics in areas of the country and in communities where they do not exist today. This is an opportunity to bring better health care to all the children of the USA. I don't want to hear it, because this provision does not effect everyone, as they have to 'qualify' for the clinics to fill a need that is unfulfilled today.

Page 999, lines 5 through 15:

‘‘(C) OPTIONAL SERVICES.—Additional services, which may include oral health, social, and age-appropriate health education services, including nutritional counseling.
‘‘(2) MEDICALLY UNDERSERVED CHILDREN AND ADOLESCENTS.—The term ‘medically underserved children and adolescents’ means a population of children and adolescents who are residents of an area designated by the Secretary as an area with a shortage of personal health services and health infrastructure for such children and adolescents.

Page 1001, lines 9 through 11 and lines 21 through 24 and Page 106, lines 15 through 23:

Subtitle C—National Medical Device Registry
SEC. 2521. NATIONAL MEDICAL DEVICE REGISTRY....

...‘‘(g)(1) The Secretary shall establish a national medical device registry (in this subsection referred to as the ‘registry’) to facilitate analysis of postmarket safety and outcomes data on each device that—...

...(2) EFFECTIVE DATE.—The Secretary of Health and Human Services shall establish and begin implementation of the registry under section 519(g) of the Federal Food, Drug, and Cosmetic Act, as added by paragraph (1), by not later than the date that is 36 months after the date of the enactment of this Act, without regard to whether or not final regulations to establish and operate the registry have been promulgated by such date.

This is self explanatory.

Page 1008, lines 4 through 16:

Subtitle D—Grants for Comprehensive Programs to Provide Education to Nurses and Create a
Pipeline to Nursing
SEC. 2531. ESTABLISHMENT OF GRANT PROGRAM.
(a) PURPOSES.—It is the purpose of this section to authorize grants to—
(1) address the projected shortage of nurses by funding comprehensive programs to create a career ladder to nursing (including Certified Nurse Assistants, Licensed Practical Nurses, Licensed Vocational Nurses, and Registered Nurses) for incumbent ancillary health care workers;

The word 'pipeline' is a bit odd unless one is discussing oil and gas, but, in this case the words 'Clinical Ladder' would have been far more important. It is a program to facilitate the movement of health care workers from vocational programs to higher education and RN jobs. It is a good idea and will provide for more 'career' oriented persons in the health care field of nursing.

That is basically 'it' for the HOuse health care bill. The provisions that add people receiving subsidies above the 200% level of poverty has to be an amendment because I didn't find any 'scale' of income attached to any of these provisions as is being discussed in the media. So, the House Bill is substantial in how it addresses the issues of Health for the people of the nation, how it relies on previous legislation to validate its precedent status, measures in addressing the issues of the nation in a continuous and 'responsive' mannner and how the provisions are implemented and enforced.

The 'body' of the bill is significant and cannot be altered in the future, however, the amendments can be modified and of course amendments can be added to it, but, that is the case of all USA legislation.

I like the House Bill. The country needs reform in this industry. The reform has been neglected for nearly two decades that Republicans held majorities in the USA and it is time to get on with it. I don't want to hear how after these bills are passed, people within the borders of the USA died because the legislation wasn't passed in time. No more delays.

Hi-Tech Healthcare. Will it give physicians more time with their patients?

President Obama speaks at a rally on health care reform at the University of Maryland Photo: AP

...Senior advisor at the White House Office of Management and Budget (click title to entry - thank you) on health policy Ezekiel Emanuel (brother to Rahm) gave a presentation on Sunday at the Medical Group Management Association's annual conference on the need to restructure how physicians deliver care.
In a speech he titled, "High-Touch Medicine, the Future of the Physician-Patient Relationship," Emanuel, who is also bioethics chair for the National Institutes of Health, said that while the use of information technology is essential for improving healthcare quality, increasing the amount of time physicians spend with patients should be an equally compelling goal....

I have some reservations about the 'character' some of the Senate bill rolls out in the way of touting health care savings based in technology. I don't really buy it. I see a lot of that as a 'spending' bill and not a health care insurance reform bill. The Republican Senate is good at that. Republicans will put together a bill that will spend a lot, but, will it actually reform and revolutionize health care delivery? Maybe.

I believe electronic records, if perfected, can save lives. Absolutely. It will provide immediate information to any physician anywhere in the country to expedite care, especially in emergency rooms.

But, I have reservations about the 'prompts' to physicians delivering care. According to some of the reviews of the Senate bill there will be all this 'data base' availability to physicians when diagnosing a patient. There will be 'prompts' regarding the tests needed and medications to order. There will be prompts to new ideas and new venues of care.

I don't believe physicians that care about their practice need all that and I think it will serve to cause 'excellant' physicians to 'pause' in administering care. It is usually the dedicated and compassionate doctors that seek the most information with a willingness to establish state of the art care for his or her patient.

I don't want my physician to be making decisions regarding my care based upon the latest trend. I want solid diagnosis with proven treatment. One has to wonder what effects this 'automated' format will look like and who has time for it. I would think physicians think new methods and medicine through before using them in their practice and it is why I don't see 'bedside prompts' as an improvement to care. I mean, where is the 'filter' to this information and whom exactly is approving it to be used in a treatment modality.

I believe some of the technologies the Senate has proposed shows short sightedness. There needs to 'trials' of the new high tech bedside doctoring before it is used in general practice. I hope that was part of the bill. Trials of any new idea in the House bill is strongly noted and the venues of change in health care delivery can come swiftly provided there is overwhelming results to the benefits to patients. I also don't see supplying such 'prompts' as a commercial enterprise and/or a 'perk' for the MD. Either it improves patient care or it doesn't.

The next section deals with the Public Helath Service Act (click here) OR here. The Public Health Service Act has been around for decades and has appropriation spending every year. This section simply states it will continue and in a perscribed manner.

The Public Health Service Act has several amendments including Health Insurance Portability, a few issues with Cancer, Muscular Dystrophy and Family Planning. The bill gives the funding a name and states where the monies are found for this provision.

Page 859, lines 1 through 5 and page 860, lines 3 through 5.

SEC. 2002. PUBLIC HEALTH INVESTMENT FUND.
(a) ESTABLISHMENT OF FUNDS.—
(1) IN GENERAL.—There is established a fund to be known as the ‘‘Public Health Investment
Fund’’ (referred to in this section as the ‘‘Fund’’)....

...(B) Amounts deposited into the Fund shall be derived from general revenues of the Treasury.

Below is a list of the 'services' the Public Health Service Act provides. There is no option in replacing it or eliminating it. It was well written decades ago and is fine the way it is:

-coordinating with the States to set (click here) and implement national health policy and pursue effective intergovernmental relations;
-generating and upholding cooperative international health-related agreements, policies, and programs;
-conducting medical and biomedical research;
-sponsoring and administering programs for the development of health resources, prevention and control of diseases, and alcohol and drug abuse;
-providing resources and expertise to the States and other public and private institutions in the planning, direction, and delivery of physical and mental health care services; and
-enforcing laws to assure the safety and efficacy of drugs and protection against impure and unsafe foods, cosmetics, medical devices, and radiation-producing projects.

and

-reducing health care costs, through studies on the interaction of cost, quality, and access; microsimulation modeling, to understand the effect of proposed health care reform; and analyzing health care costs effected by acute, ambulatory, and long-term care and AIDS;
-expanding clinical practice guideline activities by increasing production of important guidelines and evaluating their effect on the cost and quality of health care; and
-enhancing the scientific evidence base for cost-effective clinical practices, by expanding research to improve clinical decisionmaking and strengthening clinical information systems for effectiveness research.

The Public Health Service Act illustrates and sets precedent to the reform the government is working on now. It demands good quality care to Americans at a reasonable cost. One could say, it provides a 'demand' on elected officials to seek reform now that the industry is so out of control and negligent of the priorities of physicans for their patients and providing coverage to everyone. So, when opponents to health care insurance reform refuse to participate they are actually conducting themselves in an Anti-American modality and against 'established' law. Those that oppose this reform bill are sincerely incompetent to understand their role as an elected offical.

In all honesty, The Public Health Services Act is where American Health Care gets 'its tone' and 'impetus.' It wasn't as though one day a House Representative 'thunk it up' and thought it would be a good idea to reform health care. There is a reason why the House bill is so well written and very structured for its implementation. This reform has been on the agenda of the House for some time and it is the Public Health Services Act that is the basis of these reform bills. It is THE LAW, not an option.

This House bill actually is providing another amendment to the Public Health Services Act. Page 862, lines 15 through 23:

(I) appropriated under the heading ‘‘Prevention and Wellness Fund’’ in title VIII of division A of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5); and (II) allocated by the second proviso under such heading for evidence based clinical and community-based prevention and wellness strategies.

Of course, the ARRA (American Recovery and Reinvestment Act) is the stimulus package passed this year once President Obama was in office. This provision takes the monies of the stimulus and impliments it under established law.

Page 863, lines 16 through 24:

(3) BUDGETARY IMPLICATIONS.—Amounts appropriated under this section, and outlays flowing from such appropriations, shall not be taken into account for purposes of any budget enforcement procedures including allocations under section 302(a) and (b) of the Balanced Budget and Emergency Deficit Control Act and budget resolutions for fiscal years during which appropriations are made from the Fund.

The funds allocated for this portion of the bill cannnot be reallocated. They are dedicated funds for the purpose of which they are stated.

Page 864, lines 1 through 5:

TITLE I—COMMUNITY HEALTH CENTERS
SEC. 2101. INCREASED FUNDING.
Section 330 of the Public Health Service Act (42 U.S.C. 254b) is amended—

This is funding for a new provision under the Public Health Service Act to include "Community Health Centers."

"National Association of Community Health Care Centers" (click here)

The Associated Press has a nice artilce about them.

Community clinics have key role in health reform (click here)
By JULIANA BARBASSA (AP) – 3 days ago
SAN JOAQUIN, Calif. — Francisco Lupercio has insurance for his house, his truck and the store he runs with his wife. But he can't afford health insurance, so he joined dozens of other people lining up for exams at a community clinic.
As the recession grinds on, more and more people are relying on taxpayer-supported health centers that offer care on a sliding fee scale. If Congress passes a law giving more Americans access to health insurance, the clinics will also be a critical element to ramping up capacity to care for millions of new patients.
"There is going to be a wave of chronically ill people," said Tanir Ami, executive director of the Community Clinic Consortium for Contra Costa and Solano counties, east of San Francisco. "We're well positioned to care for them."...

Page 865, lines 6 through 14:

TITLE II—WORKFORCE
Subtitle A—Primary Care Workforce
PART 1—NATIONAL HEALTH SERVICE CORPS
SEC. 2201. NATIONAL HEALTH SERVICE CORPS.
(a) FULFILLMENT OF OBLIGATED SERVICE REQUIREMENT THROUGH HALF-TIME SERVICE.—
(1) WAIVERS.—Subsection (i) of section 331
(42 U.S.C. 254d) is amended—

This is establishing the 'status quo' of allowing certain waivers for loan repayment to those that come to work in a 'corp' placement. It provides for scholarships that if accepted by the candidate agree to service in places in the country where they are most needed. It is an 'equity' issue to provide high quality health care workers to all areas of the country, regardless of what is normally preceived as a low earning capacity region.

This provision goes on for awhile about definitions and how a participant has some options to satisfy the service of the contract. The physicians that funded their education through these programs actually have the option of 'servicing the contract' 50% of the time while they spend the rest of their time establishing their own private practice or entering a group practice if they desire. It is a nice option.

These programs also include funding for Dentists and Dental hygienists.

If the 'Loan Repayment Corp Program' has unused monies there is methods to use the monies for recruitment of folks to serve the underserved.

Page 875, lines 4 through 15:

‘‘(d) INSUFFICIENT NUMBER OF APPLICANTS.—If there are an insufficient number of applicants for loan repayments under this section to obligate all appropriated funds, the Secretary shall transfer the unobligated funds to the National Health Service Corps for the purpose of—
‘‘(1) recruitment of sufficient applicants for the National Health Service Corps for the following year; or
‘‘(2) making additional loan repayments under section 338B if there is an excess number of qualified applicants for loan repayments under such section.

There is an emphasis in this section to promote the 'specialty' called "Primary Care." It is also clear in the legislation that these applicants have to demonstrate financial need. There is a lot of legislative support for establishing training in family medicine, general internal medicine, general pediatrics, or geriatrics, including physican assistants including in community-based settings. Other specialties mostly take care of themselves. There is a lot of incentive to practice in high paying specialties and there really is no need to promote those, especially with government monies. There are also aspects of this section to make the public aware of these existing opportunities to those people that need financial assistance. A program is no good if no one knows about it.

Page 892, lines 14 through 25 and page 893, lines 1 through 3:

Subtitle B—Nursing Workforce
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et seq.) is amended—
(1) in paragraph (1), by inserting ‘‘nurse-managed health centers’’ after ‘‘nursing centers,’’; and
(2) by adding at the end the following:
‘‘(16) NURSE-MANAGED HEALTH CENTER.— The term ‘nurse-managed health center’ means a nurse-practice arrangement, managed by advanced practice nurses, that provides primary care or wellness services to underserved or vulnerable populations and is associated with an accredited school of nursing, Federally qualified health center, or indpendent nonprofit health or social services agency.’’.

"Institute of Nursing Centers" (click here)

The Institute for Nursing Centers is a network of organizations that focuses on the advancement of nurse managed health centers (NMHCs). The intent of the network is to enhance the work of all partners with an emphasis on developing a national data center for NMHCs. The founding members of the INC are the Michigan Academic Consortium (MAC), the American Association of Colleges of Nursing (AACN), the Nursing Centers Research Network (NCRN), the Michigan Primary Care Association (MPCA), the National Nursing Center Consortium (NNCC), and the National Organization of Nurse Practitioner Faculties (NONPF).

Nurse Health Centers can 'pick up the slack' when emergencies beset the nation. That is not all they do and many Advanced Practice Nurses have speciality areas such as anesthesia, midwives and pediatrics. Example of how a Nurse Health Center can participate:

Eugene schools offering H1N1 vaccine (click here)

Last Update: 10/15 8:07 pm

Eugene (KMTR) - Students in Eugene’s 4J school district started receiving the H1N1 flu vaccine Thursday.
The school health centers at Sheldon, North Eugene and South Eugene High Schools got a larger supply of H1N1 nasal spray vaccine than they expected, and made it available on a first-come, first-served basis.
The first doses were given to students who are in high-priority groups and who can take the nasal form of the vaccine. The live-virus vaccinations are being given to students whose parents bring them to the health centers, according to North Eugene school nurse Debbie Goodman.
“The live vaccine has very specific requirements in order to qualify for that,” Goodman said. “Number one, right now, we are targeting our most vulnerable population, so that's our priority. And with the live virus we can only give the vaccine to healthy individuals with no chronic health conditions, from the age of two years old to 24."...

There is no gender bias or discrimination as nursing is traditionally a woman's field. There are financing programs, loans and grant programs to promote Advanced Practice.

Page 907, lines 18 through 25 and page 908, lines 1 through 3:

SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE.
Section 765 (42 U.S.C. 295) is amended to read as follows:
‘‘SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE.
‘(a) PROGRAM.—The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Director of the Centers for Disease Control and Prevention, shall establish a public health workforce training and enhancement program consisting of awarding grants and contracts under subsection (b).

Page 909, lines 22 through 25 and page 909, lines 1 through 4:

‘‘(4) to provide financial assistance in the form of traineeships and fellowships to public health professionals who are participants in any program described in paragraph (1) and who plan to teach in the field of public health, including nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine.

And yes, veterinary medicine is as much a public health concern as human medicine. So, we need veterinarians, too. Examples:

15 Oct 2009: Report
The Spread of New Diseases:The Climate Connection (click here)

by Sonia Shah
As humans increasingly encroach on forested lands and as temperatures rise, the transmission of disease from animals and insects to people is growing. Now a new field, known as “conservation medicine,” is exploring how ecosystem disturbance and changing interactions between wildlife and humans can lead to the spread of new pathogens.

Look up into the tree canopy of the urban tropics in South Asia, Australia, or equatorial Africa and as often as not you will find masses of Pteropos fruit bats, hanging from the branches like so many furry stalactites. Their forests cut down by bulldozers, torched by slash-and-burn farmers, or desiccated from a disrupted climate, fruit bats increasingly intrude upon human communities, adapting to the orchards and cultivated fruit trees of the cities, farms, and suburbs that have subsumed their forests....

It's showdown time over pet licensing (click here)
Houston vows to get tough with vets who defy law for rabies data
By CINDY HORSWELL

HOUSTON CHRONICLE
Oct. 17, 2009, 1:34PM

For more than two decades, many Houston veterinarians have engaged in a quiet mutiny of sorts.
They have refused to follow a law requiring them to essentially name names — to turn over the identities and addresses of pet owners whose dogs and cats received rabies shots.
The city of Houston wants these names to identify some of the hundreds of thousands of pet owners who have failed to obtain the required city license for their dog or cat — and which could result in a citation. Only 4 percent of Houston's estimated 1 million pets are registered today, city officials said....

This section of the House bill goes on for many more pages. It allows for financial assistance to disadvantaged students and sets limits to the extent they can receive those monies. Although this is a large section of the bill, the monies being appropriated are in the millions and not the billions. So, the investment into the workforce is important, but, the bill still has its primary focus on getting good health insurance for the populous of the USA.

This section also gives permission for much more fluidity for change in the health care professions with allowances for 'inter-disciplinary' education and monitoring the need for different specialities for a changing population.

Page 931, lines 14 thorough 19:

TITLE III—PREVENTION AND WELLNESS
SEC. 2301. PREVENTION AND WELLNESS.
(a) IN GENERAL.—The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following:

It is the next section of the House bill and where I will stop for now. I am almost complete in reading the House bill as the pages number to 1018.

Regards.