Saturday, October 31, 2009

UIHC: 'Sick Brother, Can You Spare a Dime?'

October 31, 2009; November 20, 2009

Updates:

November 20: UI VP Medical Jean Robillard says patient-donation-dunning plan "canceled a week ago"; spokesperson "clarifies," says "canceled" means "under review," B.A. Morelli, "Leaders Address Employee Concerns; UI Officials: No Decision on Job Issues," Iowa City Press-Citizen, November 20, 2009, p. A3; Ashley Oerman, "UI Cancels Asking Patients for Money," The Daily Iowan, November 20, 2009, p. A1; UI's Funded Retirement Insurance Committee asks President Mason to "abolish rather than just delay" UIHC's "patient donation plan," B.A. Morelli, "Group Wants UIHC Patient Donation Plan Nixed," Iowa City Press-Citizen, November 19, 2009, p. A1;

November 4. This morning's media reports the UIHC's announcement that it will at least not immediately implement its unethical (in the judgment of a medical ethicist, quoted below) plan to ask incoming patients for cash contributions before receiving treatment. Cindy Hadish, "Patient donor plan put off at UI; Outpatients would be asked about giving," The Gazette, November 4, 2009, p. A3; Editorial, "Admission Isn't Time to Hit Up Patients for $$," Iowa City Press-Citizen, November 4, 2009; B.A. Morelli, "UIHC puts off plan to ask for donations," Iowa City Press-Citizen, November 4, 2009.

Rather than killing off this idea as soon as it became buried under an avalanche of outrage, hostility and ridicule -- in my opinion, what would have been its wisest public relations strategy -- the UIHC spokespersons chose (or were instructed) to defend it as perfectly legitimate.

Unfortunately, in doing so, they chose to misrepresent (either unintentionally or deliberately) the practices of other hospitals. Not that other hospitals' practices would have justified UIHC's (a variation of the child's plea, "But Billy's mother lets him play with matches").

Do hospitals receive gifts from grateful patients? Of course. That's never been in issue. But there is a continuum in the medical ethics of how they go about it -- a continuum that finds the UIHC at the bottom of the cliff on the wrong end.

(1) The medical ethicist, quoted below, and I, believe the most ethical -- and possibly most effective and remunerative -- approach is to make community wide appeals through the media and mailings to all citizens. This could include mailings to all UI alumni, or all donors to the UI Foundation. Particularly in the Iowa City metropolitan area an enormous proportion of the population would be, in fact, present or former patients of the hospital. Those who wished to do so, and they are a significant number, will respond to such appeals. But no one is singled out as a patient.

(2) Somewhat worse is accompanying this with telemarketing. Yesterday a faculty member became increasingly agitated while relating to me the harassment of repeated phone calls during weekends and evenings, ending with the exclamation to the unrelenting pitch man that this once-very-generous UI contributor would never again give money to the University.

(3) Worse still, in my judgment (and that of the ethicist), are personal appeals to present and former patients as patients with mailings or phone calls. The delivery of health care by the UIHC is ethically distinct from the delivery of football tickets by the Athletic Department -- which also not only requests, but demands, "contributions" as a condition of granting permission to a fan to buy tickets -- not to mention getting a seat that will optimize the experience.

(4) More questionable, obviously, are person-to-person appeals to patients at any time, as they become even more coercive than a personal mailing.

(5) Personal appeals in the hospital, by hospital personnel are worst of all, for all the reasons discussed throughout this blog entry. Because patients cannot know when they may need to return to the hospital in the future for one reason or another -- and in some instances are involved in a known series of treatments requiring return visits over a period of weeks or months -- personal appeals for funds when they are leaving the hospital are only marginally, if that, any better ethically than personal appeals at check-in.

(6) Clearly what the UIHC chose to do -- requiring/requesting the patient to make information about his or her clinic visit available to the UI Foundation for purposes of future solicitations -- at the time of check-in is the worst of all possible unethical options.

What's additionally very troubling, as I noted this morning in a comment on the Press-Citizen's online version of its editorial and story, is the repeated insistence that other hospitals are doing what the UIHC was proposing to do. ("To tell reporters (as they did) that others do this, when they don't, is either sloppy investigation of details, insensitivity to ethical nuance, or (hopefully not) deliberate disingenuousness.") As The Gazette's Cindy Hadish has repeatedly reported, below, "Moore said the idea was based on programs at other hospitals. Three of those he cited, however — the University of Michigan, University of Pennsylvania and Mayo Clinic — said they had no such system in place."

To equate a community-wide appeal, or a literature mailing, or a discovery that a high percentage of a hospital's donors have been, in fact, former patients, to equate that with a one-on-one discussion with a new clinic patient upon arrival, and cite it as justification for doing so, is shocking.

Nor has the UIHC yet offered an apology, or a mea culpa for this ethical embarrassment -- let alone stopped the idea cold. It's only willing to delay it a bit, to "listen" to the avalanche of concerns, to try to tweak it (presumably with the aid of public relations advisers) to make it acceptable to those with ethical sensitivity.

This sad, sad story is far from over.
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Update: November 4, 2009, 6:15 a.m.; Nov. 3, Nov. 2, Nov. 1; first posted, October 31, 2009, 7:00 a.m.
"Once 'revenue is needed' is the Polestar for a university's financial decisions its moral compass begins to spin as if it was located on the North Pole."
-- Nicholas Johnson
From Nicholas Johnson, "UI Loves Gambling," March 7, 2007, and quoted in Nicholas Johnson, "Revenue is Needed; Putting a Dollar Value on Our Ethics: What Are the UI's Options?" August 2, 2007.
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Now [Nov. 1] with a sampling of Press-Citizen readers' comments appended (at the bottom of this blog entry).

This was the news November 3: B.A. Morelli, "Legislators criticize plan to seek donations; Program would ask patients to sign consent form to be contacted about contributions," Iowa City Press-Citizen,November 3, 2009; it's also in the Register as B.A. Morelli, "Is asking patients for donations 'tacky'?" Des Moines Register, November 3, 2009.

And this afternoon Cindy Hadish, who deserves the credit for breaking this story last Friday [Oct. 30] ,below, brings us the news that, "University of Iowa patient donor plan delayed," Gazette Online, November 3, 2009:
The University of Iowa Foundation is delaying a plan to ask patients at UI clinics for donations.

“We want to take additional time . . . to listen to suggestions for how we might improve the program . . .," Jean Robillard, UI Vice President for medical affairs, said today in a statement.

No timeline has been set for refining or resuming the process. . . .

Under the program, patients would receive a letter at registration from Robillard and a form that authorizes the UI Foundation to contact them about donating money to the hospital. Patients who do not want to receive the information in the future would have to sign a form to opt out. . . .

A national watchdog organization, Patient Privacy Rights, had voiced concern about the program.

Founder Deborah Peel said the idea sounded coercive because patients are in a vulnerable position and may feel like they can’t say no.

Several hospitals contacted by The Gazette, including the Mayo Clinic and other universities, said they did not have similar programs.
"Delaying the plan?" Better than Admiral David Farragut's "damn the torpedoes, full steam ahead," perhaps, but scarcely even an acknowledgment of error, of ethical problems, not to mention a decision to kill the idea. (And see, B.A. Morelli, "UI Will Delay Donation Plan," Iowa City Press-Citizen, November 3, 2009, 2:55 p.m. (describing the decision as "halting plans"); John Doetkott, "UIHC Pulls Back Donation Plan," The Daily Iowan, November 4, 2009, p. A1.)

I was especially impressed with the student editorial, "UIHC Donation Plan Would Inappropriately Pressure Patients," The Daily Iowan, November 5, 2009, p. A4 ("[it's] like a surgeon placing a tip jar in the operating room"). As I commented on the DI's Web page for the editorial, "Like the boy in The Emperor's New Clothes, our students can spot nakedness of which their adult administrators are either too blind or too frightened to speak. Good editorial."

The concern with which I am left is: If an idea like this could even flit through the mind of a hospital administrator, if having done so it was not immediately rejected, if it was reviewed, approved, and prepared for by numerous persons, and when the ethical dilemmas it poses are pointed out the response is to defend the project, if the UIHC's "moral compass is spinning" -- what other projects that the media and public have not yet heard of is the UIHC capable of creating?

Here's a rumor of one; the first choice of fund raising for the UI Foundation, for which the publicized plan was a reluctant fall-back for UIHC's administrators: doctors were to notify the Foundation of the names of their patients whom the doctors believed might be able to make substantial contributions. I can't know if it's true; but if so we can all hope that this one really has been killed rather than merely delayed.
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A Check-In and a Check
(brought to you by FromDC2Iowa.blogspot.com*)

As if there weren't enough pressures from hospitals and sickness insurance companies during this time of a national health care debate, as if we weren't paying enough in the ever-escalating premiums, deductibles and co-pays (for those of us lucky enough to even have insurance), none other than the University of Iowa Hospitals and Clinics (UIHC) has decided that repeatedly pressuring patients at check-in for additional money -- a "voluntary" contribution to the UI Foundation on UIHC's behalf -- is a really nifty idea.

The Gazette has once again brought us this scoop that appears nowhere else in this morning's [Oct. 31] Des Moines Register or Iowa City Press-Citizen or other papers (so far as I know).

[In fairness, this afternoon [Oct. 31] at 2:00 p.m., during the last quarter of the Iowa-Indiana game, I discover that four hours after I posted this blog entry the Press-Citizen had an online story: B.A. Morelli, "Some question soliciting UIHC patients," Iowa City Press-Citizen, October 31, 2009, 11:13 a.m. Presumably the paper will have even more on Sunday, in its first hard copy edition to be published after this morning's Gazette. [Nov. 1, 3:00 p.m.: Here is this morning's story, B.A. Morelli, "Some question soliciting UIHC patients," Iowa City Press-Citizen, November 1, 2009.] At this time [Oct. 31 7:00 a.m.] the Register still had no story; nor could I find anything on the Daily Iowan's online site, though this five-day-a-week-hardcopy-paper did manage to have a report of the Iowa-Indiana game at halftime. This morning [Nov. 2] the DI published, Sam Lane, "UIHC Solicitation Raises Eyebrows; UIHC to Begin Indirectly Soliciting Through the 'Philanthropy Contact Consent' Program," The Daily Iowan, November 2, 2009, p. A4 (including some new quotes from the defenders of the project; e.g., "[UIHC] rely increasingly on private gifts . . . This program will enable patients . . . to self-identify.").]

[Morelli's [Nov. 1] story contributes some pitiful quotes from UI spokespeople. As I noted in a comment appended to his story, "I don't know which is sadder: that anyone would try this in the first place, or that once it was exposed to the light of day UI spokespeople would actually try to defend it, whether on their own or because ordered to do so." Here are some excerpts from Morelli's Nov. 1 story:
"'It is very low key, low pressure, ethical approach,' Moore said. 'The patient will receive world class care whether they fill out the form or not.'

Susan Shullaw, a senior vice president at the foundation, said the aim of the program is to benefit medical care and research. She said it was surprising people would question the program the same week UI announced a $26 million donation from the Pappajohn family to a new facility aimed at finding medical cures.

'I find it surprising that the same week (the donation was announced) the university is also being questioned about offering the opportunity to grateful patients who want to help make a positive impact on the lives of others,' Shullaw said. 'And, that is what this is about.'"]
[Why not just admit the mistake and move on? Mistakes can happen in the health care industry, whether an amputation of the wrong leg, or . . . The Des Moines Register awards "roses & thistles" occasionally, and Sunday morning, November 1, awarded a "half thistle to Wellmark Blue Cross and Blue Shield for an incorrect phone number in a recent mailing. Seniors who called the number listed expected to hear about Medicare drug plans. Instead they got a recording that offered chats with 'nasty girls who will do anything you want for $3.99 a minute.' The insurer apologized and sent new mailings with the corrected number - but not before raising the blood pressure of the over-65 crowd." "Roses & Thistles," Des Moines Register, November 1, 2009. There, UIHC, do you see how it's done? If Wellmark can apologize for its mistake surely you can apologize for yours. After all, you're not even asking patients to contribute $3.99 a minute.]

There are many ways to revive the declining newspaper industry. The Gazette -- one of the few remaining locally-owned newspapers in America, competing with the likes of Gannett (USA Today, 83 daily newspapers, 850 other publications) -- is succeeding, in part, by bringing back the equivalent of the newsboy on the corner shouting, "Extra! Extra! Read all about it."

After all, it was only four days ago that The Gazette was the only paper to report that (a) a grand jury was looking into the 2004 Spence labs break-in, and (b) to bring us news from inside that grand jury's legally confidential proceedings (an almost unprecedented revelation). Nicholas Johnson, "UI Spence Break-In: Gazette Scoop Illustrates Issues," October 27, 2009.

A significant amount of newspaper content is "repeating not reporting." It's from an AP wire story, a release from a corporation's public relations firm, a White House news conference, or a U.S. Senator's text message.

The Gazette is reporting. (My response to the concept of "investigative reporting" has always been, "What other kind of reporting might there be -- non-investigative reporting?")

Although UI spokesperson Tom Moore is mentioned in the Gazette's story, the sense I get is that the exchange between the reporter and Moore, on this occasion, was initiated by the reporter, not Moore.

Anonymous, uninformed sources inside the UIHC were saying there were sketchy rumors of this patient shakedown plan, but I simply dismissed them. For starters, the idea was so outrageous I couldn't believe it would even quickly flit through the imagination of any respectable hospital administrator anywhere, let alone any of those at our beloved UIHC -- or that, if thought of, it wouldn't have been immediately rejected out of hand. Moreover, I had neither a credible source to confirm or deny the rumor, nor enough details (if true) to report.

The Gazette has now provided all of the above: Cindy Hadish, "UI patients will be asked for donations; UI Foundation says no pressure; watchdog groups aren’t so sure ," The Gazette, October 31, 2009, p. A1 (the link is to the Gazette Online version, as there are no direct links to individual articles in the online version of the paper; the quotes that follow, however, are from the hard copy edition).
"The donor program, known as philanthropic contact consent . . . could [start at over 200 outpatient clinics] this winter, spokesman Tom Moore said. . . .

[A] medical privacy advocate [Dr. Deborah Peel, founder of Patient Privacy Rights, a national watchdog group] said the practice is coercive to patients. 'They’re in a vulnerable position, and they may feel like they can’t say no. . . . One party is sick and scared . . . and they don’t want to say "no" to the system they’re dependent on for living.' Under the program, patients will receive a letter at registration from Jean Robillard, UI vice president for medical affairs, and a form that authorizes the UI Foundation to contact them about donating money to the hospital. . . .

Peel said the better approach is a community-wide appeal, and 'the people who are grateful will want to give freely.' . . .

Moore said the idea was based on programs at other hospitals. Three of those he cited, however — the University of Michigan, University of Pennsylvania and Mayo Clinic — said they had no such system in place. . . ."
The Gazette does not provide any documentation in the form of internal memos, forms or instructions for those who will be carrying out this program. But based on the rumors (which, I must say, now have a little more credibility than when they first came to my attention) I will add a couple of details.

(1) Although I don't know the form it takes, there are apparently some instructions, or training programs, for the check-in clerks -- or whatever you'd call those charged with putting the arm on the suffering patients.

And the rumor was that there was at least some awareness on the part of whoever came up with this scheme that some patients might have anxiety about whether the existence, and amount, of their potential "voluntary contribution" might affect how much longer they'd have to wait to be seen, whether they'd be seen by a doctor or a medical student, and the quality of care they'd receive. (Presumably the clerks would be instructed how to respond to such concerns; although what reassurance could possibly be effective once those concerns entered a patient's mind is hard to imagine.)

Thus, the issue is not so much whether "donations" will affect the availability or quality of UIHC's service in fact ("of course not," we're assured); it's whether patients might perceive that to be the case.

On the other hand, such patient anxieties might be warranted. There was a CBS "60 Minutes" piece last night [Nov. 1] regarding a Yakuza (Japanese Mafia) godfather moved to the head of the liver transplant list at UCLA's Medical Center because of . . . well, a very generous "voluntary contribution." Here's the text from an excerpt:
Two families, Eisenberg's clients, both lost loved ones waiting for livers at another transplant center in the same area: Salvador Ceja was number two on the waiting list; John Rader was number five.

"Do you think, for one second, that this was legitimate? That they stood in line and waited just like your husband did?" Logan asked Rader's widow Cheryl.

"Absolutely not," she replied. "No. Because nobody gets a liver that quickly."

"I think they were playing God," Yolanda Carballo, Ceja's stepdaughter, added. "Now, I think they were picking and choosing who they wanted to give a liver to."

"So, in your minds, what was this about?" Logan asked.

"Money," Rader said. "Spoke loud and clear. And they listened."

"That's what it was all about. Money," Carballo agreed. Three of Goto's Yakuza cronies also got liver transplants at UCLA. For them, money was no object. UCLA says each of their transplants cost about $400,000 dollars; the Yakuza all paid cash.

The hospital also acknowledged Goto and another Yakuza each made $100,000 donations to the transplant center.

Adelstein says Goto paid even more. "According to police documents and sources, a million dollars for Goto. A million dollars," he told Logan.

"A million dollars for one liver?" she asked.

"A million dollars for one liver," Adelstein said. . . .
Lara Logan, "Yakuza: Japan's Not-So-Secret Mafia," CBS 60 Minutes, November 1, 2009.

Of course, I can't know if this story is true. But if not, CBS is looking at a rather formidable defamation suit.

Could cash affect UIHC care like it apparently did on this occasion at UCLA? Of course not. We're Iowans after all, not Southern Californians.

But we're talking about appearances here. And they're not good.

I don't know which is sadder: that anyone would try this unethical UIHC scheme in the first place, or that once it was exposed to daylight UI spokespeople would try to defend it, whether voluntarily or because ordered to do so. (It's one of those "which would be worse, in a way?" choices.)

(2) Hadish's story states that, "Patients who do not want to receive the information in the future have to sign a form to opt out." Obviously, her sources are much more authoritative than any rumors I've heard.

But my impression was that any patient who refused to sign the form -- granting permission for the Foundation to contact the patient repeatedly for contributions, presumably throughout the patient's lifetime (in other words, "to opt in") -- would continue to be asked at every visit whether they wished to do so.

There was to be no "form" to sign by which a patient could "opt out." The only "form" for opt-ing was the form to "opt in."

But it was not quite as bad as the lyrics of Michael Jackson's song in "The Wiz": a game in which "you can't win, you can't break even, and you can't get out of the game."



It would be possible to get out of the UIHC game, but only if the patient was willing to compose a letter, find a typewriter or computer with printer, prepare the hard copy, find an envelope and stamp, know the person and address to whom to send it, and carry it (or be pushed in their wheelchair with it) to the Post Office for mailing. (Apparently, the UIHC's new $60 million computer is incapable of receiving email.)

[The paragraph immediately above was written on Oct. 31, 7:00 a.m. At least some of those putting comments online following the Press-Citizen's story who have some pretty direct knowledge of all this seem to share my intuitive guess as to what's required. "JoeSchmoe5106" wrote on Oct. 31 at 6:13 p.m., "If the answer is 'no' they have to write a letter to the Privacy Officer. They can't just check a box and say 'no.'" And again at 7:10 p.m., "I have seen the form. Check the very bottom of the form where it says, 'If you do not want the UIHC or the UI Foundation to contact you for fundraising efforts, you must notify our Privacy Officer in writing,...' which is followed by the address."]

Fund raising is difficult -- in part because of the challenge of keeping imaginative and energetic folks within the bounds of moral and ethical decency in doing so. Heavy handed efforts usually backfire.
o The notion of locking potential donors in a room, embarrassing them, and keeping them there until a fixed amount has been pledged always seemed to me a little heavy handed.

o Iowa Public Radio and National Public Radio have started using an even more offensive approach. Listeners are urged to "turn in" friends and family members, Stasi-like, so that Ira Glass can call them on the phone, shame them, record the conversation, and then broadcast it to the nation -- a kind of entrapment into self-defamation. (And no, neither I nor anyone I know personally was subjected to this treatment.)

o Similarly, I don't think a hospital should ask individual patients, as patients, for financial contributions at any time under any circumstances. Putting aside the financial burden on patients of the charges already exacted for insurance and medical services (much of which, admittedly, is through no fault of doctors and nurses), asking them for contributions is always going to create at least some sense in a patient's mind that there may be a connection between the size of their contribution and the quality of the service they'll get. [See the reference to the Nov. 1 CBS 60 Minutes piece, above, regarding such a case at UCLA.]
On the other hand, I see no problem with accepting gifts from grateful patients who volunteer to do so without any contact from health care providers; as Dr. Deborah Peel puts it (quoted above), "the people who are grateful will want to give freely." Nor do I see a problem with including information about the UI Foundation in a literature rack along with pamphlets about diseases and healthy life choices -- so long as patients are not directed to it by employees. I see no problem with including literature sent to all UI alumni, or past UI Foundation donors (not just those who happen to be patients; even though a significant percentage of them will have been UIHC patients at one time or another), about UIHC programs and needs.

I do see a problem with fund raising appeals going to patients, as patients.

This is not the equivalent of the pay-to-play bribery exacted from citizens in Afghanistan, Iraq, and third world countries for goods and services that should be free from the state, or provided at posted prices, and I'm not asserting that it is. (In Washington, D.C., it's legal; the payments are called "campaign contributions.") But it does have a bit of that aura -- or might reasonably create it in the patient's mind.

And what is truly unconscionable, in my judgment, is to do this fund raising at a patient's time of greatest anxiety, stress -- and often pain: when they are checking in to a clinic.

Equally baffling is how and why such a proposal did not lead to the immediate firing of the person proposing it -- or at a minimum an immediate and unequivocal rejection of it by top administrators.

Presumably, what Paul Harvey used to call "the rest of the story" will gradually emerge as the other local media get on it and track down how it came to pass that one of America's greatest academic research hospitals is now as down on its luck as the unemployed Americans of the 1930s:



Bing Crosby sings the 1931 song, "Brother Can You Spare a Dime?" lyrics by Yip Harburg, music by Jay Gorney.

[Press-Citizen readers' comments below:]
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* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
# # #

Online Comments of Press-Citizen Readers Regarding
B.A. Morelli, "Some question soliciting UIHC patients," Iowa City Press-Citizen, November 1, 2009


Note: These readers' comments are reproduced here as merely a sample of the range and consistency of at least these readers' disapproval of the UIHC's patients "voluntary" contributions program. I neither represent, nor reproduce them here (1) because they are factually "true" (because I cannot know), although they seem intuitive when factual, (2) because I share all the opinions, for I may not, or (3) because they are a scientific sampling of public opinion (obviously they are not). They do, however, represent, merely by their number (compare the number of news stories in local papers that get no online comments), and content, that what the UIHC has done in this instance has struck a nerve with at least these readers.

There is a shared, almost instinctive, reaction that what the UIHC is doing is wrong, and that it ought to have been equally obvious to those who are doing it that it is wrong. Although I have no one's approval to reproduce these comments here, because I could not find out, and do not know, who any of them are, I feel the authors have knowingly made them public, albeit anonymously. (If anyone wishes me to remove theirs from this blog entry, just let me know and I'll delete it.) -- N.J.

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Dave, The Elder wrote:
If the group or department in charge of this planning is surprised at the response, that should say much about their knowledge of people and appearances. They are, it is perceived, taking advantage of of sick folks. They should go back to the drawing board and come up with a different plan. This one is sick.

Dave, The Elder
11/1/2009 5:03:28 AM



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NickIowa wrote:
I don't know which is sadder: that anyone would try this in the first place, or that once it was exposed to the light of day UI spokespeople would actually try to defend it, whether on their own or because ordered to do so.

For an analytical look at what's going on, what's wrong with it, some ethical judgments, and alternative approaches that could save this ethical and public relations disaster, see

"UIHC: 'Sick Brother, Can You Spare a Dime?'; A Check-In and a Check," October 31, 2009, 7:00 a.m.

http://fromdc2iowa.blogspot.com/2009/10/uihc-sick-brother-can-you-spare-dime.html
11/1/2009 7:06:37 AM



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sparkymalone wrote:
Shullaw, go home. Dave and Nick are exactly right.

Why is it that every week UI gives me something new to be ashamed of? Just yesterday I was reading about the plagiaristic exploits of a tenured English prof, Kevin Kopelson, laid out last year by himself in psychologically ill memoir fashion in the London Review of Books. He's still on faculty here, still being funded to wander off to conferences and talk, presumably, about how ludicrous is academe, which shakes a stern finger at undergrads about plagiarism and then continues to employ a lifelong plagiarist like him. I suppose this is transgressive and clever, you see. No doubt Lacan has something to say about it. Makes up for filthy theft. I actually have the issue of LRB and never read the piece, mustn't have looked interesting.

Anyway, that, & employing undergrads as TAs for no money, & pushing the kids to go dig themselves deeper debt holes, and now this. I expect greed in a U, but all this is just in poor taste.
11/1/2009 9:19:45 AM



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sparkymalone wrote:
Oh, and very nice. This from the Gazette (what's going on, P-C? Brian and the rest, are you muzzled, or just asleep?):

"Moore said the idea was based on programs at other hospitals. Three of those he cited, however — the University of Michigan, University of Pennsylvania and Mayo Clinic — said they had no such system in place."

Yeah. Trust us, reporters. And patients, trust us, no one will know whether you've opened your wallet to the hospital or not. I think any such form should carry information about Shullaw's salary ($143,325) and Moore's ($70,644) along with the Gazette stories, and ask patients whether they'd like to contribute to Shullaw and Moore's future employment.
11/1/2009 9:46:13 AM



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tvolm wrote:
The plan lacks conpassion, understanding and empathy for the sick and ill.

All I can say is it is amazing how callous people can be to the plight of others.

The University Hospital is acting like a private business, operating like a large corporation, perhaps the State should privatize the hospital?
11/1/2009 11:00:22 AM



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IowaCityGirl wrote:
"The consent form allows the hospital to pass information to the UI Foundation, a philanthropic arm of UI, so the foundation can contact the patient with medical programs and research to which the patient might want to contribute, Moore said.
The program would not disclose any diagnostic or medical information about the patient"

They may not disclose specific diagnostic or medical information, but in order to decide which programs a patient might want to cotribute to even discolsing which clinic they were in is too much information and reveals what that patient was seen for. Without some pertinent information how are they to decide where that patient might contribute? It is disgusting that they would even consider approaching a patient in any way, shape or form. If a patient has extra money and chooses to give it to the hospital they already know where it is located.

11/1/2009 11:31:27 AM



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IH8IC wrote:
This completely negates internal training called "Service Leadership." In fact, it's plain disgusting. This from two "frontline" UIHC employees. The program is designed as an "opt-out" and the Gazette reported that patients must sign a form to refuse the information being revealed to the UI Foundation. It should be an "opt-in" at best, and perhaps would be better received if the request came along with a "patient satisfaction survey" after the healthcare was provided.

The UI Foundation has had some disgusting methods of raising money, including selling off all of the student information in credit card campaigns. This just goes to show how the UI Foundation conducts itself. It has no shame and will do whatever possible to keep its internal salaries funded.

Absolutely disgusting. If I was a patient, I would take my business elsewhere. The UIHC can't be trusted to provide the best of care when these disgusting things happen.
11/1/2009 12:11:25 PM



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iowahawkeye wrote:
The only acceptable method would be a mailing. Shouldn't be forced to say no to someone at the hospital. By the way, UIHC has been sending "begging" letters to employees for at least the past year.
Next thing UIHC will probably try is to have the atm programmed for a 5% withdrawl fee/donation.
11/1/2009 12:58:30 PM



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guyinic1 wrote:
The next thing with their begging, UIHC will be trying to tell us they are one of the original mendicant orders of friars and nuns. IMHO, there is no place where begging should come into the UIHC patient care equation. Isn't the local, state and federal support they receive enough? Evidently not! This is another example of the University and UIHC's bureaurocratic administrations gone bizerk! If UIHC was privatized like some have suggested, they would fall flat on their face inside a week. They can only compete with the private sector because of their tax subsidies and the special treatment they receive by Medicare and other third party payors. Now they are going after individual patients trying to solicit "donations"! Geesh!
11/1/2009 1:37:02 PM



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rd2serfdom wrote:
No wonder UI just announced a change to the employee health plan: co-pays for UIHC office visits are going down from $10 to $5, while co-pays for Mercy or another hospital (with better patient service) will go up from $15 to $20. There are other financial "penalties" for out-of-UIHC care, to "encourage patients to utilize UIHC's services". Maybe unethical practices like these are a good reason they need to incorporate these penalties to force their own employees to use UIHC?
11/1/2009 2:19:23 PM



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JoeSchmoe5106 wrote:

Replying to rd2serfdom:

No wonder UI just announced a change to the employee health plan: co-pays for UIHC office visits are going down from $10 to $5, while co-pays for Mercy or another hospital (with better patient service) will go up from $15 to $20. There are other financial "penalties" for out-of-UIHC care, to "encourage patients to utilize UIHC's services". Maybe unethical practices like these are a good reason they need to incorporate these penalties to force their own employees to use UIHC?

Having a lower co-pay to incentivize employees use UIHC as their preferred provider is NOT unethical. THIS plan is unethical.
11/1/2009 2:41:46 PM



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guyinic1 wrote:
Soliciting "donations" and "gratuities" from patients and their family's is not the same as twisting the arms of University employees to use UIHC facilities. I think denying UI employees total freedom of choice in selecting their health care providers is wrong and another of the University's cheap tricks. I think that approaching any patient for money for any reason other than what is due for their care is unethical. How would any of you feel if you went to your private physician anyplace other than UIHC and your doctor or their office staff ask you for a "tip"? You'd be appalled at their audacity and I think the Board of Medical Examiners would hear about it---and act on it! What's the difference here?
11/1/2009 4:22:27 PM



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iowamars wrote:
Kopelson hardly admits to being a life-long plagiarist. It is a handful of examples - across his entire academic career. None are pertinent to his career. Inexcusable - maybe. But hardly unusual - and have little to no bearing on his current success.
As far as the plan to reduce co-pays at UIHC and increase them elsewhere - P/S and faculty are self-insured. The FRIC committee is made up of staff and faculty appointed by both governing bodies. The governing bodies are in turn elected by those they represent.
The committee has to address the hyper-inflation in health care costs with limited funds.
I would expect no less of them - then cutting the best deal possible to keep health care costs to employees down. Co-pays go to the provider - and offset the cost of insurance to the individual. All Mercy Hospital has to do is accept the same reimbursement rate as UIHC with a $5 co-pay -it is Mercy's decision not to do that, not the FRIC committee or UIHC.

11/1/2009 6:04:33 PM



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fnmct wrote:

Replying to guyinic1:

The next thing with their begging, UIHC will be trying to tell us they are one of the original mendicant orders of friars and nuns. IMHO, there is no place where begging should come into the UIHC patient care equation. Isn't the local, state and federal support they receive enough? Evidently not! This is another example of the University and UIHC's bureaurocratic administrations gone bizerk! If UIHC was privatized like some have suggested, they would fall flat on their face inside a week. They can only compete with the private sector because of their tax subsidies and the special treatment they receive by Medicare and other third party payors. Now they are going after individual patients trying to solicit "donations"! Geesh!
The only tax subsidies UIHC receives is Medicare, Medicade, and IowaCare. And they lose money on those.

11/1/2009 6:42:08 PM



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NickIowa wrote:
Would "volunter contributions" ever affect the quality of medical service -- or, indeed, the availability of medical service at all? Of course not, we are assured.

But I'm sitting here at the moment watching a CBS "60 Minutes" piece about a Yakuza (Japanese Mafia) godfather who was moved to the head of the list for a liver transplant at the UCLA Medical Center (another leading academic medical school/hospital like UIHC) because of . . . well, a very generous "volunteer contribution."

Is the story true? How would I know? But CBS is looking at a significant defamation suit if not.

Could money help improve your medical treatment at Iowa? Of course not. We're Iowans, not southern Californians, after all.

Still, even Iowans would be well advised to avoid the risk of the appearance of that possibility.
11/1/2009 6:52:34 PM



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tvolm wrote:
A sick solution to a sick business in a sick state in a sick nation.

All good christian greed, god bless, mr bush.
11/2/2009 8:48:52 PM



Here are some more highly edited comments from Morelli's October 31 version of the story (to which readers were continuing to attach comments on November 1):


monashaw wrote:
Sounds fairly ghoulish to me. Not to mention out of touch with reality. Most patients are already too stressed about money . . ..
10/31/2009 12:25:30 PM


guyinic1 wrote:
I think it is totally inappropriate for UIHC and/or the University's foundation to solicit "donations" from patients. The next thing they will be doing is putting up signs that say "Gratuities gladly accepted!" Even suggesting such a move to me indicates their desparate, juvenile way of thinking. I'll bet anyone the idea came from bureaurocratic administrators and not from the health care providers. More and more I get the idea that most if not all University administrators need to be housed together in a facility adjacent to Psych Hospital. They are bizarre to say the least!
10/31/2009 1:42:01 PM

NickIowa wrote:
I don't know which is sadder: that anyone would try this in the first place, or that once it was exposed UI spokespeople would (whether voluntarily, or in response to orders) try to defend it.

For an analytical look at what's going on, what's wrong with it, along with some value judgments, written early this morning in response to the Gazette's scoop, see

"UIHC: 'Sick Brother, Can You Spare a Dime?'; A Check-In and a Check," October 31, 2009, 7:00 a.m.

http://fromdc2iowa.blogspot.com/2009/10/uihc-sick-brother-can-you-spare-dime.html
10/31/2009 2:17:19 PM

mak52245 wrote:
They might as well install a toll booth at each entrance. Then they could get money from visitors and staff as well.
10/31/2009 3:12:35 PM


JoeSchmoe5106 wrote:
"Susan Shullaw, a senior vice president at the foundation, said the aim of the program is to benefit medical care and research. She said it was surprising people would question the program the same week UI announced a $26 million donation from the Pappajohn family to a new facility aimed at finding medical cures...I find it surprising that the same week (the donation was announced) the university is also being questions about offering the opportunity to grateful patients who want to help make a positive impact on the lives of others,” Shullaw said. “And, that is what this is about.”

This quote proves that these people are so out of touch! How many patients are of the status of the Pappajohns? The Pappajohns are not indigent patients, unemployed Iowans, patients on their Nth round of chemotherapy owing UIHC thousands already.

Shullaw is unbelieveable.
10/31/2009 3:43:15 PM


pharma wrote:
UIHC should take a look at their extraneous expenses and make appropriate cuts, instead of counting on patients to pick up the mismanagement slack at UIHC. . . ..
10/31/2009 3:58:19 PM


thetruthman wrote:
Here's my donation; Get serious. Thanks for making the hospital look second rate.
10/31/2009 4:15:35 PM


Curls wrote:
What lack of class.

As patients of UIHC myself and my family already receive letters requesting donations to the "patient care fund." These letters are also tacky. . . .
10/31/2009 4:27:52 PM


TWinter wrote:
It would be fine if they wanted to put donation brochures in the waiting rooms or even include them in mailings, but asking medical personell to get involved is extremely tacky. I hope most doctors and nurses at the hospital would simply refuse to do this because it would be so unprofessional.
10/31/2009 5:02:13 PM


IowaCityGirl wrote:
“I find it surprising that the same week (the donation was announced) the university is also being questions about offering the opportunity to grateful patients who want to help make a positive impact on the lives of others,” Shullaw said. “And, that is what this is about.”
Ummmm, I am pretty sure that any grateful patient can locate the Hospital once they are fully recovered to make a donation, if they choose. They should NOT ask for them. Comparing the everyday patient to the PapaJohn family is ridiculous!
10/31/2009 5:04:26 PM


JoeSchmoe5106 wrote:

Replying to hawkigirl05:
"I wish people would realize . . . If they say no, they sign a paper and they will not be contacted. . . ."

If the answer is no they have to write a letter to the Privacy Officer. They can't just check a box and say no. The simple fact is, it shouldn't be done. It's inappropriate and sick and/or confused patients shouldn't be bothered with this at the time of a clinic visit. Period.
10/31/2009 6:13:37 PM


JoeSchmoe5106 wrote:

. . . I have seen the form. Check the very bottom of the form where it says, "If you do not want the UIHC or the UI Foundation to contact you for fundraising efforts, you must notify our Privacy Officer in writing,..." which is followed by the address. It's the fine print . . ..
10/31/2009 7:10:36 PM


sparkymalone wrote:
Oh, for shame. Shame on Shullaw and Moore both. This is unconscionable. To take sick people by the arm, in the hospital, and say "Come on out and say out loud you don't want to be bothered, and see what kind of care you get next"? Because that'll be how it's perceived.

Oh, I love the excuse-making, too. "Well, my mendacious friends over there do it, so it must be OK, Mom." My God. I hope they're both paid well for the ordure they have to make come out of their mouths.

Shame, shame, shame. Next we'll see one of them giving a course in medical ethics!
10/31/2009 9:50:20 PM


Lina58 wrote:
Patients are in the hospital to heal and anticipate when they are well enough to go home where they feel they belong. The very LAST thing they ever need is to be asked for a monetary donation to the UIHC when they haven't even gotten a bill for the current visit there. Perhaps in the back of their mind they are wondering where they are going to get the money to pay for this visit.
TOTALLY out of line and insensitive. Keep asking 'The Papajohn's" of the world for money. NOT SICK PEOPLE!!!!
11/1/2009 8:41:50 AM


IowaCityGirl wrote:
They should NOT be bothered with this at all. As I previously stated...Should a gratefull patient be fortunate enough to have expendable/extra money that they wish to donate they know where the hospital is. This should not be happening.
11/1/2009 11:13:26 AM

wardedinburgh wrote:
Foundation fundraising is a necessity, and has to be handled very sensitively. Soliciting donations from current patients is NOT a sensitive way to go about it.

I'm currently an Oncology Patient, with a semi-orphan form of ovarian cancer. If I had the income, and if Title 19 would cover it, I'd be going to Mayo. Each time I hit the UIHC for a visit, I feel as if I'm being trampled by a herd of clowns who are unable to navigate in their floppy shoes. The quality of care is relatively good, but the various departments seem unable to communicate with each other, or with me. Some of the problems are probably due to lack of funding for enough staff members--perhaps the executives should take paycuts so that the "grunts" who really have patient contact, and who most closely affect proper communications, can be rehired or have their numbers increased to an acceptible level. This institution doesn't have a hope of becoming a MAGNET MEDICAL CENTER until there are more support staff.
11/1/2009 3:16:37 PM


ahhah wrote:
As often is the case, it is the method not the objective in dispute. It used to be you made an appt, checked in, sat down, waited for your name to be called, were seen, and if lucky went home. You felt anonymous and you felt your care was objective not subjective. It has become such an offputting process from beginning to end for both patients and employees. They should have made it a letter plus envelope handed to the patient and checked off on the computer by the receptionist with the date of delivery. Once a year after expiration date, you hand them another one. You also have them available in the racks and on the tables for those who like to read while waiting.
11/1/2009 4:01:48 PM

IowaCityGirl wrote:

Replying to ahhah:
Nope...it is the objective I disagree with as well. NO health care facility should ask patients for donations, EVER. If someone has the money to donate they know where the hospital is.
11/1/2009 6:36:15 PM


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NickIowa wrote:
Could "donations" affect the availability or quality of UIHC's service? Of course not, we're assured.

But there's a CBS "60 Minutes" piece tonight about a Yakuza (Japanese Mafia) godfather moved to the head of the liver transplant list at UCLA's Medical Center because of . . . well, a very generous "voluntary contribution."

I don't know which is sadder: that anyone would try this UIHC scheme in the first place, or that once it was exposed to daylight UI spokespeople would try to defend it, whether voluntarily or because ordered to do so.

For an analytical look at what's going on, what's wrong, value judgments, and some readers' comments from this and the Nov. 1 versions of the story, see

"UIHC: 'Sick Brother, Can You Spare a Dime?'; A Check-In and a Check," October 31, 2009, 7:00 a.m.

http://fromdc2iowa.blogspot.com/2009/10/uihc-sick-brother-can-you-spare-dime.html

Could cash affect UIHC care like UCLA? Of course not. We're Iowans after all, not Californians.

Appearances matter.
11/1/2009 8:08:05 PM


# # #

Friday, October 30, 2009

Cutting Slack, Cutting Budgets

October 30, 2009, 8:30 a.m.

Regents, University Presidents, Deserve Some Thanks and Credit
(brought to you by FromDC2Iowa.blogspot.com*)

The sound of one shoe dropping.

The Iowa universities' presidents have presented their budget-cutting plans to the Regents, and the Regents have taken some votes.

Those who comment on newspapers' online stories are not always known for their civility and graciousness, and they've offered little toward the decisions reported in the stories about yesterday's [Oct. 29] Regents' meeting in Cedar Falls.

I've never hesitated to provide free blog advice to the Regents and the UI administration. (See, e.g., the blog entries linked from "TARP Lessons for Iowa's Budget Cutters," October 23, 2009.)

But on this occasion, without agreeing with everything they've done, I think we need to cut the Regents and the three university presidents some slack, and give them thanks and credit for a creative effort at fairness and equity in their execution of the thankless task of deep budget cuts.

Presidents' Bonuses. In those linked prior blog entries I've called for the important symbolism of the presidents' rejection of the $155,000 in potential bonus payments promised by the Regents. In the case of UI President Sally Mason, the $80,000 bonus was as much as a 15% increase above her regular salary -- mere symbolism for the UI community and people of Iowa, perhaps, but no small amount of pocket change for an individual State employee.

Yesterday she passed up the money, saying "“This year our budget difficulties are extraordinary. I too must do my part.” ISU President Gregory Geoffroy said, “I don’t expect one, nor would I accept any kind of performance bonus under these economic circumstances.”"Mason Turns Down Bonus Pay," Daily Iowan, October 29, 2009.

ISU's President Geoffroy went further, and "called the bonuses bad public policy. 'I think that they create enormous public relations issues for us. I would urge you to think about other ways to structure compensation.'" Staci Hupp (with contributions from Jason Clayworth, Gunnar Olson and B.A. Morelli), "University employees spared from layoffs," Des Moines Register, October 30, 2009.

Geoffroy's bonus would have been a 12% salary boost; UNI's President Ben Allen was in line for an 8% bonus.

Nor is this all. Both Geoffroy and Allen were offering to sacrifice 12 days' pay -- a not insignificant contribution at their salary level.

Fairness and Equity. I've also called for basic fairness, hoping that those with the least power and pay would not end up bearing a disproportionate share of the burden, while the relatively powerful at the top of the salary scale escaped unscathed. The model I urged we avoid was that of Wall Street, where bonuses in the multi-billions continue to flow to the wealthy, while the homeless and unemployed are ignored. It's a matter of substance as well as symbolism.

Here again, I think the Regents and the presidents have made significant strides in that direction.

Although Geoffrey and Allen are taking furloughs of 12 days, ISU employees earning under $60,000 a year will only lose 4 days pay. Note that 12 days is both three times the number of unpaid days suffered by those at the bottom of the pay scale, and given the presidents' salaries a much greater total cash loss per day for the presidents as well. "Senior administrators will take 10 days." [Staci Hupp's story, linked above.]

The cut in State contributions to individuals' retirement programs also has an equitable impact. At the UI the TIAA-CREF program involves a 5% of salary contribution from the employee, and a 10% of salary contribution from the University.

The proposal is that the 10% from the State be reduced to 8%. (Regent Michael Gartner and others thought it would be better to reduce it to the IPERS 7% level -- which would have made it even more equitable.) This has been described as a "2% reduction" ("a temporary 2 percent reduction," B.A. Morelli article, linked below). That may be a good public relations characterization in selling it to the beneficiaries who are being cut. But it's bad mathematics, and poor public relations in selling it to the people of Iowa, parents and students.

To cut a contribution from 10% of salary to 8% is a 20% cut, not a 2% cut.

I think a 20% cut in a benefit program is a significant cut; though I don't think it's unreasonable (especially since employees under this program are still getting slightly more than those with IPERS).

But my point for now has to do with equity. For a university president earning $450,000, 10% represents $45,000; 8% represents $36,000. That's a $9000 reduction -- what by my standards is a significant cut.

For an employee earning $40,000 the 10% is $4000; the 8% is $3200 -- an $800 cut. That's still significant for someone earning that salary. But the point is: those who earn the most lose the most; those who earn the least lose the least in the absolute dollar contributions they would otherwise receive into their retirement fund.

The $100 Student Surcharge. In the context of the presidents' self-imposed cuts in their own pay and benefits, and the effort to spread the burdens in accordance with employees' ability to bear them, the $100 surcharge for students doesn't seem outrageous.

I opposed the surcharge, as did four of the nine Regents, both as a matter of principle and of public relations. I believe in the 21st Century a college education in 2009 is a necessity that is the functional equivalent of a high school education in 1909 -- as I have laid out from time to time in this blog. It is internally inconsistent today to provide high school education at no cost to parents, while charging them a half or more of the full cost of college. Either we should charge for high school (which I would hope no one would advocate) or we should make "K-16" the modern standard for "public education." (Ditto for one of the greatest returns on public investment: the "K-prep" programs for those age 2 to 4.) Consistent with that position, I did not support the surcharge.

From a public relations perspective I simply posed the benefit-cost question: Is the benefit (the revenue from the $100/student) worth the cost (in student-parent hostility at a mid-year $100 add-on).

However, in the necessary spirit of compromise in putting together a package that spreads the burden among the beneficiaries, a $100 contribution, that is a surcharge rather than a permanent increase, and one that enables the Regents to reach the universities' $59.8 million share of the necessary State-wide budget cuts by putting 10% of it ($5.7 million) on students, it really can't be dismissed as an unreasonable part of the package. My position is not dissimilar to that of Regents' President Miles: "“I do not favor the idea of a $100 surcharge for our students at this late a date,' Miles said. 'But I think it’s reasonable.'” "Regents support surcharge," Daily Iowan, October 29, 2009.

Capital Expenditures. I have also noted the difficulty of imposing salary and benefit cuts, and layoffs, while continuing capital expenditures at the UI that cost roughly as much as all the required budget cuts for the three universities combined ($60 million for a UIHC computer system that has had a bad track record at other institutions and requires a $250,000 administrator to watch over it; a $47 million refurbishing of the Carver Hawkeye Arena). Here again, President Mason is proposing to cut some $5.1 million in building proposals as a part of her total budget cutting efforts. "Mason outlines cuts for UI," Daily Iowan, October 29, 2009.

Lest we be too happy about yesterday's meeting we need to recall that after this year's $600 million cut in State funding comes next year's projected $1 billion cut. So long as the federal government refuses the only surefire way to increase consumer spending (in an economy 70% driven by consumer spending) -- keeping home dwellers in their homes, and starting a federal WPA-CCC-style jobs program -- unemployment/underemployment will continue to increase or, best case, hold steady, this "recession" will continue, Iowa's tax revenues will continue their decline, and the economic pain for all will only increase. Javier C. Hernandez, "Day After Rally, Stocks Retreat on Consumer Weakness," New York Times, October 30, 2009 ("On Friday [Oct. 30], the Commerce Department reported that consumer spending in September dropped by the largest amount in nine months, a dreary data point that . . . reinforced the slow, halting recovery of the United States economy.").

There are many more rewarding investments for that multi-trillion-dollar debt Washington is passing along to my great grandchildren than handing it over to the guys who created the problem -- but then, I guess the two-year-old really has been rather miserly with his campaign contributions.

I suffer no illusion that any of the decisions made by the State universities presidents, or the Board of Regents, came about as a result of entries in this blog. But given the extent to which what was done was consistent with what I was urging be done, the only decent option open to me at this point is to give all of them some credit for an exceedingly difficult job relatively well done -- along with a "thank you."

Yesterday the Regents dropped the soft, cloth house slipper. When "the other shoe" drops it, and we, may make a little louder sound.

My sources:

Staci Hupp (with contributions from Jason Clayworth, Gunnar Olson and B.A. Morelli), "University employees spared from layoffs," Des Moines Register, October 30, 2009;

B.A. Morelli, "Regents approve UI tuition surcharge; Layoffs not totally off the table," Iowa City Press-Citizen, October 30, 2009;

"Mason turns down bonus pay," Daily Iowan, October 29, 2009;

"Regents support surcharge," Daily Iowan, October 29, 2009;

"Mason outlines cuts for UI," Daily Iowan, October 29, 2009.

[When this entry was written the online Daily Iowan for today was not yet available. Now that it is, the following should also be listed:

Emily Busse, "Board of Regents Approve UI Budget Plans," Daily Iowan, October 30, 2009, p. A1;

Editorial, "UI Admins Should Share the Budget Burden," Daily Iowan, October 30, 2009, p. A6;

Tom Moore, "Students Must Take Some of the Burden with Budget Cuts," Daily Iowan, October 30, 2009, p. A6.]
_______________
* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
# # #

Thursday, October 29, 2009

Board of Regents and School Board's Boundaries

October 29, 2009, 9:15 a.m.

It's Been a Weird Week in Lake Woebegon
(brought to you by FromDC2Iowa.blogspot.com*)

The big news today for many readers of this blog will be whatever comes out of the Board of Regents' meeting in Cedar Falls today regarding budget cuts at the three State universities. Staci Hupp, "Regents, presidents to discuss budget cuts today," Des Moines Register, October 29, 2009; Diane Heldt, "Regents open to large-scale budget cuts," The Gazette, October 29, 2009, p. A1. And see Nicholas Johnson, "TARP Lessons for Iowa's Budget Cutters," October 23, 2009, with links to numerous related blog entries.

With some exceptions, during the school year I've tried to hold the blog entries to Monday, Wednesday and Friday. But this week the Spence break-in revelations, leaked out Tuesday, warranted an immediate report and comment. Nicholas Johnson, "UI Spence Break-in: Gazette Scoop Illustrates Issues," October 27. And now today the Board of Regents' actions will be the story -- but not until this evening (if I can get to it before tomorrow morning). Meanwhile, the Register and Gazette stories, linked above, give some notion of what may be coming.

Meanwhile, we can only plead with our local School Board members to reconsider their approach to the redrawing of elementary school boundaries.

School Board and School Boundaries. I've written enough op ed columns and blog entries about boundaries that a summary statement, plus these links to more, ought to be enough. For some suggestions and analysis of alternative Board approaches see the 11 blog entries linked at the end of "School Board Election: Now Work Begins," Sept. 9, especially "School Boundaries Consultant Folly," Aug. 28, and "Cluster Schools: Potential for IC District?" June 3.

1. Substantive results. Obviously, I have my own opinion about the best substantive standards. But those preferences are irrelevant to the point I want to make. I won't even comment about the rather bizarre procedure it, and the consultant, utilized to "poll" Board members rather than voting.

2. School Board flexibility. "Local control of schools" means that the Board can do virtually anything with our schools that is not prohibited by federal or state law. They can decide to let some schools sit virtually empty while others are overcrowded. They can push the disparity between schools with regard to the percentages of students in various socio-economic classes up to the limit of the law -- or try to make them more equal than the law requires. They can draw circles around each school as its boundary, or vary them somewhat to achieve a variety of goals.

3. Board must lead -- and with metrics. The Board simply must, however, go beyond the vague "prioritiz[ing of] its top criteria" reported in this morning's Press-Citizen: Josh O'Leary, "Board finalizes priorities; Not all members pleased with process," Iowa City Press-Citizen, October 29, 2009, p. A1. This is the Board's legal, managerial, and political responsibility.

For example, telling a committee of 30 that it should keep in mind the Board's "priority" of "demographic considerations" is equivalent to Congress telling the FCC in 1934 that it is to regulate radio (and then television) in "the public interest."

Continuing with the "demographics" example, within the bounds of the law the Board can choose from a range of metrics.

(a) It should start by calculating the percentage of "free-and-reduced-lunch" (FRL) students in the District-wide student population.

(b) It could then say, to state the extremes, that it wants to [1] maximize the disparity, within the limits of the law, resulting in some elementary schools with a disproportionately high percentage of FRL students, and other schools that have a disproportionately low percentage of FRL students (kind of like what we have now), or to [2] draw boundaries and/or bus students so as to make the FRL percentages equal in all schools. [3] Or it could say that all schools' FRL percentages should be within some fixed number of percentage points of each other, say 5% or 10%, or whatever other percentage it wants.

I now express no view as to which of those metrics it should choose.

But for the Board to delegate its responsibility for boundaries to a committee of unelected citizens in the form of a multiple-variable set of criteria with no algorithm, made up of vague categories with no metrics, is an abdication of its responsibility, a kicking the can down the road, a recipe for chaos and frustration, and an unconscionable imposition on the time, energy, good will and financial resources of 30 dedicated local citizens and the public at large.

Ultimately, these metrics will emerge -- either because they have, finally, been declared by the Board, or because they are evident "de facto" from the numbers that have resulted from what they've done. That being the case, the earlier on the Board puts some specific metrics on the table the better off we all will be.

Obviously, this is not to say that, having done so, the Board should be forbidden to ever change its collective mind. Quite the contrary. New data, physical impractibility, political or economic pressures may very well call for some rational modifications in the numbers from time to time.

But at any given point in time, starting now, it is the Board, and only the Board, that should be specifying the specific numbers with regard to the criteria that it, prior Boards, and I, have laid out over the years.

Having done so, it is then possible, if the Board desires, to delegate the task of alternative line-drawing possibilities to the Superintendent, a consultant, or a committee -- but not before.

__________

There has been very little actually done over the last 30 years with regard to meaningful curtailment of alcohol abuse by UI students. There have not even been many proposals that could have a meaningful impact were they to be adopted -- which they seldom if ever are.

This morning's op ed column by Professor Poe (which appeared earlier in the Daily Iowan) is an exception and very much worth reading. It may later call for some commentary on this blog, but not this morning.

Marshall Poe, "Are Drunk Students Kicking Down Your Door?" Iowa City Press-Citizen, October 29, 2009, p. A8.
_______________
* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
# # #

Tuesday, October 27, 2009

UI Spence Break-In: Gazette Scoop Illustrates Issues

October 27, 2009, 11:00 a.m.; November 20, 2009, 6:30 a.m.

Nov. 20 Updates: Two Spence break-in grand jury witnesses jailed for refusal to testify, one now indicted, "UI Spence Break-In: Gazette Scoop Illustrates Issues," October 27, 2009; Anonymous, "Davenport Grand Jury Subpoena for Scott DeMuth," Nov. 11, 2009; "Two jailed for refusing to testify before grand jury," Iowa City Press-Citizen, November 17, 2009; Carrie Feldman's Web site and the new "Support Carrie and Scott!"; "Activist indicted for alleged role in Spence Labs vandalism," Iowa City Press-Citizen, November 19, 2009 [in hard copy as "Man Indicted for Animal Terrorism," Iowa City Press-Citizen, November 20, 2009, p. A1]; Ann McGlynn, "Activist who refused grand jury testimony now charged with conspiracy," Quad City Times, November 19, 2009; Ann McGlynn and Diane Heldt, "Lab Break-in Charge Pleases UI Officials," The Gazette, November 20, 2009, p. A1; Ann McGlynn, "Animal rights activist pleads not guilty in University of Iowa vandalism," Quad City Times, November 20, 2009; Zack Kucharski, "Judge Orders Animal Rights Activist Held," Quad City Times, November 26, 2009.

Topics: Media, Shield Laws, Grand Juries (secrecy, abuse to suppress dissent, failure to testify, imprisonment for contempt), Animal Rights, Animal Research, Internet Revelations
(brought to you by FromDC2Iowa.blogspot.com*)

Media. A "Hats Off" to The Gazette for a major scoop this morning involving the November 13/14, 2004, UI Spence Labs break-in with estimated $450,000 damage and "ALF" (Animal Liberation Front) spray painting. Diane Heldt, "Young woman: I’m grand jury’s target; Minneapolis native says inquiry is for 2004 Spence Labs break-in," The Gazette, October 27, 2009, p. A1 (with links to related stories). (That link is to the Gazette Online version of the story. The hard copy version, which contains a link to the subject's Web page, is available at http://cedarrapidsgazette.ussrv06.newsmemory.com/index.php (if you access it after the date of publication, October 27, use the drop down menus to find that day's edition). [Nov. 12. And see, Anonymous, "Davenport Grand Jury Subpoena for Scott DeMuth," Nov. 11, 2009; "Two jailed for refusing to testify before grand jury," Iowa City Press-Citizen, November 17, 2009, and Feldman's Web site.]

A Minneapolis woman, 15 at the time, is publicly reporting she has been called before a grand jury she asserts has been convened regarding the crime.

While The Gazette in general, and Diane Heldt in particular (along with "Ann McGlynn of the Quad City Times [who] contributed to this article"), are entitled to credit for getting and publishing the story, one media question is why is there not a whisper of it in the Daily Iowan, Iowa City Press-Citizen, or Des Moines Register? (Notwithstanding the Quad City Times's reporters involvement, I couldn't find anything in that paper's online edition either.)

[Long after this blog entry was written, and about the same time it was posted, the Press-Citizen put a story online: B.A. Morelli, "Woman Won't Testify in UI Animal Rights Case," Iowa City Press-Citizen, October 27, 2009. It could be both papers worked on the story independently, but the Press-Citizen doesn't mention its independent source, if any, or provide a link to either The Gazette's story or the subject's site. So we're left to speculate.]

Shield Laws. What if the reason The Gazette was able to get the story is that they had access to a confidential source, Diane Heldt and Ann McGlynn are subpoenaed to appear before the grand jury to reveal that source and what they were told, and they refuse to appear? This general subject ("shield laws") happens to be something my class is briefly focusing on at the moment. So far as I know Iowa has no shield law legislation as such, but at least a couple of Iowa Supreme Court cases seem to look favorably on at least balancing reporters' rights in comparable circumstances. (See, e.g., Lamberto v. Bown, 326 N.W.2d 305 (Iowa 1982), and Bell v. City of Des Moines, 412 N.W.2d 585 (Iowa 1987). Obviously, a lot more thorough research would be necessary to formulate a reliable "legal opinion" regarding Iowa law.)

Grand Juries. Grand jury proceedings are secret, in an effort, among other things, to protect the reputation of someone whom the grand jury ultimately refuses to indict. In this instance the witness has chosen to speak publicly about the existence of the grand jury, that she was called, refused to testify, and that she suspects it has to do with the 2004 case. All of the above, plus whatever she chooses to do on November 17 when she says she is to return, may be potential bases for the judge finding her in contempt.

One of her general arguments in her attack on grand juries generally, is that she believes they are being misused by law enforcement, not to prosecute crime, but as a way to obtain otherwise unavailable information, intimidate and otherwise suppress legitimate dissent. I have no independent knowledge of that one way or the other, but it would be a concern if true.There certainly have been revelations of law enforcement infiltrating and otherwise spying on non-violent anti-war and other benign organizations.

Animal Rights; Animal Research. Animal rights organizations range the political/activist spectrum from those like the World Wildlife Fund, our local Johnson County Heritage Trust, or Pheasants Forever: The Habitat Conservation Organization, to PETA (People for the Ethical Treatment of Animals), and on to the unabashedly radical, property-destroying Animal Liberation Front (because Google warns that even the ALF's Web site can harm your computer, the latter is a link to the Wikipedia entry). [Photo Credit: The Gazette.]

Those doing animal research point out the benefits it can contribute for humans in terms of pharmaceutical and other product testing, understanding human psychology, and other scientific research; that researchers have cut back on the use of primates and dogs; and that the animals are well cared for. Needless to say, animal rights activists dispute some of these assertions.

Internet Web Pages. I doubt that this is either the first or the last use of the Internet by someone called before a grand jury, but it is also fascinating to me for that reason. She lays out the whole story -- from her perspective, of course. Her friends have attached comments of support. Her statement to the grand jury is included, along with the details of her planned events the day she returns. It's kind of a combination Web page, blog and Facebook site. It may very well figure in any future judicial findings of her being in contempt of court.

It's not often I come upon a story that touches on so many subjects of interest to me. You may find some here of interest as well.
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* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
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Monday, October 26, 2009

This Blog's Good For Your Brain

October 26, 2009, 6:00 a.m.
For UI and Iowa's budget, see links from "TARP Lessons for Iowa's Budget Cutters," October 23, 2009.

Searching the Internet to Find It Even More So
(brought to you by FromDC2Iowa.blogspot.com*)

Remember "this is your brain on drugs"?



Well, this is your brain on the Internet:









And this is your brain while reading:

[Photo credit: "Internet Use 'Good for the Brain'; For middle-aged and older people at least, using the internet helps boost brain power, research suggests," BBC News, October 14, 2009; "Internet Brain [interview with Dr. Gary Small]," "Science in Action"/BBC World Service, October 23, 2009 (with link to streaming audio).]

So that's why I modify the heading on this blog entry ("Reading This Blog") with the sub-head ("Searching the Internet"). Most of those reading this blog have come to it directly. But the next largest group have come as a result of a Google (or other) search. And it is this searching and surfing that UCLA's Gary Small, Susan Y. Bookheimer and Teena D. Moody say is expanding the mental capacity of especially older Internet users. Rachel Champeau, "First-time Internet users find boost in brain function after just one week," UCLA Newsroom, October 19, 2009.

I would guess, however, that even those of you who are coming to the blog directly are relatively heavy Internet users -- one of the groups including in the UCLA research: "The UCLA team worked with 24 neurologically normal volunteers between the ages of 55 and 78. Prior to the study, half the participants used the Internet daily, while the other half had very little experience. Age, educational level and gender were similar between the two groups."

Not incidentally, the results from their functional magnetic resonance imaging (fMRI) scans indicate there is much greater brain activity (at least activity in more areas of the brain) from Internet searching than from reading -- as indicated in the photos at the top of this blog entry. Admittedly, the participants were between 55 and 78. But there's no intuitive reason to believe that the results would not be similar among young children -- the next group the researchers plan to study.

So those parents and teachers wishing students would read more may want to apply the old adage, attributed to numerous sources, that you should be careful what you wish for because you may get it. Perhaps their concern should be addressed to to those students who are spending excessive time with books and too little time with the Internet.

Of course, I'm only half serious. (1) At a minimum students need to be able to do both; and if I had to choose I'd pick reading skills over searching skills -- though I'd prefer not to have to make that choice. (2) Once the Internet search is over, and you find the relevant document, literacy is still a useful skill. (3) Not all interaction with computers involves Internet searching. At least this research did not address the neural consequences of consuming streaming audio or video, playing video games, text messaging, conversing over Skype, or looking at photos. (4) Internet searching can be a form of procrastination that has the opportunity cost for students of falling behind in homework or other obligations. (5) Worst case, there is such a thing as Internet addiction that really needs to be tended to.

Subject to those caveats, however, Dr. Small and his associates do seem to have come up with something we need to add to nutrition, exercise, sleep and stress reduction as elements of healthy living: Internet searching.
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Gary Small, M.D. is the Director of the UCLA Memory & Aging Research Center at the Semel Institute for Neuroscience & Human Behavior and the author of iBrain: Surviving the Technological Alteration of the Modern Mind (2008) (Amazon offers the usual table of contents, excerpt, and index here); but see the Kirkus review on the Google Books site). The Gary Small and iBrain Web site has a link to streaming video of a CBS interview.

Here are more excerpts from the UCLA news release, Rachel Champeau, "First-time Internet users find boost in brain function after just one week," UCLA Newsroom, October 19, 2009:

You can teach an old dog new tricks, say UCLA scientists who found that middle-aged and older adults with little Internet experience were able to trigger key centers in the brain that control decision-making and complex reasoning after just one week of surfing the Web.

The findings, presented Oct. 19 at the 2009 meeting of the Society for Neuroscience, suggest that Internet training can stimulate neural activation patterns and could potentially enhance brain function and cognition in older adults.

As the brain ages, a number of structural and functional changes occur, including atrophy, reductions in cell activity and increases in deposits of amyloid plaques and tau tangles, which can impact cognitive function.

Research has shown that mental stimulation similar to that which occurs in individuals who frequently use the Internet may affect the efficiency of cognitive processing and alter the way the brain encodes new information.

"We found that for older people with minimal experience, performing Internet searches for even a relatively short period of time can change brain activity patterns and enhance function," said study author Dr. Gary Small, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and the author of "iBrain," a book that describes the impact of new technology on the brain and behavior. . . .

The first scan of participants with little Internet experience demonstrated brain activity in regions controlling language, reading, memory and visual abilities, which are located in the frontal, temporal, parietal, visual and posterior cingulate regions, researchers said. The second brain scan of these participants, conducted after the practice Internet searches at home, demonstrated activation of these same regions, as well as triggering of the middle frontal gyrus and inferior frontal gyrus — areas of the brain known to be important in working memory and decision-making.

Thus, after Internet training at home, participants with minimal online experience displayed brain activation patterns very similar to those seen in the group of savvy Internet users — after just a brief period of time.

"The results suggest that searching online may be a simple form of brain exercise that might be employed to enhance cognition in older adults," said Teena D. Moody, the study's first author and a senior research associate at the Semel Institute at UCLA.

When performing an Internet search, the ability to hold important information in working memory and to extract the important points from competing graphics and words is essential, [Teena D.] Moody noted. . . .
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* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
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Friday, October 23, 2009

TARP Lessons for Iowa's Budget Cutters

October 23, 2009, 7:40 a.m.

Today's blog entry is another in a series devoted to Iowa's budget crisis and its impact on the University of Iowa. Prior entries included:

"How Many Administrators Does It Take? Administrators are Multiplying & Sucking Us Dry," July 16, 2009

"A University's Strategic Communication; A Modest Proposal to the Regents' University Presidents," October 7, 2009

"Iowa's Budget Cuts and the University; Economic Collapse Tests Moral Values," October 9, 2009.

"How to Cut Iowa's Budget; Fairness, Justice and Leadership by Example," October 15, 2009.

"UI Budget: Waivers Wave Goodbye to Savings; Consistency, Hobgoblins and Waivers," October 19, 2009


Barofsky: "Anger, cynicism and distrust [an] unnecessary cost of TARP"
(brought to you by FromDC2Iowa.blogspot.com*)

Iowa Governor Culver's axe has begun to fall. Jennifer Jacobs, "1,300 state jobs at risk in proposed cuts," Des Moines Register, October 22, 2009 ("Iowans could see fewer troopers on highways, less treatment for addictions, fewer prison guards, delays in new dental coverage for children, less child abuse prevention work, longer waits for state tax refunds, less aid for college and dozens of other impacts if the governor approves budget cuts his agency directors presented to him. State corrections and human services workers would see the brunt of the layoffs. Those departments account for nearly 600 of about 793 layoffs proposed statewide.").

Next Wednesday the Board of Regents will announce with a little more specificity how the three Regents' universities should respond to the Governor's order that they, too, are expected to further cut their state appropriations by another 10%. See Staci Hupp, "Regents propose surcharge, 6.5-percent tuition and fees increase," Des Moines Register, October 23, 2009.

What an awful, and thankless, responsibility. History records no occasion when a budget cutter's decision was greeted with a standing ovation. Usually the recipients' reactions are just the opposite. No applause; little understanding; just "anger, cynicism and distrust."

These are the public reactions the Department of the Treasury's Special Inspector General, Neil Barofsky, says the Treasury's handling of the TARP program have produced: "Treasury's actions in this regard have contributed to damage the credibility of the program and of the government itself, and the anger, cynicism and distrust created must be chalked up as one of the substantial, albeit unnecessary, costs of TARP."

But note that while Barofsky acknowledges the public's "anger, cynicism and distrust," he says that reaction was not a necessary cost, and that it could have been avoided if the government officials involved had behaved differently.

It's a model Iowa's budget cutters would do well to study -- in order to avoid that reaction here, on the part of Iowans generally, and those associated with its universities in particular.

But first an update on another scandal and advice to Iowans on how not to do government programs, whether of largess or of budget cutting.

Wednesday I wrote about another example of Congress handing over taxpayers' money to generous campaign contributors from another sector of our economy -- the developers, contractors, home builders, real estate brokers and mortgage bankers. In addition to the trillions of dollars they already get, they are now pushing to expand and extend their version of "cash for clunkers" (without the need to come up with the clunkers): an $8000 grateful taxpayers contribution for each house sold (which they wish to expand from first time home buyers to all buyers, and from $8000 to $15,000). (Needless to say, there's no provision in this program to help those who are providing the houses through bankruptcy, foreclosure, and their willingness to live on the street.) "Housing for the Wealthy, Unemployment for the Poor," October 21, 2009.

Yesterday we learn of yet one more reason to oppose this program (a program that most economists agree is loony from their perspective as well). It turns out it's been riddled with fraud. Jackie Calmes, "Fraud Reported in Program to Help New Homebuyers," New York Times, October 22, 2009 ("Just as Congressional leaders are calling to extend a popular tax credit for first-time homebuyers, government investigators are reporting new findings that point to widespread fraud in the program. A previously undisclosed report from the Treasury Department’s inspector general said that as of Sept. 30, the Internal Revenue Service had identified 167 suspected criminal schemes and opened nearly 107,000 examinations of potential civil violations. In late July, the I.R.S. announced its first successful prosecution.").

That same Wednesday (October 21) PBS' "Frontline" revealed what those now advising the President were doing to beat back the calls for regulation during the 1990s, efforts that played a major role in creating our current economic crisis -- in the midst of which their Wall Street friends and former colleagues at Goldman Sachs are continuing to earn billions in bonuses.

"The Warning," PBS Frontline, October 21, 2009 ("'We didn't truly know the dangers of the market, because it was a dark market,' says Brooksley Born, the head of an obscure federal regulatory agency -- the Commodity Futures Trading Commission [CFTC] -- who not only warned of the potential for economic meltdown in the late 1990s, but also tried to convince the country's key economic powerbrokers to take actions that could have helped avert the crisis. 'They were totally opposed to it,' Born says. 'That puzzled me. What was it that was in this market that had to be hidden?' . . . Greenspan, Rubin and Summers ultimately prevailed on Congress to stop Born and limit future regulation of derivatives. 'Born faced a formidable struggle pushing for regulation at a time when the stock market was booming,' ["Frontline" producer Michael] Kirk says. 'Alan Greenspan was the maestro, and both parties in Washington were united in a belief that the markets would take care of themselves.' Now, with many of the same men who shut down Born in key positions in the Obama administration, 'The Warning' reveals the complicated politics that led to this crisis and what it may say about current attempts to prevent the next one. 'It'll happen again if we don't take the appropriate steps,' Born warns. 'There will be significant financial downturns and disasters attributed to this regulatory gap over and over until we learn from experience.'" From the "Introduction."). If you missed it, you can watch streaming video of the program from the "Frontline" site.

On October 5 the New York Times reported:
The inspector general who oversees the government’s bailout of the banking system is criticizing the Treasury Department for some misleading public statements last fall and raising the possibility that it had unfairly disbursed money to the biggest banks. . . . A Treasury official made incorrect statements about the health of the nation’s biggest banks even as the government was doling out billions of dollars in aid, according to a report on the Troubled Asset Relief Program to be released on Monday by the special inspector general, Neil M. Barofsky.

The report also provides new insight into the way the Treasury allocated billions of dollars to nine of Wall Street’s largest players.
Louise Story, "Report on Bailouts Says Treasury Misled Public," New York Times, October 5, 2009, p. B2.













[Photo Credit: Larry Downing/Reuters; Time; "TARP recipients testify before the House Financial Services Committee on Feb. 11. From left: Goldman Sachs' Lloyd Blankfein, JPMorgan Chase's Jamie Dimon, Bank of New York's Robert Kelly, Bank of America's Ken Lewis and State Street's Ronald Logue."]

Jim Kuhnhenn, "Watchdog: Bailout Helped, but At a Cost," Associated Press/Time, October 21, 2009 ("[Treasury Special Inspector General Neil] Barofsky said [in his latest quarterly TARP report that] the Troubled Asset Relief Program has come at great cost to taxpayers, to the integrity of the financial system and to the public's perception of the federal government. 'Despite the aspects of TARP that could reasonably be viewed as a substantial success,' he wrote, "Treasury's actions in this regard have contributed to damage the credibility of the program and of the government itself, and the anger, cynicism and distrust created must be chalked up as one of the substantial, albeit unnecessary, costs of TARP.' . . . The integrity of the industry: Many firms considered "too big to fail" last year, and thus in need of government assistance, are even bigger now. 'Absent meaningful regulatory reform, TARP runs the risk of merely reanimating markets that had collapsed under the weight of reckless behavior,' the report states."). (Time has also kindly provided us with "25 People to Blame for the Financial Crisis," Time.)

So now we have "Frontline" passing along former CFTC chief Brooksley Born's warning that "There will be significant financial downturns and disasters attributed to this regulatory gap over and over until we learn from experience," and Neil Barofsky warning that "Absent meaningful regulatory reform, TARP runs the risk of merely reanimating markets that had collapsed under the weight of reckless behavior."

And how is the Obama Administration and Congress -- Democrats and Republicans alike -- responding to this urgent need that their most generous campaign contributors be more effectively regulated in the public interest? With a wink and a nod and an outstretched hand.

As the Wall Street Journal reports,

Some of the biggest Wall Street firms are back in the political-spending game after hunkering down while they were getting government bailout funds. Goldman Sachs Group Inc., Bank of America Corp., Morgan Stanley and other large financial-services firms stepped up their political donations in September to members of Congress . . ..Most Wall Street firms stopped making donations to lawmakers when they were receiving government funds, and many lawmakers stopped accepting them. But now . . . they are making campaign donations again. At the same time, they are increasing their spending on lobbying . . ..
For the details on who has given how much see Brody Mullins and T.W. Farnam, "Wall Street Steps Up Political Donations, Lobbying; Firms Boost Outlays Amid Debate on Financial-Services Overhaul, After Slowing Spending While Getting Bailout Cash," Wall Street Journal, October 23, 2009.

Sadly, this includes as well the President of the United States, Barack Obama, who even personally went to New York earlier this week for another $30,400-a-plate fund raiser. David D. Kirkpatrick, "Wall St. Giants Reluctant to Donate to Democrats," New York Times, October 20, 2009, p. A1.

Ironically, the "reluctance" to which that headline refers is the Wall Street executives "fear of getting caught in the public rage over the perception that Wall Street titans profiting from their government bailout may use their winnings to give back to Washington in return. And the timing of the event, as the industry lobbies against proposals for tighter regulations to address the underlying causes of last year’s meltdown on Wall Street, has only added to the worry over public appearances."

This is not the most laudatory basis for reluctance, perhaps, but at least it's better than that of a President who seems to be either unaware of or unconcerned about "the public rage over the perception" -- what Barofsky identifies as the unnecessary public "anger, cynicism and mistrust" fomented by such fund raisers.

This is probably enough reference to stories for a blog entry. But here are a few more for those interested in pursuing this, The Crime of Two Centuries, before turning to the lessons for Iowa's budget cutters.

U.S. taxpayers may be on the hook for as much as $23.7 trillion to bolster the economy and bail out financial companies, said Neil Barofsky, special inspector general for the Treasury’s Troubled Asset Relief Program. . . . including $6.8 trillion in aid offered by the Federal Reserve, Barofsky said in a report released today. . . .

Barofsky’s estimates include $2.3 trillion in programs offered by the Federal Deposit Insurance Corp., $7.4 trillion in TARP and other aid from the Treasury and $7.2 trillion in federal money for Fannie Mae, Freddie Mac, credit unions, Veterans Affairs and other federal programs. . . .

Barofsky offered criticism in a separate quarterly report of Treasury’s implementation of TARP, saying the department has “repeatedly failed to adopt recommendations” needed to provide transparency and fulfill the administration’s goal to implement TARP “with the highest degree of accountability.”

As a result, taxpayers don’t know how TARP recipients are using the money or the value of the investments, he said in the report. . . .

The Treasury has spent $441 billion of TARP funds so far and has allocated $202.1 billion more for other spending, according to Barofsky. In the nine months since Congress authorized TARP, Treasury has created 12 programs involving funds that may reach almost $3 trillion, he said. . . .

Barofsky said the TARP inspector general’s office has 35 ongoing criminal and civil investigations that include suspected accounting, securities and mortgage fraud; insider trading; and tax investigations related to the abuse of TARP programs.
Dawn Kopecki and Catherine Dodge, "U.S. Rescue May Reach $23.7 Trillion, Barofsky Says," Bloomberg, July 20, 2009.

"Watchdog: Treasury and Fed Failed in AIG Oversight," Associated Press/New York Times, October 14, 2009 ("Treasury Secretary Timothy Geithner is 'ultimately responsible' for regulators' failure to rein in massive bonus payments at American International Group because he led the agencies that provided AIG's lifelines, according to a bailout watchdog. Geithner was president of the Federal Reserve Bank of New York before taking over at Treasury in January. He has said he did not learn until March about the $1.75 billion in bonuses and other compensation promised to AIG employees. But Geithner's subordinates at the New York Fed learned of the payments in November, according to Neil Barofsky, the special inspector general for the $700 billion financial bailout.").

Pallavi Gogoi, "TARP report slams lack of transparency," USA Today, October 20, 2009 ("In a scathing report out Wednesday, a government watchdog blasts the Treasury Department for its handling of a $700 billion bailout program and for not adopting all of its earlier recommendations [and] Treasury's failure to provide more details about the use of TARP funds . . ..").

"Bailout watchdog Barofsky: Too early to say how much of $700B will be refunded to taxpayers," Associated Press/Baltimore Sun, October 21, 2009.

"U.S. 'unlikely' to recoup aid to banks; TARP watchdog's report is also critical of secrecy," Bloomberg/Washington Post, October 22, 2009.

William A. Barnett, "Who’s Looking at the Fed’s Books?" New York Times, October 21, 2009 October 22, 2009, p. A35.

And the meat-less, dry bone thrown the public's way turns out to be little more than public relations window dressing in front of what looks very much like same-old, same-old in the back rooms. Joe Nocera, "Pay Cuts, but Little Headway in What Matters Most," New York Times, October 23, 2009, p. B1. (They don't affect many people; for those they do affect, it only impacts their salaries for November and December of this year, then they can be renegotiated; stock options are exempted, so there's no limit to that continuing source of income, so long as they hold them for two to five years -- which they'd do anyway to ride up the price; and they can make more if things improve for their company, regardless of what they personally had to do with that. As the headline puts it, there's "little headway in what matters most."). See also, Editorial, "Symbolic Cuts Need to Set Tone for Real Cuts," Iowa City Press-Citizen, October 23, 2009 (regarding Governor Chet Culver's self-imposed salary cut).

As for Iowa's budget cutting, it's important for us to keep it in context. Take a look at this report prepared by one of the other Nicholas Johnsons (in addition to this one a couple of the others are the law professor at Fordham, and the literal rocket scientist). Nicholas Johnson, Phil Oliff, and Jeremy Koulish, "An Update on State Budget Cuts; At Least 41 States Have Imposed Cuts That Hurt Vulnerable Residents; Federal Economic Recovery Funds and State Tax Increases Are Reducing the Harm," October 20, 2009 (with a link to the full report in pdf).

One of the consequences of the Washington-Wall Street Axis, described above, is that it really is tough all over. Those SOBs have harmed every single American -- except for themselves, their friends and colleagues, and others in the top 1% of the wealthiest. Iowa is even in some ways, such as unemployment, better off than many.

In terms of the universities all Iowans, not just the Board of Regents, Iowa Legislature, and the universities' presidents, need to do some serious and heavy thinking about the role of "public education."

I've written about this before, and undoubtedly will again. Here's a summary:

o A century ago or more the American people and their elected officials decided that a fourth- or eighth-grade education was not enough for our kids. If nothing else, our economy and our military required a minimum of 12 years of schooling (what is popularly referred to as "K-12"). We agreed this was so important that it would be provided free to all at taxpayers' expense, because we all benefitted.

o It is not a stretch to say that if K-12 was essential a century ago, K-16 (that is, a college education; or its equivalent for those in the trades, something similar to the German system) is equally essential for today's economy and military -- not to mention the "life, liberty and pursuit of happiness" of our citizenry and their self-governing democracy. This is also sufficiently important that it should be paid for by all.

o The GI Bill after World War II brought returning veterans to the University of Iowa and other colleges and universities throughout America, at little or no cost to the students, but with an economic return many times over for our post-War economy and the American people.

o An economic downturn is precisely the time when it makes sense to increase the number of citizens getting additional education. (a) Rockwell and other corporations are pleading with educators to help create a better educated workforce. What better time to do it than when there are fewer jobs available? (b) Isn't laying out money for public education better than laying out the same amount of money for unemployment compensation? (c) If we're looking for long term economic growth, and not just short term fixes, there's no better investment than education.

o As recently as 1981 the State of Iowa paid 77.4% of the cost of an Iowan's university education; the student, and his or her parents, paid 20.8%. Today that has dropped for the State from 77.4% to 42.8%, and increased for the student from 20.8% to 51.3%. (See the Register story and chart, below.)

o One can argue over the most appropriate allocation of the costs of education between those who benefit directly (the students, and to some extent their parents) and indirectly (every American taxpayer). But whatever that most appropriate relationship is thought to be, what is the rationale for the enormous disparity between the relationship for K-12 (0% for students; 100% for taxpayers) and the 13-16 of K-16 (51.3% for students; 42.8% for taxpayers)? Would we ever consider, as a budget cutting measure, going back to the days of K-8 -- providing free public education through junior high, and then charging parents 51.3% of the actual cost of providing high school education? Think about it.
For the Register's chart, and story, see Gunnar Olson and B.A. Morelli, "Tuition now top funding source for regents universities," Des Moines Register, October 23, 2009 (including a chart showing the relative percentage of costs covered by tuition vs. appropriations increasing from 20.8% vs. 77.4% in 1981 to 51.3% vs. 42.8% in 2010). And see the news this morning that Staci Hupp, "Regents propose surcharge, 6.5-percent tuition and fees increase," Des Moines Register, October 23, 2009.

I sympathize with you, Iowa's budget cutters. Yours is not an enviable task. But you can learn from the errors of Washington, and try to avoid them.

Be fair and just in your judgments. Be rational, and fulsome in your explanations. Be transparent and open in your process.

And keep in mind Barofsky's observation that the public's "anger, cynicism and distrust" -- while warranted and understandable -- is a dangerous thing, with long lasting consequences, and that it is, above all "unnecessary."
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* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
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