Trump following in Nixon's disgraceful footsteps

While facing impeachment over a criminal conspiracy that included a break-in at the Democratic Party's national headquarters, President Richard Nixon resigned in August 1974. President Donald Trump is making calls out of Nixon's playbook, blaming the news media and leaks of sensitive information by government officials for his failings. /bullworkofdemocracy photo illustration

"The press is the enemy."

"It's always the son-of-a-bitch that leaks."

"The American people are entitled to see the president and to hear his views directly, and not to see him only through the press."

These are all quotes from the president of the United States, but they were not uttered by the current leader of the free world. All of these comments were made by Richard Nixon, the first and only U.S. president who resigned his office in disgrace.

Since taking the oath of office less than a month ago, President Donald Trump has been channeling Nixon, railing against the press and leaks from within his own administration.

Trump says any poll that casts his performance in a negative light should not be believed, calling them "fake news."

When The Washington Post revealed Trump's national security adviser, Michael Flynn, had held policy-related discussions with a top Russian official before Inauguration Day, the billionaire businessman claimed the biggest concern was leaks from his administration not the undermining of President Barack Obama while he was still in office.

Flynn apparently discussed American sanctions against Russia with the Russian ambassador to the United States, which the FBI concluded made the national security adviser prone to blackmail from the Kremlin. Trump knew about the blackmail threat for at least two weeks, according to U.S. officials. But he kept Flynn as his national security adviser and only fired the retired general after the Post story was published.

The depth and breadth of the Flynn cover-up is a mystery, for now. The truth will come out eventually.

One of the truths that came out of Nixon's disastrous second term as president is a cover-up is almost always worse than the original crime.

There are many troubling similarities between Nixon and Trump. Just one month into the 45th president's first term, the scariest potentiality is that Trump is even worse.

War on 'mainstream media' menaces democracy

Defying President Lyndon Johnson's administration in 1968, legendary CBS journalist Walter Cronkite had the courage to tell the truth about America's disastrous war in Vietnam. /CBS News video

Nothing is more patriotic than speaking truth in the face of power.

Journalists in the so-called mainstream media are not inclined to defend themselves against misguided assaults on their integrity and commitment to telling the truth, even when their reputations and lives are under threat.

With powerful politicians peddling alternative facts, these are dark days for the free press, which has served as a bulwark of democracy in the United States for more than two centuries. The professionals who staff newsrooms at America's best news media organizations such as The New York Times need to accept that producing high-quality editorial content is no longer sufficient to ensure continuation their pivotal role in American society.

When the president of the United States declares war on the news media, journalists have a patriotic duty to defend themselves. When President Trump and his sycophantic supporters attack members of the press, it is not just journalists who are under siege; one of the pillars on which democracy stands is under assault.

When I decided to pursue a journalism career more than two decades ago, my grandest aspiration was to work at CBS News, The New York Times, The Washington Post or Time Inc., David Halberstam's powers that be. My dream came true on a modest scale in the first week of April 2013, when I started working weekends as a digital media producer at WBZ, the CBS News affiliate in Boston.

A couple of days after joining the WBZ staff, terrorists detonated two bombs along the route of the Boston Marathon. On television, radio and online, WBZ journalists provided world-class coverage of the heinous crime and the manhunt for the perpetrators that followed. I witnessed firsthand the professionalism and dedication of journalists employed in one of the bastions of the "mainstream media."

On April 19, 2013, WBZ was the first news media organization to broadcast live video of Boston Marathon bomber Dzhokhar Tsarnaev in the boat where he had taken refuge after a shootout with police in Watertown, Mass./ Massachusetts State Police image

Despite my devotion to journalism, I know even the best U.S. news media organization are far from perfect.

In addition to participating in coverage of the Marathon bombings, one of my most memorable experiences at WBZ was having lunch in the station's cafeteria with Jack Williams. The veteran newsman told me about how CBS had treated his friend, Walter Cronkite, at the end of his career.

Cronkite was still "the most trusted man in America" when CBS replaced him as anchor of the evening news with Dan Rather. As he recounted the succession story, Williams could barely control his disgust. Cronkite had plenty of journalistic "life in his tank" when CBS executives forced him into retirement, Williams told me.

Here is the key fact about the best news media organizations: for every misstep that reputable journalists make, there are thousands of examples of high-quality information provided to the American people.

Here are just a few examples of courageous and groundbreaking journalism generated at news organizations that Trump and his supporters are gleefully tarring as the "dishonest mainstream media" in America:

In 1954, CBS News icon Edward R. Murrow challenges Red Scare demagogue Sen. Joseph McCarthy. /CBS News video

In 1963, Eric Sevareid of CBS News interviews "Silent Sprint" author Rachel Carson for a CBS Reports documentary. Under pressure from the industrial chemical industry, three of the documentary's five commercial sponsors withdrew from the broadcast about Carson's book, which exposed the dangers of pesticides and revolutionized humanity's views of the environment. CBS aired the documentary despite the financial blow. /CBS image via Getty Images

In June 1971, Washington Post publisher Katherine Graham and the newspaper's editor, Ben Bradlee, are elated as they depart U.S. District Court after a federal judge upheld their right to continue publishing the Pentagon Papers. The documents, which had been obtained from whistleblower Daniel Ellsberg, exposed years of U.S. government deception about the war in Vietnam. /AP photo

Bradlee talks with reporters Bob Woodward, left, and Carl Bernstein in the Washington Post newsroom. Woodward and Bernstein exposed a criminal conspiracy in the White House that ultimately led to the resignation of President Richard Nixon in 1974. /Image via Outside the Beltway

In 1975, New York Times photo journalist Dith Pran and correspondent Sydney Schanberg stayed in Cambodia when other members of the news media fled the country's Khmer Rouge reign of terror. Both men were captured and Pran endured several years in brutal work camps. After Schanberg escaped, he earned a Pulitzer Prize for his coverage of the Cambodian genocide. /New York Times-AFP image

After publishing 600 stories in 2002 about sexual abuse perpetrated by priests, The Boston Globe was awarded a Pulitzer Prize. The Globe's coverage included the revelation that the Archdiocese of Boston's leader, Cardinal Bernard Law, had allowed a pedophile priest to prey on parishioners for years. /Boston Globe image

America's vanishing middle class documented

/ABC News image

An investigative journalism series produced at ABC News is a grim wake-up call: The American Dream is dying.

In the series, "My Reality: A Hidden America," veteran journalist Diane Sawyer exposes the undeniable truth about income inequality in the United States. Millions of hard-working, tax-paying, law-abiding citizens are getting screwed while the wealthiest Americans bank an ever-increasing portion of the nation's treasure.

There are several drivers of the transformation of The American Dream into The American Nightmare that are largely out of the citizenry's control, including automation of workplaces that make traditionally secure jobs obsolete and low-wage labor competition from countries such as China. However, income inequality in the wealthiest nation on Earth is largely a self-inflicted wound.

In a rare case of billionaire candor, mega-investor poster boy Warren Buffett gave an honest assessment of U.S. income inequality back in 2006: "There's class warfare, all right; but it's my class, the rich class, that's making war, and we're winning."

Sawyer's documentary series is shining light on the American casualties in this struggle that pits the rich against middle class and working class citizens.

Child abuse and neglect: The full story

Rachelle and Bella Bond shown in an image posted on Facebook. In June 2015, Bella "Baby Doe" Bond's body was found on Deer Island in Winthrop, Mass. Rachelle Bond has pleaded not guilty to an accessory to murder charge in the killing of her infant daughter. Her boyfriend at the time of the infanticide faces a first-degree murder charge. /Image via bostoncbslocal.com

If there is any job in state government harder than police officer, it is child-protection service worker.

In news story after news story, even reputable journalism organizations tell only part of the sad tales of the neglected and abused children whose lives are entrusted to state agencies entrusted to protect at-risk kids. An overly simplistic narrative is repeated like a mantra in the media across the country: "The state dropped the ball."

Investigation of N.H. child-protection agency: Swollen case loads are key driver of child-protection service worker turnover and under-staffing. /N.H. Department of Health and Human Services graphic

Here is what the public does not hear or learn in most news stories about the parent-betrayed innocents who have no hope other than the assistance and protection provided by state departments of child and family services:

• Personal responsibility: Every one of these children belongs to A FAMILY, not just their biological parents. The front line of defense for neglected and abused children is their family: parents, grandparents, aunts, uncles and other adult relatives. The next time you see a news story about state officials failing to protect neglected and abused children, two of the top questions begging answers are, "Who failed these children in the first place? And how many family members are willing to step to the plate and start swinging to protect their kids?" In nearly every family tormented with violence, sexual abuse and neglect involving a child, there is at least one relative who could intervene decisively.
• Collective responsibility: The general public gobbles up the incomplete and misleading narrative that media outlets usually publish whenever the state "drops the ball" and fails a child who is harmed or killed. Yet the vast majority of citizens fail to look in the mirror. If taxpayers really care about having state officials intervene to protect neglected and abused children, the agencies assigned to do the job must be fully funded and staffed. A 2003 federal General Accounting Office report listed average case loads for child welfare and foster care workers nationally at 24 to 31 children, twice the case-load level that the Child Welfare League of America recommends. Here in New Hampshire, the Division for Children, Youth and Families (DCYF) has been woefully underfunded and understaffed since the Department of Health and Human Services budget was slashed during The Great Recession. In a staffing report released in October 2016, the average monthly case load for a New Hampshire DCYF protective-service worker was pegged at 54. From December 2015 to July 2016, one third of DCYF's protective-service worker positions were vacant or held by workers in training or on leave.
• Unrealistic expectations: Anyone concerned about their personal safety is unlikely to apply for a child-protection service worker job and unlikely to stay in the role for very long. Police officers hate to go on domestic disturbance calls--for good reason. Emotions run high in domestic disputes, especially when children are involved. Police officers are at high risk of injury or death when they respond to domestic disturbance calls, and they carry several weapons to defend themselves along with body armor equipment. In most states, child-protection service workers are not allowed to carry weapons when they visit a troubled home. Fear of death or serious injury may not be a daily concern for all child-protective services workers, but brutal stress and dealings with evil perpetrated on children is on the daily.
• Social and behavioral determinants: Coming to grips with the roots of child abuse and neglect is the daunting task facing nearly all of American society: every citizen, government agencies, healthcare providers, educational institutions, law enforcement and the courts. Prevention is under-resourced, particularly substance-abuse treatment and mental health services.  

In September 2015, police were sent to the Manchester, N.H., home of Kaitlin Paquette, 22, and her 21-month-old daughter, Sadence Willott. Paquette is facing second-degree murder charges in the bludgeoning death of the infant. The young mother's troubled life illustrates some of the social determinants that are root causes of child abuse and neglect. /image via patch.com

I loathe apologists, and this post is not intended to make excuses for state officials who are untrusted to protect abused and neglected children. I have witnessed state officials "drop the ball" and put children in harm's way, including a Rockingham (N.H.) County judge who slept through portions of a child-custody hearing in which child sexual abuse was alleged.

But I also loathe overly simplistic journalism that amounts to misinformation, people who shirk personal responsibility, taxpayers who lack the conviction to pay for services they claim are essential, and missed societal opportunities to alleviate the suffering.

In August 2015, Vermont case worker Laura Sobel, left, was shot and killed while leaving her office. The woman accused of pulling the trigger, Jody Herring, was allegedly upset over losing custody of her 9-year-old child and also is suspected of killing three family members. /Image via nbcnews.com

Presidential Endorsement: Voting for Hillary Clinton

/Image via pbs.org

Editor's Note: Bullwork of Democracy was founded on the firm belief that an informed citizenry is a bulwark of democracy. As much as morally and professionally possible, this one-man-show blog strives to provide information, not advice. Although this post amounts to an endorsement of Hillary Clinton for president, the focus is mainly on why I am voting for the New York Democrat, not advice to other voters.

From the beginning of Donald Trump's presidential campaign, the most redeeming quality of the real estate magnate's candidacy has been his candor.

For millions of voters who are frustrated over a host of unmet challenges such as decades-long economic stagnation for all but the wealthiest Americans, Trump openly sharing his mind has been refreshing.

I am grateful Trump revealed his thoughts during the GOP primary season, rather than reading carefully vetted remarks off a teleprompter. If Trump had been under the influence of Paul Manafort, Stephen Bannon, and Kellyanne Conway from the beginning of his presidential campaign, the public likely would be unaware that the New York Republican is an uninformed and bigoted narcissist with strongman tendencies more fitting for dictatorship than democracy.

(A special thank-you to fellow Granite Stater Corey "Let Trump Be Trump" Lewandowski, who led the Manhattan-based businessman's GOP presidential primary run until he was fired on June 20.)

Elections are about choices.

In November, I will not choose to vote for the Libertarian Party's Gary Johnson or the Green Party's Jill Stein. The stakes are high in this election, with policy challenges galore, including racial tensions, crumbling infrastructure, foreign and domestic terrorism, healthcare reform, and North Korea's growing nuclear weapons arsenal. For me, Johnson and Stein represent pointless protest votes compared to the risks associated with a Trump presidency.

Clinton is clearly my best pick.

For a centrist who is admittedly left-of-center, there are many reasons for me to vote for the Democrat. To name a few, I favor finishing the healthcare-reform job President Obama started with the Affordable Care Act, I favor Democratic president's appointees to the Supreme Court, and I favor the Democratic Party's commitment to environmental protection.

There are even more reasons for me to vote against Trump.

A lot of folks are frustrated and angry. I get it. Getting ahead, one of the essential ingredients of The American Dream, has become a struggle for 99 percent of the people in most parts of the country.

But I cannot have a hand in the risky bet of handing the White House keys to Trump.

While it is admittedly hard to peer into the heart and soul of any politician polished enough to seek the presidency, I believe Trump revealed himself during the hotly contested Republican primary:

Trump taints Mexicans

Regardless of whether Trump is racist, he is a race-baiter

Trump maligns Muslims

Trump mocked disabled New York Times reporter

Draft-dodger Trump belittles sacrifice of U.S. prisoners of war

Trump loves himself

Trump's loose nukes policy in Asia

Trump treats women like caveman

Trump banking on ignorance

Trump's view of black people is jaded and faded

Trump is clueless about important topics

Trump tells Big Lies

STOCK UP ON POPCORN: The presidential debates should be revealing, but PBS Frontline's "The Choice 2016" documentary on Clinton and Trump set to broadcast on Sept. 27 at 9 p.m. EST should lay the candidates' shit bare.

Black Lagoon: Unheeded toxic-waste warning

In April 1996, The Black Lagoon in Marlborough, Mass., and contamination in the nearby Sudbury Reservoir were front-page news. Over the past two decades, the pollution threat in the Maple Street neighborhood of Marlborough has grown to monstrous proportions. /Ken McGagh photo for Middlesex News

Editor's Note: This story, which is available online exclusively at bullworkofdemocracy, was originally published in the Sunday Middlesex News on April 21, 1996.

'Sudbury Reservoir Unfit to Drink: Greater Boston's emergency water supply plagued by pollution' Sunday Middlesex News, published April 21, 1996, By Christopher Cheney

The Sudbury Reservoir, Greater Boston's main backup water supply, is unfit for human consumption because of isolated "hot spots" of pollution, state officials warn.

If the Massachusetts Water Resources Authority water supply system were to fail due to a drought, earthquake or sabotage, the 7.5 million gallon reservoir would have to be activated.

But state environmental officials now studying the reservoir in Southborough and Marlborough say pollution in the water exceeds safe drinking water standards.

"If we needed to use that reservoir, a 'boil order' goes out from DEP," said Michael Mislin, manager of the Sudbury Reservoir for the state Metropolitan District Commission. "We know we have numerous sites that contain hazardous materials and those materials are leaching out."

A study soon to be released by the MWRA identifies several contamination problems that are compromising water quality in the reservoir.

According to Gretchen Roorbach, the project manager of the MWRA study, the biggest concern is that an ongoing buildup of algae will "kill" the reservoir by depleting oxygen in the water. She said two of the driving forces behind the algae growth are leaking septic systems and fertilizers being used on homeowners' lawns near the water.

Roorbach said the damage may be irreversible if the algae problem is not controlled. "Basically, it becomes a huge algae swamp," she said of the worst-case scenario.

Ten MetroWest communities use MWRA water services: Framingham, Waltham and Newton are totally reliant on the MWRA for drinking water and sewers. MWRA water is the main source of drinking water in Southborough and Weston. A limited number of neighborhoods in Marlborough, Northborough and Wellesley use MWRA drinking water. Ashland and Natick are on the MWRA's sewer system.

Another contamination issue raised in the upcoming MWRA report is the existence of hazardous waste "hot spots" that are polluting the reservoir, Misslin said.

The Middlesex News has learned hazardous waste leaching from contaminated properties along a half-mile stretch of Route 85 in Marlborough is polluting the reservoir.

A century of industrial pollution on Route 85, known locally as Maple Street, has left a legacy of petrochemical contamination.

The area was home to a number of different industries since the beginning of the 20th century, including a shoe factory, a coal gasification plant, and oil distribution facilities.

Over the past eight years, the Massachusetts Department of Environmental Protection has identified 10 confirmed or suspected hazardous waste sites stretching for a quarter mile north to south from 146 Maple St. down to 311 Maple St. A tributary of the Sudbury Reservoir, which is a half mile downstream, runs through the center of the contaminated area.

The affected area of Maple Street is about a half mile north of the Marlborough-Southborough border.

The contamination developed over so many years and is so widespread that officials say it may not be possible to determine who is responsible for the pollution. "It's pretty tough to figure out where the stuff came from," Misslin said.

The commission has documented spills of hazardous materials on Maple Street going back 90 years, he said. "Now what we're seeing is the gradual movement of these materials through the ground."

The Sudbury Reservoir study being conducted by the MWRA has identified the Maple Street hazardous waste sites as a significant source of contamination. "Maple Street jumps right out at you," Misslin said of the report's findings.

This April 1996 map shows the Maple Street neighborhood in Marlborough, which is a contamination hot spot that has polluted the Sudbury Reservoir for decades. /Middlesex News graphic and bullworkofdemocracy illustration

According to water officials, the Sudbury Reservoir would only be activated under emergency circumstances such as if an earthquake damaged the aqueducts carrying water from the massive, 412 billion gallon Quabbin Reservoir in central Massachusetts. "There is no immediate danger to anyone," MWRA spokesman David Gilmartin said of the Maple Street contamination.

Roorbach said a pond off Walker Street is functioning as a catch basin for the contamination flowing down from the Maple Street toxic waste sites. "That [pond] is a very serious source of contamination."

Testing of the Walker Street pond has revealed the presence of not only petrochemicals from oil and gasoline spills but also heavy metals such as lead, she said. "That is a real settling pond for contaminants and heavy metals."

Heavy metals such as lead are considered to be highly toxic if consumed by humans.

Roorbach said the reservoir has not been tested for heavy metals since 1978, when the presence of the materials was found to be "prominent" near the reservoir's dam. Drinking water would be pumped from the dam area if the reservoir was brought online.

Roorbach said it is unlikely heavy metals would get into drinking water if the reservoir was activated because they sink into the lake's sediment. "We of course worry about it; but, the way the Sudbury Reservoir is used, heavy metals would not be stirred up."

Misslin said the level of risk posed by heavy metals in the reservoir is an open question. "So far, we haven't found significant levels of metals," he said. "We haven't gone out actively looking for metals, either."

Today, The Black Lagoon is filled with uncounted tonnage of contaminated water and silt. /Google Earth image and bullworkofdemocracy illustration

Large amounts of contaminated silt from The Black Lagoon appear to have migrated to the nearby Sudbury Reservoir. /Google Earth image and bullworkofdemocracy illustration

Environmental Nightmare: Monster of Black Lagoon

Contaminated soil covers more than half of the surface area and fills most of the total volume of The Black Lagoon in Marlborough, Mass. An aging and poorly maintained dam is containing the silt deposits from reaching the Sudbury Reservoir, which is a half-mile downstream. /Google Earth image and bullworkofdemocracy illustration

For at least three decades, The Black Lagoon has fed a steady diet of toxic waste to a tributary stream of the Sudbury Reservoir. The stream that feeds the lagoon drains storm water from Maple Street, the scene of a century's worth of petroleum-product spills, according to Massachusetts officials. /Google Earth image and bullworkofdemocracy illustration

The Black Lagoon off Maple Street in Marlborough (photo below) has spread contaminated silt to the Sudbury Reservoir (photo above). A tributary stream a half-mile long links The Black Lagoon to the reservoir./Google Earth image and bullworkofdemocracy illustration

The concrete-and-earth dam at The Black Lagoon, which is state land, has been poorly maintained for at least two decades. /Christopher Cheney photo

The Black Lagoon is located in a mixed commercial and residential neighborhood. To the west and south, several small businesses line Maple Street, including at least 10 properties that are former or active toxic waste sites. To the north and east, houses dot the landscape. /Google Earth image

The largest silt deposit areas of The Black Lagoon are on the commercial-development side of the man-made pond, which is a resting place for tons of contaminated soil, according to state officials.

The Black Lagoon is in the rotted heart of this April 1996 map. /Middlesex News image

In 1996, the first Page 1 Sunday-edition newspaper story of my journalism career featured the Sudbury Reservoir and The Black Lagoon. /Ken McGagh photo for Middlesex News

Excerpt from 'Sudbury Reservoir: Unfit to Drink,' Sunday Middlesex News, April 21, 1996, by Christopher Cheney

Gretchen Roorbach, a scientist at the Massachusetts Water Resources Authority, said a pond off Walker Street is functioning as a catch basin for the contamination flowing down from the Maple Street sites. "That is a serious source of contamination," she said.
Roorbach said testing of the Walker Street pond had revealed the presence of not only petrochemicals from oil and gasoline spills but also heavy metals such as lead. "That is a real settling pond for contaminants and heavy metals," she said.

Environmental Nightmare: Black Lagoon Tributary

The Black Lagoon off Maple Street in Marlborough, Mass. (photo below) has spread contaminated silt to the Sudbury Reservoir (photo above). A half-mile-long tributary stream links The Black Lagoon to the reservoir (photo bottom)./Google Earth images

The Black Lagoon is filled with soiled silt from toxic waste sites along Maple Street, which is the scene of more than a century of petroleum-product spills, according to Massachusetts officials.

For at least three decades, The Black Lagoon has fed a steady diet of toxic waste to its tributary stream of the Sudbury Reservoir. 

The Black Lagoon is in the rotted heart of this April 1996 map. /Middlesex News image

Environmental Memoir: Saving Hodgson Brook

Hodgson Brook at the former Pease Air Force Base in Portsmouth, N.H., was an oily mess for decades, mainly from airport operations-linked chemical contamination. /Hodgson Brook Watershed Restoration Plan image

I helped save a brook that the Air Force nearly destroyed.

I first became aware of groundwater pollution at Pease Air Force Base while working as night editor at the Concord Monitor at the turn of the century.

The last time I was aware of groundwater contamination at Pease was in 2013, when I was the first to see the damage.

Journalist death toll rises in 2015

Last year, 69 journalists were killed with the motive linked to the performance of their professional duties. Another 25 journalists lost their lives in killings with unconfirmed motives. /Committee to Protect Journalists

The number of journalists killed in the line of duty ticked upward last year, rising from 61 dead in 2014 to 69 lost.

In 2015, the bravery required to work as a journalist in countries engulfed in war or riddled with corruption is evident in the statistics:

• In the 47 journalist murders last year, no one has been brought to justice in 83% of the cases
• In the murder cases, 60% of journalists were threatened prior to their killings, 21% were taken captive before they were killed, and 15% were tortured
• Politics was by far the most dangerous beat to cover in 2015, accounting for part or all of the motivation behind 68% of journalist killings
• Political groups (52%), military officials (16%) and government officials (12%) were the leading suspects in orchestrating journalist killings

A free press is a bulwark of democracy, and journalists continue to man the front lines in the struggles against tyranny around the world.

Top 10 Healthcare Quotes: HealthLeaders Year 1

These are the most precious pearls of healthcare wisdom I have gathered since joining Danvers, MA-based HealthLeaders Media a year ago: 

David Hare, National Health System Confederation, London 

"The hospital is the symbol of healthcare, and we need to change that."

James Weinstein, DO, Dartmouth-Hitchcock Health, Lebanon, New Hampshire

"We need to create a sustainable health system, not a sustainable healthcare system. ... The model needs to focus on health, not healthcare."

Anita Goel, MD, PhD, Nanobiosym, Cambridge, Massachusetts

"Our consciousness in the healthcare industry is very much rooted in a centralized paradigm dating back to the Industrial Revolution in the 1700s. ... Just as Google disrupted the information industry and a country like India went from a few hundred thousand land lines a little over a decade ago to over 900 million cell phones today, I believe we are at the tipping point of a similar impending disruption in the healthcare industry."

David Burton, MD, Former CEO and Chairman, Health Catalyst, Salt Lake City, Utah

"In this early, adolescent stage of shared risk, you're going to have people operating in an immature manner. It's a lot harder than it looks. Providers end up doing it less efficiently than a third party payer. ... You do, in fact, need someone to do the administrative aspect of an ACO."

Rebecca Katz, Master Chef, San Francisco Bay, California

"It's looking at food and cooking food in a way that's delicious and nutritious: food you like and cooking you like. It's not just a diet, it's a way you live your life."

Otis Brawley, MD, American Cancer Society, Atlanta, Georgia

"There is basic healthcare that every human being has a fundamental right to."

Mike Beebe, Former Governor, State of Arkansas

"These states that are just saying 'no' to [Medicaid expansion] are just paying for the rest of us and not getting anything in return at the expense of their people and their hospitals. ... You're hurting your own people."

Kevin Counihan, CEO, Federal Marketplace, Washington, DC; former CEO, AccessHealthCT

"We think that retail is the future, the consumer is the future. The days of group coverage are waning. In five to 10 years, you're going to see a major change. People want more choices. They want more flexibility."

Michael Yuhas, President and CEO, Integra ServiceConnect, Owings Mills, MD

"This is not a healthcare intervention we're talking about. We've been taught historically that when something breaks, you bring the patient in to fix it. But once you find [a health plan beneficiary with a behavioral health condition], that is not enough. You have to engage them. You have to let them know you are friend and not foe. We've created a science of finding people, engaging them, and connecting them to the services they need."

Earl Ferguson, MD, PhD, Cardiologist, Ridgecrest, California

"We need to recognize that primary care can't do everything alone. Primary care providers must be the coordinators of comprehensive care, but specialty care is essential to assist them in the ongoing management of many of their patients."

American journalism's secrets revealed

 

Objectivity is declining in U.S. journalism, which is in danger of turning back the clock more than a century to a time when nearly every city in America had newspapers aligned with the Democratic and Republican parties. /Fox News image

American journalism was once widely known as the Fourth Estate, an elite sector of American society responsible for keeping an eye on the government and helping to inform the citizenry.

Now more commonly known as members of The Media, U.S. journalists walk a very fine line. Despite the necessity of a free press to serve as a bulwark of democracy, Americans are virulently skeptical about elites. There is little love for the fat cats of corporate boardrooms, political power mongers, ivory tower dwellers, or an arrogant know-it-all of any ilk.

It is hard to imagine a more public enterprise than journalism, but it is amazing how little the public knows about the inner workings of the Fourth Estate. In the spirit of benevolent know-it-allism, here is a glimpse of the newsroom's secret society:

• Headlines are the high art of journalism, whether they appear in print, online, television graphics, or at a radio broadcast's "top of the hour." The best headlines are promotional without overselling. Headline writing is a mysterious craft. The masters of this art are nameless and faceless editors, not the reporters seen on the street or working the phone gathering the news.
• Prior review of news stories has always been rare and is nearing extinction. Allowing people who serve as sources of news to review a story before publication or broadcast is a cumbersome process. When gathering news, a reporter assembles notes, video footage or audio snippets into a story format, then at least one editor massages the material into a final form. For prior review to be meaningful, it must occur after the editing process. One of the harsh realities of journalism is that only the most financially successful news magazines have the time and resources to accommodate prior review.
• Deadline pressure is intense in news media organizations. The sense of urgency is at least two-fold: avoiding the possibility of a competitor beating you to the punch and the fundamental truth that the best news is new not stale. As is the case in any industry, deadline pressure is one of the prime drivers of media errors.
• In America, journalism is a business, particularly if a news media organization produces quality content. Even in the blogosphere, which has been a democratizing force for the Fourth Estate, production of high-quality journalism is a high-cost venture. The public rightfully gravitates toward expertise and eye-catching presentation when consuming news. Expertise requires formal education or years of experience, neither of which comes cheap in America. Attractive presentation requires a knowledge of design and mastery of technology, which also come with a price.
• Story selection is a constant source of consternation in the public, but it reflects one of my best friend's favorite adages: be care what you ask for, you just might get it. Editors have always known sex and violence sells. With the rise of the Internet as a journalism medium, now editors have data that shows conclusively the kinds of stories that draw the public's interest. There are media outlets that consistently present important stories about government policy and community affairs, but there are many more that pander to prurient page clicks.
• Trust is the secret sauce of journalism. Reporters have to establish a level of trust with their sources to gather information that is often sensitive in nature. Editors have to trust their reporters are gathering accurate information and representing it truthfully. The public is best served when it can turn to trustworthy news organizations for information that affects individuals, families, communities and the country.

Pain pills an excruciating necessity

Hillsides at the Aquinnah Cliffs on Martha's Vineyard start to turn green in May 2014. Death stalks us even at the most beautiful places on Earth. /Christopher Cheney photo

Opinions are almost never news; but when they are, the stakes are almost always astronomical.

For nearly two decades, I steadfastly avoided writing opinion columns, fearing it would loosen my desperate grasp on objective reporting. The possibility of crafting a weekly health plan column that would have any significant impact was not even the shred of a thought in my mind when I was covering the town of Franklin, Mass., as a cub reporter in the mid-1990s.

As I reach the six-month mark working at HealthLeaders Media, a weekly health plan column installment has become a surprising source of pride, albeit of the bittersweet variety.

A rarely shared secret of the journalism profession is the frequency of occasions when reporters are required to become nearly instant experts, with varying degrees of success. When I decided to write a health plan column about efforts to curb painkiller medication abuse, my opinions were supportable but insufficiently expert to capture the full truth.

One of my best friends, who worked with me in the Franklin Bureau back in the day, shared his expert opinions on painkiller medications and helped me shine light on one of the country's darkest medical quandries. The Mayor of Martha's Vineyard started forming those expert opinions the dark night death visited the seat next to him in the twisted wreckage of car on the island.

Read his truthful account about painkiller medication abuse in America.

Fox News: Right turn into irrelevancy

Bill O'Reilly serves up a favorite whipping-post story tailored to Fox News' conservative viewership. /Fox News image

A battle for the heart and soul of the Grand Old Party is about to rage in congressional districts across the country. Then in 2016, the Republicans will get a shot at an open seat in the White House.

There's a bitter irony ahead for FOX News chief Roger Ailes and other conservative Republican kingmakers. Fox News has been successful in energizing the far-right of American politics, but the candidates and policies generating the most passion in the Republican Party are now so extreme that winning a presidential election seems unlikely.

Journalism mission marches forward

New Year's Eve fireworks in Market Square, Portsmouth, N.H. /Seacoastonline.com photo by Ioanna Raptis

Nearly 18 years ago, I looked into a computer screen for the first time as a professional journalist and wrote:
By Christopher Cheney
Staff Writer

Later this month, I return to fast-paced writing as a journalist at HealthLeaders Media. Given the pressures in the journalism industry, it is humbling to continue working as a journalist. It also is a great honor to report on the U.S. health care industry at a key time in its evolution.

The change sweeping through U.S. health care is hard to underestimate and the stakes are astronomical. Innovation at the institutional and market level are in full swing, or rearing back to swing, across the country.

A hospital CEO recently told me: "We need to keep people out of the hospital." Clearly change is here.

I look forward to reporting on the reform efforts in the health care industry: working with professionals in the medical field to understand both fundamentals and emerging trends, then sharing stories with valuable information for those inside and outside the boardroom.

As Bullwork of Democracy closes in on 15,000 page views, I also look forward to producing more valuable journalism with this blog.

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JFK gravedigger: 'It's an honor just for me to do this'

On Nov. 25, 1963, first lady Jacqueline Kennedy, her children, Caroline and John F. Kennedy Jr., and other family members leave the Capitol during the state funeral of President Kennedy. /White House photo by Abbie Rowe

By Jimmy Breslin
Newsday
Washington (Nov. 26, 1963) -- Clifton Pollard was pretty sure he was going to be working on Sunday, so when he woke up at 9 a.m., in his three-room apartment on Corcoran Street, he put on khaki overalls before going into the kitchen for breakfast. His wife, Hettie, made bacon and eggs for him. Pollard was in the middle of eating them when he received the phone call he had been expecting. It was from Mazo Kawalchik, who is the foreman of the gravediggers at Arlington National Cemetery, which is where Pollard works for a living. "Polly, could you please be here by eleven o'clock this morning?" Kawalchik asked. "I guess you know what it's for." Pollard did. He hung up the phone, finished breakfast, and left his apartment so he could spend Sunday digging a grave for John Fitzgerald Kennedy.

When Pollard got to the row of yellow wooden garages where the cemetery equipment is stored, Kawalchik and John Metzler, the cemetery superintendent, were waiting for him. "Sorry to pull you out like this on a Sunday," Metzler said. "Oh, don't say that," Pollard said. "Why, it's an honor for me to be here." Pollard got behind the wheel of a machine called a reverse hoe. Gravedigging is not done with men and shovels at Arlington. The reverse hoe is a green machine with a yellow bucket that scoops the earth toward the operator, not away from it as a crane does. At the bottom of the hill in front of the Tomb of the Unknown Soldier, Pollard started the digging.

Leaves covered the grass. When the yellow teeth of the reverse hoe first bit into the ground, the leaves made a threshing sound which could be heard above the motor of the machine. When the bucket came up with its first scoop of dirt, Metzler, the cemetery superintendent, walked over and looked at it. "That's nice soil," Metzler said. "I'd like to save a little of it," Pollard said. "The machine made some tracks in the grass over here and I'd like to sort of fill them in and get some good grass growing there, I'd like to have everything, you know, nice."

James Winners, another gravedigger, nodded. He said he would fill a couple of carts with this extra-good soil and take it back to the garage and grow good turf on it. "He was a good man," Pollard said. "Yes, he was," Metzler said. "Now they're going to come and put him right here in this grave I'm making up," Pollard said. "You know, it's an honor just for me to do this."

Pollard is 42. He is a slim man with a mustache who was born in Pittsburgh and served as a private in the 352nd Engineers battalion in Burma in World War II. He is an equipment operator, grade 10, which means he gets $3.01 an hour. One of the last to serve John Fitzgerald Kennedy, who was the thirty-fifth President of this country, was a working man who earns $3.01 an hour and said it was an honor to dig the grave.

Yesterday morning, at 11:15, Jacqueline Kennedy started toward the grave. She came out from under the north portico of the White House and slowly followed the body of her husband, which was in a flag-covered coffin that was strapped with two black leather belts to a black caisson that had polished brass axles. She walked straight and her head was high. She walked down the bluestone and blacktop driveway and through shadows thrown by the branches of seven leafless oak trees. She walked slowly past the sailors who held up flags of the states of this country. She walked past silent people who strained to see her and then, seeing her, dropped their heads and put their hands over their eyes. She walked out the northwest gate and into the middle of Pennsylvania Avenue. She walked with tight steps and her head was high and she followed the body of her murdered husband through the streets of Washington.

Everybody watched her while she walked. She is the mother of two fatherless children and she was walking into the history of this country because she was showing everybody who felt old and helpless and without hope that she had this terrible strength that everybody needed so badly. Even though they had killed her husband and his blood ran onto her lap while he died, she could walk through the streets and to his grave and help us all while she walked.

There was mass, and then the procession to Arlington. When she came up to the grave at the cemetery, the casket already was in place. It was set between brass railings and it was ready to be lowered into the ground. This must be the worst time of all, when a woman sees the coffin with her husband inside and it is in place to be buried under the earth. Now she knows that it is forever. Now there is nothing. There is no casket to kiss or hold with your hands. Nothing material to cling to. But she walked up to the burial area and stood in front of a row of six green-covered chairs and she started to sit down, but then she got up quickly and stood straight because she was not going to sit down until the man directing the funeral told her what seat he wanted her to take.

The ceremonies began, with jet planes roaring overhead and leaves falling from the sky. On this hill behind the coffin, people prayed aloud. They were cameramen and writers and soldiers and Secret Service men and they were saying prayers out loud and choking. In front of the grave, Lyndon Johnson kept his head turned to his right. He is president and he had to remain composed. It was better that he did not look at the casket and grave of John Fitzgerald Kennedy too often. Then it was over and black limousines rushed under the cemetery trees and out onto the boulevard toward the White House. "What time is it?" a man standing on the hill was asked. He looked at his watch. "Twenty minutes past three," he said.

Clifton Pollard wasn't at the funeral. He was over behind the hill, digging graves for $3.01 an hour in another section of the cemetery. He didn't know who the graves were for. He was just digging them and then covering them with boards. "They'll be used," he said. "We just don't know when. I tried to go over to see the grave," he said. "But it was so crowded a soldier told me I couldn't get through. So I just stayed here and worked, sir. But I'll get over there later a little bit. Just sort of look around and see how it is, you know. Like I told you, it's an honor."

Knox story example of crack cocaine journalism

An Italian appellate court has reversed the murder acquittal of American college student Amanda Knox and ordered a new trial, prompting a self-serving frenzy of media coverage. /Image via wbtw.com


There are a lot of people who like crack, but handing it to addicts on a silver platter has been deemed harmful to the common good. There is profit in peddling crack, but dealing the dope has been deemed illegal.

There is profit to be made in peddling stories about a beautiful young woman caught up in a sex game gone bad that ended in murder. But playing the latest twist in the sordid Amanda Knox saga among the top stories in the world is the journalistic equivalent to waving a packed crack pipe in front of a roomful of strung out junkies.

The U.S. and European media is going gaga over the Knox story yet again, drawn as irresistibly to the college student hottie's plight as an addict is drawn to his sugar daddy. The latest development -- the reversal of Knox's murder acquittal in Italy -- has generated more than 550 news stories over the past 24 hours.

It's a classic case of shameless pandering to the most base desires of media consumers. Given the hallowed principle of double jeopardy in the U.S. legal system, it is highly unlikely that American officials would allow Knox to be extradited to face a second trial for the 2007 murder of her British college student roomate in Perugia, Italy, Meredith Kercher. And Knox and her attorneys have made it clear that she will not return to Italy willingly to participate in a new trial.

So, other than the opportunity to cash in on Knox yet again, there's little justification to make the acquittal reversal a top story. Based on a Google news search, here are other stories of the day that deserved more attention but fell far short of the Knox case reporting:
- The U.S. gun control debate, including reports of school districts arming administrators in response to the Newtown, Conn., elementary school massacre: 97 stories.
- This week's meeting of leaders from the world's fastest emerging economics, the so-called BRICS nations Brazil, Russia, India, China and South Africa: 499 stories.
- North Korea's issuing of a new round of threats against U.S. military bases: 358 stories.
- Studies showing that fewer hours of doctor training in the United States is leading to more medical
errors: 22 stories.

Murder cases are inherently interesting, and even this nearly meaningless twist in the Knox case deserves a measure of media coverage. But is it really more important than the 10,000 Americans on average who are killed in gun violence every year? Is it more important than fundamental changes in the global economy? Is it more important than the potential of North Korea sparking a nuclear war that would claim the lives of millions? Is it more important than an increase in the number of patients suffering death and disability in U.S. hospitals?