Bullwork of democracy never rests

North Korea hacks Sony, November 2014 - January 2015

With the launching of a blatant cyber attack on Sony over the release of "The Interview," Kim Jong-un's regime revealed its greatest weakness: the truth.

North Korea took a significant risk hacking Sony, weighing exposure of the country's cyber warfare capabilities against the threat to Jong-un's cult of personality. The inevitable retaliation from abroad was a built-in bonus for the pariah country's Stalinist government.

ISIS poses grave threat

The aftermath of George W. Bush's war in Iraq was always a matter of how bad the outcome would be for the United States and the Middle East. This is about as bad as it gets.

The most prescient critics of the Iraq War compared the U.S.-led invasion to plunging a fist into a hornets nest. Now, Iraq is a nearly failed state, with a dysfunctional army; Iran is ascendant; and the region is buzzing with violence and reeling under the crushing weight of religious extremism reminiscent of The Crusades.

The Islamic State of Iraq and Syria, aka Islamic State of Iraq and the Levant, is so vicious that even disgraced Syrian President Bashar al-Assad is a palatable partner in the fight to defeat them. Mass executions and immolation of prisoners are never good hallmarks of social movements.

Rudy Giuliani plays with weapon of mass political destruction

It's like the script to an apocalyptic science-fiction movie about a society developing weapons of mass destruction that careen out of control. Republican should be careful what they ask for, they just might get it.

Former New York Mayor Rudy Giuliani beat the lowest drum of Republican politics last week, accusing President Obama of lacking love for his country and harboring hostile intent in his heart for America because of his upbringing.

Socialism reality check: Obama has been as friendly to Wall Street as any Republican president. The Hawaii native let the perpetrators of the 2008 financial meltdown skate.

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."

MLK holiday: 'Tame the savageness of man'

On April 4, 1968, Sen. Robert F. Kennedy delivered one of the greatest speeches in U.S. history.

Kennedy was in Indianapolis for a campaign event in his run for the presidency. At the rally, the New York senator and brother of a slain president delivered timeless remarks about civil rights icon Martin Luther King Jr., who had been assassinated earlier that evening.

This speech overflows with wisdom, but I do have a favorite gem of sage advice:
"Dedicate ourselves to what the Greeks wrote so many years ago: to tame the savageness of man and make gentle the life of this world."

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.

Ebola bares hospital training, disease control flaws

Nina Pham, a critical care nurse at Texas Health Presbyterian Hospital Dallas, is the first American to contract Ebola on U.S. soil. /Image via pbs.org

Despite confident statements from the federal Centers for Disease Control and Prevention, America's first test treating an unexpected case of Ebola teetered on the brink of total failure.

Missteps at Texas Health Presbyterian Hospital, insufficient CDC protocols, and an apparent shortfall of preparedness across the public health spectrum have exposed gaping holes in capabilities to stave off potentially cataclysmic biological threats. As the crisis deepens, a moment of truth looms for U.S. health care.

Beyond containing the outbreak in Texas, there are colossal challenges in the weeks and months ahead:

• Rearranging the CDC's national response to Ebola on the fly
• Boosting preparedness at more than 4,000 acute care hospitals
• Restoring confidence in hospitals, both among caregivers and the general public

Russian Big Lie Watch: Lost Paratroopers in Ukraine

After Russian paratroopers were captured in Ukraine in late August 2014, they were quickly swapped for Ukranian prisoners of war. /AFP image

Big Lie: Ten Russian paratroopers captured recently in Ukraine "really did participate in a patrol of the Russian-Ukranian border, crossed it by accident at an unmarked section, and as far as we understand showed no resistance," the Russian Defense Ministry said according to the BBC.

Closer to the truth: "This wasn't a mistake, but a special mission they were carrying out," a Ukranian military spokesman said.

Ukraine bulwark against Russian aggression

A resident reacts to shelling damage in Donetsk, eastern Ukraine, in August 2014. /CTV News image

Ukraine is a fledgling democracy, and young governments of the people are more imperfect than their mature counterparts such as Australia, Switzerland and the United States.

Vladimir Putin's Russia is imperfection incarnate.

The Russian president, ex-KGB officer, Judo expert and all-star power monger has pushed his James Bondesque villain game to an Ivan the Terrible level. In 2014, Putin has racked up a string of stains on humanity, from exterminating dogs at Sochi during the Winter Olympics to launching an aggressive war against Ukraine.

Putin's Russia, which ranks as an authoritarian regime in indexes of democracy, appears determined to re-establish key elements of the Soviet Union, including large chunks of Ukraine.

This is starting to look a lot like Stalin's Russia.

Russian tanks are invading an Eastern European country and the Kremlin has dusted off a propaganda tool imported from Nazi Germany during World War II: The Big Lie. Joseph Goebbels, who operated Hitler's propaganda machine, was the master of the WWII whopper: "If you tell a lie big enough and keep repeating it, people will eventually come to believe it."

For weeks, the Russians have been deploying The Big Lie about their military activity on Ukrainian soil. Foreign Minister Sergei Lavrov shamelessly fired up the propaganda machine, claiming NATO satellite photos showing heavily armed Russian military units conducting operations inside Ukraine had "turned out to be from video games."

NATO satellite imagery reportedly shows Russian military units operating inside eastern Ukraine.

Ferguson reminder about race in America

Police in riot gear confront protesters in Ferguson, Mo. The fatal police shooting of an unarmed African American teenager on Aug. 9 inflamed racial tensions in the St. Louis suburb. /Image via npr.org

Many Americans want racially charged issues to go away.

But the final steps in the country's 400-year-long journey through the pitfall-strewn landscape of racial injustice have yet to be taken.

Whether it fits into your view of the United States or not, the racially charged violence sparked by the police shooting of 18-year-old Michael Brown in Ferguson, Mo., is an ugly reminder about the country's struggle to overcome centuries of bias against African Americans.

As long as African American teenagers walking down the street are at high-risk of being shot to death, America has more steps to take.

As long as white men think it is acceptable to drive around in their pickups with battlefield Confederate flags flying from the truck bed, America has more steps to take.

As long as nearly half of the people incarcerated in the United States are black, America has more steps to take.

Iraq War: Surge II decision looms after U.S. election

Marines maneuver in Umm Qasr during a hot phase of the Iraq War for U.S. forces. /U.S. Department of Defense photo

The Iraq War is far from over.

In yet another journalism tour de force, Frontline has laid bare the folly of two American presidents in Iraq. From George W. Bush's bumbling occupation of the country to Barack Obama's ill-fated rush to find an exit, successive U.S. administrations have been poking a hornet nest in the heart of the Middle East.

The Iraq War smeared Bush's legacy. As Iraq's bubbling cauldron of sectarian animosity between Shiites, Sunnis and Kurds threatens to explode, Obama's standing in the eyes of history now weighs in the balance.

If Obama is not pondering renewed intervention in Iraq, he should be.

With the Islamic State of Iraq and the Levant (ISIS) threatening to overrun the central government in Baghdad, al-Qaeda and other groups openly hostile to the United States and its allies in the region are flourishing in the Fertile Crescent country.

The current occupant of the White House faces a challenge dripping with irony: Obama inherited the Iraq War from his predecessor, and he has wanted to disengage from Day 1 of his administration. Now, he faces the prospect of launching his own war in Iraq.

The clock is ticking.

If Obama intervenes to rescue Iraq from chaos, he would likely doom many Democrats running for Congress in November. The Iraqi state could meet its doom any day.

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.