Archive for the ‘health reform’ category

Disputes of Peacekeeping Forces During the War

September 2nd, 2010
Artur Victoria asked:




If a belligerent becomes a peacekeeper, they are more likely to be targets of those who had been on the opposing side of the conflict. It is obviously the kind of demand that is likely to be rejected by those who are independent minded, let alone those who are suspicious of NATO motives. It is bound to be resisted by those on the other side of the conflict which will naturally see this as an army of occupation. Such a demand was bound to prolong the negotiations, and the failure to reach agreement was used as a convenient reason to intensify the bombing of increasingly civil targets (bridges, oil refineries, and even a TV station).

If NATO believed that the situation justified the waging of war and believed that they should become a belligerent, then they should have seen that taking such action ruled them out of a role in the peacekeeping force. Under such circumstances, the peacekeeping role would fall to others. The suggestion that there were no others who could perform that role is an insult to many countries with a record of peacekeeping second to none -including Australia, New Zealand, India, Finland, Sweden and Fiji. There are plenty of other countries with sufficient experience to serve under the command of a seasoned peacekeeper from one of the above named neutral countries. Under these circumstances, Russian would be a better bet than the belligerents. If NATO troops were to be used, they could at least be from those NATO countries that did not actively participate in the hostilities.

One of the most curious disputes was generated by NATO insistence that the bombing would not stop until the Serb had engaged in significant withdrawals from Kosovo. This is a catch twenty-two of which Joseph Reller would have been proud. If NATO insist that the Serb withdraw but also insist that they will keep bombing for a period after the withdrawal has begun then that logically means that they have the right to bomb the troops after they have left their protected positions and started retreating. The Russian described this as contrary to all military logic and commonsense. In the end, NATO did not insist on it and agreed in advance that they would not bomb the withdrawing troops.

NATO used this as an excuse to take command of K-FOR and control it as they saw fit. NATO gave each of its own members a part of Kosovo to patrol but denied the Russian any area (something which may well have led the Russian to make their move to Pristina airport).

The move by the Russian to rush into Pristina airport was criticized in the West as an act of hostility and the Russian acting on their own. However, from the point of view of the Russian, NATO had been acting on its own without reference to the UNSC for three months. Now that there was a UNSC resolution which clearly included a Russian role, NATO seemed to be trying to cut the Russian out of it by stalling on an agreement on where the Russian would be. It is not as if there had not been enough time to consider this matter. The mixed force had been agreed for more than a month.

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The Constitutional Value of Sovereignty

August 31st, 2010
Artur Victoria asked:




The constitutional value that is most under threat is, of course, sovereignty itself. Sovereignty is being weakened as the forces of globalization ensure that forces outside the walls of the state fundamentally affect, and sometimes determine, what goes on within them.

Sovereignty and the consequential ban on intervention are also being undermined normatively. As an essentially Westphalia construct, modem ideas of sovereignty predate the Enlightenment by one hundred years. The greatest threat to sovereignty and the associated stigma attached to intervention lies in the full implementation of Enlightenment values.

There were many reasons for this limited role of Enlightenment values in international law. Initially, democratic nations sought the protection of sovereignty against autocratic states that might intervene to crush their fledgling democracies. Their inclination was to keep domestic political values out of international law lest the major views of other states (for example, in favor of monarchies) might be imposed on them. Democrats were only too aware that the French Revolution and the revolutions of 1848 were defeated by autocrats allied to the regimes which the new democracies had ousted.

With the notable exception of US interventions in the Americas, virtually all interventions during this century have been by autocratic states -and the enlightenment credentials of most US interventions in the Americas were dubious, to say the least. It is only recently that the majority of nation states came to enjoy any real measure of democracy and it becomes possible to think of international law being reflective of liberal democratic ideals.

The glaring inconsistency between the bases of constitutional legitimacy in domestic and international law has been sustained by a number of factors:

1. The idea that international law is a law for all states, of which not all are democracies.

2. Cultural relativist notions that different cultures have different approaches to governance.

3. The understanding that it is necessary to ‘do business’ in both commercial and political terms with a particular territory and that the only way to do this is through the group which exercises effective power in that territory.

4. The idea that there is no alternative to political authority based on the prior successful use of force in a state where there has never been a democratic government which can speak for the people. Even where a democratic government is ousted, it may not be able to retain the integrity of its representative principles for long (as it becomes difficult to collect all elected representatives in one place and it is impossible to conduct new elections).

5. The regretful history of interventions. Nations will rarely intervene solely for the benefit of the citizens of another nation state. They will only do so if it is in their interests. The danger is that nations will intervene to further their interests on the pretext of helping the citizens of the target state, but their ‘assistance’ will actually work to the detriment of those citizens.

Intervening nations generally intervene in the name of international law but are rarely willing to subject themselves to it. For all these reasons, liberal democrats are traditionally wary of interventions and skeptical of their ability to achieve further liberal democratic values.

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The Power of Media: Russian Perspective

August 30th, 2010
Helen Shelestiuk asked:




Journalism, as it is often said, is the ‘fourth branch of power’, along with legislative, executive and judiciary, not any less mighty than those three, even if not legally endorsed in the Russian constitution. It is the power of symbolism, and it cannot be escaped, but can only “used” to bring truth, or “abused” to bring propaganda. The French sociologist Pierre Bourdier claims, that it is the opportunity to create reality with the help of words: we are approaching the time, when the social universe is described and prescribed by mass media. One cannot but agree with this view.

It is common knowledge that political parties in a country exist owing to the replication of their trappings and slogans in mass media, rather than to their strong organizations. Journalists sometimes complain that they have no real levers to affect the public opinion. Quite the opposite. Elvin Toffler, USA mass media analyst, correctly observes that new communication systems or new methods of using the old systems serve to maintain, challenge or even overthrow the government power. The above-mentioned Pierre Bourdier holds, that jounalists, led by their prejudices, values, individual perception, subconscious expectations (and sometimes conscious detrimental intentions – H. Sh.), can create the effect of reality and actually change the existing reality. This effect may have disastrous consequences.

Russia has sustained three revolutions. The latest of them, the late 1980s -1990s ‘perestroika’, was virtually instigated by mass media. It was they which created the notorious ‘effect of reality’ and changed the existing reality. The disastrous consequences of it are on hand: the post-revolutionaty trauma, affecting the public morale in the first place is still here to stay. But for nearly 17 years the mass media in Russia have been archly convincing the public that the things generally go right, and the fact that the consequences of the disintegration of the Soviet Union are disastrous may be accounted for the ‘communist totalitarian regime’. Now some of them who acclaimed the ‘orange scenario’ in Ukraine are calling for the fourth revolution.

When we hear the discussions on the information policy of the contemporary Russian government, we are struck by the diametrical opposition of views. Some think that the mass media in Russia are ‘gripped in a vice’ of numerous interdictions imposed by the government. Others lament that the information policy is no more than a catchword, and the journalists enjoy absolute license. It is noteworthy that both parties understand the information policy as a kind of government’s prohibitive encroachment on the mass media. But this view is definitely oversimplifying the complex phenomenon.

In fact the very essence of information processes suggests the governmental monitoring of media. The mass media are not a gigantic factory for creating information, but no more and no less than a means of a system’s observation of its processes. When these observations take place the interference with the purpose of improving the situation can only be cautious, expert, intelligent and really needful. The media should be aware of the fact that the system’s self-observation demands accurate registration of its processes and does not permit of anarchy of views.

The information policy introduced by the present Russian government is based on the principle of a free choice of information consumption. It prescribes that the mass media should produce a considerably full, unobtrusive and unbiased information flow, letting an individual and the community draw their conclusions, make their well-grounded and competent choices. It rests on the trust in journalists’ expertise. And, as was said at the beginning, real professionals should know what can and what cannot be said and shown.

Today the freedom of speech in Russia has taken the form of a variegated sea of periodicals. Their often biased, eclectic or untrustworthy presentation of subjects is not what is needed in order to foster respect for the nation, compliance with its interests, culture and ethics in providing information. One cannot but admit that the media are a long way from this ideal.

The mass media which came out victorious in the 1990s revolution in Russia are still called ‘new’, although many of them are old brands with a new content. Their ethos since this revolution has been to impose their ideas on the public, to inculcate their world outlook and their approach. This ineradicable desire to monitor the ‘inert’ public mind has frequently prevailed over the journalists’ moral code to consult the interests of the nation. Their chief arguments are: who knows the people’s opinion? even sociologists cannot give veritable data about it! And then… the people are really backward: they do not see their interests, they should be prompted and directed.

All right, be the leading light. But it is impermissible to disregard public opinion tested by the acknowledged methods, like a referendum or a representative survey.

A glaring disregard of public opinion was the reaction of mass media to the All-Russia Referendum of March 17 1991, at which people, practically one and all, declared that they wanted to retain the Union of Soviet Socialist Republics. What was the media response to this result? An angry torrent of abuse of the stuck-in-the-mud ‘sovok’ (Soviet citizen) and the fiery propaganda of the disintegration of the USSR. With every strength of their gift they convinced the people that the USSR is a complete nonentity, which might be destroyed and never repented of. There is nothing valuable in that country: its industry, education, science, the mode of life – all should be eradicated and built anew. And the biggest of all evils is the Government – let the public authority be damned, let individualism and all-in privatization be blessed…

Another example of the media slighting the people’s opinion is taken from the recent past. It regards the national anthem of Russia. The representative survey showed that the population of Russia supported the anthem with the old Soviet anthem music and new words. So what was the media’s response to that? A volley of irony, sarcasm and hatred, which continues reverberating in the media in the form of indignant remarks, even though the anthem was legitimately adopted by the Parliament.

Since the power of media is symbolic, journalists should know the various functions of symbols, one of which is to relieve the dynamism of the world development. Symbols also help to fasten the uniting ties in a society after the anarchic pseudo-democratic license. Therefore it was only natural for the public authority to adopt the symbols recognized by the people, rather than the ones artificially constructed by a bunch of people opposing the national mentality.

It should be noted that the present pro-western radical mass media understand the crisis of their incompatibility with the public way of thinking and realize the lack of sympathy for them. They have abandoned the idea of direct and massive information attack and begun the cautious inculcation of ideas by more sophisticated technologies. Proceeding from the sociological data, that an idea assimilated by 20 per cent of the population does not any longer require intensive information support, but begins to live its own life and proliferate, they sporadically, yet systematically launch the ideas of the unqualified rightness of the West, the USA, of the advance of Putin’s dictatorship in Russia; inspire aversion to the union with ‘undemocratic’ Byelorussia (the Byelorussian President Alexander Lukachenko having become the virtual butt for the media), etc.

On the other hand, the media gloss over the glaring truth about the terrorist war against Russia on the Chechen territory. Even after the horrible events in Beslan on September 1-3 2004, when more than 4,000 children and teachers were held hostage and 330 people perished, the mass media, striving to present the situation in all the ‘pluralism of opinions’, accentuate those of them which are accusatory of the Russian public authority. For ten years the mass media have persistently represented the people’s sentiment in Russia as opposed to the war in Chechnya. All this despite the data that most people, both Russian and Chechen, stand for the State’s victory in this conflict. Our peoples’ national consciousness is very sensitive to this issue, but as usual the central mass media have ignored the public opinion.

It is understandable, when a foreign channel shows a Chechen saying that the world is on their side – for the full independence of Chechnya from Russia, that Russia is hated by other nations, it is doomed to disintergation and that they are sure of their victory. But when the Russian channels, for the sake of wrongly understood pluralism, highlight an anti-Russian meeting abroad, complete with anti-Russian placards, even though there are no more than a handful of people at it, it is a blow to national consciousness.

Generally, the media refuse to reckon with the people’s will (and the government’s policy) to remember the historical eminence of Russia, to develop its own ‘fairway’ in the international politics.

Seeking dubious popularity (if not intentionally undermining the public conscious), they act as ‘disturbers of peace’, work for the split in the Russian society. The media claim the role of an arbiter in politics, but in reality they virtually resuscitate the almost abaited strifes between the supporters of socialist and market-oriented values, pro-western and Slavophile outlooks. Some programs, for example, the ORT journalist Vladimir Pozner’s Vremena (Times) sometimes seem to deliberately fuel and even artificially instigate other conflicts, uncharacteristic of the Russians as a nation (whose mentality was historically internationalist, generally tolerant and collectivist), such as the oppositions Russians – ‘blacks (Asians)’, Christians – Muslims, people – authority, businessmen – government officials, even drivers – the State traffic safety inspectorate, etc. All this is done against the backdrop of permanent verbal humiliation of the Russians, the reminder of their inferiority; the defamation of the Soviet period of the Russian history, the Russian Orthodox church and the Russian civilization in general.

A pacifying voice is heard only too rarely, for example, Sergey Shargunov’s (the journalist and the leader of ‘For Motherland’ Youth Union) statement about the young people in modern Russia: ‘There are no real barriers between the young supporters of ‘Yabloko’ (the liberal democratic party headed by Grigory Yavlinsky), nationalist Bolsheviks and red-bannered Komsomol leaders. The difference of ideologies has long faded away… All sound people should discard the useless doctrines. What really matters is people, those who do not shy away from the common national values, who are ready to work for the public boon and believe in Russia’s capacity to shine in the world. The battle of imaginative society models is in the past… Let us stop being scared by our own grandfathers and grandmothers’.

The mass media today is the front of counterproductive opposition. As if the unity of Russian society is necessary to Vladimir Putin alone! It is necessary to all those who are concerned about Russia’s future.

Except for news programs, the choice of subjects for the information provision of our society is today arbitrarily determined by the mass media. Are they always right in their choice? The answer is ‘no’. The topics of labor and creative endeavour, science, folk arts and crafts, the burning subject of poverty, the debatable subjects like the territorial self-government, etc. have all been forced out of the mass media programs. The TV journalists evidently assume that the viewers will be more interested and educated if they are shown pictures of glamorous life, luxurious dwellings and clothes of stars, models and celebtities, soap operas, innumerable mafia serials, TV games of fortune, occasionally, prefabricated political debates and preconceived political analyses, instead of the pictures of everyday work. They warp the viewers’ taste by spicing their programs with obsenities, public exposures, indiscreet confessions, public insults and rows. They pride themselves of having eradicated the notorious ‘weavers and steelmakers’ achievements’ TV stuff of the Soviet times.

Certainly, the journalists may account for their slighting the subject of creative labor by the decline of interest to it in the society. But isn’t this interest worth reviving? Isn’t it noble to raise the prestige of an honest working individual, capable of earning his living and simultaneously advancing the progress of his or her country? If you are the fourth branch of power, your task is not only to criticize (or serve to) the first three, nor it is to ensure the survival of your periodical by any means. Being the power you should work as an authorized government department, rendering tangible help to the society, helping people to cope with their problems, to develop and improve.

Take the subject of regional self-government in Russia. It appears, that the journalists do not understand that with the viable regional self-government the efficiency of mass media would be higher, for example, the backing of the united self-organized masses could help them fight corruption. The law of regional self-government has never been given proper attention to in the press, except for the cases of squabbles between governors and mayors. Fundamentally, the mediamen assume that their papers will read better if there is shadiness and intrigue in their information. ‘Governor Urges Mayor to Resign’, ‘Retired Mayor Threatens to Fire All Officials Who Follow His Deputy’s Instructions’ run the newspaper headngs. The information itself is frequently outrageously biased and smacks of bribery by this or that disputing party, rather than of the journalsts’ genuine interest in the common cause. Most of the audience are sure that a crying elderly lady, say, in a delapidated hut will be given no real help, but serve as a mere tool to get a mayor dismissed.

Yet what is really needed is that jounalists clarify the essence of the law to the people, let them know their rights. For example, for several years there has been despoliation of forests, despite the protests of the people of the nearby settlements and villages. No one can get the lumbermen to stop or even be more careful. The dwellers of the settlements do not know that under the regional self-government law they have considerable rights for their lands and forests. Probably, neither do the journalists, who even confuse the terms ‘regional self-government’ and ‘ local administration’.

Most central mass media in Russia stand up in a united front against Vladimir Putin’s strengthening of the ‘vertical of power’, disparaging it as the onslaught on democracy. One can only imagine their outcry if Putin repeats the Russian czar Alexander II’s decision in 1861 to appoint a centralized institution of Senate-approved arbitrators – intermediaries, helping the regional authorities to settle the issues of repartition of estate between the landowners and the former serf peasants. They also observed the organization and functioning of peasants’ self-governments, which at that time, just like today, placed the governors’ authorities at certain disadvantage. The latter had preferred to keep the people in backwardness and ignorance.

The repartition of estate is too serious a matter to be done without control of a disinterested party. Now, with the adoption in Russia of the law on private property for land, people often quite suddenly find themselves living on a new landowner’s estate. There are cases of country communities wishing, for example, to repair an old road or bridge and being refused by their landowners. The mass media used to be fervent advocates of the law on private property for land. Why aren’t they vocal in exposing the negative consequences of land privatization and calling for their amendment? This would be their work for the common cause.

Sociologists have invented the method of ‘participant observation’ . Unfortunately, very few journalists have adopted this approach, although is it the observation ‘from within’ that can give the truest view on the society and the possible solutions of its problems.

So far the impression is that the information war is being waged against Russia on its own territory. The specific stratagem of this war is that the people do not realize they are being fought against; their opponents profess themselves to be their guides and tutors. They claim to be teaching the Russian nation what ‘democracy’, ‘freedom of speech’, and ‘panhuman values’ are. Simultaneously the national mentality is being undermined and destroyed, which results in lowering the morale, hence, selling up industry, plundering the country’s resources, disorganization of the army and security services, etc.

It is time for us to realize, that the mass media, raised to unprecedented heights by information technologies, virtually guide our lives, even though they lack responsibility, are indifferent to the actual demands of the society, do not attempt to foresee the prospects for social development, disregard, distort and transform the public opinion and values. It is also time for the mass media to conduct an unbiased self-analysis, stop imposing counterproductive ideas on the public, and start showing themselves not as combatants with, but as servants of the community.

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Achieve Health Reform Now by Controlling Costs in Meaningful Ways

August 26th, 2010
Emory Daniels asked:




I’ve been following all the news in the press and on television about health care reform and one of the major issues has been cost containment. One of the elements overlooked in the trillions of dollars being tossed around is the importance of controlling costs in our present system as a means of immediate reform.

This comes to mind because a friend of mine, who is very good at tracking his own health, talked about a book that was a very valuable resource for him. So I borrowed a copy of Taking Charge of Your Own Health by Lisa Hall. The author challenges readers to take responsibility for their own health care and to be accountable for tests doctors order, prescriptions given, and treatments suggested.

Lisa Hall was misdiagnosed 37 times before a doctor discovered she had an autonomic nervous system dysfunction, likely caused when she was struck by lightning at age 15. Through that entire experience she learned the importance of seeking second opinions, understanding her health insurance coverage, and taking steps to avoid duplicate tests, thus reducing costs.

Among the cost-saving suggestions the author makes are to:

* Manage medications to prevent costly and unnecessary medical interventions

* Use outpatient clinics instead of ERs when appropriate

* Avoid costly duplication of tests by maintaining and bringing to the doctor’s office your own diagnostic history.

Hall makes sense to me when she argues that it is the patient’s responsibility to keep records of their health care and be an active partner in reducing the costs of your own care. She suggests forms to use for medical record keeping in the book and offers the forms for download at her website by doing a search on “theproactivepatient.”

If this approach were followed by thousands of patients the cost savings would be astronomical. In this way we could get an effective head-start on health care reform before the government’s complicated package takes effect two and three years from now.

If you are interested in being a participant in health reform now by containing costs in a meaningful way, pick up a copy of Taking Charge of Your Own Health by Lisa Hall. It’s good reading and makes a lot of sense to me, as it will to you also.

By Emory Daniels

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How Will the Health Reform Affect Medicare Advantage Plans 2010?

August 26th, 2010
Joseph Rosario asked:




When the final health care bill will be passed, there will be changes to Medicare that affect seniors and beneficiaries in 2010.

What Is Planned? Currently, House and Senate bills plan the following changes in regards to Medicare Advantage plans 2010:

Eliminate The Open Enrollment Period from January 1st to March 31st from 2011 on. If this is approved, Medicare beneficiaries will have only get one opportunity to change their Medicare coverage during the Annual Election Period from November 1 to December 15 of each year. Payment cuts to Advantage plan carriers in 2011 Around 5% in cuts compared to 2010 are expected and will most likely be passed on to those enrolled in the plans. So it is to be expected that there will be no or very few ‘zero premium’ Advantage plans found in 2011.

The Centers for Medicare and Medicaid Services (CMS) recently released information about the plans that will be available in 2010. On average, Medicare beneficiaries will be able to choose from more than 30 Medicare Advantage plans in 2010, some will have as many as 73 different plans to choose from in their area. The mix of the plans offered will change as carriers respond to current and anticipated program changes.

Firms withdrawing from the PFFS market are continuing to offer coordinated care plans (mainly HMOs) and new plans of various types. Some firms, like Kaiser Permanente, are making no changes in their offerings in 2010. Kaiser Permanente will continue to offer only HMO and cost plans.

Fewer MA-PD enrollees will be in plans with no premium in 2010 than in 2009, if they stay in their plans. However, a plan with no premium does not necessarily represent the best value for enrollees because out-of-pocket costs are affected by a combination of premiums, covered benefits and cost-sharing requirements.

Beneficiaries who decide to remain in their same Medicare Advantage plan in 2010 can expect premium increases of, on average 32, percent, although the magnitude of the increase will obviously vary from plan to plan.
Therefore, beneficiaries may find it in their interests to review and compare coverage their health care plan options, taking into account premiums, benefits, cost-sharing, and provider networks, to choose the option most likely to meet their individual needs and circumstances.

For more information about the planned changes, what you can do to add additional coverage to your health care, and to compare Medicare Advantage Plans available to you, please visit my Medicare Advantage Plans 2010.

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