The State of Opportunity

Thursday Immigration Blog Roundup

•    Alan Jenkins, Executive Director of The Opportunity Agenda, has written an op-ed for OurFuture.org.  The piece, titled “Challenge and Community in the Heartland,” discusses the horrific effects of the recent immigration raid on the community of Postville, Iowa:

After the Postville raid, half of the local school system’s 600 students were absent. Many businesses were shuttered and churches left empty. And many families and friends were separated. But, unlike this month’s terrible storms and twisters, the Postville raid could have happened differently, or not at all.

The raid is an example of the U.S. government officials using quick, destructive tactics to shift attention away from the fact that the federal legislature has been incapable of passing meaningful immigration reform.  Moreover, the government did not arrest any of the managers from Agriprocessors, the company that was responsible for the Postville plant, even though the Iowa Department of Labor found numerous workplace safety violations there:

A federal enforcement strategy concerned with public safety and accountability would have focused on these alleged practices which, if true, pose a real threat to economic opportunity within the state. And it would fix our broken immigration system so that immigrant workers can be realistically and fairly held accountable.

•    The Night of 1000 Conversations is taking place tonight, June 19.  The event consists of thousands of individuals across the U.S. getting together in their local communities and discussing the detrimental effects of the anti-immigration actions of the Department of Homeland Security.

•    A June 19 article that appeared in The Washington Post details how a local sheriff in Maricopa County, Arizona dispatched his deputies into predominantly Hispanic communities and told them to arrest anyone who could not immediately prove he or she was a legal U.S. resident.  Mary Rose Wilcox, a local supervisor and longtime Hispanic activist said:

All he is doing is going after everybody with a brown face.  There's no doubt in my mind that this is racial profiling. None.

The inability of the federal government to enact meaningful immigration reform has forced state and local governments to address the issue.  According to the Post article, more than 240 immigration reform measures have been passed in the last year.  However, the inaction of the federal government has also allowed anti-immigrant officials like the Maricopa County sheriff to enact their own extremist policies of racial profiling without any regulation from political leaders.

To learn more about the importance of protecting immigrants’ rights, take a look at The Opportunity Agenda fact sheet, Immigrants and Opportunity.

•    A posting on Of América addresses the increasingly cruel treatment of immigrants held at Immigration and Customs Enforcement (ICE) detention facilities.  The treatment of people detained at these facilities is being compared to the treatment of people detained at the U.S. military base in Guantanamo Bay:

In the case of both the military and immigrant detention facilities, says [Amrit] Singh, [staff attorney at the ACLU,] the Bush Administration has used national security imperatives to deny many of the Freedom of Information Act requests she and her colleagues have filed in their efforts to find out things like how people are being treated in detention, under what conditions did detainees die and what kind of medical treatment they are receiving.

Monday Health Blog Roundup

•    Last week, Governor M. Jodi Rell signed legislation that established a “Commission on Health Equity” in the state of Connecticut.  The act is a crucial step forward in ensuring that all people in Connecticut have equal and appropriate access to health care.  It also explicitly recognizes that health is a human right:

Whereas the General Assembly finds that: 1) Equal enjoyment of the highest attainable standard of health is a human right and a priority of the state...

The Universal Health Care Foundation of Connecticut, an organization that works to achieve quality, affordable health care for every resident of Connecticut, applauded the Governor’s decision to sign the legislation.  Foundation President Juan A. Figueroa said in a statement (that can be accessed here):

The new commission represents an important first step toward addressing racial and ethnic health care disparities, a serious problem facing our state. Dismayingly, the health and health care trends of our state’s African American and Latino communities reflect a troubling national trend.  There is much work to be done here in Connecticut and throughout the nation.

•    The New York Times reported that a study conducted by researchers at Dartmouth University and released by The Robert Wood Johnson Foundation found that there are wide racial and geographic disparities in the treatment of Medicare beneficiaries.  Race and place of residence can have a significant impact on the level of care a patient receives:

For instance, the widest racial gaps in mammogram rates within a state were in California and Illinois, with a difference of 12 percentage points between the white rate and the black rate. But the country’s lowest rate for blacks — 48 percent in California — was 24 percentage points below the highest rate — 72 percent in Massachusetts. The statistics were for women ages 65 to 69 who received screening in 2004 or 2005.

In all but two states, black diabetics were less likely than whites to receive annual hemoglobin testing. But blacks in Colorado (66 percent) were far less likely to be screened than those in Massachusetts (88 percent).

The Robert Wood Johnson Foundation has committed $300 million to improve health care quality in regions across the United States.  Foundation President and CEO Risa Lavizzo Mourey said:

Despite having the most expensive health care system in the world, patients are subject to too many mistakes, too much miscommunication and too much inequity. As a result, too many Americans aren’t receiving the care they need and deserve. This unprecedented commitment of resources, expertise and training will turn proven practices for improving quality into real results in communities across America.

•    On June 15, an article that appeared in The Philadelphia Inquirer reported that health care for female veterans “lags behind” the care that male veterans receive at VA facilities.  The review of the facilities, which was conducted the Department of Veterans Affairs, found that there are clear needs for more equipment and more physicians trained in women’s care, as well as improved access to outpatient services for female veterans.

•    A recent posting on the Health Care Renewal Blog refers to a number of stories regarding the recent actions of UnitedHealth Group, the largest for-profit health insurance or managed care corporation in the U.S.  For example, the Hartford Courant recently reported that UHG had to refund $50 million to the small businesses in New York that it overcharged.  The Courant claims:

[Eric] Dinallo [the superintendent of the New York State Insurance Department] and New York Governor David A. Paterson said the settlement came about because insurers have the right to raise rates at will while regulators are empowered to review them only retrospectively. The agreement was reached after UnitedHealth's Oxford Health Insurance unit spent 70.6 percent of premium revenue on medical benefits in 2006, less than the 75 percent minimum.

•    Matthew Holt, blogger from The Health Care Blog and organizer of the Health 2.0 User-Generated Healthcare Conference, was recently interviewed on MDMG and gave his thoughts on the impact of Health 2.0:

The impact of the ability to search into other people’s experiences and match with cases online in these communities is going to be substantial. A doctor may see one or two of these cases in a lifetime, but there may be 20 or 30 or 1,000 of these people, and if you can put them all together in one group, it makes the information much easier to find.

GoogleHealth: Improving Access to Health Care, or Destroying People’s Privacy?

With the emergence of GoogleHealth and Microsoft HealthVault, many people have been speculating as to whether the ability of individuals to post their health records online will be beneficial or harmful.

For individuals who are interested in accessing their health records, there is a huge benefit to having them be available online: you can access them at a very low or no cost.  Through GoogleHealth, you can request your health records through any one of the GoogleHealth Partners.  Before this service was available, most people, particularly those who did not have easy access to a primary care physician, were forced to request records from their insurance companies.  Those who did not have insurance or a regular doctor were left with few options.  However, with GoogleHealth, all individuals have the ability to build their own health profile.  For those who did not have access to their health records, creating their own online profile makes the process much easier. 

GoogleHealth also enables you to search for physicians and hospitals online, and provides locations as well as directions for them.  This aspect of GoogleHealth could have the very positive effect of improving people’s access to primary care.  Depending on how many doctors and hospitals register with Google, many people could be able to find a health care provider in their area and have access to a service they might not have otherwise known about. 

As The Opportunity Agenda discusses in numerous reports, specifically Unequal Health Outcomes in the United States and Identifying and Evaluating Equity Provisions in State Health Care Reform, there is a significant and widespread problem of unequal access to health care in the U.S.  It is crucial that everyone, especially a website like Google that is able to reach so many people, commits to tackling this problem.  If Google can convince many primary care physicians and facilities, particularly those in deprived communities, to register on the website, then people will be able to find more health care facilities, not just the ones that are in their immediate area.  This could do a great deal to improve people's access to health care.

Thursday Immigration Blog Roundup

•    The Washington Post is reporting that a recent audit of the FBI system for checking the names of immigrant applicants found significant problems with the Bureau’s process, claiming that it has “serious deficiencies.”  According to the Post:

The bureau's name checks have fallen victim to "outdated and inefficient technology" as well as inadequately trained employees, according to a report issued yesterday by the Justice Department inspector general.

•    Standing FIRM recently posted a YouTube Video documenting the effects of last month’s raid on an immigrant community in Postville, Iowa.  Many local residents are interviewed.

•    A posting on DREAM ACT discusses a number of stories of young immigrant students, including one valedictorian, who were recently deported.  According to the the blog, passage of the federal Dream Act, which died in Congress last year, would have allowed them to graduate and remain in the country.   

•    A June 11 New York Times Editorial claims the U.S. government has failed in its responsibility to ensure that its immigrant detention facilities are safe and secure.  The editorial argues:

The government should be rushing to improve the oversight and care in its sprawling detention system to protect all detainees. Instead, the official reaction has been slow and defensive, promised improvements are piecemeal, and criticism of the system is making immigration hard-liners indignant.

•    According to ImmigrantProf Blog, Professor Margo Schlanger is creating a database of original court documents in civil rights cases.  The database, named Civil Rights Litigation Clearing House, has a category for immigration cases.  The information is all publicly available and can be accessed here.

A Chance to Tell A New Story

The national print media are starting to report on the divisive, counterproductive effects of immigration raids and punitive local ordinances. A New York Times editorial and news articles by the Times and Time Magazine are representative, highlighting the harmful effects of these tactics on children, families, schools, local businesses, and communities—including citizens as well as documented and undocumented immigrants—and the ways in which these approaches depart from our national values.

For supporters of human rights and opportunity, this is an important time to drive home the narrative of rejecting raids and other divisive and disruptive tactics in favor of Real Solutions that Uphold our National Values and Move our Country Forward Together. This means showing how vindictive, anti-immigrant measures fail to address the real challenge of immigration, and how more constructive approaches like a pathway to earned citizenship and a focus on fair labor practices and living wages for all workers offer real solutions. It also means highlighting our national values of Opportunity, Unity, Due Process, and Accountability, and why our real solutions uphold those values while punitive policies undermine them. And it means documenting the ways that immigrants are a part of our economic engine and the social fabric of our communities—that immigrants are a part of us and crucial to our economic and democratic future.

The current media moment offers a surprisingly promising opportunity to convey that message.

Six Years Later, Health Disparities by Race and Ethnicity Persist

Amidst the energy and momentum for health care reform in the United States, it is important to remember that getting an insurance card into everyone's wallet is not the same as guaranteeing equal access to quality health care.  Recent studies have shown that, in America, health is not just about having insurance or paying bills: it's also, unfortunately, about the color of your skin.

The Lancet, a journal of global medicine, published an article this last Saturday (free registration required) on persisting racial and ethnic disparities in health, six years following the groundbreaking Institute of Medicine study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.  The Opportunity Agenda Research Director and primary editor of the 2002 IOM study, Brian Smedley, is quoted in the Lancet article:

“As the report's study director, I was pleased to see that Unequal Treatment prompted a sober discussion in health policy, academic, and political circles”, Brian Smedley, former senior programme officer at the US Institute of Medicine, wrote in a blog to mark the latest issue of the journal Health Affairs, which includes research on health disparities. “But ultimately the report failed to prompt passage of significant new federal legislation or spur the Department of Health and Human Services to adopt its core recommendations. As a result, little has been done, in my view, to systematically address the problem.”

Citing some of the papers in the latest issue of Health Affairs, called Disparities: Expanding the Focus [paid subscription required], he said that some of the most shocking health care gaps that were not documented when Unequal Treatment was published, were found in mental and oral health care. Meanwhile, the biggest gains in life expectancy occurred among the best-educated Americans.

Because of the failure of HHS to adopt recommendations to reduce disparities, and the stalling of major legislation in Congress to address disparities, many of the inequities identified half a dozen years ago are still prevalent.  In very real terms, this means that communities that often have the most need for quality health care are the ones that receive the least of such care. 

Monday Health Blog Roundup

•    The House Ways and Means Health Subcommittee is holding a meeting on disparities in health and health care in the United States.  The hearing will take place on Tuesday, June 10 at 10:00 am in the main committee hearing room, 1100 Longworth House Office Building.  Individuals not scheduled to give oral testimony at the hearing are able to submit a written report to the Committee.  Subcommittee Chairman Pete Stark (D-CA) said upon announcing the hearing:

While we can make a big dent in addressing disparities by getting everyone covered, we must recognize that these issues transcend access to coverage.  We must pay special attention to ensure access to care and good outcomes for everyone, regardless of race, gender, or ethnicity.

The Opportunity Agenda has been extensively involved in researching health disparities in the U.S.  We collaborated with a number of organizations in publishing the CERD Working Group Report to the U.N. Committee on the Elimination of Racial Discrimination, titled “Unequal Health Outcomes in the United States.”  The report, which can be accessed here, details the extent of racial and ethnic disparities in health care treatment and access, the role of social and environmental determinants of health, and the responsibility of the state. 

In addition, The Commonwealth Fund issued a report, "Identifying and Evaluating Equity Provisions in State Health Care Reform," that was written by Brian Smedley and Betty Alvarez of The Opportunity Agenda along with Rea Panares, Cheryl Fish-Parcham, and Sara Adland from Families USA. The Report, which analyzes how recent state health care reforms have targeted health inequalities and disparities, can be accessed at The Commonwealth Fund website.

•    On June 3 The New York Times published an article discussing the recent Urban Institute study on the introduction of mandatory health coverage in Massachusetts.  The study, which was published in the Health Affairs and can be accessed here, found that Massachusetts was able to cut its uninsured population in half within the first year of instituting mandatory health coverage.  The study also found that Massachusetts made significant gains in expanding access to routine preventative care.  The NY Times analysis of the study emphasizes that:

Indeed, contrary to national trends, the share of residents receiving insurance through their employers increased in Massachusetts by nearly three percentage points from fall 2006 to fall 2007. Nationally, the percentages of employers that offer benefits and of workers who receive them have been sliding steadily throughout the decade.

•    A recent Trusted.MD posting titled Where Shall We Turn For Leadership in REAL Wellness?  contemplates the future of REAL Wellness in the U.S.  According to Trusted.MD , health and wellbeing education has seen more expansion and innovation in countries in Europe, as well as Brazil, Australia and Japan, than it has in the U.S.  Wellness education, which is an integral part of improving the quality of life of all Americans, is not focused on as much in the U.S. as it is in other countries.  Trusted.MD says:

The whole point of wellness should be to promote/facilitate and otherwise boost this mission - better life quality. Corporate wellness programming today, at least in the US, is weighed down with features designed to reduce company health insurance costs. These efforts are well and good and should be continued. However, expanded endeavors would follow if wellness were recognized as larger than a health concern. With a greater perspective and higher expectations, the orientation would not be limited to testing, monitoring, lecturing, pressuring or even coaching and mentoring.

Behind the Curtain

The recent article about the immigration debate on-line, published earlier this week in Chicago Tribune, sent a jolt of fear down my spine when reading through the comments section of the article.

The piece, which is about how the pro-immigration movement has moved onto the Web--thanks in part to bloggers like The Unapologetic Mexican, previously sited in this blog--unfurls the span between reason and insanity, community and disunity.

There's no question that the anonymity of the web affords people the chance to make bold statements they normally would not make in person. This, in some ways, is a positive tool for communicating, allowing people to speak with complete openness. However, far too often, the comments sections posted at the end of articles is a scary reminder that racism and bigotry are not dead in this country. I recently heard one pro-immigrant American compare the web's hate speech, common on blogs and cloaked by anonymity, to that of old racist groups that would hide their true identity in the South.

Myself, having spent much of my childhood in the Deep South, I can see this powerful image transcending itself into the modern blogosphere. The rhetoric used is fiery , indeed, the kind of words that rouse anger in the reader and fuel one heated debate. It's hard for me to think that some comments intend to persuade, since often they are so outlandish that any application of reason is like applying sunscreen to the sun.

What needs to be stressed is that these comments are never the voice of a "people," but rather the voice of a few die-hard opponents playing wizard behind the curtain. The only difference is that they don't want to send anyone back to Kansas, but rather send them somewhere very, very far away.

The road to opportunity, call it the Yellow Brick Road, wasn't traveled alone. It took the help of everyone in that clustered community of outcasts to show each other that success was within the reach of everyone. No one was excluded on their journey, especially for a young girl and her dog who traveled from a far-away land.

Thursday Immigration Blog Roundup

•    Yesterday’s Chicago Tribune article that describes the ongoing battle between pro-migrant and anti-migrant bloggers mentions The Opportunity Agenda’s report, Immigration in the Public Discourse: 2006-2007.  The article also specifically refers to two pro-migrant bloggers, The Unapologetic Mexican and Citizen Orange.

•    Migration Policy Institute recently published an article on female immigrants detained in Mexico.  The article details Mexico’s restrictive migration policies, the harshest of which applies to individuals attempting to enter the U.S.  Below is a clip from the article, which can be accessed at Standing FIRM:

This article analyzes the situation of women migrants held in detention centers in Mexico. It explains the detention system's structure and some of the recurring problems, highlighting the latter with information from women interviewed in the Mexico City Detention Center.

•    Tuesday’s New York Times Editorial  discusses the real repercussions of the U.S. government’s war on illegal immigration:

This is not about forcing people to go home and come back the right way. Ellis Island is closed. Legal paths are clogged or do not exist. Some backlogs are so long that they are measured in decades or generations. A bill to fix the system died a year ago this month. The current strategy, dreamed up by restrictionists and embraced by Republicans and some Democrats, is to force millions into fear and poverty.   

•    A May 30 post on Migra Matters titled “ICE: Keeping America safe from High School Valedictorians” tells a story of a young man from Fresno who was recently deported.  The blogger goes on to say:

This is just another case, in a long list, for why the failure of Congress to pass the DREAM Act was so important. This young man should have been heading off to college this fall to further his already successful academic career … instead he'll be shipped off to a country he doesn't even know and an uncertain future.

On another note:

•    Jack and Jill Politics  has an amusing summary of the past Democratic primary season.  Highlights of the blog posting include “The Michigan Fake Primary” and " Oh @*#&! He MIGHT ACTUALLY WIN!"

Not Just a Bill

A surreal debate is playing out on Capitol Hill over a proposed expansion of the GI Bill of Rights.    Bi-partisan coalitions in the House and Senate want to increase college support under the law to give a new, promising start to veterans who’ve served at least three years in the military.  President Bush and John McCain oppose the bill, ostensibly on the ground that it would motivate too many soldiers to seek college over re-enlistment.  But the Congressional Budget Office estimates that an augmented GI Bill would increase the number of new recruits by about the same amount that it would coax out of the armed forces. 

So what’s really going on?  The GI Bill is not just a bill.  Through its values, its language, its history and impact, it embodies a profoundly progressive vision of opportunity, linked to a populist form of patriotism.  That combination is especially threatening to the conservative elite.

First, it’s a “bill of rights”—a phrase and idea that derive from our most cherished constitutional foundation.  The bill conveys not benefits or privileges, but rights that veterans hold by virtue of their service to our country.

Second, it’s an economic bill of rights, tied to Franklin Delano Roosevelt’s vision of a “Second Bill of Rights” for all Americans that included not only “the right to a good education,” but also “the right to a useful and remunerative job in the industries or shops or farms or mines of the nation; the right to earn enough to provide adequate food and clothing and recreation;…the right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad; the right of every family to a decent home;…the right to adequate medical care and the opportunity to achieve and enjoy good health; [and] the right to adequate protection from the economic fears of old age, sickness, accident, and unemployment….”

That vision connects us to internationally-recognized economic and social human rights, embodied in the Universal Declaration of Human Rights, that recognizes a similar range of economic and social rights, as well as civil and political rights like the right to freedom of speech and religion.  While the United States, led by Eleanor Roosevelt, helped to craft and elevate the Universal Declaration at the end of World War II, presidential administrations of both parties have largely opposed the notion of economic and social human rights since the start of the Cold War.  Polling by The Opportunity Agenda shows that large majorities of Americans, however, recognize and support the economic rights that the Roosevelts worked to advance.

Fourth, the history and impact of the original GI Bill of Rights demonstrate how expanding opportunity advances our national interests and the common good.  The GI Bill helped an entire generation of Americans—and America itself—to take a giant leap toward shared prosperity.  It instigated a wave of ingenuity, innovation, entrepreneurship, productivity, and mobility from which our country continues to benefit sixty years later.

Finally, expanding the Bill of Rights today will make plain the connection between those progressive ideals and the men and women now serving in our military—a connection that conservatives have successfully undermined (often with progressive assistance) since the days of the Vietnam War.

The original GI Bill of Rights was almost defeated by Southern conservative lawmakers, Democrats, who opposed higher education and economic mobility for returning African-American veterans.  Today, conservatives’ objections may be expressed differently, but they rest on similarly ideological grounds.  Today, as in 1944, the GI Bill is not just a bill.