• Threat of Ebola Highlights Problems in the U.S. Public Health System

    Oct 15, 2014Emily Cerciello

    It is likely that Ebola will be contained in the United States, but errors in Texas show we have room for improvement in responding to public health emergencies.

    It is likely that Ebola will be contained in the United States, but errors in Texas show we have room for improvement in responding to public health emergencies.

    On October 15, the second case of Ebola transmitted in the United States was confirmed in Texas between patient Thomas Eric Duncan and a health worker. Even more frightening, perhaps, is the sequence of events leading up to the transmission, and the many questions it generates about the preparedness of the U.S. in responding to public health emergencies.

    Six days after Duncan arrived in the United States  – having passed a screening for fever at a Liberian airport – his symptoms progressed and he sought care at a Texas hospital, where he was promptly sent home with antibiotics.

    The hospital claimed his early discharge was the fault of the electronic health record (EHR) for not communicating the patient’s travel history, but soon issued a correction saying his history was “available to the full care team…there was no flaw in the EHR.”

    No matter who or what is at fault for letting Duncan fall through the cracks, we cannot let this huge breach in protocol happen again.

    More than a week later, and several days after the patient was confirmed to have Ebola, the apartment at which he was staying with four individuals remained unsterilized. The quarantined family had the responsibility of arranging clean bedding until a waste management company agreed to clean the apartment. When they arrived, contractors wore no protective equipment and used power washers to sanitize – a practice which is likely not the most effective method of treating infectious surfaces.

    And then, on October 12, the CDC confirmed that a nurse who had worn full protective gear while treating Duncan had contracted Ebola due to a yet unknown breach in protocol. On, October 15, another nurse who treated Duncan was confirmed to have the virus, showing symptoms just one day after boarding a commercial flight returning from Cleveland to Dallas.

    These events point to several issues in the U.S. public health infrastructure: who is in charge when high-stakes infectious diseases spread? How should the U.S. prevent diseases originating in other countries? What can we learn from this case to prevent other errors in the system?

    First, we need to decide who, or which agency, is in charge when a public health emergency occurs. Larry Copeland, a reporter at USA Todayagrees. Currently, the CDC provides assistance and guidelines to states and educates providers about how to prepare for Ebola. The choice to enact these protocols and successful operation of these procedures remains with the states. The CDC also issues guidelines to prohibit practitioners who have treated Ebola patients from boarding commercial flights. Separately, the Department of Homeland Security controls issues of air travel, including providing guidance to airlines and calling for symptom screenings at high-profile airports.

    So there is no single entity leading the public health response to Ebola. While the CDC may fall into this role, it is up to individual hospitals and practitioners to respond promptly and effectively. Unfortunately, in Texas, several errors – including sending the patient home while infected, delaying sanitation of the patient's apartment, and developing two more confirmed cases – showcase how disorganization in public health can lead to unfavorable outcomes.

    And how should the U.S. prevent diseases originating in other countries? Experts agree that closing borders of West African countries would worsen the crisis. Unfortunately, the issue of Ebola as it relates to air travel has become politicized by conservatives, prompting CDC Director Tom Frieden to speak out strongly against a travel banConservative Republicans have even attempted to relate Ebola to anti-immigration reform by claiming that migrants from Central America could bring Ebola through the southern U.S. border (despite the fact that no outbreak of Ebola has ever occurred in Latin America).

    In a press conference, Dr. Frieden assured that strong core public health functions could stop the spread of Ebola. Although the CDC and public health workers successfully tracked close contacts of Duncan and isolated those at high risk, those steps could not stop the first incorrect diagnosis or the spread to front-line health workers – arguably the most important role in stopping the epidemic.

    The implications of public health slipups cannot be understated. We need to start a conversation about the relationship between federal, state and local public health authorities. We need to simplify and communicate protocols to hospitals and ensure that providers and communities are enacting preparations for infectious diseases. Valuing the field of public health as much as we do individual appointment-based care is essential to stopping an epidemic. We need to organize authority and mobilize an informed and efficient workforce to improve the preparedness of the U.S. health system in responding to public health emergencies.

    Emily Cerciello is the Roosevelt Institute | Campus Network Senior Fellow for Health Care, and a senior at the University of North Carolina at Chapel Hill.

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  • Obama Administration Defends Amazon’s Low Pay – Again

    Oct 9, 2014Richard Kirsch

    It's hard for workers to trust the President's support for policies that help them when the administration sides with Amazon at the Supreme Court.

    Amazon’s business model is based on quick easy buying and low prices. One way it does that is to force its warehouse workers to wait a long time to leave work, without getting paid. And that’s just fine with the Obama administration, which continues to have a blind spot when it comes to decent pay and working conditions at Amazon.

    It's hard for workers to trust the President's support for policies that help them when the administration sides with Amazon at the Supreme Court.

    Amazon’s business model is based on quick easy buying and low prices. One way it does that is to force its warehouse workers to wait a long time to leave work, without getting paid. And that’s just fine with the Obama administration, which continues to have a blind spot when it comes to decent pay and working conditions at Amazon.

    Yesterday the Supreme Court heard a case (Integrity Staffing Solutions v. Busk) in which workers are suing the temp firm that staff’s Amazon warehouses. The workers are in court because they don’t get paid for the time they are forced to stand on line for a security check when they leave work to be sure they haven’t stolen anything. The security screening itself reveals the poor working conditions and lack of respect that Amazon has for its workers. Workers who are well paid and have job security will not take the risk of stealing. The lack of pay adds costly insult to their injury.

    The legal issues revolve around whether the security screenings, which can take 20 minutes or more, are “integral and indispensable” to the job, which would trigger pay under the Fair Labor Standards Act. Amazon certainly thinks so; the screenings aren’t optional. Still the firm, which pays warehouse workers around $11 or $12 an hour, cheaps out by denying the workers pay when they are waiting on line to leave.

    As Jesse Busk, the lead plaintiff in the case, told The Huffington Post, "You're just standing there, and everyone wants to get home. It was not comfortable. There could be hundreds of people waiting at the end of the shift."

    While President Obama has made numerous passionate speeches about giving Americans a raise, his administration is taking Amazon’s side at the Supreme Court, filing an amicus brief, alongside the U.S. Chamber of Commerce and other business lobbies.

    Unfortunately, there’s nothing new about this from the administration. Last August, as I wrote at the time, “President Obama gave a great speech on why good jobs are the foundation for his middle-out economic strategy... from a huge Amazon warehouse where the workers do not have good jobs.”

    The President told the Amazon warehouse workers who were in the audience, “we should be doing everything we can as a country to create more good jobs that pay good wages.”

    Everything, it turns out, except being sure they get paid for all the time they are required to be at work.

    The Obama administration may wonder why the President does not get more credit for the economic progress the nation has made coming out of the Great Recession or more recognition for his calls for raising the minimum wage. The core reason is that for too many Americans too low wages, too few hours at work, and job insecurity or no job at all remain their reality.

    The President’s defense of Amazon reveals another reason. Americans see that he is unwilling to take on the powerful forces that are driving down the living standards and hopes of American workers. They see his embrace of Amazon and Wal-Mart, where he gave a speech on energy earlier this year. And too many come to the conclusion that it is only campaign contributors that matter, despairing of finding leaders who understand what really is going on in their lives – and who are willing to take their side against the powerful.

    Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform.

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  • The Federal Reserve Won't Save the Economy for All

    Oct 9, 2014Joelle Gamble

    Deepening political participation in and beyond voting is key to achieving policies that raise outcomes for the working class.

    Deepening political participation in and beyond voting is key to achieving policies that raise outcomes for the working class.

    Inflation hawks have been the talk of the town in elite economic circles in recent weeks. More liberal-leaning minds critique their (frankly) unsubstantiated concerns that the Federal Reserve is driving the U.S. economy toward high levels of inflation. Hawks are concerned that high levels of inflation due to expansionary monetary policy will lead to negative economic outcomes for major firms and, in turn, the rest of the American public.

    Instead of worrying about inflation, which has remained at or below 1.5 percent for a year and a half, many prominent economists argue that we should focus on wage growth and jobs. We have seen profits for corporations rise to nearly pre-recession rates, while the poverty rate is not declining as fast as it should be. It’s clear there are some big policies that need changing: the minimum wage, the corporate tax structure, federal budget priorities, and regulations ranging across industries. So why is there so much focus on the Fed and the inflation hawks that circle it? Is there some policy lever we can pull here that would raise outcomes for the working class?

    Let’s lay it out on the table: Current economic debates have focused on U.S. and global monetary policy because our fiscal policy problems appear to be inoperable. A Congressional stagnation, of sorts, has led to a fixation on a different institution, the Federal Reserve. But, overall, can this fixation actually translate into outcomes for the middle class?

    With a gridlocked federal system, where can we push for substantial changes in wages and investment infrastructure that support the working class? Executive orders have their limits, of course. Advancements in cities like Seattle and New York City or states like Maryland have started to take effect. But at some point, a deeper, sustainable change must take place. This is a change in who leads in governance and who leads on policy change.

    Elections are our general go-to on these matters. If political representation fails, we can just vote them out! Elections matter, but, there are some facts to consider. Currently, the average U.S. voter has an income higher than the median. This is due to lack of access, as well as the privilege of being able to make time to vote. Thus, we should open up opportunities, such as early voting, to more people. But even still, with faith in government falling, access reforms only go so far.

    Beyond the act of voting itself, we have to question the responsiveness of the federal government, in particular, to voters. The growing influence of interest groups and coalitions of the wealthy make the ability to change political outcomes from the ballot box less and less secure.

    We need to grow the bench. Deepening political participation in and beyond voting is key to achieving policies that raise outcomes for the working class. It is not enough to vote; government must be responsive. As Roosevelt Institute Fellow Sabeel Rahman notes, historic movements of substantial political reform have popular sovereignty and grassroots movements at their core.

    Sabeel's words ring especially true in our current political climate. With congressional ineptitude and an unwillingness of the elites to take responsibility for the current state of our democracy, we must return to local movements and communities to build the foundations needed to create tangible economic change. That’s why members of the Campus Network are piloting the Rethinking Communities initiative. We recognize that democracy starts not in Washington but at home, in our own classrooms, our own cities, and our own communities.

    There is no silver bullet or hero in this fight for economic justice. Not one public official, nor one economist, nor one President will solve our mess. A return to democratic principles and a deepening of participatory process is what it will take to uplift the working class.

    Joelle Gamble is the National Director of the Roosevelt Institute | Campus Network.

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  • At NextGen IL Conference, Young People Set the Agenda for Their State

    Oct 7, 2014Julius Goldberg-LewisDominic RusselRachel Riemenschneider

    At the NextGen Illinois conference, Campus Network leaders found a policy space shaped entirely by young people.

    At the NextGen Illinois conference, Campus Network leaders found a policy space shaped entirely by young people.

    Last Saturday, the Midwest Regional Team of the Roosevelt Institute | Campus Network met in Chicago to attend the NextGen Illinois conference, the culmination of months of discussion, caucuses, and ideas from around Illinois. NextGen IL, an initiative led by the Campus Network and Young Invicibles, is working to bring young adults in Illinois together to shape a youth policy agenda for Illinois. What set NextGen apart from so many other conferences was that its content, agenda, and execution were a direct outcome of power and coalition building among Millennials. NextGen’s attendees included high school students, college students, and graduates; they were organizers, activists, and policy wonks of every kind. Throughout the day, attendees were able to vote on a slate of statewide policy proposals that were the product of the dozens of caucuses that took place over the previous few months. Young people had the opportunity to shape the outcome of the conference and take ownership of their ideas.

    One common theme that resounded through the day at the NextGen IL conference was that young people are capable of making a difference in their communities. We all have the knowledge, ability, and passion to make real change. This was thoroughly underscored by the number of young people and students that were panelists throughout the day. Each breakout session featured professionals working in the field, as well as Millennials already working to change the landscape. Whether discussing environmental policy or restorative justice, the young panelists were just as able to engage their audience in a variety of statewide policy issues.

    The breakout sessions gave the audience a picture of the issues being addressed on the front lines of the progressive political fight, but the plenary sessions gave us a chance to hear from the elected officials who have the power to turn our ideas into action. Will Guzzardi, a 27-year-old candidate for the Illinois House of Representatives, and Amara Enyia, a 31-year-old running for Mayor of Chicago, both spoke about how young people need to step up to make a difference. They both referenced a common realization many young adults have about growing up. When you’re young, you are told to defer to those in charge, trust your elders, and wait your turn. These candidates stressed that in order to be taken seriously and have our issues adequately addressed, our generation must step up and realize that while our parents and grandparents have a lot to teach us, they don’t have all the solutions. This realization may be scary, but it is also empowering: if no one actually has all the answers, young people have the opportunity to create just as much of an impact as older generations. We have the opportunity to think creatively, and see our age as a benefit, and not a burden to creating and realizing innovative policies that better our communities.

    If there was one message that we as participants and attendees took away from the NextGen IL conference, it was an echo of Franklin Delano Roosevelt’s 1936 address to the Democratic National Convention: “There is a mysterious cycle in human events. To some generations much is given. Of other generations much is expected. This generation of Americans has a rendezvous with destiny.” Our generation faces seemingly insurmountable problems, but if the NextGen space was any indication, we can expect bold solutions.

    Julius Goldberg-Lewis is the Midwestern Regional Coordinator for the Roosevelt Institute | Campus Network and a senior at the University of Michigan. Dominic Russel is the Midwestern Policy Coordinator and a sophomore at the University of Michigan. Rachel Riemenschneider is the Midwestern New Chapters Coordinator and a junior at Northwestern University.

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