Flesh and Stone

The truth comes out about Gulf War Illness

2008-11-21T13:24:00-06:00

After an agonizing 17 years, the U.S. government will finally have to admit what veterans and their families have long known -- Gulf War Illness is a very real and debilitating condition that has affected one-quarter of soldiers who served in the 1990-91 war.

The Research Advisory Committee on Gulf War Veterans' Illnesses (RAC-GWVI) -- a committee of scientists and veterans appointed by Congress in 2002 to investigate the illnesses experienced by veterans of Operation Desert Storm -- presented its 450-page report to Secretary of Veterans Affairs James Peake on November 17.

The new report, which chronicles the ailments suffered by some 175,000 Gulf War veterans--including memory and concentration problems, persistent headaches, unexplained fatigue, widespread pain, respiratory symptoms, digestive problems and skin rashes -- contradicts previous reports, which denied that Gulf War Illness even existed.

Among those previous reports, a 2006 National Academy of Science's Institute of Medicine, claimed that the soldiers were simply suffering from stress disorders typical to any combat zone.

The Research Advisory Committee on Gulf War Veterans' Illnesses report is available on the Boston University School of Public Health web site.

As the RAC-GWVI report plainly states:

Gulf War illness fundamentally differs from trauma and stress-related syndromes described after other wars. Studies consistently indicate that Gulf War illness is not the result of combat or other stressors and that Gulf War veterans have lower rates of posttraumatic stress disorder than veterans of other wars.

According to the committee's scientific director Roberta White, veterans "have been plagued by ill health since their return 17 years ago. Although evidence for this health phenomenon is overwhelming, veterans repeatedly find that their complaints are met with cynicism and a 'blame the victim' mentality that attributes their health problems to mental illness or non-physical factors."

Lea Steele, who served as RAC-GWVI scientific director, told the Washington Post, "VA docs often know nothing about it and aren't able to help them. Sometimes, they treat them as if they are head cases or malingering."

As Anthony Hardie, national secretary for Veterans of Modern Warfare, told the Seattle Post-Intelligencer, "It really closes one of the darker chapters of the legacy of the Gulf War, and that is Gulf War illness."

Hardie, a 23-year-old sergeant during the war, now suffers from respiratory problems, fatigue and chronic pain. "The report clearly lays out that Gulf War illness was caused by unique exposures; it lays out clearly that Gulf war illness is not a stress-related or trauma condition, that it is not the same as in wars before or since. It is unique," he said.

The report cites two main causes of Gulf War Illness -- exposure to toxic chemicals, including pesticides that were used against sand flies and other pests, and pyridostigmine bromide, or PB, a drug administered to troops that was supposed to protect them from nerve gas.

At least half of all troops in the 1991 war took PB, a drug that was not approved by the Federal Drug Administration, but for which the FDA gave the Defense Department a waiver for informed consent. In other words, soldiers were being used as guinea pigs, and they had no way of knowing.

The committee also did not rule out some other causes of Gulf War Illness, including exposure to nerve agents and smoke from oil well fires, and receiving a large numbers of vaccines. Department of Defense reports show that about 100,000 U.S. troops may have been exposed to low-level nerve agents after the demolition of Iraqi munitions near Khamisiyah, Iraq, in 1991. Even being exposed to low levels of nerve gas can have lasting brain deficits.

The report cites a veteran who said:

I arrived in Theater on January 6, 1991...During official visits to strategic military cities, there were frequent SCUD attacks during which I heard chemical alarms sound. When I asked if these alarms meant chemicals had been detected, I was told that the chemical alarms had malfunctioned.
I became ill and was treated for nausea, headaches, vomiting, diarrhea and high temperature. Rashes I had over my body I thought were normal and expected since I spent most days in the sand, wind and sun, with all the attendant fleas, flies and desert parasites. Headaches I attributed to fatigue and lack of sleep. The symptoms...continued after I returned home and got progressively worse.

British Gulf War veterans are also seeing the effects. "Recognition of the full extent of the illnesses suffered by these veterans of the conflict and the obligation owed to them is long overdue," said David Craig, Marshal of the Royal Air Force and chief of the defense staff during the Gulf War. "They are victims of the war, as much as any one struck by a bullet or shell."

While the report did not link depleted uranium (DU) to the Gulf War Illness, the widespread effects of soldiers' exposure to DU are also a part of the report. Said one veteran:

I knew we were shooting DU rounds, but we were never told to stay away from vehicles that were hit by DU rounds. Now I know that we probably got DU dust all over us. But we didn't know any better, and we were dipping, smoking and eating without having washed our hands.
Right after the war, we saw lots of guys from other units climbing on the vehicles we had shot with DU rounds...In April 1991, while we were in Kuwait, I started getting diarrhea, nausea, stomach cramps, headaches, and tightness in my chest. My problems have gotten worse since then.

According to the RAC-GWVI report, Gulf War veterans developed amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's Disease) at twice the rate of nondeployed veterans. It also found that personnel stationed downwind from the Khamisiyah munitions demolitions have died from brain cancer at twice the rate of other Gulf War veterans.

The report showed that very few veterans have recovered from Gulf War Illness, and the researchers had no recommendations for treatment. This is hardly surprising, since the government has done everything it could to refuse to recognize that the condition even existed.

And even though millions of federal dollars have gone to supposed Gulf War research, little has changed for sick veterans of the war. "In recent years, both the Department of Defense and the Department of Veterans Affairs have reported a lot of studies that weren't Gulf War illness as Gulf War research," said the RAC-GWVI's Steele. "Some of the money was misused."

The Department of Defense (DOD) and the Department of Veterans Affairs claim they have spent nearly $440 million since 1994 on Gulf War research. But the RAC-GWVI found that the money was largely used to fund research that had nothing to do with Gulf War Illness.

A lot of the DOD money actually went to projects for soldiers currently deployed in Iraq and Afghanistan. According to the report, the department has cut funding for the Gulf War research from about $30 million a year in 2003 to less than $5 million in 2006.

This is hardly unique for the soldiers sent to fight U.S. wars. It took 20 years for the soldiers suffering from the effects of Agent Orange, the chemical defoliant used during the Vietnam War, to force the government to acknowledge their illness.

Now that the facts are finally exposed on the impact of Gulf War Illness, we have to press the federal government to spend the money necessary to find a treatment for the tens of thousand of veterans who are paying for the U.S.'s wars with their health.

Elizabeth Schulte is a correspondent for Socialist Worker, where this article first appeared.

The mind and cosmetics: What's your make-up telling you?

2008-11-17T21:13:00-06:00

Washington, DC – A “game face” conjures up the expression worn by an athlete geared up for spirited competition. A study presented Sun., Nov. 16, at the Society for Neuroscience annual meeting suggests young women use cosmetics as a similar tool when presenting their “social self.”

When neuroscientists asked this demographic group of the cosmetic-conscious to observe images of themselves and others with or without make-up, they found different areas of the brain were stimulated and some new insights into individual perception of “self.”

Ayako Onzo, PhD, a researcher with the Sony Computer Science Lab in Shinagawa-ku, Japan, and colleagues at the Tokyo Institute of Technology recruited 32 young women ages 20-35 who wore cosmetics on a daily basis to take part in the study. Their faces were photographed in their typical made-up faces and in their natural states. When the study volunteers observed hundreds of images of themselves and others in random order, researchers measured which areas of the brain were activated using magnetic resonance imaging (MRI).

When observing the images of themselves wearing makeup, regions of the amygdala, that part of the brain associated with the sense of self and body ownership, were stimulated. When the participants viewed images of others, there was no significant activation, whether or not the others wore make-up. “People are indifferent to others’ makeup,” concluded Onzo, “but it’s important for themselves.”

Apparently, make-up bolsters confidence in the wearers. “Some people can’t go out of the house without makeup,” observed Onzo. “If they put on makeup they have a greater sense of self and can be more active.”

That’s not to say that participants viewed images of themselves without make-up negatively. These images activated the dorsal striatum, a region associated with learning and reward, said Onzo.

Neural stem cells deficient in specific protein cause improper brain cell development

2008-11-11T15:51:00-06:00

Inactivating a specific gene in adult neural stem cells makes emerging nerve cells form inaccurate connections in the brain, according to a study published in today’s PLoS Biology.

The investigators believe the finding could have significant value for researchers working on neural tissue regeneration to treat brain injuries and neurological diseases. Fred H. Gage, PhD, professor in the Laboratory of Genetics at the Salk Institute in La Jolla, Calif., and colleagues found that the cdk5 protein is necessary for both correct development of dendrites (which can be compared to many branched and complex antennae), their neuron extensions, and the proper migration of cells bearing those antennae.

“The surprising element was that the dendrites of newborn granule cells in the adult hippocampus lacking cdk5 stretched in the wrong direction and actually formed synapses with the wrong cells,” according to Gage. Synapses are the contact points where dendrites receive input from the long processes, or axons, of neighboring neurons.

“Our data shows that cells that fail to find their ‘right spot’ might actually become integrated into the brain and possibly interfere with normal information processing,” said study author Sebastian Jessberger, MD, a former postdoc in Gage’s lab and now an assistant professor at the Swiss Federal Institute of Technology in Zurich, Switzerland.

Gage noted that the therapeutic targeting of new tissue, presumably derived from stem cells, to the brain or spinal cord may demand extreme accuracy. “Our findings reflect the need for therapeutic approaches that will assure that cells used in regenerative medicine are strategically placed so that they will make appropriate rather than promiscuous connections.”

In the study investigators first injected retroviruses into the adult mouse brain hippocampus (responsible for memory formation) to tag and knock out cdk5 activity in newborn granule cell neurons. Over time they observed that newborn neurons not only failed to move to their correct position in the brain but also developed mistargeted dendrites.

“We found that dendrites of cells lacking cdk5 seemed to integrate into the brain no matter what direction they grew in,” Jessberger said. “That they formed synaptic contact points was highly unanticipated. In fact, the inappropriate synaptic connections made by cdk5-deficient cells persisted for months after the treatment with cdk5-antagonizing retroviruses. One might have predicted that aberrant maturing nerve cells would get kicked out of the circuitry later on. Even after one year, some of those cells remained in the wrong part of the hippocampus.”

The study builds on previous work in which the Gage lab searched the whole genome for chromosomal hot spots associated with adult neurogenesis, and specifically a 2005 PNAS study that identified a large region of mouse chromosome 5 as an area of interest, and cdk5 was a gene embedded within that locus.

“The nice part of this story is that it emerged from a systems genetics approach,” says Gage. “It continues our effort to apply genetic analysis to find chromosomal regions harboring genes that may play a critical role in neurogenesis.”

The study was supported by the Swiss National Science Foundation and the Deutsche Forschungsgemeinschaft and grants from the National Institutes of Health, the Lookout Fund, the Christopher and Dana Reeve Foundation, the Picower Foundation, the James S. McDonnell Foundation, and the Damon Runyon Cancer Research Foundation.

Citation:

Cdk5 Regulates Accurate Maturation of Newborn Granule Cells in the Adult Hippocampus Jessberger S, Aigner S, Clemenson Jr. GD, Toni N, Lie DC, et al. PLoS Biology Vol. 6, No. 11, e272 doi:10.1371/journal.pbio.0060272

Society of Vertebrate Paleontology urges repeal of Louisiana ‘Creation Law’

2008-11-11T14:05:00-06:00

The Society of Vertebrate Paleontology (SVP), an international organization of 2,200 members, has urged Louisiana legislators to repeal the Louisiana Science Education Act, sometimes referred to as the creation law, and to “prohibit the injection of religious content in America’s public school classrooms.”

The SVP is one of numerous scientific organizations to publicly oppose the law, including the National Association of Biology Teachers, American Institute of Biological Sciences, and the American Association for the Advancement of Science.

The SVP states that the law was passed “under the guise of ‘academic freedom’” but that its real intention is to “garner support and legal protection for the introduction of religious, creationist concepts, including intelligent design, in public school science curricula. By permitting instructional materials that are not reviewed by the state’s science standards committees, the Louisiana Act and those like it encourage teachers and administrators to work outside these standards. This makes it possible for local school boards to define science and science education to suit their own agendas, thereby compromising the quality of science education for students, and allowing religious discrimination in America’s public school science classrooms.”

The group Americans United for Separation of Church and State has warned Louisiana officials that lawsuits will result if the law is used to introduce religion into public school classrooms. “Louisiana has a long and unfortunate history of trying to substitute dogma for science in public school classrooms," said AUSCS executive director Rev. Barry W. Lynn. “Let me state clearly and upfront that any attempts to use this law to sneak religion into public schools through the back door will not be tolerated.”

In 2005 a U.S. district judge ruled that a Dover, Penn., public school board had violated the Establishment Clause in the First Amendment (concerning the separation of church and state) when it voted to introduce intelligent design into science classes by requiring students to listen to a disclaimer critical of evolution. The lawsuit had been filed by AUSCS and the Pennsylvania ACLU on behalf of Dover parents.

People judged more on skin color than race according to new book

2008-11-09T10:45:00-06:00

At his first press conference as president-elect, Barack Obama self-deprecatingly referred to himself as a “mutt.” In March, when political opponents insinuated race into the presidential primary, Obama answered with a speech asking citizens to unite over critical issues instead of remaining divided over past history. He asked African-Americans not to be “victims of our past,” and that White Americans acknowledge “that what ails the African-American community does not just exist in the minds of black people; that the legacy of discrimination - and current incidents of discrimination, while less overt than in the past - are real and must be addressed.”

It was only four years ago that the U.S. Justice Department revealed blatant discrimination taking place at Cracker Barrel restaurants, including segregated seating and inferior service for patrons and poor treatment of employees based on race. It was only two years ago that a consent decree resolved a workplace race and sex discrimination lawsuit brought by the U.S. Equal Employment Opportunity Commission (EEOC) against Cracker Barrel.

But last week, Americans “breached a racial barrier,” as Frank Rich called it, by electing Obama the first African-American U.S. president.

Is that a clear signal that the nation has turned away from prejudice based on race? Not exactly, according to researchers who authored a new book, Racism in the 21st Century-An Empirical Analysis of Skin Color published by Springer.

Racism “is no longer an issue of black and white,” said Ronald Hall, co-author and editor of the book. Instead, it’s a matter of skin color. Hall and co-authors make the case that lighter-skinned blacks, Hispanics, Asians, Native Americans and other minorities tend to receive better treatment than darker-skinned counterparts in areas ranging from employment and education to housing, and other areas. Hall is associate professor of social work at Michigan State University and has studied skin color discrimination for 25 years.

“As we move further into the 21st century, with increased levels of interracial marriage, we won’t be able to make racial differentiations,” adds Hall. “You’re going to have people, for example, with Asian facial features, African hair texture, and Caucasian skin tones – and that’s unprecedented. But the way we’ll continue to assess one another, unfortunately, is going to be based on the manifestations of skin color.”

Joni Hersch, a co-author and Vanderbilt University professor, wrote that immigrant workers with lighter skin color make more money on average than those with darker complexions.

The book also states that complaints to the EEOC regarding skin-color based discrimination are increasing. In one recounted example, the EEOC successfully sued the owners of a Mexican restaurant in San Antonio, Texas, after the restaurant directed the white manager to hire only light-skinned staff to work in the dining room.

Can Obama’s presidency be the transition that will end both overt and subtle racism? All signs are that the son of a black man from Kenya and a white woman from Kansas will not shy away from long overdue action on racial injustice.

Nebraska safe haven law opens old wounds

2008-11-09T10:29:00-06:00

On Nov. 7, Nebraska’s Division of Children and Family Services announced that an 11-year-old girl was left at Bergan Mercy Hospital in Omaha through LB 157, Nebraska's "safe haven" law.

It was the twenty-first time a parent had used the law since it went into effect in July. As of last week 23 children had been left at Nebraska hospitals, including nine from one family. Parents have come from other states, including Iowa, Michigan and Georgia, to leave their children. Many of the drop-offs are teenagers. None are babies and just one is under age six.

Nebraska Governor Dave Heineman will call the legislature into special session Nov. 14 to “correct” the safe haven law, the governor said in a press statement. “A proposed three day safe haven law that the legislature has agreed to will be introduced by Speaker [Mike] Flood on my behalf. This law needs to be changed to focus on its original intent, which is to protect infants.”

It’s expected that Nebraska’s legislature will quickly revise the law by limiting it to covering newborns up to three days old. The public, fanned by media reports of deadbeat parents taking advantage of the law to rid themselves of difficult teens, has been in an uproar ever since the first adolescent child was dropped off.

But the question remains. If the intent of the law was to protect infants, why wasn’t it written that way? Nebraska was the last state to enact a safe haven law and its provisions extending safe haven to children from birth to age 18 was a major departure from other states. Why did Nebraska create its own model?

At least one citizen sees a nefarious reason behind the broader wording of the Nebraska law.

Judi Wheeldon, a Council Bluffs, Iowa parent and activist has protested the safe haven law, but not for the reasons you have read about.

Her passion for protesting the law on street corners, on MySpace, through outreach to reporters, and even on eBay, stems from her discovery of a 20-year-old pedophile scandal linked to top government officials that has never been fully resolved. Despite a county grand jury ruling that the ring was a hoax, one of its victims was awarded $1 million. The scandal rears its ugly head every couple of years, becoming more detailed and alarming in its details and web of connections, before fading back into the shadows.

In September Wheeldon stumbled upon the book, The Franklin Coverup: Child Abuse, Satanism, and Murder in Nebraska, by John DeCamp (originally published in 1996 with a second edition published in 2006) which details a massive pedophile ring based in Omaha. DeCamp is a former Republican Nebraska state senator and an attorney in the investigations and court cases of the above mentioned title.

Wheeldon was disturbed to realize she knew some of the victims whose stories are recounted in the book.

Wheeldon said she fears that children abandoned in Nebraska under the law could be intended targets of the pedophile ring which she and others believe may still exist 20 years after the state closed the book on the investigation. “I protested this law to protect the parents who have come to their wits end with their out of control children because I knew that if those parents realized what they were doing by putting their children in Nebraska's foster care system, that it was possible for those innocent children to become victim of a crime that not one politician or individual has been convicted of,” said Wheeldon.

According to Nebraska's Department of Health and Human Services, about 16 of the dropped off children are in state custody and receiving treatment in foster care and other residential settings.

When Nebraska revises its law on Nov. 14, it could also hasten the scandal back into the shadows.

DST: Falling back, springing forward is good and bad for our health

2008-11-01T20:25:00-05:00

Being a devout hater of Daylight Savings Time, I always knew it’s bad for one’s health and psyche, and a study by Swedish researchers proves it.

Daylight Savings Time turns our body clocks inside out and backwards.

According to the Associated Press, the findings, which are reported in the October 30 New England Journal of Medicine, Swedish scientists discovered the following after reviewing health records for the last 20 years: In the week after "spring forward," there was a 5 percent increase in heart attacks, with a 6 percent bump Monday and Wednesday and a 10 percent increase Tuesday.

In the week after "fall back," the number of heart attacks was about the same as in the previous and subsequent weeks, except for a 5 percent decrease Monday.

In my opinion, contrary to popular belief that DST is an energy saver verges on worldwide urban legend; Daylight Savings is NOT an energy saver.

If anything, it’s an energy waster.

Because the sun sets an hour later, it means we keep our energy-guzzling air-conditioners running an hour longer. Keeping the A/C on longer is certainly more energy-consuming that flipping on a few light switches.

Not only that, but the last two weeks of DST are depressing as hell. It’s dark for so long in the morning it puts a drag on the entire day while draining our own personal energy.

When I look at the clock and it says 7 a.m. and the sun is barely peeking over the horizon, it feels like something is terribly wrong.

Blame the charcoal industry for extending DST hours; it was their lobbying efforts that done this to us, because they wanted a little more daylight so they could sell more charcoal.

Who uses charcoal bar-b-ques anymore anyway? As for me, I find it a pain in the butt to make all those trips out back to cook what I can whip up just as well and far more easily in my kitchen.

Even with gas bar-b-ques, I rarely smell the tempting aroma of sizzling steaks wafting into my back yard, so I’m not sure how many people are still throwing shrimp or anything else on the barbie.

Sandy Sand is currently a guest columnist for the Los Angeles Daily News, and community correspondent and op-ed writer for ronkayela.com. More on this author.

Conflict of interest? Major report comparing McCain, Obama health plans authored by insurance company

2008-11-01T20:25:00-05:00

The Lewin Group has released the most optimistic assessment to date of John McCain’s health insurance reform plan—without disclosing the firm’s acquisition last summer by the largest health insurance company in America, UnitedHealth. Ingenix, the UH subsidiary that now owns Lewin, has been condemned by a lead investigator at the New York Attorney General's office as "a conduit for rigged data."

Lewin is a leading source of independent, nonpartisan health policy analysis for the U.S. government. Despite assurances given in June 2007, however, no corporate policy has been written to protect Lewin from interference by its parent companies.

October 27, 2008—A study comparing the Obama and McCain health insurance reform plans was released on October 8 by The Lewin Group, an influential health policy consulting firm and leading source of analysis for Congress and U.S. government agencies. The study rapidly became a mainstay of media campaign coverage, cited hundreds of times as a definitive source on the probable out-comes of each candidate’s plan.

The Lewin Group makes most of its money consulting for government agencies on health care policy. Seeking lucrative managed health care contracts with some of the same agencies, Value Health sold Lewin in 1996 to avoid conflicts of interest.

A decade later, Ingenix did exactly the opposite, acquiring Lewin during a strategic push to win new government contracts.

Ingenix’s name, not Lewin’s, is embedded in the study's PDF metadata—a mistake at the printer's, say company officials. But they refuse to name the print shop in question.

The Lewin study offers the most optimistic assessment to date of McCain’s proposal, estimating that it would result in health insurance coverage for an additional 21 million Americans (compared with 26.6 million under Obama’s plan) —more than twice the estimates of other independent analysts. The study is cited on the McCain ’08 website and in campaign literature.

Undisclosed in the study was Lewin’s acquisition last June by Ingenix, a subsidiary of
UnitedHealth Group—America’s largest health insurance company. UnitedHealth director Gail Wilensky is an unpaid McCain ’08 campaign health policy advisor. UnitedHealth founder, Chairman Richard Burke, is a long-time McCain campaign contributor.

“It didn’t occur to us that we might have to address this,” said Lewin senior executive Vice President Lisa Chimento about the firm’s failure to disclose its ownership by UnitedHealth when it released the Obama/McCain study. “In hindsight, maybe we should have.”

"We even mention Ingenix on our website," a Lewin Group official told epiNewswire. But a search of the Lewin website yielded no mention of Ingenix.
She added, however, that such a disclosure in the report may have been interpreted as
evidence of inappropriate influence by Ingenix or UnitedHealth on Lewin.

Given recent controversy over Ingenix’s business practices, she may have a point.
Investigators at the New York Attorney General’s office believe Ingenix manipulated medical billing software to under-reimburse doctors, sticking patients with higher bills. “Ingenix is nothing more than a conduit for rigged information," said chief investigator Linda Lacewell. Ingenix officials hotly contest that assessment and emphasize the integrity of their employees and company.

“I don’t see why you don’t let this go,” said Lewin senior marketing manager Gregory Butera on Friday. “There's absolutely no subterfuge here. We even mention Ingenix on our website.”

A search of Lewin’s public website Friday afternoon found no mention of Ingenix. Nor did the firm website’s archive of press releases for 2007 include any announcement of their acquisition by Ingenix.

Conflict of interest, or business plan?

Value Health owned Lewin in 1996, when they were competing for managed health care contracts at the Department of Defense (DoD) and other federal agencies. Lewin was consulting with several federal agencies on managed health and other health care policies, so in order to avoid any conflicts of interest, Value Health sold Lewin to another firm, Quintiles.

A decade later Ingenix did almost exactly the opposite—acquiring Lewin from Quintiles early in the company's strategic push to win government health care contracts. In 2006, without public fanfare, Ingenix launched a comprehensive 'public sectors initiative' to secure lucrative contracts with the DoD, U.S. Food and Drug Administration (FDA) and other government agencies. By May 2007, Ingenix officials were finalizing negotiations for their acquisition of Lewin.

The acquisition raised some questions in the trade press about Lewin’s continued ability to consult for firms that compete with UnitedHealth and Ingenix. But similar questions were not raised regarding the firm’s consulting for the same government agencies from which Ingenix sought government contracts. Most of Lewin's revenues come from government consulting.

Despite pledge, no firewall policy

When Ingenix purchased Lewin in June 2007, company officials pledged that Lewin would benefit from Ingenix’s data resources and “analytics and technologies.” Because the details of the acquisition were never made public, it is unclear exactly what that meant.

Less ambiguously, Ingenix also announced that Lewin’s editorial independence would be honored. But more than a year later, no formal “firewall” policy exists to protect the consultancy from interference by its new owners, Lewin officials confirmed.

“Nothing’s written—there are no legal documents,” said Chimento. “They did issue a press release when [Lewin was] purchased, that said we’d have editorial independence—and that has never been breached,” she said.

“That’s not good enough,” said Jim Balassone of the Markkula Center for Applied Ethics at Santa Clara University. An informal pledge that UnitedHealth and Ingenix will respect Lewin’s editorial independence “doesn’t measure up to industry ethical standards,” he said.

Other independent health policy analysts expressed dismay that there is not a written policy protecting Lewin’s independence. “That’s surprising, but there you go,” said one leading academic health policy analyst. “With all the controversy around Ingenix, who knows what to expect anymore.”

“When they say, ‘we have a firewall but it’s not written down,’ I become more suspicious,” said Balassone. “Good intentions are not enough. There must be formal policies—not just rumors of policies—ensuring independence and transparency. Lewin should have a written and public policy related to this potential conflict of interest and include it in reports and publications.”

No formal firewall policies exist to protect Lewin's independence. Indeed, Ingenix is recruiting—and paying—analysts to work at Lewin.

“The ownership ought to be disclosed in every report and press release,” agreed Merrill Goozner, director of Integrity in Science, an industry watchdog group. “They need internal controls and explicit, written policies.”

“The policy should include a help line for Lewin employees to report any pressure to ‘bend’ the policy,” Balassone added.

‘Autonomy is too strong a word’

Four months after acquiring Lewin, UnitedHealth was recruiting analysts familiar with the DoD and VA health systems to work at Lewin.

Chimento admitted that “autonomy is too strong a word” for Lewin’s relationship with Ingenix and UnitedHealth. “We are owned by them,” she said.

It is difficult to gage where the boundary exists between Lewin’s operations and those of Ingenix. UnitedHealth and Ingenix are recruiting and paying analysts who work at Lewin, confirmed Lewin senior marketing manager Gregory Butera on Friday. UnitedHealth subsidiaries frequently integrate operations and share software and expertise. In Ingenix company literature Lewin is described not as an independently run company but as an Ingenix “market-facing brand.”

Lewin executives make all final hiring decisions, Butera and Chimento emphasized. But asked who pays the salaries of Lewin analysts, Butera said, “We’re all employees of UnitedHealth and Lewin.”

Asked whether it would be accurate to state that UnitedHealth and Ingenix recruit and pay Lewin analysts, Butera said, “Yes.”

Butera and other Lewin officials insist that Ingenix and UnitedHealth were not involved in any aspect of the production or editing of the Obama/McCain study. “They didn’t even see it until its release,” said Lewin spokeswoman Pat McMurray. Chimento said Ingenix did receive a copy of the study before it was released but that “It wasn’t edited after that.”

However, it is Ingenix’s name—not Lewin’s—that is embedded as metadata in the PDF version of the Obama/McCain study. The document’s title field reads “Microsoft Word - 92035-ingenix-pcr-cx2.DOC.”

The PDF document’s author field reads “wmills.” There is no Lewin employee named Mills, epiNewswire confirmed.

A day after repeated requests for an explanation for Ingenix’s name appearing in the study’s title field, Chimento said by email that Lewin’s study had been printed by an outside print shop that is an authorized Ingenix vendor. She said that W. Mills is an employee at the print shop in question and that it was this individual who included “Ingenix” in the PDF’s title field, as part of a print work order code.

Chimento did not respond to requests for the name of the print shop. Butera repeatedly refused to disclose the name or location of the print shop.

“I don’t think it’s necessary to name our vendor,” he said. “We’ve stated several times that there was no Ingenix involvement in the study. There is no ethical issue here.”

Asked whether the print shop was in Falls Church, VA, where Lewin is based, or in Reston, VA, or Eden Prairie, MN, where Ingenix offices are located, Butera did not answer the question, saying instead only, “There is no W. Mills in Eden Prairie.”

“They’re still obfuscating,” commented Balassone Friday evening. “There’s just not transparency here.”

Asked Friday whether Lewin would now press Ingenix for a formal policy protecting its independence, Butera said, “I am not able to answer that.”

Bryant Furlow covers the health care industry, public health policy, and international trade and security issues. He is contributing editor at epi Newswire and can be reached bryant at epinews dot com.

Related:

Special Report: National Financial crisis threatens US health reform Bryant Furlow in The Lancet Oncology, Published online October 22, 2008

The Journalist and the Buddha

2008-10-31T12:50:00-05:00

Perhaps unfairly, I tend to fault the mainstream media in America for contributing to the many problems facing not only my nation, but nations far away -- in the Middle East, Africa, and Central and South America. When journalists "parrot" the sitting government and promote its agendas without question, they are not living up to their highest potential as public advocates, as watch dogs, purveyors of truth and noble public servants.

Still, there are some journalists that continue to reach for high journalistic standards, including the elusive objectivity and compassion. Doug McGill, a former New York Times and Bloomberg reporter who returned to his native Minnesota after a successful career at the top of mainstream journalism to practice "glocal" journalism, meaning local journalism that ties the local community to global affairs, is one of them. A proud citizen journalist, McGill has trained novices as well as experienced journalists to be "glocal" in their writing.

Last fall McGill wrote:

The stranger who has made the deepest impact on me as a journalist and as a person – from whom I’ve learned the most – is both among the most exotic people I've ever met, and the most dead.

He is Siddhartha Guatama, a prince-turned-monk who lived in northern India in the 6th century B.C. He is known to history as the Buddha, the formal name he took after experiencing a tranquility of the soul so deep he felt compelled to spend his life teaching it to others.

This particular stranger has struck me as so wise -- his life experiences and his teaching so profound and so relevant to our times -- that I’ve decided to spend a little more time as a journalist with him. I want to learn more, and to share more of what I am learning from this stranger.

Starting today, alternating with my regular Global Minnesota columns, I’ll begin publishing a series of reports of my encounters with the Buddha at The Journalist and the Buddha.

McGill lived up to his word and publishes frequently on the topic of Buddhism and journalism. He has been joined by others. He encourages journalists to meditate to gain transformative insight and clarity. Being fully in the present helps journalists give readers "accurate and useful reports on the present conditions of public life," says McGill.

Stepping out in public (he’s given lectures at prominent institutions on the benefits of meditating and publishes widely on how Buddhism has affected his writing and worldview) has gained McGill a reputation. Not everyone admires his work. Some have even taken to attacking him for his views, denigrating him as a "lackey," a "preacher" and accusing him of holding journalists to "unreasonable standards."

Such is the life of a trail blazer.

Whether or not you are a journalist, some of McGill's suggestions may apply to your own profession, or speak to your own search for meaning and purpose. McGill is a wise and entertaining writer and teacher and gives much to his profession and the communities in which he lives.

The Buddha, the Dharma and the Media February 20, 2008

Why Journalists Should Meditate October 02, 2007

The Monks of Burma September 26, 2007

For more articles, visit The Journalist and the Buddha.

Math + politics = art

2008-10-29T22:15:00-05:00

Less than a week before the election and if someone sends one more political ad I’m inclined to hit delete. But this one was forwarded by someone who never sends junk so I was intrigued and clicked the link.

“Thinking Man,” a video ad making the rounds on YouTube and other sites is not your typical low-grade propaganda. This is a short (2 min., 29 sec.) film, with no stone left unturned in attending to detail. Mathematics experts with Hollywood Math and Science Film Consulting (a group that reviews scripts for authenticity and accuracy for TV and films) lent their expertise. Thinking Man incorporates symbolism reminiscent of Russian classical film, a Rachmaninov score, and numerous scenes and lighting changes to create mood.

R. Larkin Clarke, an attorney in Washington, DC, produced the ad from start to finish. The music is Sergi Rachmaninov’s Concerto #3, played by Vladimir Ashkenazy.

Watch it here and then read Clarke’s thoughts behind Thinking Man.

How and why did you choose that music and those particular scenes?

One day, my friend Shaun [Dr. Shaun Harris, a specialist in organizational development who plays the Thinking Man], while listening to his musical collection, called me and suggested I take a listen to Rachmaninov #3. The 20+ minute piece creates a mood, which sparked creativity.

Will you walk us through the scenes?

It opens with a dream. I attempted to create an old Soviet sterile intellectual warehouse feel with the locked file cabinets framing the shot. The Laundromat was used because of the geometric circles of the washers, and the fact that the color scheme of the Laundromat was the same as the old USSR flag.

When he starts to think about the idea he is framed by the Soviet colors, unknowingly living in a world that might be beginning to approach that under Bush.

As he begins work on realizing the answer to the theorem, the musical mood is festive, and he is seen out during the day. As he becomes more obsessed with solving the theorem, he changes, and is only seen out at night. He is lonely and focused on solving it and nothing else.

When the Thinking Man is walking down the street on his way to the diner, the cop car that passes behind him is almost Orwellian in that Thinking Man is obtaining clarity as he works on the theorem and is moving away from the police state/thought police. Are the police looking for him because through his math he is starting to see things for what they really are?

The shot of him leaving the diner walking down the street is actually a reflection from a car side view mirror. All the mirrors: bathroom mirror with writing, car reflection, him sitting on a bed staring at the mirror in a room and then him writing on the mirror are all symbolic of Thinking Man looking within himself to "be the change you want to see in the world,” which is a quote from Gandhi.

When he solves the theorem he steps back and drops the chalk, and in the time it takes for the chalk to drop, images of Katrina, war, Rumsfeld, McCain, Bush, unemployment and other problems with the Bush Administration quickly pass through his mind.

The last shot circles back to the Laundromat and the word "change" on the wall. This is what Thinking Man subconsciously saw in the opening when he was in the Laundromat walking toward the machine.