The U.S. government, USAID, and the Departments of State and Defense are working closely together to take appropriate action. Due to the extensive damage, the country is unable to accommodate all the volunteers interested in helping at this time. The U.S. government has asked that all people and agencies interested in responding to the disaster wait until some on-the-ground organization can be accomplished.
However, for those interested in helping immediately, you can donate to the international fund of the Red Cross. Contribute online to the Red Cross, or donate $10 to be charged to your cell phone bill by texting HAITI to 90999. CNN has put together a list of organizaitons already operating in country. Since this list is not comprehensive, I would add two additional organizations already there - Operation Blessing and the UN High Commissioner for Refugees; I have personally worked with these groups - they are good people doing exceptionally good work.
While monetary donations are preferred, commodity contributions and volunteer support can also be of value. If you would like to volunteer your medical skills as a physician, you can register your skills and experience at the Center for International Disaster Information's registration page. "Volunteer Opportunities for Disaster Relief are Extremely Limited. Volunteers without prior disaster relief experience are generally not selected for relief assignments. Candidates with the greatest chance of being selected have fluency in the language of the disaster-stricken area, prior disaster relief experience, and expertise in technical fields such as medicine, communications logistics, water/sanitation engineering. In many cases, these professionals are already available in-country. Most agencies will require at least ten years of experience, as well as several years of experience working overseas. It is not unusual to request that volunteers make a commitment to spend at least three months working on a particular disaster. Most offers of another body to drive trucks, set up tents, and feed children are not accepted. Keep in mind that once a relief agency accepts a volunteer, they are responsible for the volunteer's well-being - i.e., food, shelter, health and security. Resources are strained during a disaster, and another person without the necessary technical skills and experience can often be a considerable burden to an ongoing relief effort."
The CIDI website gives these guidelines for those who wish to help:
"Monetary Contributions to Established Relief Agencies are Always the Most Useful Response to Disasters
Financial contributions allow professional relief organizations to purchase exactly what is most urgently needed by disaster victims and to pay for the transportation necessary to distribute those supplies. Unlike in-kind donations, cash donations entail no transportation cost. In addition, cash donations allow relief supplies to be purchased at locations as near to the disaster site as possible. Supplies, particularly food, can almost always be purchased locally - even in famine situations. This approach has the triple advantage of stimulating local economies (providing employment, generating cash flow), ensuring that supplies arrive as quickly as possible and reducing transport and storage costs. Cash contributions to established legitimate relief agencies are always considerably more beneficial than the donation of commodities.
Confirm There is a Need for All Items Being Collected
Do not make assumptions about the needs of disaster victims. Exactly what is needed can be confirmed by checking with an established relief organization that has personnel working on-site. Do not send what is not needed; unneeded commodities compete with priority relief items for transportation and storage. Organizations that receive in-kind relief donations can help this process by clearly communicating what items are required (in what size, type, etc.) as well as clearly stating what items or services are NOT needed. Please remember, certain foods, particularly in famine situations, can make victims ill. In most cases, donations of canned goods are not appropriate. The collection of bottled water is highly inefficient. It is important to have an accurate analysis of need before determining response.
Deliver Items Only to Organizations having Local Distribution Capacity
Distributing relief supplies requires personnel and financial resources within the affected country. To efficiently distribute relief commodities, staff, warehouses, trucks and communications equipment are required. It is not enough to gather supplies and send them to an affected region; a sound partnership with a reliable local agency having transport and management capacity is mandatory.
Donate Only to Organizations having the Ability to Transport Collected Items to the Affected Region
Immediately after a disaster, many local organizations will spontaneously begin collecting miscellaneous items for use in disaster relief. However, at the time that these collections are begun, agency officials will not have thought about to whom, or how, the items will be sent. It is not unusual for community and civic groups to have collected several thousands of pounds of relief supplies only to find that they do not know whom to send the supplies to and that they do not have viable transportation options for shipping the goods. At this juncture, it is often advisable for those collecting the goods to auction them off locally, converting commodities into cash to be applied to the relief effort.
Never Assume the U.S. Government or any Relief Agency Will Transport Unsolicited Relief Items Free of Charge
It is important to make arrangements for the transportation before collecting any kind of material donations. Never assume that the government or any relief agency will transport donations free of charge (or even for a fee). In the majority of cases, the collecting agency will be responsible for paying commercial rates for the transportation and warehousing of items gathered."
{Heavily adapted from AOA email concerning the Haitian situation.}
Friday, January 15, 2010
Monday, January 4, 2010
States AGs revolt as House and Senate Bills expand Medicaid
Expect more states to join the 13 AGs who threatened to sue if either health bill is enacted by Congress claiming certain Senators and Representatives were given sweetheart deals to get them passed.
Forty-three states are facing financial deficits given the down turn in the economy. According to a CNN report December 10, "As states attempt to get their budgets in line for the new fiscal year, ...budget constraints are causing 25 states to reduce services to their residences. So far 17 states have already made cuts or are considering cuts to programs that affect low-income children's and family's access to health insurance and health care services." In the last House vote of 2009, it passed the "Jobs for Main Street Act" by a 217-212 vote along party lines, which provided states with some funding mostly for current operations, including $53 Billion for extending benefits/health insurance subsidies for the unemployed and $23 Billion for Medicaid.
Given that Medicaid is a program jointly funded by federal and state governments and administered by the states, it is easy to see why states are financially unable to expand benefits programs. It seems Congress is out of touch with the reality of the severity of the economic crisis and continuing politics as usual, in these are anything but usual times. Unlike the federal government states cannot just print money. Despite claims to the contrary by our politicians, neither bill seriously does anything to bend the proverbial cost curve downward. However, as mentioned before in this blog, both do an extensive amount of cost-shifting.
No one wants to see anyone without healthcare, but it's time we take the politics and politicians out of it. The reason why became clear in talking with a friend who is an Indiana State Representative. He said, "So much of what we do with regard to legistlation is in response to some horrific hardship case we hear about. We feel compelled to right a wrong, and so we pass legistlation. But we don't take the time to look circumspectly at the issue to understand the potential unintended
consequences of what we pass."
It seems Congress is using the same rationale my friend described. Poorly, reasoned laws are worse than none at all. Let's be financially responsible and fair to all our citizens. Perhaps the States can succeed in getting Congress to appreciate we need to be writing good bills rather than paying people off to pass any bill.
Forty-three states are facing financial deficits given the down turn in the economy. According to a CNN report December 10, "As states attempt to get their budgets in line for the new fiscal year, ...budget constraints are causing 25 states to reduce services to their residences. So far 17 states have already made cuts or are considering cuts to programs that affect low-income children's and family's access to health insurance and health care services." In the last House vote of 2009, it passed the "Jobs for Main Street Act" by a 217-212 vote along party lines, which provided states with some funding mostly for current operations, including $53 Billion for extending benefits/health insurance subsidies for the unemployed and $23 Billion for Medicaid.
Given that Medicaid is a program jointly funded by federal and state governments and administered by the states, it is easy to see why states are financially unable to expand benefits programs. It seems Congress is out of touch with the reality of the severity of the economic crisis and continuing politics as usual, in these are anything but usual times. Unlike the federal government states cannot just print money. Despite claims to the contrary by our politicians, neither bill seriously does anything to bend the proverbial cost curve downward. However, as mentioned before in this blog, both do an extensive amount of cost-shifting.
No one wants to see anyone without healthcare, but it's time we take the politics and politicians out of it. The reason why became clear in talking with a friend who is an Indiana State Representative. He said, "So much of what we do with regard to legistlation is in response to some horrific hardship case we hear about. We feel compelled to right a wrong, and so we pass legistlation. But we don't take the time to look circumspectly at the issue to understand the potential unintended
consequences of what we pass."
It seems Congress is using the same rationale my friend described. Poorly, reasoned laws are worse than none at all. Let's be financially responsible and fair to all our citizens. Perhaps the States can succeed in getting Congress to appreciate we need to be writing good bills rather than paying people off to pass any bill.
Friday, January 1, 2010
Social Safety Nets with Growing Holes
After much hoopla, Congress finally began its Christmas vacation last week.
House or Senate plan, public or private, it really doesn't matter - what the politicians seem to have forgotten is that any plan must be underwritten correctly and with the appropriate safeguards or it won't be solvent. For some reason, beneficiaries tend to get upset there is no money to pay claims.
The CBO takes a snapshot in time approach to financial analysis. This static accounting approach does not account for the way human beings react in the real world, a fact they readily admit with multiple disclaimer footnotes in all their reports. Rather, what is needed is an underwriting analysis of the proposals. Underwriters try to predict the future given past behavior, human nature, changing market conditions and nature of the risk pool. The fact that accountants rather than underwriters are determining the feasibility of our social welfare programs may explain why Medicare, Medicaid and Social Security are projected to have a combined deficit of well over $100 Trillion into the future.
Underwriting isn't sexy enough for the politicians, which is no doubt why they ignore it entirely. Underwriting is risk assessment, and sometimes risk management; the very words convey dullness and boredom. No, it's much more exciting for Democrats to accuse Republicans of wanting you to die, and die quickly, and for Republicans to say that Democrats want to kill Granny. But where does this leave the American people? Don't we deserve better?
House or Senate plan, public or private, it really doesn't matter - what the politicians seem to have forgotten is that any plan must be underwritten correctly and with the appropriate safeguards or it won't be solvent. For some reason, beneficiaries tend to get upset there is no money to pay claims.
The CBO takes a snapshot in time approach to financial analysis. This static accounting approach does not account for the way human beings react in the real world, a fact they readily admit with multiple disclaimer footnotes in all their reports. Rather, what is needed is an underwriting analysis of the proposals. Underwriters try to predict the future given past behavior, human nature, changing market conditions and nature of the risk pool. The fact that accountants rather than underwriters are determining the feasibility of our social welfare programs may explain why Medicare, Medicaid and Social Security are projected to have a combined deficit of well over $100 Trillion into the future.
Underwriting isn't sexy enough for the politicians, which is no doubt why they ignore it entirely. Underwriting is risk assessment, and sometimes risk management; the very words convey dullness and boredom. No, it's much more exciting for Democrats to accuse Republicans of wanting you to die, and die quickly, and for Republicans to say that Democrats want to kill Granny. But where does this leave the American people? Don't we deserve better?
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