Saturday, June 30, 2012
The present heat wave has brought wild weather in large parts of the nation. There are 3 million customers without electricity in Ohio, West Virginia, Virginia , DC area and Maryland.
Both my daughter in Roanoke Va. and my Granddaughter in Thornville,Ohio are sans current and expect no relief until after the 4th.
9AM: I learned that my daughter in Arlington Va. (DC area) had no electricity and neither cell phone or land line services for 24 hours. That is pure isolation.
Meanwhile, as an antidote from the present Heat Wave; some pictures from the winter of 2010 and fall 2011.
(3) 2[If in the office of purchasing agent a vacancy occurs in a position formerly held by a qualified purchasing agent,] Following the appointment of a qualified purchasing agent as the purchasing agent for a contracting unit pursuant to subsection a. of this section, and if the person appointed no longer performs such duties,2 the governing body or chief executive officer, as appropriate to the form of government, may appoint, for a period not to exceed one year commencing from the date of the vacancy, a person who does not possess a qualified purchasing agent certificate to serve as a temporary purchasing agent. Any person so appointed may, with the approval of the director, be reappointed as a temporary purchasing agent for 2a maximum of2 one additional year following the end of the first temporary appointment. No contracting unit
shall employ a temporary purchasing agent for more than two consecutive years.
Thursday the Supreme Court by its rulings upheld two of three provisions of the ACA that had been the subject of legal challenges.
What that will mean in the future of Health Care is yet to be determine. In the mean time there are several aspects to this action; the first is the legal implications of the Courts rulings; the second is the future of the nature of health care which I hope to opine about next week.
One must first realize that Thursday was not a vindication of “Obama Care”. The one act that was rejected will impact on the scope of care to those who live within the level of income limits eligible for Medicaid. That can vary in various states.
The court turned down the Government’s provision for States receiving increased funding they must expand to certain levels their Medicaid programs. The present law which allocates to each state fund that the state must supplement to provide services; permits States to have the ability to determine within definite parameters what services and who will be covered by Medicaid
The Court found the new law to be coercive since it had universal mandates that had to be followed or the state would lose its present funding. Therefore it was unconstitutional.
The problem with that ruling is that there are several programs they give states funds and include a prescribed usage of those dollars. Many are in the educational field a May now become open to legal challenge.
In upholding the mandatory insurance act, Roberts’ majority opinion in essence rewrote the law by declaring it constitutional under Congress’s tax powers. But not under its Commerce powers.
Roherts said that the law does not truly impose such a mandate on Americans. It simply requires those who do not have health insurance to pay a tax penalty. That tax requirement, he said, passes constitutional muster.
"The federal government does not have the power to order people to buy health insurance," he wrote. "The federal government does have the power to impose a tax on those without health insurance."
Justice Ginsburg while voting to uphold the mandatory provision disagreed that it was covered under the Taxation powers but was constitutional under the Commerce provisions. She was alone in that position.
The Court has entered a dangerous area of the Nine Justices usurping Congress’s Constitutional prerogative of writing laws through use of novel interpretations instead of just judging their constitutionality.
The example here was stating that the Mandatory Insurance act would be unconstitutional if held to the Congressional powers relating to Commerce which was the rational under which the act was conceived. Instead the Court declared its Constitutionality was valid under the Federal Taxation powers.
What has been gained is the ability of all to have affordable health insurance. I am sure that present premiums will rise because the insurance carriers will spread increased risks over the entire buyers base.
Perhaps the end may justify the means. However this may prove to be a truly Pyrrhic Victory in which the Republicans will have ammunition to prove that the Democrats are committed to raise taxes; always a bad idea in an election year.
Friday, June 29, 2012
Last night's Special Council Meeting with the exception of two other r4esolutions was devoted to the annual liquor license reissue from July 1 for the year.
This meeting gives Bill Reid the opportunity for his yearly protest about the excessive number of licenses in Plainfield especially the inactive ones or pocket licenses. He knows that the Council can not do anything about eliminating them or even non renewal per ABC regulations. He continued his statement with no votes on every non contested application; knowing it would not impact on the results.
Perhaps if the ABC would issue a regulation limiting the number of consecutive years a license can be dormant that would solve many problems. However since these licenses have monetary value that may never happen.
The Council voted not to renew the license for the "Latin Bar" after a Police Department recommendation for such action. This ws due to the fact that there were 26 Police calls there in 2011;11 summons issued to to various violations or incidents; 4 pending administrative violations (ABC). The manager has been uncooperative and even alluded to as antagonistic.
Other licenses not renewed for failure to r4eceive the needed 4 yes votes included;Pueblo Viejo, Chez Maree.
All non renewals can apply to the ABC for a 30 day temporary license while the ABC reviews the reason for the non renewal. In the past the ultimately has been an ABC instruction for renewal.
Four establishments had their request tabled pending correction of coded violations most from the Fire Department.
The one other resolution of importance had to do with rejecting the bids for I believe package 3 of the 4 road reconstruction pac kages for 2012. The problem wa sa technical one since one of the bids was opened with those in another group about 2 hours before the advertized time. There will be a resolution in July requesting new bids.
One of the excuses for the error was the vacancy in the Purchasing Officer's position. Council President Mapp read a communication from City Administrator Berry announcing the temp[orary appointment of Special Corporation Counsel Lucas Phillips to that position. I trust he has the qualifications required by law.
11:06 AM (19 hours ago)
Like every year I spent one week in Normandy in June . This week is sacred for me . It's not really the time to think about WW2 veterans because it's every day . But It's special because you walk where so many heroes gave their lifes for our liberty . Like every year my first stop was at Daint Mère Eglise Church for a prayer to all my US friends .
I took 2.000 photos but I can't put all ... You will find here around 180 photos , my favorites ... Hope you will enjoy it .
God Bless America
Thursday, June 28, 2012
Well maybe it did or didn't. At this point it is difficult to understand exactly the ruling. The rhetoric by the media pundit after the decision was mostly a matter of shooting from the hip as they read the opinion.
What it seems is that the Court's decision on the mandated portion of the act was not based on the constitutionality of Congress to write such a law based on the Commerce provisions of the Constitution but since it called for penalties to be paid on the Income Tax return it was based on the Governments rights of taxation. Boy, this is going to be the focus of the Presidential election verbiage.
The Court seems to have wiffed on the other issue that the states were suing to overthrow; the mandatory increases in Medicaid benefits. Since some of that would be covered by increased federal funding; the Court gave the states the option to not accept the grants and therefore did not need to change their present Medicaid operation.
I would take that to be a partial rejection of that section; the goal prescribed remains but states now have an out from conforming.
I hope to be able to scan Chief Justice Robert's opinion and I expect that there will be more than one dissent opinion to read before I can formulate soome non lawyer understanding of what was today's ruling.
No serious blog today while we wait for the Supreme Court’s action on the Health Care Laws.
Those of you who know me have learned that I have never found a microphone I did not like. Thus I am not reticent to tell stories about myself.
In the early 80s, while President of the Hospital Medical Staff. I was one of the eight organizing members of the “Medical Society of N.J.’s, AMA Hospital Medical Staff Section”. As a member of its Governing Council and a delegate from our hospital, I would attend HMSS sessions at the semiannual AMA meetings. Several of us would routinely stay a few extra days in order to include the AMA Delegates Reference Committee meetings.
I would always attend the committee that was hearing proposed resolutions related to AIDS. Since the floor was open to all AMA members, I would advocate a more aggressive position then the AMA wanted to take. In fact the AMA was treating it a political and civil rights question from which it wished to disassociate itself.
I argued unsuccessfully that testing for AIDS was important; that it was not a matter of privacy or civil rights but public health. Also that there was the precedent of teh mandatory premarital serology testing for syphilis before it became a curable disease. I knew that we were faced with an epidemic and should not procrastinate.
Once when a prominent pathologist from California said it was not cost effective to test, I went to the microphone and after giving my affiliation, Muhlenberg Hospital, Plainfield N.J. I started my comments with “We who live between the gay white way and the City of Brotherly Love are seeing a rapid increase in cases”. I had not continued more than a few words, when a ripple of laughter began in the back and soon engulfed the room.
At another Reference Committee meeting there was a hearing on a resolution limiting the practice of the drug manufactures to give grants or gifts to physicians. Many of the speakers were opposing such a resolution especially those in academia who were afraid that this would stop there research grants.
This was not the target of the proposed resolution; rather it was the practice of the drug companies to reward those with large practices who were known to prescribe their drugs with dinners or day trips to some desirable site, or even “vacations” in the guise of educational courses. Of course spouses or significant others were included.
Post graduate education was becoming a requirement at that time and so many hours were needed. The companies would give a “course” part of the day on a subject that was related to a treatment they were pushing. There was always time for golf and or the beach.
I spoke for the resolution by alluding to the airlines frequent flyer programs as similar to the manufacture’s “rewards as “Frequent Prescriber Points”. My comments were quoted in the AMA news paper.
Wednesday, June 27, 2012
The other was of great interest to me since it concerned my alma mater; University of Virginia: About three weeks ago the Board of Visitors (Governors) appointed by the Governor since it is a State University abruptly and without explanation "fired" the University President who had only be in office a little over two years.
There was an immediate unanimous expression of outrage from the faculty as well as from the student body as well as the alumni. That included emails from Faculty leaders to alumni as well as from former members of the Board of Visitors condemning the lack of openness and the following of Due Process before the Board had taken its action. There was a belated email and press release from the University Rector (the Chairperson of the Board of Visitors) leading to the Boards action explaining her reasoning .
As the public expression of disapproval increased, the Governor threatend to remove the Board if it did not come up with a definitive action with explanation by this Thursday.
The result, last night ,Tuesday, the Board of Visitors met and unanimously rescinded its action restoring President Sullivan into her office. It is noteworthy that in the interim the Vice Rector and another member of the Board had resigned.
Despite the fact that the 4th Ward Town Hall Council meeting Tuesday the 26th did not merit any mention on the City Site this appeared Tuesday.
UNION COUNTY SUPERIOR COURT SAYS PLAINFIELD CITY COUNCIL VIOLATED MAYOR’S RIGHTS
PLAINFIELD - On May 25, 2012, Union County Superior Court Judge, Karen M. Cassidy, A.J.S.C., ruled in favor of Mayor Sharon Robinson-Briggs and denied the Plainfield City Council’s Motion to Dismiss Mayor Robinson-Briggs’ lawsuit.“I am pleased that The Honorable Judge Cassidy recognized the fact that the City Council violated my rights. I hope in the future, the City Council will afford me the opportunity to be heard on matters of public importance,” said Mayor Sharon Robinson-Briggs. ( link to this press release)
June 25, 2012
For Immediate Release
UNION COUNTY SUPERIOR COURT SAYS PLAINFIELD CITY COUNCIL VIOLATED MAYOR’S RIGHTS
PLAINFIELD - On May 25, 2012, Union County Superior Court Judge, Karen M. Cassidy, A.J.S.C., ruled in favor of Mayor Sharon Robinson-Briggs and denied the Plainfield City Council’s Motion to Dismiss Mayor Robinson-Briggs’ lawsuit.
“I am pleased that The Honorable Judge Cassidy recognized the fact that the City Council violated my rights. I hope in the future, the City Council will afford me the opportunity to be heard on matters of public importance,” said Mayor Sharon Robinson-Briggs.
In denying the Motion, Judge Cassidy ruled that the imposition of the $200.00 fine was a violation of the Mayor’s right to Due Process under the law.
Mayor Robinson-Briggs added, “The governing body took my good intentions and used them for their political gain.”
Robinson-Briggs added, “The Union County Prosecutors Office found nothing criminal in my effort to establish a gang truce that ultimately saved lives.”
I fault the Administration for using the municipal information Internet site for its own propaganda use.
I will hope that the Council will post the Judge's ruling since I am not sure that which has been posted has not been taken out of context and the decision was not entirely something else. My blog is open.
Another question; Although when the budget was passed I did not remember any funding for a Public Information position. There was additional funding for IT for needed part time specialists.
"Media" was given its own lines in the budget and I thought that would be for the video and cable purposes. I did not think there was enough funding for filling a vacant position. Obviously I must be in error, although I hate to admit that.
The heading on the press release reads:
CITY OF PLAINFIELD
PUBLIC INFORMATION OFFICER
DIVISION OF INFORMATION TECHNOLOGY MEDIA & COMMUNICATIONS
Where in the TO is this Division?
Addendum 9:30: Check this link Mayor Misuses City Resources Once Again to read Councilor Williams' take on the press release.
I regret that I had other commitments and did not attend last night's Town Hall Meeting.
Tuesday, June 26, 2012
A reader asked why I had not opined on immigration.
I did reply that I had, but since as of Jun. 25,12 I have made 2323 postings in this blog since Feb. 2008 that even though I can isolate most that mentioned immigrants it would be too time consuming to review all.
Likewise over the years I have posted many times on the subject of Health Care. This included a review in 2008-9 of the systems in many other countries.
In June 2009 I made at least 3 posts on the subject; one was on June 19 “HEALTH CARE #1 If the link works try it. The sidebar should list others that month.
On Feb. 19 this year I ended a post as follows: “health care has become a business and must be treated as one.” That is the difference between the practice of medicine in the Golden Age of the 60s and today.
I will wait until after the Supreme Court releases its decision on Thursday and perhaps have time to absorb the various Justice’s opinions. There will without doubt be more than one affirmative and dissenting opinion on this monumental act.
Monday, June 25, 2012
You will note that there is a difference in type size in parts of this blog which I cannot explain. I write it in Word 7 using Veranda 14.
When I copy it to post in the blog the "article" is all the one font and one size, yet when posted there is the variations you see. Who has a good explanation?
In New Jersey if you get arrested for a DUI, you must take a Breathalyzer test. When you get your license in New Jersey, you give consent for this test, known as "implied consent." If you refuse to take a Breathalyzer test, you will be detained and brought to a hospital where hospital staff may draw blood. Without that "implied consent" the procedure of having blood drawn at the hospital would be a violation of the 5th Amendment;" nor shall be compelled to be a witness against himself".
If you refuse a Breathalyzer test, you will face the same loss of driving privileges as a DUI offense. But, I am not sure what the charge is. Unless there is obvious impairment DUI can not be proven.
I have no knowledge how the decision about impaired judgment and/or function at certain blood levels were established. Whether the 0.08 level represented a mean above which all individuals exhibited symptoms or it picked as the upper limit of normalcy because no one exhibited difficulty at that level.
However the American Medical Association says that a person can become impaired when the blood alcohol level hits 0.05
For many years, the legal standard for drunkenness across the United States was 0.10, but many states have now adopted the 0.08 standard. The federal government has pushed states to lower the legal limit. If a person's BAC measures 0.08, it means that there are 0.08 grams of alcohol per 100 ml of blood.
Research indicates that breath tests can vary at least 15% from actual blood alcohol concentration. An estimated 23% of individuals tested will have a BAC reading higher than their true BAC. Police in Victoria, Australia, use breathalyzers that give a recognized 20% tolerance on readings. Noel Ashby, former Victoria Police Assistant Commissioner (Traffic & Transport), claims that this tolerance is to allow for different body types.
None the less; the law is definitive and does not provide for cognitive and motor testing for those that just are above the 0.08 level although there may be some abnormalities in the actual level.
The Chief, if there cannot be proven to be any improprieties in the testing, and ambient temperatures have been known to affect readings as well as the training of the test administrator, is guilty by the law. It is sad but it matters not if the reading is 0.09 or 0.16.
The other question that cannot be answered is; was the Chief a subject of profiling? At 1 am it would be hard to determine by a patrolman if the driver of a car was a young adult or an older black woman; groups that surrounding forces are notorious for stopping for various moving vehicle offenses.
As I wrote before the fact that at an early morning hour if there was no traffic at a green light in the left turn lane and no cars being passed on the right the driving through on the left turn lane was just nit-picking
Since there was plenty of time between New York Ave and New Market Road for the officer to stop the violating vehicle, that action must have precipitated the stop.
NOTE: In these two blogs I do not intend to judge or condemn Chief Tidwell; I consider him to be a most competent sincere professional and an invaluable asset to the community. I only wish that I could feel the same about others in various levels of authority and responsibility of all segments of our city governance.
I urge all not to adjudge him until all facts are known, and consider if it could under some possible not propable circumstance be you.
Saturday, June 23, 2012
None the less the news Friday of Fire Chief's Tidwell being stopped for DUI in South Plainfield early Wednesday morning about 1am can not escape comment.
Like everyone else, my knowledge of the circumstances is only 3rd person from reading the Courier. My first impression was that he was just plain unlucky. The breath analyzer gave a reading of 0.09 when 0.08 is the legal upper limit for operating a vehicle.
That is just like a running backs heel hitting the edge of the sideline chalk briefly while running 80 yards for a touchdown, only to have the ball placed back on the 10yard line.
Don't misunderstand; the law is the law and 0.9 means legally under the influence.That is a statistical level set to provide a legal guide line.
However there are many whose metabolism makes them more susceptible than others. Someone whose reading would be 0.07 may have less control of his operational facilities than one with the 0.09 reading.
If at 1 am in the morning with no oncoming traffic one might be tempted to ride in the middle of the street or even be close to the double line that it would be easy to stray over. In Tidwell's case what is not noted is how great was the distance between the two violations that suggested lack of control of the car.
South Plainfield Lt. Kevin Murtagh said in a statement."The vehicle then traveled straight in a marked left-turn lane" near New Market Avenue.”
I wonder under the same circumstances with no cars on the road at an intersection where there is a left turn lane at 1 am how many of us have not moved into the through lane?
Yes the Chief was unlucky to have caught the attention of a vigilant Police Officer, but if the Breath Analyzer was accurate and the test administered properly that even though the result was only 0.01% over the limit, by law the charge of DUI must stand.
Ahead are two interesting actions. The first is of course the legal process; the second is how the City handles the possible violation.
Thursday, June 21, 2012
As a relief from the turmoil of Plainfield politics and the heat wave, I have decided to recall some vignettes from my years of medical practice starting in 1946.
First, to set the stage; I had taken over my Fathers practice which he started in 1911 and was using his office and home.
The self-contained medical building or offices are a post war innovation. As was common in those days, the office occupied a portion of our house, on the corner of Fourth and Grant. A porch had been enclosed and was the waiting room. A new entrance had been built on 4th St. and there was a small entryway between the waiting room and the consultation room, which you entered from the upper left. A door at the far end of this room led to a hall, which was closed off, from the living quarters by two doors. You turned right down the short hall and entered the examination room, which had formerly been a kitchen. An old outside pantry and rear entry had been converted in the toilet etc. facility. In essence, this was like a “railroad flat”.
Most of my practice consisted mostly of blue-collar families. Many were of Italian, Polish, or Irish extraction. In those days, my practice as with almost every doctor in those days was not specialized and included pediatrics, obstetrics, minor surgery as well as medicine. Even those who called themselves Surgeons treated patients for medical conditions.
In the 40s and 50s, there were a large number of area residents who were commuting to New York from the station on Grant Avenue. Many were patients and all too frequently, someone would ring the office bell before 7 o'clock in the morning. They wanted to see the doctor before catching their train. It did not matter whether I was asleep or not, they were awake.
Before the war, it was not customary for doctors to have female help, but I soon felt I should have a nurse. I put her small desk and filing cabinet for the patient’s records in the entry hall by the door. I hired a delightful young RN from the Hospital for $48.00 a week! (gasoline was 17 cents a gallon-so that would be about $950.00 in today’s dollars).
One day a young girl and her mother came rushing into the office. The girl while using the slicing machine in the family deli on Grant Ave. between 2nd and third had cut off the extreme tip of a finger. The mother stayed in the waiting room while I, assisted by the nurse, repaired the wound. When I went to tell the mother that everything would be okay, I found her lying on the floor. She had fainted. She was a greater problem then her daughter.
One of my patients was a young black man, who with his wife later became very active in city political life. In the late 40s he had pneumonia which I treated with antibiotics. After examining in the office, I had discharged him as cured. When he left, there were no other patients in the waiting room; I remained sitting at my desk with the door to the reception area ajar. The outside door opened and this young man reentered, and knowing that I could hear said to my nurse. "I forgot to ask the doctor if I could play the clarinet now.” I called out "of course you can". "That's funny", he said,” I never could before". I had fallen for an old saw and started laughing. Fifty years later, and Clem and I were still laughing at this joke.
Once I told the patient, who was not following my advice or taking his medication, that unless he did as I recommended he was wasting his money and my time. He never came back Twenty years later when he reappeared in my office with a serious illness. He told me that he had been afraid to come back since he was not complying with his treatment, and had seen other doctors. Because he felt that I was a superior physician, he had swallowed his pride and sought my help. He continued under my care for several years.
Among my patients was a family with two young boys. The older one had developed ileitis. I had referred the family to a GI specialist at Mt Sinai in NYC; however, his case had not only been missed diagnosed by them as ulcerative colitis but the treatment had resulted in a demanding invalid. The younger boy was uncontrollable, probably because his brother was receiving so much attention. One day he and his mother were in my consultation room, when I looked up and noticed that he had not only opened the door to the entry area, but had tied the window drapes pull cords to the to the door knob. He was getting ready to slam the door closed when I stopped him. I do not think mother even scolded him.
One Italian family had several daughters. The eldest had severe mitral regurgitation a complication of Rheumatic Fever itself a complication of Scarlet Fever. Ultimately the heart failure from that after many years proved fatal. Fortunately due to antibiotics Scarlet Fever as not seen anymore and that dangerous complication of Rheumatic Fever would probably never seen or be recognized by today’s doctors.
One of the other daughters was very obnoxious and nosey. Her younger naive sister, who 50 years later still sends me a Christmas card, was able to conceal her several months pregnancy when married.
I was her obstetrician. A little over five months after the wedding towards the end of her 7th month, she phoned me hysterically complaining of severe pains in her stomach. I immediately made a house call and had her transported to the hospital in active labor. The baby boy weighed about 3 pounds and ultimately suffered from a hearing loss. He, himself, is now a grandfather. Her older sister questioned me whether I thought that the baby had come too soon after marriage, i.e.: questioning if her sister had been pregnant before the wedding. I pointed out that the baby’s size showed he was premature which satisfied her curiosity.
Incidently my wife and were honored to be invited to her wedding.
Then there was Irish foundry worker who developed severs urinary retention as the result of an enlarged prostate. Although in sever pain he walked about six miles from Hoes in Dunellen to my office. I had the Hospital ambulance transport him to the hospital for the Urologist to treat. That particular surgery was crude and brutal in those days. There was a prolonged period of recovery often complicated by urinary tract infection.
These are just a few funny and pleasant memories of years gone by. By the way that office had no AC until in the 50s when I bought one Carrier winow unit that kept the whole office comfortable.