Saturday, April 05, 2014

Rural journalists among Editor & Publisher's annual '25 under 35' to watch and to learn from

Some rural journalists are included in Editor & Publisher magazine's annual "25 under 35," newspaper executives under 35 who have "business acumen to lead through trying times and vision to implement bold, new strategies to move their newspapers forward." They are:

Sara Konrad Baranowski, 34, editor, Times Citizen, Iowa Falls, Iowa: "As a crossover reporter with the paper’s in-house radio station and now as editor, she has led the convergence effort within the company and has published a book focusing on the topic of newspaper evolution and the different business models being pursued. Her advice for peers: "Be ambitious. When you have the opportunity to learn a new skill, take it."

Danielle Gordon-Broome, 28, editor, Swan Valley Star and Times, Swan River, Manitoba, "has encouraged the use of social media in the newsroom and increased traffic to the paper’s website. In addition, she directed a massive update and redesign of the newspaper layout that had not been done in more than 15 years." Her advice for peers: "It’s not your background or education that makes you a good journalist. It’s your dedication, your passion, your creativity and the vision you put behind every piece."

Tommy Felts, 31, managing editor, The Ottawa Herald, Ottawa, Kansas: "he literally wears his pride for the newspaper on his personally-purchased company polo shirts daily though he knows wearing it often may invite as many critiques as it does praise from the public," says Editor-Piblisher Jeanny Sharp. Felts's advice for peers: "Don’t ignore journalism industry trends, but don’t follow them blindly either."

Adam Silverman, 35, associate editor for news and audience development, Burlington Free Press, Vermont: "Silverman was elevated to associate editor last year due in part to his leadership, dedication and work in helping the Free Press shift from a broadsheet to a compact tabloid." His advice for peers: "Be tenacious, fearless and flexible. We have a great public trust as journalists, and it’s incumbent upon us to take that seriously. . . . Vigorously pursue your watchdog role."

Eric Lane Stearley, 24, editor, The Paper of Wabash County, Wabash, Indiana: "Stearley strives to bring his audience of 16,000 the most current, relevant, and meaningful news stories, paired with stunning images in an updated layout." His advice for peers: "Don’t underestimate your community. Great journalism doesn’t have to come from a big city publication, and it doesn’t have to have a global focus." (Read more)

Journalists say federal agencies are too reticent and spokespersons often lack knowledge

The Environmental Protection Agency and the federal Centers for Disease Control and Prevention failed in their responsibility to inform the public in the wake of the West Virginia chemical spill, says Tim Wheeler of The Baltimore Sun and chair of the Freedom of Information Task Force of the Society of Environmental Journalists.

Wheeler is quoted by SEJ President Don Hopey of the Pittsburgh Post-Gazette in his column in the latest SEJournal, the group's magazine. Hopey says more than ever, people "need accurate, factual news delivered as quickly as possible to best assess the risks and threats to their health and the environment. But the public isn’t getting what it needs from federal and state agencies. . . . EPA refused to speak about the contamination for nearly a week, and took several more days to supply information about water quality to local residents thirsty for news." Wheeler said the CDC spoke to some national news outlets, " ignored the local audience most in need of the information and desperate for news about the contamination during that crisis situation."

Hopey says government public-information officers aren't as helpful as they once were. "More and more they seem almost afraid to speak, and when they do are often loath to give out information about research, investigations and ongoing crisis management. Often as not we must deal with PIOs who know little about the subject at hand, or have no authorization or expertise to speak of it." Too many of them come from political campaigns, says Ken Ward Jr. of The Charleston Gazette. "We don’t need political operatives in those positions,” he told Hopey. “We need and want someone who believes in the public’s right to know.” (Read more)

Friday, April 04, 2014

Silas House urges fellow Appalachian academics to join the fight against gay discrimination

Appalachian author Silas House told the Appalachian Studies Association's annual conference last weekend that the faculty and presidents of the region's colleges and universities must become more involved in the fight against discrimination based on sexual orientation "instead of acting as shrinking violets who want to avoid controversy that might upset people."

House told the gathering of Appalachian academics, meeting at Marshall University, that many professors have told him "they rarely broached orientation in class because students are so divided" on the topic. "This is the every reason we should be discussing this issue more often, and more openly," he said.

"Too many of our young people feel as if they're camping a whole here in the wilderness before their exodus," House said, and they give many reasons. He choked up as he said, "The one that hurts me the most is when they say they're leaving because they feel invisible, or they feel as if they are only accepted with suspicion."

In his final appeal, House said "Appalachian people have been at the forefront of the major movements for change in this country. We have to be as active in this fight for fairness and equality. . . . I challenge all of you to stand against discrimination, and to foster discussion on this issue. Don't allow gay Appalachians or anyone who's different to feel invisible or silenced. . . . In every single Appalachian state, it is absolutely and perfectly legal to kick a gay or transgendered person out of a restaurant, to refuse them service. We would no longer stand for this happening to a person of color. . . . To my knowledge, among sitting college presidents in the region, only one, the president of [Kentucky's] Morehead State University, has made a blatant gesture of support for the fairness movement. I find that upsetting and unjust." For a video of the speech, click here.

Group tells Congress many firefighters, especially rural, aren't ready to deal with crude-oil train fires

Fireball from exploding train
car at Casselton, N.D., Dec. 30.
A firefighters' group told Congress Wednesday that many fire departments, especially rural ones, are not properly trained to deal with hazardous-materials incidents, a rising concern because crude-oil transport by rail has become more common, Curtis Tate reports for McClatchy Newspapers.

Budget cuts have impeded efforts to keep firefighters trained and informed about new hazards, said Elizabeth Harman, assistant to the general president for training and grants at the International Association of Fire Fighters.

Of the fire departments that deal with hazardous-materials accidents, 65 percent have not trained all of their workers for such incidents, Harman told the House Subcommittee on Railroads, Pipelines and Hazardous Materials. "This is an untenable situation that must be rectified," she said. A 2011 National Fire Protection Association survey showed that 77 percent of departments "have at least some hazardous materials response capability; the majority of those that lack it are in rural areas," Tate reports.

Because railroads are hauling larger amounts of flammable liquids such as ethanol and crude oil, accidents can be very complicated and dangerous. Fewer than 10,000 carloads of crude oil were transported in 2008, but more than 400,000 were transported last year, according to the railroad industry. Harlan said many firefighters who only have basic training in this area are "unqualified to do anything more than call for help." Operations training, the level above basic training as outlined by the Occupational Health and Safety Administration, would be more useful for first responders, he said. (Read more)

Up to 3,300 postmasters could lose their jobs by Oct.

Because the U.S. Postal Service will change its staffing policies in September, as many as 3,300 postmasters could lose their full-time jobs. The policy involves shortening post-office hours and providing more part-time positions and fewer full-time ones. "By October, the institution of the small-town career postmaster will become a thing of the past at almost half the country's post offices," says (Hat tip to the Daily Yonder)

Around 8,800 post offices have already cut some hours during the past year and one half, 300 have scheduled public meetings and 3,900 have not scheduled a meeting or implemented any such changes. "If implementation continues at the current rate (about a hundred a month), some 600 of these post offices will have their hours reduced during the spring and summer," SavethePostOffice says. To see an interactive map showing post offices planning to reduce services, click here.

Leading enviro journo tells how he does it, advises would-be followers to work for small newspapers

Ward at "Covering Coal," an Institute
for Rural Journalism
workshop in 2005
Ken Ward Jr. of The Charleston Gazette, whose work on the West Virginia chemical spill again proved his rank among America's top reporters, has some advice for journalists and would-be environmental and labor reporters in an interview with Beth Daley of the New England Center for Investigative Reporting in the latest edition of SEJournal, the magazine of the Society of Environmental Journalists.

"It's always critical not to take the government's word for anything," Ward says, quoting muckraker I.F. Stone: "All governments lie." In covering the spill that fouled the water of 300,000 people, "It was especially important to have outside sources and independent experts," he says, including fellow SEJ members who knew experts he didn't.

Asked how he "cuts through emotion and rhetoric" on his Coal Tattoo blog, Ward says he's not sure he does, "and I would say there’s absolutely nothing wrong with people being emotional about issues that affect both their health and safety and their ability to provide for their families. Journalists or government officials or industry lobbyists who pretend emotion has no place in these discussions are sending us down the wrong path in covering environmental stories."

Finally, asked for advice yo young journalists who want to cover environmental news, Ward warmed out hearts by saying, "Find a small, community-based and locally owned newspaper in your home state and work there. [He did that.] Avoid Washington and New York. Smaller communities need good journalism, and the stories you find will be much richer – so will your life. Think especially about reporting in and on the place you came from – a sense of place is all too rare in journalism these days. And try to stick around a while, so you can include a sense of history and context in your reporting." (Read more)

Open enrollment ends, but Medicaid and CHIP stay open for adults, children and teens who qualify

Regular open enrollment for coverage under the federal health-reform law is ending, but enrollment is available year-round for children and teenagers who are eligible for free or low-cost health insurance through Medicaid and the Children's Health Insurance Program, commonly known as CHIP. Adults who qualify for Medicaid can also sign up at any time.

According to the CHIP website, the program "provides health coverage to nearly eight million children in families with incomes too high to qualify for Medicaid, but can't afford private coverage." Each state sets its own eligibility requirements an  in states that are expanding Medicaid, many qualify who had not previously. Millions of uninsured children and teens across the country are eligible for these programs.

Thursday, April 03, 2014

Fellow Republicans line up against GOPer who wants to get tough on abusers of walking horses

A Tennessee walker does the "big lick."
Republican senators from Kentucky and Tennessee are at odds with a Republican congressman from Kentucky who wants strong legislation to stop the mistreatment of Tennessee walking horses.

Sens. Mitch McConnell and Rand Paul of Kentucky and Lamar Alexander of Tennessee are supporting legislation identical to that sponsored by Rep. Marsha Blackburn, R-Tenn., and Reps. Andy Barr and Hal Rogers, R-Ky. Hers is a competing bill to one filed by Rep. Ed Whitfield of Kentucky, where the horses are also popular. Whitfield says he is having none of it.

"Any legislation that does not ban stacks and chains; does not eliminate the failed self-policing inspection system; does not increase criminal penalties to provide a truly effective deterrent; and does not strengthen the USDA's ability to enforce the Horse Protection Act, will not work," Whitfield, left, whose wife lobbies for an arm of the Humane Society of the United States, said in a press release this week.

The other Republicans' bill would ban soring, the intentional irritation of horse hooves, ankles and legs to produce the "big lick," the high step for which Tennessee walking horses are known. But soring is harder to catch than the use of chains, and of stacked pads in place of horseshoes. "Trainers put chains around a horse's sored ankles so that as the horse walks, the chains slide up and down, irritating areas already made painful by soring," notes Janet Patton of the Lexington Herald-Leader. "The Humane Society, the American Association of Equine Practitioners, the American Veterinary Medical Association, the American Horse Council and dozens of other groups have backed Whitfield's bill."

Patton quotes Tennessee veterinarian John Haffner, "who once helped hide the effects of soring so Tennessee walkers could pass vet inspections," as saying that the big lick requires soring at some point, so it is used by many owners. "The Blackburn bill continues to allow the industry to self-police," he told Patton. "They've had 43 years to self-police. If anybody's been given leniency and time to come around, it's the walking-horse industry." (Read more)

Blackburn got an editorial slapping from The Tennessean in Nashville, which said, "Stronger than a desire for mere show-ring glory, this appears to be about deriving pleasure from causing pain. . . . Blackburn’s bill is, in fact, a Trojan horse — institutionalized abuse disguised as animal protection. It would set up a single horse industry organization (HIO), whose board would be chosen by the current trainers association that is populated with repeat violators of the Horse Protection Act. Those HIOs that currently prohibit soring at their shows would be left out." (Read more)

UPDATE: A Senate committee has approved a Senate version of Whitfield's bill.
Read more here:

'Hollow,' interactive documentary about a West Virginia county, wins a Peabody Award

An interactive documentary about a southern West Virginia county trying to revive itself has won a Peabody Award, given for outstanding efforts in electronic media.

"Hollow" introduces McDowell County, right, as one of the one-third of U.S. counties where more people are leaving than staying, but it is an extreme example: its population of 20,000 is about a fifth what it was 60 years ago. ('Hollow' map)
The producer is 26-year-old Elaine McMillon, left, who grew up in adjoining Logan County. She combined personal documentary video portraits of 30 people who have , user-generated content, photography, soundscapes, interactive data and grassroots mapping on an HTML5 website.

“The more attention the project gets, the more pressure is put on the residents to do what they say they wanted to do in the documentary,” she told Zack Harold of the Charleston Daily Mail, where she interned. “I got a message yesterday from a McDowell County resident, saying ‘Thanks for waking us up.’”

"The film recently won third place in World Press Photo’s annual interactive documentary contest, and was named a finalist for the 2014 South by Southwest Interactive People’s Choice Award," Harold notes. "Last year, the documentary was accepted as part of the New York Film Festival, Camden International Film Festival and the International Documentary Festival of Amsterdam’s 'Doc Lab'." (Read more)

Other Peabody Award winners of rural interest include NBC's "In Plain Sight: Poverty In America;" "Hanford's Dirty Secrets" by KING-TV of Seattle, exposing waste, deception and mismanagement at a nuclear reservation in southwest Washington; and "A Chef’s Life," a "stereotype-cracking nonfiction serial" about a farm-to-fork restaurant in North Carolina's Low Country. For the press release, click here.
- See more at:

Writer offers suggestions for rural groups and farmers to connect with people in urban areas

New York Times food columnist Mark Bittman will host an event at the Cooper Union in New York on Friday about the future of agriculture, focusing on the question of how that future should include farmers in deep rural America who produce dairy and grain. "An Upstate New York farmer and lawyer says it's time for small commodity farmers to start telling their own stories. Here's how to do it," Lorraine Lewandrowski reports for the Daily Yonder.

Commodity farmers do not usually gain attention in mainstream media unless a crisis happens, so sometimes they have to take public relations into their own hands, Lewandrowski writes. On Nov. 8, New York dairy farmers traveled around New York City offering free cheese samples, thanking police and nonprofit workers for their service and visiting retail stores. "The Cabot farmers cooperative did what has never been done: delivered a massive influx of actual dairy farmers into New York City."

Lewandrowski offers suggestions for promoting greater understanding among urban people of farmers and rural groups: Promote rural writers, journalists and photographers who may not otherwise be recognized by urban media, so rural stories can reach a broader audience. Find ways to speak in cities; "If you see an urban discussion on agriculture, do not be afraid to call and ask who from rural America is going to be on the panel." Don't speak negatively about other farmers who aren't there; focus on being a voice for all rural groups. It may also be advantageous to "form alliances with other rural-interested groups."

Also look for unique opportunities and spaces. Plenty of people in urban areas might be interested in what rural groups have to say; it is just a matter of finding out who they are and how to communicate with them. Emphasize what rural areas have to offer, focusing on both the beautiful landscapes and the environmental challenges we face.

If farmers want to talk with urban people about important issues and if they want fair prices and treatment for rural areas, they should speak up, Lewandrowski writes: "Craft your own images, rural America—or they will be crafted for you!" (Read more)

Mining interests prevail in Wisc. county election

Taconite deposit appears in red; mine site is circled
"In a sparsely populated northern Wisconsin county where residents are split over a proposed open-pit iron mine, five pro-mining candidates prevailed in Tuesday’s county board election after receiving last-minute help from a well-funded national conservative group," while four others lost, Steven Verburg reports for the Wisconsin State Journal.

All received "aggressive support from the Wisconsin chapter of Americans for Prosperity, which was founded by billionaire businessmen David and Charles Koch," Verburg writes. "The Madison-based group sent a field organizer to Iron County after a strongly pro-mine candidate for the board was defeated in a three-way primary in February," and ran a direct-mail campaign.

Bob Seitz, a spokesman for Gogebic Taconite, which wants to open the mine, "said the most vocal anti-mine challengers lost. Seitz said the current board has been cooperative."

Opponents of the mine pointed out that "three other AFP-supported incumbents lost along with one challenger who had the group’s backing," Verburg reports. "AFP didn’t indicate a preference in the other contested race. Losses by incumbents are unusual in a county where the election clerk can’t remember the last time anyone even filed to challenge a board member in an election." (Read more)

Ken Kesey's novel Sometimes a Great Notion still poses important questions about rural life, work

This statue of Kesey is in Portland, Ore.
Even 50 years after it was published, Ken Kesey's book Sometimes a Great Notion still asks important questions about American rural life: "Should we stick together or go our separate ways? And are those the only two options?" Tarence Ray writes for the Daily Yonder. The novel is about the Stampers, a logging family living in Wakonda, Ore., that declines to be part of a strike against a logging company.

The Stamper family motto, "Never give an inch," is compromised when Hank, one of the family leaders, hesitantly hires his quasi-socialist brother Lee to help meet production quotas and stop the strike. The rest of the book details the family's decent into deeper trouble as Hank's preoccupation with the strike costs him almost everything.

"Kesey's objective is to show the value of one inch: At what point does it cost more—environmentally, mentally, physically—to live the life of a the detached yeoman, the rugged libertarian?" Ray writes. Now fewer than 1 percent of Americans attempt to farm as a result of agricultural policies and corporate farming. "Aquifers are drying up; pipelines carve through the earth and its water sources; chemical spills blanket coastlines," Ray notes.

When confronted with a choice between libertarianism and collectivism, Kesey's story raises a third option: death. This can also be viewed as a compromise between rural and urban society. "Can we afford to keep boxing them [rural communities] into impossible choices and false compromises?" Ray writes. (Read more).

Wednesday, April 02, 2014

Decline in nonmetro population continues; in Nebraska, lawmakers discuss what to do about it

Last year 46.2 million people lived outside metropolitan areas, accounting for almost 15 percent of U.S. residents, continuing a two-year decline. "While hundreds of individual counties have lost population over the years, this is the first period of overall population decline in nonmetro America," says the Economic Research Service of the United States Department of Agriculture. For a video of a C-SPAN discussion of the phenomenon, click here.

Between July 2011 and July 2012, the non-metro population was estimated to have declined by 47,500 residents. Between July 2012 and 2013, it was estimated to have lost about 28,000. More than 1,200 non-metro counties are estimated to have lost population since 2010. Since the mid-1990s, non-metro areas have seen much less growth than metro areas, and the disparity has recently become greater. (Read more)

In Nebraska, years of rural population loss have left more than half of Nebraska's population in three counties: Douglas, Lancaster and Sarpy, noted David Drozd of the University of Nebraska at Omaha Center for Public Affairs Research. Lawmakers are discussing what to do about it, Christine Scalora reports for The Associated Press.

Sen. Paul Schumacher of Columbus suggested establishing a new city close to the interchange of Interstates 80 and 76 in the western part of the state. "I think we need to just start talking about something, because western Nebraska is being evacuated by the fact that people have a hard time seeing an exciting future for it," Schumacher said. Sen. Kate Sullivan said the state is offering support to rural Nebraska, but it's incremental. "For example, a prison reform bill that just received first-round approval includes loan repayment assistance for attorneys who will practice in rural areas," Scalora writes. "The state also has a tax credit for beginning farmers."

Sullivan said rural communities need to work together, using resources effectively and drawing upon ideas from those who live in the area and know it best. Sen. Tyson Larson said that young leaders need to rise up and repopulate rural areas, although he understands that this can be difficult because of high land prices and property taxes. He suggested property tax relief as a potential encouragement for people to move back into agriculture.

Also important to note is that living in a small town offers benefits that a big city does not have to offer. Small town life offers "a true sense of community and a true sense of coming together on a lot of things," Larson said. (Read more)

Rural homelessness is an overlooked and worsening problem

Although the homelessness rate is lower in rural areas than in urban ones, the U.S. Interagency Council on Homelessness reports that poor rural communities suffer from some of the highest homeless and poverty rates in the U.S. "If President Obama wants to do something about income inequality, he could start by calling attention to an overlooked problem: rural homelessness," Timothy Collins writes for the Daily Yonder.
Source: Geography of Homelessness
Typically, rural homelessness is not as visible as urban homelessness. In cities, one can often see people sleeping in the streets, while in rural areas, one might only see a person hiking along a highway every once in a while. "Rural, like urban homelessness, can be a result of poverty, inadequate housing, domestic violence, mental illness and the invisible injuries of combat," according to the Interagency Council on Homelessness, Collins reports.

Rural people are between 1.2 and 2.3 times more likely to be poor than urban people, Collins notes. These numbers show the rural geographic discrimination that will go on because of the recession. Almost one in five rural counties has a poverty rate of 20 percent or higher. Some of those people live in crumbling structures in rural slums, and they should be considered homeless as well, he argues.

Collins writes that Obama should use his remaining time in office to combat poverty, and that if Congress won't support the funding of anti-poverty measures, the president can still "educate Americans about the human, social and economic costs of poverty that are dragging our nation down." (Read more)

Agricultural community faces wildlife and water regulatory issues

The agricultural community is facing several regulatory issues, reports Agri-Pulse, a Washington newsletter. The Environmental Protection Agency's proposal to define "waters of the U.S." was met with opposition from Republicans and even some Senate Democrats. President Obama was acting in a "dictatorial manner . . . trying to usurp the power that the Constitution gives to people," said Sen. Chuck Grassley, R-Iowa.

American Farm Bureau Federation President Bob Stallman said, "The EPA proposal poses a serious threat to farmers, ranchers and other landowners. Under EPA's proposed new rule, waters—even ditches—are regulated even if they are miles from the nearest 'navigable' waters." He said that the new law is essentially "federal veto power over a farmer's ability to farm." Though an EPA spokesperson did not respond to questions regarding agricultural exemptions, the agency is expected provide additional informational information soon.

Also causing concern is the Endangered Species Act, which prevented Joe Hopkins, an Oregon tree farmer, from harvesting wood after a forest fire on his farm because the area contained red-cockaded woodpeckers, which are considered an endangered species, according to the U.S. Fish and Wildlife Service. Hopkins lost the opportunity to make between $250,000 and $300,000. He said that he is concerned that the ESA has "'draconian one-size-fits-all approach'" that is being used 'as a powerful tool in the hands of those who would halt land management activities."

Rep. Kurt Schrader, D-Ore., said, "It's clear that the ESA is no longer an act to help the survival of species; it's meant to shut down forestry." He said ESA should be reformed and return to its original goal of maintaining diverse species, reports Agri-Pulse, which is a subscription publication but offers a free trial.

New book provides advice on how to encourage entrepreneurship in rural areas

Promoting entrepreneurship is a key economic-development strategy for rural areas. A new book, Energizing Entrepreneurial Communities: Pathway to Prosperity, provides a guide to becoming an entrepreneurial community. Authors Don Macke, Deb Markley and John Fulwider explain the importance of, and strategies for, positively influencing your community's economic future, offer unique approaches to economic development and provide tips to reaching greater prosperity, says the Center for Rural Entrepreneurship.

"We have worked with thousands of rural entrepreneurs across the Arkansas Delta over the past 15 years," says Ines Polonius, executive director of alt.Consulting in Pine Bluff, Ark. "Energizing Entrepreneurial Communities: A Pathway to Prosperity has given us a whole new perspective on effectively engaging communities in our work in order to create ecosystems in which rural entrepreneurs can be more successful," To order the book, click here.

Tuesday, April 01, 2014

Obamacare has passed the first big hurdle, but many more remain; impact differs from state to state

Monday was the deadline for starting open enrollment for policies offered through the health-insurance exchanges created under the federal health-reform law, and there were signs that final-day rush of signups pushed the total close to the Obama administration's goal of 7 million. But it remains to be seen how many of those people actually pay their premiums and how many of them are young people whose participation is considered essential to the law's success.

"With millions of people signing up, the law has cleared one long, difficult set of hurdles and has defied the darkest predictions of its critics. But that doesn't mean it's out of the woods entirely—it's just on to the next long, difficult set of hurdles," writes Sam Baker of the National Journal. "The national total doesn't say much about of the law's sustainability or what happens to premiums next year. Premiums will go up, because premiums go up every year. The size of next year's premium increases depends on enrollment and demographics in each state, and even within specific regions of each state. Some states are faring better than others," as the Kaiser Family Foundation map below shows.
"Generally, if the risk pool in a particular market turns out older and sicker than expected, insurers are more likely to raise their premiums," Baker writes. "We don't know precisely what insurers expected—they all priced their plans independently, and the law includes several programs designed to absorb any surprises and keep premiums as steady as possible. In competitive markets, insurers likely will try to keep increases to a minimum, but industry insiders caution that hikes are looking likely, at least in some parts of the country."

"The biggest question by far," said Drew Altman, president of the Kaiser Family Foundation, is how people will like their plans, and the proportion of winners (those who couldn't get affordable coverage) to losers (those who had to get more expensive policies that may not include their doctor or preferred facility). But even the winners might "sour on their coverage" as they have to pay thousands of dollars in deductibles before full coverage kicks in, Baker writes.

Charles Ornstein of ProPublica has a good look at how the success or failure of Obamacare can be judged. Chris Cilliza of The Washington Post has a good set of charts illustrating the politics of the law. For a look at how Obamacare was embraced by ruling Democrats in Kentucky, a state with a large rural population, and how it may backfire on them in upcoming elections, read this story by Louisville native and former Post political reporter Perry Bacon Jr. of Yahoo News.

Primary-care doctors burn out; patients stressed too

"Tim Devitt, a family physician in rural Wisconsin, took calls on nights and weekends, delivered babies and visited his patients in the hospital," Roni Caryn Rabin writes for Kaiser Health News in The Washington Post. "The stress took a toll, though: He retired six years ago, at 62." There are thousands like him, and that is worsening America's shortage of primary-care physicians, which is particularly acute in some rural areas.

Though physician stress has always been a concern, recent reports and studies show an increase in discontent, particularly among primary-care doctors, Rabin writes: "Tired of working longer and harder because of discounted insurance payments and frustrated by stagnating pay and increasing oversight, many [doctors] are going to work for large groups or hospitals, curtailing their practices or in some cases, abandoning primary care or retiring early, experts say."

"The lack of an adequate primary-care infrastructure in the U.S. is a huge obstacle to creating a high-forming health-care system," said David Blumenthal, president of the Commonwealth Fund, a health-care research foundation. According to a 2012 Urban Institute study of 500 primary-care doctors, 30 percent of those 35 to 49 years old—and 52 percent of those over 50—planned to leave their practices in the next five years.

The doctors are stressed, and the patients are, too; some feel that their physicians don't have enough time to spend on each appointment and even worry about an increase in mistakes. In a 2012 Mayo Clinic survey of more than 7,200 doctors, almost half of those surveyed said they had at least one symptom of burnout. "What drives physician satisfaction is also what patients and payers want: delivering good care. And we're less and less able to do that," said Christine Sinsky, an internist in Dubuque, Iowa. "You spend less time listening to patients, getting to know them and thinking more deeply about their care."

American Board of Internal Medicine President Richard J. Baron wanted to record how much time a doctor spends caring for patients and found out "that on a typical day, he or she handles 18.5 phone calls, reads 16.8 emails, processes a dozen prescription refills (not counting those written during a visit), interprets 19.5 lab reports, reviews 11 imaging reports and reads and follows up on 13.9 reports from specialists," Rabin writes.

A related problem is the new policy about electronic medical records, which many greatly dislike, according to physician Mark Friedberg, a co-author of last year's RAND study. Instead of saving time, many doctors say the new system causes more problems and leaves "little room for the kind of personal, nuanced observation that was captured in an old-fashioned doctor's note," Rabin writes. "Many physicians said to us, 'I used to be a doctor; now I'm a clerk,'" said Jay Crosson, a pediatrician and vice president of professional satisfaction for the AMA. (Read more)

Would you like guns with that? That is the question for restaurateurs in some Southern states

"You have to learn to speak like a politician when you are speaking to people," said Sean Brock, a well-respected Southern chef who grew up in southwest Virginia and has restaurants in Charleston, S.C., and Nashville. "Twenty or 30 years ago you were just a guy who made eggs Benedict." The dilemma he and many others in the restaurant business are facing is whether or not to allow concealed weapons in their establishments, Kim Severson reports for The New York Times.

How restaurants deal with highly politicized issues can really affect business, and for many years they have created informal public policy through their dealings with certain social issues. "It's almost like restaurants have to have a political strategist on board now when they put together their marketing plan," Andrew Freeman, a San Francisco-based consultant to the restaurant and hotel industry, told Severson.

"It's more than just cooking food," said David McMillan, an owner of the coastal restaurant Drunken Jack's in Murrells Inlet, S.C. "We have to be allergen experts and nutritional experts and now Second Amendment experts."

Pete Matsko, second from right, at his bar
(Photo by Mike Belleme for The New York Times)
In February, South Carolina became of the states that allowed people with permits to bring concealed guns into restaurants in bars—unless they planned to drink alcohol or unless the restaurant chose to post a sign banning guns. Clemson restaruant owner Pete Matsko posted a sarcastic sign and had to deal with considerable backlash. "On some night you have college kids wall to wall in here drinking," he told Severson. "You don't want a gun in here."

Others haven't quite decided how to proceed. "It's a bit strange to me that you think you need to carry a gun when you're having a cheeseburger," Brock said. Even though he grew up with guns in Wise County, Virginia, he doesn't want them in his restaurant. He still isn't sure if he will put up the signs. "The pressure to make the right move is intense," he told Severson. "When you start to become this stage for rights, you have to be so careful."

Gun-Free Dining Tennessee, which began after the state allowed concealed weapons in bars and restaurants in 2009, publishes a list of restaurants that do and don't enforce gun control. Ray Friedman, who began the list, asked Brock to post the sign or deal with pickets. "I sympathize with the restaurant owners because they didn't choose to be in the middle of this," Friedman told the Times, "but this is where it is playing out." (Read more)

U.S. farmers are shifting from corn to soybeans

"After years of planting one massive crop after another, U.S. corn farmers are planning to pull back for the first time since the recession, signaling a new era of uncertainty for the nation's largest crop," Mark Peters and Tony C. Dreibus report for The Wall Street Journal. Their news peg is the Prospective Plantings Report from the National Agricultural Statistics Service, which predicts a big shift to soybeans, which are "nearly three times the price of corn," notes Agri-Pulse, a Washington newsletter.

"Producers surveyed across the United States intend to plant an estimated 81.5 million acres of soybeans in 2014, up 6 percent from last year and an all-time record high," NASS said in its news release. "Corn growers intend to plant 91.7 million acres in 2014, down 4 percent from last year and if realized the lowest planted acreage since 2010."

Part of the reason is global competition, as illustrated in these Wall Street Journal charts:
Another negative factor for corn is the "flattening out of federal ethanol mandates," the Journal notes.
Gasoline refiners keep pressing Congress to cut back the requirement, ans a new report will add impetus to their lobbying. "Last year's spike in the price of ethanol blending credits cost independent refiners at least $1.35 billion, more than three times as much as the year before," reports Cezary Podkul of Reuters.

Monday, March 31, 2014

Consumer Reports ranks hospitals for safety

How safe is your hospital? Consumer Reports released its hospital ratings, ranking Miles Memorial Hospital in the small town of Damariscotta, Maine, as the country's safest and Bolivar Medical Center in Cleveland, Miss,. as the least safe hospital in the U.S. The ratings come on the heels of a study published last year in the Journal of Patient Safety that found that 440,000 deaths occur each year in U.S. hospitals because of a medical error.

Ratings were determined based on "patient outcomes (avoiding infections, readmissions, avoiding mortality, and adverse even ts in surgical patients), patient experience (including communication about hospital discharge, communication about drug information and other measures), and hospital practices (appropriate use of scanning, and use of electronic health records)," Consumer Reports says. Those measures were then combined for a safety score from 1 to 100. Miles Memorial received a 78, while Bolivar Medical Center got an 11. Rankings by state, city and county are available by clicking here (subscription may be required).

Bolivar isn't alone in its poor ranking. The average overall score of the more than 4,000 hospitals ranked was 51, and 43 hospitals scored below 30. John Santa, M.D., medical director of Consumer Reports Health, said, “It is unacceptable that so many hospitals are doing so poorly, especially since our ratings show that some hospitals can do a good job at keeping patients safe.” (Read more)

To read how Consumer Reports rated hospitals click here. To read the Consumer Reports Health report on the rankings click here.

UPDATE, April 4: There are many forms of hospital rankings, some done with questionable business practices such as "licensing fees" they get from hospitals, notes Pia Christensen of the Association of Health Care Journalists.

Health insurers' adaptation to Obamacare has widened the cost gap between rural and urban areas

"Health care has always been more expensive in far-flung communities, where actuarial insurance data show fewer doctors, specialists and hospitals, as well as older residents in need of more health care services. But the rural-urban cost divide has been exacerbated by the Affordable Care Act," reports Kristen Wyatt of The Associated Press.

Western Colorado rancher Bill Fales told Wyatt, "We've gone from letting the insurance companies use a pre-existing medical condition to jack up rates to having a pre-existing ZIP code being the reason health insurance is unaffordable." Wyatt notes, "Geography is one of only three determinants insurance companies are allowed to use to set premiums under the federal health care law, along with age and tobacco use. Insurance officials say they need such controls to remain viable." (Read more)

The Rural Blog has previously reported on the rural problem, caused in part by insurance companies' unwillingness to sell policies in certain areas, resulting in a lack of competition and rates that would otherwise be lower. Also, states that did not embrace the health reform law do not have non-profit insurance cooperatives, which must offer policies statewide, and for-profit insurers are avoiding poor areas, which are disproportionately rural.

Regulators suspect feed ingredient as a cause in deaths of millions of pigs, but lack concrete proof

Trying to find why a disease has killed millions of young pigs in 27 states, scientists and regulators are examining a wide variety of possible causes, including porcine plasma, "a widely used feed ingredient made from the blood of slaughtered hogs and fed to piglets," Jesse Newman reports for The Wall Street Journal. The virus, porcine epidemic diarrhea, is thought to have killed four million pigs, but actual numbers could be higher because deaths are reported voluntarily. (WSJ graphic)
"The number of new confirmed cases of the virus has accelerated recently, confounding farmers and veterinarians, who have ramped up their already stringent 'biosecurity' measures since last spring," Newman writes. "Those precautions include more aggressively disinfecting trucks and workers' boots and clothing when they enter and leave farms and barns."

The Food and Drug Administration, the Department of Agriculture and pork-industry officials "are examining a range of feed ingredients and manufacturing processes as well as other possible pathways for the virus, like contaminated air or dust particles carried from farm to farm," Newman writes. "Though the evidence is inconclusive, some researchers say that porcine plasma could be spreading the virus from adult pigs that show few symptoms, or that some plasma may have been contaminated in transit."

While come cases of PED are being linked to plasma, it's still not clear if feed is the cause of the illness, Newman writes. Greg Stevenson, a veterinary pathologist at Iowa State University who has studied the virus, told Newman, "Many people think that feed is the most likely suspect. But practically speaking, we have no proof." (Read more)

Republican farmers in Calif., Ariz. push their party to get on board with immigration reform

While Democratic-supported immigration reform remains in limbo, concern is growing in California, chiefly among Republican farm owners who are growing frustrated with their own party for stalling a bill that could bring much-needed relief to a business whose workforce relies heavily on immigrants, some of whom are in the U.S. illegally, Jennifer Medina reports for The New York Times. California has more illegal immigrants than any other state, with an estimated 2.5 million. (NYT photo by Matt Black: California's Central Valley relies heavily on immigrants)

Chuck Herrin runs a large farm labor contracting company in the Central Valley, where most of the workers are immigrants and about half are there illegally. Herrin, a lifelong Republican, told Medina, “What we have going on now is a farce — a waste of time and money. We need these people to get our food to market.” About a third of Herrin's workers are over 50, and he has struggled to fill open positions.

"A work force that arrived in the 1990s is aging out of heavy labor, Americans do not want the jobs, and tightened security at the border is discouraging new immigrants from arriving, they say, leaving them to struggle amid the paralysis on immigration policy," Medina writes. "No other region may be as eager to keep immigration legislation alive. The tension is so high that the powerful Western Growers Association, a group based in Irvine, Calif., that represents hundreds of farmers in California and Arizona, says many of its members may withhold contributions from Republicans in congressional races because of the party’s stance against a comprehensive immigration overhaul."

"A report released this month by the Partnership for a New American Economy and the Agriculture Coalition for Immigration Reform, two business-oriented groups that are lobbying Congress, said foreign-grown produce consumed in the United States had increased by nearly 80 percent since the late 1990s," Medina writes. "The report argues that the labor shortages make it impossible for American farmers to increase production and compete effectively with foreign importers. While the amount of fresh produce consumed by Americans has increased, domestic production has not kept pace, and the report attributes a $1.4 billion annual loss in farm income to the lack of labor."

All of which has led lobbyists like Tom Nassif, president of the Western Growers, to push Republicans to support the immigration bill. “We’ve had secure borders with Mexico for the last decade; we don’t have that argument at this point," Nassif told Medina. "Now we want people to see the real damage of not doing anything, which is a declining work force, and it means losing production to foreign countries. I can tell you if the Republicans don’t put something forward on immigration, there is going to be a very loud hue and cry from us in agriculture. We are a tremendously important part of the party, and they should not want to lose us.” (Read more)

Sheriff denies request for concealed-weapons data

In another case of a sheriff refusing to uphold a law because he doesn't agree with it, the sheriff of Ohio County, West Virginia (Wikipedia map), is refusing a request by the local newspapers for a list of all residents who have received a permit to carry concealed deadly weapons, records that are open to the public under state law, Corey Hutchins reports for Columbia Journalism Review.

A similar case occurred last year in Cherokee County, North Carolina, leading to the publisher formally apologizing for the editor asking for the names of permit holders, and the editor subsequently resigning.

Ohio County Sheriff Patrick Butler "acknowledged in a recent interview with a local TV station that the permits have been 'ruled… a public record,'" Hutchins writes for CJR. He told Hutchins, “I disagree with that and I am going to disagree with that until the day I’m out of office. We’re prepared to fight it all the way.” Butler says the paper hasn't provided him with a good enough reason to release the names.

Mike Myer, editor of The Intelligencer and the Wheeling News-Register, sister papers, said they have no plan to publish the names, but "want the public information so they can evaluate whether local sheriffs are handling the permitting process properly," Hutchins writes. "In West Virginia, county sheriffs are in charge of granting and revoking permit." Myer said, “Guns are part of our state. The newspaper industry isn’t anti-gun—we’re just against hiding information from the public.” Legislation was recently proposed in West Virginia to make records of permit holders private.

Butler called the request an invasion of privacy, and even went so far as to say that if the list was published, people who don't own guns could be at risk, because criminals would know they are unarmed. He also called the request personal, stating that he doesn't have a good relationship with the paper. (Read more)

Backyard rodeos could be riding off into the sunset; costs, low turnout, liability fear are main concerns

Backyard rodeos have a long tradition in rural America, introducing children to the sport in a friendly environment that encourages competition as much as it does camaraderie. But the high costs of hosting an event, low turnouts, and fear of liability are threatening the very existence of backyard rodeos in places like Iowa, where they once flourished, John Eligon reports for The New York Times. (NYT photo by KC McGinnis: Barrel racing at a backyard rodeo)

"Rodeo enthusiasts in Iowa say they remember a time when they did not have to drive far to find a neighbor hosting a rodeo," Eligon writes. "But as the cost of livestock and feed has increased, and as liability concerns have made insurance a necessity for home rodeo organizers, many people folded their backyard operations because of the expense."

Wayne Fisher, who hosted backyard rodeos on his Iowa farm for more than 20 years, stopped three years ago because he lacked time and the number of contestants kept dwindling. He told Eligon, “It’s a sad thing. It teaches kids a lot of stuff. Not just rodeo, either — camaraderie. Everybody competes themselves, individually. They build a lot of friendships.”

That's why some people, like Mitzi Fleming, still bring her children to Deep River, Iowa, to Widmer’s Rock ’N Roll Arena, to experience one of the last remaining backyard rodeos in the state, Eligon writes. "There are many small rodeo events on rural patches throughout the country, but backyard rodeos like the one on the Widmers’ ranch separate themselves with a blend of competition and camaraderie. Here, the charm of sipping hot chocolate while exchanging friendly banter is as important as how fast someone can rope a calf." Fleming told Eligon, “It’s somebody’s home. They’re welcoming in their home. That’s what’s unique.” (Read more)