The New Medical Privacy

I did a pre-employment drug test recently for a new position -- my first drug test in my multi-decade career. I was past the indignance of my previous decade and the puzzlement I might have experienced the decade before that. After all, for all my 'interesting' background, drug use has been anathematic to my life. Not that it was anyone's business but my own.

The company -- Concerna -- had an oozy enough name that I was somewhat tense coming in the door. Inside were over a dozen people. Some waiting for pre-employment drug screening, others for OSHA-injury analysis. Behind the counter was a highly proceduralized crew of people that reminded me of all those late-night "you too can be a medical industry professional" advertisements. Lots of on-the-spot training, scrubs on people that clearly didn't use them, and a sense of grime all about the place. I didn't sit in any of the rows of chairs. I guy in a 3-piece suit (very out of place in this part of the country) kept walking in and out of the back office area. Smug, with a little soul patch/landing strip kind of beard.

Clearly, I went in seeing baggage. I filled out the forms, then waited as they input them (asking me for the spelling of every field, as reading didn't seem to be the clerk's strong suite). Then they gave me some forms to sign. One of them read (paraphrased here), in large letters "Signing this cover letter means have read and accepted the terms of our privacy agreement." I shuffled papers -- didn't see anything like that. I asked the person behind the counter where it was.

"Um, we have one if you'd like to read it."

"Of course I want to read it," I said, "you're asking me to sign that I read it."

She fought the filing cabinet for a couple of minutes, then came up with a form. "Here it is," she said (mechanically) brightly.

"Do you often have people ask for the form?" I asked.

"Oh, yeah," she said, "all the time."

If so, I'd guess she probably didn't give it to 'em often. She didn't know where it was.

I read the form. At no point did it mention the HIPAA acronym. Don't get me wrong, HIPAA doesn't mean your or my privacy is ensured. But at least there's a nod to the processes and procedures involved.

I called the number for the privacy officer and got immediately bumped to voicemail. Pressed zero, then asked for the Concerna's Privacy Officer. That led to a different voice mail. I left a message.

To Concerna's credit (and this is a good thing), she did call me back within ten minutes.

"So, I had a question," I said. "Are you HIPAA compliant?"

"What's on the form details our privacy statement," she said.

"Um, yeah, but are you HIPAA compliant?"

She paused. "We are reasonably compliant with HIPAA," she said.

Knowing when to fold, as Kenny Rogers pointed it, is a good thing. The woman was upset that the lab didn't give me the paper, or wanted me to sign without seeing it. She took down the number and location of the lab ("we have so many; I don't know all of them," she said) and promised a training update to get them up to speed.

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There's no point in trying to reason with 'jack in the box' medical labs. They sell a commodity service to employers, and location and price are the determinants. But to employers, caring about whether their employee information is private should be a priority. And "Concentra is reasonably compliant with HIPAA...and privacy regulations" (quote from their web site) is not, in my professional opinion, good enough.

HIPAA compliance either is or isn't. It's like 2/3 pregnant -- comply with regulations, or fall short. My social security number, birth date and drivers license number are in the hands of a company that might or might not comply with Federally mandated regulations (pathetic, in light of identity theft).

Employers have a duty to ensure that their subcontractors and vendors adhere to at least the level of privacy that their customers expect from them.

Puppet Journalism

When Nasrallah speaks, the world listens, even if he speaks idiocy. "I believe Israel could have been behind [the two incidents in which Spanish and Columbian UN troops were killed]." No doubt that's why his group is escorting UNIFIL soldiers so they're not hit by Al-Queda IEDs.

There's no thought to reality testing his claims, or refuting them (or even discussing them) in the article (look here). This is an example of the kind of idiot journalism that has come to symbolize this generation's journalists. After all, if you talk back, question, or disagree with a Famous Name, at best you won't be invited for any exclusive interviews! (At worst, it's fatwa time!)

Yes, Israeli could have been behind the killings of the UN soldiers (no doubt it would be easier to accomplish when they take their R&R in Israel, which is where they go). Israel also could secretly be transmitting mind control signals to the Iranian President through its squirrel spies, or, equally probably, using nuclear space lasers to melt the ice caps so as to drown the Arab countries' shoreline populations and oil terminals. Oh, please, would someone quote an unnamed former Israeli intelligence source as saying that?

We depend on journalists to report news. Idiotic babble does not rise to that level and should not be quoted. Maybe if public officials were only quoted when they made sense, they would speak more rationally (and sparingly!). On speak, but not be heard, which, all in all, isn't a bad thing.

Writing Haitus

News and RL have a way of overwhelming a blog. So many issues, so little patience.

I'd lust like to draw your attention to Israel's latest attempt to prove the hypothesis that repeating an experiment without changing any variables will not create different results. By this I mean that the release of prisoners to attempt to garner 'favor' with corrupt and weak regimes.

The Freedom of Speech as a Dull, Blunt Object

A straight-A high school student was arrested for turning in a disturbing creative writing assignment, which included visions of mass killings with a pistol and necrophilia.

School: Danger! Virginia Tech! Alternative learning center, criminal charges, brou hah hah!
Student: Just being creative! Lookit the assignment! (Check out his hometown paper article on the subject and his comments on it.)

They're both right, and the issue lies with the technical vs. temporally cultural definition of "free speech." (I'm gonna get in trouble with this one: I've got a bro-in-law who's a constitutional law professor).

I'd argue that if this student had written this in 1999, before Columbine1 and before VT, it would have come off as weird, sick, and perhaps resulted (if the teacher really cared) in a referral to the school shrink.

Now, after seeing what high capacity magazines and sick twisted minds can do, that same piece is a giant red flag for possibly aberrant behavior. And this kid should "suffer" the consequences of stupidity, the same as a person who yells "fire" in a crowded movie theater.

No, there's no implied threat from the student. But there doesn't need to be one for someone to see the writing as a warning sign that a person is capable of homicidal fury. After all, when a child is found to engage in animal cruelty, especially serial animal killings, it's a sign this person may grow up to be a serial killer. It's a known, established track. And if the writer happens to be a high school or college student, caveat emptor: find something equally creative but less disturbing to write about.

In each generation we learn more about the 'tells' that indicate what a person might do. Twenty years ago was the animal thing. After Columbine, we learned that a young person's writings had weight in terms of their future actions. That Virginia Tech outstripped Columbine in sheer numbers of martyred students was only due to some mistakes on the part of the perpetrators of the Columbine massacre2.

At this point, we can't take that chance with our youth. The Illinois student deserves not just reprobation, but punishment. And counseling, for in every fantasy there is the grain of truth.

Having said that, it would be great if Americans could see past their own borders to the magnitude of tragedy overseas. What I'm about to say has nothing to do with my opinion of the President's Iraq policy. We read on a daily basis about the tragedies that befall the citizens of Iraq and Afghanistan. There have been two incidents involving students in schools in the last month. The total murmur on this in the general media has been body count and then moving on. To the children maimed or traumatized by being bombed, to the parents of those children, these events will change their lives forever. Helping them overcome or heal from those wounds is every bit as important as helping the survivors of the Virginia Tech or Columbine shootings. For all the money we're pouring into Iraq in terms of bribes, generator and food handouts, and other 'calming actions,' helping these kids and their families is a greater and more powerful way for us to minimize the chance that they, some day, do not turn into hatred-fueled perpetrators of massacres of their own.

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1. I'm including Pearl River and all other school shootings throughout the world when I say "Columbine"
   


2. Kliebold and associate had over 40 bombs set up in lockers and in two cars, placed so they would cause maximum casualties to police and ambulance responders -- but they didn't realize the alarm clocks they'd used had plastic instead of metal minute hands, which meant the circuits (thankfully) did not connect. The bombs were found and diffused after the last bullets had been fired. More on that here.
   

Nappy Hair, Rap and Virginia Tech

In a seven day span that has seen a talk show host who built his career as a shock jock have his career ended (for the moment) and national Black figures finally talking about accountability for misogynistic rap "artists," the horrific attack at Virginia Tech has pointed out the next real need for media improvement.

I'm not trying to compare any of the above in terms of impact. Of course my heart goes out to the victims, their families, and the entire staff and student body at Virginia Tech. It's healthy for the nation to join in their sorrow, to have a connection with their anguish, and to have the opportunity to help them feel a little less alone at a time like this.

What the media -- all the media -- have done is to create the kind of second-hand PTSD effect that we had with the 9/11 attacks: rerunning the traumatic sounds and sights on television, radio and the web. Splashing the picture of the lunatic responsible for the carnage, and focusing on the little details of a life he ended, dragging innocent victims along with him.

This coverage, the drilling in on the evil, the violence, the technical execution of this act, has the effect of diminishing the focus on the survivors and victim families in the name of 'ear share' or 'eyeballs.' Revelling in the pornography of this demented person's violence advances no causes, heals no wounds and provides no solace or closure. It inflames, incites formless anger and rage, or the kind of sadness that only helplessness can bring.

I can shield my children from the news at home or in the car, but the ever-pervasive media reaches beyond my hands clutching at their eyes and ears. I want to spare them from this far more than I wanted to spare my young children at the time from Clinton's 'little black dress' and explanations of sex positions at too young an age.

As a nation we have to stop. Stop our unholy fascination for violence and its depiction in audio or video formats. Stop our obsession with guns (and this as a pro-carry supporter -- they're tools, not fetish objects).

We must also start. Start paying attention to the "loners," the "losers," the children or adults that have come adrift in the midst of our lives. It takes a village to have a village, not just to raise children. In Jewish Shtetls a century ago, every village idiot had a place to turn to for food, for a warm place to sleep. It wasn't personal adoption, it was communal responsibility. Because all our children, all our co-workers are at risk from people allowed to break free from the social contract or from reality as we live it.

Which would you rather see: children being hauled out of dormitories covered in blood, or a glimpse of a breast? Which is more horrific? Which more deserving of 'community values' sanction?

What to do?

• Call your local media outlets. Sure, they're (statistically) probably owned by ClearChannel or Cox or some mega-corporation, but they have to document and report to the mother ship about listener/viewer feedback.
  
• Send e-mails to the web site.
  
• Complain to the FCC.
• E-mail your state representative and senators.
• Fax your federal representative and senators.
• Bring the issue up at city council meetings, school board meetings and in your place of worship.
  

Every state has a child abuse hotline. If you see someone under fifteen acting strangely, get some details, at least the name of the child, their school and the name of a teacher. Then call the hotline. It's anonymous, and it might save the life of someone you know or love.

Adults behaving oddly, stalking, making threats, should always be taken seriously. There are laws in place to protect people from "terroristic threats," and protective orders, while not always effective, can be a good deterrent. The best deterrent is to stand up for your neighbor, your co-workers, and even strangers. Police officers would rather handle a dozen false alarms than one homicide. Every time.

I wish peace and comfort for the Virginia Tech victims and their families. And a measure of peace for the rest of us, so that we can comfort, not relive by proxy their experiences.

Easy killings, relative freedoms

Switzerland has started down the slippery slope of allowing people with death wishes to kill themselves. One of the countries that evaded the deNazification trials after WW II by claiming "neutrality." Eugenics continue where not positively abated.

In a country where President Clinton went out of his way to apologize for the Tuskegee Airmen, where States abandoned their forced sterilization of "mental incompetents" in the 1980's, reading about a first-world country moving towards helping sick people kill themselves is tragic.

Depression, bi-polar disorders and other mental illnesses can take a rational person and make them think suicide is a real option. They're right -- from a purely animal basis. But the damage they do to family really negates their selfish, tactical, short-sighted attempts to escape their pain. Medicine works. Therapy works. Suicide, as the MASH movie quote went, might be 'painless,' but the 'changes' it brings on affect the parents and families and co-workers (or fellow students) are far from that.

It's easy to toss away those in society who waver. It takes a strong society, a just society to stick up for members who are not capable of sticking up for themselves.

Switzerland is showing it's Nazi roots. The world should look at this, and then look at Darfur, the Gaza Strip and Iraq to see how it can avoid the curse of the blind eye in treating world citizens as they should be treated.

Christmas 1914 and how This isn't Your Grandparents' War

The first year of the War to End All Wars, was shockingly brutal for all sides. The accepted rules of combat from the previous century were shredded by technology: the machine gun, the tank, mobile cannon. Gas attacks, which helped birthed the Geneva Convention had yet to be committed.

On Christmas day, 1914, Germans and English, at various places along the front, stopped fighting. They came out first to bury their dead in shared prayers, then went on to talk (most Germans knew some English), trade tobacco, pipes, buttons and other momentos, and sing and even pray together. German barbers even shaved English troops during the ten day truce. Even after the truce was expired, some troops on both sides tried not to kill their erstwhile trenchmates.

This was the last global conflict of the nation-states. By World War II, the conflict had shifted from pure national supremacy back to the US' Civil War: industrial and financial dominance and national fascism¹.

Our enemy bears no resemblance to our German foes, now turned full partners in democracy and cold, international industrial might. They don't share our values of war, of life (theirs, their constituents, or their enemies), aims, goals. We have nothing they want, other than our subjugation or extinction. They have things we want, and have raped them for decades to get, and we Western nations are now reaping this bountiful crop.

This "war on terror" is truly the Jihad and Crusade, terms villified by both sides for its loaded terms. The emperor has no clothes. The fanatics backing terror will not come out of their trenches to sing Kumbaya on an emotional basis. And if they do, beware the blades behind their backs and bombs strapped to their torsos.

There are some similarities. Innocent civilians are caught in the middle. Cynical military leaders use 'martyrs' on one side, and socioeconomically hungry citizens on the other to do their bidding². And the grinding war itself has little point, cannot be resolved by force, and seems to be intermidable.

World War I ground to a halt in part due to the Allies finally strangling the Axis powers' industrial might: oil, machinery and humans. It ended also in large part due to the influenza pandemic that was slaughtering close-quartered troops at a rate far in excess of any human cannons or machine guns.

Europe suffered from demographic cratering. Due to the sheer devestation and the magnitude of this high-impact war, the societies were able to rebuild -- only to lash out less two decades later in nationalistic angers partly fueled by the nature of the initial defeat.

This low-impact, slow-motion war gives both sides endless opportunities to rearm, learn from their tactical mistakes, and, at least on the terrorist side, fill in the gaps in their ranks with new martyrs, disempowered, emasculated virgins in this world looking to make their first score with their counterparts in the next.

The question is: is the West willing to really fight for victory, or keep the sniping up?

Economically, international corporate-nations with ties to all sides of the conflict are profiting by the tens of billions; it's not in their interest to fight this war to conclusion. Why rebuild a school once if you can rebuild it three times? If the current infrastructure destruction in Iraq continues, it will be importing gasoline like some other major oil producers, a clear added bonus for these "reconstruction firms." This is the ugly military-industrial complex of which President Eisenhower warned.

Politicians have loved the war until recently: fear sells votes. The turnover in the US House and Senate were as much about absolute corruption as the Iraq War. War is great for a country's economy: the huge post-WW II boom was fueled by the technologies and capacities built up during the war³.

I've heard many Americans cut the Gorgian knot and point to the obvious solution: Do not to abide by Western rules of conduct; instead follow that of the enemy. Attack with full strength, quickly cause maximum, lasting damage, and ensure that whatever population is left rebuilds by our rules, not theirs.

That might have worked in Iraq at the start of this war. Now, it would resemble a sore loser tossing a board game into the air, scattering the pieces, when play does not go his way.

There is something to be said, however, for overwhelming, drop-that-20,000-ton-bomb- and-then-invade-with-200,000-soldiers force in small areas. If the United States is to be taken seriously, it will need to be serious, pervasive force, with specific objectives and a take-no-prisoners attitude.

Right now the administration doesn't have the guts to make that decision, and generals may not have the force strength to take that decision. Maybe some variant of the H5N1 flu will come to our aid. God forbid.

Happy holidays.

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[1] Hitler's rise to power was funded by industrialists who saw the money to be made in a war-oriented German economy. America didn't want to get involved in the foreign war because it was not economically expedient. Like England until the Nazis got too close, it was seen as better to let the various powers fight their own war. Japan attacked the US in part because it was threatened by Washington's oil (energy) sanctions -- a turnabout on America's oil policies of today.

[2]Even after joining, many US soldiers' families rely on food stamps or other aid, as the pay, even with hazardous duty bonuses, is not sufficient to raise a family. Non-citizens join the US army in hopes of citizenship -- which is granted posthumously in some cases.

[3]The difference today is in debt and trust. Whereas in WW II Americans were exhorted to save gasoline, grow their own vegetables and be more frugal, President Bush exhorts citizens to keep up their level of spending (debt) and consumption. That's critical because we are not short so much of supplies as we are of the movement of money in our economy.

From the Mouths of (Jewish) Babes

My daughter, to a school friend trying to convert her (named Christian, lest there be any doubt): "I know you're trying to save me like, from the burning flames of hell, but... I'm okay."

Apartheid -- A Stinking Rose by Any Name

Former President Carter is a naive fool, playing into the hands of both a cynical media and an equally cynical antisemitic Arab PR machine.

Jewish leaders protesting Carter's use of apartheid are self-delusional at best, lying at worst.

Israel has generally treated not only the West Bank and Gaza residents (however they want to refer to themselves) as something a little better than cattle, and something definitely less than human for over thirty years. I've seen it, anyone who's lived or worked in the agricultural, construction, or industrial sector has seen it, and anyone denying it is lying.

Israeli arab towns and cities get less economic, social, cultural, infrastructure, tourism, security and every other support available to their Jewish -- and even mixed ethnicity -- cities. Go drive up a street in Deir Al Assad, then take a spin in neighboring Karmiel. Check out the practice soccer pitches in Haifa, the drive up to Massadeh on the Golan Heights (officially annexed by Israel years ago).

That's not to say that there aren't great people, companies and relationships that transcend these terrible and institutional practices. But the norm is a form of apartheid. Carter's blunder is to let the media equate the concept of apartheid with the level of apartheid. Israel, at its worst, was far better a master than the South Africans. Just writing that sentence makes me cringe, but it's a true, qualitative statement.

And Carter using that statement turns a possible discussion about the non-revolutionary ways out of the quagmire that is the Middle East into a firestorm of fury about the players, guilty and innocent, that have to survive it.

President Carter should stick to building houses for the homeless, and American rabbis should stick to helping their constituents. Neither seems qualified to engage in this current discussion.

The Nuclear Non-Proliferation Treaty is Dead

With the signing of the deal with India, North Korea, Iran and even Israel can breathe a sigh of relief. No longer can the United States declare that it has been even-handed in how it treats 'rogue' nuclear nations. Even the concept of a 'rogue' nation is no longer valid. India and Pakistan can now figure out how to stockpile for their next testosterone-fueled war of brinksmanship. Israel (whose possible possession of nuclear weapons I personally support) can stand proud in its theoretical ownership of these weapons -- and several different and very accurate delivery systems.

The United States had had the ability to force Iran and North Korea to the table: the NNPT is, after all, something to which almost all countries are signatories. Now that chance is lost, and those two fascist regimes can stand beside Israel as rebels with a cause. After all, if India could cut a separate deal, why can't they? And in the meantime, just like India, why should they not continue to create the tools for world blackmail?