Health Care forum blasts high costs

At Monday's forum on health care, moderator Dr. Jeffrey Solomon got the meeting started.

Surprise! High costs are the No. 1 problem in the U.S. health care environment. So said most people in the group your blogger moderated at the Miami-Dade Democratic Party’s forum that will send up a report to the Obama-Biden transition team.

The event Monday evening at American Legion hall in Miami drew about 75 people, pretty close to capacity. Most were members of the party’s Democratic Executive Committee but with a strong representation from outside the DEC, especially people in the health field, from nurses to doctors and administrators and specialists in alternative care. Thanks to all for participating.

We were split into five groups to discuss a range of issues and eventually to report to the Obama-Biden Transition Team and to the incoming secretary of health and human services, former Sen. Tom Daschle. (Daschle was not in Miami, but rather at a forum in Indiana.)

Your blogger hopes to publish our full submission here on Miami-Dade Dems. For now, a few impressions from a lively time in my group.

· Participants easily agreed that high costs were the main problem in U.S. health care. Related but not identical was access to health care.

· Health insurers got a lot of criticism for contributing to high costs and to access problems.

· Most in the group favored moving to a system like Medicare for all.

· The role of employers in providing health insurance got a lot of debate.

· Alternative care such as acupuncture and homeopathy was strongly supported.

· Practically everyone has detailed knowledge of serious and specific problems in health care, often with poignant stories of problems of their own or their loved ones.

Overall moderator was DEC member Dr. Jeffrey Solomon, who has the unenviable task of wrapping it all up for the Transition Team. Good luck, Jeff!

And this corner says Thank you to Barack Obama for letting the public talk about this issue. Now, what do we think about climate change and vast coal-ash spills? About money in politics? About torture and military-based foreign policy? I’ll bet we’re going to be asked.

As to how to attack poverty, here’s a thought-provoking article in a recent Sunday NY Times magazine on how Mexico is leading the way. Yes, Mexico. And not a moment too soon for me. I was about to write off Mexico as a very large failed state right on the southern border.

Footnote: There was no sign of our meeting being packed by the insurance industry, as was speculated recently in a NY Times article. Or … did anyone hear suspiciously vociferous support for health insurers?

Part One: Health Care forum report for Obama-Biden Transition Team

Community Health Care Discussion, Miami Florida
December 15, 2008

[Most of the dozen participants were members of the North Beach for Progress group, which came together during the Obama presidential campaign. The group is continuing on an ad hoc basis. Its first major action was to call a forum on health care and report its conclusions to the Obama-Biden Transition Team. In three parts, this is the complete report.]

By Dava Michelson

Our meeting represented a diverse group of providers and consumers of health care; the professions represented were Medical Doctor, Ophthalmology, Acupuncture, Medical Qigong & Chinese Medicine, Homeopathy, Massage Therapy & Chiropractic. Among us were a retired journalist, computer specialist, lawyer, student, independent medical and health care practitioners and owner of complementary and integrative multi specialty clinic. Comments here represent everyone’s ideas, but not necessarily consensus; they also include those from people who were unable to attend the meeting but wrote in their ideas.

In discussing the problems with our current system and the changes we would like to see, certain themes emerged. We found ourselves coming back again and again to the question of: What is health care? What is the difference between promoting medicine as opposed to promoting health? What are our choices, and what are our responsibilities in regard to developing and maintaining our own health? How can the priorities of providing the service of caring for and responding to the needs of another human being be reconciled with the bottom line of the finance departments and stock holders? What is preventive medicine and the importance of expanding choice.

In outline form below is a synopsis of our concerns, observations, experiences and suggestions, followed by some of our personal stories.

COSTS
• Huge administrative costs and legal issues siphon off funds from health care
• As we tax cigarettes, tax certain foods that are now known to present health risks and use those revenues for health care
• Do not allow patents to be issued on naturally occurring substances, or products in common use for years, such as ayuvedic herbs.
• Apply UCR: usual, customary & reasonable pricing standard
• Insurance companies have created a system, not based on UCR, that forces practitioners to inflate charges… in one example, doctors having to charge $900 to get paid $72
• Control pharmaceutical advertisements and charges.
• Disallow price fixing by the drug & insurance companies. Disparity of pharmaceutical costs in the US vs. other countries. One participant paid $50 in Israel for a prescription that cost $300 here in Florida. Many people trying to go to other countries for their meds.
• Exaggerated costs of dental care need to be brought under control.
• One participant paid $12,000 in Colombia for medical procedures that would have cost $1,500,000 in the U.S. IF someone would agree to do it, but couldn’t get the surgery approved. She would have died if she had been limited to care in the U.S. (see Linda’s story below)
• Drs. and providers put in a position by insurance reimbursement policies to work to build up their billings rather than making decisions solely on what is best or necessary for the patient.
• Concerns with insurance greed in lobbying: good for insurance companies for medical costs to be high: more money, more lobbying power.
• A hugely excessive amount of time is required for providers to fight with insurance companies for payment. Even on pre-approved cases, it can take over a year to get paid, or be denied. One participant in private practice spent 3 days of her week working on insurance billing until having to hire someone to do this. Obviously her costs now must cover this extra time and salary.

CHOICE & EQUAL ACCESS
• We need Health Care Freedom of Choice, and for it to include alternative and complementary providers and modalities and other natural remedies.
• Independent research is necessary, rather than by pharmaceutical companies who have motive to skew research results and minimize or deny side effects.
• We are stating strong opposition to the Department of Health and Human Services' (HHS) Provider Conscience Regulation, which allows providers to deny health services without disclosure based on personal moral beliefs. It simply must be repealed.
• People’s health care choices are severely limited by the lobbying of the AMA and pharmaceutical companies, which have prevented the availability and education of many forms of care.
• Make pharmaceutical televisions ads illegal (companies spend $10,000 per year per doctor, use of sorority girls to sell pharmaceuticals: put money towards doctor education

EVIDENCE BASED MEDICINE & INTEGRATIVE CARE
• The emerging information technologies provide much promise and benefit, yet great care must be taken to make sure that we not become limited to information and research that makes it through only a certain filter of review. An outrageous example of this is my daughter’s pediatrician who was chastised and warned by those in charge of her group practice for prescribing alternative unproven medicine. Chamomile tea for mild stomach upset apparently is dangerous until it goes through scientific double blind studies, so the drugs that have a list of side effect disclosures are what must be prescribed. We MUST remain open minded knowing that tomorrow’s wisdom will prove things we are as of yet unaware. (See My mother’s 15 years of pain story below) Some wisdom has yet to pass scientific scrutiny; years of experience should not be reduced to “heresy”. There must be respect for empirical evidence.
• Many forms of complementary medicine, such as Homeopathy, Acupuncture and Chiropractic, are constitutional based medicines, treating issues in the context of the whole person; body mind & spirit. As such, treatments are individual; what works for one person’s headache will not be the right approach as for another. The efficacy of these protocols cannot therefore be evaluated through the current statistical model which requires the same treatment be repeatable.
• The training programs for MDs to be certified as acupuncturists are between 100 and 300 hours. While they may do some good with their training, it should not be considered equal or comparable to professionals who study 4 years in the current entry level Masters degree programs in Acupuncture and Oriental Medicine. One cannot understand or master an entire medical system in such a short time, the best they can do is use some of the tools of Oriental medicine in a western allopathic way.
• As such, it is imperative that as acupuncture and Oriental medicine is embraced and included in integrative practices, it’s design and regulation must not come from MDs, but from people FULLY trained in the field.

PROMOTING HEALTH
• While Western Medicine can be brilliant at fighting disease, promoting health requires a perspective shift from a disease model to health model.
• What helps people to want to be healthy? What can government do to create incentives for the public to be healthier?
• Start in the schools. As recycling was popularized by kids bringing the ideas and passion for it home from their learning and involvement at school.
• Promote physical fitness with mandatory PE classes in school.
• Expand our understanding and practice of PE (physical education) to include yoga, marshal arts, meditation, and self care)
• Create infrastructure that supports physical health such as: bicycle & walking paths. As we have a public library system, create public exercise facilities, and promote public transportation
• Promote healthy food choices and availability: teach kids better habits in school through nutrition classes, providing healthier food in cafeterias and removing junk food from vending machines. Investigate corporate influence in American Dietetics Association.
• Get McDonalds out of the hospital lobbies. Provide healthy food choices.
• Vegetable gardens in public schools and provide, promote victory gardens in cites and suburbs, plant fruit trees on public lands
• Promote air, water & food quality
• Create incentives at work for healthy life style choices: smoking cessation is an easy one to agree on, but things like food choices and exercise are so individual, trying to come up with a standard to reward people for is difficult but should be explored.
• Expand & support Second Harvest, and other food recovery programs. A blemished tomato, a broken chicken leg render these items unable to be sold and are routinely thrown away along with tons of perfectly good products whose expiration dates really do not render the products inedible at the stroke of midnight. This waste is unconscionable considering how many people are hungry and undernourished in this country.
• Funding of community health clinics that offer holistic and preventive as well as allopathic choices of care. These clinics should be as easily accessible as Starbucks!

[MORE: continued in following post.]

Part Two: Health Care forum report for Obama-Biden Transition Team

[This is Part Two of the report from Dec. 15 Health Care discussions by the North Beach for Progress group]

PROMOTING PERSONAL RESPONSIBILITY
• Is it fair to ask insurance companies or taxpayers to take care of the consequences of people refusing to take care of themselves? An example is the prediction that 1/3 of children today will end up at some point with diabetes. We KNOW that lack of exercise and a diet high in refined sugars and carbohydrates causes this disease, yet the fast food industry thrives and most products in our children’s cereal boxes, lunch trays, snacks and drinks are poison to people with this condition. Should society, in the form of taxes or health care insurance costs have to be obligated for this lack of personal care?
• In fairness, many people don’t have the education, time, money, or incentive to either understand the choices that are available, or the ability to make the changes.
• We need to stop Cola ads the same way we stopped cigarette adds.
• We need to curb the fast food industries’ reliance on highly processed nutritionally deficient foods and provide more vegetables and whole grains.
• We need to have a public advertising campaign that makes healthy food and exercise and health choices a “cool” thing, and find some way to create incentives for people to make better choices.

ISSUES EFFECTING DOCTORS ABILITY TO PRACTICE WELL:
• An excessive 20% to 30% of time is spent on paperwork & billing & other non-patient activities, significantly reducing the amount of time available to spend with patients.
• The high costs of medical education (about $160,000) and malpractice insurance limit the kinds of care they can offer and creates an imperative of choices doctors have to make to stay in business. There is a need for more primary care physicians, but they are dwindling in number as it becomes difficult to afford to pay back school costs.
• Due to legal, insurance and administrative costs, doctors are in a position where they must practice defensively, rather than what is in the best interest of the patient.
• No reason or consistency in denial of claims from insurance companies, good Drs. are leaving practice, can’t afford to cover costs on what insurance companies will pay, and their whim of when they will pay or deny, even on pre-approved items.
• Large uninsured population in Florida
• We need to make a decision about what part money plays in the type of services available. Here, cost is paramount in decision making as opposed to human care.

MANAGED CARE
• Procedures, tests and referrals are limited or disallowed to provide cost savings. Drs. are paid far below UCR per patient visit, necessitating overfilling of treatment slots. Quality of care is often inferior.
• Consider efficacy of eliminating managed care.

PREVENTIVE MEDICINE
We applaud Obama’s vision of expanding promotion and coverage of preventive medicine, but the understanding of what is prevention needs to be greatly broadened. Early screening for cancer is a great idea, but early detection in the fight against a disease is NOT prevention. Broadly speaking, prevention is about building our health, not fighting disease. It is building our immune system, keeping our body strong and cleansed of toxins; about dealing appropriately with stress and working to bring our lives into balance: physically, mentally, emotionally and spiritually. We perform regular maintenance on our cars so they won’t break down, but wait until we are sick or ailing before we take care. Western medicine is great at fighting disease, but it is complementary medicines such as Acupuncture, Homeopathy, Massage Therapy and Chiropractic that are best at helping people stay well by maximizing optimal balance and function, and relieving stress. If we brought ourselves in for seasonal “tune-ups” like our cars, the “machine” of our body would have far fewer breakdowns. Lifestyle choices like the food we eat, type of exercise, cleanliness of our environment, how we deal with stress, how we balance our personal, professional and spiritual lives; all of these are what we must look at if we are going to promote preventive medicine. And we need prevention inculcated from elementary school onwards so children learn how to keep themselves sound of Body/Mind/&Spirit.
Another aspect of understanding what preventive medicine is about is the screaming child. When our child starts screaming we are alerted to their being in distress, that something is needed to help them, and maybe we look and see a big red hot swollen bump and realize that’s where they fell and that’s the place that needs the icepack. We respond with what they need, they feel better and the crying stops. No one would think that an appropriate intervention would be to tranquilize their vocal cords to stop the screaming, yet that is in fact what much of our accepted standard of care does in suppressing symptoms. We need to learn to reach for the natural remedies that support our body first before we turn to the big guns of drugs and invasive procedures. A cup of chamomile tea often works to calm an upset stomach and nerves and is certainly worth a try before reaching for the medications with their higher costs and side effects.

IN MAKING A PLAN:
• Must be very careful to make sure policy is not unduly influenced by self serving motives of pharmaceutical companies, lobbyists, legal profession, providers with special interests (AMA) to the exclusion of other forms of care that serve patient and public needs.
• Confusing health insurance with health care: we are paying for insurance, not treatment.
• Reduce technology where it causes excessive time away from actual patient care and evaluation, and where it removes the ability for human oversight and individual response. And…
• Make technological resources available to practitioners, including those in smaller private practices not associated with hospitals or institutions.
• Stress public plan option to force existing companies to promote health rather than stockholders.
• Revamp how providers are going to get paid.
• Provide universal health care with tight transparency and accountability. Our citizens should neither fear ill health due to horrendous bills nor should they feel alienated from the health care facilities due to impersonalness, excessive emergency care waits.........poorly trained or exhausted nurses and doctors.
• Use lottery slush fund resources to fund community health projects.
• The pharmaceutical industry needs to be made into a tool of a health care system that provides safe and totally proven effective remedies.
• Since medical school costs are prohibitive and the ability to take loans is shrinking, provide medical school training to qualified students in exchange for their working in community based not-for-profit clinics for a certain number of years upon graduation and licensing.

CONTINUED ACTION:
• Feedback from administration on these community conversations that this participation has a chance to create effect will increase motivation for continued involvement.
• Support Health Care Freedom lobbyist in Tallahassee
• Watch congressional hearings, call and write to representatives
• We need a spirit of volunteerisms and a toppling of laissez faire mentality for health matters.

[MORE in following blog post]

Part Three: Health Care forum report for Obama-Biden Transition Team

[This is Part Three of the report from the Dec. 15 Health Care discussions by the North Beach for Progress report.]

OUR STORIES:

Linda’s story:
In April 2007 I began having trouble defecating. Although I had health
insurance, my deductible was $5,000. I therefore paid cash ($600) for a CT
exam which was inconclusive. The colo-rectal surgeon who ordered the test
told me that I probably had a gynecological problem and to go to a
gynecologist. I then went to a gynecologist who told me I probably had a
hematoma and that I needed to consult a general surgeon.

I had a trip scheduled to Colombia and while there my symptoms worsened. I
visited a bio-energetic M.D. there who ordered a pelvic ultrasound, CT and
colonoscopy. They were all performed that the same day, and I left each exam
with results in hand. The next morning the bio-energetic M.D. reviewed the
results and advised immediate surgery to remove a mass in my colon. A
colo-rectal surgeon was added to the team and surgery was scheduled.

One hour after the surgery began my partner was advised that I had cancer
and that I would be given a colostomy and a 3 month life expectancy. My
partner, to whom I am not married, protested this conclusion and asked the
surgeons to consider another alternative. After discussion, the surgeons
agreed to attempt to remove all of the abnormal cells from my colon and
abdomen, but told my partner that I had about a 10% chance of survival.

The surgery lasted 9 hours and involved removal of a central mass, two 6"
sections of bowel, removal and reconstruction of the bladder, removal of the
cervix and 1/2 of the vagina, and removal of an ovary. During the surgery a
urological surgeon and a gynecological surgeon were called in to consult and
assist in the surgery. The urology surgeon actually found the second mass in
the colon. I received both allopathic and homeopathic medications during
the surgery, in intensive care and post-operatively. I spent two days in
intensive care and ten days in a private room in the hospital. My total cost
for the pre-op exams, 9 hour surgery, all physicians and surgeons, and
medications was about $12,000, paid in cash.

After returning to the States two months later, I was examined by physicians
here who all said that I would not be alive if I had stayed in the States.
Apparently malpractice insurance rules would have prevented the surgery from
being performed here because the chance of survival was so low.

I submitted receipts to my U.S. insurance company for reimbursement. They
reimbursed $3,800 of the $12,000 and have ignored requests for explanation.
Soon after submitting the receipts, I received a retroactive notice of
termination of my insurance. Three months of premiums were reimbursed with
the notice.
Two deaths:
My story is about how 2 beautiful women in my care died of end stage cancers. One was my mother who died in pain and anguish as the chemo drugs poisoned her body. The other was my dear friend Laurie who refused traditional western medicines and chose healing instead. She used herbs and diet to cleanse and balance her body and build her immune system, acupuncture and medical qigong to cleanse pathogenic qi, balance her body’s energetic pathways, build her immune system and relieve stress, therapy to resolve deep emotional patterns, and spiritual counseling to open to the healing of spirit. As my mother’s disease progressed, her skin became more and more grey and pasty, her eyes duller and duller. Laurie on the other hand, became brighter and clearer, her skin and eyes radiant. Neither wanted to die. My mother’s last days were filled with bitterness and pain. In Laurie’s last days she said she had never before experienced such deep love and peace. My mother was poisoned; Laurie was healed. Yet our doctors’ choices, under standard of care guide lines set by the AMA, the drug company lobby and the insurance companies, are limited to surgery, chemo and radiation. Chemotherapy, the use of poisons first developed in the concentration camps, and radiation whose “success” rates are limited; procedures that in some cases yes save lives, yet are often themselves the cause horrible pain and death; these are the procedures that insurance will pay for. None of the modalities that brought healing and peace to Laurie were covered by insurance. According to the insurance companies, supported by the drug companies and the AMA, these alternatives are considered “too experimental” and there is no “proof” that they provide value.

My healthy daughter’s inability to get health insurance:
While a senior in high school, my daughter was exhausted; typical of a teenager burning the candle at both ends and the middle, yet I took her to our doctor to make sure she was ok. While her blood tests were fine, he put her on a low dose of thyroid medicine as a test to see if she was in the beginning stages of sub-clinical hypothyroidism. In 3 weeks he determined that her thyroid was fine and she stopped the medicine. It was during those 3 weeks however that I applied for health insurance for her. I told the insurance agent about the test of medication, asked if I should wait until the test was over to apply, was told it was not going to be a problem, and a week later was denied coverage for “a pre-existing condition”. I called, I wrote letters, my doctor called and wrote letters all explaining the test of medication and it’s proof she is a normal healthy teenager who, as suspected, was tired because as most teenagers she needed more sleep! After numerous appeals, we gave up. About 6 months later I applied to another insurance company who this time denied her because she was previously denied by another insurance company. Followed more appeals and letters from the doctor, and this time copies of her complete medical records since she was born. Upon evaluation of her records, they now denied her on grounds of chronic depression. What? There is nothing in her experience or her records to indicate that. What was there was that she was frightened and depressed for a short while as her mother went through a mastectomy and began chemotherapy, a normal healthy response for anyone. Now my daughter’s records show that she has been denied by 2 insurance companies for a pre-existing thyroid condition and manic depression, none of which is true, yet I cannot clear her record.

My mother’s 15 years of pain:
When I was 8 years old I watched my father and brothers carry my mother up the stairs to her bedroom, screaming in pain. She was returning from surgery on a slipped disc in her low back, a surgery that is no longer performed because they discovered it caused more pain and damage than the condition it was meant to help. The doctors said there was nothing left but for her to live on painkillers. For years she took their prescription of Darvan Tran, until it was taken off the market when they found it caused irreparable nerve damage. For my entire childhood I barely saw my mother out of bed, and when she did move it was slowly, painfully in a full body brace; she had to crawl up the stairs. I went away to college and during my third year my mother called me one day, sobbing uncontrollably. It was the first day in 15 years that she felt no pain. She was off of her painkillers, out of her body brace, and capable once again of dancing with her husband. Nine months earlier, a friend began to pick her up and twice weekly bring her to a Chinese acupuncturist whose treatments healed her. Procedures unknown and unproven to western science, yet practiced and refined for thousands of years by cultures around the world.



Thank you for your consideration!

[Last of three parts of the report from the Dec. 15 Health Care discussion by the North Beach for Progress group.]

Christmas present: Finally revealed who was B. Virdot

Those of us of a certain age and from the heartland will have known this story for many years. Picture the Great Depression, hard times in Ohio, and an anonymous donor is offering money in small amounts to people who only have to write and describe their need.

The checks for $5 or $10 came from an account with the name B. Virdot on it. That was 75 years ago. I didn't learn who B. Virdot was until this fine article in the Monday NY Times. I hope readers will enjoy the same thrill of remembrance and heart-warming that struck me.

And a footnote: I sent the link to friends in Ohio, with a note that the author, Ted Gup, is a journalism prof at Case Western Reserve University, and perhaps their son who's studying there knows him. Turns out the young man is about to take his second course from Prof. Gup and has nothing but praise for him.

Bus? Train? Get if off your chest

Take a survey about public transport.

http://www.questionpro.com/akira/TakeSurvey?id=1072270

This is about Miami-Dade County and its public transit present and future.

Shoes

Click here, thanks to the Huffington Post, and enjoy a roundup of the brilliant shoe jokes on the Monday night talk shows.

Florida enjoying youth wave in politics

This is heartening news – more young people drawn into political activism in Florida. This particular story in the St. Pete Times is about the Tampa Bay area, but I’d guess it will apply to most of the state. Note that it’s not only Democrats who have been energized by our youngish presidential candidate. The Republicans are on to this, too.

I have a comment pending there to toot Dade’s horn, since we elected 29-year-old BJ Chiszar to be chair of the county party leadership body, the Democratic Executive Committee. We have plenty of wise old gray heads and new blood, too.

Can't wait for Jeb to run

It would be a fantastic test of the Florida electorate's new-found intelligence, were the former Gov. Jeb Bush to run for U.S. Senate or anything else -- dogcatcher, for instance. What a record he has. The following rant from Florida Politics is an example of what should be planted repeatedly in front of the public until Jeb slinks off to, say, Oklahoma, where minds are not clouded by facts and Bushite candidates win big. (In the presidential voting Oklahoma went for McCain-Palin 2-1 (66% to 34%) -- the biggest red margin in the nation -- while we smarter Floridians were 51% to 48% for Obama-Biden.)

UPDATE: A few hours after this went up I learned that George W. Bush is touting his brother for U.S. Senate. Check out the Tampa Tribune where it's reported that W and Laura pushed the idea at their Christmas party Thursday. My dream coming true ... END of UPDATE.

Here without any abridgement is what was posted Thursday on Florida Politics. Please linger a while and click on the links. This fine blog post is a treasure of trusted sources about bad stuff on Jeb. Your attention is especially drawn to the last paragraph's compact summary of the cruel condition we Floridians are in, thanks to Jeb Bush and his party:

Laff Riot

It has been quite the laffer to read Florida's newspaper companies blasting Illinois state government corruption, after sitting on their hands in Florida for the last decade.

Where were these geniuses - who are all atwitter about the Illinois Governor - when Florida's own Mr. "Make the Money and Run" ...

... who has since cashed in by jumping on board several gravy trains, including Lehman Brothers (the investment company that sold the state millions in bad mortgages), Rayonier (the Jacksonville-based timber and real estate company from which the state purchased nearly $100M in land during Jebbie's tenure), and the "nearly $37,000 a day" Tenet joy ride ...

... was corrupting Florida's election process, fomenting state constitutional crises, gutting Florida's system of public finance*, handing state work to "'a network of contractors who have given him, other Republican politicians and the Florida G.O.P. millions of dollars in campaign donations'", and otherwise according to the radical Time Magazine, leaving Florida with the

worst real estate meltdown since the Depression. We've got a water crisis, insurance crisis, environmental crisis and budget crisis to go with our housing crisis. We're first in the nation in mortgage fraud, second in foreclosures, last in high school graduation rates. Our consumer confidence just hit an all-time low, and our icons are in trouble--the citrus industry, battered by freezes and diseases; the Florida panther, displaced by highways and driveways; the space shuttle, approaching its final countdown. New research suggests that the Everglades is collapsing, that our barrier beaches could be under water within decades, that a major hurricane could cost us $150 billion.

The End of the End of the Revolution - Castro's Cuba at 50 - NYTimes.com

It's sneaking up on me that we're a few weeks from the 50th anniversary of Castro. What to do about it? Read stuff about Cuba. I'm recommending one good summary of the Cuba situation in the Sunday NY Times magazine:

The End of the End of the Revolution - Castro's Cuba at 50 - NYTimes.com

You can read and read and not find a whole lot of new information. Toward the end I found a nugget in this:

Cuba is some way down Obama’s priority list. But early in his presidency, another Democratic president, Jimmy Carter, did something that changed views of him in the hemisphere: he negotiated, against all the odds, the transfer of sovereignty over the Panama Canal to Panama. It seems clear enough that a breakthrough of similar proportions with Cuba would bring a major reconciliation with Latin America.

Dan Gelber: "Seriously looking" at U.S. Senate

Here it is on Dan Gelber's blog: There is this senate seat in Washington, once held by Bob Graham, one of the great Democrats of the late 20th Century, now held by Mel Martinez, who's retiring after a supremely undistinguished first term as a Republican yes-man, and Dan Gelber is "seriously looking" at it.

Read it at this link to the Dan Gelber blog, which is charmingly named "Dan Gelber for Senate" without saying State Senate or U.S. Senate.

For the uninitiated, Gelber has just been promoted from Florida State Representative to Florida State Senator. I am privileged to live in his state rep and state senator districts.

New chair of Miami-Dade Democrats is BJ Chiszar

BJ Chiszar is the new chairman of Miami-Dade Democrats. It’s an energized throng of 600,000-plus with a big presidential victory under their belts and many more goals before them.

We have a charming and powerful new director – charming enough to have his lovely mother, Dawn Goldman, be one to second his nomination with stories of how the “born politician” was an organizer as a toddler, and powerful enough to quiet a disputatious crowd starting to … well, let’s not predict how that might have developed.

Back to bare facts: This was the organizational meeting of the Miami-Dade Democratic Party, in its legal body, the Democratic Executive Committee, with some 200 members present Wednesday evening and voting on officers for four-year terms, as we must right after every presidential election. Most of the voters are precinct committeemen and committeewomen elected in the August primary. Well over the quorum of 141 were present in the Firefighters Hall in Miami, and we were watched over by representatives of the Florida Democratic Party, Pasco County Chairwoman Alison Berke Morano and Hamilton County Chairman Rhett Bullard, who counted the votes along with Pinecrest Mayor Cindy Lerner, our outgoing state committeewoman.

As this blog will be neutral and positive in local party issues, here are the bare results.

--For Chair: BJ (Benjamin John) Chiszar, a professional campaigner, defeated tax attorney Eric Copeland in the second round of voting, 108-87. Miami Beach activist Dave Patlak, outgoing vice chair for outreach, was eliminated in the first round with 41 votes.

--For State Committeewoman: Verna Lewis Edington won in the second round over Millie Herrera, 92-86. Ann-Lynn Denker was eliminated in the first round with 38 votes.

--For State Committeeman: Bret Berlin won over Dr. Thomas Pinder, 134-57. Berlin has been the party chair for most of the past year and previously was state committeeman since 2004.

--For First Vice Chair: Daisy Black, a former mayor of El Portal, won over outgoing First Vice Chair Bess McElroy, 95-77.

--For Program Vice Chair: Liz Collins won in the first round with 76 votes over Edith Owens with 33, America Schroh with 23 and Walter Liebowitz with 19.

--For Outreach Vice Chair: Henry Crespo Sr. won over Alix Desulme, 84-75.

--For Secretary: Fanny Olmo won unopposed after the outgoing secretary, Charlotte Klieman, declined to run.

--For Treasurer: Paul Barthole won over Gabriel Mendoza, 101-52.

Thanks to all who ran! Thanks to those who served as officers in the previous term! Thanks to all who stayed through a long meeting and voted repeatedly!