Bishop Mariann Budde spoke to Trump in a soft voice but her pleas for mercy were heard around the world

What Did Bishop Mariann Budde Say To Trump During The Inaugural Prayer Service? Here’s The Full Transcript in Forbes. 

By Siladitya Raym a New Delhi-based Forbes news team reporter.

Watch a video here

Rev. Mariann Budde urged Trump to show mercy

Right Rev. Mariann Budde, the Episcopal Bishop of Washington, urged President Donald Trump to “have mercy” on people who are “scared now” during the inaugural prayer service at Washington's National Cathedral Tuesday, January 21st, including families with LGBTQ+ members and immigrants.

Key Facts

During her 15-minute sermon on Tuesday January 21, Budde addressed Trump—who was seated in the front row—directly, by citing his belief about being saved by God from assassination and said: “In the name of our God, I ask you to have mercy upon the people in our country who are scared now.”

Budde's plea mentioned “gay, lesbian and transgender children in Democratic, Republican, and Independent families,” across the country “who fear for their lives.”

The bishop also spoke up for immigrant workers, including those who may not “have the proper documentation,” saying the vast majority of them are “not criminals” but rather “good neighbors.”

In an inappropriate response, Trump rudely demanded a public apology from the Episcopal Church and Budde, who he called a “Radical Left hard line Trump hater” who “brought her church into the World of politics in a very ungracious way” and was “nasty in tone, and not compelling or smart” on Truth Social.

Speaking at the White House afterwards, Trump said the service was “not too exciting” (but for millions of others the Bishop's service was very exciting❗)  and he added, 😒 “I didn’t think it was a good service…They could do much better.” (As if Donald J. Trump knows what a good church service should be when he could not even put his hand on the Bible during his inauguration.....like a demon, the Holy Scripture might have burned his hand.)

Transcript Of Rev. Budde’s Plea To Trump

“Let me make one final plea, Mr. President. Millions have put their trust in you and, as you told the nation yesterday, you have felt the providential hand of a loving God. In the name of our God, I ask you to have mercy upon the people in our country who are scared now. There are gay, lesbian and transgender children in Democratic, Republican, and Independent families, some who fear for their lives. The people who pick our crops and clean our office buildings; who labor in poultry farms and meat packing plants; who wash the dishes after we eat in restaurants and work the night shifts in hospitals. They…may not be citizens or have the proper documentation. But the vast majority of immigrants are not criminals. They pay taxes and are good neighbors. They are faithful members of our churches and mosques, synagogues, gurudwaras and temples. I ask you to have mercy, Mr. President, on those in our communities whose children fear that their parents will be taken away. And that you help those who are fleeing war zones and persecution in their own lands to find compassion and welcome here. Our God teaches us that we are to be merciful to the stranger, for we were all once strangers in this land. May God grant us the strength and courage to honor the dignity of every human being, to speak the truth to one another in love and walk humbly with each other and our God for the good of all people. Good of all people in this nation and the world. Amen”
Crucial Quote

After the sermon, Budde told the New York Times that she “wasn’t necessarily calling the president out,” but rather making a plea “because of the fear” she has seen among immigrants and LGBTQ+ communities. Budde said she wants Trump to be “mindful of the people who are scared,” and added “I was trying to say: The country has been entrusted to you…And one of the qualities of a leader is mercy.”

Rachel Maddow scores record numbers of viewers during her Liz Cheney interview

Rachel Maddow’s MSNBC cable interview with Liz Cheney leads Cable News With 3.2 Million Viewers - an echo report in Forbes by Mark Joyella:

It was one of the most unusual interviews in Rachel Maddow’s long tenure at MSNBC: former Republican Rep. Liz Cheney, who joined Maddow on set Monday night. As Maddow told viewers, “I disagree with Liz Cheney about everything. My whole adult life on everything in politics, I would not just say that Liz Cheney and I were on different proverbial teams, I would say we are from different proverbial planets. And they are planets that are mostly at war with each other.” 

Rachel Maddow

Maddow's Cheney interview drew a big audience: 3.15 million viewers, which made The Rachel Maddow Show the most-watched show in all of cable news Monday night, well ahead of Fox (fake❗) News Channel’s Hannity, which had a total audience of 1.936 million viewers, and CNN’s The Source with Kaitlan Collins, which drew a total audience of just 375,000 viewers.

Maddow's interview on MSNBC also won among viewers 25-54, the key demographic most valued by advertisers, drawing a total audience of 249,000 viewers, ahead of FNC’s Hannity (221,000 viewers) and CNN’s The Source (70,000 viewers). The Rachel Maddow Show pushed MSNBC to an overall win in prime time, with 2.293 million viewers, ahead of Fox News (1.996 million viewers) and CNN (402,000 viewers). Fox News won in prime in the key demo, with a total audience of 230,000 viewers to MSNBC’s 179,000 viewers and CNN’s 79,000 viewers.

Cheney, who has been fiercely critical of former President Donald Trump, made the trip to MSNBC to talk about her new memoir and her concerns about what might happen should Donald Trump win in 2024.

Trump corroborated on FOX News the reason for the government's 37 count federal indictment

This blog falls under the heading of "you can't make this stuff up"- On Fox News, Bret Baier certainly nailed the former guy to the political wall: 

And then, there is this picture taken of an exhibition where someone created a mock bathroom on the Donald Trump star, on the Hollywood Walk of Fame.

Reported in Forbes by Mark Joyella:  "When Asked about the documents and why Trump hadn’t simply returned them when he was asked to, the former president said he was 'too busy'.”

Former Republican Governor of New Jersey Chris Christie and now a presidential candidate opposing Donald Trump said this, reported in The Hill by Julie Mueller:

"GOP presidential candidate Chris Christie 

suggested that the former guy, President Trump, should have “skipped a couple of rounds of golf” to go through boxes containing classified materials after Trump said he did not have time to do so in response to a subpoena."


Cristie said, “none of this would’ve happened to [Trump] or to the country if he had just returned the documents.”

“Last night, I think the worst moment for him was that — talking about the fact that he just didn’t have time to go through these boxes … in response to a grand jury subpoena, yet he told the government and had his lawyer certify that he had returned all of the documents that were responsive to the subpoena,” Christie argued. “That is obstruction of justice.”

Reported in VOX by Li Zhou: Trump’s Fox News interview was a defense attorney’s nightmare. The former guy ( i.e., president) offered a confusing, and likely damaging, defense about his latest indictment, for his concealment of government classified and secret documents.

In a tense Fox News interview, the former guy Donald Trump offered a confusing defense in response to his recent indictment, touting his right to keep sensitive documents and effectively admitting that he held onto them even after he was supposed to return them.

Trump’s interview follows a 37-count indictment that’s centered on his decision to take classified national security documents after leaving the White House, for which he was arraigned in court in Miami last week.

“I have every right to have those boxes,” Trump told Fox News host Bret Baier as part of their conversation, while claiming that these documents were “declassified,” a point the indictment rebuts. “This is purely a Presidential Records Act. This is not a criminal thing.”

Trump’s statements, many of which were meandering and difficult to follow, both provided a muddled defense, and may have offered fodder to reinforce some of the charges against him. 

By acknowledging that he had the documents in his possession and that he had reasons for not returning them promptly, Trump’s statements corroborated allegations he’s charged with regarding mishandling these materials.

Wyoming Republicans must look at Congresswoman Cheney's GOP voting record!

Cowboy State Extra- Liz Cheney and The Trumpists- Published on June 9, 2022:  Letter to the Editor

Dear Editor: It is a curious obsession that keeps me tied to Wyoming, where I lived and worked for thirty-five years, and where my children and grandchildren still live.

There are many wonderful things about Wyoming: the trout-fishing on mountain streams, the clear night skies in the mountains when there are too many stars to count and the kindness and warmth of old friends.

Nevertheless, there are also some things to not like about Wyoming, these days. Chief amongst those unfortunate aspects of life in Wyoming is the fact that the loudest voices on Wyoming social media (including Facebook) are persons with extremist views and a low level of historical and political literacy.

Rep. Liz Cheney has exposed #DonaldTrump as a cheat, liar, bully and narcissist. 

These radical people have now taken over the Wyoming Republican Party and claim to represent the average Republican voter, when in fact they just represent angry anarchistic activism.

This kind of so-called "Republican" would make Eisenhower and Nixon ashamed.

Wyoming Republicans must recognize how Congresswoman Cheney voted with Donald Trump. In fact, Cheney voted with Trump 92.9 percent of the time on his policies (Forbes). 

They would make Eisenhower ashamed because he always put the nation’s welfare first and did not see government as the enemy, but rather as a vehicle for accomplishing worthwhile social goals like building the interstate highway system and integrating the military and schools.

Eisenhower had seen what really bad governments looked like in Europe, and he understood that an imperfect but essentially benign government like that of the United States was a force for good in the world.

He did not want to tear down the government. Moreover, Nixon, despite his many personal failings, understood that the United States government had the power to do good in the world: to bring about peace between warring factions, to use government power to control inflation and to improve the lives of Americans.

The current crop of Wyoming culture warriors who emphasize guns, abortion, gender and race in their campaigns while name-calling “RINO” seem to be completely ignorant of real Republican presidents like these and like Reagan and even George W. Bush.

Instead, many Wyoming Republicans are quick to idolize the habitually lying, boasting, bullying, preening narcissist and degenerate who preceded the current President Biden; and they thoughtlessly smirk, sneer and jeer at those of us who oppose them, often being those who oppose them by speaking the truth.

To the current Wyoming Republican leadership, truth is anathema. No reasonable adult, for instance, doubts that Trump and his allies deliberately tried to subvert the results of the last presidential election by a combination of fraud, trickery, subterfuge, force and violence.

That is why there was a riot at the Capitol on January 6, 2021 and that is why all the stupid and unsuccessful lawsuits against the election results have failed.

The enemy of these people, the one who has drawn their vitriolic ire the most, is Liz Cheney, Wyoming’s lone representative to Congress.

She is routinely called a “RINO” on social media in Wyoming, when she is, in fact, an ideologically committed Republican and except for the fact that she is not slavishly obeisant to Trump, a loyal party functionary.

Many of Cheney's Wyoming critics do not understand that kissing Trump’s feet (or other parts) is not the equivalent of being a good Republican. Most of her Wyoming critics really don’t have any ideology, they are just angry. Additionally, for many of them “RINO” is the only epithet they can spell that won’t get them thrown off Facebook.

There are lots of things to not like about Liz Cheney, including her record of voting the party line so closely for most of her career.

But there is this to admire about Ms. Cheney: when most Republican politicians either adopted the big lie that Trump had won the election, or slunk off, and said nothing about that lie, Liz spoke up and called it what it was.

When Trump organized, and deployed a seditious criminal riot at the Capitol on January 6, 2021, Liz called it what it was and placed the blame where it belonged by voting for impeachment.

To judge from posts on Wyoming news pages on Facebook, truth-telling and historical and political literacy are in short supply among the loudest of Wyoming Republicans.

Liz should take some solace in the fact that although the loudest and emptiest of the Wyoming Republicans are often on Facebook, they are probably not the majority.

She should also be proud that truth telling is its own reward. Truth brings the reward of being able to hold one’s head up despite maintaining an unpopular position.

When the next volume of Profiles in Courage is published Liz Cheney and Adam Kinzinger will probably figure prominently in it. The current Wyoming Republican leadership and its degraded cheering section on social media, however, will recede into the obscurity they deserve.

Michael Krampner

Michael Krampner lived in Wyoming for 35 years and practiced law there during that time. Besides a law degree from the University of Wyoming College of Law he also earned a Ph.D. in history from The University of Maryland. He currently lives in Jerusalem, Israel.

Crazy is as crazy does: Former Guy lives in delusion

Trump supporters and QAnon believers anticipating a coup that would restore Trump to the White House, Maggie Haberman noted.

Echo report published in Forbes Magazine from an article by Maggie Haberman:

CIACD

Trump has been telling a number of people he’s in contact with that he expects he will get reinstated by August (no that isn’t how it works but simply sharing the information).

(Maine Writer: Crazy is as crazy does!)

The former president is telling allies he will be reinstated as President in August, due to fake audits by his fans and new GOP laws to overturn elections. Any politician who thinks the value of the filibuster exceeds the value of protecting America’s voting process is an idiot!

The New York Times’ Washington Correspondent Maggie Haberman reports that former President Donald Trump is telling “a number of people he’s in contact with that he expects he will get reinstated” as president by August.

In a message posted to Twitter sharing a CNN report on Trump supporters and QAnon believers anticipating a coup that would restore Trump to the White House, Haberman noted “that isn’t how it works but simply sharing the information.”

Haberman says “it isn’t happening in a vacuum” but seems to be part of a strategy by Trump to counter the possibility of an indictment. “He is not putting out statements about the ‘audits’ in states just for the sake of it,” Haberman writes. “He’s been laser focused on them, according to several people who’ve spoken with him.”

The idea that the former president could be reinstated has gained traction among some die-hard supporters. At an event called the For God and Country Patriot Roundup Saturday, former Trump election lawyer Sidney Powell said Trump could “simply be reinstated,” a comment that drew cheers, according to a Newsweek report.

As CNN’s Donie O’Sullivan reported, former Trump national security adviser Michael Flynn appeared at the same convention and appeared to support the idea of a “Myanmar-style coup” that could return the presidency to Trump—though he has attempted to walk back that suggestion.

The idea that the former president could be reinstated has gained traction among some die-hard supporters. At an event called the For God and Country Patriot Roundup Saturday, former Trump election lawyer Sidney Powell said Trump could “simply be reinstated,” a comment that drew cheers, according to a Newsweek report.

As CNN’s Donie O’Sullivan reported, former Trump national security adviser Michael Flynn appeared at the same convention and appeared to support the idea of a “Myanmar-style coup” that could return the presidency to Trump—though he has attempted to walk back that suggestion. (Maine Writer- It's impossible to believe how #FlynnUSARet continues to receive a military pension when he has lied to the #FBI! 

The Photo That May Help Unlock the Trump-Russia Scandal
Congressional investigators say Trump’s former national security adviser lied about being paid to dine with Putin. (Mother Jones photo)

CIACD! "It's a ridiculous, preposterous statement. The idea that it comes from a former flag officer of the United States is beyond appalling," Neal Katyal says. "This is a guy who lacks any credibility, any sense of honor, any sense of decency.").

(Maine Writer- Flynn's behavior should cause him to face a court- martial!) 

But not everyone in Trump’s orbit buys into the idea that Trump could soon get his old job back. Jenna Ellis, another of the former president’s attorneys, said “no, President Trump is not going to be ‘reinstated.’” (Trumpzi-Dumpzi had a great fall.....!)

The U.S. Constitution has only one process for removal of a sitting president: impeachment and conviction. 

No, Trump is not going to be “reinstated.”

#FormerGuyDelusion

Ouch - now read this! An dire economic tariff forecast

Trump Is Making The Same Trade Mistake That Started The Great Depression by John Mauldin, a financial writer, publisher, and New York Times author. 

Published in Forbes - We all wonder if (stupid!) Trump’s trade actions are as random as they appear or if there is a broader strategy.

Some of my contacts argue that the relatively strong U.S. economy allows the administration to take a harder line than would normally be advisable.

The thinking is that we can ride out a trade war better than China can. (OMG this is delusional economic thinking. In fact, it's not even thinking, dangerously, just bluffing....)

This only works if the U.S. economy keeps growing long enough for the tariffs to make China bend. 

We can postpone a recession for another year or two if the trade war doesn’t intensify and Europe holds together.

Since it is intensifying, we may not get that time. In other words, tariffs could end the conditions that justified them.

Something similar happened before, during the most famous trade mistake in U.S. and global history.
The 1930s Smoot-Hawley Tariffs

Similar to today, the Roaring 1920s saw rapid technological change, namely automobiles and electricity.

This created a farm surplus as fewer horses consumed less feed. Prices fell and farmers complained of foreign competition.

Herbert Hoover promised higher tariffs in his 1928 presidential campaign. He won, and the House passed a tariff bill in May 1929.

The Senate was still debating its version of the bill when the stock market crashed in October 1929. Today, we use that event to mark The Great Depression’s beginning.

But at the time, people didn’t know they were in a depression or even a recession. Most economists expected a quick recovery. Stocks did recover quite a bit in the following months, though not back to their prior highs.

So, when the Senate finally passed a tariff bill in March 1930, the thinking was not that different from what we see today. They thought they could preserve and even extend the good times.

But conditions worsened quickly, and by 1931, unemployed men were standing in soup lines.

In 1932, both Smoot and Hawley lost their seats as Franklin Roosevelt beat Hoover in a landslide—57% of the popular vote.

That history won’t necessarily repeat this time, but it’s not a good sign.

Throwing Caution to the Wind?

Last year, I wrote about a sandpile experiment conducted by physicists back in the 1980s. I described how a sandpile can slowly grow in size, apparently stable. At any moment, however, something could trigger an avalanche.

The global trade system is something like that. Of course, it’s not perfect or even optimal. Countries erect barriers to their advantage.

I can point to several countries whose economic policies are mercantilistic, but at least everyone knows about them. 

We see the the dangers and back off to avoid an avalanche whose victims are impossible to predict.

It is a kind of equilibrium.

Everyone’s incentive is to avoid catastrophe and make incremental improvements. That makes trade talks extraordinarily difficult.

The Trump administration doesn’t seem to care about equilibrium. Whether it’s coming from the president himself or those around him, the strategy appears to be “kick apart the sandpile and make everybody rebuild it.”

And whether we like it or not, many of Trump’s supporters actually like the concept of throwing a wrench into the system, (stupid is as stupid does!)

So, it is not the case that the U.S. has no choices. We have many choices. Tariffs are the wrong one. But then, that is just me, and I am one lone voice and vote.

I predict an unprecedented crisis that will lead to the biggest wipe-out of wealth in history. And most investors are completely unaware of the pressure building right now. Learn more here.

Con man development of Donald Trump ~ echo from Gloucester Mass

In 1982, when Donald Trump was 36 years old, he began an annual ritual of lobbying Forbes magazine to include him on its list of the 400 wealthiest Americans. Forbes debuted the list that year, and Trump pursued his inclusion with gusto — lying, cajoling and repeatedly jumping on the phone to make sure that a young reporter at the magazine, Jonathan Greenberg, would accept his inflated claims about how much money he had.

Greenberg wrote. “Nearly every assertion supporting that claim was untrue. Trump wasn’t just poorer than he said he was. Over time, I have learned that he should not have been on the first three Forbes 400 lists at all.”

Greenberg’s column is a reminder that Trump has been running a very long con on the American public, and it raises a question that now has an urgency it didn’t decades ago: How long can the long con last?

Trump’s shtick in its early days was limited to New York, and most New Yorkers (who, of course, have good antennae for such things) knew it was awash in snake oil. Yes, Trump might say he was a business titan worthy of the Forbes 400. But he wasn’t among the upper echelon of New York real-estate developers, he wasn’t a fixture of civic life, and he seemed more at home on Page Six than on the front page of the Wall Street Journal.

Trump’s love of the con — borrowing billions he couldn’t repay so he could invest in splashy properties and projects he didn’t understand — drew national attention and blanket media coverage just before the game unraveled in serial bankruptcies in the early 1990s. After that debacle, Trump refashioned himself as a ubiquitous media curiosity, one who held center stage in part by being the one famous guy who could reliably be called upon to chat about sex, women and even his own genitals.

Trump’s emergence on “The Apprentice” in 2004 enabled him to extend the con once again. He had been spinning myths about being a can-do businessman for years, but the show allowed him to play an entrepreneurial guru in front of millions of people each week. Although it soon fizzled, Trump used the show to refashion himself as a calculating executive — one who some thought might just be talented enough to shake up the federal government.

I wrote a biography of Trump at the peak of his fame, and he later sued me for libel because, among other things, the book scrutinized his years of patty-cake with Forbes to get on its rich-list while also raising doubts about whether he was a billionaire. (Trump lost the case in 2011.) During a deposition, Trump conceded that he was so broke at one point that he had to borrow millions of dollars from his father’s estate to avoid personal bankruptcy — something he had earlier contested when I asked him about it during our many conversations for the book. (“I had zero borrowings from the estate,” Trump told me. “I give you my word.”)

Greenberg mentioned my reporting as one reason why he came to realize that Trump had hoodwinked him over the years, and cited documents that were available to me but not to him when he was at Forbes.

Even without those documents, though, there were plenty of reasons to doubt Trump’s honesty — and Forbes’s methodology. Between 1982 and 1983, for example, the magazine allowed the Trump family’s stated real-estate fortune to double from $200 million to $400 million, even though a savage recession was underway. In 1989, Forbes ranked Trump 26th on its list, then dropped him entirely a year later. He was gone for five years and then resurfaced with $450 million in 1996. That jumped to $1.4 billion a year later. And so on.

You don’t need tape recordings to understand this con. You just need common sense.

When I asked Trump in 2005 about his obsession with the Forbes 400 and with being perceived as a billionaire, he was dismissive. “It seems to be that they’re the barometer of individual wealth. It doesn’t really matter. It matters much less to me today than it did in the past.”

That was false, of course. About a decade later, Trump would brag about being worth more than $10 billion while he was running for president. Trump has latched onto such fanciful figures not simply because he’s insecure about his wealth, but because he knows that pretending he has that kind of money keeps him in the media’s eye and keeps potential business partners interested in him. It’s all part of the long con.

That con now has global consequences. Trump doesn’t fulminate about North Korea or building a wall on the Mexican border because he’s a policy maven with deeply held principles. It’s because he knows that toying around with sensitive and sometimes dangerous subjects gets the media’s attention and keeps certain blocs of voters interested in him.

That’s part of the long con too. And the president will keep it up — and get away with it — as long as voters play along.

Timothy L. O’Brien is the executive editor of Bloomberg Gadfly and Bloomberg View. He has been an editor and writer for the New York Times, the Wall Street Journal, HuffPost and Talk magazine. His books include “TrumpNation: The Art of Being The Donald.”

Nurses trained in Advanced Practice are quality providers

"...value-based models that emphasize getting treatment in the right place and at the right time. That tends to mean care is given upfront in a primary care setting where nurses are on the front lines."

This Forbes article (below) describes an unfortunately dicey situation between Advanced Practice Nurses (APRNs) and the American Medical Association.  This unnecessary and unproductive difference of professional opinion risks eroding decades of progress made between physicians and nurses about how to implement best practices for quality patient care and positive health outcomes.

Nurses Say AMA Launching 'Turf War' Over Direct Patient Access ~ Forbes article by Bruce Japsen

Nurses across the U.S. are upset at new American Medical Association policy opposing efforts to allow advanced practice registered nurses to practice independently of a physician’s supervision.

The AMA opposes "the continual, nationwide efforts to grant independent practice . . . to non-physician practitioners” including advanced practice registered nurses (APRNs), the nation's largest doctor group voted at last week's AMA policy-making House of Delegates interim meeting. The move is designed to intensify the AMA’s lobbying agenda through model legislation in Washington and state capitals “to initiate creation of a consistent national strategy.”

The development of a new AMA national lobbying strategy comes as APRNs are seeing states and branches of the federal government allow more direct access to patients without a physician’s supervision. A year ago, for example, the Department of Veterans Affairs grantedveterans access to advanced practice registered nurses in a landmark decision.
The American Nurses Association accused the AMA of perpetuating “the dangerous and erroneous narrative that APRNs are trying to ‘act’ as physicians and are unqualified to provide timely, effective and efficient care.” There are four APRN roles: 

• nurse practitioner
• clinical nurse specialist
• certified registered nurse anesthetist and 
• certified nurse midwife

“(APRNs) practice advanced nursing, not medicine, in which they regularly consult, collaborate and refer as necessary to ensure that the patient receives appropriate diagnosis and treatment,” ANA President Pamela Cipriano said in a statement. 

“For AMA to imply that APRNs are incapable of providing excellent care or that their care puts the patient at risk is blatantly dishonest. The future of health care calls on all health care professionals to work together as a team to meet the growing demand for health care services.”

Increasingly, states are easing restrictions to allow patients direct access to APRNs such as nurse practitioners as a way to get patients low-cost primary care, particularly in areas of the country that lack providers of medical care. South Dakota earlier this year became the 22nd state to allow nurse practitioners to practice independently, no longer requiring supervision by a physician as momentum builds to give NPs full practice authority.

Several nurse groups including the ANA and American Association of Nurse Practitioners (AANP) say the new state and federal laws allowing direct access are often efforts to speed care to patients that is slowed by bureaucratic red tape and not an effort to take business away from physicians. Rather, increased access to APRNs is in keeping with the U.S. health system’s move to value-based care models.

Government and private insurers including Aetna, Anthem, UnitedHealth Group and Blue Cross Blue Shield plans are moving away from fee-for-service medicine to value-based models that emphasize getting treatment in the right place and at the right time. That tends to mean care is given upfront in a primary care setting where nurses are on the front lines.

Anthem abdicates health mission and social responsibility

It's irresponsibly for Anthem to sign a letter in opposition to the Graham-Cassidy legislation, while, in the same news cycle announcing the company's decision to withdraw from the insurance exchanges, supported by the Affordable Care Act.  In this wrong minded decision, Anthem is abdicating its mission and ignoring the social responsibility that comes with their healthy financial situation.  A bad decision to abandon the Affordable Care Act's health insurance exchanges is leaving tens of thousands without coverage.

Moreover, consider this article from Forbes- September 27, 2017: 

Want To Engage Millennials? Try Corporate Social Responsibility- by Marissa Peretz

Millennials are becoming even more engaged in philanthropic causes in 2017 than they were in late 2016, according to Phase 1 of the Millennial Impact Report. At the same time, employers continue to search for ways to engage millennials to successfully attract, hire and retain them. As millennials become an increasingly large percentage of the workforce, companies may take the opportunity to support their local community. Colleagues working together to accomplish a shared goal can have a positive effect on company culture. Embracing corporate social responsibility can benefit the bottom line as well. In a recent Cone Communications survey, 87% of Americans will purchase a product because a company advocated for an issue they cared about, and millennials are more likely than other generations to research the issues a company supports and the extent to which the company contributes.

Leading by example

Integrity- vision-positive attitude-inspiring

What does corporate social responsibility look like? 

There is a wide range of options. Some opportunities involve multiple companies devoted to community service. One such event is organized by nonprofit Technology Underwriting Greater Good (TUGG), which was founded by 3 venture capitalists from Accomplice and General Catalyst. “Our Annual Tech Gives Back day of service is the largest day of service in the tech industry globally,” said Elizabeth Dobrska, Executive Director of TUGG. “This is our 7th year, and we will have 1500 volunteers and 90+ companies at 50+ volunteer sites.” Participating companies include Wayfair and WeWork.

The opportunities are as diverse as the employees who volunteer for them. “We accumulated 1,570 volunteer hours on company time in 2016,” said Amy Hattan, Vice President of Corporate Sustainability at engineering firm Thornton Tomasetti. “One group used their time to volunteer at GrowNYC’s Teaching Garden, an urban farm featuring vegetable beds made from recycled plastic lumber, a small-scale farm, fruit trees, a high-tunnel greenhouse and rainwater harvesting systems.”

While some companies have formal programs, others let employees follow their individual passion for volunteering. “Our leadership team doesn’t dictate where people volunteer because we want our team members – those who live and work in the communities we serve – to decide where their time will have an impact,” said Chris Martin, President and CEO, Provident Bank. 

“Whether that’s picking up a hammer and helping Habitat for Humanity or spending the day throwing strikes during the Big Brothers Big Sisters Bowling Tournament, we encourage all team members to take time to give back. That is why we give every employee 2 paid days per year to volunteer.”

Corporate social responsibility may even dovetail with the company’s main business. “United By Blue, a sustainable outdoor apparel company with a strong focus on waterway conservation, allows its employees to take time off to volunteer at our company-hosted cleanups,” said United By Blue PR Associate Ethan Peck. “These take part on/near bodies of water (rivers, lakes, ponds, oceans, etc.) and are part of our mission to remove a pound of trash for every product sold - something we've stringently followed. We've picked up over a million pounds of trash thus far!”

Some companies approach projects with a longer time frame. “There is a nice trend in Fortune 500 companies such as Johnson & Johnson and Cigna that offer global pro bono advisor or volunteer programs to their employees," said Paula Caligiuri, PhD, D'Amore-McKim School of Business Distinguished Professor at Northeastern University. “In these programs, employees are on loan, whether for a few weeks or several months, to volunteer their professional skills in in developing countries. Companies can achieve their CSR goals while dramatically increasing employee engagement through volunteerism.”

Marissa Peretz is Founder of Silicon Beach Talent, a boutique recruiting and consulting firm in Los Angeles. SBT recruits designers, engineers, and leadership for emerging tech companies.

(I'm certain there're many people at Anthem who read Forbes. Maybe, they will even read and consider the message in this blog.)

Disappearing Hospitals - Imploding Under Reform

Log in

Dr. Robert Pearl writes about how health care reform will bring about changes in how hospitals deliver acute care and many will go out of business or change.

Pearl writes: Last week’s (Forbes) article discussed the “strategic inflections point” as that defining moment in any industry when the rules of the game begin to change. In the era of health care reform, hospitals across this country are now experiencing a time of transition.
Pearl writes: We can predict that the first hospital CEO who suggests closing down a cardiac surgical program will be fired on the spot. The doctors and local community will do everything in their power to stop it from happening.

Consolidating or closing entire hospitals will be even more painful. Regulators would likely intervene. Change will be resisted and delayed.

But, if there were fewer hospitals with higher volumes, quality would rise and the overall spend on hospital services would decrease. We should not underestimate how difficult this process will be or how long it may take. But once it is complete, patients will barely miss the old hospital down the street.

Pearl speaks about volume, but there's more to this story. Obviously, volume drives profit margins, regardless of what proceedures are performed. Also, volume is positively correlated with quality outcomes. In other words, those hospitals where volume of services are high report better patient outcomes.

Nevertheless, insurers must agree to pay for these procedures and there's a limit to what's covered. 

Hospitals are also in decline because the cost of keeping them modern (like hotels), fueled for temperature control and germ free have exceeded the reimbursement received for providing care. Some hospitals are booking post operative patients in real hotels rather than absorb the expense of keeping their in-patient facilities staffed to licensing requirements. For example, hospitals can only charge so much exuberant costs for simple wound dressings to compensate for the cost of care. Frankly, it's cheaper to send patients home with an instruction sheet about how to change bandages. 

So, just how can hospitals bring down the cost of care and create profit margins? It seems like small hospitals will need to merge with health care systems where high volume services can be performed, like MacDonald's produces hamburgers. It's a harsh analysis but describes the way it works. Some hospitals will become centers for volume in heart care, others for orthopedic care and some for cancer care. This means the local community hospitals will become outpatient emergency centers and feeder systems for the larger volume facilities.   

Patients will be focused on managed care organizations rather than their hospitals. In the future, it makes sense for people to live in places where their managed care plans provide coverage because, otherwise, receiving care will require paying large co-pays. Also, advanced practice nurses will become integral to every primary care practice, to provide access to growing number of patients who will buy coverage through the health care exchanges.

Here is more of Pearl's interesting Forbes article:

What first comes to mind when you hear the word “hospital”?

Your reaction may depend on your past experiences. You may feel gratitude for the birth of a child or the treatment of acute appendicitis. You may feel sorrow, remembering a loved one who passed away on a hospital bed.

Regardless of our experiences, many of us assume the closer our hospital is to where we live, the safer and better off we are. But that assumption is wrong. Fewer hospitals with increased volumes would lead to higher quality of care and better clinical outcomes.

Some hospitals were born to fail

In the early 1700s, hospitals provided little medical care. Instead they served as isolation facilities for those with contagious illnesses, as shelters for vagrants and those with mental illness, or as almshouses for the poor. Those who could afford medical care (middle- and upper-class families) received it in their own homes, including surgery.

By the end of the 19th century, medical care was becoming too complex to be delivered in the home. As a result, care shifted to centralized facilities where patients benefited from the latest medical advancements and around-the-clock physician and nursing availability.

A century ago, traveling even moderate distances was incredibly slow and expensive compared to the cost of hospital care. Therefore, building a hospital in every town made sense. Hospitals became a source of great civic pride for community leaders who comprised the governing boards. And so the “community hospital” was born.

Founded by physicians, religious groups and public municipalities, the number of U.S. hospitals grew exponentially from 178 in 1873 to 4,300 in 1909 to 6,000 in 1946. The passage of the Hill-Burton Act in 1946 helped further expand that number to 7,200 by 1970.

With the introduction of the publicly funded Medicare and Medicaid programs in 1966, the number of individuals with health insurance skyrocketed – as did the demand for inpatient services, as did hospital costs.

By the 1990s, high-margin procedures such as heart bypass surgery and total joint replacement were performed in (and advertised by) nearly every hospital. But the demand for inpatient services sharply declined in the 1990s with the introduction of managed care, the expansion of outpatient alternatives, and the mounting costs of a hospital stay. During that decade, some hospitals were forced to merge or shut down.

Since 2000, the number of acute-care hospitals has held steady at around 5,700. However, the push to limit utilization at these high-cost facilities continues while low-volume hospitals across the country are struggling to survive.

Hospitals are facing a strategic inflection point

Last week’s article discussed the “strategic inflections point” as that defining moment in any industry when the rules of the game begin to change. In the era of health care reform, hospitals across this country are now experiencing a time of transition.

The reduction in their volume, revenue and margin threatens their independence and even their existence. Over the past decade, 16 percent of hospitals have consolidated by joining a health system. That trend is accelerating in the context of the Affordable Care Act, also known as Obamacare.

And there's more of this article at this link: 

http://www.forbes.com/sites/robertpearl/2013/11/14/hospitals-may-be-disappearing-in-the-era-of-health-care-reform/2/ 

Therefore, what's going to happen to closed hospitals?

They'll become relics like empty textile mill buildings, inner city schools and underutilized churches. Self care will trump hospital admissions. Moreover, insurance companies will gain from profits once absorbed by acute care hospitals because they'll reap an incentive for keeping people well, thereby saving the cost of paying for expensive sickness care. 

All of the above information, of course, can be turned upside down as people live longer and require more chronic care. I haven't read Pearl's analysis of how to pay for the care of an aging population. 

Stay tuned.  

New Democratic Campaign Slogan - "Mittens is a Mess"

"Mittens is a Mess" was posted by my Y generation granddaughter on facebook. Her comment is the bumper sticker status of the Romney campaign in mid-September 2012.

Although Romney's presidential campaign is justifiably regrouping after weeks of mis-steps, the buzz of discontent with the candidate's poor leadership and immoral management styles are finally showing up in unanticipated media - Forbes and Rolling Stone are two.
http://www.forbes.com/sites/frederickallen/2012/09/14/mitt-romneys-one-two-leadership-punch-against-himself/
Mitt Romney's One-Two Leadership Punch--Against Himself by Frederick E. Allen

"First Mitt Romney showed his weakness as an executive manager, as the leader of a disciplined team doing the best possible job to meet a crucial organizational goal, the goal of making the Republican convention a positive turning point of his campaign, especially in its single most crucial hour. This week he doubled down, failing another big leadership test in showing how he would respond to an international crisis."

http://theimmoralminority.blogspot.com/2012/08/matt-taibbis-rolling-stone-article-on.html

Etch-a-Sketch Photo credit - www.theimmoralminority.blogspot.com

Forbes is stoic, but "Go Matt Taibbi in Rolling Stone"! 

A "must read" is the detailed investigative report to dismantle Romney's immoral management style exposed in:

"How the GOP presidential candidate and his private equity firm stated an epic wealth grab, destroyed jobs and stuck others with the bill", by Matt Taibbi.d 
Read more: http://www.rollingstone.com/politics/news/greed-and-debt-the-true-story-of-mitt-romney-and-bain-capital-20120829#ixzz26dI1lhCF

"The incredible untold story of the 2012 election so far is that Romney's run has been a shimmering pearl of perfect political hypocrisy, which he's somehow managed to keep hidden, even with thousands of cameras following his every move. And the drama of this rhetorical high-wire act was ratcheted up even further when Romney chose his running mate, Rep. Paul Ryan of Wisconsin – like himself, a self-righteously anal, thin-lipped, Whitest Kids U Know penny pincher who'd be honored to tell Oliver Twist there's no more soup left. By selecting Ryan, Romney, the hard-charging, chameleonic champion of a disgraced-yet-defiant Wall Street, officially succeeded in moving the battle lines in the 2012 presidential race."
Read more: http://www.rollingstone.com/politics/news/greed-and-debt-the-true-story-of-mitt-romney-and-bain-capital-20120829#ixzz26dJzBU71

"...what most voters don't know is the way Mitt Romney actually made his fortune: by borrowing vast sums of money that other people were forced to pay back. This is the plain, stark reality that has somehow eluded America's top political journalists for two consecutive presidential campaigns: Mitt Romney is one of the greatest and most irresponsible debt creators of all time. In the past few decades, in fact, Romney has piled more debt onto more unsuspecting companies, written more gigantic checks that other people have to cover, than perhaps all but a handful of people on planet Earth."

While the world continues to be a tinder box of ethnic and religious turmoil, our nation can't afford to hire an entrepreneurial leader who risks other people's reputations and money to fuel his own ambitions.  "Mittens is a Mess" aptly describes how Romney has knitted his campaign into knots, while wasting millions of campaign contributions manufacturing a presidential campaign.  

A "Mittens is a Mess" bumper sticker campaign should begin as soon as possible. It's the fastest way Democrats can communicate the urgency of the presidential choice voters must make in the November election.  

Americans must re-elect consistent and experienced political leadership.  President Obama and Vice-President Biden are the leaders we can rely on, to provide political leadership we can trust.