Hospitals, Language, and Culture: A Snapshot of the Nation – Exploring Cultural and Linguistic Services in the Nation’s Hospitals: A Report of Findings

Source: Amy Wilson-Stronks and Erica Galvez, The Joint Commission, 2007

As our nation becomes more diverse, so do the patient populations served by our nation’s hospitals. Few studies have explored the provision of culturally and linguistically appropriate health care in a systematic fashion across a large number of hospitals. With funding from The California Endowment, the Hospitals, Language, and Culture: A Snapshot of the Nation project is working to strengthen this understanding. Hospitals, Language, and Culture is a qualitative cross-sectional study designed to provide a snapshot of how sixty hospitals across the country are providing health care to culturally and linguistically diverse patient populations. This project sought to answer the following questions:

• What challenges do hospitals face when providing care and services to culturally and linguistically diverse populations?

• How are hospitals addressing these challenges?

• Are there promising practices that may be helpful to and can be replicated in other hospitals?

The project findings will be presented in multiple reports. This report highlights findings regarding the first two research questions.

What Can Worker Training Do? Plenty, But Career Ladders Need to Lead to Rewarding Jobs

Source: Joan Fitzgerald and Andrew Sum, American Prospect, Vol. 18 no. 5, May 2007

One out of every six full-time U.S. workers earns less than 125 percent of the poverty line—under $18,865 a year for a family of three. And the share of low-wage workers is considerably higher in many of the sectors with the most job growth: retailing, hotel and food services, health care, and human services. Full-time workers in the bottom tenth of the wage distribution saw their weekly earnings decline by about 1 percent over the past six years, reversing the trend of rising wages that occurred from 1995 to 2000. For low-skilled youths, finding even a bad job has become more difficult. The problem is especially acute for young black men, with only 33 percent of black high school dropouts able to secure any type of job, and only 25 percent working full time in 2005.

Workforce development can be a promising strategy, but by itself it cannot compensate for inadequate schools, the serial disadvantages of poverty in early childhood, and a labor market that often leads only to more low-wage jobs. Workers would have a far better chance of improving their earnings if they were better educated before they entered the workforce, and if education and training were complemented by other labor market interventions such as higher minimum wages, stronger unions, and a national strategy of creating good jobs.

The Health of Nations: How Europe, Canada, and our own VA do health care better

Source: Ezra Klein, American Prospect Vol. 18 no. 5, May 2007

Medicine may be hard, but health insurance is simple. The rest of the world’s industrialized nations have already figured it out, and done so without leaving 45 million of their countrymen uninsured and 16 million or so underinsured, and without letting costs spiral into the stratosphere and severely threaten their national economies. Even better, these successes are not secret, and the mechanisms not unknown. Ask health researchers what should be done, and they will sigh and suggest something akin to what France or Germany does. Ask them what they think can be done, and their desperation to evade the opposition of the insurance industry and the pharmaceutical industry and conservatives and manufacturers and all the rest will leave them stammering out buzzwords and workarounds, regional purchasing alliances and health savings accounts. The subject’s famed complexity is a function of the forces protecting the status quo, not the issue itself.

Health Policy Rx: States Taking the Lead, Setting Examples

Source: Sean Slone, State News, Vol. 50 no. 4, April 2007

Health care is the most important challenge facing state governments today, according to a recent state trends survey of state leaders by The Council of State Governments. States, spurred by the urgency of rising health care costs, aren’t waiting for Washington to take action. Many states are serving as policy laboratories for innovative plans to reduce the number of uninsured. States are also developing initiatives to encourage healthier living by addressing poor diet and tobacco use, two factors that continue to threaten overall improvements in the nation’s health over the last two decades.

Capping the Burden: Property Taxes Under Scrutiny

Source: Jennifer Burnett, State News, Vol. 50 no. 4, April 2007

In 1927, Oliver Wendell Holmes said “taxes are what we pay for a civilized society.” Eighty years later, one form of tax—the property tax—is being scrutinized by state and local governments, due in part to the meteoric rise of property values in recent years. A flood of legislation is being considered across the country to address concerns about property tax increases, how tax revenues are calculated and distributed, and local governments’ reliance on those revenues.

The Tax Grab Game

Source: Josh Goodman, Governing, Vol. 20 no. 7, April 2007

Cities are finding ways to raise revenue from suburbanites, without actually calling the levy a commuter tax.

Talk about a politically charged phrase. “Commuter tax” is such a loaded term that people who support one often try to find some other way of saying it. Alice Rivlin, who’s spent much of her professional life managing or overseeing federal budgets and helping to rescue local finances, steers clear of the phrase–even though she’s a firm believer in the idea of her hometown, the District of Columbia, taxing the income earned in the city by people who live in the Maryland and Virginia suburbs. “I never use the term ‘commuter tax,'” she says. “That’s anathema.” It’s also the fastest way to doom a city’s attempts to raise money from suburbanites. At the heart of the commuter-tax debate is this question: Do the millions of people who enter cities to work each weekday cost more than they contribute to the urban center? Suburbanites almost always answer “no” and they’ve made sure their representatives in elected office agree. For years, central cities have been learning that this is a fight they can’t win as, time and again, their efforts to tax the wages of suburbanites have failed in the face of political tension and economic reality. Often, cities also face the opposition of their own business communities, which believe that such a tax could drive employers away. No city, after all, can be a center of economic activity without its commuters. But there may be an end run around the commuter-tax dilemma. Quietly, a number of cities are figuring out ways to raise revenue–without also raising the spectre of a commuter tax–from workers who commute to the city. Cities in Ohio and Texas have found success by casting inter-jurisdictional taxation as an alternative to something suburbs and their residents fear even more: annexation.

The Retail Chase

Source: Christopher Swope, Governing, Vol. 20 no. 7, April 2007

Cities will do almost anything to land the store of their dreams.

Next month, legions of retailers, developers, bankers and brokers will descend on Las Vegas for one of the biggest schmooze fests in the world. It’s the International Council of Shopping Centers’ spring convention, and to anyone who hasn’t been there, the scene — literally a city under a roof — can be a bit overwhelming. Exhibitors set up booths as wide as office buildings, and the aisles are platted into a sprawling street grid. At the corner of “38th Avenue & Q Street,” mobs swarm the Cold Stone Creamery booth for free ice cream; a “block” away, they get free pretzels from Auntie Anne’s. But the real business happens behind closed doors, where the bigwigs of chain retail shake hands on hundreds of deals that decide where America will shop and eat for years to come. Because the commercial stakes are so high, the ICSC conference isn’t just an affair for the industry anymore. It’s a big event for local government as well. Mayors, city council members, city managers and economic development officials have become regulars at this annual carnival of deal-making. Some 4,000 public-sector people are now members of ICSC, and they are one of the fastest-growing segments of the association.

Fouling An Attack

Source: Robert Barkin, American City & County, Vol. 122 no. 3, March 1, 2007

Preparing for emergencies is nothing new for Patricia Bean, Hillsborough County, Fla., administrator. After all, hurricanes are a way of life in the Southeast, and readiness for the next storm is at the top of every official’s list of essential tasks. But, anticipating an influenza pandemic is different. “We’re used to dealing with a situation that we see coming and then passes,” she says about hurricanes. “But this situation is very different. We may have 30 to 40 percent of our staff out of work. How can we cover that?”

Hillary Was Right: The Health Care Plan That Dare Not Speak Its Name

Source: Jonathan Cohn, New Republic, Vol. 236 no. 4814, June 4, 2007
(subscription required)

More than a dozen years later, Hillary Clinton wants the world to know that she has seen the error of her ways. That health care plan–the one that was supposed to revolutionize the medical industry and guarantee every American insurance–wasn’t such a hot idea after all. “I think that both the process and the plan were flawed,” Clinton admitted in an interview with The New York Times, demonstrating a level of contrition more fitting for an Iraq war architect. “We were trying to do something that was very hard to do, and we made a lot of mistakes.”…

Should Unions Play Golf With Republicans?: Labor PAC Support Across Political Parties

Source: Roland Zullo, Working USA: The Journal of Labor and Society, Vol. 10 no. 2, June 2007
(subscription required)

This essay examines the strategy of political voluntarism, defined as a neutral political affiliation, by testing whether or not union political action committee (PAC) donations to congresspersons in the 2000 election cycle affected their roll call votes in subsequent years. Results indicate that overall, the Republicans became more antilabor in their roll call patterns after the election of George W. Bush, and that labor PAC donations did not moderate this shift. Democrats, however, became more prolabor in their roll call voting, and this trend was likewise independent of labor support. Finally, there is no evidence that congresspersons retaliated against labor when an electoral rival was supported. These findings underscore the importance of political parties in shaping public policy and challenge the utility of a labor political strategy that is party neutral. A strategic alternative, political idealism, is discussed.