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Every politically sentient American knows that Congress has been dominated by special interests, and many people do not remember a time when Congress legislated in the public interest. In the 1960s and '70s, however, lobbyists were aggressive but were countered by progressive senators and representatives, as several books have documented. What has remained untold is the major behind-the-scenes contribution of entrepreneurial Congressional staff, who planted the seeds of public interest bills in their bosses' minds and maneuvered to counteract the influence of lobbyists to pass laws in consumer protection, public health, and other policy arenas crying out for effective government regulation. They infuriated Nixon's advisor, John Ehrlichman, who called them "bumblebees," a name they wore as a badge of honor. For his insider account, Pertschuk draws on many interviews, as well as his fifteen years serving on the staff of the Senate Commerce Committee that Senator Warren Magnuson chaired and as the committee's Democratic Staff Director. That committee became, in Ralph Nader's words, "the Grand Central Station for consumer protection advocates."
Examines the safety problems of oil tankers which could threaten the ecology and quality of the oceans and coastal areas.
Children represent a special challenge for emergency care providers, because they have unique medical needs in comparison to adults. For decades, policy makers and providers have recognized the special needs of children, but the system has been slow to develop an adequate response to their needs. This is in part due to inadequacies within the broader emergency care system. Emergency Care for Children examines the challenges associated with the provision of emergency services to children and families and evaluates progress since the publication of the Institute of Medicine report Emergency Medical Services for Children (1993), the first comprehensive look at pediatric emergency care in the United States. This new book offers an analysis of: • The role of pediatric emergency services as an integrated component of the overall health system. • System-wide pediatric emergency care planning, preparedness, coordination, and funding. • Pediatric training in professional education. • Research in pediatric emergency care. Emergency Care for Children is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency health care providers, professional organizations, and policy makers looking to address the pediatric deficiencies within their emergency care systems.
The story of West Indian immigrants to the United States is generally considered to be a great success. Mary Waters, however, tells a very different story. She finds that the values that gain first-generation immigrants initial success--a willingness to work hard, a lack of attention to racism, a desire for education, an incentive to save--are undermined by the realities of life and race relations in the United States. Contrary to long-held beliefs, Waters finds, those who resist Americanization are most likely to succeed economically, especially in the second generation.
Our ability to treat common bacterial infections with antibiotics goes back only 65 years. However, the authors of this report make it clear that sustaining a supply of effective and affordable antibiotics cannot be without changes to the incentives facing patients, physicians, hospitals, insurers, and pharmaceutical manufacturers. In fact, increasing resistance to these drugs is already exacting a terrible price. Every day in the United States, approximately 172 men, women, and children die from infections caused by antibiotic-resistant bacteria in hospitals alone. Beyond those deaths, antibiotic resistance is costing billions of dollars through prolonged hospital stays and the need for doctors to resort to ever more costly drugs to use as substitute treatments. Extending the Cure presents the problem of antibiotic resistance as a conflict between individual decision makers and their short-term interest and the interest of society as a whole, in both present and future: The effort that doctors make to please each patient by prescribing a drug when it might not be properly indicated, poor monitoring of discharged patients to ensure that they do not transmit drug-resistant pathogens to other persons, excesses in the marketing of new antibiotics, and the broad overuse of antibiotics all contribute to the development and spread of antibiotic-resistant bacteria. The book explores a range of policy options that would encourage patients, health care providers, and managed care organizations to serve as more responsible stewards of existing antibiotics as well as proposals that would give pharmaceutical firms greater incentives to develop new antibiotics and avoid overselling. If the problem continues unaddressed, antibiotic resistance has the potential to derail the health care system and return us to a world where people of all ages routinely die from simple infections. As a basis for future research and a spur to a critically important dialogue, Extending the Cure is a fundamental first step in addressing this public health crisis. The Extending the Cure project is funded in part by the Robert Wood Johnson Foundation through its Pioneer Portfolio.