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March Links: Stimulus Madness, Grants.gov, Health Care and More!

* We wrote about how to get your piece of the stimulus pie, noting that better-prepared organizations are more likely to be funded. Now the Washington Post reports that “Much in Obama stimulus bill won’t hit economy soon:”

It will take years before an infrastructure spending program proposed by President-elect Barack Obama will boost the economy, according to congressional economists.

[…]

Less than half of the $30 billion in highway construction funds detailed by House Democrats would be released into the economy over the next four years, concludes the analysis by the Congressional Budget Office. Less than $4 billion in highway construction money would reach the economy by September 2010.

* At The New Yorker, Steve Coll decided to blog the Stimulus Bill. Good luck on your journey! I, for one, would prefer not to wander in the desert for 40 years, but I’m glad someone else is willing to do so and perhaps bring something enlightening down from the mountain at the end. From his first post:

I particularly like the turn from the setting to the main title: “Begun and held at the City of Washington on Tuesday, the sixth day of January, two thousand and nine…An Act.” It’s all very grand—and a long way from the aesthetics of Fox News or MSNBC, which is how we usually encounter this material, in a summary of a summary.

And so, herewith launches an irregular series about the stimulus bill. I will read all of it, carefully, so that you don’t have to, and every so often I will stop and try to write something useful. It seems doubtful that the full law will prove either as funny or as morally edifying as the Old Testament, but I will do what I can.

* The Washington Post reports that Grants.gov Strains Under New Demand:

An early casualty of the stimulus package was identified by the Office of Management and Budget this week when OMB Director Peter Orszag told agency heads to plan for a possible meltdown of the government’s online grantmaking portal… “Grants.gov continues to experience system slowness due to the high volume of users,” the Grants.gov blog advised readers Tuesday.

The question is, how will we be able to distinguish new problems from business as usual?

* From the department of unintended consequences: “Doctor-Owned Hospitals Fare Poorly in Child Health Bill” says:

A bill making its way through Congress to provide more low-income children with health-insurance coverage could spell financial trouble for scores of hospitals owned by physicians.

The number of doctor-owned hospitals has tripled to about 200 since 1990, but they have long been mired in controversy. Supporters say these hospitals, which often focus on one or two lucrative services, such as cardiac care or orthopedics, are highly efficient, saving expenses for both patients and insurance programs, including Medicare.

Critics say physicians who refer patients to hospitals in which they have an ownership stake drive up costs, because they order more tests or perform unnecessary surgery. They argue that the physician-owned hospitals also cherry-pick the healthiest patients, which hurts the finances of other hospitals, the majority of which are nonprofits.

* More on unintended consequences and kids in “New Law Cripples Small and Independent Children’s Toy and Clothing Makers:”

The gist is that the new regs impose debilitating new testing requirements on anyone who makes, markets, or sells toys to to children. The bill is a hysteria-filled reaction to last year’s China lead scare, and its reach is really pretty incredible. Thrift stores, libraries, independent toymakers, people who hand-make toys and clothes to sell online, and on down the line are all going to be affected. It’s going to put thousands of people out of business. Just what the economy needs.

As is the case with most new regulations, the one group that won’t have any problem complying will be the giant toy companies—the very companies responsible for the lead scare that inspired the legislation in the first place.

* The New York Times is In Search of the Just-Right Desk. They neglect the best desk of all, however, which is one with a Humanscale keyboard system attached to it. The 5G system can be found for $225 – $300, and once one has it, the only question is having a surface on which to mount it. We wrote about such equipment issues in Tools of the Trade—What a Grant Writer Should Have.

* Although the Wall Street Journal editorial page is a notoriously lousy place to seek informed or balanced opinions, it does have a useful piece about What Medicaid Tells Us About Government Health Care. Ignore the political slams and focus on the parts about access to care:

The federal and state governments are equally culpable for the program’s troubles. The federal government matches state Medicaid spending, paying an average of 57% of costs. States expand enrollment in order to qualify for more federal aid. Insurance coverage has become the end itself, with states spreading resources widely but thinly — without enough attention to the quality of care, accessibility, or whether coverage was actually improving health. States have no obligation to rigorously measure health outcomes in order to qualify for more federal money.

One major healthcare problem in the United States is insufficient access to care, and in particular to specialty care. While insurance rates get enormous amounts of media coverage, virtually no one discusses how hard it can be to use public insurance like Medicare/Medicaid because relatively few providers accept them. We’ve worked for clients in relatively large cities that lack an adequate number of basic specialists like ob/gyns and cardiologists, and often have no practices that will accept Medicare/Medicaid. As the editorial notes, the preference for these programs has been on enrolling the maximum number of people—sometimes at the expense of the quality of care given:

For its part, the federal government has often prevented the states from taking steps to fix their own Medicaid programs, such as by devising outcome-based standards for evaluating performance, and de-emphasizing the goal of growing the number of covered people to focus more on improving the health of those served.

* Elsewhere in the WSJ, an article discusses “Heroin Program’s Deadly Toll: Needle Exchanges Save Lives but May Imperil Workers:”

Worker drug abuse is “a huge problem,” says Jon Zibbell, the founder of a Massachusetts drug users’ coalition who is now an assistant professor at Skidmore College. “We prevent [overdoses] among our clients,” he says. “So we should try to prevent them among our workers.”

Studies suggest that needle exchanges work. In San Francisco, Chicago and New Mexico, heroin-related deaths dropped after users were taught how to administer an anti-overdose medication to each other. In New York City, the rate of new HIV infections among injection-drug users dropped more than 75% between 1995 and 2002 as the number of clean needles distributed doubled, according to a study by epidemiologists there.

Many needle-exchange programs employ recovering addicts who might not always be as recovering as they say. This is a near-universal tactic in service delivery under the theory that those who can empathize with a person’s struggle are better able to help that person and to provide a positive role model.

* Ever wondered why people can’t give unused airline tickets or frequent flyer miles to you? So did the WSJ, and in “Why Fliers Can’t Donate Unused Tickets” Scott McCartney explains that airlines make a lot of money from unused tickets and would rather make specious security and technical arguments than allow greater customer choice.

* Note to the person who found our site by searching repeatedly for “grant writeting in la.”: you’ve correctly realized that you need help with writeting writing.

* In other search news, someone found us by searching for “should we hire a grant writer?” Being grant writers, our answer is almost always yes, but one can find more on this subject in a tangentially related post on “Why Can’t I Find a Grant Writer? How to Identify and Seize that Illusive Beast.” This subject might also become a post of its own at some point: watch this space for more.

* In still more search news, someone else found us by searching for “free grant writing software.” Software isn’t going to help you: learning how to write, however, will. But there are a number of lovely free and open source pieces of writing software, including AbiWord and OpenOffice.org. In the paid but inexpensive world, I’m fond of the Mac program Mellel.

* Why is the U.S. Department of Transportation (DOT) giving out money for the Garrett A. Morgan Technology and Transportation Education Program, which is designed “to improve the preparation of students, particularly women and minorities, in science, technology, engineering, and mathematics (STEM)?” Isn’t that the Department of Education’s job? It’s a good example of a point we occasionally make: just because a federal, state, local, or foundation/corporate giving resource doesn’t appear to fund in your area doesn’t mean they won’t issue an RFP in it anyway.

* If you think running your program is hard, consider the Chiricahua Leopard Frog Conservation project, which “will involve hand removal of frogs and monitoring refuge sites to determine status of the Chiricahua Leopard frog and possible re-invading bullfrogs.” Where do I sign up?

* The New York Times is smart enough to try following federal money to A.I.G., as reported in “Where Taxpayers’ Dollars Go to Die.” They should try the same with federal grant programs.

* State smiling lessons for liquor store employees in Pennsylvania. Good luck! One of the nice parts about moving from Seattle to Tucson was the civilized practice of selling booze in grocery stores, which Washington State lacks.

* One of the very few genuinely intelligent recent articles about the financial mess: The Problem With Flogging A.I.G.:

By week’s end, I was more depressed about the financial crisis than I’ve been since last September. Back then, the issue was the disintegration of the financial system, as the Lehman bankruptcy set off a terrible chain reaction. Now I’m worried that the political response is making the crisis worse. The Obama administration appears to have lost its grip on Congress, while the Treasury Department always seems caught off guard by bad news.

And Congress, with its howls of rage, its chaotic, episodic reaction to the crisis, and its shameless playing to the crowds, is out of control. This week, the body politic ran off the rails.

There are times when anger is cathartic. There are other times when anger makes a bad situation worse. “We need to stop committing economic arson,” Bert Ely, a banking consultant, said to me this week. That is what Congress committed: economic arson.

* Writing in the Wall Street Journal, Dambisa Moyo examines Why Foreign Aid Is Hurting Africa: Money from rich countries has trapped many African nations in a cycle of corruption, slower economic growth and poverty. Cutting off the flow would be far more beneficial. He also wrote the book Dead Aid: Why Aid Is Not Working and How There Is a Better Way for Africa

* Your eyes might deceive you: Slate’s Dahlia Lithwick asks: “Have the Eyes Had It?
Is our eyewitness identification system sending innocents to jail?
” The answer, according to her article, is yes.