Joseph A. Califano Jr.2013-05-19T01:30:00-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/author/index.php?author=joseph-a-califano-jrCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Joseph A. Califano Jr.Good old fashioned elbow grease.What the 2012 Election Is Really All Abouttag:www.huffingtonpost.com,2012:/theblog//3.19271572012-10-01T16:38:55-04:002012-12-01T05:12:01-05:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
Barack Obama is the first African American to occupy the highest office in the land. Can anyone doubt that Obama owes his presidential opportunity to the Voting Rights Act of 1965, Civil Rights Act of 1964, and LBJ's commitment to give African Americans a fair shot at educational and economic opportunity?
The demography of the electorate has been recast not simply by LBJ's domestic civil rights legislation, but by his repeal of the National Origins Act of 1924. That Act restricted immigration to white Protestants (largely British and northern Europeans), in reaction to the flood of Italian and Irish Catholics, Jews and Eastern Europeans that entered the United States in the late 19th and early 20th centuries. Hours after the Voting Rights Act was passed, Johnson was phoning senators to pass his Immigration Reform Act to eliminate those restrictions. When he signed the bill beneath the Statue of Liberty two months later, he said, "Never again will the twin barriers of prejudice and privilege shadow the gate of freedom."
LBJ's civil rights and immigration reform legislation is why the electorate is such a pageant of black faces, brown faces, and first generation faces of Indian, Hispanic and Asian Americans, alongside white Americans, participating as citizens of their country. It's why there are Indian-American Republican governors in Louisiana and South Carolina, a Hispanic female governor in New Mexico, and thousands of congressional, state and local candidates who trace their ethnic heritage to Latin America, Asia, Africa, India and the Middle East.
The issues in 2012 echo many battles of Johnson's Great Society. LBJ drove Medicare for seniors and Medicaid for the poor through Congress in a bare-knuckled political brawl, and then wrestled reluctant physicians and hospitals to participate. I wish he could hear both presidential candidates vehemently and repeatedly promising to preserve Medicare.
Republicans attack the Great Society Food Stamps program because 46 million Americans are using them; Democrats counter that Food Stamps keep millions off of the kind of bread lines that marked the Great Depression. Republicans question the value of Head Start and appropriateness of federal involvement in pre-school education; Democrats defend the government's role in providing pre-school help to the poor, noting as LBJ did that "rich kids have always had such help, why not poor kids."
Conservatives and liberals fight over the constitutional validity of affirmative action, the program Johnson articulated with that marvelous analogy of the unfair race between two runners at the starting line, one who had been training for years, the other whose legs had been locked in chains.
The arguments over administration efforts to impose new financial and corporate regulations are 21st-century versions of the Great Society's truth in lending, packaging and securities laws, and its auto safety and wholesome meat laws, all designed to protect the individual in dealing with large corporate interests. Today's environmental clashes between the parties resemble the Great Society rumbles over the nation's first clean air and water and motor vehicle pollution laws.
Finally, there is the overarching conflict over redistribution of wealth and the role of government. Republicans call Obama's effort to redistribute wealth a mortal sin against American capitalism. LBJ spoke often, openly and proudly about redistributing wealth as an essential part of lifting Americans out of poverty and cushioning the sharp elbows of capitalism. He saw redistribution as the essence of the progressive tax system to provide resources for social programs to fulfill government's obligation to help the most vulnerable in our nation.
There is a signal difference. When Johnson went about enacting the tax reduction that President Kennedy had been unable to pass, he faced bitter opposition from conservatives in Congress and had full support from liberals. (The top rate was 90 percent; LBJ proposed lowering it to 70 percent with comparable reductions down the line.) By his commitment to tighten spending, Johnson got enough votes to pass the tax reduction that unleashed the prosperity which provided federal tax revenues to fund the Great Society!
Johnson would appreciate the popular support for Medicare, but he would recognize that change is inevitable. He knew it's the music of commitment, not the legislative lyrics that count. As he said in 1964, "The Great Society is not a safe harbor, a resting place, a final objective, a finished work. It is a challenge constantly renewed, beckoning us toward a destiny where the meaning of our lives matches the marvelous products of our labor."
All in all, LBJ would be pleased that President Obama and Democrats are fighting for his programs -- though he'd likely be upset that they never mention his name.
Joseph A. Califano Jr. was President Lyndon Johnson's chief assistant for domestic affairs and Secretary of Health, Education, and Welfare from 1977 to 1979. He is Founder and Chair Emeritus of the National Center on Addiction and Substance Abuse at Columbia University.]]>The Dangerous Joker in the Presidential Political Decktag:www.huffingtonpost.com,2012:/theblog//3.14455392012-04-23T19:18:02-04:002012-06-23T05:12:02-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
Rather, the deciding factor is far likelier to be a little discussed internet operation called Americans Elect. That elegantly titled organization is the joker in the presidential election deck that could trump every other card and determine whether Barack Obama or Mitt Romney is elected in November.
Americans Elect is a political reform movement funded by Peter Ackerman and others, and supported by some distinguished citizens like former New Jersey governor Christine Todd Whitman, television producer Mark Burnett, and former FBI Director William Webster, who sit on its advisory committee. The object of Americans Elect is to assemble a non-partisan ticket through a series of caucuses and national nominating convention on the internet. To "balance" the ticket, presidential candidates seeking Americans Elect's nomination must select a vice presidential candidate from the other party (or if an independent, tilting the other way). More than 2.5 million individuals have already qualified as delegates to vote in this nomination process.
The remarkable -- and unprecedented -- achievement of this movement is that it is laying claim to a voting line for president in just about every one of the 50 states. The group's larger objective is to collect enough votes in each state to maintain that powerful political positioning for congressional and other races in 2014, as well as quadrennial national elections in 2016.
Americans Elect is sparked by concerns that the two major political parties are so partisan and polarized that they have paralyzed the national government in Washington. It hopes to return control of the Congress and executive branch to a moderate middle ready to compromise. Americans Elect would rather be seen as middle-of-the-road mediator than a third party, but its impact this year will be like that of a third party.
We haven't seen anything quite like Americans Elect with a line in every state ballot. But we have seen third parties. The two most recent examples show the political mischief such parties can cause, however well meaning. Ross Perot ran on a Reform Party line in several states in 1996. Thanks to the conservative votes he garnered, Bill Clinton defeated George H.W. Bush. Ralph Nader ran in 2000 and captured enough votes in Florida to snatch that state from Al Gore and put George W. Bush in the White House.
If the presidential candidate of Americans Elect is conservative, that will almost certainly gain Barack Obama a second term. If, on the other hand, its candidate is liberal, that will likely send Mitt Romney to the White House. The "balance" required for the vice presidential nominee will be lost on voters who focus on the top of the ticket.
The potential for malevolent mischief is enormous. In the no-holds-barred world of presidential politics, it is in the interest of Democrats to maneuver for a conservative or Republican to be Americans Elect's presidential candidate, while Republicans will want a liberal or Democrat to be the Americans Elect nominee.
Think about this: Ideologically driven high roller super PACs on the left would like to see a conservative like Ron Paul for the Americans Elect nomination, while right-wingers with deep pockets like the Koch brothers would prefer a liberal like Bernie Sanders in that position. (Americans Elect's web site lists both as possible nominees.) Moreover, hard-nosed Democratic campaign professionals may seek discreet (deniable) ways to discourage any liberal or Democrat who wins the internet nomination from accepting it; their Republican counterparts will pressure any winning conservative or Republican candidate to just say no.
The backers of Americans Elect are well-intentioned and concerned, as many of us are, with the dysfunction in Washington. Congress is gridlocked in perpetual campaign mode as control of the Senate and House are up for grabs every two years. Indeed, in an act of supreme political cowardice and individual self-interest, both parties have quietly agreed to put off the pressing budget and public debt issues, like raising taxes and trimming entitlements, until after the election -- and then to be handled in a lame duck session filled with members who did not run for reelection, lost their reelection bids, or won by camouflaging their true intentions during the campaign!
The frustration of the Americans Elect folks is understandable. But even the most well-intentioned initiatives can produce unintended, and in this case, dangerous consequences. Before we replace the two-party system with the dream of a mediating non-partisan middle, we should ponder the old Basuto proverb: "If a man does away with his traditional way of living and throws away his good customs, he had better first make certain he has something of value to replace them."
Two-party petty partisanship may not look like a tradition worth keeping or a good custom today, but does introducing a third party that is virtually certain to tip the election to one of the other two offer a better value for our nation?
Joseph A. Califano, Jr. was secretary of health, education, and welfare from 1977 to 1979, President Lyndon Johnson's top assistant for domestic affairs from 1965 to 1969, and general counsel for the Democratic party from 1969 to 1972. His email address is jcalifano@casacolumbia.org.]]>Increase in Youth Smoking: The Surgeon General's Pink Panther Public Health Policy tag:www.huffingtonpost.com,2012:/theblog//3.13625772012-03-21T12:59:30-04:002012-05-21T05:12:01-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/Preventing Tobacco Use Among Youth and Young Adults, the Surgeon General sounds more like Inspector Jacques Clouseau in The Pink Panther than the nation's top health officer. After demonstrating beyond a reasonable doubt that menthol flavoring is the key culprit in getting children and young adults to smoke cigarettes, she fails to urge the Food and Drug Administration to exercise its power to ban use of this flavoring by tobacco companies. It's like Inspector Clouseau finding someone holding a smoking gun over the dead victim riddled with bullets and not making the connection that he might be the killer.
Here are some of the findings in the Surgeon General's report:
--Mentholated flavoring increases the addictive potential of smoking among youth.
--A higher percentage of adolescent and young adult smokers smoke mentholated cigarettes than in any other age group.
--Up to 58 percent of middle school smokers and 49 percent of high school smokers smoke menthol cigarettes.
--In recent years, adolescent and young adult smoking of menthol cigarettes has increased significantly, while smoking non-mentholated cigarettes has gone down significantly.
--Menthol flavoring is a masking agent that enhances smoking initiation by softening the harshness of smoke to allow inhalation (key to nicotine addiction).
--By the mid-1970s tobacco industry marketing research found that menthol cigarettes "were popular among young smokers because they were perceived as less harsh and easier to smoke."
--National surveys "confirm that menthol cigarette use is disproportionately common among younger and newer teen smokers."
--Menthol cigarettes are more likely to be marketed in stores near schools with higher proportion of African American students.
--Among black smokers, mentholated Newport cigarettes are preferred by 59 percent of adolescents and 70 percent of young adults (thanks to targeting by the tobacco companies).
--Tobacco companies use menthol to increase the appeal of smokeless tobacco products to young people.
--Evidence indicates that highly addictive, smooth tasting tobacco products like menthol cigarettes increase the likelihood that tobacco will be consumed by young people.
The Surgeon General expresses alarming concern that smoking among 12 to 17 year olds and young adults age 18 to 25 has increased. Then after she presents overwhelming evidence that menthol cigarettes are largely to blame for that rise, what does the Surgeon General do? In an Inspector Clouseau imitation, she simply finds that "mentholated cigarettes deserve special note" and "continued surveillance of menthol cigarettes is warranted"--all of this in an appendix to the report!
The Surgeon General does express awareness that menthol cigarettes "are the focus of a report by the U.S. Food and Drug Administration's Tobacco Product Scientific Advisory Committee," set up by Congress to advise the FDA. She notes that this Committee has concluded that "the availability of menthol cigarettes have [sic] an adverse impact on public health in the United States by increasing the number of smokers with resulting premature death and avoidable mortality," and that "removal of menthol cigarettes from the marketplace would benefit public health in the United States."
Again in Inspector Clouseau mode, the Surgeon General concludes that this was not a recommendation to remove menthol cigarettes from the marketplace and writes that "tobacco companies submitted their industry perspective...to the FDA...and argued that menthol cigarettes had no disproportionate impact on the public health."
Nowhere in the report, or in any other statement, does the Surgeon General urge the Food and Drug Administration to ban menthol flavoring of cigarettes by the tobacco industry; rather, she stands by, ignoring the smoking gun, waiting for the FDA to act.
With such clear and convincing evidence that menthol is the heavy artillery in the tobacco industry campaign to get kids to start smoking and get hooked, the Surgeon General's report is Pink Panther public health policy that lets the Food and Drug Administration continue to drag its feet on banning menthol flavoring in cigarettes.
We need a Surgeon General like C. Everett Koop who pulled no punches in dealing with the tobacco industry, found that cigarettes were addictive and killed and crippled hundreds of thousands of people each year, and added new energy to my calls as Secretary of Health, Education, and Welfare in 1978--more than 30 years ago--that smoking is Public Health Enemy Number One.
]]>How to Permanently Reduce State Medicaid and Prison Costs Instead of Postponing and Papering Over Themtag:www.huffingtonpost.com,2011:/theblog//3.8186452011-02-04T11:33:00-05:002011-05-25T18:30:24-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
And there is one common tapeworm that spawns this ravenous appetite for state funds: substance abuse and addiction.
New York, California, Illinois and New Jersey make the headlines for their huge budget deficits and whopping Medicaid and prison costs, but in fact most every state faces budget deficits due to the same culprits.
The reaction of governors to Medicaid's explosion in costs tends to be to eliminate coverage of services such as hearing and vision care, transplants, and obesity surgery, and to reduce payments to doctors, hospitals, and ambulance services. To cut prison costs, most governors appear to favor releasing inmates early to trim the size of the prison population and, as New York City is doing, reduce things like the size of food portions that prisoners get.
Such tactics are short term and short sighted. They assure that in the long run (on somebody else's watch) the need for public services and the burden on law abiding, taxpaying citizens will increase.
Here's a proposal for any governor who can see beyond getting through his or her term, or winning re-election or election to some other office, and who has the courage to do what any business executive in the private sector would do: Make an investment that will solve, not simply postpone or paper over the problem. If small business owners want to increase their business, or lawyers or doctors want to add to their practice, or large corporations want to get into new markets -- or if any of them want to reduce costs by modernization or eliminating inefficiencies -- they make additional investments in order to make more money in the future, over the long haul.
Is there a governor with the courage to apply this simple concept to permanently reduce Medicaid and prison costs?
If there is, here's how.
First, Face the Facts:
Some 30 percent of Medicaid health care dollars are spent to treat the injuries from violence and accidents and the 70 plus diseases caused or aggravated by substance abuse and addiction. Medicaid patients with drug and alcohol problems cost $5,000 to $10,000 a year more in health care costs than those without such problems. Most Medicaid hospital patients readmitted within 30 days are those with drug and alcohol problems. In New York, Governor Andrew Cuomo estimates that on average each such patient costs Medicaid $100,000 a year.
Some 80 percent of inmates are incarcerated for violent and other crimes committed while they were high on alcohol or other drugs, stole to get money to buy drugs, violated the alcohol or drug laws, or are alcohol or drug addicts or abusers.
Of all state substance abuse related expenditures, 94 percent goes to shovel up the burden of substance abuse and addiction in crime, health care, education and social services, while only 2.4 percent is spent on prevention, treatment or research. (3.6 percent is used to regulate alcohol and tobacco sales, collect taxes and operate liquor stores.)
For each dollar that states collect in tobacco and alcohol taxes and liquor store revenues, they spend more than seven dollars on the health care and criminal justice consequences of smoking and alcohol abuse and addiction.
Then, Act on the Facts: Invest resources in the prevention and treatment of substance abuse focused on these populations:
For all Medicaid patients, provide screening for drug and alcohol abuse and addiction and then intervene to put those with this disease into treatment.
For all in prison who need it, provide treatment and the carrots and sticks likely to get inmates into treatment, like early release for those who remain clean for at least six months. Then condition early release and probation of these inmates on their entering and staying in programs like Alcoholics or Narcotics Anonymous. CASA studies have demonstrated that if only 10 percent of inmates treated remain sober, crime free and employed for a year after release, the economic benefits and reduced criminal activity will pay for the treatment of all inmates who need it.
Pay for these investments in the short term by increasing cigarette and alcohol taxes, which offer the added bonus of discouraging smoking and excessive drinking and deterring initiation of smoking and binge drinking by underage teens.
Long term, systemic control of state budgets requires a serious effort to prevent and treat the disease of drug and alcohol abuse and addiction, which in turn requires Governors and state legislators to have the guts to make short term investments to attack this fundamental problem. Otherwise, taxpayers will end up paying more and more for less and less.
Is there a governor and state legislature with the courage to face the facts and act in a way that will solve the problem, rather than postpone or paper over it during their term in office? That's the multi-billion dollar "to be or not to be" question in American politics today. Our states desperately need governors with the guts to be problem solvers rather than problem postponers.
Joseph A. Califano, Jr. is Founder and Chairman of The National Center on Addiction and Substance Abuse at Columbia University. He was President Lyndon B. Johnson's top assistant for domestic affairs and Secretary of Health, Education, and Welfare from 1977 to 1979.]]>Marijuana's Role in the Arizona Shootingtag:www.huffingtonpost.com,2011:/theblog//3.8103362011-01-21T08:47:15-05:002011-05-25T18:25:24-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
But there is -- and it is as important as any other lesson to come out of this tragedy.
There has been plenty of media and talking head attention to the weak gun laws that allow purchase of automatic weapons and super size ammunition clips. There has been story upon story, and comment upon comment, bemoaning how easy it was for this mentally deranged young man to buy such a gun and ammunition clip. And the reporting about the twisted mind of Jared Lee Loughner and his erratic behavior has been extensive.
But I haven't seen press reports or talking heads discuss their concern about how easy it has been for this mentally ill young man to get marijuana. And there has been no mention of the potential of marijuana to spark latent psychosis and exacerbate schizophrenia and other mental illnesses.
In 2007, the British Medical Journal Lancet concluded that an exhaustive review of cannabis use and mental health "leads us now to conclude that cannabis use could increase the risk of psychotic illness." Since then, there has been more research on the relationship of marijuana use and psychosis.
Scientists at the Albert Einstein College of Medicine in New York City conducted a study of individuals who suffered from schizophrenia, half of whom used marijuana. They found that among marijuana users, three fourths had begun smoking pot before the onset of their mental illness and their schizophrenia appeared two years earlier than it did in those who did not smoke pot.
Marie-Odile Krebs, a psychiatrist at the National Institute of Health and Medical Research in France, found that among a group of 121 patients who used cannabis, 44 either developed schizophrenia within a month of beginning to smoke pot or significantly intensified their existing psychosis with each successive use of the drug. Schizophrenia appeared some three years earlier in these 44 than in the other marijuana users.
From CNN and other press reports, we know that Loughner was turned down by the Army because of his admitted regular marijuana use. His childhood friend Kylie Smith tells us that after Loughner's sophomore year in high school, "he got involved with marijuana, and he was really into psychedelics." Smith described how Loughner got more and more involved with marijuana and alcohol during his high school years and how he began hanging out with potheads. In his short stay at Pima Community College, one professor described Loughner's "hysterical kind of laugh, laughing to himself, and his bright red complexion, and his kind of shaking and trembling, as if he was under the influence of drugs."
The question that not enough people are asking -- and the one that should be answered -- is this: Was Loughner under the influence of drugs at the time of the shooting?
If the police have any of the hair shaved from Loughner's head, they can easily find out if marijuana was in his system at the time of the shooting. They may even be able to do so from hair that grows back in.
So as we continue to think about this killer and his deranged mind, we should be asking this question: Is Jared Loughner an individual whose psychosis was prompted or exacerbated by the use of marijuana?
Whether or not he is, it is important for the press and parents to see this horrendous incident not only as a teaching moment about the easy availability and dangerous potential of automatic weapons, but also as a teaching moment about the easy availability and dangerous potential of marijuana to spark and exacerbate psychosis and schizophrenia in individuals with latent mental illnesses.
The missing story line in existing news reports and television chatter shows is about the terrible trinity of easy availability of guns, easy availability of marijuana and mental illness.
The question for all of us, especially parents of teenagers, to ask is this: Is the media's failure to acknowledge this tragic trinity due to its tendency to overlook or underplay the dangers of marijuana use?
Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration, and served from 1965 to 1969 as chief domestic affairs assistant to president Lyndon B. Johnson.]]>Obama's Opportunitytag:www.huffingtonpost.com,2011:/theblog//3.8110362011-01-19T12:48:55-05:002011-05-25T18:25:24-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
In 1966, LBJ proposed gun control legislation to ban all mail-order and out of state sales of hand guns, shotguns and rifles; stop the sale of guns to minors; and require national registration of guns and licensing of gun owners. Despite energetic efforts, supported by almost weekly editorials in the Washington Post written by Alan Barth, Johnson was unable to convince Congress to act. In the Senate, he could not even get his bill out of the Judiciary Committee.
LBJ always tried to get something of value out of every tragedy. He persuaded Congress to pass the Civil Rights Act of 1964 prohibiting discrimination in employment and public accommodations as a tribute to the slain president John F. Kennedy. On the day after the assassination of Martin Luther King, Jr. he pressed House Speaker John McCormack and Minority Leader Gerald Ford to pass the Fair Housing bill which had been bottled up in the House Judiciary Committee for three years.
LBJ pressed Congress to enact his gun control proposals as a legacy for Robert Kennedy in the wake of that assassination.
"We have two weeks," he told me, "Maybe only ten days to get this bill out of the Senate. After that, the gun lobby will defeat us."
Unfortunately we were unable to get the Senate Judiciary Committee to act fast enough. It took more than a month to get the committee to consider our bill. As a result of a tie vote, we were unable to get the committee to report it out. With Herculean efforts (and some strategically placed public projects), LBJ was able to move some parts of his bill to the Senate floor. The Senate passed his provisions to stop mail order sales and sales of lethal weapons to minors, as well as importation of $10 dollar "Saturday night specials." But the gun lobby killed LBJ's proposals to require licensing gun owners and registration of guns.
In signing the bill in the Cabinet Room on October 22, 1968, Johnson said:
"The voices that blocked these safeguards were not the voices of an aroused nation. They were the voices of a powerful lobby, a gun lobby that has prevailed for the moment in an election year... We have been through a great deal of anguish these past few months and these last few years -- too much anguish to forget so quickly... So now we must complete the task which this long needed legislation begins."
Obama now has an opportunity to complete this task. Unlike LBJ, who by the fall of 1968 was a lame duck hobbled by his pursuit of civil rights and an unpopular war, Obama is strengthened by his remarkable legislative successes in December and his brilliant and healing speech in Tucson.
But he must learn the lesson of timeliness. If he pushes for immediate action aggressively and emotionally in his State of the Union message next week, he has an extraordinary opportunity -- the best in half a century -- for real gun control, not just banning automatic weapons and super size cartridges, but licensing all gun owners and registering all guns than any president has had in half a century. Let's hope he picks up the standard, as he has with health care, and completes the task begun in 1968 by LBJ for comprehensive gun control.
Joseph A. Califano, Jr. is Founder and Chairman of The National Center on Addiction and Substance Abuse at Columbia University. He was President Lyndon B. Johnson's top assistant for domestic affairs and Secretary of Health, Education, and Welfare from 1977 to 1979.]]>Where's the Superman to Tackle Drug and Alcohol Abuse in our Schools and Colleges?tag:www.huffingtonpost.com,2010:/theblog//3.7724332010-10-26T01:55:41-04:002011-05-25T18:05:23-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
The tough stuff is revamping communities, strengthening parents and families, and getting rid of the drugs and the alcohol abuse that infect so many schools and campuses. If we don't tackle the tough stuff, these high ticket investments are not likely to have more than a marginal impact and we'll still be Waiting for 'Superman'.
Failure to face up to that truth is why school reform so often has little effect on our kids' education. There is only so much high tech tools and high paid teachers can accomplish.
Overall, only 71 percent of American students graduate from high school; in most urban centers, the number is no more than 50 percent. And usually, those graduation rates are calculated only from the kids that enter high school. If we started counting from first-grade in elementary school, the drop out rates would be much higher.
According to the NBC News Education Nation summit, among 30 other industrialized countries American students rank 25th in math and 21st in science. Seven out of 10 of our eighth-grade students can't read at their grade level.
To what extent are low reading and math scores and high drop out rates attributable to the failure of schools to have more modern plants and equipment? Or to teachers unions? And to what extent are they due to drug and alcohol use by teenagers in high school and their parents use or neglect?
Congress has appropriated $4.35 billion for schools in the 10 states that won the Race to the Top school reform contest. That same Congress eliminated $295 million in funding for the state grants to fund drug and violence prevention programs.
Take a walk around the outside of the schools in your community. Is there a sign that says Drug-Free School Zone? Have you ever thought about whether that sign is telling the truth? At The National Center on Addiction and Substance Abuse at Columbia University we have. We have talked to thousands of middle and high schoolers in small towns, medium-size cities and major urban centers all over the country. Most of them tell us that the words on that sign aren't worth the paint they're printed with.
Drugs and alcohol threaten our children's academic performance. Research shows that adolescents who smoke, drink or use other drugs have poorer grades, higher levels of truancy, cognitive impairments at school, and higher rates of suspension or expulsion. They are less likely to graduate from high school or to obtain a college or post-graduate degree than teens who remain substance free.
For the past 16 years CASA Columbia has been asking 12 to 17 year olds about the presence of drugs in the corridors, classrooms and grounds of their schools. Their consistent responses are these:
Responding to an open ended question, the largest percentage of teens say that their number one problem is drugs.
Eight of 10 high school students and four of 10 middle school students say that they see schoolmates possessing, using or dealing drugs, or getting high or drunk, at school.
One in three middle schoolers and two out of three high schoolers report that drugs are used, kept, or sold at their schools, continuing a steady increase in drug-infected high schools since 2006.
And what about those kids that do graduate high school and head to college? America now ranks tenth in the world in the percentage of young adults who graduate from college -- we used to be first.
There are many reasons why college students do not graduate, especially in these difficult economic times. But here's one you may not be aware of:
Among the college students who never graduate are these:
The 2,000 students who die each year from alcohol poisoning or alcohol related accidents and violence on college campuses.
Some of the 100,000 college women who each year are victims of sexual assault or rape due to alcohol abuse.
Some of the 700,000 college students who each year are injured as a result of alcohol related accidents or violence.
Don't get me wrong. I'm all for the reforms that Education Secretary Arnie Duncan, state education officials, and mayors like Mike Bloomberg are seeking. I'm for all kinds of competition, from Race to the Top to charter schools, parochial schools, vouchers, for profit and not-for-profit private schools. I recognize that we must do lots of things to repair our broken elementary, middle and high schools and get our colleges to be more than a four- or five-year alcohol drenched party for millions of students. But if America wants to get serious about improving the education of our children in schools and colleges, all of the big bucks spent on other stuff will be for naught or of only marginal value unless we find the Superman to deal with the problem of alcohol and other drug abuse and addiction that undermine the education of our children.]]>Why the Great Recession is Not Another Great Depressiontag:www.huffingtonpost.com,2010:/theblog//3.7640252010-10-15T09:58:29-04:002011-05-25T18:00:30-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
The Great Society.
That's something for those who support - or question - the role of government in bolstering our economy and protecting our people and our democracy should keep in mind.
True, things aren't great. We have seen the highest poverty rate in 15 years and one of the greatest year-to-year increase in poverty during Barack Obama's first year as President. We are experiencing a stubborn 9.6 unemployment rate where 15 million Americans are out of work and seeking it, and millions more idled Americans have given up. But without the Great Society Programs, things would be much worse and the nation might be in a state of shock that would rival the turmoil of 1929.
Take food stamps, the Great Society program to relieve hunger in America. Since the recession started in December 2007 the number of Americans on food stamps has climbed from 27.6 million to 41.8 million in 2009. Newt Gingrich may mock the program, but without it there would likely be 14 million more Americans in lines at soup kitchens.
Take health care. Medicaid enrollment has jumped by almost six million since the start of the recession, from 42.8 in 2007 to 48.5 in 2009. And the number of individuals seeking help in the Great Society's Community Health Centers is up by 25 percent from 16 to 20 million over that same period.
Take Social Security. Lyndon Johnson wanted to put in place an income maintenance program, but the political hurdles were too high. So he used the biggest ATM in town. He persuaded the Congress to enact a minimum Social Security benefit and adjust all rates accordingly. That action and its ripple effect in 1966 lifted 2.5 million elderly Americans from poverty. Today, the impact of that minimum benefit concept on Social Security lifts 20 million Americans above the poverty level, including more than 13 million elderly, more than 5 million disabled and more than one million children.
Take Unemployment Insurance. Johnson proposed a minimum benefit increase to 50 percent of pay for most wage earners, two 26 week extensions depending on economic conditions, federal grants to states, and an increase in payroll taxes to pay for these adjustments. Unfortunately he was unable to get his proposals enacted during his term, but a year later in 1970 the Congress revamped unemployment insurance in line with his proposal and that is essentially the system in place today.
So without these Great Society Programs, there would be millions more Americans living in poverty and the nation would face an even more catastrophic situation. These programs are proof positive of the value of government action to aid the most vulnerable in our society.
Why can't Democrats cite these programs and LBJ's Great Society as an example of how important government intervention and safety nets are, not only as a matter of social justice, but also to preserve our democracy and avoid disruption, perhaps violence, driven by unemployment, hunger and poverty?
Of all people, one would think that Barack Obama, whose path to the presidency was paved by the Voting Rights Act of 1965 (and other LBJ civil rights legislation) would cite these examples of the importance of government intervention. It's time for all Democrats to dust off their reluctance to mention LBJ and help our people understand that government is key in times like these, that in 2010 the Great Society is the difference between the Great Recession and another Great Depression.
Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration, and served from 1965 to 1969 as chief domestic affairs assistant to president Lyndon B. Johnson.]]>With Drug Abuse Up: "We Have Met the Enemy and He Is Us"tag:www.huffingtonpost.com,2010:/theblog//3.7195982010-09-17T15:31:40-04:002011-05-25T17:40:20-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/reported by the government today threatens the health and safety of every child and family in this nation.
Now is not the time to point fingers. Now is the time for all of us to look in the mirror: the President, political leaders, professionals in medicine and public health, and parents, and begin to deal with this scourge head on.
The greatest decline in drug use in this nation occurred during the 1980s when Nancy Reagan led a campaign to "just say no," a message that resonated with the nation and brought drug use to its lowest point in the last 40 years. Drug abuse and addiction is the nation's deadliest disease, killing almost half a million people each year and destroying the lives of millions of families and friends. With this morning's report, we are more than half way back to the highest drug use this nation has ever experienced.
In order to eradicate this epidemic -- which shatters more lives and livelihoods than any other disease -- the public health and medical professions must mount the kind of campaign they did to combat smoking and AIDS. In a matter of a few years, their efforts changed America's opinion of AIDS as a social curse to recognition that it was a dangerous disease needing research and medical attention to cure it.
It took many years more, but beginning in 1978, the government and the public health professionals got Americans to understand that smoking was an addictive disease and were able to change the culture from an individual saying, "Would you like a cigarette?" to "Do you mind if I smoke?" and the rest of us readily replied, "You bet we do."
So instead of pointing fingers -- Republicans and Democrats at each other, parents at schools, schools at parents, public health professionals at the media -- let's all of us come together and mount the kind of national health effort against the disease of addiction that we have successfully done with smoking and AIDS and are now starting with obesity.
If we don't, we will continue condemning millions of our children and families to lives filled with tragedy, illness and death.
Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration.]]>Requiring Parents to Send Children to Gang- and Drug-Infected Schools Is State Sanctioned Child Abusetag:www.huffingtonpost.com,2010:/theblog//3.6992442010-08-30T13:18:54-04:002011-05-25T17:30:22-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
Are you going to do something about it or just accept it as an inevitable experience your child has to go through because "that's just the way things are today"?
If you heard that your child's classroom and school building were infected with asbestos, wouldn't you demand that the school authorities certify that the asbestos was cleaned out before you sent you child to school for five or more hours each day?
Are you more concerned about your child breathing asbestos dust than you are about your child drinking, smoking, popping pills, using marijuana, or experimenting with drugs like acid, ecstasy, meth, cocaine, and heroin?
That's the question you've got to answer because here's what CASA's 2010 Survey reveals:
Twenty-seven percent of public school children attend schools infected with gangs and drugs. Compared to teens at gang- and drug-free schools, the 5.7 million teens at these schools are five times likelier to use marijuana, three times likelier to drink, twelve times likelier to smoke, and five times likelier to be among friends and classmates who use illegal drugs like acid, ecstasy, meth, cocaine and heroin.
One in three middle schoolers say that their schools are drug infected, a 39 percent jump over the past couple of years. Ten percent of the kids at these drug-infected middle schools admit they smoke pot, while none of those surveyed at drug-free middle schools use marijuana.
Sixty-six percent of high school students say their schools are drug infected; continuing a steady increase in drug-infected high schools since 2006, when 51 percent of high school students said they attended drug-infected schools.
These increases in the number of drug-infected schools is a trajectory for tragedy for millions of 12- to 17-year olds in our nation because kids in drug-infected schools are much likelier to smoke, drink, get drunk, and use drugs than those in drug-free schools.
Hopefully these dismaying survey results will change the hear-see-speak-no-drugs mentality of so many public school administrators, from the U.S. Department of Education down through state school commissioners to local school board members. They all bemoan the number of dropouts and the low graduation rates, but they never mention that the bulk of those dropouts are kids with drug and alcohol problems or whose parents have such problems.
Indeed, if you want to know one of the reasons why so many public schools are failing our children, consider the difference the CASA survey reveals between public schools and private and religious schools: 46 percent of teens at public schools say there are gangs at their schools compared to only 2 percent of teens at private and religious schools. In other words, public schools are 23 times likelier to be gang infected than private and religious schools.
Where there are gangs, there are likelier to be drugs. Not surprisingly, 47 percent of public school students said their school was drug infected compared to six percent of private and religious school children.
The drug-free school gap between public schools and private and religious schools is up sharply from its narrowest point in a decade. In the 2001 CASA teen survey 62 percent of public schools and 79 percent of private and religious school students said they attended drug-free schools; in this year's survey, 43 percent of public school students and 78 percent of private and religious school students say they attend drug-free schools, widening the drug-free school gap from 17 points to 35 points.
Most adults do not encounter gangs and drugs at work each day. Why do we force millions of our children to encounter gangs and drugs at school each day? If adults faced gangs and drugs in their factories and offices they would protest, call the police, and if that failed, change jobs. Yet we expect millions of our children to return to the same school, day after day, and face the menace of gangs and drugs.
Placing our young teens and pre-teens in an environment where drinking and drugging are common is state sanctioned child abuse, since we know that the earlier a child begins to smoke, drink or use drugs, the likelier that child is to become addicted. States require parents to send their children to school; in some states it is a crime if parents fail to do so. These states have an obligation to provide safe and drug-free schools. Requiring parents to send 12- to 17-year olds-and even younger children-to drug- and gang-infected schools is an outrageous misuse of government power-and a mandate that no parent should be forced to respect.
Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration.]]>The Greatest Failure of the Medical and Public Health Professionstag:www.huffingtonpost.com,2010:/theblog//3.6525622010-07-20T11:01:42-04:002011-05-25T17:05:23-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
Against the scientific knowledge we now have, physicians' refusal to give alcohol- and other drug-addicted patients the same medical care and attention they provide individuals with other chronic illnesses like hypertension and diabetes is inconsistent with their Hippocratic oath to "prescribe regimen for the good of my patients...and never to do harm to anyone." The harm due to this long term failure of the medical profession and public health community is measured in untold lives lost and ruined and the incalculable human misery of families, friends and colleagues of alcoholics and drug addicts.
Why has this happened?
Twenty years ago, former First Lady Betty Ford said to me, "Joe, if our nation does nothing else, if we can only get the stigma off this disease, we will have accomplished a great deal."
At the time I didn't realize how prescient the former First Lady was. As many will remember, Betty Ford revealed her own addiction to mood altering prescription pills and alcohol in an effort to put an end to the stigma that clings to this disease.
Well, over these years I think we've made progress and become better informed about how drug and alcohol addiction causes and exacerbates just about every social problem the nation faces -- crime, health care costs, lousy public schools and besotted college campuses, domestic violence, child abuse, teen pregnancy, homelessness -- and developing effective prevention and treatment programs for the most vulnerable in our society, like high risk children and mothers on welfare. But we haven't peeled the stigma off this disease of addiction.
I now believe we won't be able to do that until the medical and public health professions accord addiction to alcohol and other drugs the respect they pay to other chronic illnesses. Addiction ranks as the nation's most prevalent ailment. Indeed, if ten percent of our people had the flu or measles, we'd all call it a monstrous epidemic and pull out all the stops to confront it. Yet that many people in our country -- some 30 million -- are likely addicted to alcohol, prescription and illegal drugs and steroids, and we ignore this elephantine epidemic.
Why?
Because so many Americans don't consider addiction to alcohol or illegal or prescription drugs a disease. They think it's just a personal indulgence or a moral failing that the addicted individual ought to be able to shed like a winter coat in warm weather.
Well, I hold the medical and public health professionals responsible for that gross misunderstanding and the havoc it wreaks.
Remember AIDS? Most Americans considered AIDS a social curse for homosexuals. Then the doctors and the public health pros mounted an all-fronts education campaign, and in just a few years Americans accepted the fact that AIDS was a serious disease -- and acted on that fact raising money for research and volunteering to help afflicted individuals.
Remember when smoking was a common practice everywhere? Well, it took a little longer, but the public health community organized a relentless education campaign and doctors urged their patients to quit -- and now all except the hard-core nicotine pushers like Altria (nee Philip Morris) and Brown and Williamson accept that nicotine addiction can be cured with pharmaceuticals and attentive physician care. And the smoker who once said, "Would you like a cigarette?", now asks, "Do you mind if I smoke?", and most people respond, "You bet I do!"
Well the time has come for physicians and public health professionals to say to the American people, "Addiction to alcohol and other drugs is a disease, and we are going to accord it the same medical attention we accord other chronic diseases." Setting that example in their own practices, the doctors will have the credibility needed to support a massive public health campaign to get our people to understand that addiction is indeed a disease and a preventable and treatable one.
It will take years, perhaps a generation as it did with smoking (I started the national anti-smoking campaign in 1978), but eventually as we curb this disease we will sharply reduce the consequential crime, health care costs and other social ills, shut down the huge market for illegal drugs that exists in our nation and spawns so much violence in other nations like Mexico, and save millions of lives and the related misery for the families and friends of those who suffer from the disease of addiction. Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration.]]>Medical Marijuana in the New York State Legislature: Sheep's Clothing for the Wolf of Legalizationtag:www.huffingtonpost.com,2010:/theblog//3.6226402010-06-24T18:05:59-04:002011-05-25T16:50:20-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
The United States has the best system in the world for assessing the safety and efficacy of medicines in the Food and Drug Administration and I, like Mayor Bloomberg and New York City's top narcotics prosecutor Bridget Brennan, support government study of the use of marijuana (and its active ingredient THC) for medicinal purposes. But like them, I do not support the con game going in the dysfunctional New York State legislature.
The bill Albany is considering is legalization in drag, a loosely drafted piece of legislation that, as special narcotics prosecutor Brennan points out, would allow an unlimited number of shops to sell "medical" marijuana and does not even require a physician in good standing to meet with patients before "prescribing" pot. Indeed a small army of non-physicians can dispense this state's "medical" marijuana, including podiatrists, veterinarians and nurses. The law does not even require any checks for contaminants that could harm patients with weak immune systems like HIV victims and those undergoing chemotherapy.
The two Albany legislators pushing this bill, Senator Thomas Duane, (D-Manhattan, 29th District) and Assemblyman Richard Gottfried, (D-Manhattan, 75th District) are chairs of the Health committees in the state senate and house. They are also stealth drug pushers who, like street drug pushers who deal their stuff in dark alleys, are trying to bury their marijuana bill in the state's budget legislation. That way members can hide their vote on it and do not have to take any heat from their constituents for the marijuana shops that open up in their districts. Senator Duane and Assemblyman Gottfried won't propose their marijuana bill as a separate piece of legislation because they don't have the votes to pass it. Their colleagues in the Albany legislature should demand that this three-card Monte attempt to force them to vote to legalize marijuana should be rejected.
Legislative drug pushers Duane and Gottfried are trying to escape responsibility and blame for themselves and their colleagues for the scores of marijuana shops that will open up in neighborhoods across the city and the state. This is exactly what occurred in Los Angeles where the city council faced an onslaught of angry citizens whose neighborhoods were overrun with pot heads and just recently closed 437 of the thousand or more marijuana shops that opened up after passage of California's medical marijuana law. The LA city council acted in an effort to "achieve some order out of what has essentially been a very chaotic situation" where marijuana dispensaries were popping up all over the city, some near schools and churches, and were serving recreational marijuana users.
And the New York law is far looser than California's. As Brennan notes, the New York bill is "far too loosely drawn, and offers no safeguards to protect the health of those who use it, and the safety of the communities where marijuana dispensaries would be located."
Politically prescribing medicine, rather than scientifically prescribing it through the Food and Drug Administration, is a dangerous and cynical game. Searching for the therapeutic potential of any substance is appropriate, but approving "medicine" by political referendum is a slippery slope that plays fast and loose with the desperate cries of help from the sick.
When I was Secretary of Health, Education, and Welfare in the late 1970s, more than half the states responded to frantic pleas from cancer victims by passing bills to legalize the use of laetrile, a concoction of crushed apricot pits and cyanide, which was touted as a cancer cure. At least 50,000 cancer patients took it before our scientific analysis exposed it as completely worthless.
The plight of individuals in chronic pain and with serious diseases like cancer and multiple sclerosis should not be used by politicians to make "medical" marijuana widely available to anyone with a cough or a cut and to recreational users.
So I say, hurrah for Bloomberg and Brennan. I hope Bill O'Reilly gives them his Patriots award and slaps the two Albany legislator drug pushers with his Pinhead award.
If we do not nip this problem in the bud now it will continue to grow like a weed, making me wonder what the next drug we'll approve by political referendum will be. Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration.]]>The Tobacco Leopardtag:www.huffingtonpost.com,2010:/theblog//3.6211062010-06-22T12:54:02-04:002011-05-25T16:50:20-04:00Joseph A. Califano Jr.http://www.huffingtonpost.com/joseph-a-califano-jr/
The city has enacted a requirement that stores selling cigarettes--some 11,500 establishments--show at point of sale where the tobacco products are displayed one of three Health Department signs. One displays a smoker's damaged lung; another, a decayed tooth; and the third, a stroke-damaged brain, respectively captioned "Smoking Causes Lung Cancer," "Tooth Decay" or "Stroke." Each urges individuals to "Quit smoking today" and take advantage of New York City's quit programs.
Philip Morris, R. J. Reynolds Tobacco and Lorillard--the big three tobacco merchants--have gone to their old playbook, the one they use to battle any effective anti-smoking effort. First, create (or support) as allies individual local stores or restaurants and an association to "represent" them. Second hire the biggest legal guns money can buy. Third, file a lawsuit that sprays charges and legal attacks like buckshot hoping one or another will hit their target.
When the industry resorts to one or another of those ploys, you know the program they are attacking is effective.
In 2003, R. J. Reynolds and Lorillard sued the California Department of Health Services to kill the state's effective tobacco control advertisements. Among the two companies' claims was that California violated their First Amendment rights by imposing a surtax on cigarettes and using the proceeds for the state's anti-smoking media campaign. The outcome: the federal district court rejected this spurious claim (and others) and the Ninth Circuit Court of Appeals affirmed the trial court's rulings.
Beginning in 2002, Lorillard engaged in a legal battle with Legacy, the foundation set up by the tobacco master settlement agreement to discourage youth smoking, to kill its extraordinarily effective youth smoking prevention truth® campaign. The litigation dragged on for almost five years, distracting Legacy's executives and draining the foundation's resources. The outcome: a unanimous Supreme Court of Delaware decision upholding the Legacy program and rejecting the industry's claims that Legacy's hard hitting ads vilified tobacco executives in violation of the settlement agreement.
The lawsuit filed against New York City echoes the spurious claims made by the tobacco companies in the past. Among the complaint's charges, the industry claims that requiring a store seller to put up such a graphic sign violates the First Amendment rights of a seller or store owner who doesn't agree with it. That's like saying that the government requirement that drug companies warn patients of adverse side effects violates the First Amendment rights of pharmaceutical companies who don't agree with the warning. Other claims splattered through the complaint are that the law violates plaintiffs' civil rights and that federal law prohibits the city from imposing this requirement.
This effort to block New York City's potent public health initiative is reminiscent of big tobacco's assertions that nicotine was not addictive and its denial of smoking's adverse health consequences, while concealing the mounds of data it had to the contrary. That tactic led the federal district court in Washington to find the big three tobacco companies guilty of civil racketeering and defrauding the public, a finding which was upheld on appeal just last year.
New York City's posters have been on display for the better part of a year. From our experience, it doesn't take tobacco companies that long to file a lawsuit to kill something they oppose. What going to court now to kill this program reveals is that these posters are achieving their intended objective of discouraging smoking. Such action also shows the tobacco industry's concern that other cities and states are likely to follow Mayor Bloomberg's example.
New York City has become the leader and trend setter in discouraging smoking through its comprehensive program of imposing higher taxes on cigarettes to make them more expensive, guaranteeing New Yorkers smoke free space, and offering its citizens free medical support to help them quit smoking. Massachusetts is already preparing a warning sign program modeled on New York's. Other states and cities are indeed likely to follow, as several already have with respect to increasing taxes and mandating smoke free space in restaurants and other public places.
From 1964, when the first Surgeon General's report alerted the nation to the dangers of smoking, through our experiences in the Carter and George H.W. Bush administrations, right up to the present, it appears that the tobacco industry, like the jungle's leopard, cannot change its spots.
Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration. Dr. Louis W. Sullivan, President Emeritus of the Morehouse School of Medicine, was Secretary of Health and Human Services in the George H.W. Bush Administration.]]>