Job Growth: May

The Department of Workforce Solutions finally got their news release about May job performance posted. See: http://www.dws.state.nm.us/dws-Mnews.html) The released appeared June 30, only four days after the scheduled June 26 date. Not too bad, I suppose.
The good news is that the statewide job growth rate continues to improve, though only very slowly. From May 2007 through last month, the number of jobs (which is different from the number employed) grew 1.1%. This is more than half a point above the 0.5% growth from February 2007 through February 2008.
As has been noted before, the number of wage jobs and the number of employed come from different sources. The number "employed" plus the number "unemployed" equal the number of people in the labor force. The "employed" figure and the "wage jobs" figure are almost never the same and sometimes go in different directions. The DWS release starts with unemployment and, in the next paragraph, goes to "job growth," which I think means wage jobs. The unannounced switch of context is sloppy at best and, at worst, might reflect an effort to put a happy glow on the numbers. The DWS staffer listed at the top of the release, Carrie Moritomo, did not answer her phone.
The not so good but inevitable news is that the unemployment rate is growing. At 3.8% for May, seasonally adjusted statewide, the rate remains low, which the DWS release points out. However, the rate, in terms of percent unemployed, is up 23% from the 3.1% in January. DWS claims that May's 3.8% is "not much above" the January rate, which indeed was a record low.
May to May Metro Performance:
Albuquerque: 0.4%. (This was for "payroll employment.")
Farmington: 3.1%. (for "jobs")
Las Cruces: 1.5% (for "job growth")
Santa Fe: 0.5% (for "job growth")
The DWS publication, Labor Market Review, which has all the numbers and has them in proper context, was scheduled to be posted June 30. It wasn't.

Energy: News from the Front

From today and yesterday, there are stories of interest about energy. They come with quite different perspectives. The stories are from the CArlsbad Current Argus, the Denver Post,

Carlsbad Current Argus )www.currentargus.com)
Center among competitors in race for turning algae into biofuel
By Stella Davis, Current-Argus Staff Writer
Article Launched: 06/28/2008 09:05:59 PM MDT

CARLSBAD — The race is on, and Carlsbad's Center for Excellence for Hazardous Materials Management plans to be the first at the finish line in producing a biofuel from algae oil.
In 2006, when CEHMM began working to extract oil from micro algae and turn it into a biofuel, it was the only group in that field. Today, several research universities and private industries in the U.S. and abroad are competing, said Ned Elkins, who heads the Los Alamos National Laboratory's Carlsbad office. LANL and New Mexico State University Agriculture Science Center are partnering with CEHMM in the research and development project.
CEHMM has... the three components in its backyard needed for algae to thrive and generate a new industry in Carlsbad. "It's all about location, and Carlsbad is the right place," Elkins said. "We have the hot, dry climate, the availability of land that will not take agriculture land out of production, and lots of salt brine. There are few places in the world that have all three components like Carlsbad does."

Denver Post (www.denverpost.com)
Western Slope finds an economic oasis
By Andy Vuong , The Denver Post
Article Last Updated: 06/29/2008 12:11:45 AM MDT

Navigating the Downturn is an occasional series examining how people and businesses are dealing with the economic climate.
GRAND JUNCTION — A "Now Hiring" sign blankets the front of Halliburton's main western Colorado campus, visible to drivers on the busy street running past it.
The oil-field-services company has 100 open positions with an average annual salary of $50,000 and is relocating the hub for its fast-growing drilling service from Wyoming, adding another 50 workers.
"We've increased our employment by about 30 percent a year (since 2003)," said district manager Larry Kent. "We don't anticipate a slowdown."

Gallup Independent, June 28, 2008 (www.gallupindependent.com)
First load of coal ships out of Grants, More coal trains to roll through Gallup

By Helen Davis Cibola County Bureau

GRANTS — Peabody Energy, based in St. Louis, announced this week the that the El Segundo Mine near Grants began shipping out its first loads of coal last Saturday (June 21). The coal mine is adjacent to the better-known Lee Ranch Coal Mine, also a Peabody enterprise. El Segundo, which means "The Second," in Spanish, will serve two power plants in Arizona and haul its product by Burlington Northern Santa Fe and Union Pacific rail transport.
El Segundo has agreements to supply coal to the Arizona Public Service Company. The mine will provide 65 million tons of over 19 years to the Cholla Generating Station near Joseph City, Ariz.

The New Mexico Independent
The New Mexico Independent (www.newmexicoindependent.com) is a new "progressive," i.e., left leaning, Web site / newspaper. The Independent was aghast at $4 million of federal mine rehab money being directed toward coal. In June 27 story, editor Trip Jennings said this was "a doozy."
There seemed just a bit glee, to me anyway, in the Independent's story about New Mexico dropping nine places, to 33rd, in a new ranking of state receptiveness to oil and gas development. The report, Global Petroleum Survey 2008, was released Thursday by he Fraser Institute (www.fraserinstitute.org) of Canada, which calls itself an "independent research organization." To the Independent, the Fraser Institute is "conservative."
Heavier tax and regulatory burden explains most rankings declines, the report said, according to the Independent, which then went to comments from Eric Jantz, a staff attorney at the New Mexico Environmental Law Center in Santa Fe, another liberal outfit. Jantz talked at some length about "community push back."

Housing in New Mexico

In Albuquerque the number of closed sales of homes dropped 34% to 674 in May from 1,020 in May 2007. For the layman, that means it may be a stretch to say that "The Albuquerque market continues to improve," which is the statement of Cathy Olson, chairman of the Albuquerque Board of Realtors, in the board's news release about May sales.
Among the states, New Mexico continues in the middle of the pack in housing market performance, according to numbers from "The State of the Nation's Housing, 2008," released Monday by the Joint Center for Housing Studies of Harvard University.
Residential building permits are down 35.1% from 2005 to 2007. For comparison, two states—Florida and Michigan—were down more than 60%. Arizona was down 45%. Building permit levels are down more than 45% in Ohio, Alaska, California and Nevada.
During the fourth quarter of 2007, one half of one percent of mortgage loans in New Mexico were entering foreclosure. At the end of the quarter, one percent were in foreclosure and another 1.9% were seriously delinquent. Only six states had less that one percent of loans in foreclosure.
Being married seems to give one the best shot at being a homeowner. Across the nation, 87.4% of married couples without children are homeowners. The next highest rate of homeownership is married couples with children are homeowners with 78.6% owning their home. All other household types were more than 20 points below the married with children group.

Economic Development: Abq Journal & HP

An article tucked in the back of today's Albuquerque Journal began with gratuitous editorializing of the sort that makes more difficult the job of economic developers. The article, by staff writer Andrew Webb,began, "The planned opening of a Hewlett-Packard call center in Rio Rancho may come at a cost to 800 employees in Colorado Springs, highlighting the often ephemeral nature of incentive-driven business recruitment."
I'm confused. HP's Rio Rancho facility, plus another new one set for Arkansas, will indeed cost the Colorado Springs employees. That's because the Colorado Springs operation is going to close. Together, the two new operations will eventually employ 2,500, more than three times the employment in Colorado. I have zero information about HP's decision process, but to start, the increased employment suggests that HP decided to expand the tech support operations. The question, then, becomes, "Where?"
Colorado Springs was in the game. That the choice went elsewhere suggests HP liked the labor force better in New Mexico and Arkansas. There may have been complications with the existing site as well. And other things.
Economic developers, consultants and companies will tell you that the answer comes from a technical analysis that probably starts with labor force availability, quality and cost. Incentives—job training, industrial revenue bonds and the like—may sway the decision at the margin but only at the margin. That means there is no such thing as "incentive-driven business recruitment."
To be sure of the meaning, I looked up "ephemeral." It mean fleeting or of very short term effect. In the context the implication is that firms receiving incentive packages may move again quickly. The trouble with that logic is that moving is really, really expensive. Even if that happened often, which it doesn't, there was nothing in the story to back up the "ephemeral" cheap shot in the lead.
Last Tuesday, June 24, the Colorado Springs Gazette reported that HP offered present employees a moving allowance to come to Albuquerque. This seems to me a good thing, though that wasn't the tone of the news reports. Home prices in Albuquerque are a bit less than in Colorado Springs. The geography of the two cities is similar.

Health Care: Wiese Introduction. Capitol Report Update

The following post was written by William H. Wiese, MD, MPH. Dr. Wiese is Interim Associate Director for Health Sciences at the University of New Mexico’s Robert Wood Johnson Foundation Center for Health Policy. For more about the center and Dr. Wiese's stellar career of contribution to health care in New Mexico, see http://rwjf.unm.edu/. Dr. Wiese wrote the article as a special contribution to the planned spring issue of the Capitol Report New Mexico magazine.
However, there was no spring issue. Advertising sales did not grow as anticipated during our year of magazine publication. We have suspended publication of the magazine and are seeking financing to relaunch as a quarterly magazine/Web site or in another format. If you would like more information about Capitol Report, email to hmorgan@mac.com.
In the meantime, the blog continues. Part of our current plan is to post articles by highly qualified professionals such as Dr. Wiese. We thank him.

Health Care: The Gordian Knot

The Gordian Knot of Health Care: May 24, 2008

By William H. Wiese, MD, MPH

Dr. Wiese is Interim Associate Director for Health Sciences at the University of New Mexico’s Robert Wood Johnson Foundation Center for Health Policy

In order to even make it through the door for a medical care visit, a person needs to be financially covered for the service. In current parlance, that means having some form or insurance (or have some mandated or approved access such as needing emergency care or eligibility for sliding fee at a community health center). Without insurance, only a few can afford to pay out of pocket the full charges for much beyond the most basic or simplest of services. Most would find themselves simply unable to pay the full charges. The service may be rendered as charity care, or the provider may write off the bill, either before or after being referred to a collection agency. In most instances when a service goes unpaid, the un-recovered costs are passed along to other patients who are insured and can pay or to the taxpayer (The Kaiser Commission 2003).

An estimated 26% of the New Mexicans under age 65 are without insurance for at least six months out of the year (Chollet 2007). Over the course of a year, an estimated half of the population under age 65 years experience at least some time without coverage (Chollet 2007).

Not having health insurance and not having access to timely and effective health care are associated with adverse effects on quality of care and on health outcomes including death. This is well-documented and important (Institute of Medicine 2002, Families USA 2008).

In this brief essay, I am presuming that achieving coverage for all, or nearly all is a desired goal. Reaching this goal, however, has eluded political success, as demonstrated by the gridlock that blocked substantive progress in New Mexico’s 2008 Legislative session.

Meaningful progress may be akin to the fabled challenge to Alexander the Great that he untie the untieable Gordian knot. The famous Greek conqueror met the challenge by slashing the knot apart with his sword. What follows are some considerations pertinent to ever making progress and one fanciful (alas) idea for cutting through our Gordian knot.

An intractable problem?

Access to timely and effective health care is simply not available for increasing numbers of citizens. Locked into the present system, as we seem to be, the problems are worsening, not improving. The numbers of the uninsured are increasing. Payment for an episode of illness can be ruinous to families even with insurance. The present structures and operations of health care are extremely expensive and not aligned or adequately distributed to address the needs in the population. While the current structure of the market addresses the perceived needs of some, overall it has failed the public in terms of access, cost, quality, and outcome. Nevertheless, this current structure has incredible endurance and staying power.

Health care desperately needs fundamental restructuring with financial incentives and competition to encourage efficient and effective services that are accessible to all. The current open market system fails in this regard with its costly imbalance of specialized services, rewards for volume of care, care that is available to some but not all, inconsistent attention to quality, problems of duplication and outcome, and generation of an unremitting spiral of increasing costs.

Setting the stage – to whom is accountability owed?

The health care market has three components: (1) payers, (2) patients, and (3) providers. Payers are taxpayers, individuals, and employers. ∗ (Payers, as the term is used here, are not the insurers. Insurers hold/invest the payers’ money, accept risk, and reimburse providers of services). Except for patients paying out of pocket, payers are usually not the ones receiving services and have little say either in what services are provided or the price paid for those services. Patients are the people receiving, needing, or eventually in need of health care services. Providers include clinicians, hospitals, producers and vendors of equipment, pharmaceuticals, and a host of supportive personnel and entities. For our purposes here, the insurance businesses that hold the money and manage the insurance and financing are included in the “provider” category. In some instances the insurance businesses partner with provider systems, and risk-bearing corporations both hold the money (e.g., the premiums) and arrange for the services.

Public policy related to health care is (or ought to be) accountable to the patients for the care they receive and to the payers to assure value for the amount paid. While health care obviously requires a functioning and successful provider system, public policy has no a priori responsibility to protect and preserve provider interests.

Spiraling costs

Any plan for universal coverage that does not concurrently address the built-in spiral of inflation of the current system will fail. There will not be enough money to pay for it.

Multiple factors contribute to inflation of health care costs, some of which are unavoidable (aging population) and potentially beneficial (introduction of new technologies). Factors that distinguish U.S. health care from other developed countries are fragmentation, redundancies and unnecessary services (estimated as being as much as a third of all services) (Wennberg 2008), the preponderance of specialty services, the high price of services relative to cost of services and overhead (Reinhardt 2004, Anderson 2005).

These issues must be addressed and will require reconfiguring the reimbursement incentives. Our currently managed (or not managed) fee-for-service rewards the volume of services, most especially those at the highest price. The system builds in compelling financial incentives to attract clinicians into procedure-oriented subspecialty areas. Current reimbursement structures neither promote cost containment or efficiency nor reward quality of care or outcome (performance).

Hospitals in urban centers may compete in ways that inherently add to the upward spiral of total costs. An example would be investing heavily to add and configure beds and equipment and then marketing to patients populations around services that will generate increased revenue and the return on capital, revenues which will eventually be covered by “payers” – ultimately, that is, by the public. This may be socially justified if it provides needed facilities and services that are otherwise unavailable. Competition in the provider sector serves the public if it extends needed services, improves quality, and reduces costs. The justification becomes tenuous, however, if such investment results in redundant facilities and specialty services.

In many parts of the country, chronic disease (the single most costly segment of care within health care) and end-of-life care are demonstrably carried out with an excess of specialty services that do not result in better outcomes (Wennberg 2008). This excess of services can generate substantial and, in some instances, extraordinary profitability within our non-profit health care system (Carreyrou 2008).

Because the opportunities for reward are fewer, the market-driven system invests far less in primary care, prevention, and community-based outreach and services. Research shows that community settings that have relatively more primary care providers and fewer specialists have lower health care costs, better organization and less fragmentation of care, and better health outcomes (Grumbach 2002, Institute of Medicine 2002, Macinko 2007).

The inflationary spiral is felt across the array of payers and manifest regularly with deficits or shortfalls publicly financed programs such as Medicaid. In New Mexico, we have witnessed the sad inconsistency of the administration calling for universal coverage based in part on an expansion of Medicaid, while concurrently cutting back on Medicaid enrollments. The extraordinary demands for funding deplete the treasury, diverting resources away from needed services, not only in Medicaid, but also in public health, school health, even prison health, and away from opportunities to address the underlying social determinants of health through programs such as pre-K education or through other strategies such as minimum wage support and economic development.

Mandates

Universal participation is essential for universal health care. As long as there is the opportunity, some those who perceive themselves to be at low risk will take the chance and opt out rather than pay a premium. As that happens, the risk profile of those remaining in the pool is adversely affected, putting upward pressure on the price of premiums. This leads to more people with low risk opting out, and the cycle continues. As premiums rise, employers stop offering coverage or try to shift an increasing share of the costs to their employees, who, in turn, can no longer afford the coverage. This is pretty much where we’ve been heading, with a collapsing employer-based system and rising percentages of the employed population without insurance coverage. Without full or near-full participation in the risk pool and, by extension, in the financing, the financing for a system of universal coverage can not work.

For patients and payers, the word, “mandate,” is scary, connoting a loss of freedom. That a universally financed system might cost less (overall) is viewed by many who see themselves at low risk or otherwise unhappy about monthly premium payments with understandable skepticism. Proposals calling for “individual mandate” or “employer mandate” generate political pushback.

One might look to Medicare as an example of program with mandate for universal individual participation that has gained acceptance.

It is not surprising that mandates tend to be favorably viewed by the insurance companies and the providers. The insurance companies welcome the low-risk enrollees. The providers like having all their patients insured. In short, a universal system with its mandates will mean more money (lots more!) into the system. The spiral of costs climbs even higher. Such system of universal coverage will bankrupt the payers unless there are concurrent, major reforms that address cost.

Risk pools

Insurance carriers would prefer to enroll and retain the low-risk individual or employee group. One way insurance businesses compete financially with each other is to optimize risk pools with subscribers who are low risk. Using high premiums to drive out high-risk subscribers, whether individual or employer-based groups achieves the same purpose. Selectively seeking the low-risk subscriber, “cherry picking”, has the eventual effect of driving those who are sick or at greater apparent risk into risk pools that have higher premiums. This subverts the purpose of insurance (to spread financial risk) and has socially negative effects. It is a point of contention with employers, who come under pressure to make hiring decisions on the basis of health risk (Human Resources Management Study Group 2007). It penalizes individuals who, through no fault of their own, are sick or are at high risk. While recent legislation to limit denial of insurance to persons with pre-existing conditions may be salutary, competition to enroll people into insurance plans leads to cherry picking.



Currently, marketing of health care by insurance carriers and health systems is largely on the basis of price of premiums. Competition at this level (i.e., between insurers) can succeed only by either cherry picking, by increasing co-payments and deductibles or finding other ways to cut back (deny) payments, or by directing subscribers to low cost providers – none of which particularly serves the interest of the payers or the patients.

One approach to avoid these scenarios is to bypass the competition based on the marketing of insurance premiums. Large, consolidated risk pools, premiums that are independent of personal risk or group experience, and broad (mandated) participation together avoid issues such as cherry picking. This is what we have with basic Medicare. Payers and patients are better served in the long run when competition turns, instead, on the scope, quality, access, availability, and acceptability of clinical service and on outcomes.

Opportunities today — before universal coverage

The list of those calling for fundamental restructuring grows (Berwick 2003). It needs to proceed on behalf of payers and patients.

Health care services can be better aligned with needs and can be applied more efficiently and effectively, at lower cost, and with less fragmentation. System changes that limit the spiral of increasing costs must be a meaningful component of substantive expansion of health care insurance coverage — and should be in place before universal coverage. This will require restructuring incentives and reforms in the market place. The following are examples of areas and opportunities perhaps as demonstration projects that we can act on now:

1. Do whatever is needed to support the training, geographic distribution, and relative and necessary remuneration of providers of primary care. The goal is to have a medical home for every person or family as soon as possible.
2. Identify models for reimbursements to reward outcomes, quality, efficiency, and evidenced-based practices.
3. Open the financing to pay for systems and innovations that improve health outcomes at lower cost. This may involve, for example, more use of home health care and community outreach workers.
4. In particular, open the reimbursement for the management of chronic disease to support an integrated system of care rather than confining care to a sequence of medical visits.
5. Pay for clinical preventive services that work.
6. Limit reimbursements for services where price greatly exceeds cost.
7. Support (require) shared information systems that reduce wasteful replication in diagnostic testing and promote quality improvement.
8. Promote pooled purchasing practices and sharing of drug formularies wherever possible.
9. Promote shared access to major capital investments and limit capital investments that are not geographically appropriate and cost-effective for the public.
10. Eliminate cherry picking by insurance carriers by mandating large risk pools and enrollments independent of medical history or risk.
11. Promote competition among providers on the basis of access, acceptability, cost, quality, and outcomes.
12. Assure that payers and patients who purchase care and must choose among providers have access to clear and standardized information concerning costs, history of premium increases, medical loss ratios, administrative overhead, scope of benefits, and information regarding access, quality, and outcomes.
13. Assure that public health is appropriately supported to address safety net services and population issues around prevention and reduction of incidence rates of new disease.

Systems changes, including those listed, need to be evaluated for effectiveness and cost. This is the role health services research and policy analysis.

The Gordian Knot

For years, efforts of health care reform have been able to penetrate only the edges of the problem — ineffectively picking away at the Gordian knot, a strand here, a loose end there — with limited progress toward universal coverage and little impact on controlling the unchecked spiral of costs.

Substantive proposals to restructure the financing either have been met with overwhelming resistance as the vested stakeholders mobilize (Harry and Louise 1993) or managed in ways that ultimately protect their interests. With over six billion dollars that flow in New Mexico from payers to providers to finance services for the under-65 population (Chollet 2007), it is not surprising that provider groups work to influence politicians to protect and preserve their financial interests (Common Cause New Mexico 2007).

Without question, reform requires public input and the oversight and approval of both executive and legislative branches of government as conditions for public regulation and financing. The details and technical nuts and bolts of health care reform, however, should be the assigned responsibility of some form of a mandated authority. Optimally that authority is guided by accountability to those who pay the costs and to all of us who need the services and is shielded from disproportionate influence from stakeholders with financial interests in maintaining the structure and operations of our present health care system.

This is not to say that provider interests are unimportant. The health care managers bring to the table essential experience and technical and administrative expertise needed to inform the process and needed restructuring. Furthermore, today’s clinicians and facilities will be needed to assure the availability and provision of services under any form of universal coverage. Nevertheless, public accountability must go first to the payers and patients.

With the multiple and often conflicting interests, can we actually move beyond tinkering at the edges of the problem — move beyond gridlock? The sword needed to cut through the Gordian knot will be the sword held by whoever figures out how to keep vested stakeholders from controlling the decisions. Legislative responsibility is to focus on the macro-issues of prioritizing the streams of public financing, assuring access to services, and assuring accountability. Planning for the structure, process, and technical details should fall to an independent body in the form of an authority appointed on behalf of payers and patients.

So far, no Alexander has emerged with that sword. In default, we have financing reform caught in political process that remains largely under the influence of stakeholders in the provider system. Meaningful health care reform, accountable to the payers and patients, continues to languish.

Footnotes
1 Even though I classify employers among the “payers”, more accurately, it’s less the employers that pay than their workers, who accept health benefit in lieu wages, and the public that pays for the increased costs of goods and services the companies pass-through to consumers (Emanuel 2008).

2. Since the market area for professionals is a least regional, limiting reimbursements in any one state will be a challenge.

References:

Anderson GF, Hussey PS, Frogner BK, Waters HR. Health spending in the United States and the rest of the industrialized world. Health Affairs. 2005;24(4):903-914. http://content.healthaffairs.org/cgi/content/abstract/24/4/903. Accessed April 22, 2008.

Berwick, DM, et al. Paying for performance: Medicare should lead. Health Affairs. 2003;22(6):8-10.

Carreyrou J, Martinez B. Nonprofit hospitals, once for the poor, strike it rich. Wall Street Journal. April 4, 2008;page 1A. http://online.wsj.com/article/SB120726201815287955.html. Accessed April 7, 2008.

Chollet D, Liu S, Gillia B, Biderman P, Reynis L, Wiese, W. Quantitative and comparative analysis of reform options for extending health care coverage in New Mexico: draft final report. Mathematica Policy Research, Inc., Washington DC, June 19, 2007.

Common Cause New Mexico. The Role of the Health Care Industry in New Mexico State Politics, 1998-2004. 2007. http://hsc.unm.edu/som/iph/documents/Final%20HC%20Industry%20PDF.pdf. Accessed April 25, 2008.

Dorn S. Uninsured and Dying Because of It: Updating the Institute of Medicine Analysis of the Impact of Uninsurance on Mortality. The Urban Institute; 2008. http://www.urban.org/UploadedPDF/411588_uninsured_dying.pdf. Accessed April 8, 2008.

Emanuel EJ, Fuchs VR. Who really pays for health care? The myth of shared responsibility. JAMA. 2008;299(9):1057-1059.

Families USA. Dying for Coverage in New Mexico. 2008. http://www.familiesusa.org/assets/pdfs/dying-for-coverage/new-mexico.pdf. Accessed April 26, 2008.

Grumbach K, Bodenheimer T. A primary care home for Americans: putting the house in order. JAMA. 2002;288(7):889-893.

Human Resources Management Study Group. Health Care Financing Reform:
Proposed Goals. 2007. http://hsc.unm.edu/som/iph/documents/HRMreport2-12-07Final.pdf. Accessed April 27, 2007.

Institute of Medicine. Care without Coverage: Too Little, Too Late. 2002. http://www.iom.edu/CMS/3809/4660/4333.aspx. Accessed April 7, 2008.

Macinko J, Starfield B, Shi L. Quantifying the health benefits of primary care physician supply in the United States. Int J Health Serv. 2007;37(1):111-26.

Reinhardt UE, Hussey PS, Anderson GF. U.S. health care spending in an international context. Health Affairs. 2004; 23(3): 10-25

The Kaiser Commission on Medicaid and the Uninsured. Access To Care For The Uninsured: An Update. (2003) http://www.kff.org/uninsured/4085.cfm. Accessed April 6, 2008.

Wennberg JE, Fisher ES, Goodman DC, Skinner JS. Tracking the care of patients with severe chronic illness. Dartmouth Atlas of Health Care 2008. Dartmouth Institute for Health Policy & Clinical Practice. Summary available at http://www.dartmouthatlas.org/atlases/2008_Atlas_Exec_Summ.pdf. Accessed April 20, 2008.

Mt Taylor: Telecommunications

I did leave early from last Saturday's meeting in Grants about Mt. Taylor and the designation as a traditional culture property. During the time at the meeting I heard no mention of telecommunications. Nor have I seen anything about telecommunications in the following media reports, which, in truth, I have only scanned. But....
Mt. Taylor is the ideal telecommunications tower spot, set perfectly in a 200-mile east to west line. There towers on Mt. Taylor and telecom firms want to add more. The firms do get flack from tribes, perhaps because cell phones are a transformative technology, just like pick up trucks.

Traditional Cultural Properties (NPS 38)

What are traditional cultural properties?

The National Register of Historic Places contains a wide range of historic property types, reflecting the diversity of the nation's history and culture. Buildings, structures, and sites; groups of buildings, structures or sites forming historic districts; landscapes; and individual objects are all included in the Register if they meet the criteria specified in the National Register's Criteria for Evaluation (36 CFR 60.4). Such properties reflect many kinds of significance in architecture, history, archeology, engineering, and culture.
There are many definitions of the word "culture;" but in the National Register programs the word is understood to mean the traditions, beliefs, practices, lifeways, arts, crafts, and social institutions of any community, be it an Indian tribe, a local ethnic group, or the people of the nation as a whole (see Appendix 1).

One kind of cultural significance a property may possess, and that may make it eligible for inclusion in the Register, is traditional cultural significance. "Traditional" in this context refers to those beliefs, customs, and practices of a living community of people that have been passed down through the generations, usually orally or through practice. The traditional cultural significance of a historic property, then, is significance derived from the role the property plays in a community's historically rooted beliefs, customs, and practices. Examples of properties possessing such significance include:

a location associated with the traditional beliefs of a Native American group about its origins, its cultural history, or the nature of the world;
a rural community whose organization, buildings and structures, or patterns of land use reflect the cultural traditions valued by its long-term residents;
an urban neighborhood that is the traditional home of a particular cultural group, and that reflects its beliefs and practices;
a location where Native American religious practitioners have historically gone, and are known or thought to go today, to perform ceremonial activities in accordance with traditional cultural rules of practice; and
a location where a community has traditionally carried out economic, artistic, or other cultural practices important in maintaining its historic identity.
A traditional cultural property, then, can be defined generally as one that is eligible for inclusion in the National Register because of its association with cultural practices or beliefs of a living community that (a) are rooted in that community's history, and (b) are important in maintaining the continuing cultural identity of the community. Various kinds of traditional cultural properties will be discussed, illustrated, and related specifically to the National Register Criteria.
In my newspaper column about the June 14 traditional cultural property listing for a large tract north of Grants, I referenced the National Park Service's Guidelines for Evaluating and Documenting Traditional Cultural Properties (NPS Bulletin 38) (See http://www.nps.gov/history/nR/publications/bulletins/nrb38).
I did this because the flyer from the State Register of Cultural Properties distributed at the June 14 meeting described a Traditional Cultural Property with two sentences. One said, "A Traditional Cultural Property is a place that matters," which is meaningless at best. At the risk of politically incorrect, my back yard "matters." The following material is taken from the Bulletin.

"What are traditional cultural properties?

"The National Register of Historic Places contains a wide range of historic property types, reflecting the diversity of the nation's history and culture. Buildings, structures, and sites; groups of buildings, structures or sites forming historic districts; landscapes; and individual objects are all included in the Register if they meet the criteria specified in the National Register's Criteria for Evaluation (36 CFR 60.4). Such properties reflect many kinds of significance in architecture, history, archeology, engineering, and culture.
"There are many definitions of the word "culture;" but in the National Register programs the word is understood to mean the traditions, beliefs, practices, lifeways, arts, crafts, and social institutions of any community, be it an Indian tribe, a local ethnic group, or the people of the nation as a whole (see Appendix 1).

"One kind of cultural significance a property may possess, and that may make it eligible for inclusion in the Register, is traditional cultural significance. "Traditional" in this context refers to those beliefs, customs, and practices of a living community of people that have been passed down through the generations, usually orally or through practice. The traditional cultural significance of a historic property, then, is significance derived from the role the property plays in a community's historically rooted beliefs, customs, and practices. Examples of properties possessing such significance include:

'a location associated with the traditional beliefs of a Native American group about its origins, its cultural history, or the nature of the world;
"a rural community whose organization, buildings and structures, or patterns of land use reflect the cultural traditions valued by its long-term residents;
an urban neighborhood that is the traditional home of a particular cultural group, and that reflects its beliefs and practices;
"a location where Native American religious practitioners have historically gone, and are known or thought to go today, to perform ceremonial activities in accordance with traditional cultural rules of practice; and
"a location where a community has traditionally carried out economic, artistic, or other cultural practices important in maintaining its historic identity.
"A traditional cultural property, then, can be defined generally as one that is eligible for inclusion in the National Register because of its association with cultural practices or beliefs of a living community that (a) are rooted in that community's history, and (b) are important in maintaining the continuing cultural identity of the community. Various kinds of traditional cultural properties will be discussed, illustrated, and related specifically to the National Register Criteria."

"Traditional cultural values are often central to the way a community or group defines itself, and maintaining such values is often vital to maintaining the group's sense of identity and self respect. Properties to which traditional cultural value is ascribed often take on this kind of vital significance, so that any damage to or infringement upon them is perceived to be deeply offensive to, and even destructive of, the group that values them. As a result, it is extremely important that traditional cultural properties be considered carefully in planning; hence it is important that such properties, when they are eligible for inclusion in the National Register, be nominated to the Register or otherwise identified in inventories for planning purposes.
Traditional cultural properties are often hard to recognize. A traditional ceremonial location may look like merely a mountaintop, a lake, or a stretch of river; a culturally important neighborhood may look like any other aggregation of houses, and an area where culturally important economic or artistic activities have been carried out may look like any other building, field of grass, or piece of forest in the area. As a result, such places may not necessarily come to light through the conduct of archeological, historical, or architectural surveys. The existence and significance of such locations often can be ascertained only through interviews with knowledgeable users of the area, or through other forms of ethnographic research. The subtlety with which the significance of such locations may be expressed makes it easy to ignore them; on the other hand it makes it difficult to distinguish between properties having real significance and those whose putative significance is spurious. As a result, clear guidelines for evaluation of such properties are needed."

Native American Metaphysics and Other Grants Notes

A week ago the Cultural Properties Review Committee, which is a policy oversight group for the New Mexico Historic Preservation Division which in turn is part of the Cultural Affairs Office, met in the gym at Grants High School in a do-over exercise and named as a Traditional Cultural Property (TCP), a 660-square-mile tract, including Mt. Taylor and much, much more, mostly in an oval north and east of Grants. There is a second, small tract due north of Grants. See the following entry for more about Traditional Cultural Properties.
My newspaper column, to run in seven papers around the state starting Monday, described the meeting, which was extraordinary, a part of New Mexico that our north central urban area scarcely know exists. The metaphysics reference stems from that is how the five applicants for the TPL—four pueblos and the Navajo Nation—began their presentation—with a summary of the tribal metaphysics. They spoke, almost totally, of Mt. Taylor, ignoring the fee (private) land comprising about half the TPL.
The notes here touch items squeezed from the column by the 650 (or so) word limit. The pickups and SUVs more than filled the gym parking lot. As of 2006, Native Americans were the biggest single group in Cibola County, of which Grants is the county seat. Native American were 41% of the population, followed by Hispanics with 34%, White non-Hispanics (Anglos to New Mexicans), 24%; and blacks, 1.5%. The people attending the meeting seemed to about half Native American, half Hispanic with a handful of Anglos. McKinley County, immediately north of Cibola, was 74% Native American in 2006. Folks, this is not the Northeast Heights of Albuquerque
The TPL seems to be above 8,000 feet in altitude. I think Ambroisia Lake, the center of the previously uranium activity, probably is below 8,000. The main activity in the area is Uranium Resources' insutu project near Crownpoint, though there is a fair amount more. They haven't started, but are moving forward ever so slowly. In other words, I didn't correlate today's exploration activity with the TPL. This may have something to do with being uninformed.

One young man, a Cibola County deputy sheriff, said to me: I can understand the Indians viewpoint. But there are the jobs.....

On Monday, Navajos broke ground on a casino. Some of the June 14 signs said that casinos were a bad idea.
Navajos, the Navajo administration, that is, have banned uranium mining. But they embrace coal, which will cause them far more health problems than uranium ever did. From what I have seen, the ban stems from the legacy issues. The Navajos are still pissed about the bad old days and unwilling to accept the industry argument that things have changed.

I think, from industry's view, that the key worry is where does this go. Probably there will be a pitch for a federal TPL. Is the TPL a way around the problem of extending Indian jurisdiction to fee land? Just from looking at the topo map, the land in the new TPL seems roughly half federal (forest service) and half fee land, the mesas to the northwest. There is a little state land.
Apparently the February vote, the first effort to designate the TPL, was unanimous. Not this time, though. There were No votes.

A problem for industry is that no one was around for 20 years. So, somewhat by definition, the industry guys are "outsiders." I do think industry is absolutely trying to do the right thing, partly for moral reasons and partly because they have no choice for regulatory reasons. Coal, though worse for health uranium, is part of the background.

Navajos, I'm told, are still mad about a tailings pond spill at Church Rock, I think in the 1970s. Not unreasonably so. The industry cleaned up the mess and left. The locals stayed and have stayed mad. There is no appreciation that the industry guys doing the cleanup probably were even unhappier about the whole situation than the locals.

The uranium story is important for the nation's energy future and for New Mexico's future. The story is complex, putting is mildly. I will continue to follow it.

HP in Rio Rancho

Congratulations to Rio Rancho Economic Development for scoring a new sales and customer service facility from Hewlett-Packard. This kind of operation broadens the base economy, which is exactly the task of economic developers and is important to all of us working in support sectors such as communications.
The Albuquerque Journal's story this morning missed one item and slud, as Dizzy Dean used to say, over another. I have commended to the Journal's accuracy email line. We'll see what they say.
The story said Intel "remains the state's largest private sector employer....," That isn't true. Rio Rancho Economic Development told me this morning that Intel now employs about 3,500 plus another 3,000 contractors. Presbyterian Healthcare Services, which is in the private sector though a creature of the government, employs more than 9,500 across the state, according to an April 23, 2008, PHS news release.
I suspect that Wal-Mart is the state's largest private sector employer. My Wal-Mart numbers are old, so it is entirely possible I'm wrong. However, it has been more than 15 years since Wal-Mart, statewide, passed Intel's New Mexico employment total. Since then Wal-Mart (including Sam's Club, etc.) has done nothing but grow and Intel has had it's ups and, now, a down.
The story also said the HP jobs will be "in customer support and sales (and) could help offset..." Intel's 2007 layoffs. Without directly stating, this language suggests a far stronger relationship between the HP jobs and the Intel jobs than can be justified. Simply by placement of the two sentences, it is implied that Intel people will go to work for HP. This is highly unlikely because, first, Intel in Rio Rancho is a manufacturing facility, not a customer support operation. The skill sets are different. Second, there is timing. The Intel layoffs were last year, as the story says. But HP will not start hiring until next summer, two years after the Intel layoffs. Nearly all the Intel people will have gone on to something else. Thus the only "offset" will be in job totals separated by several years. The only real relationships are that both companies are major corporations, employ people and are part of the base economy. So is the CitiCorp call center.

Carlsbad Caverns

The item yesterday suggested that a declining attendance at Carlsbad Caverns National Park represented a big challenge to the buyer or buyers of White City. Here are some sample numbers for "recreation visits" to the Caverns.
2007 - 409,560
2002 - 476,259
1997 - 540,797
1992 - 688,742
1987 - 781,300
1982 - 781,963
The cuo-half-full approach might be that 400,000 visitors is still a lot of people.
The pattern for White Sands National Monument is different. A look at the same five-year intervals shows visits growing to a peak in 1997 of 629,509 and then dropping to 437,042 in 2007.

White's City For Sale

White's City, New Mexico, is the place nearest to Carlsbad Caverns to buy gas and spend the night in a bed. It's also not really a city, being privately owned and managed by the White family, descendants of Charlie L. White, who founded the "city" in the early 1920s. The whole thing will be sold July 14 at a three-day auction starting at 11 a.m., according to a news release from Higgenbotham Auctioneers International, a Lakeland, Florida, real estate auction firm. The Carlsbad Current Argus ran the story yesterday. Albuquerque TV stations picked it up for tonight.
The auction covers 366 acres, 460 acre feet of water and 11 parcels of land. Amenities on parcel one, as Higgenbotham puts it, include two motels, a restaurant, an RV park, a museum, retail shops, a gas station, a water park, and more. See www.higgenbotham.com/auctiondetails.asp?AuctionID=1175.
I had the pleasure of knowing Jack White Jr., for more than 20 years before his death in 2005. Jack had worked at White's City Inc. for 39 years when he died. He was president of White's City Inc. Jack was a blustery and completely decent man. His business interests were White's City, Carlsbad Caverns (though he was not fond of the Park Service), Carlsbad and New Mexico.
The buyers of White's City face a problem that Jack White struggled with for maybe 20 years—declining visits to Carlsbad Caverns. And this is not a gently dropping count. Today's gas prices compound the challenge.

State GOP & The Press

The press—in the person of our friend and Capitol Report New Mexico colleague Mark Bralley—was thrown out of the state Republican Party's Quadrennial Convention that was held Saturday in Las Cruces. Other press representatives, who didn't arrive early enough to get tossed, were kept from entering, Bralley says.
While amazing and inappropriate, the behavior is consistent. When building the Capitol Report mailing list, I went to the two parties for names. The Democrats said: Our central committee is posted. Download and go for it. The Republicans would not even give me the few names that were on the party Web site, much less the entire central committee.
It toughs, GOP dudes, to talk about transparency when you don't play by those rules.
Amazing...

Copenhagen Consensus

It's been a couple of weeks since Bjorn Lomborg's Copenhagen Consensus Center (www.copenhagenconsensus.com) released the results of its latest look at what to do about the world's really, really big problems. Lomborg is the Danish economist and environmentalist who, in 2001, completed "The Skeptical Environmentalist", a look at the numbers behind environmental arguments. Lomborg found, to his surprise, that the numbers weren't very good. After publication of the book and all sorts of things were hurled his way by the enviro establishment but nothing stuck.
in response, Lomborg started the Copenhagen Consensus Center in 2004. The idea is that top economists and others consider the Big Problems and recommend what should be done first. Those "others" have included United Nations ambassadors and a groups of college students, mostly from developing countries.
The conclusions of these quite different groups track one another. In general, there are a bunch of modest actions—modest on the scale of things—that can be done to reap large benefits. The latest report, from 50 economists including Nobel prize guys, The report is, the release says, "A prioritized list highlighting the potential of 30 specific solutions to combat some of the biggest challenges facing the world (starting with).... Combating malnutrition in the 140 million children who are undernourished." Item two is global trade, DOHA development plan.
Global warming is happening, Lomborg says. It just that tale is far more complex than allowed by the preaching of Al Gore and his acolytes. And Gore's recommended radical actions would produce trivial benefits at great cost. In his latest book, "Cool It," Lomborg argues his approach by saying, "Far from being amoral to compare costs and benefits, it is essentially moral to ask: How do we help the most? Can it be moral to do anything less?"

Political Notes

The Democrats are underway. A young woman representing, she said, the Democratic National Committee, came to our door last night to verify that the family Democrat was on board for the general election. The family Democrat said yes. The woman was well presented, articulate and charming, I'm told, unlike some of the Sierra Club and PIRG slackers who come to our door.

Building Permits Way Down

Before the city of Albuquerque went to Web posting and associated fancy stuff, one could get a month's building permit data by the 10th or so of the following month. The report was a seven page spreadsheet, photocopied. Now the most recent building permit data I can find at www.cabq.com is for 2007. However, the figures somehow get to HousingEconomics.com, an arm of the National Association of Home Builders. The figures are in thousands and are for metro areas. Even getting metro Albuquerque figures is an accomplishment. I think five entities issue permits. Metro Albuquerque issued 860 permits for single family homes during the first four months of 2008, down 35% from 2007. New Mexico's metro areas are basically out of the apartment construction business with permits issued for all of 230 units so far this year.

SINGLE-FAMILY
YTD YTD YTD YEAR
Apr-08 Apr-07 PCT CHG Tot 2007

New Mexico 1.90 2.99 -36% 8.23
Albuquerque NM 0.86 1.32 -35% 3.70
Farmington NM 0.09 0.13 -33% 0.37
Las Cruces NM 0.33 0.59 -44% 1.37
Santa Fe NM 0.05 0.11 -54% 0.28

New Mexico Independent

The New Mexico Independent is a two-month old news site. See: http://www.newmexicoindependent.com. The Independent appears to be a work in progress, far more than one would expect from an operation for which Albuquerque is the sixth subsidiary (which may not be quite the right word) of the Washington, D.C. based Center for Independent Media. (http://newjournalist.org) Employees are called "fellows." They operate within a lengthy code of ethics, much longer than any human can remember. Upon first reading, a couple of month ago, my memory is that the word, "progressive," appeared often in he ethics code, or somewhere on the main site. Tonight's rereading didn't find the word. "Progressive," in case no one knows, is leftist code for a bunch of things, but mainly that capitalists are bad guys and government folks are good guys.
That the Independent is a work in progress comes from Trip Jennings, site news editor and former Albuquerque Journal political writer. Jennings spoke to the Albuquerque Press Women at lunch today. About 25 attended. The Independent is "trying to marry traditional newspapers with this new online world of blogs," Jennings said.
At newjournalist.org, I did not find any indication of the source of the money, an omission that is, at best, unfortunate. Had, say, Robert Murdoch, owner of lots of things including Fox News and, now, the Wall Street Journal, been behind the new effort, my conservation twitchyness wonders, I suspect there would be loud proclamations. Jennings wasn't worried about the money, which, he said, is handled through D.C. Further, he said, there is a thick wall between the investors and his concern, the editorial side.
As an additional journalistic voice in the market, the Independent is to be welcomed. However, it would be nice to know about the money. That's because money, nearly always, is not impartial.
For all the proclamations, the Independent is not immune to old sloppiness. Unsubstantiated use of "more" and "many" are my hot buttons. On the Independent's site, as I write, there is a gas price story saying "more New Mexicans" are choosing to ride scooters, the Vespas of my childhood. But how many more? Two more? 12 more? 27? The story doesn't say.

Election Notes

A representative of Tom Udall came to my door last night at 5:30 p.m., asking if the family Democrat had voted. This level of effort in a heavily Democratic precinct suggests that the Udall campaign is well organized.
The Steve Pearce election night party was at the Albuquerque while the Republican party was at the Hotel Albuquerque. A Pearce staffer maintained the separation was happenstance, purely a function of where Pearce was staying. There was no other motivation, the staffer maintained. I take the staffer at his word. Certainly the Hilton is closer to the Albuquerque airport than the Hotel Albuquerque and Pearce had an early plane this morning back to Washington.
However....
The Pearce / Wilson battle was fierce and the GOP establishment came down for Wilson in the form of Domenici's endorsement. Why bother to go were one is not wanted?
And....
Pearce certainly could have gotten space at the Hotel Albuquerque had he wanted.

Job Growth: April

New Mexico’s year-over-year job growth rate bumped up to 1% in April, up from 0.6% in March and even lower in January and February. One data point is never a trend, so we’ll have to wait to see if a recovery is beginning from the state’s 21-month drop in job growth. An encouraging note is that the primary driver of the New Mexico economy, namely the national economy, seems to be holding its own.
Albuquerque’s April to April job growth was 0.7%.
Las Cruces grew 1.7%.
Santa Fe grew 0.9%.
Farmington was up 3.9% with a 2,000 job increase that was 24% of the state’s growth during the April 2007 to April 2008 year.