Matt Masiello, M.D., MPH

Category: Human Rights

  • Matthew Masiello and Jessica Lynn Kurtz | Child protection must also focus on human rights

    All too often, adults at multiple levels of societal and academic responsibility fail to appropriately identify, react and respond to extreme allegations of child abuse. Defending children is an issue that should transcend all political and legal aspects of society.

    All adults have a moral and social responsibility to take action against child-related violence. The United States prides itself on championing fundamental liberties, yet there is clearly a void in terms of protecting the rights of children in this country.

    20120517-165845.jpgDeveloped in 1989, the United Nations’ Convention on the Rights of the Child is an international set of standards and obligations that sets forth the full spectrum of social, political and economic rights to be afforded to children. The U.S. has yet to ratify the convention. The only other U.N. member state to decline to ratify this international document is Somalia.

    As a result of the serious lack of academic and political attention paid to child human rights in the U.S., children frequently lack the protections they require and deserve. American society needs to experience a greater level of awareness and insight to the many violence-related issues affecting this vulnerable population.

    So, how can we accomplish this? Or better still, how can a U.S. center of higher education, as Penn State and Syracuse University are presently attempting, take on the task of addressing the sexual, physical and mental abuse of children in America and identify themselves as leaders in such a cause?

    Most U.S. colleges and universities currently lack comprehensive research and study programs directed to the rights of children. To a significant degree, such academic activity can be found at many international academic and research centers. Though Penn State should be commended for developing the Penn State Hershey Center for the Protection of Children, the current description of activities and participants is lacking in identifying international experts in the area of child abuse and/or child human rights.

    The challenge for American academic institutions would be to create progressive and new interdisciplinary initiatives focused on the human rights of children – An Institute for the Study of Human Rights of Children. The social sciences, medicine and law, as well as education, are just a few of the areas that can serve as the foundation to this U.S.-based field of study.

    Child human rights encompass more than just child abuse or child protection. An increased and deeper knowledge of the special issues that children face and how to create a safer society for them will ultimately be the best response to the child-sex scandals facing Penn State and Syracuse universities as well as our country.

    A simpler approach would be to investigate the accusations of abuse, change institutional policy, donate money to child protection agencies, lobby for a new law for better reporting processes, or develop a limited academic or research initiative.

    While each of these alternatives has its own merits, realistically, little more will be contributed to society in general. They will only serve as political or academic Band-Aids to a much larger societal wound.

    A holistic, educational approach based on the advanced study of the human rights of children may allow the U.S. to move ahead and be identified as a leader in terms of how we can most optimally care for and protect our children. It will assure a better and safer life for our children.

    A new, progressive, academic approach will increase the national sense of moral and social responsibility, filling the presently existing void in how we should respect, and, yes, honor our children by finally providing them with the safeguards they deserve.

    **This article was published in the Tribune Democrat on 1/6/12

    http://tribune-democrat.com/editorials/x1477841616/Matthew-Masiello-and-Jessica-Lynn-Kurtz-Child-protection-must-also-focus-on-human-rights

  • The Poorest Example of Leadership

    20120517-163717.jpgNever before have I come so close to abandoning my right and privilege to vote. The level of disdain, frustration and sadness I and so many others have with our political system has now surpassed the same feelings many have for our educational and health systems.

    Why should the silent majority of Americans turn over one more dime to individuals, politicians, who cannot work together? This lack of leadership, now perceived by many to be at every level of government, is affecting Americans much deeper than our leaders can possibly realize. And I can only hope that it is simply not realizing the ramifications of partisan politics. If politicians were living in the reality of the majority of our citizens then this behavior is shameful. The political system is allowing for a pervasive sense of hopelessness, frustration and fear. Especially fear for those who are already at that point of no return with their health care bills; college tuition; mortgages and more.

    Sadly, It is really not a matter of trying to convince politicians to compromise at this critical point in our American history and that somehow all will be right. Compromise is an absolute must. The work will be in the recovery from this latest and worse political/civil debacle I have experienced in my lifetime. Americans are not losing faith in their politicians. It is lost.

    I make this as clear as possible- compromise, and make every effort to deliver this message to your democratic and republican congressional colleagues. This is the request, the demand. Though my desire to cast a vote may be in question I would offer and predict that if there is not compromise the reaction by citizens will make the popular tea party shenanigans look like the true definition of a “tea party.”

    Lead, give hope, do the right thing.

  • Local experts weigh in on health-care reform

    20120517-164136.jpgLocal medical leaders are closely watching health-care reform legislation developing in Washington. While most agree with the importance of providing affordable options to the estimated 45 million to 50 million uninsured Americans, they have different views on how the insurance should be structured and what additional changes should be addressed.

    “The question is: How are we going to pay for that expanded coverage?” said Scott Becker, president and chief executive officer of Conemaugh Health System. “The real interesting debate is going to be how far do they go with this public option. The key is how the benefits package is shaped.” Answers to those questions could change the structure of how health insurance is delivered in the United States, Becker said.

    The public option, or government-sponsored health care plan, would be available as an option along with private insurance company plans, Democratic Sen. Robert P. Casey Jr. said during a teleconference announcing one of the bills had been approved by committee and sent to the full Senate.

    In the Health, Education, Labor and Pension committee’s bill, the public option is a gateway to getting access, Casey said, adding it is expected many would move on to traditional private plans. But the public option is crucial to controlling costs. “I believe big, powerful insurance companies need to be held accountable.” Casey said. Under the committee’s bill, the gateway program would be launched with federal money but managed by a nonprofit cooperative, he said. “It’s meant to be a self-sustaining entity that can be competitive in the marketplace,” Casey said.

    While any government-funded health insurance is meeting stiff opposition from Republicans, none of the local experts interviewed was ready to totally dismiss the idea. “I think the good thing is we are trying to develop coverage for 45 million people who don’t have insurance”, Becker said. “It is going to create a level playing field, but you are not going to get that for nothing.”

    The final structure of a new public option will be developed after both the House and Senate pass bills and they are sent for reconciliation. Until then, Conemaugh is taking a wait-and-see attitude. “As they say: The devil is in the details,” he said. Lack of details has many in the insurance industry worried, Highmark spokesman Michael Weinstein said. Government insurance plans such as Medicare and Medicaid have traditionally paid physicians and hospitals less than private companies.

    “There is a natural advantage to government-run plans: They dictate the payments to doctors and hospitals,” Weinstein said. “It is going to drive up the cost.” If the government-funded plan does not pay enough to cover expenses for hospitals and doctors, he said, the medical organizations will shift those costs to private plans such as Highmark. As those rates go up, insurance companies fear more employers will drop private plans and put their workers into the government plan. Bringing down costs must be part of any plan. Highmark supports a plan that would base payments more on outcomes, Weinstein said. “We haven’t seen enough debate on this: How doctors and hospitals are paid,” he said. “The way Medicare works, the more tests a patient has, the higher the cost. It doesn’t guarantee better outcomes.”

    Some local preventive medicine advocates agreed that reform should include restructuring the way doctors and hospitals are reimbursed. “The good thing about the discussion is we are going to look at policy change,” Dr. Matthew Masiello, chief wellness officer, said from Windber Research Institute. “It opens up the doors with universal health care to look at policy we have not dared address in a serious way before. ”Smoking, obesity and nutrition can be addressed by adding financial incentives for physicians who direct patients into programs that help them overcome unhealthy habits”. Although Casey said his committee’s bill addresses preventive medicine and wellness, Masiello says all the proposed reform falls short.

    “I see very little in there to support developing a substantial health-promotion, disease-prevention infrastructure,” Masiello said. “For that reason we are going to see higher cost of health care until we develop significant infrastructure.” Adding 45 million to 50 million people to the insured “pool” will be expensive, especially because many of those uninsured have chronic conditions that may be undiagnosed because they haven’t been seeing doctors.

    Windber Research Institute is part of a study using electronic medical records to identify patients with unhealthy behavior and direct them into intervention programs. “Those kind of things should be on the front burner,” Masiello said. “Down the road you are going to get the results that will allow a reduction in the cost of health care.” The research institute’s top dog is more blunt. “This isn’t health-care reform,” said Tom Kurtz, Windber’s president and chief executive officer. “It is misnamed. They are going after an insurance product.” The 45 million or more people are just a symptom of a larger issue, he said. “It addresses nothing of the underlying problems of the health-care system.” Kurtz said, adding it might even be time to ask why the U.S. health insurance structure is based on employers. Recent layoffs highlighted the issue. “They need to revamp the system,” Kurtz said. “No one has even addressed the basic questions: Is health care a right? Is it an entitlement? What should be covered?”

    Other countries have addressed many of these issues successfully, he said, adding “Japan is a good example.” But it’s tough to legislate behavior, Becker warns. Insurance companies could, however, charge higher premiums for those with greater health risks.

    For now, Congress and the health-care industry should look at focusing on improving access to primary care doctors, Becker said. The current system pushes more money toward specialists, but family physicians are the front line of prevention. “It’s a cultural challenge we face now,” Becker said. “We need to open up roads and create incentives for more physicians to go into primary care.” Like his former Windber colleagues, health-care consultant F. Nicholas Jacobs believes the reform does not go far enough. “Tort reform, intelligent efforts toward stemming the continued surge of illegal aliens, a wellness rather than a sickness reimbursement system, acceptance of hospice and palliative care for end-of-life care, electronic medical records and new efforts to bolster our medical school attendance are just a few of the changes needed to allow health-care reform to gain meaningful traction,” Jacobs said in a statement.

    The former president and chief executive officer of both Windber Research Institute and Windber Medical Center worries that current proposals have been watered down too much to appease conservatives and others. “Health reform is critical,” Jacobs wrote.
    “But meaningful, ethical leadership is much more critical and both seem to have been on life support for a very long time.”

    **This article was published in the Tribune Democrat on July 19, 2009

    http://tribune-democrat.com/local/x914502174/Local-experts-weigh-in-on-health-care-reform

  • War No Longer an Option for Our Nation

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    “In the counsels of Government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the Military Industrial Complex. The potential for the disastrous rise of misplaced power exists, and will persist. We must never let the weight of this combination endanger our liberties or democratic processes.”
    – Dwight D. Eisenhower, 1961.

    “It’s a growth industry and we will get what we want.
    – Gen. David Petraeus, when asked recently about the need for the deployment of more troops to Afghanistan.

    As we came to the end of our walking-wheelchair trek from the Jefferson Memorial, Korean and Vietnam War memorials, to the World War II site, my 82-year-old mother offered a most surprising comment.

    “We Americans sure like our wars,” she said sadly.
    This from the wife of a WW II veteran who was awarded the Silver Star and a Purple Heart for his heroism.

    It was that simple comment that made me pause and reflect on where we were as a society, a country.

    I am also the sibling of a two-tour Vietnam War veteran who suffered through the aftermath of that conflict. Drugs, joblessness and life without a wife and children were his rewards.
    Thousands of our young have died, depriving us of a social force that may have brought us to a more peaceful, a more academically enlightened, and possibly a more environmentally friendly time decades later.

    Dwight Eisenhower said it best when he commented on the need for war to “prevent” communism, terrorism or world domination: “When people speak to you about a preventive war, you tell them to go and fight it. After my experience, I have come to hate war.”
    As thousands of our young soldiers have died in our current wars, many more thousands have returned with a multitude of war-related illnesses.

    And as we were underprepared to properly equip and protect our soldiers on the battlefield, so are we now so ill-prepared to care for these young Americans, their children and their wives upon the soldiers’ return to our communities.

    And again, another generation lost and a country missing out on what could have been – would have been – if these thousands of young men and women were here today, healthy and alive.
    The compromised physical and mental health of these soldiers will have an immeasurable toll on their families, our health-care system and our country for years to come.

    “The time not to become a father is 18 years before a war,” E.B. White said.
    A conservative number of 100,000 innocent Iraqi and Afghan men, women and children have died in these wars.

    An apology and a few thousand dollars are offered as payment for loss of home and life.
    For generations, the families of these innocent victims will hold us accountable for their sadness, misery and loss – a breeding ground for sustainable acts of terrorism.

    “And one of the things we should learn is you can’t fight and win a civil war with outside troops, and particularly not when the political structure in a country is dissolved. So it wasn’t the press that was the problem. The problem was that we were in the wrong place with the wrong tactics.”
    – Robert S. McNamara, secretary of defense during the Vietnam War.

    One in eight Americans and one in four children now rely on food stamps. We have more families and children living in poverty now than we did during the Lyndon Johnson war on poverty era.
    In this nation, a child is born into poverty every 33 seconds (Children’s Defense Fund, CDF).

    As we continue to experience the numbing greed of Wall Street, we have more children going to bed hungry than ever before.

    According to economist Jeffrey Sachs, “Wall Street takes more bonuses each year than the U.S. gives in all official development assistance.”

    Many of our community food pantries were finding it difficult to keep shelves stocked for this past Thanksgiving, and quite possibly will for the upcoming holidays and holy days.

    According to Marian Wright Edelman, president of CDF, we spend $60 billion per month on the war. It will take $105 billion over 10 years to provide maximum health-care reform for children. What is the child worth? Who are we?

    As our health system is fragmented and failing, our educational system is also suffering.
    The high school dropout rate is unacceptable by anyone’s standards.

    Our science and math scores are noncompetitive at the international level, and the ability of our students to obtain degrees once they enter college is surprisingly and sadly low.

    Our children still do not have the right to an education and health care as is the case in other modern, industrialized countries.

    Our young adults leave their educational environment thousands of dollars in debt before they have their first job offer.

    This is not the case in the great majority of other modern societies.

    We still abuse children by the hundreds of thousands, with one in 10 suffering some form of maltreatment. More than 10,000 children are known to have died from abuse and neglect from 2001 through 2007. The number could be much larger.

    Nations are staging special events to mark the 20th anniversary of the Convention on the Rights of the Child, which came to be on Nov. 20, 1989. It is the most widely ratified international human rights treaty. Every country in the world, with the exception of the United States and Somalia, has ratified it.
    Poverty breeds social unrest and violence. Though we need to be intelligently and morally responsive, militarily, to terrorism, the real war to win is that on poverty.

    Our military experts are now negotiating with the Taliban, realizing that they fight for food and money, regardless of who pays.

    According to Sachs, it will take one-tenth of one percent of the world’s gross national product to provide basic financial support to the world’s poor. And $35 billion, total, as compared to the $60 billion per month on the war effort, to significantly and positively alter the course of world poverty.
    When Gen. David Petraeus, the overall commander of U.S military forces in Iraq and Afghanistan, was asked recently about the need for more troops, his response was, “It’s a growth industry and we will get what we want.”

    Many Americans are now approaching that Vietnam mind-set of war weariness, and at a time when we are in a deep economic depression.

    There is discussion of a war surtax just as we are realizing the cost of overhauling of our health-care system, upgrading our educational system, and moving to cleaner, more-efficient energy sources.
    It is also the poverty, the hunger and the declining spirit of the masses.

    “The most successful war seldom pays for its losses,” Thomas Jefferson said.
    I believe this country has a “machine” as strong and powerful as our military machine of generals and war strategists.

    “Give peace a chance” should no longer be a cliché of the past. Today we are much better prepared to call upon and muster nations, economists, community planners, sociologists, educators, medical and public health professionals, and political peacemakers who can strategically infiltrate a society in conflict, or a country experiencing massive poverty, and reap significant gains with significantly less loss to life.

    It is time for a new world order – whether it be with the advice of a well-known Demo-crat, John Kennedy, “Mankind must put an end to war, or war will put an end to mankind,” or that advice of another distinguished soldier, Gen. Douglas MacArthur, when he courageously stated: “I believe that the entire effort of modern society should be concentrated on the endeavor to outlaw war as a method of the solution of problems between nations.”

    It is now that moment, in the history of our country, at this place in time, to speak out, peacefully protest, write and stir the spirit of this country.

    “May we never confuse honest dissent with disloyal subversion.”
    – Dwight D. Eisenhower.

    “War will exist until that distant day when the conscientious objector enjoys the same reputation and prestige that the warrior does today.”
    – John F. Kennedy.

    **As published in the Tribune-Democrat on December 06, 2009 12:42 pm

  • Why a blog?

    I look forward to sharing my experiences from the world of health. As a Board Certified Pediatrician and Public Health Professional, I view health from a more systematic perspective.I will begin to post about my current national and international work, overall health promotion, and issues that appear in the media.

    My current activities:

    • School-based bullying prevention-My team and I are responsible for the largest implementation of the Olweus Bullying Prevention program in the U.S. which was made possible through a private health foundation.
    • WHO Health Promoting Hospitals -I am a member of the WHO-HPH Governance Board and am working with a hospital in Italy regarding pediatric asthma.
    • Medical Home development at several hospitals throughout the country
    • Establishment of undergraduate Public Health Curricula

  • Bullying Prevention: Strategies to Support Statewide Collaboration Webinar

    Bullying Prevention: Strategies to Support Statewide Collaboration Webinar

    Yesterday a few of my bullying prevention collaborators and I were featured speakers of a webinar hosted by the National Institute of Health Care Management and Children’s Safety Net.