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Questions? Need an updated map? Email me andy@andyarthur.org.

The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think

"Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It’s not you. It’s your cage."

"After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days — if anything can hook you, it’s that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can’t recover? Do the drugs take you over? What happened is — again — striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)"

"When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don’t seem to make sense — unless you take account of this new approach."

Map: Bars In New York State

Map: Bars In New York State

Most of the watering holes in New York State are located in populated areas. I guess that is not real surprising, as that's where the people is and that's where you would build a business. Some of the rural towns in upstate are dry. This might be a more interesting map if I had done bars per capita -- maybe that's a project for a future date. Map shows density of licensed establishments selling liqour for on-site consumption.

Data Source: https://data.ny.gov/Economic-Development/Liquor-Authority-Quarterly-List-of-Active-Licenses/hrvs-fxs2

U.S. to end policy that let legal pot flourish, sources say

"Attorney General Jeff Sessions is rescinding the Obama-era policy that had paved the way for legalized marijuana to flourish in states across the country, two people with knowledge of the decision told The Associated Press. Sessions will instead let federal prosecutors where pot is legal decide how aggressively to enforce federal marijuana law, the people said. The people familiar with the plan spoke on condition of anonymity because they were not authorized to discuss it before an announcement expected Thursday."

"The move by President Donald Trump’s attorney general likely will add to confusion about whether it’s OK to grow, buy or use marijuana in states where pot is legal, since long-standing federal law prohibits it. It comes days after pot shops opened in California, launching what is expected to become the world’s largest market for legal recreational marijuana and as polls show a solid majority of Americans believe the drug should be legal."

"While Sessions has been carrying out a Justice Department agenda that follows Trump’s top priorities on such issues as immigration and opioids, the changes to pot policy reflect his own concerns. Trump’s personal views on marijuana remain largely unknown. Sessions, who has assailed marijuana as comparable to heroin and has blamed it for spikes in violence, had been expected to ramp up enforcement. Pot advocates argue that legalizing the drug eliminates the need for a black market and would likely reduce violence, since criminals would no longer control the marijuana trade."

Maintaining Tissue Sample Quality Might Reduce Medical Errors

"You might not suspect that the success of the emerging field of precision medicine depends heavily on the couriers who push carts down hospital halls."

"But samples taken during surgery may end up in poor shape by the time they get to the pathology lab — and that has serious implications for patients as well as for scientists who want to use that material to develop personalized tests and treatments that are safer and more effective."

Poll: Discrimination Against Women Is Common Across Races, Ethnicities, Identities

"Discrimination in the form of sexual harassment has been in the headlines for weeks now, but new poll results being released by NPR show that other forms of discrimination against women are also pervasive in American society. The poll is a collaboration with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health."

"For example, a majority (56 percent) of women believe that where they live, women are paid less than men for equal work. And roughly a third (31 percent) say they've been discriminated against when applying for jobs because they are women."

Are Republicans paying for tax cuts with reductions in Medicare, Medicaid?

"Schumer said, "The Republicans are proposing to pay for their giant tax cut to the rich by gutting Medicare and Medicaid."

"He has a point that the tax proposal includes significant tax cuts and that the Senate Republicans’ budget proposal reduces projected spending levels for Medicare and Medicaid by hundreds of billions of dollars over 10 years.

"However, Schumer has overstated the linkage between the proposed tax and spending cuts. In addition, his decision to highlight Medicare and Medicaid cuts with the vivid word "gutting" leaves the impression that such reductions are a drastic reshaping and are likelier to occur than they actually are."

"We rate his statement Half True."

I was reading about how the federal tax bill would cut Medicare. That is disconcerting, as this is a vital health program for many seniors in our country. I hate being told things by political pundits but having no data or evidence to back up there views.

So I was curious what a cut to Medicare really mean for both today’s seniors and generations to come, including myself in another 30 years? First off, a cut to Medicare does not mean a reduction in benefits or higher co-pays for consumers. It’s a cut payments to physicians and hospitals. Your doctor gets the hair cut, and depending on how you view these cuts, it might reduce access to care. Or it might not. Certainly doctor and hospital lobbyists would protest any cut to their fat. As the AARP explains:

The Senate tax proposal would add $1.5 trillion to the federal deficit over the next 10 years. Under PAYGO, if this bill were to become law, the government would have to lop off $150 billion in spending every year for 10 years.

Medicaid, Social Security, food stamps and other social safety net programs are exempt from the PAYGO law, which went into effect in 2010. But Medicare and other programs — such as federal student loans, agricultural subsidies and the operations of the Customs and Border Patrol — are not exempt.

The law caps how much the government can trim from Medicare at 4 percent. That’s $25 billion the first year, according to a report by the nonpartisan Congressional Budget Office. The annual amount could increase in subsequent years depending on the size of the deficit and Medicare’s budget.

The $25 billion reduction would affect the payments that doctors, hospitals and other health care providers receive for treating Medicare patients. Individual benefits would not change and neither would premiums, deductibles or copays. But with so much less money going to providers, the cuts could have major impacts on patient access to health care — such as fewer physicians accepting Medicare patients.

Source: https://www.aarp.org/politics-society/advocacy/info-2017/senate-tax-medicare-cuts-fd.html

So cuts to Medicare could affect seniors, by denying them access to new doctors who might decide not to take new Medicare patients. It’s not clear though if doctors are actively dropping Medicare patients.  This 2015 article from Kaiser foundation looks at how many doctors currently accept Medicare patients.

The vast majority of non-pediatric primary care physicians (93 percent) say they accept Medicare—comparable to the share accepting private insurance (94 percent) (Figure 1). A majority of primary care physicians also say they are also taking new Medicare patients (72 percent), but this share is somewhat lower than the share of primary care physicians accepting new privately insured patients (80 percent).

Source: https://www.kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/

While doctors often have high malpractice insurance costs, not to mention all the costs of education debt, most doctors in America live fairly well off. Other medical professionals not as well, but their employers usually aren’t struggling for cash. Many medical facilities and doctors probably could survive on lower Medicare payments, but they would have to trim fat from their businesses. But would they? Or would they focus more on private insurance business or those who paid with cash? Maybe. But seniors need the most medical care, so it seems unlikely they would leave the government money on the table, even if it was reduced levels from years past.

Unneeded Treatment And Overpriced Services Fuel Health Care Waste

Rooting out waste, fraud, and abuse in all sectors of the economy including government, healthcare and education should be everybody's top priority.

"Wasteful use of medical care has "become so normalized that I don't think people in the system see it," said Dr. Vikas Saini, president of the Lown Institute, a Boston think tank focused on making health care more effective, affordable and just. "We need more serious studies of what these practices are."

"Experts estimate the U.S. health care system wastes $765 billion annually — about a quarter of all the money that is spent. Of that, an estimated $210 billion goes to unnecessary or needlessly expensive care, according to a 2012 report by the National Academy of Medicine."

Majority of N.Y. voters support legalizing and taxing pot: poll

"New Yorkers are high on legalizing weed as a cure for the state’s budget woes, a new poll Monday revealed."

"Sixty two percent of New York voters said they supported making marijuana use legal for people 21 and older, with only 28% opposed, according to the poll commissioned by the Marijuana Policy Project Foundation and the Drug Policy Alliance."

"The poll, conducted by Emerson College, also found that legalizing and taxing marijuana was, by far, the most popular way to erase New York’s looming budget deficit, with 60% of voters supporting it."

"Between 15% and 27% of voters supported other deficit-reducing options, such as increasing sales or income taxes, increasing tolls, or cutting support for public education."

Opioid crisis arrives on auto industry’s doorstep

"Automakers have programs to help workers with addictions and mental-health disorders, but the programs aren't necessarily equipped to handle the long recovery times that opioids require. And workers who fear for their job security are often reluctant to seek help, especially if they've lapsed more than once. Among the efforts to break the cycle of drug abuse is Soberfest, with the ballfields and picnic tables flanked by booths for community organizations such as Odyssey House, Serenity House and the Brighton Center for Recovery, where local native Eminem once checked himself in."

Why Is Triclosan in Toothpaste?

"Triclosan, an antibacterial ingredient recently banned by the Food and Drug Administration in some products but currently allowed in toothpaste, appears to accumulate on toothbrushes and can be released in the mouth, according to a study published this week in the journal Environmental Science & Technology."

"The FDA began prohibiting the sale of soaps and body washes that contain one or more of 19 antibacterials—including triclosan—last month because manufacturers haven’t proved that they’re safe for long-term daily use and more effective than regular soap and water for controlling certain infections. But because toothpaste is not included in the ban, triclosan can still be found in Colgate Total toothpastes (the only toothpaste line in the U.S. that contains the substance). Triclosan is also permitted in a slew of other items, including cosmetics, athletic clothing, and cleaning products."

One of President Trump’s better ideas is saying that health insurance should cost only $15-20 a month. I wholeheartedly agree with that proposal as many working families struggle to put food on their table, pay the rent, mortage, car and recreational expenses and shouldn’t be overly burdened with healthcare expenses. $15 to 20 a month seems like a reasonable expense for most people — except the most povert stricken people to pay for the healthcare.

While I reject the idea of greater government involvement in people’s personal lives, and think people should be able to choose the health plan they want, it’s obvious that $15-20 a month isn’t going to go very far when somebody breaks an arm when they fall off their four wheeler, or slip on a ladder. To say nothing of the common diseases of old age or poor fortune.

So how do you get to a system where health insurance costs only $15-20 a month but offers people choices on what plan they get and what benefits are included? What system can use market forces to encourage hospitals and doctors to economize but produce the care you need?

I think the solution is government-subsidized healthcare with private insurance. Allow private companies to sell insurance, and allow some flexibility in the plans beyond basic financial protection for people. But have the bulk of the money that funds insurance come from government taxation on the wealth centers of our country, e.g. Wall Street.

Healthcare is enormously expensive. The single individual who lives in a mobile home, works in a factory or more commonly a retailer like Walmart or Lowes, squeaks out a few extra bucks maybe raising some beef cows on their land can’t be expected to care the whole load of their healthcare. The kind of people you see on the back roads of Pennsylvania, Maryland or West Virginia. But there is enormous money out there in our economy — on Wall Street, the big banks, in various financial investments. The rich can and should take a haircut to ensure everybody can afford decent healthcare.

Obamacare tries to do this but it really under invests in our healthcare system, spending too little money and preserving too much of our employer based system. Quality healthcare shouldn’t be tied to one’s job. You shouldn’t have to work for a large company to have access to good care. Obamacare was an incremental improvement but more should be done. The solution is not to repeal Obamacare but to make it better — put more taxpayer money obtained from the wealth centers of our country — and use it to make sure everybody, including those in the backwoods of Appalachia can afford quality healthcare.