Longview ambulance operator sentenced to 30 months in prison for health care fraud – CBS19.tv KYTX

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LONGVIEW, Texas A Longview man was sentenced Friday for federal violations involving Medicare fraud, according to the U.S. Attorney Joseph D. Brown.

According to the attorney's office, Joseph Valdie Kimble, 57, pleaded guilty on Sep. 11, 2019 to health care fraud and was sentenced to 30 months in federal prison.

Kimble was also ordered to pay restitution in the amount of $751,986.30 to Medicare and Medicaid, and was ordered not to seek or retain employment in the health care fraud industry while serving three years of supervised release.

According to information presented in court, Kimble operated Tiger EMS, a business providing non-emergency ambulance transport, mostly between skilled nursing centers and hospitals and dialysis centers.

Ambulance providers may bill for ambulance services only if there is a demonstrated medical need.

Kimble disregarded medical necessity requirements and billed Medicare and Medicaid for ambulance services provided to patients for whom ambulance transport was not medically necessary.

This case was investigated by U.S. Health and Human Services Office of Inspector General and the Texas Attorney Generals Medicaid Fraud Control Unit and prosecuted by Assistant U.S. Attorneys Alan R. Jackson and Frank Coan.

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Longview ambulance operator sentenced to 30 months in prison for health care fraud - CBS19.tv KYTX

Fewer People Signed Up For Health Insurance Through The State Exchange This Year – Colorado Public Radio

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Nearly 167,000 Colorado residents signed up for 2020 health insurance through the state's official marketplace. That represents a slight decline from last year, although on average rates of enrollment have remained steady for the past couple years.

Connect for Health Colorado, the state insurance exchange set up through Obamacare, announced the final numbers of enrollees after open enrollment closed Wednesday.

Last year, the exchange reported nearly 171,000 Coloradans signed up for health coverage for 2019 by the close of open enrollment in mid-January. The year before, it saw almost 166,000 medical enrollments over the same span of time.

This has been another successful open enrollment period, said Connect for Health Colorado CEO Kevin Patterson in a statement. He said the exchange will keep working to increase access, affordability and choice for residents.

About 20 percent of the customers are new and the rest returned to buy individual plans on the exchange.

Outside the open enrollment period, Coloradans can only sign up for a health plan on the exchange if they have a significant life event like losing job-based insurance, losing Medicaid or some family changes.According to the Wall Street Journal, the administration has taken a number of steps to limit the reach of the Affordable Care Act since Congress failed to repeal it. That includes cuts to funding for outreach and publicity about ACA enrollment by 90 percent. The administration also reduced funding for groups that help consumers sign up for coverage by 40 percent.

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Fewer People Signed Up For Health Insurance Through The State Exchange This Year - Colorado Public Radio

Bipartisan bill introduced to support Colorado’s mental health care, recovery providers – coloradopolitics.com

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Lawmakers on Thursday introduced bipartisan legislation to boost the role of peer support professionals in Colorado, potentially easing a shortage of specialists who can help treat patients with mental health and addiction issues.

House Bill 20-1139, sponsored by state Reps. Yadira Caraveo, D-Thornton, and Rod Pelton, R-Cheyenne Wells, would authorize Medicaid to pay for additional services provided by peers caregivers who have experienced various mental health and substance-use situations and establish a tax credit to help them pay for continuing education.

Their lived experience and training enable them to relate to and connect with people in powerful ways, said Vincent Atchity, president and CEO of nonprofit advocacy organization Mental Health Colorado, in a release cheering the legislation's introduction.

Added Atchity: Without continuing education, peers may reach a professional ceiling. The tax credit gives these individuals a pathway to continued professional development and incentivizes them to pursue long-term careers in health care, thereby creating better outcomes for the mental health of our state.

The bill, which was assigned to the HousePublic Health Care & Human Services Committee, creates a refundable income tax credit available to peers who go back to school or who graduate and return to work in the health care field. It would be authorized for 10 years and capped at a total of $100,000 annually.

Caraveo and Pelton sit on the Public Health Care committee.

Moe Keller, a former state lawmaker and Mental Health Colorado's director of advocacy, told Colorado Politics before the legislative session opened that peers are considered a vital component in the behavioral health and recovery systems, but their services can only be provided in limited settings.

Some peers work in mental health centers and detox centers, but they cannot work in jails, they cannot work in emergency rooms, Keller said. Were trying to work this up so peers can run clubhouses, do mentoring, provide help with writing psychiatric advance directives.

Atchity said that encouraging peers to fill more roles and helping pay for their continuing education could increase the number of professionalsavailableto treat Coloradans. Currently, he added, only 30% of the documented need for those services is being met.

Other states that have taken similar steps foundthatrobust peer servicesdrasticallyreduced hospitalizations and helped cut psychotic symptoms among patients, Atchity said. In Georgia, reliance on peers helped save the state more than $5,000 per patient.

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Bipartisan bill introduced to support Colorado's mental health care, recovery providers - coloradopolitics.com

Get ready for the health-care battle – Airdrie Today

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When it comes to government budget cuts here in Alberta and the inevitable protests that follow weve only sampled the appetizer. But rest assured the main course being cooked-up in the various ministerial back rooms of the current Kenney government promises to be a hearty humdinger of a dish.

Because the main ingredient, heck perhaps the only ingredient given the size of the resulting entree is none other than the behemoth that goes under the title of Alberta Health. This is where the provincial government hopes the future balanced budgetary goose will be cooked and that any lingering bad taste will be long forgotten when the next election rolls around.

You see, theres really not much of a choice than to attempt getting to grips with spending on health, thats if pledges of balancing the books by the end of this governments mandate are to be realized. After all, the dollars doled out are astronomical when you consider theres fewer than 4.5 million of us generally hearty souls actually living in this province.

As a mind-boggling example, this budgetary year were expecting to spend $20.6 billion on health alone. Thats a whopping 43 per cent of the entire provincial budget. So, now Albertas entire medical system is facing yet another major shake-up, according to Health Minister Tyler Shandro, whos expected to release a draft report later this month on whats going to change.

Of course, the basis for this latest kick at the can of re-inventing health care in our province will be based upon a report by Ernst & Young, which has been reviewing the operations of Alberta Health Services. Youd think nobody employed in governmental departments has any clue whatsoever whats actually going on, given politicians love of inviting all sorts of outsiders to take a look-see under the hood.

Last fall another government-appointed panel, led by former Saskatchewan health minister Janice MacKinnon, had its own take on rising health care costs announcing were often getting substandard service despite paying more per head than other similar jurisdictions in Canada.

Well best of luck to Shandro. Because hell need it if he hopes to turn back the tide of relentlessly increasing costs for taxpayers in paying for our health care system. The fights been going on for decades with the outcome rarely in doubt the bill will just keep on rising.

Heck you can go back as far as 1983 when the Lougheed government tried the tide-turning business. Then health minister Dave Russell famously suggested introducing user fees on some hospital stays $20-a-day if my memory serves me correctly. That went down like a lead balloon in Ottawa, which threatened withholding transfer payments because such levies were an assault on the Canada Health Act. The plan was shelved.

Twenty years later it was Ralph Kleins turn, coming up with some confusing bafflegab about a third way of funding health care, one involving public and private partnerships. That too ended in failure.

Back then of course the province was on a roll, thanks mainly to the revenues from spiking natural gas prices across the land. Thats certainly not the backdrop Shandro enjoys. Were more than eight-billion bucks a year in the hole and hopes that rising provincial GDP will eventually close that gap appear less and less likely with the economy stuck in neutral.

So get ready for the health-care battle. Doctors, nurses, unions and a bevy of protest groups covering the gamut of the hard done by is already preparing to march.

Pass the popcorn: this is going to be a doozy.

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Get ready for the health-care battle - Airdrie Today

New Jersey rejects bill to weaken doctors’ role as care team leaders – American Medical Association

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Whats the news: Lawmakers in New Jersey this week opted against moving forward with legislation that would have allowed advanced practice registered nurses (APRNS) to prescribe without any physician oversight. The legislation (Senate bill 1961 and the identical Assembly bill 854) would have also given APRNs full signatory authority, meaning they could have signed off on any document requiring a physician signature by law.

The New Jersey Senates health committee moved the bill to the floor in June 2019, but the states physicians were able to persuade lawmakers against taking up the bill to weaken the physician-led health care team during the 20182019 legislative session that closed Monday. Most states do not allow APRNs to prescribe independently.

The AMA Scope of Practice Partnership gave the Medical Society of New Jersey a grant to support its efforts to defeat the legislation. In 2019 alone, the AMA State Advocacy Resource Center worked with 35 states and secured more than 50 victories on scope-of-practice issues. That includes Mississippi Gov. Phil Bryants decision to maintain Medicares physician-supervision requirements for certified registered nurse anesthetists.

Learn more about AMA efforts on scope of practice.

Why it matters for patients and physicians: The difference in the education and training of physicians and other health professionals is vast. Physicians complete between 10,000 and 16,000 hours of clinical education and trainingthats four years in medical school and another three to seven years of residency training. By comparison, APRNs complete between 500720 hours of clinical training after two or three years of graduate-level education.

Thirty-five states representing more than 85% of the U.S. population require some physician supervision or collaboration of nurse practitioners, one type of APRN.

The issue of doctors leadership role within the health care team also is surfacing at the federal level, where the Centers for Medicare & Medicaid Services (CMS) has requested information pursuant to a presidential executive order that aims, in part, to weaken physician supervision requirements.

Patients deserve care led by physiciansthe most highly educated, trained and skilled health care professionals, says a letter to CMS Administrator Seema Verma from the AMA and nearly 100 other organizations representing hundreds of thousands of doctors nationwide. A physician-led care team is especially needed in the management of medically vulnerable Medicare patients.

We cannot and should not allow anything less, says the letter, which notes that four out of five patients prefer that doctors lead their health care team. That preference for the physician-led care team rises to 86% among patients with one or more chronic conditions.

Whats next: Implementing President Trumps executive order policies would require a combination of congressional and regulatory actions. The administration is at the beginning of the regulatory process. The AMA will actively engage the administration on these and other issues outlined in the executive order.

Meanwhile, the 20202021 New Jersey legislative session opened Jan. 16.

Each year, in nearly every state, nonphysician health professionals lobby state legislatures and regulatory boards to expand their scope of practice. While some scope expansions may be appropriate, others definitely are not.

Through resources, research and the Scope of Practice Partnership, the AMA has what you need to advance your scope of practice advocacy agenda.

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New Jersey rejects bill to weaken doctors' role as care team leaders - American Medical Association

Your mattress covered by health care? Why Sleep Number thinks it could happen – Yahoo Finance

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As technology gets more sophisticated and stressed-out consumers find it harder to get some shut-eye Sleep Number (SNBR) thinks the day could arrive when a mattress can be covered by health insurance.

Sleep disorders which the Centers for Disease Control (CDC) has deemed a public health crisis have been linked to health conditions like heart disease.

Meanwhile, institutions like the Mayo Clinic are shelling out millions to fund studies on why people find it harder to rest. And just Friday, Sleep Number competitor Casper Sleep filed paperwork to go public, citing the opportunities presented by what it estimated is a $432 billion sleep economy.

Its also a hot button issue for technology companies looking to get a slice of health care spending thats set to get even larger. Apple (AAPL), Samsung (SSNLF) and Google (GOOG) which recently acquired Fitbit are all analyzing sleep patterns through wearables.

Those efforts laying the groundwork for Sleep Number, which is pivoting toward health and wellness. Already, the 32-year old company is working with Mayo to analyze Sleep Numbers anonymous data from its SleepIQ technology.

In 2012...I could see the value of having that technology in our beds, Shelly Ibach, president and CEO of Sleep Number, told Yahoo Finance on the sidelines of last weeks CES technology confab in Las Vegas.

Photo courtesy: Sleep Number

Ibach said the use of wearables helps the company take sleep analysis a step further, since a mattress functions as a whole-body monitoring system.

Still, not everyone can afford one of Sleep Numbers $1,000 mattress. To that end, the CEO said the idea of beds becoming part of the health reimbursement system wasnt far off the mark.

If we see sleep deprivation certified as a disease to the degree that it would be funded by a health care organization, then Sleep Number could become a covered medical device, Ibach told Yahoo Finance.

The Mayo Clinic is collecting data through its Sleep Numbers SleepIQ technology, and studying how sleep (or lack thereof) affects a persons health.

The $1 million endowment for sleep science and $9 million research fund will analyze SleepIQs sleep science information. SleepIQ collects more than 10 billion biometric data points each night and has analyzed 25 million sleep sessions.

To-date, the technology has helped individuals increase sleep time by at least 15 minutes per night, according to Sleep Number.

Prevention is a way to control health care costs. We expect to be able to work together and deliver evidenced-based solutions, she said.

Anjalee Khemlani is a reporter at Yahoo Finance. Follow her on Twitter:@AnjKhem

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Cigna-Express Scripts bets on digital care as the future of health

Study: The health sector is splurging on digital, but not reaping the rewards just yet

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Your mattress covered by health care? Why Sleep Number thinks it could happen - Yahoo Finance

Under Elizabeth Warren, there’s no choice but government-run healthcare – Washington Examiner

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The top story out of this week's Democratic presidential debate was Sen. Elizabeth Warren's accusation that Sen. Bernie Sanders called her "a liar on national TV." Both progressive firebrands have a casual relationship with the truth, especially when it comes to their plans for healthcare. But Warren's pitch has grown ever more misleading.

For months, she adamantly defended "Medicare for all," a full-blown government takeover of the U.S. health insurance system. Private insurance would be outlawed, and the federal government would be granted a monopoly over payment for health services.

Many of the 180 million people with private insurance greeted Warren's plan coldly. So she began to frame her plan as a public option first, with a three-year transition to "Medicare for all." At this week's debate, she said she'd "build on the Affordable Care Act, but where we end up is we offer healthcare to all of our people. And we can offer it at no cost or low cost to all of them."

A public option would quickly become the only option for consumers. Private insurers can't match the low prices of a government-run insurer that doesn't have to cover its costs. The public option would also be able to dictate providers' reimbursement rates. Private insurers don't have that kind of negotiating power.

As a result, private insurers would exit the market, unable to compete. One analysis projects that more than 130,000 people with private exchange coverage would be jettisoned from their plans in a public option's first year. Millions more with employer-sponsored coverage could meet a similar fate.

Of course, that's the point. It's easier to nationalize the health insurance system if a government-run public option has already swallowed a few million people who previously had private coverage.

Then there's Warren's "no cost or low cost" claim. She says her plan would require a $20.5 trillion increase in federal spending over a decade more than we currently spend on Social Security, the largest line item in the federal budget. Virtually everyone else who's analyzed "Medicare for all" thinks $30 trillion-plus is more realistic.

That's some definition of "low cost." If this is the best "offer" Warren can make, no thanks.

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All, (Encounter 2020). Follow her on Twitter @sallypipes.

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Under Elizabeth Warren, there's no choice but government-run healthcare - Washington Examiner

Key 2020 trends for payers and providers – Healthcare Dive

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The healthcare industry is set to see a dynamic 2020 as the presidential election approaches, with questions about who will challenge President Donald Trump and whether the call for "Medicare for All" feared by many in the industry survives the Democratic primaries.

No matter who wins the White House come November, healthcare experts say the push to reimburse providers for value and the aim for greater transparency surrounding prices will keep moving ahead. But uncertainty around the fate of the Affordable Care Act and key legal decisions will linger, including whether HHS can require hospitals to reveal negotiated rates and whether insurers are owed billions in the risk corridor case before the U.S. Supreme Court.

Consolidation is set to continue with deals already underway, though some expect fewer mega deals and more bolt-on acquisitions and regional tie-ups.

Here's a guide to big themes for the year ahead.

The legal threat to overturn the ACA, a law deeply intertwined in the U.S. healthcare system, has racked up two wins in the lower courts and now awaits a decision from the nation's highest court on whether its justices will take on the case. If the Supreme Court decides to take it on an expedited timeline, a decision could be rendered before the presidential election, which would ensure the ACA will once again be center stage throughout another campaign season.

It's unclear how the court will rule, "but there is certainly a significant risk" to the law,Dean Ungar, an analyst for Moody's, told Healthcare Dive.

It would disrupt the insurance market and pose a significant problem for insurers with a large presence on the exchanges and in Medicaid expansion states, including Centene and Molina, Moody's analysts said in a recent note.

Alternatively, the high court could wait to hear the case until the next term, which would push the issue past the election and into next year.

At the same time, Democratic challengers who hope to unseat Trump in November pose their own risk to the industry as they tout ideas for reform, though of varying degrees. The most extreme idea is the call to move to a single-payer system, boxing out traditional insurers.

"Any of it would not be good for the insurers," Ungar said of Medicare for All. "The likelihood of that happening is low, very low, but nevertheless it's there."

Other legal question marks include pending cases over whether HHS can force hospitals to reveal the secret, negotiated rates they reach with insurers for services. The legal clash is set to heat up quickly. The judge has the case on an accelerated timeline as the American Hospital Association wants a swift ruling and summary judgment.

The hospitals argue HHS has exceeded its government authority in crafting the rule, which they say violates their First Amendment rights as it would force them to disclose confidential and proprietary information.

Also before the Supreme Court is the question of whether insurers are owed billions in risk corridor payments, a program that was supposed to financially protect insurers who attracted a disproportionate share of sicker patients through the ACA exchanges. A few nonprofit co-ops were driven to close when CMS declared the program had to be budget neutral and therefore only paid out about one-eighth of the expected payments.

Payers and providers are under increasing pressure to provide heightened transparency into prices as more costs have been shifted to patients through high-deductible plans and as health spending consumes a greater portion of the nation's GDP.

The Trump administration wants providers and payers to publicly reveal the negotiated rates for services, expanding a previous push that required providers to release their chargemaster list, which shows prices for certain services but not necessarily what insurers agree to pay.

The hospital lobby is fiercely opposed to such regulation and filed suit against the final rule.

Regardless, experts say don't expect the push on prices to slow down as regulators and consumers seek to rein in healthcare spending.

"Definitely more [to come] on greater transparency, more requirements and focus on that both in terms of the proposals from CMS and the Trump administration," Rick Gundling, senior VP of the Healthcare Financial Management Association, told Healthcare Dive.

Adding fuel to the transparency push is continued frustration over sky-high surprise bills. Congress zeroed in on the practice last year but never reached a deal for legislation banning it. The issue will no doubt continue into 2020 as it has garnered bipartisan support. The only thing standing in the way is debate over how to craft a legislative solution that will effectively box out surprise bills.

"I will continue to do everything I can to keep surprise medical bills at the top of the congressional priority list until its done," Republican Sen. Lamar Alexander of Tennessee said in December. Alexander is also the chairman of the Senate health committee, which has focused on surprise billing.

Still, lawmakers (and payers and providers) have competing ideas on how to fix the problem.

Payers favor rate-setting when out-of-network issues arise and providers support arbitration, a means to dispute the issue with payers with a third-party.

Hearings on surprise billing this year have yet to be scheduled.

The industry is coming off a wave of significant deals, including CVS' buy of Aetna and Cigna's acquisition of Express Scripts as well as provider unions like Advocate-Aurora and Bon Secours Mercy Health.

Mergers and acquisitions will continue as hospitals struggle to overcome a number of headwinds and as both payers and providers seek greater scale for additional leverage. But the pace and size may slow a bit, experts say.

There are few opportunities left for mega deals, Ungar said. "And we know the Justice Department has stepped in in the past when they're too big," he said, referencing the failed deals of Aetna-Humana and Anthem-Cigna.

A recent report from KPMG also predicted a slowdown. Industry experts told Healthcare Dive they expect to see consolidation bring together more regional players.

"Although size and scale alone do not necessarily result in success, further consolidation is a logical outcome given current industry pressures," Fitch Ratings said in a recent research note finding the outlook is stable for nonprofit providers in 2020.

Still, just days into the new year, Molina said it entered into a deal to buy an Illinois Medicaid managed care provider to expand its footprint.

On the provider side, Michigan-based Beaumont Health and Ohio-based Summa Health announced merger plans.

Gundling expects continued consolidation and the rise of major regional players akin to Advocate-Aurora. Healthcare is not as consolidated as other sectors. "We don't really have a national provider across the country," he said.

Traditional health systems are under intense pressure as their operating model is under threat from the rise in consumerism and the shift in reimbursement.

This rise in the retailization of healthcare is a massive driver of change. "You can't underestimate it,"Patrick Pilch, who leads BDO's healthcare advisory practice, told Healthcare Dive.

Health systems operate in an environment now where consumers are accustomed to seamless customer experiences in other sectors. From an app on their phones, consumers can order groceries or a ride to a particular destination, and they have come to expect that packages containing their orders for just about anything will arrive on their doorstep in just two days or sooner thanks to Amazon.

Meanwhile, more healthcare consumers are saddled with high-deductible health plans and are on the hook for more of their care financially, causing them to look for inexpensive modes of care or put off care altogether.

At the same time, providers are being asked to shoulder more risk through value-based arrangement by caring for a certain set of patients and are expected to reach certain targets or risk a financial penalty (or fail to earn a bonus). Though the change has been slow, more value-based arrangements are expected to continue in 2020, experts said.

Payers and providers "that fail to respond to the imperatives of consumerism will risk losing relevance as the move to value-based payment gains traction, while consumer-savvy organizations will be positioned to thrive," HFMA CEO Joseph Fifer said in a recent report.

Nontraditional players have posed the biggest threat to hospitals in the realization of healthcare.

For its part, CVS made a bet on Aetna. Together, CVS believes it can use its pharmacists and retail clinic model to better coordinate and ultimately reduce the cost of care.

Though it's not just CVS and Aetna making bigger strides into the industry. Walmart is also attempting to make access to care quicker and more convenient for consumers who are demanding such changes by opening its own healthcare stores.

For traditional systems, it means patients are being siphoned away from their outpatient facilities.

In an ominous sign for traditional providers, outpatient visits declined for the first time in recent history for many hospitals, according to data with the American Hospital Association.

Ken Kaufman, managing director of Kaufman Hall, told Healthcare Dive hospital CEOs will need to adapt to that change by offering competitive pricing, exploring more virtual care and listening to what patients want.

"What it means is the introduction of a new business model in healthcare, where that new business model is splitting off inpatient from outpatient so you have numerous competitors who are coming in who are not interested in the inpatient sector at all," he said.

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Key 2020 trends for payers and providers - Healthcare Dive

New Hampshire seeking federal waiver that could lower health insurance premiums – The Laconia Daily Sun

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Gov. Chris Sununu has announced that New Hampshire intends to file a waiver with the federal government that could help stabilize the individual health insurance market and lower premiums by as much as 15 percent next year.

Preserving and stabilizing New Hampshires individual health insurance market has been a key priority for our administration, Gov. Chris Sununu said in a news release. Our previous efforts have kept our states three current insurance companies in the market and have lowered premiums for two consecutive years."

But Sununu said federal policy has impeded state efforts to control costs.

"However, continued dysfunction and lack of reform in Washington is likely to produce increased prices next year that could put healthcare out of reach for too many Granite Staters," he said. "Thanks to good financial management and the reforms my administration made to our states Medicaid Expansion program, this waiver, unlike previous proposals, makes sense and could reduce prices for individuals by 15 percent.

What the Section 1332 State Relief and Empowerment Waiver ultimately could do is help bring thousands more people into the individual market in New Hampshire, which currently has about 44,000 people, Greg Moore, state director, Americans for Prosperity New Hampshire, told The Center Square.

When you have more healthy people joining the pool, they will bring more stability to the marketplace, which should help bring down premiums for everyone, Moore said. "If you could bring in another 10,000 healthy people into the exchange, you would really see an effect on premiums.

The long-term success depends on bringing in uninsured people who because of high prices perhaps found it made more sense to sit it out and simply pay for health care when needed.

New Hampshire currently ranks among the nations highest for insurance costs, but premiums have improved the last two years since people with Medicaid expansion began being served through managed care organizations instead of the individual marketplace. That was a one-time opportunity, Moore noted, and now the waiver decision is a good next step.

The federal government has been encouraging innovations at the state level, Moore said, and the 1332 waiver is representative of that goal.

Its a relatively new landscape," Moore said. "Once [President] Trump was elected, his folks at HHS encouraged new and creative solutions under 1332, and states are trying to understand the landscape of whats doable and what isnt.

In theory, this could benefit everybody if it works well, Moore added.

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New Hampshire seeking federal waiver that could lower health insurance premiums - The Laconia Daily Sun

Dispensed: Business Insider’s weekly healthcare newsletter JPM 2020 recap – Business Insider

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Hello,

Welcome to our annual post-J.P. Morgan Healthcare Conference edition of Dispensed, which is coming to you from a coffee shop in LA. I can use all the caffeine I can get after this week, and I'm looking forward to spending the weekend exploring the city and soaking up as much sun as I can before getting back to NYC next week.

I'm feeling so grateful for all the folks I got a chance to catch up with, all the new introductions, colleagues willing to get drinks at 4 p.m. so I can do happy hour and catch a flight, and all the story ideas that'll keep me busy for at least part of 2020! Until next year, San Francisco.

Are you new to thenewsletter?You can sign up here.

Last week, I mentioned we'd be spending our week in San Francisco running around the conference. It was my fifth time, and the first time I can remember that came and went without any ground-shaking news. Based on the conversations I had around the conference seems to be connected to the elephant in the room: the upcoming 2020 presidential election.

While the election is still months and months away, the sense I got was it's a good time to be as measured as possible, rather than dream up new acquisitions or business strategies. Curious to hear if you all got the same vibe ping me at lramsey@businessinsider.com with your thoughts.

Which isn't to say there wasn't anything to follow along with coming out of the conference. Here's what you might've missed over the week.

First, Verily made waves in its presentation Monday (and ruffled some partners' feathers). I have the play-by-play.

I mentioned I'd be tuning in to both Verily's presentation and Oscar Health's. During his presentation, CEO Mario Schlosser made an interesting comment about where he sees the employer-funded (aka a prevailing way Americans get their healthcare coverage) market going.

Zach Tracer and I followed up with him about it in an interview Tuesday. Here's what he told us.

To kick off the week, we covered the ambitions of EQRx, a startup founded by former Third Rock Ventures VC Alexis Borisy and Foundation Medicine chief business officer Melanie Nallicheri, raising from investors like Andreessen Horowitz, Arch Venture Partners, and GV.

Please enjoy this view of the city from the hill near my AirBnB! Lydia Ramsey

Stocks predictably soared and dropped based off good and bad news. Notably, Adaptimmune's cancer data sent the stock up 330%, while billionaire doctor Patrick Soon-Shiong'scancer drugmaker NantKwest's stock soared 92% on an interview he gave where he mentioned that exactly one person treated with the company's drug was in remission.

Deals (albeit, smaller in scale) were struck, with telemedicine company Teladoc buying InTouch Health for $600 million, Neon Therapeutics selling to German biotech BioNTech, and Pittsburgh-based health system UPMC raising an $800 million fund to invest in life sciences.

We also got updates on company strategies. That includes the potential for the newest most expensive drug in the world, as BioMarin anticipates pricing its gene therapy for the blood disorder hemophilia between $2 million and $3 million, per the Wall Street Journal. Right now, the most expensive drug in the world carries a price tag of $2.1 million. There was also news of a partnership between digital health company Livongo and Dexcom.

More to come as I sort through my notes from our various encounters around Union Square.

Also - if you're interested in clean energy, my colleague Benji Jones just launched his own weekly newsletter, Power Line! You can subscribe here.

(Finally, please send me your LA weekend eats recommendations!)

- Lydia

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Dispensed: Business Insider's weekly healthcare newsletter JPM 2020 recap - Business Insider

At the intersection of Trump’s health care lie and his ACA case – MSNBC

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For proponents of the Affordable Care Act, the last couple of months have been quite encouraging, at least as far as the substance of health care is concerned. Totals from the recent open-enrollment period, for example, were solid and in line with expectations, while the latest industry data pointed to stable health care markets, Republican sabotage efforts notwithstanding.

It was against this backdrop that Utah's Medicaid expansion program got underway on Jan. 1, while policymakers in Kansas reached a bipartisan compromise to bring Medicaid expansion to the Sunflower State. Others may soon follow: Phil Cox, a former head of the Republican Governors Association and a well-known figure in D.C. circles, was quoted saying two weeks ago, "The battle has been fought and lost on Medicaid expansion."

There is, however, just one dark cloud hanging over the ACA's head. A Republican lawsuit, backed by the Trump administration, is trying to destroy "Obamacare" in its entirety, and a Texas judge has already ruled in the GOP's favor. The 5th Circuit, in a move that appeared awfully political, recently left the future of the nation's health care system in limbo, almost certainly until after the election.

The legal process may, however, move more quickly. The ACA's proponents asked the U.S. Supreme Court to take up the case, and a week ago today, the justices directed the Trump administration and Republican state officials behind the lawsuit to respond. As NBC News' Pete Williams explained, "Such a highly abbreviated timeline the rules normally allow a month for filing a response gives the court the option to take up the case during its current term, which would mean a ruling on a contentious issue this spring, just as the presidential campaign heats up."

On Friday, the administration filed a brief, effectively telling the high court to cool its heels. The Washington Post reported:

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The Trump administration and a coalition of conservative states that have been challenging the Affordable Care Act said Friday that there is no reason for the Supreme Court to rush a ruling on the issue this term. [...]

President Trump's solicitor general, Noel Francisco, replied that the [5th Circuit's] decision simply preserved the status quo until a lower court looked more closely at which parts of the law should survive. It would be premature to intervene now, he said.

The full filing is online here (pdf).

To put it mildly, the Trump administration's argument is a tough sell, at least as it relates to the ACA itself. On the one hand, the lawsuit argues that the law's individual mandate, which Republicans gutted in late 2017, was so integral to the ACA that the nation's health care system can't function effectively without it, so "Obamacare" should cease to be. On the other hand, the Trump administration is also arguing that the mandate-less ACA is working fine right now, so there's no reason for the justices to act with any haste.

Both points cannot be true.

In case this isn't obvious, political considerations appear to be at the heart of the developments. It's likely that Trump and his team realize that if the Supreme Court takes up the case in the short term, there's a very real possibility that the White House and Republicans would either (a) lose a humiliating health care case in an election year; or (b) convince five conservative justices to take health care benefits away from tens of millions of Americans in an election year.

Or put another way, this isn't a great issue for the president or his party, which helps explain why they're so eager to convince the Supreme Court to push the whole issue off for a long while.

It also helps explain why Trump is peddling truly outrageous nonsense on the issue, including a tweet this morning in which the president claimed, "I was the person who saved Pre-Existing Conditions in your Healthcare." He added, "I will always protect your Pre-Existing Conditions, the Dems will not!"

It's as brazen a lie as Trump has ever told -- and to know anything about the president is to know the competition in that category is fierce. In reality, Trump didn't "save" protections for Americans with pre-existing conditions; he fought to take those protections away through a series of far-right repeal-and-replace proposals he couldn't get through a Congress led by his own party.

Trump, of course, is also helping champion an ongoing federal lawsuit which would -- you guessed it -- strip protections for Americans with pre-existing conditions.

MORE: Today's Maddowblog

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At the intersection of Trump's health care lie and his ACA case - MSNBC

The Future Of Nano Medicine

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Nanomedicine, refers to highly specific medical intervention at the molecular level for curing disease or repairing damaged tissues. Though in its infancy, could we be looking at the future of medicine? Early clinical trials certainly look promising.How Nanomedicine Works

- Nanomedicine works by injecting nanoparticles into the body- Can be used to:- Deliver medicine- Find and treat disease- Repair damaged cells

One human hair is approximately 80,000 nanometers wideApplications of Nanomedicine

- Drug Delivery- Using nanotechnology to deliver medicine, diabetic rats kept stable blood sugar levels for 10 days after injection- Cancer Diagnosis and Treatment- Using microRNA from a patient's blood plasma and nanotechnology:- Medical professionals can determine if lung cancer is present- Begin treatment the same day- Using Nano-Therm therapy to overheat brain cancer cells helps to destroy them- In clinical trials, those with recurrent glioblastoma survived a median of 13 months- More than double the survival rate of those not receiving Nano-Therm therapyNanotechnology is already commonly used in sunscreen and to make tennis balls more bouncy

- Flu Testing- Today's flu tests are:- Time consuming- Inaccurate- Nanomedicine gold flu testing provides:- Instant results- Immediate treatment cycle to avoid spreading to others- commercial nanotech testing no more than 5 years away- Cell Feedback- Nanomedicine can be used to test cell's response to drugs offering new drug testing methods- Provides instant feedback to how cells respond to medicine- Can save years and millions of dollars on testing and clinical trials- Can improve current medications

In a 1956, Arthur C. Clarke first envisioned the concept of nanotechnology in a short story, The Next TenantsAdvantages of Nanomedicine

- Faster diagnosis of many ailments- More precise treatments of conditions such as cancer- Repair tissue deep within the body- Target only diseased organs, lessening the need for drugsSources

- https://commonfund.nih.gov/nanomedicine/overview.aspx- http://www.understandingnano.com/medicine.html- http://pubs.acs.org/doi/abs/10.1021/nn400630x- http://www.nature.com/nnano/journal/v6/n10/full/nnano.2011.147.html- http://www.dana.org/news/features/detail_bw.aspx?id=35592- http://pubs.rsc.org/en/Content/ArticleLanding/2011/AN/C1AN15303J- http://onlinelibrary.wiley.com/doi/10.1002/smll.201001642/abstract- http://www.clinam.org/benefits.html

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The Future Of Nano Medicine

New Approaches in Breast Cancer Therapy Through Green Nanotechnology a | IJN – Dove Medical Press

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Menka Khoobchandani, 1, 2 Kavita K Katti, 1, 2 Alice Raphael Karikachery, 1, 2 Velaphi C Thipe, 1, 2 Deepak Srisrimal, 3 Darsha Kumar Dhurvas Mohandoss, 3 Rashmi Dhurvas Darshakumar, 3 Chintamani M Joshi, 3 Kattesh V Katti 1, 2, 4

1Department of Radiology, University of Missouri, Columbia, MO 65212, USA; 2Institute of Green Nanotechnology, University of Missouri, Columbia, MO 65212, USA; 3Dhanvantari Nano Ayushadi Pvt Ltd, Chennai 600017, India; 4Department of Physics, Department of Pharmacology, Department of Biological Engineering, University of Missouri Research Reactor (MURR), University of Missouri, Columbia, MO 65212, USA

Correspondence: Kattesh V KattiDepartment of Radiology, University of Missouri, One Hospital Drive, Columbia, MO 65212 USATel +1 573 882-5656Email KattiK@health.missouri.edu

Purpose: The overarching objective of this investigation was to investigate the intervention of green nanotechnology to transform the ancient holistic Ayurvedic medicine scientifically credible through reproducible formulations and rigorous pre-clinical/clinical evaluations.Methods: We provide, herein, full details: (i) on the discovery and full characterization of gold nanoparticles-based Nano Swarna Bhasma (henceforth referred to as NSB drug); (ii) In vitro anti-tumor properties of NSB drug in breast tumor cells; (iii) pre-clinical therapeutic efficacy studies of NSB drug in breast tumor bearing SCID mice through oral delivery protocols and (iv) first results of clinical translation, from mice to human breast cancer patients, through pilot human clinical trials, conducted according to the Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (abbreviated as AYUSH) regulatory guidelines of the Government of India in metastatic breast cancer patients.Results: The preclinical in vitro and in vivo investigations, in breast tumor bearing mice, established unequivocally that the NSB Nano-Ayurvedic medicine-gold nanoparticles-based drug is highly effective in controlling the growth of breast tumors in a dose dependent fashion in vivo. These encouraging pre-clinical results prompted us to seek permission from the Indian Governments holistic medicine approval authority, AYUSH, for conducting clinical trials in human patients. Patients treated with the NSB drug capsules along with the standard of care treatment (Arm B) exhibited 100% clinical benefits when compared to patients in the treatment Arm A, thus indicating the tremendous clinical benefits of NSB drug in adjuvant therapy.Conclusion: We have succeeded in clinically translating, from mice to humans, in using proprietary combinations of gold nanoparticles and phytochemicals to develop the Nano-Ayurvedic drug: Nano Swarna Bhasma (NSB), through innovative green nanotechnology, for treating human metastatic breast cancer patients.

Keywords: gold nanoparticles, mangiferin, mango peel, Nano Swarna Bhasma, NSB, triple negative breast tumor, pilot clinical

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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New Approaches in Breast Cancer Therapy Through Green Nanotechnology a | IJN - Dove Medical Press

Controlled phage therapy hints at future alternative to antibiotics – New Atlas

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Phages, viruses that thrive by infecting bacteria, have long been mooted as a potential replacement for antibiotics. But where antibiotics pose the problem of the bacteria they target mutating into dangerous resistant strains, phages pose risks due to their own fast-paced evolution, though those risks are poorly understood.

But new research suggests it may be possible to mitigate those risks. Left to nature, particular phages are able to seek out and destroy particular types of bacteria. But here its only the seeking that the researchers are interested in, using the phages to deliver a payload of gold nanorods which, with the help of light, destroy both the target bacteria and their phages at once. If youll forgive the grim analogy, you can think of the phage as the guidance system and the nanorods the warhead of this particular antibacterial guided missile.

What we did was to conjugate the phages to gold nanorods, UC Santa Barbaras Irene Chen explains in a press release. If you thought conjugation was something that happened only to verbs, dont panic: it can also simply mean to join or couple. When these nanorods are photo-excited, they translate the energy from light to heat, and that creates very high local temperatures.

The so-called phanorod combinations of nanorods and phages were added to in-vitro cultures of mammal cells with an added bacteria biofilm. They were then exposed to light in near-infrared wavelengths to cause the all-important photo-excitement. The resulting heat kills both the bacteria and the phage.

In experiments, the phanorods successfully destroyed the potent human pathogens E. coli, P. aeruginosa and V. cholerae. Its important to note that the phanorods also destroyed 20 percent of the mammal cells in the culture, which the research categorizes as a low rate of damage.

This issue of whether it damages mammalian tissues is very important, Chen explains. Work in nanotechnology and nanomedicine treating bacterial infections indicates that when its non-targeted, it really does burden the surrounding tissues.

As well as the unpredictable nature of unchecked phage evolution, there are other issues with their historical use. They can potentially carry toxins, and its hard to gauge the success of the treatment. You might see it completely work or you might see it completely fail, but you dont have the kind of dose response you want, Chen explains. But this new controlled approach to phage therapy could potentially mitigate these issues as well.

The teams research will go on to look at more phages to target more types of bacteria, as well as exploring photothermal methods to treat several bacterial infections at once. However, the work is very much at the research stage, and theres no suggestion of clinical use at this stage.

The teams research was published Monday in Proceedings of the National Academy of Sciences. Its free to read online.

Sources: UC Santa Barbara, Proceedings of the National Academy of Sciences

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A New Old Therapy – The UCSB Current

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The fight against drug-resistant pathogens remains an intense one. While the Centers for Disease Controls (CDC) 2019 biggest threats report reveals an overall decrease in drug-resistant microbe-related deaths as compared to its previous report (2013) the agency also cautions that new forms of drug-resistant pathogens are still emerging.

Meanwhile, the options for treating infections by these germs are diminishing, confirming doctors and scientists worries about the end of the age of antibiotics.

We knew it was going to be a problem early on, said UC Santa Barbara chemistry and biochemistry professor Irene Chen. Basically as soon as penicillin was discovered, a few years later it was reported that there was a resistant organism. Thanks to factors such as horizontal gene transfer and rapid reproduction, organisms such as Gram-negative bacteria are able to evolve faster than we can produce antibiotics to control them.

So Chen and her research group are seeking alternatives to antibiotics, in a growing effort to head off the tide of incurable bacterial infections. In their work, the group has turned to bacteriophages, a naturally occurring group of viruses that colonize on bacteria.

Thats their natural function, really, to grow on and kill bacteria, said Chen, author of a paper that appears in the Proceedings of the National Academy of Sciences. By taking advantage of the bacteriophages ability to home in on specific bacteria without damaging the rest of the microbiome, the researchers were able to use a combination of gold nanorods and near-infrared light to destroy even multidrug-resistant bacteria without antibiotics.

Phage therapy isnt new, Chen said. In fact, it has been used in the former Soviet Union and Europe for about a century, though they are seen largely as last-resort alternatives to antibiotics. Among the unresolved issues of phage therapy is the incomplete characterization of the phages biology a biology that could allow for unintended consequences due to the phages own rapid evolution and reproduction, as well as potential toxins the viruses may carry. Another issue is the all-or-nothing aspect of phage therapy, Chen added.

Its difficult to analyze the effect of a phage treatment, she said. You might see it completely work or you might see it completely fail, but you dont have the kind of dose response you want.

To surmount these challenges, the Chen lab developed a method of controlled phage therapy.

What we did was to conjugate the phages to gold nanorods, she explained. These phanorods were applied to bacteria on in-vitro cultures of mammalian cells and then exposed to near-infrared light.

Conjugated to phages,gold nanorods find their target: a bacterial cell wall

Photo Credit: COURTESY IMAGE

When these nanorods are photo-excited, they translate the energy from light to heat, Chen said, and that creates very high local temperatures.

The heat is enough to kill the bacteria, and it also kills the phages, preventing any unwanted further evolutions. The result is a guided missile of targeted phage therapy that also allows for dosage control. The lab found success in destroying E. coli, P. aeruginosa and V. cholerae human pathogens that cause acute symptoms if left unchecked. They also were able to successfully destroy X. campestris, a bacteria that causes rot in plants.

In a collaboration with UC Santa Barbara mechanical engineer Beth Pruitt, the lab determined that while the heat successfully destroyed bacteria and phage, more than 80% of the mammalian cell culture underneath the bacteria biofilm survived.

Bacteria under fire: Green bacteria are alive, while the red ones are dead

Photo Credit: COURTESY IMAGE

This issue of whether it damages mammalian tissues is very important, Chen said. Work in nanotechnology and nanomedicine treating bacterial infections indicates that when its non-targeted, it really does burden the surrounding tissues.

The lab plans to investigate other possible phages to counter other bacteria, possibly engineering a photothermal method that could treat multiple bacterial infections.

Research on this study was conducted also by UCSB postdoctoral fellow Huan Peng (lead author), Raymond E. Borg and Liam P. Dow.

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A New Old Therapy - The UCSB Current

Most engineered nanoparticles enter tumours through cells not between them, U of T researchers find – News@UofT

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University of Toronto researchers have discovered that an active rather than passive process dictates which nanoparticles enter solid tumours, upending decades of thinking in the field of cancer nanomedicine and pointing toward more effective nanotherapies.

The prevailing theory in cancer nanomedicine an approach that enables more targeted therapies than standard chemotherapy has been that nanoparticles mainly diffuse passively into tumours through tiny gaps between cells in the endothelium, which lines the inner wall of blood vessels that support tumour growth.

The researchers previously showed thatless than one per centof nanoparticle-based drugs typically reach their tumour targets. In the current study, they found that among nanoparticles that do penetrate tumours, more than 95 per cent pass through endothelial cells not between gaps among those cells.

Our work challenges long-held dogma in the field and suggests a completely new theory, saysAbdullah Syed, a co-lead author on the study and post-doctoral researcher in the lab ofWarren Chan, a professor at theInstitute of Biomaterials and Biomedical Engineeringand theDonnelly Centre for Cellular and Biomolecular Research.

We saw many nanoparticles enter the endothelial cells from blood vessels and exit into the tumour in various conditions. Endothelial cells appear to be crucial gatekeepers in the nanoparticle transport process.

The findings were recently published in thejournalNature Materials.

From left to right: U of T researchers Jessica Ngai, Shrey Sindhwani, Abdullah Syed and Benjamin Kingston (photo by Qin Dai)

Syed compares nanoparticles to people trying to get into popular restaurants on a busy night. Some restaurants dont require a reservation, while others have bouncers who check if patrons made reservations, he says. The bouncers are a lot more common than researchers thought, and most places only accept patrons with a reservation.

The researchers established that passive diffusion was not the mechanism of entry with multiple lines of evidence. They took over 400 images of tissue samples from animal modelsand saw few endothelial gaps relative to nanoparticles. They observed the same trend using 3D fluorescent imaging and live-animal imaging.

Similarly, they found few gaps between endothelial cells in samples from human cancer patients.

The group then devised an animal model that completely stopped the transportation of nanoparticles through endothelial cells. This allowed them to isolate the contribution of passive transport via gaps between endothelial cells, which proved to be miniscule.

The researchers posit several active mechanisms by which endothelial cells might transport nanoparticles into tumours, including binding mechanisms, intra-endothelial channels and as-yet undiscovered processes all of which they are investigating.

Meanwhile, the results have major implications for nanoparticle-based therapeutics.

These findings will change the way we think about delivering drugs to tumours using nanoparticles, saysShrey Sindhwani, also a co-lead author on the paper and an MD/PhD student in the Chan lab. A better understanding of the nanoparticle transport phenomenon will help researchers design more effective therapies.

The research included collaborators from U of Ts department of physics in the Faculty of Arts & Science, Cold Spring Harbor Laboratory In New York and the University of Ottawa. The study was funded by the Canada Research Chairs Program, Canadian Cancer Society, Natural Sciences and Engineering Research Council of Canadaand the Canadian Institutes of Health Research.

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Most engineered nanoparticles enter tumours through cells not between them, U of T researchers find - News@UofT

Letters to the editor: In response … – Las Cruces Sun-News

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Letters to the editor(Photo: iStockphoto)

These letters were published in the Jan. 19 print edition of the Las Cruces Sun-News.

Randy Lynchs op-ed, Minimum wage increases just dont add up,prompts me to respond with a bit of clarity.

First, a minimum wage law is a legal requirement established by the Thirteenth Amendment which abolished slavery and involuntary servitude. The question is not whether, but how.

Next, he segues into the bogus idea of government fixing things which is a ploy used by those who would reduce legal requirements to survival of the dominant.

Finally, he promotes the idea that business owners who are trying to keep their business in the black are victims. Since every business is subjected to the same minimum wage, those which create and operate the most effective enterprises will prosper. Isnt that the American business ideal?

Gordon Hill, Las Cruces

In her Sunday guest column, "My first year in Congress," Xochitl Torres Small bragged about what all she has done for her constituents in Congressional District 2.However, Small left out something big the elephant in the room.Of course, I'm talking about her vote to impeach President Trump.Unbelievably, the congresswoman madeno mention of the single most important act of her career, as well as her biggest mistake.

Small wrote, "I remain committed to putting in the work guided by all my constituents."Really?Then why did she ignore our wishes, and vote forimpeachment anyway?

In this column, Small toots her own horn about what she has done for the folks in her district, but is strangely silent about voting to impeach Donald Trump.I guess she's hopingwewill forget about this despicableactbeforethe next election. But like elephants, Republicanvotershave long memories.And in November we will make sure that this will be Xochitl Torres Small's last year in Congress.

Paul Hoylen, Deming

Mr. Heald says he voted liberal and then spends the rest of his article on Republican talking points.What doestruly high crimes and misdemeanors mean? The prez shoots someone?The prez gets into a barroom brawl?Fraud?Sexual assault?

The Government Accounting Office reviewed the presidents actions and stated that he committed a crime.Eighteenwitnesses corroborated each other regarding this crime.Trump committed extortion of the Ukrainians by withholding federal funds in trade for an announcement of dirt of Biden.That was the presidents sole purpose.This is typical behavior.Over 400 experienced federal trial lawyers said they could maintain a charge of obstruction of justice because the evidence in the Mueller report.Trump has certainly obstructed Congress.There are witnesses such as Mulvaney, Pompeo and Bolton who have first-hand information of Trumps innocence.Trump says no deal.Then there is the actual transcript of the entire conversation with Ukraine that Trump refuses to release because it proves his innocence.

What kind of stupid is required to not understand the nature of Donald Trump?He is corrupt.His charity was a fraud.His university was a fraud.He sold out the Kurds as a favor to a client, Mr. Erdogan, who supported a Trump Tower in Istanbul (2010). Trump wants another Tower in Moscow, which neatly explains his performance at Helsinki and since.

The only question remaining is how will Trumps corruption affect our country in the future.How bad will it get?If Trump loses the election, will he declare it a fraud?Claim the election was stolen?Look at his history.You tell me.

Andrew Wilson, Las Cruces

I'd like to respond to Rick Reynaud. The "right to work laws" have nothing to do with the right to work. They are instead "right to free legal representation" laws, designed to destroy unions. Union employees fought long and hard, and still do, for those wages and benefits that applicants for those jobs covet. Some of those applicants don't feel that they should have to pay the union dues that pays for the lawyers that negotiate their labor contracts and must, by law, represent them in grievance proceedings against the employer for violations against the contract and excessive punishment against the employee when mistakes or accidents happen.

There are many nonunion jobs available in every field the unions represent. If somebody does not wish to pay for their benefits then they should not be allowed in a workplace where others pay, or at least the union should not have to represent them in any work disputes. I paid union dues for 30 years and represented my fellow workers in many grievances for 29 of them. I never lost a grievance. I saved a number of people their jobs and others excessive punishment for infractions because in grievance proceedings the company lawyers agreed that management violated contract terms.

I also had much better health coverage, and enjoy a much better pension, than my managers, and when the company ceased operations in this region, got a much better severance deal than the employees in our nonunion shops. Do you believe that a mechanic should fix your car free, or a doctor should treat you free, or an accountant do your taxes free? Then why should union employees pay for nonunion workers' legal services?

Frederick Zentz, Chaparral

Recently the Sun-News has displayed a number of oil/gas industry op-eds praising the "financial benefits" of their operations in NM. True enough the state government receives substantial revenues from the industry.But it's not all roses.

One characteristic of civilized behavior is refraining from harming others.One characteristic of criminal behavior is harming others, particularly for financial gain.

There is little doubt that pollution of the air, soil and water by oil and gas operations is a danger to life.This health damage results in long term, recurring medical expenses, loss of employment, premature death and other costly side effects.When we deduct these costs, the financial benefits of the oil/gas industry diminish quickly.

Additionally, negligent disregard for human life is a crime.Poisoning is a crime.If the crime is committed by a private individual there are criminal charges filed, followed by severe punishment.If the crime is committed by management using a corporation, the criminal behavior is rarely punished and, if so, by a small fine that is tax deductible.

Not too sure about those benefits.As one executive said: "Keep your Sunday School lessons to yourself, this is a business".

Charles Clements, Las Cruces

It's easy to see why Trump supporters feel that he is "just like one of us." At his rallies when he calls people names or makes fun of them or lashes out at the Democrats, you cheer and applaud him.He loves that. He talks like one of the guys, using language you love hearing, some crude and demeaning.And he talks mostly about himself. No, he is not just like one of you; he's all for the honor and glory of Donald Trump.

If you're fine with him being a liar, bully, vindictive, crass, insensitive; unwilling to take responsibility for his actions or work with the Democrats; thinks he is king but acts and talks like a mob boss; demoralizes the institutions of our government; and feels he is above the law then you are not showing allegiance to the United States but to a cult personality.

And if you accept the fact that he is void of character, humility, compassion, warmth, morals and honor then you have every right to say "he's just like one of us."

For those of you who wear shirts that read: "I'd rather be Russian than a Democrat" be careful what you wish for.Putin is watching.Take a look into your souls and ask yourself: Is this who America is?

Theodore Roosevelt once said:"Character in the long run, is the decisive factor in the life of an individual and of nations alike."There is a resident of Las Cruces who once described Trump "as a breath of fresh air."I wonder if she really believes that now.

Carolyn Christy, Las Cruces

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In 1851, a Maryland Farmer Tried to Kidnap Free Blacks in Pennsylvania. He Wasn’t Expecting the Neighborhood to Fight Back – Smithsonian.com

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The muse for this story is a humble piece of stone, no more than an inch square. Sometime in the mid-19th century, it had been fashioned into a gunflintan object that, when triggered to strike a piece of steel, could spark a small explosion of black powder and propel a lead ball from the muzzle of a gun with mortal velocity.

Archaeologists often come across gunflints. Thats because during the 19th century, firearms were considered mundane items, owned by rich and poor alike. Gunflints, like shell casings now, were their disposable remnants.

But this gunflint is special.

In 2008, my students and I, working with nearby residents, unearthed this unassuming little artifact during an archaeological dig in a little Pennsylvania village known as Christiana. We found it located in what today is a nondescript corn field, where a small stone house once stood.

For a few hours in 1851, that modest residence served as a flashpoint in Americas struggle over slavery. There, an African American tenant farmer named William Parker led a skirmish that became a crucial flareup in the nations long-smoldering conflict over slavery.

Its been 160 years since the uprising, which for most of its history was known as the Christiana Riot, but is now more often referred to as the Christiana Resistance, Christiana Tragedy, or Christiana Incident. In taking up arms, Parker and the small band of men and women he led proved that African Americans were willing to fight for their liberation and challenge the federal governments position on slavery. Finding a broken and discarded flint offers a tangible piece of evidence of their struggle, evoking memories of a time when the end of slavery was still but a hope, and the guarantee of individual liberty for all people merely a dream.

The events at Christiana were a consequence of the Fugitive Slave Act of 1850, federal legislation passed in the wake of the Mexican-American War of 1846-1848. California, a key part of territory seized by the U.S. following that conflict, had rejected slavery in its constitutional convention in 1849 and sought entry to the Union as a free state. To placate white Southerners who wanted to establish a slave state in Southern California, Congress forged the Compromise of 1850. The Fugitive Slave Act, its cornerstone legislation, forced all citizens to assist in the capture of anyone accused of being a fugitive in any state or territory. A person could be arrested merely on the strength of a signed affidavit and could not even testify in their own defense. Any person found guilty of harboring or supporting an accused fugitive could be imprisoned for up to six months and fined $1,000, nearly 100 times the average monthly wage of a Pennsylvania farm hand in 1850.

In some places, alarmed citizens began pushing back against what they perceived to be an overreach of federal power. In Lancaster County, Pennsylvania, however, the new law began fanning racial tension. Many whites in the area resented the movement of formerly enslaved people across the southern border, perceiving it as an invasion of destitute illegals that would depress wages in factory and field. Others were simply negro haters, as William Parker himself put it, all too happy to assist federal agents in sending African Americans back across the border. Some unscrupulous Pennsylvanians profited from illegally trafficking free African American men, women, and children south into slavery. A new and insidious slave trade blossomed in the border states. The price of an enslaved person in nearby Maryland, for instance, jumped an estimated 35 percent following the passage of the law, which made kidnapping free people increasingly profitable and common. One infamous Philadelphia kidnapper named George Alberti was indicted twice for selling free people into slavery, and eventually admitted to kidnapping some 100 people over the course of his notorious career. The governor of Pennsylvania would pardon Alberti after he served less than a year of a 10-year sentence for kidnapping an infant.

With white Pennsylvania ambivalent at best about the fate of African Americans, it wasnt shocking that someone decided to tell Maryland farmer Edward Gorsuch that two men who had escaped from his land two years before, Samuel Thompson and Joshua Kite, were hiding in William Parkers rented house near Christiana.

William Parker, a 30-year-old tenant farmer born in Maryland, had escaped slavery just a few years prior, and had found refuge, if not full acceptance, in this quiet corner of Pennsylvania. Despite encountering sympathy from the Quaker community, Parker still feared for his safety. He joined other African Americans in the area to form mutual aid societies to defend against kidnapping, and established networks of lookouts to keep track of the movements of known kidnappers and their allies. One such network tipped off Parker that Gorsuch and a small band of relatives and supporters, accompanied by a notorious Philadelphia constable named Henry Kline who had been deputized as a U.S. marshal for the occasion, were hunting for Thompson and Kite. The black community of Christiana was on high alert.

Gorsuchs armed posse crept through the rising mist at dawn on the morning of September 11, 1851, as Parker and his men waited at the house. Informed that kidnappers were about, but not knowing where they would strike, black neighbors for several miles around nervously waited for a distress signal calling out for help against the intruders.

Not knowing they had lost the element of surprise, Gorsuch and Kline attempted to storm the Parkers small stone house, only to be driven back down a narrow, winding stairway by armed defenders. Next they tried to reason with Parker, who, barricaded in on the second floor, spoke for the group. Parker refused to acknowledge Klines right to apprehend the men, dismissing his federal warrant as a meaningless piece of paper. As tensions mounted, Eliza Parker, Williams wife, took up a trumpet-like horn, and blasted a note out of an upstairs window. Startled by the piercing sound, the Gorsuch party opened fire at the window, hoping either to incapacitate Eliza with a bullet wound or frighten her into silence. Despite the danger, she continued sounding the alarm, which reportedly could be heard for several miles around.

Within half an hour, at least two dozen African American men and women, armed with pistols, shotguns, corn cutters and scythes, arrived to assist the Parkers. Several white Quaker neighbors also appeared at the scene, hoping to prevent a violent confrontation. Favored now by the strength of numbers, Parker, Kite, and Thompson emerged from the house to convince Gorsuch and Kline to withdraw. Kline, recognizing the futility of the situation, quickly abandoned his comrades and retreated. But an enraged Gorsuch confronted Thompsonwho struck Gorsuch over the head with the butt of his gun. Shots rang out. Within minutes, Gorsuch lay dead on the ground, his body riddled with bullets and lacerated by corn knives. His posse did their best to flee. Son Dickinson Gorsuch had taken a shotgun blast to the chest at close range, barely had the strength to crawl from the scene, and was coughing up blood. Thomas Pearce, a nephew, was shot at least five times. Joshua Gorsuch, an aging cousin, had been beaten on the head, and stumbled away, dazed. Gorsuchs body was carried to a local tavern, where it became the object of a coroners inquest. Despite their serious wounds, the rest of his party survived.

Retribution was swift. In the days that followed, every black man in the environs of Christiana was arrested on treason charges, as were the three white bystanders who had tried to convince Gorsuch to withdraw. The subsequent treason trial of Castner Hanway, one of the white bystanders, resulted in an acquittal. Despite the fury of both pro-slavery and compromise-favoring politicians, the prosecution, led by U.S. Attorney John Ashmead, moved to dismiss all charges against the other defendants, who were soon released. No one was ever arrested or tried on murder charges for the death of Edward Gorsuch, including the known principles at the Parker HouseKite, Thompson, Parker, Eliza and their familywho fled north to Canada and remained free men.

Over time, the black community of Lancaster County grew to remember the Christiana Riot as a tragic victory. The events significance was more complicated for the white community. In the short term, many Lancastrians followed the pro-slavery lead of James Buchanan, who lived in the community and was elected U.S. president in 1856. Thaddeus Stevens, an abolitionist politician who represented Lancaster in the U.S. House of Representatives and had assisted in the defense of the accused, lost his seat to a member of his own Whig party in 1852, spurned by constituents who could not tolerate his liberal views on racial justice. But after Buchanans election, Stevens was soon buoyed by growing anti-slavery sentiment and returned to Congress, and with the outbreak of the Civil War, Lancastrians both black and white rallied fully to the Union cause.

The Parker House, abandoned after the family fled for Canada, became a place of pilgrimage after the Union victory. Curious visitors from around the region sought out the abandoned Riot House and took pieces of it away with them as souvenirs. By the late 1890s the farmer who owned the land perceived the Parker House as a dangerous nuisance, and had it knocked down and plowed over. In the years to come, it became hidden in time, presenting as nothing more than a scatter of stone and debris in an otherwise unremarkable field.

That was how we found it when we visited the cornfield at the invitation of a group of community volunteers who were interested in rebuilding the house as a memorial to William Parkers struggle. Black and white descendants of the participants in the uprising joined us at the excavation, spellbound when we uncovered the first fragment of foundation wall, a remnant of a place that resonated with the power of ancestors who had risked their lives to prevent neighbors from being kidnapped into slavery.

Archaeologists know that communities create and preserve deep knowledge of their local history. Often, stories of the past help communities create an identity of which they can be proud. This was certainly the case at Christiana.

We can say with some confidence that the small, square piece of stone recovered during the excavation is an artifact of the famous conflict. The gunflint was discovered nestled into the cellar stairs, right below the window where Eliza Parker sounded her alarm. We know that Gorsuchs men fired at her from virtually this same spot, and that men in the house returned fire. By 1851, flintlocks were old-fashioned weapons, widely replaced by more modern and efficient firearms, but we know from records of the treason trial that the weapons William Parker and his associates wielded were old muskets. That suggests the flint we found may have fallen from one of their outdated guns.

The artifact gives us pause. The gunflint reminds us of the progress we have made in overcoming racial injustice in the United States, but also that the work to reconcile with the violent legacies of slavery is far from over. It reminds us that the cost of liberty is often steep, and that the events that have secured that liberty are often quickly forgotten. American stories like this one lie everywhere around us. They wait, mute, to be reconsidered, pointing to the past, and prodding us to tackle what yet is left to do.

James Delle is an archaeologist at Millersville University, in Millersville, Pennsylvania. He is the author of The Archaeology of Northern Slavery and Freedom.

This story was originally published on Zocalo Public Square.

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In 1851, a Maryland Farmer Tried to Kidnap Free Blacks in Pennsylvania. He Wasn't Expecting the Neighborhood to Fight Back - Smithsonian.com

Letter to the Editor: No polite time in U.S. history – Tulsa World

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The phrase slavery was ended on the North American continent conflates the Emancipation Proclamation and the passing of the 13th Amendment. There is no mention of the exception to the 13th Amendment: slavery exists as punishment for crime.

The 13th protects for-profit prisons where inmates are forcibly moved across state lines and work for less than minimum wage, or even no wage at all.

The letter laments the division of our country, quotes Dr. Martin Luther King Jr. and wishes to return to a mysterious time when the U.S. had more agreeable standards. Which year has the polite order that we should return to?

Our country has systematically divided and oppressed certain groups of people since inception and hasnt stopped. Disorder is a consequence of this system.

Fighting this system, not lamenting disorder or division, requires MLKs radical view of justice.

I recommend a different MLK quote: The Negro's great stumbling block in the stride toward freedom is not the White Citizens Counciler or the Ku Klux Klanner but the white moderate who is more devoted to order than to justice.

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Letter to the Editor: No polite time in U.S. history - Tulsa World

Labour rights abuse on the rise – The ASEAN Post

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Labour rights violations in ASEAN are among the negative effects of an increase in production due to the United States (US)-China trade war which has resulted in a shift of some production from China to this part of the world. While the region is embarking on the Fourth Industrial Revolution, numerous industries in ASEAN still rely on labour-intensive factories. Unable or unwilling to invest in technological advances that would automate production and ease workloads, many factories across Southeast Asia are filled with migrant workers who have appeared in the news for all the wrong reasons.

Featuring more prominently in the headlines though is the US-China trade war which has seen the US and China impose tariffs on each others goods worth US$360 billion in 2018, slowing global growth and creating uncertainty in markets worldwide.

China is officially looking to move away from low-level manufacturing towards innovation and consumption, and while the worlds second largest economy will retain much of its manufacturing footprint in the coming years, brands will continue to diversify their supply chains and seek sourcing and production in new (cheaper) markets.

Shifting production

Supply chain auditing firm QIMA conducted a year end survey of more than 100 businesses across the globe last year. They found as many as three-quarter of them had already started sourcing suppliers in new countries as a result of tariff increases many citing ASEAN countries as alternative markets. Most companies already sourced ASEAN countries in the textile and apparel industry, but rising tariffs have accelerated this process as the uncertainty is making ASEAN a more attractive destination.

However, ASEAN is also an attractive destination for migrant workers - the influx has led to a wide range of labour rights violations being documented with numerous stories of overworked workers being underpaid and mistreated. According to the International Labour Organisation (ILO), among the most common labour rights violations include unsafe workplaces, excessive working hours, lack of overtime pay, wage theft and lack of freedom of association.

Speaking exclusively to The ASEAN Post, QIMAs CEO and founder Sbastien Breteau said that there has been an increase in workers rights violations in ASEAN countries that have seen shifts in production from China.

In many of the countries that employ migrant labour, such as Malaysia and Thailand, an uptick in instances of modern slavery that coincides with the sourcing shift has been observed, said Breteau. Generally speaking, most of the factories in ASEAN countries score lower in ethical compliance than those in China and have suffered more cases of critical non-compliance. As the number of audits being performed increases in the region, the issue is being amplified, he added.

It is important to note that ethical compliance issues were prevalent in ASEAN even before the shift and many of the recent high-profile modern slavery cases such as in Top Glove (Malaysia) and Bangkok Rubber (Thailand) were identified before the trade war. Breteau noted that factory compliance remains an issue across markets. Vietnam and Indonesia, for example, saw their average factory scores deteriorate by -5.1 percent and -3.2 percent year-on-year, respectively according to QIMAs Q1 2019 data.

With key consumer markets such as the US, UK, Australia and the Netherlands proactively passing legislation which holds companies accountable for cases of modern slavery within their supply chain, ASEAN will have to adjust accordingly to ensure their industries maintain ethical production standards and eliminate labour rights violations.

While the increase in Western buyers switching to new sourcing countries will have a positive impact on workers rights in the long term, in the short term, the shift does have some negative implications as rapid growth often does.

If you look back at China 20 years ago in regard to workers rights, you saw similar issues to what you are seeing in ASEAN. Thanks to the pressure to meet global trade requirements, working conditions in China have improved dramatically and we expect to see similar improvement in ASEAN countries over time, said Breteau.

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Labour rights abuse on the rise - The ASEAN Post