Inside the Beltway: Libertarian health care: Repeal and deregulate … – Washington Times

The health care clash continues, pitting Republican against Democrat. A third combatant has entered the fray, however: The Libertarians now are weighing in on the challenge to create a workable, healthy health care system out of the loose ends and leftovers of Trumpcare and Obamacare.

Although Libertarians might disagree on what constitutes meaningful health care reform, it makes no sense to replace one bad plan with another. Obamacare is like two government bureaucrats and an insurance company bureaucrat getting between you and your doctor. The Republicans would replace that with two insurance bureaucrats and a government bureaucrat between you and your doctor, declares Nicholas Sarwark, chairman of the Libertarian National Committee.

The Libertarian solution is to repeal and deregulate. You dont cover oil changes with your car insurance. You should not be forced to cover flu shots with your health insurance, larding the cost with overhead and profits that flow to insurance companies and government functionaries, he says, pointing out that a certificate of need must be approved before new hospitals and other health care facilities can be built in 35 states. Find the partys healthcare ideas here

Econ 101 tells us that restricting the supply of medical care increases costs, Mr. Sarwark advises. Repeal and replace Obamacare with Obamacare light? The Libertarian Party says no. Instead, repeal and replace with massive deregulation that will make the health care market competitive again and result in lower prices for everyone.

WHERE THE GOP REALLY STANDS

A West Virginia governors switch from Democrat to Republican means the GOP will have full control of legislative and executive branch in 26 states. Democrats have full control in just six states, advises John Karch, spokesman for American for Tax Reform, a nonpartisan coalition of the frugal and fiscally minded.

Indeed, West Virginia Gov. Jim Justice made his intentions clear on Thursday. Numbers are telling here.

Mr. Kartch points out the total population of Republican-controlled states is now 164,138,104 people. The population of Democrat-controlled states: 50,190,213.

INFANTILIZATION OF THE AMERICAN SPIRIT

Snowflakes have become a veritable blizzard as many of the nations universities and colleges give way to demands of students who seek safe places, careful conversations and utter political correctness when they are on campus. And here comes the book.

Not a Day Care: The Devastating Consequences of Abandoning Truth by Everett Piper, president of Oklahoma Wesleyan University, arrives Monday, published by Regnery Faith Books.

Mr. Piper has listened to students who felt victimized by passages in the Bible; he himself has cautioned them to seek faith, not self-actualization and to skip delivering arrogant lectures in favor of humble learning.

What has happened to the American spirit? Weve gone from give me liberty or give me death! to Take care of me, please. Our colleges were once bastions of free speech; now theyre bastions of speech codes. Our culture once rewarded independence; now it rewards victimhood. Parents once taught their kids how to fend for themselves; now, any parent who tries may get a visit from the police, the author writes in the book, found here.

Such schools as Yale University and Oberlin College now include safe spaces and trigger warnings as part of the campus vocabulary. Mr. Piper calls the trend a sad and dangerous infantilization of the American spirit.

Theres a way out though.

It will get worse before it gets better, Mr. Piper tells Inside the Beltway. When we avoid truth it creates a vacuum, causing anarchy, which always leads to tyranny. But in the end, I trust the words of Christ: the truth shall set us free. If we reintroduce truth, truth will prevail.

DAYS OF YORE

Annoyance with the news media has been fomenting for, well, centuries.

From 40 years experience of the wretched guesswork of newspapers of what is not done in the open daylight, and of the falsehoods even as to that, I rarely think them worth reading, and almost never worth notice, Thomas Jefferson wrote in a letter to James Monroe.

The date: Feb. 4, 1816.

WEEKEND REAL ESTATE

For sale: The Penwell House, built in 1896 on Garden Creek in Challis, Idaho. An active bed and breakfast, original floors, woodwork, architectural details, staircase. On National Historic Register of Homes. Four bedrooms, five baths, formal dining and gathering rooms; 4,361 square feet; completely renovated electrical, plumbing systems and baths; commercial kitchen with catering license. Multiple sitting porches, expansive lawns, guest house. Priced at $475,000 through Mtnwestrealestate.com; find the home here.

POLL DU JOUR

66 percent of Americans say the mood of the country is Its everyone for themselves; 65 percent of Republicans, 66 percent of independents and 67 percent of Democrats agree.

18 percent are unsure what the mood of the country is; 15 percent of Republicans, 23 percent of independents and 14 percent of Democrats agree.

16 percent say the mood is Were all in this together; 21 percent of Republicans, 11 percent of independents and 20 percent of Democrats agree.

64 percent are pessimistic that Republicans and Democrats in Congress can work together to solve the nations problems; 61 percent of Republicans, 62 percent of independents and 71 percent of Democrats agree.

20 percent are optimistic the two sides can work together; 30 percent of Republicans, 16 percent of independents and 20 percent of Democrats agree.

15 percent are not sure if they can work together; 9 percent of Republicans, 22 percent of independent and 10 percent of Democrats agree.

And Economist/YouGov poll of 1,500 U.S. adults conducted July 31-Aug. 1.

Follow Jennifer Harper on Twitter @HarperBulletin

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Inside the Beltway: Libertarian health care: Repeal and deregulate ... - Washington Times

Guam: Island paradise turned ballistic target – USA TODAY

Guam residents speak on recent threats from the North Korean government. USA TODAY NETWORK

This photo taken on July 14, 2017 shows tourists on a beach in Guam's capital Hagatna. As Guam prepares to celebrate Liberation Day this week, political leaders on the Pacific island say it's time to decide whether to remain a US colony or become an independent nation.(Photo: MAR-VIC CAGURANGAN, AFP/Getty Images)

The remote island paradise of Guam -- a 210-square-mile blot of land in the Pacific -- is at first glance an unlikely place for a ballistic missile crisis.

But the island, considered a vacationer's dream with crystal-clear waters, fabulous sunsets, white beaches, and near-perfect temperatures, has long been an important strategic U.S. military outpost.

And that's likely why North Korea, located roughly 2,100 miles away to the northwest, has selected it as the focal point of a high-stakes game of chicken with the United States.

North Korea's military said Wednesday that it is considering operational measures to strike near the U.S. strategic military installations in Guam with its intermediate range ballistic missiles, South Korea's Yonhap News Agency reported. Donald Trump, meanwhile, is threatening "fire and fury" on North Korea.

The North's official Korean Central News Agency reported that the rogue nation's military may send a strong message that it can neutralize the U.S. military bases in Guam that house nuclear bombers and other key assets.

This photo taken on July 14, 2017 shows a child on a beach in Guam's capital Hagatna.(Photo: MAR-VIC CAGURANGAN, AFP/Getty Images)

How it will play out remains to be seen. But the world is watching intently as North Korea and the U.S. are standing virtually toe-to-toeagainst the backdrop of one of the world's most beautiful islands, home to some 163,000 people as of 2016.

Among the U.S. military installations on Guam is the sprawling Andersen Air Force Base, as well as Naval Base Guam. The island's positioning in the Pacific is considered a key strategic point for U.S. military planning and presence. At least 6,000 U.S. troops are stationed there.

Guam's residents are considered U.S. citizens, but Guam itself is a U.S. territory and not a state. Admiral Robert Willard said in 2010 that Guam "is the farthest west U.S. territory that we own. And, you know, this is part of our nation . . . Guam is vital."

According to Guam's online history:

"Guams unique culture derived from its original native inhabitants, the Chamorros, who were on Guam as early as 2,000 B.C. The proud Chamorro culture has survived and flourished to the present day and has been influenced and enriched over the centuries by the countless Pacific Islanders, Asians, Europeans, Mexicans and North American peoples who have visited, occupied, and immigrated to Guam."

Guam is part of the Marianas island group, which has a noted past in the annals of U.S. military history. One of Guam's neighbor islands in the Marianas, Tinian Island, was the launching point for the atomic bomb attacks against Hiroshima and Nagasaki in Japan at the end of World War II.

Tinian, easy to supply by sea and perfect for launching air attacks against Japan, was desired by the U.S. military because of its key strategic importance, according to the Atomic Heritage Foundation. The proximity of the Marianas to North Korea -- and its history as a launching point for long-range bomb runs in Asia -- is a likely reason that the North Korean military has taken an interest in Guam.

Guam has had more than its share of international headlines this week. News of nearly 100 sex abuse lawsuits against Catholic priests have shaken the island.

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Guam: Island paradise turned ballistic target - USA TODAY

The Faroe Islands may get their own constitution – The Economist

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The Faroe Islands may get their own constitution - The Economist

For endurance athletes worth their salt, Casco Bay Islands SwimRun ‘a whole different type of challenge’ – Press Herald

Jeff Small of Scarborough took his boat out Tuesday afternoon, puttering about the islands of Casco Bay, considering tides and currents and what conditions might be like Sunday morning.

Thats when Small and his sister, Angela Bancroft, plan to swim between and run over nine islands in the second annual Casco Bay Islands SwimRun competition. Theyll cover nearly 5 miles in the water and another 14 on land, starting on Cliff Island and finishing on Peaks.

Its something different, said Small, 44, who raced with Zack Priest of Cumberland last year in the mens division. I think I was a little more excited about it than he was.

Small and Bancroft are triathletes who grew up as competitive swimmers in Cape Elizabeth. Bancroft, who lives in Paris and has three kids in the Oxford Hills school system, couldnt take part in last years inaugural SwimRun race because of an Ironman Triathlon race in Mont-Tremblant, Quebec.

This is a whole different type of challenge, said Bancroft, 47. Its a completely different type of racing, yet still hard, and to do something like that with my brother should be pretty fun.

The idea of racing through an archipelago sprang from a bar bet in Sweden in 2002. Four years later, two guys turned the thing into a commercial race and now theres an entire series, mainly in Europe but spreading. Casco Bay hosts the only island-to-island event in North America, although there are swim/run races centered around lakes.

Jeff Cole, a triathlete from Kennebunk, read about Otillo (Swedish for island to island) in Outside magazine and checked out video on YouTube. He called a friend in Texas who is passionate about endurance sports, and it turned out the friend already had competed in the Otillo world championship race in Stockholm.

We need to bring this to North America, Cole told his buddy, Lars Finanger, and they became co-directors of the Casco Bay race, which involved about four miles of swimming and 10 of scampering over islands. They chose the Travis Mills Foundation, which benefits combat-injured veterans, as their charity and donated $10,000 last August.

Were hoping we can do more this year, said Cole, who makes his living as an insurance broker.

The feedback they received from the inaugural race?

Make it longer.

So we have, Cole said. Within that long course race weve embedded the short course to attract people who might want to give it a try.

Last years race included 122 teams of two in three divisions (mens, womens and mixed). Entry fees this year were $750 and $550 per team, and Cole expects about 85 pairs for each race.

The long course, which starts on Cliff Island, involves nearly 5 miles of swimming and 14 miles of running. The short course, starting on Long Island, totals 2.3 miles of swimming and 6.7 miles of running.

Wetsuits, emergency whistles and compasses are mandatory. You can use a variety of gear, including hand paddles, swim fins and small flotation devices called pool buoys for your legs, but if you start with it you must finish with it.

Teammates must remain within 10 meters of each other at all times, so they use tethers about 10 feet long to remain together. They can unclip while they run.

Its unlike any other type of endurance competition were accustomed to seeing here in North America, Cole said. There are interesting social dynamics. Its not uncommon where one of them wants to bail out and the other one doesnt, and theyve got to work that out.

The longest swim is close to a mile across Hussey Sound from Long Island to Peaks. The longest run stretches more than 4 miles on Chebeague Island. While mapping the course last weekend, Cole came across youngsters who plan to set up a lemonade stand. He advised athletes to stick a few dollar bills in their wet suits because a glass of lemonade is going to taste mighty good.

Cole worked with private landowners and land trusts as well as island rescue personnel and the Coast Guard to put the race together, and is grateful to have their blessing.

We emphasize to no small degree to our athletes, he said, enjoy the natural environment but leave it in better shape than you found it.

Along the way are eight aid stations (five on the shorter course) for water and refueling. The longer course includes two checkpoints, at Fowlers Beach on Long Island and Torrington Point on Peaks. Competitors who havent reached them by a certain time are not allowed to continue.

John Stevens, who grew up on Little Diamond Island, and Matt Hurley, who grew up in Belfast, are the defending mens division champions, having completed the course in roughly 31/2 hours.

Last month they placed second and third in the Peaks to Portland Swim, separated by fewer than a second.

Were pretty well suited to doing this together, said Stevens, 38. Were definitely a little more aware of whats going to be thrown at us, but theres so many factors weather, tides, current that we really wont know what were up against until we get out there.

Nate Stevens, Johns brother, is competing in the Short Course race. Stevens and Hurley, 33, will be doing the Long Course.

Last year Stevens used paddles for the swim and Hurley did not. This year Stevens plans to add the pool buoy. They also will wear wet suits with zippers in front instead of the back so they can be opened up for the running portions.

We found we overheated, Stevens said.

Even with his lifelong knowledge of the islands, Stevens said he and Hurley got lost a few times in last years race and had to backtrack. Running through the Peaks Island Land Preserve can be incredibly tricky, he said.

Spectator ferries from Casco Bay Lines depart at 5:30 and 5:45 Sunday morning for the 7 a.m. starts. The Long Course begins on Cliff Island the Short Course on Long Island. They share a finish line on Peaks, near the ferry landing, so anyone on the later-morning ferries to Peaks can catch plenty of action.

When Stevens mentions the race to anyone, the reaction falls somewhere between a kind of disbelief that something like this exists to shock, he said.

If you talk to triathletes, they say, Wow, thats awesome, how do I get into that? If you talk to my mother, its Youre crazy.

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For endurance athletes worth their salt, Casco Bay Islands SwimRun 'a whole different type of challenge' - Press Herald

Spain’s Balearic Islands to fine illegal tourist rentals – Reuters

BARCELONA, Spain (Reuters) - Spain's Balearic Islands will from Tuesday penalize landlords for illegally renting apartments to tourists with fines of up to 40,000 euros ($47,228) amid a backlash against the effects of mass tourism across the country.

The move is an escalation in efforts to crack down on home-sharing sites such as Airbnb by city councils or local authorities in Spain, as concern mounts over the side-effects of their increasing popularity.

Airbnb, much like ride-hailing firm Uber, is facing a crackdown from legislators worldwide triggered in part by lobbying from the hotel industry which sees the rental service as unfair competition.

In the Balearic Islands, which drew more foreign visitors than any other region in Spain this June, rental costs have jumped and there are fears of a housing shortage for residents.

Rental prices in Palma de Mallorca, the Mediterranean archipelago's biggest city, have risen 40 percent in the last five years, according to property platform Mitula.

The island of Ibiza has the biggest density of Airbnb rentals, with a tourist apartment for every 30 residents, data from analytics firm Airdna showed.

Renting apartments without a licence was banned in the region in 2012 under a previous administration but enforcement was largely nonexistent, according to the Balearic government.

"We want balanced and sustainable tourism so that it can keep being our lead economic activity for many years to come," the region's tourism chief Biel Barcelo told Reuters.

The new legislation establishes fines of between 20,000 and 40,000 euros for those offering short rentals without a license to tourists.

Local residents will be able to report suspected illegal flats though a website, and online platforms such as Airbnb and Homeaway could also face fines of up to 400,000 euros if they are found to advertise rentals without a license number.

The Balearics' four islands will each have a year to decide if and where they will allow licensed tourist rentals to continue.

Airbnb said the new rules were complex and confusing as they did not distinguish between local families sharing their homes and professional operators running a business. It said it was ready to collaborate with the local authorities on establishing clearer regulation.

"By working together, we can help build sustainable tourism models that spread benefits to many - not keep them in the hands of a few," the firm said in an emailed statement.

Barcelona, in the northeastern Spanish region of Catalonia and another tourism magnet, has also introduced controls on tourist apartments and sought to fine Airbnb and Homeaway for advertising ones that are unlicensed.

Additional reporting by Madrid TV and Emily Lupton; Editing by Sarah White and Matthew Mpoke Bigg

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Spain's Balearic Islands to fine illegal tourist rentals - Reuters

Canary Island tourists warned to avoid toxic ‘sea sawdust’ algae – The Guardian

A picture taken with a drone shows a spot on the sea surface caused by micro-algae near Tabaiba beach, off the coast of El Rosario on the Spanish Canary island of Tenerife. Photograph: Desiree Martin/AFP/Getty Images

Tourists have been warned to avoid blooms of toxic micro-algae that have been proliferating in hot weather in the sea off Spains Canary Islands.

Tenerife in particular is awash with visitors at this time of year but some of those having a dip in the Atlantic ocean have come out scratching themselves after brushing up against the tiny algae.

The spreading algae have produced a greenish-brown hue in the waters off some beaches in the tourist haven.

Since the end of June we have seen episodes of massive efflorescence, or bloom, of microalgae, sometimes reaching as far as bathing beaches, said Jose Juan Aleman, director of public health for the Canaries.

The algae are a type of bacteria, trichodesmium erythraeum, also known as sea sawdust, said Aleman.

Its proliferation is a natural, temporary phenomenon which is going to disappear in due course, he added, suggesting global warming was helping the algae spread.

The bacterium contains a toxin which can lead to skin irritation, dermatitis, hence one must avoid coming into contact with it in the water and on the sand.

With the islands last year welcoming more than 13 million foreign tourists, local authorities were keen to reassure sun-seekers.

Generally it has not been necessary to close the beaches, said Aleman.

However, AFP found that several have been closed to swimmers over recent weeks, including the popular Teresitas beach at Santa Cruz de Tenerife.

Marta Sanson, professor of plant biology at Tenerifes La Laguna university, said that ideal conditions are allowing proliferation of these micro-algae.

Those include an increase in water temperature as well as a dust cloud sweeping in off the Sahara which is rich in iron, a nutrient which micro-organisms like.

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Canary Island tourists warned to avoid toxic 'sea sawdust' algae - The Guardian

Grant to compare large-scale genomic sequencing, standard clinical tests for childhood cancer patients – Baylor College of Medicine News (press…

Baylor College of Medicine is one of six U.S. institutions to receive a grant through the National Human Genome Research Institutes Clinical Sequencing Evidence-Generating Research Consortium, or CSER2. The four-year grant, including $2.8 million for fiscal year 2017, co-funded by the National Cancer Institute, will support Baylors new KidsCanSeq program that will compare the results of large-scale genomic testing, such as whole exome sequencing, to targeted clinical tests in childhood cancer patients at five sites across the state that serve a highly diverse patient population, including Texas Childrens Cancer Center.

In addition to Texas Childrens Cancer Center, pediatric patients will be enrolled in KidsCanSeq at the Vannie E. Cook Childrens Cancer Clinic in McAllen, the Childrens Hospital of San Antonio, the University of Texas Health Science Center at San Antonio, and Cook Childrens Health Care System in Fort Worth.

KidsCanSeq follows the Baylor Advancing Sequencing in Childhood Cancer Care(BASIC3) study at Baylor and Texas Childrens Cancer Center, which developed the initial protocols for performing clinical genomic testing of pediatric cancer patients, reporting results and communicating those results to families and oncologists. BASIC3 was part of the NHGRI Clinical Sequencing Exploratory Research program, a precursor to CSER2.

Through BASIC3 we explored broad questions, such as whether we could conduct large-scale genomic testing in a clinical setting, what kind of results it would generate, and how to communicate the results to families and physicians. KidsCanSeq is focused more on generating specific data on what tests are better or worse than standard tests in pediatric cancer patients, said the studys principal investigator Dr. Sharon Plon, professor of pediatrics and of molecular and human genetics at Baylor and director of the Cancer Genetics Clinical and Research Programs at Texas Childrens Hospital.

BASIC3 was essentially a pilot study, and now that we have a better idea of how to implement broad-scale genetic testing in the clinic, we can focus this study more specifically on determining which patients would be most likely to benefit from it or for whom it would be most likely to impact care, said Dr. Will Parsons, co-principal investigator and associate professor of pediatrics at Baylor and Texas Childrens Cancer Center. For example, tumor sequencing of cancer types for which kids are almost always cured at the time of diagnosis is not likely to be as useful as for high-risk and relapsed cancers.

KidsCanSeq will strive to answer questions such as how effective is a germline and tumor panel of approximately 150 to 200 genes at picking up hereditary genetic factors and tumor-specific actionable information compared with larger scale tests, like whole exome sequencing, which evaluates thousands of genes. Specifically, the study will compare the targeted cancer panel to whole exome sequencing of a blood sample of all enrolled childhood cancer patients to find hereditary factors and to whole exome sequencing, transcriptome sequencing and copy number array of tumor samples for the subset of patients with high-risk or relapsed tumors to find mutations that might guide treatment. This comprehensive set of genomic tests will be performed by a unique collaboration between multiple diagnostic facilities with the involvement of Dr. Richard Gibbs, director of the Human Genome Sequencing Center, Drs. Christine Eng and Shashikant Kulkarni, professors of molecular and human genetics, all of Baylor, and Dr. Angshumoy Roy, assistant professor of pathology & immunology at Baylor and Texas Childrens Hospital.

The program, in which about 900 patients are expected to be enrolled over four years, also will include parent and doctor surveys to determine what they found most useful from the testing as well as the development of video and other educational materials in both English and Spanish. Understanding differences among families from different ethnic or racial backgrounds as well as in different healthcare settings, including large academic medical centers versus smaller clinical settings, also is a goal of KidsCanSeq.

Dr. Amy McGuire, Leon Jaworski Professor of Biomedical Ethics and director of the Center for Medical Ethics and Health Policy at Baylor, also is co-principal investigator of the study. She will investigate the ethics and utility of genomic testing for pediatric cancer patients.

It is important to study the clinical and psychosocial risks and benefits of any new technology in order to plan for its responsible use, McGuire said. We also want to make sure the infrastructure is in place so that oncologists in non-academic settings can understand, effectively communicate and appropriately manage the results of germline and tumor whole exome sequencing.

Specific aims of the KidsCanSeq study include:

Assess the clinical utility of large-scale genomic testing by measuring the frequency of diagnostic and/or actionable germline (blood) and tumor findings and the effect on treatment decisions Compare uptake by first-degree relatives for familial genetic testing and recommended cancer surveillance by race, ethnicity and clinical settings. Describe perceived utility of large scale testing by surveying and interviewing parents and participating pediatric oncologists. Work with pediatric cancer stakeholders, including advocates, BASIC3 study parents and national organizations, to create and evaluate the use of culturally sensitive educational materials, including videos in English and Spanish, improved integrated genomic test reports and counseling materials, and compare in-person versus telemedicine exome results disclosure. Provide data to guide future application of clinical genomics through three innovative pilot projects focused on health economics, decision support for cancer surveillance and whole genome sequencing.

Drs. Plon, Parsons and McGuire all are members of the NCI-designated Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine.

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Grant to compare large-scale genomic sequencing, standard clinical tests for childhood cancer patients - Baylor College of Medicine News (press...

‘May you die in pain’: Another GOP lawmaker grilled at health-care town hall – Washington Post

Rep. Doug LaMalfa (R-Calif.) held a contentious town hall in Chico, Calif., on Aug. 7. (Nolan Ford/North State Public Radio)

The people of Californias 1st Congressional District made their congressman see red Monday morning.

Like other Republican lawmakers before him, Rep. Doug LaMalfa (Calif.) held a town hall on the ongoing health-care debate and the effort, led by President Trump and the GOP, to repeal and replace the Affordable Care Act.

And like some of his colleagues, LaMalfa was met with boos, catcalls and verbal barbs shouted from the 400-person-strong audience at the Chico Elks Lodge in Northern California, recorded on video and audio by North State Public Radio.

It was the most recent of a declining number of health-care-focused town hall meetings charged byemotional pleas and debates between constituents and their representatives, meetings that have sparked anxiety among GOP lawmakers heading home to face tough questions.

The audience was armed with blunt questions, harsh comments and red placards they used to signal their disapproval of audience queries or LaMalfas responses. Green cards were used to show approval.

LaMalfa saw his fair share of red over his responses. He did not help himself, occasionally veering into sarcasm over concerns ranging from health care to climate change.

[To hold a town hall or not? Its a lose-lose situation for many Republicans right now.]

Out of a sea of moments threatening to boil over, one stood out as particularly tense.

I think that your vote to throw 22 million people off of health is reprehensible and in the service of the rich, a resident told LaMalfa on his efforts to defund Planned Parenthood.

I hope you suffer the same painful fate as those millions that you have voted to remove health care from. May you die in pain, he added.

The comments drew a stream of groans from the audience in a rare moment of sympathy for LaMalfa.

We pray for our constituents too, sir, LaMalfa, who took office in 2013, quickly countered.

Once dotted on Republican lawmakers schedules early in the Trump administration,town halls in VFW halls, rotary clubs and school gyms have become flash points of partisan politics, where local activists marshaledopposition against conservativeleaders in the months leading up to Julys vote, when the Senate rejected a partial repeal of Obamacare.

Town halls have become a damned-if-you-do, damned-if-you-dont situation for GOP lawmakers hoping to sell their message to voters, some in reliably red districts where constituents have used new health-care laws to their advantage, such as receiving coverage for preexisting conditions.

[GOP lawmakers wouldnt come to a town hall so voters brought literal empty suits]

Some lawmakers have refused to hold the meetings. Others have prescreened participants in the hopes of excluding activists who do not live in their districts. That decision has drawn fire.

Even when you had the conservative outrage over Obamacare, I dont recall anyone trying to preselect attendance. The unwillingness to take criticism or any heat from a legislative decision is really unusual,Norm Ornstein, a congressional ethics expert, told The Washington Post in May.

Videos and tweets from events have gone viral, prompting Congress to slow the pace of town halls in recent months. Over the July 4 recess, only three GOP senators announced decisions to hold town halls. Sens. Ted Cruz (Tex.), Jerry Moran (Kan.) and Bill Cassidy (La.) all voiced concern over the health-care bill. Only Cassidy broke ranks to vote against the full repeal-and-replace measure.

LaMalfas district is comfortably red. He cruised to his last victory by 15 percentage points, and Trump soundly defeated Hillary Clinton in the presidential election there.And for his part, LaMalfa has held other town halls recently, with one each in March and April, according to the Los Angeles Times. LaMalfa spokesman Parker Williams told The Post that he plans to hold more town halls in the coming weeks and months.

I think things went about as well as could be expected, given the high emotions in our country at present, Williams said, calling the town hall alargely cordial and productive conversation.

[A town hall in Kansas shows Republican struggles with health-care bill]

Mondays meeting might be a test case in how to manage a crowd. As the audience appeared to get agitatedduring LaMalfas meandering explanation of Medicaid costs, he stopped to address the civility of the participants.

Ive got the mic, folks, okay? If we want to have a positive interaction, if you want to do any more of these, then we need to have LaMalfa said, before being cut off by boos, hisses and laughter among audience members who appeared to take his tone as a condescending lecture. Scores of red cards waved back and forth.

The districts voters have also watched LaMalfas voting record to roll back environmental regulations.

A Chico woman who identified herself as Barbara Richman told LaMalfa that 50 years ago, she could see uninterrupted views of Mount Shasta, a towering nearby volcano buttressed by glaciers. Those views are now filled with haze, she said.

Unlike what you have said, mankind is playing some role in this, she said.

LaMalfa took aim at regulations in response.

Indeed, mankind is preventing forest management that keeps our forests from burning.

He barely finished the sentence. Boos erupted, and red cards shot up.

Iowa congressman walks out of a TV interview and into an angry town hall meeting

A Republican senator defended Betsy DeVos at a town hall. Boos drowned her out.

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'May you die in pain': Another GOP lawmaker grilled at health-care town hall - Washington Post

The GOP’s Monstrous Health Care Fail Might Just Have Saved the Party – POLITICO Magazine

Saul Loeb/AFP/Getty Images

Politics

By MATT LATIMER

August 08, 2017

Its easy these days to disparage President Donald Trumps instinctshow, after all, could he get rid of The Mooch, easily the best character on his reality TV show? But there is one thing the president was right about from the start: The Republican Party probably should have left Obamacare repeal well enough alone. At least, that is, until the party had gotten its act together.

When the president decided to go against his instincts and support Obamacare repeal, he was thinking undoubtedly what pretty much everyone who didnt live and work in Washington, D.C., thought: that members of Congress did have their act together. That those who voted over and over again to repeal Obamacare in meaningless show votes would actually repeal it when they had their first real chance. That a party vowing to swiftly enact a plan to replace Obamacare once in full control of Congress would have an actual replacement plan in mind. That when an ailing Senator John McCain was flown in to cast a decisive vote on the bill, the decision would have worked in Republicans favor instead of leaving them at the receiving end of a bracing censure. Or that when Senator Lisa Murkowski voted in favor of allowing debate on Obamacare repeal and replacement, she wouldnt then vote no on every method to accomplish it. Who is running strategy now? Jamie Lannister.

Story Continued Below

And yet, ironically, the GOPs complete, even historic, ineptitude has managed to work in the partys favoras the president might saybig league. Quite unbelievably, the party has an opportunity to emerge in a better position from this mess. Of course, its hard to argue that a GOP-led Congress, currently with an approval rating even lower than that of O.J. Ive lived a conflict-free life Simpson, can do much worse.

First, lets give the president his due: From the earliest days of the administration, perhaps sensing Washingtons love affair with inertia, Trump called for letting Obamacare fail on its own. One might strongly disagree with various methods that might lead to this failuresuch as refusing to shore up wobbling health care marketsbut his point, from a political perspective at least, was valid. If the federal government is to enact something as sweeping and controversial as a total rewrite of Americas health care policy, a sense of national crisis is essential. Over the past few months, the crisis mentality worked against the Republicansbecause Americans were convinced that the crisis was Republicans trying to take away something theyve been given (such as one of Obamacares most popular provisionsprotection for pre-existing conditions). Voters tend not to like losing things they think theyve gained. This explains in part why Obamacare, which has dragged down the Democratic Party through multiple election cycles, is suddenly more popular than ever.

Yet it is astonishing how determined Republicans seem to have been to replicate the very process that led to Obamacares enactment in the first place. For the past several election cycles, the consistent GOP complaint, after all, was that the villainous Obamacare was a rushed law, cobbled together in secret and passed without a single vote from the other party. If anything, this years Republican effort was more rushed, more secret and far less popular. According to one congressional historian, Trumpcare, as the House plan was called, was the most unpopular bill contemplated by Congress in at least three decades (and there were some doozies over that period, let me remind you.)

Indeed, the Republicans missed the most important lesson of Obamacare: Because the law passed without a single Republican vote in the House or the Senate, all of Obamacares miscues or early, inevitable missteps fell on one party. And one party alone. At least one study, and there are others, found that those Democrats who voted for Obamacares passage lost an average of about 6 points in polls, costing Democrats 66 House seats in 2010 alone.

Had Congress actually passed an Obamacare replacement law, with a bare majority of votes, loved by nearly no one, endlessly assailed by the new media, its consequences would be the GOPs to bear. And unless the health care of Americans vastly improved, premiums magically went down, and editorial writers across the country suddenly proclaimed they had been wrong and that Trumpcare was the elixir we needed after all, the GOP would pay an ugly price. When Obamacare was passed, Republicans warned about death panels determining whether patients lived or died. If Trumpcare had passed, the death panels could have been applied to their own political future. Having escaped that fate by the thinnest of margins, the GOP now has an opportunity to turn things around. How would they do this? Through an approach that has become increasingly un-Washingtonlike in recent years: focusing on what that people actually want and, heres the real surprise, giving it to them.

So what does the GOP do now?

First, the Republican Congress can show Americans that it knows how to run a railroad, so to speak, by actually fixing railroads. And bridges. And highways. Oh, and the tax code. You know, things that are popular, needed, and just might get at least a handful of the Democrats to pick up a phone call from the White House every once in a while.

Second, if elected Republicans truly want to enact a massive rewrite of the health care system (and lets be honest, many dont), then they need to wait for a new health care crisis to develop. This will come. And soon. Americas health care system, as it is currently structured, is unsustainable. Premiums will continue to rise. Insurers will continue to shut down operations in various locales. There will continue to be complaints and horror stories from governors and mayors about the toll being taken on their communities. Only when there is a mass consensus that something sweeping needs to be done to fix the system will Congress find the fortitude to act. And at that point, you might at least get help from a Democrat or two. If Obamacare taught anything to anyone in Washingtona city allergic to lessonsbipartisan buy-in, no matter how minimal, is crucial.

Until then, Obamacare is more secure than ever. That, ironically, may turn out to be the biggest legacy of the largest Republican congressional majority in nearly 90 years. If they dont start getting something meaningful accomplished soon, it may be their only legacy.

Matt Latimer is a former speechwriter for President George W. Bush. He is currently a co-partner in Javelin, a literary agency and communications firm based in Alexandria, andcontributing editor at Politico Magazine.

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The GOP's Monstrous Health Care Fail Might Just Have Saved the Party - POLITICO Magazine

Tom Price: ‘Healthcare challenge is not dead’ – Washington Examiner

Health and Human Services Secretary Tom Price indicated Tuesday that the Trump administration still believes Congress should act on healthcare.

Republicans in Congress failed in late July to pass a healthcare bill that would repeal and replace portions of Obamacare. Though the administration pressed them to continue the effort, Senate leaders have said they are prepared to move on to other priorities. They are expected to hold bipartisan hearings in September aimed at stabilizing the exchanges where people can buy tax-subsidized coverage, but divisions already have emerged over which approaches might receive bipartisan support.

Price made the statements after conducting a press briefing in Bedminster, N.J., on the opioid epidemic. When he was finished with his remarks, reporters asked him about planned cuts to Medicaid in the Senate healthcare bill, which advocates have decried as counterproductive to tackling the opioid epidemic.

"Nobody is interested in cutting Medicaid," Price said. "The fact of the matter is that the president's budget and the proposals that were before Congress were an effort to try to secure and make a Medicaid system work for patients. That's the goal we had."

One version of the Senate healthcare bill aimed to tie the growth in Medicaid spending to the standard rate of inflation, rather than to medical inflation, which is higher. The Congressional Budget Office estimated that the change, which would be scheduled to go into effect in 2025, would result in cuts to the program of $770 billion over a decade. The plan also would have rolled back Obamacare's Medicaid expansion, which covered low-income people, beginning in 2021.

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Tom Price: 'Healthcare challenge is not dead' - Washington Examiner

Large employers say health plans will cost more than $14000 for an employee in 2018 – Washington Post

Large employers say the cost of health-care plans will grow 5 percent next year, to an average cost of more than $14,000 per employee. The increases, reported in a new survey of 148 large companies, were attributed largely to expensive specialty drugs and individuals with high medical costs.

The average 5 percent hike is modest in comparison to thedouble-digit premium increasesthat insurers that sell plans in the Affordable Care Act marketplaces have been requesting, citingthe financial challenges of the marketplace and threats by the White House to discontinue federal subsidies.

"Its the fifth year in a row that employers are saying their costs will rise 5 percent. Its not great, because it's still multiples ofwage increases and general inflation ... but its not the volatility youre seeing in the public exchanges," said Brian Marcotte, president of the National Business Group on Health, a nonprofit organization whose members are large employers, including 73 Fortune 100 companies.

According to the survey, employers will shoulder approximately 70 percent of those health costs, leaving employees on the hook for an average of $4,400, through premiums, out-of-pocket costs and contributions to health savings accounts.

The survey found that an ongoing shift toward high-deductible plans will continue, with 40 percent of employers offering one as the only plan option next year -- an increase from last year. Nearly all employers -- 90 percent -- will offer at least one high-deductible plan in 2018.

The average deductible in such a plan was $1,500 for an individual and $3,250 for a family, although the employer often makes a contribution to a health savings account that significantly reduces the cost to individuals.

Marcotte said that much of the current debate over health care has been about the question of access: whether people have health insurance.

In the employer-sponsored health plan world, where there is greater stability, the focus islargely on containing costs. Companies areincreasing their use of cheaper telemedicine consults, with nearly all employers offering plans that allow phone and videoconferencing with doctors if it is allowed in their state. More employers are opening on-site health centers. There's also a growing push toward health plansthat reward employees for activities that result in more efficient care, such as reduced premiums when they actively manage chronic diseases.

Not all cost-containment efforts may succeed. A study by the Rand Corp.found that,instead of replacing visits that would have otherwise taken place in person, most telemedicine consults were new utilization -- made up of complaints that would never have triggered a visit to the doctor. The ease of picking up the phone could thus increase the use of health-care resources; the researchers found that yearly spending on acute respiratory illness increased by $45 per user.

An emerging concern for employers is the cost of specialty drugs, expensive medications that can cost thousands or tens of thousands of dollars a month. A quarter of employers cited specialty drugcosts as the biggest driver of spending in 2017, and 80 percent ranked it in the top three contributors to rising costs. In contrast, three years ago only 6 percent of employers cited it as the major contributor to high spending.

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Large employers say health plans will cost more than $14000 for an employee in 2018 - Washington Post

Why Tenet Healthcare Shares Dropped 14.4% Today – Motley Fool

What happened

After reporting second-quarter earnings and offering up guidance for 2017, shares ofTenet Healthcare(NYSE:THC) have fallen 14.6% as of 2:30 p.m. EDT on Tuesday.

Tenet Healthcare's year-over-year same-hospital patient revenue improved 0.4% as a 1.9% increase in revenue per adjusted admission was largely offset by a 1.4% drop in adjusted admissions. Tenet Healthcare also reported that bad-debt expense increased over the period as more uninsured patients sought out care.

IMAGE SOURCE: GETTY IMAGES.

Overall, the company's net revenue declined 1.4% in the quarter, to $4.8 billion, and its net loss expanded 19.6%, to 55 million, or $0.55 per share. On an adjusted basis, the net loss per share was $0.17. The company's top and bottom line was shy of what industry watchers were expecting.

In terms of uncompensated care expenses, those costs increased 13.6% year over year, to $1.375 billion.

The poor quarterly performance led management to adjust its full-year forecast lower. It now expects full-year revenue of between $19.1 billion to $19.4 billion and a net loss of between $90 million to $115 million. On an adjusted basis, the company is forecasting earnings per share (EPS) of between $0.69 to $0.99, a wide range that reflects a lot of uncertainty in the marketplace. Previously, Tenet was guiding for revenue of at least $19.7 billion and adjusted EPS of at least $1.05.

The lower expectations do little to add confidence to investors that Tenet Healthcare is turning a corner, and that's particularly a problem because decisions in Washington, D.C. could result in more people canceling their health insurance. Until Tenet Healthcare demonstrates that it's right-sized itself, and uncertainty surrounding health insurance markets is resolved, there are probably better investments to make.

Todd Campbell has no position in any stocks mentioned. His clients may have positions in the companies mentioned.The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.

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Why Tenet Healthcare Shares Dropped 14.4% Today - Motley Fool

Blue Cross names top federal health care official as CEO – WRAL.com

Durham, N.C. Blue Cross Blue Shield of North Carolina on Tuesday named a top official in the federal Centers of Medicare and Medicaid Services as the company's next president and chief executive.

Dr. Patrick Conway will start at Blue Cross on Oct. 1, succeeding Brad Wilson, who announced in February he would retire late this year after seven years in charge of North Carolina's largest health insurer.

Conway is deputy administrator for innovation and quality at CMS the most senior non-political executive at the agency and director of the Center for Medicare and Medicaid Innovation. He is one of the driving forces behind the national movement to value-based care, with health care payments tied to quality and innovation.

"Dr. Conway is a national and international leader in health system transformation, quality and innovation," Frank Holding Jr., chairman of Blue Cross' Board of Trustees, said in a statement. "His unique experiences as a health care provider and as a leader of the worlds largest health care payer will help Blue Cross NC fulfill its mission to improve the health and well-being of our customers and communities."

A practicing pediatric hospitalist, Conway joined CMS in 2011 as chief medical officer. He previously oversaw clinical operations and research at Cincinnati Childrens Hospital Medical Center. He was elected to the National Academy of Medicine Institute of Medicine in 2014 and has received the Presidents Distinguished Senior Executive Rank and HHS Secretarys Distinguished Service awards.

He earned a bachelor's degree from Texas A&M University, graduated from Baylor College of Medicine and completed a pediatrics residency at Harvard Medical School's Children's Hospital Boston.

"Blue Cross NCs role in transforming the health care system in North Carolina is a model that other plans aspire to and that I want to work with the Blue Cross NC team to further improve," Conway said in a statement. "I look forward to collaborating with Blue Cross NC employees, health care providers and employers to deliver the best health outcomes and best service experience at the lowest cost for our customers."

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Blue Cross names top federal health care official as CEO - WRAL.com

Trump’s health care antics carry consequences for consumers – MSNBC


MSNBC
Trump's health care antics carry consequences for consumers
MSNBC
The pattern is familiar: the public learns of discouraging news about the health care system; the right seizes on the news as evidence against the Affordable Care Act; and a closer look at the news shows the developments are less about Obamacare and ...
Report: Healthcare failure costs Senate Republicans $2M in donationsThe Hill
How to Compromise on Health CareBloomberg
GOP donors withhold $2 million amid Senate failure on health plan, sources sayCNN International
ABC News
all 156 news articles »

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Trump's health care antics carry consequences for consumers - MSNBC

Can Scans Predict Some Autism Cases? – Sioux City Journal

TUESDAY, Aug. 8, 2017 (HealthDay News) -- People with a particular genetic cause of autism show structural abnormalities in the brain that are readily detected with noninvasive imaging, according to a new study.

Using MRI brain scans, researchers found clear brain structure abnormalities in people with autism caused, in part, by defects in chromosome 16.

Those MRI findings were, in turn, related to particular impairments, such as problems with communication and social skills.

It all suggests that brain imaging could one day be used to spot young children most in need of therapy for an autism spectrum disorder, the study authors said. It's estimated that one in 68 U.S. children is "on the spectrum," and symptoms usually appear early in life.

The study included 158 people who carried either of two defects in chromosome 16 that raise the risk of autism.

The flaws are found in a small piece of the chromosome known as p11.2. In some cases, people are missing the p11.2 portion -- which is known as a deletion. In other cases, there is an extra copy of it (known as a duplication).

Together, the defects are thought to contribute to less than 1 percent of all autism cases, said Dr. Elliott Sherr, the senior researcher on the study.

Sherr's team found that p11.2 deletions and duplications were each linked to specific brain structure abnormalities that were visible on MRI.

People with a deletion had excess tissue near the brain stem, and a thick, abnormally shaped corpus callosum -- a bundle of fibers that connects the left and right sides of the brain.

In contrast, people with a p11.2 duplication had a thin corpus callosum and "undergrowth" in certain other areas of brain tissue.

"Their brains look very different," said Sherr, a professor of neurology at the University of California, San Francisco.

And those structural abnormalities appear to correlate with different types of impairments, the study found.

The MRI findings in deletion carriers were tied to problems with communication and social skills. Meanwhile, the findings in duplication carriers were linked to lower IQ scores and problems with verbal skills.

What does it all mean? It's not clear yet, Sherr said.

"What we can say is, there's a strong link between these anatomical features of the brain and people's behavior," he said.

In general, people with p11.2 deletions or duplications have "intellectual challenges," such as lower-than-normal IQ, Sherr explained.

But they do not all develop autism, he said. The risk is thought to be 20 to 25 percent.

The current findings, Sherr said, raise the question of whether MRI could help identify young children likely to need therapy for autism.

First, though, important questions would need to be answered, he noted.

The current findings are based on one-time brain scans of people who ranged in age from 1 to 63 years. So it's not clear whether the MRI findings predict future impairments in people who carry the p11.2 abnormalities.

"We'd like to find out whether we can see these brain changes early in development," Sherr said. "And if we do see them, do they point to the risk of developmental challenges later on?"

Thomas Frazier is chief science officer for the nonprofit Autism Speaks.

He said studies like this are important because they help reveal the biology underlying autism.

"And that might point us to new therapies," Frazier said.

In general, experts believe that autism arises from a perfect storm of conditions. A child has some type of genetic vulnerability, then is exposed to one or more environmental factors during early development that, together, lead to autism.

At this point, Frazier said, researchers have found nearly 100 genes believed to contribute to autism risk.

Some genetic flaws -- like the chromosome 16 defects -- have a "major effect," Frazier said. But they, alone, are still not enough to cause autism.

If researchers can figure out why certain people with chromosome 16 defects develop autism, Frazier said, that could give insight into autism more generally.

As it stands, the chromosome 16 abnormalities are detected only if genetic tests are done after an autism diagnosis has been made based on behavior, Frazier said.

Still, researchers are interested in whether MRI can be used to "predict" autism risk in certain young children, Frazier said.

One recent study focused on babies who were at heightened risk because a sibling had autism. It found that early brain differences did show up on MRI, and accurately predicted a future autism diagnosis 80 percent of the time.

But, Frazier said, more work is needed to verify those findings.

The new study was published online Aug. 8 in the journal Radiology.

The U.S. National Institute of Neurological Disorders and Stroke has more on autism.

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Can Scans Predict Some Autism Cases? - Sioux City Journal

Ohio State researchers report breakthrough in cell regeneration – The Columbus Dispatch

JoAnne Viviano The Columbus Dispatch @JoAnneViviano

In what researchers consider a major scientific leap, a team at Ohio State University has discovered a new way of turning skin cells into any type of cells the body might need, a technology that has limitless potential, from regenerating a wounded limb to repairing a brain after stroke to healing a damaged heart.

The process involves placing a square chip about the size of a fingernail on the skin, adding a droplet containing genetic code, and zapping it with an energy source.

While it hasn't been used in humans yet, the process was used in animals to healbrains after stroke and to generate blood vessels in legs wherethe femoral artery, the limbs major blood supply, had been cut, said Chandan Sen, the director of the Center for Regenerative Medicine and Cell-Based Therapies at Ohio State's Wexner Medical Center.

In leg experiments involving mice, researchers placed the chip on the animals' wounded legs, delivered the appropriate genetic material, and saw blood vessels grown to regenerate limbs within seven to 14 days, Sen said. Legs that otherwise would have turned black and required amputation were pink, and the mice were able to run again.

In brain experiments on mice, the chip was again placed on the leg, different genetic material was dropped on, and neurological cells grew in the area. Three weeks later, scientists detected firing neurons, and the new cells were taken from the leg and inserted into the brain.

The leg-healing process was duplicated in pigs after the Walter Reed National Military Medical Center in Bethesda, Maryland, expressed interest. Sen said the technology could be used to heal troops in the field. One caveat: It must be deployed within 72 hours of a limb being damaged.

Twenty-six Ohio State researchers from the fields of engineering, science and medicine worked together to make the technology a reality.

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The discovery could have countless applications across various medical disciplines, Sen said. He's hopeful other researchers will help stretch the impact of the device.

"There are many smart minds throughout the country and the world that will take this and run," Sen said.

Sen expects that human trials will come soon, after a letter on the research is published Monday in the Nature Nanotechnology journal, a peer-reviewed scientificpublication.The research was led by Sen and L. James Lee, professor of chemical and biomolecular engineering in Ohio States College of Engineering.

Sen said it takes less than a second to deliver the genetic code that spurs the skin cells to switch to something else, then several days for new cells to grow.

The equipment needed can fit in a pocket. And the process can be done anywhere; no lab or hospital is needed.

The black chip, made of silicon, acts as a carrier for the genetic code.

"Its like a syringe thats the chip but then what you load in the syringe is your cargo," Sen explained. "Based on what you intend the cells to be, the cargo will change. So if you want a vasculogenic (blood vessel) cell, the code would be different than if you wanted a neuro cell, and so on and so forth."

The genetic code is synthetically made to mirror code from the patient.

The electric field pulls the genetic material into the skin cells.

Because the research project had a high risk of failure, and because Ohio State wanted to keep it close to the vest, public money was not sought, Sen said. Instead it was funded by university and philanthropic money from Leslie and Abigail Wexner, Ohio States Center for Regenerative Medicine and Cell-Based Therapies, and the universitys Nanoscale Science and Engineering Center.

Approval from the federal Food and Drug Administration is required before Sen, Lee and the research team can try the technique in humans. He expects to get that approval and prove human feasibility within a year. Sen's hopeful that "the floodgates will open" and then thetechnology will be used widely within five years.

The chips are already being manufactured locally due to an assist from the Rev1 Ventures business incubator on the Northwest Side, and the technology has gained interest from Taiwan-based Foxconn Technology Group.

Lee called the concept very simple and said he was surprised by how well it worked.

He had developed similar technology prior to 2011, but it only worked on individual cells and only in processes separate from the body. Since then, he said, many researchers and companies have approached him to come up with a system that worked on tissue in the body.

"More and more people said, 'This technology can be very, very powerful if you can do tissue,'" he said. "It turns out that it works. It was very surprising."

This version, he said, is a very significant advancement and is "much, much more useful for the medical applications."

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Ohio State researchers report breakthrough in cell regeneration - The Columbus Dispatch

A Chip That Reprograms Cells Helps Healing, At Least In Mice – NPR

The chip has not been tested in humans, but it has been used to heal wounds in mice. Wexner Medical Center/The Ohio State University hide caption

The chip has not been tested in humans, but it has been used to heal wounds in mice.

Scientists have created an electronic wafer that reprogrammed damaged skin cells on a mouse's leg to grow new blood vessels and help a wound heal.

One day, creator Chandan Sen hopes, it could be used to be used to treat wounds on humans. But that day is a long way off as are many other regeneration technologies in the works. Like Sen, some scientists have begun trying to directly reprogram one cell type into another for healing, while others are attempting to build organs or tissues from stem cells and organ-shaped scaffolding.

But other scientists have greeted Sen's mouse experiment, published in Nature Nanotechnology on Monday, with extreme skepticism. "My impression is that there's a lot of hyperbole here," says Sean Morrison, a stem cell researcher at the University of Texas Southwestern Medical Center. "The idea you can [reprogram] a limited number of cells in the skin and improve blood flow to an entire limb I think it's a pretty fantastic claim. I find it hard to believe."

When the device is placed on live skin and activated, it sends a small electrical pulse onto the skin cells' membrane, which opens a tiny window on the cell surface. "It's about 2 percent of the cell membrane," says Sen, who is a researcher in regenerative medicine at Ohio State University. Then, using a microscopic chute, the chip shoots new genetic code through that window and into the cell where it can begin reprogramming the cell for a new fate.

Sen says the whole process takes less than 0.1 seconds and can reprogram the cells resting underneath the device, which is about the size of a big toenail. The best part is that it's able to successfully deliver its genetic payload almost 100 percent of the time, he says. "No other gene delivery technique can deliver over 98 percent efficiency. That is our triumph."

Chandan Sen, a researcher at Ohio State University, holds a chip his lab created that has reprogrammed cells in mice. Wexner Medical Center/The Ohio State University hide caption

Chandan Sen, a researcher at Ohio State University, holds a chip his lab created that has reprogrammed cells in mice.

To test the device's healing capabilities, Sen and his colleagues took a few mice with damaged leg arteries and placed the chip on the skin near the damaged artery. That reprogrammed a centimeter or two of skin to turn into blood vessel cells. Sen says the cells that received the reprogramming genes actually started replicating the reprogramming code that the researchers originally inserted in the chip, repackaging it and sending it out to other nearby cells. And that initiated the growth of a new network of blood vessels in the leg that replaced the function of the original, damaged artery, the researchers say. "Not only did we make new cells, but those cells reorganized to make functional blood vessels that plumb with the existing vasculature and carry blood," Sen says. That was enough for the leg to fully recover. Injured mice that didn't get the chip never healed.

When the researchers used the chip on healthy legs, no new blood vessels formed. Sen says because injured mouse legs were was able to incorporate the chip's reprogramming code into the ongoing attempt to heal.

That idea hasn't quite been accepted by other researchers, however. "It's just a hand waving argument," Morrison says. "It could be true, but there's no evidence that reprogramming works differently in an injured tissue versus a non-injured tissue."

What's more, the role of exosomes, the vesicles that supposedly transmit the reprogramming command to other cells, has been contentious in medical science. "There are all manners of claims of these vesicles. It's not clear what these things are, and if it's a real biological process or if it's debris," Morrison says. "In my lab, we would want to do a lot more characterization of these exosomes before we make any claims like this."

Sen says that the theory that introduced reprogramming code from the chip or any other gene delivery method does need more work, but he isn't deterred by the criticism. "This clearly is a new conceptual development, and skepticism is understandable," he says. But he is steadfast in his confidence about the role of reprogrammed exosomes. When the researchers extracted the vesicles and injected them into skin cells in the lab, Sen says those cells converted into blood vessel cells in the petri dish. "I believe this is definitive evidence supporting that [these exosomes] may induce cell conversion."

Even if the device works as well as Sen and his colleagues hope it does, they only tested it on mice. Repairing deeper injuries, like vital organ damage, would also require inserting the chip into the body to reach the wound site. It has a long way to go before it can ever be considered for use on humans. Right now, scientists can only directly reprogram adult cells into a limited selection of other cell types like muscle, neurons and blood vessel cells. It'll be many years before scientists understand how to reprogram one cell type to become part of any of our other, many tissues.

Still, Morrison says the chip is an interesting bit of technology. "It's a cool idea, being able to release [genetic code] through nano channels," he says. "There may be applications where that's advantageous in some way in the future."

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A Chip That Reprograms Cells Helps Healing, At Least In Mice - NPR

Genetic Engineering with Strict Guidelines? Ha! – Discovery Institute

Human genetic engineering is moving forward exponentially and there is still no meaningful societal, regulatory, or legislative conversation about whether, how, and to what extent we should permit the human genome to be altered in ways that flow down the generations.

But dont worry. The Scientists assure us, when that can be done, there will (somehow) be STRICT OVERSIGHT. From the AP story:

And lots more research is needed to tell if its really safe, added Britains [Robin] Lovell-Badge. He and [Johns Hopkins University bioethicist Jeffrey] Kahn were part of a National Academy of Sciences report earlier this year that said if germline editing ever were allowed, it should be only for serious diseases with no good alternatives and done with strict oversight.

Please!No more! When I laugh this hard it makes mystomach hurt.

Heres the problem: Strict guidelines rarely are strict and they almost never offer permanent protection. Theyare ignored, unenforced, or stretched over time until they, essentially, cease to exist.

Thats awful with actions such as euthanasia. But wecant let that kind of pretense rule the day withtechnologies that could prove to be among themost powerful and potentially destructive inventions in human history. Indeed, other than nuclear weapons, I cant think of a technology with more destructive potential.

Strict oversight will have to include legal limitations and clear boundaries, enforced bystiff criminalpenalties, civil remedies, and international protocols.

They wont be easy to craft and it will take significant time to work through all of the scientific and ethical conundrums.But we havent yet made a beginning. If we wait until what may be able to be done actually can be done, it will be too late.

Photo: Genetically engineering mice, via Wikicommons.

Cross-posted at The Corner.

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Genetic Engineering with Strict Guidelines? Ha! - Discovery Institute

Timeline: Gene therapy’s long road to market – Reuters

LONDON (Reuters) - Gene therapy, which aims to patch faulty genes with working DNA, has been a long time in development. The following are major milestones:

1972 - Researchers first suggest gene therapy as a treatment for genetic diseases but oppose its use in humans "for the foreseeable future", pending greater understanding of the technology.

1990 - A four-year-old girl with severe immunodeficiency became the first patient to undergo gene therapy in the United States.

1999 - American patient Jesse Gelsinger dies following a gene therapy experiment, setting the field back several years as U.S. regulators put some experiments on hold.

2002-03 - Cases of leukaemia are diagnosed in French children undergoing gene therapy in a further blow to the field.

2003 - The world's first gene therapy is approved in China for the treatment of head and neck cancer.

2007 - Doctors carry out the world's first operation using gene therapy to treat a serious sight disorder caused by a genetic defect.

2012 - Europe approves Glybera, the first gene therapy in a Western market, for an ultra-rare blood disorder.

2016 - Europe approves Strimvelis for a very rare type of immunodeficiency.

2017 or 2018 - The first gene therapy could be approved in United States.

Reporting by Ben Hirschler; editing by David Stamp

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Timeline: Gene therapy's long road to market - Reuters