The Continuing Threat to Religious Liberty – National Review

Two years to the day after the Supreme Court redefined marriage in Obergefell, the Court announced that it would hear a case about the extent to which private parties may be forced to embrace this new vision of marriage. The case involves Jack Phillips, a Colorado baker who declined to bake a wedding cake for a same-sex-wedding reception.

There was nothing remarkable about Phillipss decision. With every cake he designs, Jack believes he is serving Christ. He had previously turned down requests to create Halloween-themed cakes, lewd bachelor-party cakes, and a cake celebrating a divorce. Yet Jack was never reprimanded over those decisions. He found himself in hot water only with the same-sex-wedding cake.

The immediate question before the Supreme Court is whether its constitutional for Colorado to penalize Jack under its sexual orientation and gender identity (SOGI) antidiscrimination statute. But the case has implications for millions of believers from every walk of life and, beyond that, for the health of our culture and our constitutional system of ordered liberty.

While there has always been disagreement about what religious liberty requires in particular cases, the idea of religious liberty as a fundamental human right has more or less been a consensus in America. It became controversial only in recent years as the government tried to force religious conservatives to violate their beliefs on sex and marriage, and as liberal advocacy groups decided that civil liberties arent for conscientious objectors to the sexual revolution.

Thats why we saw the American Civil Liberties Union oppose Catholic nuns attempt to get out of the Obamacare HHS preventive-care mandate, in which the Department of Health and Human Services required employers to provide insurance covering sterilization and birth control including forms of birth control that prevent embryos from implanting in the uterus, thereby causing abortion.

The HHS mandate garnered the most headlines, but its far from the only flashpoint. In several jurisdictions, Catholic Charities and other faith-based adoption agencies have been forced to abandon their invaluable work simply because they want to place needy children only in homes with married moms and dads. The government calls that discrimination based on sexual orientation.

Agree or disagree with Catholic Charities, its belief that mothers and fathers are not interchangeable, that moms and dads are not replaceable, has nothing to do with sexual orientation. And respecting conscience here wouldnt make a single concrete difference to same-sex couples, who would remain free and able to adopt from public agencies and other providers.

Yet lawmakers arent just coercing agencies such as Catholic Charities; theyre punishing states for declining to coerce those agencies. When Texas passed a law protecting the freedom of such agencies, California barred state employees from traveling to Texas on non-essential official business.

Religious schools adhering to the historic vision of marriage are also at risk. They stand to lose accreditation and nonprofit tax status as well as eligibility for student loans, vouchers, and education savings accounts. The Left regularly equates homophobia with racism, knowing full well that the latter can serve as grounds for ending tax-exempt status, as happened to Bob Jones University in the 1970s as a result of racist policies (lifted in 2000) regarding dating and marriage.

During Obergefell oral arguments, Justice Samuel Alito asked the solicitor general whether the state should yank tax exemptions for schools that uphold marriage as the union of man and woman. The solicitor general replied: Its certainly going to be an issue. Right on cue, the Sunday after the Supreme Courts ruling in Obergefell, the New York Times religion columnist wrote a piece for Time magazine titled Nows the Time to End Tax Exemptions for Religious Institutions.

These vulnerabilities extend to Orthodox Jews, Roman Catholics, Evangelical Christians, confessional Lutherans, Latter-day Saints, Muslims, and anyone else who believes that we are created male and female, and that male and female are created for each other. Charities, schools, and professionals will find themselves on the wrong side of regulations: bans on what government deems discrimination in public accommodations and employment; mandates in health care and education; revocation of nonprofit status, accreditation, licensing, and funding. Rolling Stone just profiled the LGBT activist Tim Gill, who has pledged his $500 million fortune to passing SOGI laws that will, in his words, punish the wicked.

And it wont just be government that does the punishing. As the law insists that social conservatives are like racists, big businesses and other institutions will bring their own pressure to bear on anyone who dissents. Professional associations, through licensing and accreditation procedures, will enforce the new orthodoxy. The American Bar Association has promulgated new model rules of professional conduct that make it unethical for lawyers to discriminate on the basis of sexual orientation, gender identity, marital status or socioeconomic status, including in social activities, which, as former attorneygeneral Ed Meese has explained, would include church membership and worship activities. Legally and culturally, believers should prepare for challenges.

Just how far is the Left willing to go? Consider the ACLUs Health Care Denied project. Launched in May 2016, the project solicits complaints against Catholic hospitals to form the bases of lawsuits. These lawsuits claim that, in declining to perform abortions, Catholic hospitals use their religious identity to discriminate against, and harm, women. But this is absurd. The mothers sex has nothing to do with a Catholic hospitals refusal to kill the unborn and its commitment to saving lives instead.

The ACLU has also sued Catholic hospitals for declining to perform sex-reassignment surgeries. A headline for a California NBC affiliate read: ACLU sues Carmichael faith-based hospital for denying transgender man hysterectomy. The hospital was being accused of discrimination based on gender identity.

But Catholic hospitals refuse to remove a healthy and harmless uterus from anyone, whether the person identifies as cisgender or transgender. This doesnt reflect discrimination based on gender identity, but rather an honest vision of the role of medicine and the proper treatment of gender dysphoria. But the Left is working hard to label all refusals to march with its sexual revolution as exercises of a license to discriminate.

It wasnt always so. The American Civil Liberties Union used to defend civil liberties. Back in 1993, when Bill Clinton signed the Religious Freedom Restoration Act into law, the ACLU was one of its biggest supporters. Nadine Strossen, president of the groups national board of directors, testified before Congress in support of the law. It was needed, she argued, to restore to religious liberty the same kind of protection that the Court has given and still does give to other fundamental freedoms.

Strossen explained that in order for government to infringe on a liberty, including religious liberty, it has to show some compelling interest, and it has to show that the measure is narrowly tailored so as to do as little damage as possible. She embraced this legal standard, identifying it as strict scrutiny and saying it was hardly a radical approach. She even stated that RFRA was needed to protect such familiar practices as permitting religiously sponsored hospitals to decline to provide abortion or contraception services and ensuring the inapplicability of highly intrusive educational rules to parochial schools. She concluded that these were decisions...that society had previously assumed that religious groups had the right to make for themselves and could not be compelled to change just because society thought otherwise.

Let that sink in. In 1993, the ACLU endorsed RFRA, saying it would rightly restore for religious liberty the standard used to protect other freedoms and specifically celebrated the very applications of RFRA that progressives now call abuses never imagined by its supporters. Today, the group sues Catholic hospitals over abortion and sex reassignment and supports a bill the Do No Harm Act that would amend RFRA so that it couldnt be used to defend against progressive government mandates in employment and health care, amongst other areas, in response to the Hobby Lobby decision.

RFRA-style laws have been used to protect a variety of claimants: Apache Indians told they cant wear the feathers of endangered eagles in their headdresses, Sikhs told they cant carry a kirpan (a small ceremonial knife) if they work for the government, inner-city black churches zoned out of existence, Muslim prisoners forbidden to grow short beards, and Jewish inmates denied kosher meals. RFRAs became controversial only when the federal RFRA protected the Evangelical owners of Hobby Lobby and when people thought state RFRAs might protect bakers, florists, and photographers who object to same-sex marriage. Rejecting religious liberty as a fundamental natural right means that the freedoms of a variety of faith traditions on any number of issues may become casualties of progressives zeal to quash conservative dissent on sex.

Three historical developments have created our current predicament: a change in government, a change in sexual values, and a change in how religion is practiced and how it is viewed by our leaders. An adequate response to current and looming threats to religious liberty will need to address each of these three shifts.

What has changed regarding government? A presumption of liberty has been replaced with a presumption of regulation. Citizens used to think that liberty was primary and government had to justify its coercive regulation. Now people assume that government regulations are the neutral starting point and citizens must justify their liberty.

The progressive movement gave us the administrative state. Limited government and the rule of law were replaced by the nearly unlimited reach of technocrats in governmental agencies. As government assumed authority to regulate more areas of life, the likelihood of its infringing religious liberty increased.

If Thomas Jefferson and James Madison came back to America today and heard about the plight of the Little Sisters of the Poor, their first response would not be to cite the First Amendment; it would be to ask what the Department of Health and Human Services is and what authorizes it to issue a preventive-care mandate. This should be a lesson to religious believers including many who supported the passage of Obamacare in how policies that violate economic freedom and massively expand the role of government also can end up violating religious freedom. We must assist those in need without unduly infringing on liberty and while respecting their and everyone elses consciences.

The best defense of religious liberty is a defense of liberty more broadly, a return to limited government and the rule of law. Nowhere is this more applicable than in the never-ending expansion of anti-discrimination statutes. What started out as well-justified efforts to combat racism, sexism, and anti-Semitism have morphed into laws protecting against the dignitary harm (i.e., harm to dignity) allegedly inflicted by anyone who disagrees with progressives about human sexuality.

Laws that exist to prevent discrimination on the basis of race, sex, and religion are now being expanded to ban discrimination on the basis of sexual orientation and gender identity. As a result, harmless actions and interactions, such as decisions not to perform sex-reassignment surgery or not to bake a cake for a same-sex wedding, are being declared unlawful forms of discrimination. While no federal SOGI law exists, half of the U.S. population lives in a jurisdiction with a local or state SOGI. And these SOGIs frequently employ overly broad definitions of public accommodation so that almost every business is considered a place of public accommodation. It is essential to limit the damage these laws cause and to defeat them when they are proposed.

The comparison with racism is instructive, but not in the way SOGIs advocates think. In the 1960s, widespread and systemic racism radically limited African Americans freedom to flourish. Social and market forces were not sufficient to remedy the problem. Legal remedies were essential. Do Americans who identify as LGBT face similar challenges today?

Racist businesses refused to serve black people or to serve them in the same spaces and on the same terms as whites. If a business refused to participate in an interracial marriage, it was because that business thought whites were superior to blacks and therefore shouldnt marry them not that such a union wouldnt be a marriage in the first place. By contrast, bakeries dont refuse to serve people who identify as LGBT because they so identify. Rather, a small number of bakeries cant in good conscience celebrate same-sex weddings because they think marriage cant be same-sex.

What justifies the government in telling Jack Phillips that he must create cakes for same-sex weddings? Government has redefined marriage, but that didnt create an entitlement for some citizens to demand that other citizens help celebrate their same-sex marriages. Activists are using SOGI laws to weaponize the redefinition of marriage. And so we see three important considerations for anti-discrimination policy: the underlying need and justification for government regulation, the scope and reach of that regulation, and the actions and interactions that count as discriminatory.

What about the change in sexual values? How America views the human body, sexuality, marriage, and the family has also changed profoundly since the 1960s. What started as a liberationist movement asking for the freedom to live and love, be it with contraception or abortion, same-sex relations or transgender identities now demands that other people support, facilitate, and endorse such choices: that Hobby Lobbys insurance cover them, that Catholic hospitals perform them, and that various professionals celebrate them.

While the ACLU has largely failed in forcing pro-lifers to perform or pay for abortions, theyve had more success in coercing traditionalists on LGBT issues. This highlights the reality that, for many people on the left, pro-life views are wrong but understandable, while traditional views on sex, marriage, and gender identity are not merely wrong but bigoted and deplorable. Thats why Catholic hospitals have prevailed against the ACLU in lower courts but Jack Phillips has to plead his case to the Supreme Court.

Any effective long-term response, therefore, cannot merely be about religious liberty or limited government. Ultimately, our goal should be to convince our neighbors that what we believe about sex is true. In the meantime we need to convince them that what we believe is at least reasonable and poses no harm to others, and thus that theres no reason for the government to penalize it.

You can be in favor of gay marriage and be in favor of Jacks not being forced to celebrate gay weddings. But if you think support for marriage as the union of husband and wife is akin to racism, youre less likely to support Jacks freedom to dissent. Conservatives need to explain why we believe what we believe in terms that our neighbors can understand. We may never convince the ideologues and activists, but most Americans arent driven by ideology or activism, and their opinions on these issues arent that deep or well informed. These people are persuadable if we make the effort.

In addition to changes in government and sex, religious practice and our understanding of religious liberty have also changed. The mainline Protestant churches became the old-line and now are on the sideline, in the memorable slogan of Father Richard John Neuhaus. This evolution sparked the growth of Evangelicalism, which is now challenged by the influence of mere cultural Christianity. On the Catholic side, the American implementation of the Second Vatican Council splintered the Catholic community into politically liberal, doctrinally heterodox Spirit of Vatican II Catholics and politically conservative, doctrinally orthodox John Paul II Catholics with ex-Catholics composing one of the largest religious groups in America. These changes helped fuel the rise of the nones those with no religious affiliation. As Americans become less religious, they care less about religious liberty, for people are most vigilant to protect the rights that they themselves want to exercise.

At the same time, a form of secularism has challenged the role of religion in public life, arguing that religion is appropriate inside the four walls of a house of worship but not on Main Street or Wall Street. The result has been an ever more naked public square, another memorable Neuhaus locution, where religion is viewed as a merely private affair with no public relevance.

These changes help explain why some liberals are trying to drastically narrow the natural right to the free exercise of religion by redefining it as the freedom of worship. If they succeed, the robust religious freedom that made American civil society a light to the world will be reduced to Sunday-morning piety confined to a chapel. The Little Sisters of the Poor will be free to worship how they want in their chapel, but will be forced to comply with the HHS mandate.

To adequately defend religious liberty, then, we must defend religion and work to spread it. In other words, we must evangelize. This takes many forms. Parents and pastors need to form their children and congregants in the truth. Spreading the faith to others and helping them see the reasonableness of our beliefs is likewise essential.

So is helping both believers and nonbelievers appreciate the importance of religious liberty. James Madison explained that religious liberty is a natural right because what is here a right towards men, is a duty towards the Creator. Only if people can come to grasp the good of religion will they come to defend robust religious-liberty rights. Even people who arent personally religious can see that it is good for us to seek out and answer questions about ultimate origins, destiny, purpose, and meaning. They can see that it is good to live in accordance with religious truth as we each understand it. Religious liberty gives us the space to do precisely that.

And in doing so, it reminds the state that it is limited. As Sherif Girgis and I explain in our new point-counterpoint book with John Corvino, Debating Religious Liberty and Discrimination, religious liberty plays a crucial role in preserving civil society as something separate from government. It makes conceptual room for and promotes in practice private associations and self-determination. Respect for religious liberty sears into political culture an image of government as limited by higher laws: transcendent moral norms and timeless truths about humanitys pre-political needs and duties.

Government has no natural general mandate to coerce us, with our rights coming merely from its gracious self-restraint. Its the other way around: Civil society has moral claims on government. A government that can tell nuns that their health-care plan must cover contraception is a government that can do anything.

To meet the attacks on religious liberty, conservatives must avoid two pitfalls: opting out of politics and defending only our people.

Religious liberty has been defended almost exclusively by lawyers, pastors, academics, and other people at 501(c)(3) nonprofit organizations. As Maggie Gallagher has noted numerous times, social conservatives have largely ignored actual politics. We talk about politics and we litigate to keep the courts from deciding issues against us, but we rarely engage in the actual electoral and political process.

Only one side has flexed political muscle. As Mike Pence will tell you, big business will make it painful for an elected official to do the right thing on these issues. We need 501(c)(4)s, PACs and super PACs, 527s, and other organizations to engage in direct political action, supporting bills and politicians that are good for religious liberty and opposing those that do it harm. What the Susan B. Anthony List has done for the pro-life cause we need done for religious liberty.

As for the second pitfall, conservatives must avoid following the Lefts lead in treating religious liberty as a partisan or tribal issue. In abandoning the religious liberty of conservative believers, the Left has betrayed a fundamental human right. Some on the right seem inclined to commit their own version of this mistake by denying the religious-liberty rights of Muslims, such as when towns refuse to let Muslims build mosques. But the same legal standard must apply to all faiths because the same human right is at stake.

Provided they dont harm the common good, violate human rights, or otherwise offend justice, Muslims should be free to be authentically Muslim, just as Jews should be free to be authentically Jewish and Christians should be free to be authentically Christian. All of America is better off when these freedoms are protected, as they allow room for all of us to live according to our consciences and to appeal to other peoples consciences in seeking to persuade them of what we regard as the truth in matters of faith.

Religious liberty is not an embrace of relativism. As we disagree about religious truth, we need to agree to leave legal room for that disagreement to play out in worthy and healthy ways among people who are free to persuade and convert. People are free to try to convince Jack that he should bake the cake, but the government shouldnt be allowed to force him to do so.

Religious-liberty protections help preserve the conditions that make peaceful coexistence possible. They acknowledge both mans dignity and the reality of pluralism and diversity even as we work to know and live the truth.

READ MORE: This Is a Fight for the First Amendment, Not against Gay Marriage Legal Radicals Dont Want the Separation of Church of State The Supreme Courts Religious Freedom Message: There Are No Second-Class Citizens

Ryan T. Anderson is the William E. Simon Senior Research Fellow at the Heritage Foundation and a contributor to the American Project at the Pepperdine School of Public Policy. He is the author, with Sherif Girgis and John Corvino, of the new book Debating Religious Liberty and Discrimination. This article appeared in the August 14 issue of National Review.

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The Continuing Threat to Religious Liberty - National Review

Family goes to home where they believe missing Liberty teen was last seen alive – KSHB

KANSAS CITY, Mo. - A small army gathers every week at a church at 77th & Troost. They arm themselves with fliers, water bottles and hope, setting out to search for Desirea Ferris.

Ferris left her Liberty home the night of May 1 to hang out with some friends and went missing in the early morning hours of May 2. After that, her social and phone activity went silent; her family hasn't seen or heard from her since.

On Tuesday, the group was preparing to confront their worst fear going to the place where her phone last pinged, just blocks away from their meeting place.

"It's been three months and nobody's talking," Patti Tam, Desirea's mom, told a neighbor.

Fliers with the 18-year-old's face are all over south Kansas City, tucked beneath windshield wipers and stapled up on light poles.

Desirea's big, brown eyes resemble her mothers, but Patti's reflect a fierceness only a mother on a mission could have.

Lead by men on motorcycles, the group marched to a house off 81st Street in the Marlborough neighborhood, the last place they believe Desirea was last seen alive.

When asked if she thinks she'll see her daughter again, Patti answered, "Come hell or high water, I will. It's not going to be the way that we want it to be, but she will be home. It's time to bring her home."

Working with Liberty police investigators, the family narrowed Desirea's last cell phone pings to two areas: an abandoned house in a wooded neighborhood and the house in Marlborough, only six minutes away. Both are known for drug activity.

"After she left this house, she dropped off the face of the earth. It's disgusting. Disgusting. My daughter didn't deserve this," Patti said, looking at the house.

Through conversations and tips, the family believes the people connected to both houses did something terrible to Desirea.

"My worse time is when it storms. She didn't like storms, I didn't like storms. And all I can think of is that she's out there by herself, and they just threw her out like a piece of trash," Patti cried.

The bikers, whom the family considers their body guards, walked up to the door in Marlborough and knocked. No one answered. Patti and Desirea's stepmother hoped to come face-to-face with the people inside.

Instead, they said a prayer.

"We're not backing down. We're not going away," Patti said.

A mother's intuition tells her someone knows something, and she'll bring it to light.

"I know she didn't go down without a fight. In the back of my head, I can hear her screaming, screaming for me, and I couldn't help her," Patti said, breaking into tears. "I just want her home."

Liberty Police couldn't go on camera with 41 Action News, but said they are still actively following up on leads.

They can't say whether Desirea is dead or alive. Captain Hendrick said they've gotten hundreds of tips.

Investigators have interviewed people in jail and out people the family believes are connected to Desirea in the hours leading up to her disappearance.

There is more information police aren't ready to release yet.

Anyone who has information on Desirea's whereabouts should call the Liberty Police Department, or make an anonymous tip with the TIPS Hotline. The family is offering a $4,000 reward.

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Family goes to home where they believe missing Liberty teen was last seen alive - KSHB

‘The Statue of Liberty Weeps’ as Trump Takes Aim at Legal Immigration – Common Dreams


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POTUS' new #immigration plan: The Statue of Liberty weeps as she watches Trump flush America's moral leadership down the toilet. Anne Frank Center (@AnneFrankCenter) August 2, 2017 ...

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To Duke Historian Nancy MacLean, Advocating Free Markets Is Something ‘The World Has Never Seen Anything Like … – Reason (blog)

Duke University historian Nancy MacLean recently issued Democracy in Chains: The Deep History of the Radical Right's Stealth Plan for America, an alas quite hot book that purports to expose the dark secrets of Nobel Prize-winning economist James Buchanan and the "radical right"/libertarian movement he's allegedly the brains behind.

Democracy in Chains/Amazon

MacLean has been convincingly accused by many who understand his work and the libertarian movement with both less built-in hostility and more actual knowledge than she has (including me here at Reason) of getting nearly everything wrong, from fact to interpretation. She recently took to the Chronicle of Higher Education to allegedly reply to her critics.

A quick wrap up of many specific problems found in her book by her criticsby no means allthat MacLean ignores even while allegedly "respond[ing] to her critics," and which the editors at the Chronicle let her ignore:

Her claim of meaningful similarity between John Calhoun's constitutional vision and that of Buchanan and his public choice school cannot be reasonably maintained.

Her assertion that the modern public choice/libertarian constitutionalist vision has nothing to do with James Madison is not true.

Buchanan did not, contra MacLean, believe that all taxation above voluntary giving is theft akin to a mugger in the park.

She attributed to Buchanan the belief that those receiving government aid "are to be treated as subordinate members of the species, akin to animals who are dependent" though he used that phrase to describe the attitude that was the opposite of his.

Her attribution of Buchanan's use of the Hobbesian term "Leviathan" to (racist, uncoincidentally for her rhetorical smear purposes) Southern Agrarian poet Donald Davidson rather than, well, Hobbes, falls apart with study of when and how Buchanan began using the term in his work.

She regularly cites libertarian thinkers as saying nasty things implying a contempt for the poor or for democracy that are not supported by the full context of the quotes; victims of her malicious misinterpretation including David Boaz and Tyler Cowen.

It's a pattern of hostile incomprehension, and her "response" indicates that this is partly because she's deep-down unable to view thinkers or funders who advocate limiting government's scope, expense, or power any other way.

MacLean speaks to none of the above specific critiques of her book in the Chronicle, merely generically complaining about being attacked and insisting that people who critique her work clearly hadn't read or understood it, or linking to people who sophistically defend some possible meanings in a manner far more subtle and complicated than she bothered to do.

Mostly eschewing factual or interpretational specifics, she reached instead for sympathy by complaining these specific critiques on her methods and understanding as a historian made her "feel vulnerable and exposed" and interpreting an intellectual metaphor for a physical threat.

She does a cute turnaround insisting against all evidence that those who praised her book were the only ones who read it, and that the very political forces she inveighs against in her book "helped create the current toxicity" allegedly exemplified by academic experts explaining how she got so many things so very wrong in her attempt to make her readers hate and fear anyone who wants to restrict government's power to manage our lives.

She certainly does not address a core problem with her book I detailed in my review: the "historical fact" upon which her entire thesis depends, her book's distinguishing selling point, which she claims to have uniquely discovered through diligent archival work, that James Buchanan was the secret influence behind the political funding machine of Charles Koch and that that machine is deliberately and conspiratorially disguising its libertarian goals, is completely invented. She creates an illusion of proof by citing documents that do not support the thesis in any way, shape, or form.

The most telling part of her defense in the Chronicle is how hard, well-nigh impossible, it is for her to imagine that people who might want the government to do less are actually a legitimate part of any public policy debate:

Sam Tanenhaus, in his otherwise favorable review in The Atlantic, said, "a movement isn't the same thing as a conspiracy. One openly declares its intentions. The other keeps them secret. It's not always clear that MacLean recognizes the difference." As a scholar, I understand the problems of conspiracy theories and while I never called this movement a conspiracy in the book, we do face a problem that our language has not caught up to our world.

In hindsight, I wish I'd said more about that in my book because we do not yet have a conceptual system adequate to capture what is happening....a messianic multibillionaire [has] contributed vast amounts of dark money to fund dozens upon dozens of ostensibly separate but actually connected organizations that are exploiting what Buchanan's team taught about "the rules of the game" of modern governance in a cold-eyed bid to bend our institutions and policies to goals they know most voters do not share....

....The world has never seen anything like it before; no wonder it's hard to find the right term to depict it. It's a vexing challenge to understand, let alone stop, and in hindsight I wish had been more explicit about that conceptual challenge....

What she is writing about is, yes, exactly what Tanenhaus called it: a movement. There is no need for her peculiar hyperventilating pretense that it's utterly unprecedented that donors and intellectuals in a democratic Republic would attempt to spread ideas or pass legislation in the direction of limiting government's expense or reach.

Despite her pretense that Buchanan is some secret linchpin to this movement, he always played a minor role in any kind of explicit policy terms (you wouldn't know it from this book but he explicitly eschewed reducing his high-minded constitutional musings to policy recommendations or political activism) in the loose association of free market thinkers dating back at least to the 1940s.

Had she known more about the history of free market and libertarian advocates and organizations since the '40s, she would have known that musing over various ways to actuate their goal of turning the culture more toward free markets have been consistent and often amount to nothing in particular, and cannot meaningfully be read as a secret conspiracy. The very fact that respected historians like MacLean can have this bizarrely uncomprehending attitude toward the libertarian movement is the very reason it needs to exist, and why it still fights an uphill battle.

When MacLean, for example, treats one particular 1973 memo from Buchanan skylarking about a "Third Century Project" to spread free market ideas as something of great significance, she seems to hope she's discovered another "Powell Memo," a 1971 memo written for the Chamber of Commerce by future Supreme Court justice Lewis Powell that similarly, and similarly in a long tradition, mused about how defenders of free enterprise could fight back in a world they (rightly) felt was rallied against them.

That Powell memo has also been overemphasized by academics dipping into the history of free market ideas as some secret origin of the modern right. It was just one more effort in a continuing, and still-fighting-for-air, movement to limit government growth. It only seems weird and secret to intellectuals of the mainstream or left because they don't know much about it.

That strong free market policies don't currently reign in the American public is exactly why an intellectual movement she considers sneaky and evil arose, to try to convince Americans both public and elite that liberty is the path to prosperity and peace. It is not destroying democracy to try to shape public discourse, even if MacLean doesn't like the way libertarians are trying to shape it.

Her belief that libertarianism is so inherently horrendous she is unable to conceptualize it as perfectly legitimate and totally predictable led to her kookoo public declarations of a deliberate organized conspiracy to discredit heragain without actually defending her work's credibility on any specificson the part of academics who are part of this, yes, movement.

On a personal note, while she states that her book is the "first detailed picture of how this movement began...and how it evolved over time" (see, using the word "movement" wasn't so hard there, was it?), she also cites my own book that does exactly that (Radicals for Capitalism: A Freewheeling History of the Modern American Libertarian Movement) over a dozen times.

For the most part, she does so reasonably and accurately. The one doozy of an exception is designed, unsurprisingly, to feed her "secret thesis" (one she spends a third of her book implying but never actually stating, so she can avoid having to explicitly defend it) that libertarian attitudes toward the state were essentially created by anger with the Supreme Court decision Brown v. Board of Education that desegregated public schools.

She cites to three pages of my book, and to other sources that similarly in no way support it, the idea that "Brown so energized this ragtag collection of outraged radicals of the right that some were no longer happy calling themselves 'libertarian.'"

Suffice it to say, nothing in the three pages of mine she cites, or the other sources in her cluttered endnote, support the contention that anything about Brown did anything to libertarians in the 1950s to make them question the term, or (outside of James Kirkpatrick, a right-wing segregationist fellow traveler) particularly motivate them in any way.

But that weird assertion is central to MacLean's purposes: making her readers think less of anyone who might want to restrict government power in a way she disapproves.

To baldly declare her real central point, which is that "I prefer, and I believe Americans prefer, more taxing and spending and redistribution than James Buchanan and libertarians want," would reveal her confused alleged historical epic as what it truly is: a hypertrophied polemical op-ed larded with often irrelevant smear and speculation, telling a story about James Buchanan that is neither true nor relevant to "the radical right's stealth plan for America."

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To Duke Historian Nancy MacLean, Advocating Free Markets Is Something 'The World Has Never Seen Anything Like ... - Reason (blog)

Is it Time to Retire the Duopoly? – Being Libertarian

There is a secondary discussion beyond the obvious (and redundant) back-and-forth about who was worse during the 2016 Presidential election, Hillary Clinton or Donald Trump:

Is the duopoly (a.k.a. the stranglehold on American politics perpetrated by the Republicans and Democrats) in need of retirement?

Many (if not most) people agreed it was indeed time to switch things up.

As we can see, most agreed the best way to do that was to put a non-politician into office in the form of Donald J. Trump so be it.

Like it or not, President Trump is indeed doing things in an unconventional manner (to put it VERY mildly) and my sincere hope is that this will loosen the grip of establishment politics on Washingtons throat.

The reality TV star and real estate mogul (turned president) will pave the way for more unconventional candidates who are equally sick of all the bullshit (there is no other way to put it in my mind , sorry for the profanity).

But Trump only has two terms, thats the law of the land.

Then what?

I highly doubt that we will ever (and overwhelmingly hope that we never) end up with a President Pence; it would be a throwback to a Republican Party most do not want.

I guess my bourbon fueled rant comes to one, single point: who replaces the Republicans and Democrats once they are gone?

The obvious answer is the Libertarian Party (LP).

For starters, (dont worry, we will tackle the rest in a second sweetheart) it is the third largest party in the country and the only one whos numbers have actually grown in the last decade. But who does it replace; the Republicans? Hmmm, I question that one.

While the economics and constitutional approach is certainly on par with your average Elephant, the southern US is still far too socially conservative to fall in with legal weed and a nuanced policy on abortion.

The LP replacing the Democrats is an even trickier concept to tackle.

In the first scenario, the social conservatives are really the only ones left out. Luckily, they still have the Constitution Party (what a joke of a name that is).

With Democrats, a major chunk of them would have to abandon how they were raised when it comes to fixing economic problems. They would have to learn that its people, not government, that fix economic and societal problems.

But, in my experience, most Democrats know very little about libertarianism, let alone the Libertarian Party.

In this last election, I was able to convert so many to either classical liberalism or straight-up libertarianism solely on its merits also because a few were pot heads who liked Gary Johnsons stance on marijuana legalization.

The overall reaction however, was this shit is great! How have I gone my whole life not knowing about this?

Yes I said confidently, remembering my own trip from the moderate left to libertarianismhow indeed.

But it wasnt how indeed. It was a sickening look at modern-day academia that pushes the divisive narrative that only a Republican or Democrat can win, and in a way its true.

Our current system was only built to accommodate two major parties. Any third party (a term I despise) simply throws the election to the House of Representatives for the office of President, and to the Senate for the office of Vice President.

We would literally be handing more power to people we consistently criticize for already being there too long and having too much power!

I think most of us dont want that!

But lets move past that and ask (as well as answer) another obvious question: no matter which side the Libertarian Party replaces, who will replace the other side?

Of course it is completely possible only one party even gets replaced, but lets just say for the sake of argument they both get replaced; who becomes the new opponent?

If youre thinking the Green Party, think again!

A party so left-wing that it makes Democrats go yeah, those hippies are fucking crazy? They are right too (you just need to listen to the music of Jill Steins failed second career to figure this out).

Will it be the Constitution Party? Yeah right!

I do not want any kind of a theocracy even one based around my own religion!

So here we are, back to square one; we are either infiltrating the two parties from within (which has failed repeatedly) or we will have to continue to try and force either the donkeys or elephants into extinction.

As I conclude this article I hope you did not think I was going to suggest which way this will go I dont know. But I am hoping to spark an idea, a thought, and a debate.

Do we finally put our foot down and say enough is enough! You guys all equally suck! or do we continue to run non-establishment candidates with Rs and Ds next to their names, in hopes of change from within?

One thing is for certain, we all have a very big decision to make in 2019 and 2020.

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Is it Time to Retire the Duopoly? - Being Libertarian

Why I’m Losing Faith in the NAP – Being Libertarian

Recently, I saw a video floating around Facebook of a 15-year-old girl being detained by loss prevention employees for stealing a candy bar. The person who shared the video claimed the force was excessive because they had her locked into a full-nelson and were attempting to drag her back into the store.

The reaction from those who strictly believe that the Non-Aggression Principle is all thats needed, in regard to laws in a libertarian society, shocked me.

Many were saying that because the girl aggressed on the store owners property that the escalation in violence was justified.

As a young minarchist, who believes in market anarchism and is enthusiastic about the tenets of libertarianism (but would still like an extremely limited government), I had yet to come into a situation involving retribution, within the NAP, that has actually made me question its validity in society.

I will not be able to accept the NAP if it leads to an eye-for-an-eye type of law in society; where an act of aggression is punished by a more severe act of aggression. Shooting someone for trespassing on your property, or beating someone with a bat for stealing money from you, are completely passable forms of self-defense in a society run by NAP law.

The issue that arises for me, is that this form of law is extremely barbaric and not conducive to a civilized society. Many act as if the NAP is absolute; as if the only deterrent (and proper punishment) for crimes is to use additional aggression. But, the justification of increased force in response to aggression is a retaliatory form of law, as found in the Code of Hammurabi.

By criticizing this, I am not taking a pacifistic approach or claiming that thieves and those who damage property should be let go, but the punishment and methods of preventing crime should not be more severe than the act of aggression.

Mike C. Materni describes this in his essay Criminal Punishment and the Pursuit of Justice, The common good, combined with the respect for the citizens originary freedom, demands that penalties be mild but certain, so that they can serve a deterrent effect without brutalizing society.

Cesare Beccaria, an 18th Century criminologist and philosopher, explained it best in On Crimes and Punishments, saying,The purpose of punishment [] is none other than to prevent the criminal from doing fresh harm to fellow citizens and to deter others from doing the same. Therefore, punishments and the method of inflicting them must be chosen such that, in keeping with proportionality, they will make the most efficacious and lasting impression on the minds of men with the least torment to the body of the condemned.

This is where I feel the NAP may fail as the standard of an all-encompassing law because it justifies punishment that is not equal to the crime.

Non-aggression is a good framework to begin to construct the laws and consequences of a civilized society, but it alone does not strive for the non-violent and even rehabilitative form of punishment that is necessary in society.

Fines and imprisonment were developed as the preferred forms of restitution in civilized society because they can deter crime and compensate victims without harming the criminal. While a tad extremist, I could foresee an anarchist society of NAP law resorting [back] to executions, quartering, and hangings as reasonable punishments for crimes.

As libertarians, it is our duty to uphold the NAP, but also recognize its shortcomings and be able to appropriately compensate for them. A mission to abolish the government shouldnt mean throwing out developments in justice that have made the free world into a better, more civil society.

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Why I'm Losing Faith in the NAP - Being Libertarian

20 Greek islands you may not have heard of – The Guardian

Despite its many crises in the past few years, tourism is booming in Greece. Most travellers, however, still rarely venture beyond the more famous islands and a little exploration is all that is needed to take you to some lesser-known gems. Here are 20 of our favourites.

All accommodation prices are for a double room in low season and include breakfast, unless stated otherwise. In most Greek tavernas you can eat and drink well for 15-20pp, but if a place is more expensive, I have indicated this.

NORTH-EAST AEGEAN

Mainly visited by Greeks, its size and large population mean that Lemnos (aka Limnos) avoids becoming simply a tourist destination. The capital, Myrina, is a working fishing port and you will still see fishermen mending their nets by the harbourside. Its low coast has several great beaches. What to do Perched on a headland above the capital is a large, 13th-century Venetian castle, now inhabited by wild deer. The spectacular view stretches as far as the monks republic of Mount Athos on the mainland. Where to stay The Arxontiko (70, ) was Lemnos first hotel and is still one of its best, mixing a traditional guesthouse with modern boutique style. It is in the centre of Myrina, but on a quiet side street and a short walk to the beach. Where to eat Grammofono (on Facebook), on the main square by a taxi rank, is not in the best location, but this little meze bar takes its food seriously and is great value. Try a seafood pikilia, or mixed plate calamari, shrimps, mussels and various small fried fish. There is often live music in the evenings.

The island owes its existence to Icaruss plunge into the sea after the wax of his wings melted. Ill-fated people have been visiting ever since it was a place of exile for left-wingers during the civil war and the Colonels dictatorship. Dont let this put you off; the locals revel in their quirky reputation and the varied landscape rewards exploration. What to do Talking of quirky, how about bathing in radioactive hot springs? Apparently, this is actually beneficial to the health researchers are exploring whether this is the reason for the islanders legendary longevity and can be experienced at several bathhouses. Where to stay Toxotis Villas (from 110) is a group of seven gorgeous villas, which combine a fantastic location with luxury, privacy and a traditional style. Where to eat Theas Inn is a proper Greek taverna in the pretty village of Nas, focusing on local food, including meat and vegetables from the owners organic farm.

Nestled between two prongs of the Halkidiki peninsula, this small island has great sandy beaches and is a welcome relief from some of the bigger resorts on the mainland. Most visitors are Greek and it retains an authentic atmosphere. What to do Boat trips around Mount Athos can be arranged, which is the closest most of us will get to this male-only monks republic. It is well worth having a peek the cliff-hanging monasteries are spectacular. Where to stay If you are young and/or adventurous it is perfectly possible to bring a tent over to Greece and camp nights are warm, campsites are well-equipped, and most sites are right on the beach. Try Alikes Camping (pitches from 5 per tent, plus 5 each per adult). Where to eat Tzanis is a seafood taverna right by the water. The clams are particularly good.

IONIAN

This small island consists of only three villages and a population of just over 1,000. Just across from popular Lefkada, its not usually considered a destination in its own right, and is mainly visited on day trips. Staying on the island means you can explore its many hidden coves at your leisure. What to do There is much debate as to which beach is Meganisis best. Most can only be reached by foot or by boat, so it will take you a while to review them all. Limonari, with its isolated clean sands, would be in most peoples top five. Where to stay Tucked away in the winding alleys of Spartochori, The Teachers House (studio from 65, family apartment from 100) has been expertly renovated, and split into a studio and two apartments that share a small pool. The contemporary interior design gives a light and airy feel. Where to eat Lakis Taverna is a solid, family taverna at the heart of the village. Its Greek Night on Thursdays is great fun, but may not be everyones shot of tsipouro.

CYCLADES

Paros is well known, but relatively few make it to the island opposite. For those in the know, including a fair few celebrities, Antiparos provides a relaxing haven in this often busy group of islands. What to do The large cave in the centre of the island is awe-inspiring, but be warned, there are lots of steps. Where to stay On its own sandy and sheltered cove, Beach House (80) is a stylish little hotel, with good-value small rooms for couples, but try to splash out for their larger rooms, including family suites. It also has a great restaurant, lots of family-friendly beach activities and a massage service. Where to eat Two good signs to look for when hunting down a seafood taverna are octopus hanging out to dry outside, and the ability to toss your olive stones and fishbones straight into the sea from your table. Captain Pipinos is a win on both counts.

Its proximity to Athens, fabulous beaches and famous thermal springs mean that this island gets rammed with visitors mainly Greek in August. Come out of season, however, and it can be perfect. What to do Take a sea taxi to Kolona, a narrow strip of sand connecting to a small island. The two bays on either side have azure water which is rarely without a few yachts at anchor. Where to stay Due to its popularity, Kythnos is not the cheapest, but Xenonas Afroditi (70) is a more reasonable option in the spa town of Loutra. And it is exactly what you expect from a Greek hotel: whitewashed, simple rooms, and by the beach. Where to eat Chartino Karavi (+30 22 8103 3004) is a reliable little tavern on the backstreets of Dryopida, a pretty inland settlement. When its not too hot there is a footpath that winds the 2km up to here from the islands capital, Hora.

Serifoss main town, Hora, is one of the most picturesque in Greece, its whitewashed cubes clinging to the side of a mountain. Its aspect is one reason so many artists choose to settle on the island. What to do Livadi, the port town, is a pleasing throwback to what the Greek islands used to be like. Its heart is the grandly named Yacht Club, in fact an old-style kafenion. It is the ideal place to sip a Greek coffee and chat to the locals. Where to stay Apanemia (40) is an old-fashioned rooms-only place in Hora. Its nothing fancy, but clean, well-cared for and at the centre of this lovely town. Where to eat To get the most out of Serifos you need to hire a car and explore youll certainly need one if you want one of the islands best food experiences. Aloni taverna could trade on its great views, but its local food is also excellent try the slow-cooked goat, or mastelo saganaki, a fried goats cheese similar to halloumi.

This is another island that, while relatively unknown to Brits, is an achingly trendy destination for the Greek set. It can get crowded, but the atmosphere is authentic and it has a culinary reputation one of the first famous Greek chefs, Nicholas Tselementes, came from here, and it still attracts the foodies. What to do Sifnos has a fantastically well-maintained and mapped selection of hiking trails to suit all levels of fitness. An excellent guidebook is available locally. Where to stay The main town, Apollonia, is where the trendy go to see and be seen, wandering up and down the Steno, its buzzing, narrow main street. Surprisingly close to this, but hidden in their own peaceful olive grove, are the Eleonas apartments and studios (65). Where to eat Rambagas is the smart spot to experience local food mixed with the latest on-point experiments. Start with a sea-bass tartare in traditional lemon and oil sauce, and end with chilled melon soup for dessert. The setting, just off the Steno, is gorgeous too.

Folegandros has similarly dramatic cliffs and hillsides to the magnificent volcanic landscape of Santorini, and is far less visited. What to do The main town, another Hora, perches on the cliffs, and wandering around its pedestrianised centre from square to square beneath the bougainvillea is what Greek dreams are made of. Where to stay Everything about the chic Anemi Hotel (from 153) is blindingly white, from the walls to the decor. But it is also surprisingly family friendly, with babysitting, a playground and even a kids cinema. The adults will be kept happy by one of the best bar/restaurants on the island. Where to eat Some dishes at Blue Cuisine sound a little over the top (deconstructed Greek salad with feta sushi?), but the local ingredients, including cheeses and cured meat from the surrounding islands, are superb.

This dramatic island does have good beaches, but is better known for its hiking and diving (French film The Big Blue was shot here). What to do The extraordinary whitewashed monastery of Hozoviotissa, which dates back to the 11th century, clings to the cliffs of the dramatic south coast. It is well worth a stiff climb up many stairs to reach it (but if youre not modestly dressed the monks will send you straight back down). Where to stay Decorated in classic white and blue, Emprostiada (from 50) is a comfortable guesthouse at the edge of the islands main town (inevitably named Hora). Out of season, the rooms are a real bargain. Where to eat The green tables and chairs of Tranzistoraki fill a little side-alley in the main town. The cute setting is matched by some interesting local food and a good selection of meze.

Actually made up of three islands, although only one is inhabited, Koufonisia is increasingly a destination for Greeks, including many who camp on the amazing beaches here during the summer, inspiring a laid-back 1960s vibe. The locals take it in their stride, and many of the 400 or so still fish for a living. What to do Take a boat ride to the other two islands. Kato Koufonisi has the best beaches, and dramatic Keros was where many of the finest early Cycladic statuettes were discovered now to be viewed in Athens, these inspired artists such as Picasso and Brancusi. Where to stay Those who like living in the round will love Windmill Villa (295, breakfast not included, sleeps 4), an expertly renovated windmill in an idyllic location. Its a little cramped on the inside, but its charm is hard to resist. If your budget doesnt stretch to that, Michalis Little Houses near the port has simple two- and three-bed rooms with bay views from 75. Where to eat Given that Mixalios Grill House (on Facebook) doubles up as the islands butcher, it is unsurprising that meat is the order of the day. Try the goat.

With a population of around 250, this island rightly describes itself as a small paradise and the atmosphere is suitably chilled out. The only settlement is a one-kilometre walk above the little port, but most hotels will meet you off the ferry. What to do Beaches, and walking to them, are pretty much the only activity on the island; but locals claim to have 18 of them hidden away, so theres plenty to keep you occupied. There is a boat tour as well, for the lazy. Where to stay Meltemi (50) has simple rooms set in a nice garden, and a friendly atmosphere. Where to eat Deli Restaurant and Bar has a cool bar downstairs, and chic restaurant upstairs and a surprisingly sophisticated take on Greek food for such a small island.

DODECANESE

Along with some of the larger Dodecanese, Tilos is greener and more lush than many Greek islands, and is renowned for its wildlife, from flowers to birds. Its gentle landscape rewards hiking, and it offers small villages and unexploited beaches. What to do If you want to get away from the beaches, the ruined medieval capital of the island, Mikro Horio, is a fascinating place to explore, and a not unreasonable hike up into the hills above Livadia, the port. Where to stay Friendly, family-run Eleni Beach Hotel (90) has whitewashed, simple rooms and its own beach. Where to eat Everything about Tilos seems to belong to a Greece of 20 years ago, and Omonoia cafe doesnt seem to have changed in those years. Its gigantes (giant beans) are particularly famous.

Halki is one of those islands you fall for instantly. Arriving in its main town and port of Emborio, you immediately notice the many 19th-century mansions that bear testament to the islands history as a thriving fishing and merchant capital. Its sleepy atmosphere makes exploring a delight. What to do The interior of the island is capped by a castle built by the Knights of St John, which perches above the ruined remains of Horio, once the capital. Where to stay Halki doesnt have many hotels. Try the Captains House (50, +30 69 3251 1762) or villa options with Nissia Holidays. Where to eat Pondamos is perhaps Halkis best beach, and the fish at Nicks Taverna makes a trip here doubly worthwhile. If you have lunch, they may well let you use their beach chairs and umbrellas free.

Those who know their Bible will tell you that it was on Patmos that St John wrote the Book of Revelations. Thus the island gets many visitors some of them genuine pilgrims, and many just curious tourists from huge cruise ships. Few stay, however, and fewer still venture further than the central monasteries a shame, as the island abounds in good beaches, and the interior is a rural idyll. What to do You must walk up from the port to see the monasteries. One contains the cave where St John received his visions, and the top one is impressively fortified against pirates. Where to stay It is much more atmospheric to stay in the old town surrounding the monasteries than down in the port. Although not cheap, the five rooms at Archontariki (200) have the air of an authentic village house, rather than a hotel. A cheaper alternative, but near the port, are the Kalderimi Studios (from 50). Where to eat There are a few options in town, and plenty more down at the port, including some fine dining, but its worth going out to Lambi beach, where the pebbles are backed by the traditional Lambi Taverna (+30 22470 31490). A great spot with food to match.

Despite being the second largest of the Dodecanese smaller than Rhodes and bigger than Kos Karpathos has been inexplicably neglected by tourists. Admittedly Pigadia, its main town and port, is not as immediately pretty as some, but stay awhile and its old-fashioned atmosphere grows on you. From here, hire a car and explore the islands low-key resorts and rugged interior. What to do Visit the village of Olympos, high in the mountains, where the women dress in traditional costume and back alleys wind past pastel houses to amazing views. Where to stay The perfect little resort of Lefkos boasts a sandy sweep of beach and several relaxed places to stay and eat. Le Grand Bleu (60) is one of the most comfortable. Where to eat Back in Pigadia, Ellinikon is an old-school taverna. Feel free to look into the various pots that will be bubbling, and discuss todays specials.

Essentially little more than a mountain rising out of the sea by the island of Kalymnos, and reached from there by a 10-minute boat ride, Telendoss chief attraction is its complete lack of cars, or indeed roads. Most people visit just for a day trip, but its a perfect place to chill out for longer the three beaches and six tavernas (all excellent) will keep you occupied. What to do Despite its diminutive proportions, there is plenty to explore on the island, with various small ruins to find of a Roman town, a castle, a couple of early Christian basilicas, etc. There is also a burgeoning rock-climbing scene. Where to stay George and Poppi are justifiably proud of On The Rocks (studios from 40, rooms from 50), which includes a taverna and a few simple rooms. And they are a mine of local information. Where to eat All the tavernas are a good bet. Zorbas is fish based, generally caught earlier on that day by the owner, who often takes guests out with him on his boat.

Locals will tell you this small island (just 8km long) got its name because this is where the beautiful nymph Calypso detained Odysseus, delaying his trip home to Ithaka, and his wife Penelope, by several years. It is certainly a good place to while away some time. The one village settlement is pretty and there are some great beaches to explore. What to do Perhaps the best of the beaches is Hohlakoura, with its bright white pebbles and interesting rock formations. Its a little difficult to get to, with the only road being a bit rough, so there are boat trips instead. Where to stay Just a short walk from the town, Nefeli (studios from 60, apartments from 75) is a classy boutique hotel set above its own strip of sandy beach. Nice and peaceful, but near enough to the centre of things. Where to eat Pefko taverna has an enviable location right on the sea, and the food matches the view. Nikos, the owner, is from one of the oldest families on the island, and is sure to come over to your table for a chat.

Leros has everything going for it. It is big enough to explore and there are plenty of whitewashed villages and enchanting coves. Fortunately, it has escaped the large-scale development of some islands, and the resorts are low key and charming. What to do The islands main town of Platanos is just 10 minutes walk above the port, and is well worth exploring, with its backstreets peppered with large mansions, now often in disrepair. Above the town is a row of picturesque windmills and an imposing fortress. Where to stay The long, sandy beach and blue waters of Alinda make one of the islands most appealing mini-resorts. A few minutes walk from the beach is Archontiko Angelou (50), a gorgeously restored 19th-century villa, which is like stepping back in time. Where to eat The cove of Dio Liskaria is tucked away at the north end of Alinda, and is the best place to swim on the island. Luckily the food at Vareladiko is pretty good too.

ARGO-SARONIC

Only a short hop from Athens, this little island is to be avoided in high season (July and especially August, when all of Greece is on holiday), but in the quieter months is a fantastic place to visit, especially in combination with a city break in the capital. It is also not far from the famous ancient ruins of the Peloponnese. What to do Chilling out is the order of the day, but kayaks are available to hire and a circuit of the island is possible if you are particularly energetic. Where to stay Rosys Little Village (doubles from 68) feels more like a community of friends than an impersonal hotel. Perched above the sea, on multiple levels, it has its own swimming platforms and sandy beach. Where to eat A string of restaurants and small hotels lead out of Skala, the islands bustling main port. Gistri, a fish taverna, has a great location by the pebble beach, and reliable food.

GETTING THERE

These lesser-known islands are surprisingly easy to get to. Some of the larger ones have airports and can be reached by charter flights in season, as well as scheduled airlines (such as easyJet, Ryanair and BA), and domestic flights from Athens and Thessaloniki. All of the islands can be reached by ferry from Athens port of Piraeus (although Lemnos, for instance, is a 20-hour ride). Most islands are within two hours ferry ride of a hub island. Arriving by ferry at an island is the best way to start to get to know the place, and by ferry you could combine two or three islands in one trip proper, old-school island-hopping.

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20 Greek islands you may not have heard of - The Guardian

The countries with the most islands (and the idyllic ones you must visit) – Telegraph.co.uk

You can't beat an island holiday for sheer escapism. Knowing you're surrounded by open water fosters a sense of complete removal from the daily grind of commuting, spam emails and overpriced coffee. But which country has the most islands on Earth? And of those islands, which is the perfect place to relax? Read on...

How many? Ordnance Survey has mapped 6,289 UK islands, mostly in Scotland. The British Isles (including Ireland) has 6,806.

Which should I visit? You can't beat Skye, reckons Nick Crane. "There are sights on Skye you will see nowhere else in Britain," he says. "Up in the north, the road between Staffin and Uig squirms above the 250m contour past the pinnacles and cliffs of Quiraing, with its alien place-names such as The Needle, The Prison and The Table. Over on the west coast, on the moor beyond Talisker, there's a mountain walled with polygonal columns of solidified lava as strange as the Giant's Causeway. Then there are the Black Cuillins, the most ferocious range of peaks in Britain."

How many? 6,852, of which 430 are inhabited. The Japanese archipelago stretches for 1,869 miles, around the same distance as the US east coast.

Which should I visit? We've written about Japan's weird and wonderful islands before. There's Naoshima, home to a growing number of outdoor art projects; the Yaeyama Islands, which look like they've been lifted from the Caribbean; or how about the spooky abandoned island of Gunkanjima, which appeared in Skyfall.

How many? 7,641, according to the most recent estimate from the countrys National Mapping and Resource Information Authority. That was an increase on a previous estimate of 7,107. They are clustered into the three major island groups:Luzon,Visayas, andMindanao.

Which should I visit? Our expertSteve Lunt advises a trip toPalawan. He writes: "Think of The Beach with Leo, and you'll know roughly what to expect from these islands prehistoric charms. Whether selling cars or beaches, pristine is chronically over-used but in Palawan, the superlative often truly applies. Jagged limestone cliffs rise like ossified Gothic cathedrals, towering over misty lagoons; countless white-sand beaches fringe these mysterious islands. Mostly untroubled by humans, wildlife dominates the environment."

How many? 8,222, according to official statistics. Most of them (3,747) are in Western Australia, followed by Queensland (1,955), Tasmania (1,000), Northern Territory (887) and South Australia (346). The largest, excluding Tasmania (and Australia itself) is Melville Island, just north of Darwin.

Which should I visit?Kangaroo Island, according to Kate Humble. "Its renowned for its wildlife and nature reserves, my two loves," she says. "You can hire a bike and explore anywhere on the island, or take one of the many walking trails. It has lots of small farms and artisanal producers selling lavender, sheeps milk, ice cream and honey.There are magnificent views from the coastline, including sea lions and these amazing rock formations called the Remarkable Rocks. And, unsurprisingly, youll see kangaroos everywhere, bouncing around. The island is dotted with lots of lakes and forests filled with koalas and rare birds."

How many? 18,307, according to a 2002 survey by the National Institute of Aeronautics and Space (the CIA World Factbook seems to think its 17,508, however, while a more recent survey, by a different agency, put the figure at 13,466).

Which should I visit? Bali is beautiful, but gets a little busy. So head instead for Sumba. Telegraph Travel's Natalie Paris writes: "Surfers were the lucky few to make it out to this remote outpost, an hours flight from Bali. That was until Nihiwatu opened - a luxury resort that takes the best of the islands fascinating tribal and animalistic culture and accommodates guest in lodges built like Sumbanese houses, with distinctive, tall thatched roofs that poke up above the treetops like witches hats."

How many? At least 30,000. The exact number is not known, but Georgian Bay contains the worlds largest freshwater archipelago, known as Thirty Thousand Islands. The Saint Lawrence River, meanwhile, which makes up part of the Canada-US border, contains an archipelago of 1,864. The Canadian Gazetteer Atlas records the names of 1,016 individual islands, along with 129 island groups, of which around 250 are inhabited.

Which should I visit? Kathy Arnold's pick of the county's best islands should have you covered. How about Cape Breton Island, on Nova Scotias northern tip, and home to the Cabot Trail, one of the worlds great scenic drives.

How many? More than 50,000, stretching from Svalbard, deep inside the Arctic Circle, to Bouvet Island, one of the most remote on Earth, and inhabited only by birds and seals, in the South Atlantic.

Which should I visit? The Lofoten Islands. There are beautiful beaches, like Utakleiv, pictured below, as well as stunning mountains and fjords. And despite its Arctic Circle location, the Gulf Stream means temperatures sometimes reach 20C in summer.

How many? 179,584, according to its tourist board, including 98,050 on the countrys 188,000 lakes.

Which should I visit? Theland Islands belong to Finland and are a good bet if you want to escape the Sturm und Drang. Paul Miles, who visited in 2012, wrote: "It was a week of Blyton-esque adventures outings in our own little motorboat, horse riding along flowery lanes, playing on a sandy beach, kayaking between low, bare skerries, spotting sea eagles and fishing for pike with a local fisherman."

How many? 267,570, according to Statistics Swedens 2013 Islands in Sweden report. Just 984 are inhabited. The number, curiously, appears to be growing, its 2001 report listed 221,800. Either way, it makes Sweden the world's island capital.

Which should I visit?Marstrand. Most go there to sail, swim, enjoy the seafood and wander along the harbour front admiring the yachts and the traditional wooden houses. For gorgeous views of the whole island and beyond, it is also worth climbing to the top of the Carlsten fortress.

The Bahamas:3,200

Chile: 2,324

Greece: up to 1,600

Thailand: 1,430

Croatia: 1,200

Maldives: 1,192

Estonia: 900

New Zealand: 600

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The countries with the most islands (and the idyllic ones you must visit) - Telegraph.co.uk

Saudi Arabia to turn 50 Red Sea islands into luxury tourism resorts ‘not subject to conservative kingdom’s rules’ – The Independent

The Kingdom of Saudi Arabia has announced it plans to turn a huge part of its pristine Red Sea coastline into a semi-autonomous luxury beach resort.

The 50 islands and 180km (110 miles) stretch of coastline - amounting to an area the size of Belgium - will be developed to home luxury hotels and other necessary infrastructure which will exist under laws on par with international standards in an effort to draw tourists to the country, the government said Tuesday.

The plans are part ofVision 2030, Saudi Arabias long-term blueprint for weaning itself off its reliance on oil revenue. It involves investments to the tune of $20m (15.6m) including a shot in the arm for the kingdoms nascent tourism industry.

Trump 'de-emphasises human rights' in Saudi Arabia speech: "We are not here to lecture"

While 18 million people visited Saudi Arabia from abroad in 2016, almost all foreigners came on pilgrimage to Mecca, rather than to spend time and money soaking up the countrys other sights.

Although the Kingdom is home to many archaeological sites, pristine beaches and excellent diving, it is not a holiday destination like Egypts Red Sea resorts or the city of Petra in Jordan. It currently does not offer tourist visas, making visiting difficult.

Conservative social rules, a lack of alcohol and restrictive dress codes coupled with blazing desert heat arent the usual ingredients Western holidaymakers look for.

Forms of recreation such as theatre and cinemas are banned, and despite tentative efforts at reform, Saudi Arabia is still widely criticised for its institutionalised discrimination against women.

It is not clear whether western women - or local women - will be allowed to don bikinis or other clothing which does not fit the kingdom's strict dress codes while visiting the resorts, or travel without the presence of a male guardian.

The Kingdoms authorities say the new tourist zone will not necessarily be subject to the laws in place in the rest of the country, although there are no details on how the semi-autonomous area will function yet.

The governmentis working on introducing tourist visas to make it easier for foreigners to visit. It is hoped one million people a year - a combined domestic and international total - will stay at the new Red Sea destinationsby 2035.

Construction at the Red Sea site will begin in autumn 2019 and be completed by the end of 2022, state news agency SPA said. The Kingdoms Public Investment Fund will provide the initial funding before international bodies are invited to invest.

Up to 35,000 jobs will be created by the project, which is eventually projected to generate 15 billion riyals (3bn) a year.

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Saudi Arabia to turn 50 Red Sea islands into luxury tourism resorts 'not subject to conservative kingdom's rules' - The Independent

Crash north of Cloverdale kills Virgin Islands man – Santa Rosa Press Democrat

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Sonoma County wants your feedback on Santa Rosa building planned for housing

Roseland annexation clears latest hurdle

Suspected prowler arrested in Rohnert Park

Horse racing is struggling at the Sonoma County Fair amid a nationwide industry decline

Climate group sees end to gas-powered cars in Sonoma County

Mendocino County Sheriff: Child, 2, tied to tree without food, water

JULIE JOHNSON

THE PRESS DEMOCRAT | August 2, 2017, 8:19AM

| Updated 7 hours ago.

An 18-year-old man visiting California from the Virgin Islands was identified as the person killed Tuesday night in a rollover crash that injured three others in southern Mendocino County, according to the CHP.

James Zion, 18, was pronounced dead at the scene. He and Yirakmeal Henry, 18, also from the Virgin Islands, were not wearing seat belts when the SUV they were riding in crashed at about 6 p.m. on the highway about five miles north of Cloverdale, near Geysers Road, according to a CHP report.

They were heading north in a 2001 Mitsubishi Montero driven by Shakela Hill, 24, of Ukiah when she lost control of the vehicle for unknown reasons, the report said. The vehicle overturned, careening across the highway and eventually coming to rest on its side on the southbound shoulder.

Both men were ejected from the vehicle. With major injuries, Hill was trapped and freed by firefighters. Another passenger, Lynesia Richards, 18, of Ukiah, also had major injuries and was able to free herself.

Henry, Richards and Hill were taken to Santa Rosa Memorial Hospital.

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Suspected prowler arrested in Rohnert Park

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Crash north of Cloverdale kills Virgin Islands man - Santa Rosa Press Democrat

Arlington youth visit Boston Harbor Islands – News – The Arlington … – Wicked Local Arlington

So far this summer, 230 kids from Arlington have set sail on free Tall Ships Cruises and free day trips to the Boston Harbor Islands.

The trips are part of Save the Harbor/Save the Bays free All Access Boston Harbor program.

The program, which provides free access to the Boston Harbor Islands to more than 100 area youth and community groups, features environmental exploration, historical sea chanteys and art on the shore, as well as fishing, crabbing, swimming and storytelling by the sea.

Save the Harbors free Youth Environmental Education Programs are the cornerstone of our work to Share the Harbor with young people and their families and create a new generation of environmental stewards, said Chris Mancini, Save the Harbors vice president of operations and programs. This season we expect to serve 30,000 youth and teens ages 7-17 at eight program sites, on 28 free island excursions and at 20 free beach events from Nahant to Nantasket.

All Access trips begin at the Blue Hills Bank Pavilion where the group learns the history of Boston Harbor and the harbor cleanup with an interactive presentation from Save the Harbors maritime historian David Coffin. Save the Harbors summer youth staff of teachers, college assistants and high school students then bring the kids aboard Bay State Cruise Companys Provincetown II to set sail to the Harbor Islands where each group enjoys a picnic lunch before exploring the island.

What a great way to spend a summer day, said Save the Harbors spokesman Bruce Berman. We believe that every child and family deserves the opportunity to enjoy these spectacular urban natural resources, and are doing our best to make it happen.

The Boston Harbor Islands serve as educational and recreational resources for youth development and community groups from around the region. On Spectacle Island, Save the Harbors educators teach kids to fish for flounder, skates and the occasional striped bass from the pier, and help them explore the shore looking for sea glass and historic artifacts from Spectacles Treasure Beach.

On Georges Island, youth and teens explore the maze of passageways at Fort Warren, a historical landmark used for coastal defense during the Civil War, where they may even catch a glimpse of the famous ghost of the Lady in Black. The docks on the island offer fishing spots while the parade ground is a great space for sports and games.

At Save the Harbor/Save the Bay we are particularly proud to serve as the BostonHarbor Connection for a generation of young people, said Save the Harbor/Save the Bay President, Patricia Foley. The best way we know to save the harbor is to share it with the regions kids and families.

Save the Harbor/Save the Bays free youth and beach programs have introduced more than 160,000 young people to Boston Harbor and the islands since they began in 2002.

Save the Harbor/Save the Bay is a nonprofit public-interest environmental advocacy organization for Boston Harbor, whose mission is to restore and protect Boston Harbor, the Boston Harbor Islands, the regions beaches and the marine environment and share them with the public for everyone to enjoy.

For more information: http://savetheharbor.org.

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Arlington youth visit Boston Harbor Islands - News - The Arlington ... - Wicked Local Arlington

Vacationers from Ocracoke, Hatteras islands having trouble getting money back – WCTI12.com

VIDEO: Vacationers from Ocracoke,...

EMERALD ISLE, Carteret County - Jennifer Corbin and her family are enjoying some home cooking away from home.

They traveled from the Midwest expecting to vacation in the Outer Banks. Instead, they are at a rental home in Emerald Isle.

Did you ever think at this point in your vacation that you would be in Emerald Isle?

"No, we we're supposed to be in Waves, North Carolina," said Corbin.

She and her family are one of many tourists who were forced to change their plans when the Hatteras and Ocracoke island areas lost power last week. Luckily for them, they were able to find an alternative place to stay. With that being said, they've fallen into the same predicament as many others with a company called Surf or Sound Realty.

"We ended up getting a email from the realty company saying there has been a mandatory evacuation and, by the way, you are entitled to zero refunds because our policy is no refunds," Corbin said.

A Facebook page has since been made with more than 800 members all concerned about not being refunded.

"We spent over $6,000 dollars in Waves," Corbin said. "I paid for that back in February, and then so this home we spent another $4,000 to rent this and not everybody can do that. Really, for the people who had to completely cancel and have lost all their money and we don't know if we are going to get it back."

Corbin said like so many others, she'll probably have to take legal action.

"We realize that we are probably going to have to give legal counsel and get somebody involved that way because we've gotten no information from anybody else saying they will be understanding and try to work with us," Corbin said.

Surf or Sound Realty has responded to many people on the Facebook page asking for time to figure out what their next will be. The company said it will contact guests through email with updates. That even applies to people with rental insurance who say they are experiencing the same problem.

Other tourists have been having similar problems with other realty companies. Read this story from WTVD on what actions you can take.

Originally posted here:

Vacationers from Ocracoke, Hatteras islands having trouble getting money back - WCTI12.com

Geisinger experts say gene editing progress, but have concerns – Sunbury Daily Item

Two Geisinger Health System scientists said Wednesdaythe successful editing of human embryos' DNA to erase an inheritable heart condition shows potential in preventing disease. But both urged caution and said there is more work to be done to ensure the process is safe.

W. Andrew Faucett,Geisinger Genomic Medicine Institute professorand director of policy and education, andF. Daniel Davis,Geisinger chief bioethics officer, were not greatly concerned, however, that the research would lead to genetic manipulation to produce so-called designer babies.

They were commenting on the firstgene editing on human embryos that has been conducted in the United States. The Washington Post reported on Wednesday that researchers said that they consider their work very basic. The embryos were allowed to grow for only a few days and there was never any intention to implant them to create a pregnancy. The ultimate goal, though, is to "correct" disease-causing genes in embryos that will develop into babies.

Details of the experiment using thelaboratory tool known as CRISPR (or Clustered Regularly Interspaced Short Palindromic Repeats), a type of "molecular scissors,"became public Wednesday with a paper in the journal Nature, the Post reported.

"I'm certainly not an expert on that end of it," said Davis, the bioethics officer. "But this does represent an advance along the evolutionary pathway of a technology. It's a step forward in ways most people would agree represents progress. There still are legitimate concerns about the more widespread use and clinical applications at this point."

According to The Post, the researchers used eggs from 12 healthy female donors and sperm from a male volunteer who carries the gene that causes hypertrophic cardiomyopathy, a disease of the heart muscles that can cause no symptoms and remain undetected until it causes sudden cardiac death. The researcherssnipped out the gene that causes the disease and replaced with a copy of the gene.

Faucett said his concerns include whether the technology could lead to other changes in "off-target" genes that would be passed on to future generations.

"We'llfix the heart gene but damage a cancer-causing gene," he said. "We'll solve this problem but cause another problem."

Faucett said it's impossible to weigh one problem against the other because no one knows what the off-target gene is until it shows itself years later.

"There are 20,000 genes in the human body," he said. "A lot of genes we don't understand. Part of what we're doing at Geisinger is trying to understand the use of genes. Also what do you do with the genes you understand."

He said, though, Geisinger is not doing gene editing research but studying DNA samples to check for potential for disease in patients and their families.

"We're not studying embryos," Faucett said.

Davis said concerns about manipulating DNA to create specific humans are overblown.

"I don't mean to be a naysayer," he said. "I just think the real ethical concern is about safety and efficacy."

He has less concern about designer babies than about people that are going to be harmed by technology. He cited bone marrow transplants and hormonal therapy for women that have been harmful to some patients because the treatments were not adequately investigated.

The Post reported that Shoukhrat Mitalipov, one of the lead authors of the paper and a researcher at Oregon Health & Science University, said he is conscious of the need for a larger ethical and legal discussion about genetic modification of humans, but that his team's work is justified because it involves "correcting" genes rather than changing them.

Faucett was on the American Society of Human Genetics committee that wrote the society's position paper on the genome editing. The paper, which comes out today and is endorsed by a number of genetic study groups from around the world, states it is against anything but laboratory testing (without humans).

Email comments to jsylvester@thedanvillenews.com. Follow Sylvester on Twitter @JoepSylvester.

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Geisinger experts say gene editing progress, but have concerns - Sunbury Daily Item

Kathiresan and Topol on Genomics of Heart Disease – Medscape

Focusing on Heart Attacks Among the Young

Eric J. Topol, MD: Hello. I'm Eric Topol, editor-in-chief of Medscape. I'm privileged today to speak with Sekar Kathiresan from the Broad Institute, who heads up the Center for Genomic Medicine at Massachusetts General Hospital, which is not even a year old, and who also is on the faculty at Harvard Medical School. Sek, you've done some remarkable things to advance our knowledge in cardiovascular genomics. In fact, you're my go-to guy.

I'd like to start with your background and how you got into this area. You grew up in Pittsburgh, went to Penn for undergrad, and then to Harvard?

Sekar Kathiresan, MD: I graduated from Harvard Medical School in '92 and have stayed there since. I did internal medicine (clinical cardiology) training, and I was a chief resident in medicine at Mass General. I started my research training in 2003 after all those years of medical school and clinical training. It was originally supposed to be just a 2-year stint in genetic epidemiology, but I ended up liking it so much that I spent 5 years as a postdoctoral fellow2 years at the Framingham Heart Study and 3 years at the Broad Institute, learning human genetics. I got all of the foundation for genetics research during that experience.

I started my own lab in 2008. The whole time, we've been focused on trying to understand why some people have heart attacks at a young age, specifically looking at the genetic basis for premature myocardial infarction (MI).

Dr Topol: In addition, you've established worldwide collaborations of people doing similar things. How did you start that?

Dr Kathiresan: That's an interesting story. I started in this work in 1997 as an intern at Mass General, recruiting patients who'd had an MI prior to the age of 50 for men and 60 for women. A faculty member there, Chris O'Donnell, started that project and got me involved. Over the subsequent 6 or 7 years of my clinical training, we recruited about 500 such patients at Mass General. I realized quickly that it wasn't going to be a sufficient sample size to make the kind of observations needed to understand the biology of the disease. It's a complex disease; a few patients were not going to help solve the problem.

In the mid-2000s I worked with David Altshuler. He was my mentor, and he encouraged me to reach out to people around the world who had similar collections of patients. As a postdoctoral fellow, I emailed investigators in Malm, Sweden, who had a similar collection. They had published their findings. I said, "Do you want to work with us?" They invited me to Malm, and I went. We ended up partnering with six or seven other investigators to start what we called the Myocardial Infarction Genetics Consortium. That's been the foundation for all of our work on heart attack genetics.

Around the same time, I started a similar consortium for looking at cholesterol level genetics. That has now expanded to more than 50 centers around the world.

Dr Topol: There is a real misconception that heart attacks and coronary disease are tightly interwoven with lipids and cholesterol, but plenty of people who have virtually normal or even better-than-average lipid profiles wind up having heart attacks. Where do you see this field going in terms of better understanding the non-LDL cholesterolor other lipidfoundation for MIs?

Dr Kathiresan: I'll share with you what we have learned about heart attack genetics over the past 10 years. Doing something unbiased, in the sense of looking across the genome and asking, "Where in the genome is there risk for heart attack in terms of cases versus controls?", we have learned that several previously known pathways show up. For example, one of the top results in any genetic analysis for heart attack is LDL cholesterol and several genes related to LDL cholesterol. In addition, we've been able to clarify some controversies in the lipids area.

It was unclear when I got into the field which of the twoHDL, the so-called "good cholesterol," or triglycerideswas more important. When I was in medical school I was taught that anything that raised the good cholesterol must be good for you. Our genetics have shown that is not the case. Basically, HDL cholesterol is a very good marker of risk but it's unlikely to be a causal factor. We published a genetics study[1] a couple of years ago that challenged the conventional wisdom and suggested that drugs that raise HDL are not going to work. We actually had a hard time publishing that study; it took a couple of years, but since then, there have been five randomized control trials of medicines that have tried to raise HDL cholesterol.

Dr Topol: It's been a big bust.

Dr Kathiresan: It turns out that we probably were on the wrong side of the seesaw. When HDL is down, triglycerides are up. People thought that HDL was what was important. The genetics now strongly point to triglycerides-rich lipoproteins.

We have LDL and we have triglyceride-rich lipoproteins. The other key factor in the lipids space is something called lipoprotein(a). The genetics are compelling that these three things are very important for heart attack. The surprising thing has been that of the 55 gene regions we've identified for heart attack, only about 40% point to things that we already knew about. Another 60% don't relate to any of the known risk factors, like blood pressure or cholesterol, suggesting that there are new mechanisms for atherosclerosis. As a community, we need to figure those out.

Dr Topol: For example, the common variant of 9p21, a 60 kb noncoding region, has nothing known to do with cholesterol, and we are still working on what it really means, right?

Dr Kathiresan: Yes. At Scripps, you played a big role in trying to sort that out. It's been 10 years and it's been very challenging. None of this is going to be easy. Cholesterol was hypothesized to play a role in heart attack more than 100 years ago, and some people are still debating the role of LDL cholesterol. This isn't going to be straightforward, but it does suggest that there are lots of other mechanisms.

Dr Topol: That's obviously very important because Brown and Goldstein, the famous Nobel Laureates who were instrumental in the development of statins at the turn of the century, published an editorial in Science, "Heart Attacks: Gone With the Century?"[2] That was the notion that statins would be widely used and that we would stamp out heart attacks. That hasn't exactly happened, although there has been a reduction in large ST-elevation infarcts.

Dr Kathiresan: There are a couple of issues. Their hypothesis is sound; it says that if you start treatment early enough, and if the LDL is low over an extended period of time (30-40 years), you won't develop atherosclerosis. They based that hypothesis on model organism work but also on human genetics. People who carry mutations that naturally lower their LDL to very low levels lifelong rarely develop atherosclerosis. Societies like rural China, where LDL is very low, have very little atherosclerosis. It is a very good hypothesis and we still have to test it. We don't know.

Dr Topol: If you could do it at birth...

Dr Kathiresan: If we could do it safely...

Dr Topol: And safelyright.

Dr Kathiresan: Even if you do that, there are still several other elements or pathways. We are seeing now, in the United States at least, a transition from risk that was driven over the past century by blood pressure, smoking, and LDL, to this century, when risk is basically being driven by abdominal adiposity, insulin, and triglyceridesthe cardiometabolic axis. That's what we're seeing with the obesity epidemic. LDL levels are coming down and heart attack rates have come down as a result, but we have the countervailing force of cardiometabolic disease. That's where triglyceride-rich lipoproteins come ininsulin and so forth. This is on an incredible rise in the United States and also worldwide.

Dr Topol: One of the most seminal studies in the three decades during which I studied cardiology and coronary heart disease was one that you and your colleagues published last November in the New England Journal of Medicine.[3] In that study, you had the genetic risk scores, so you knew the various polygenic markers and could separate people into low, moderate or intermediate, and high risk, and you showed the titration of high riskwhich has never been done before, genomicallywith better lifestyle.

A Cell editorial[4] published very soon after your paper said that diet and exercise will save us all.

I want to get your thoughts about this. These days, if people knew that they were at high risk without any connection to family history, blood pressure, or LDL, they could benefit from this knowledge and this could be a way to promote, for them in particular, a healthy lifestyle.

Dr Kathiresan: Thank you for your kind words about the paper. The work started with a very simple observation. In my preventive cardiology clinic at Mass General, we have patients who come in and say, "My father died of a heart attack at age 50. I am doomed." They feel that DNA is destiny for this disease. We wanted to address that if you are at high genetic risk, can you overcome or counterbalance that risk with a favorable, healthy lifestyle? We've known for many years that a favorable lifestyle is associated with a reduced risk for coronary heart disease. In the context of genetic risk, how do they interact?

We found that if you are at high genetic risk, based on 50 different DNA markers, you could cut that risk in half by having a favorable lifestyle that included not smoking, regular fruit and vegetable intake, maintaining an ideal weight, and so forth. It was a very sobering message in some sense and a good public health messagethat if you are at high genetic risk based on, let's say, family history, you should not take this DNA-as-destiny approach. Rather, you do have control over your health, specifically by trying to practice these healthful behaviors.

Dr Topol: It transcends the Framingham Risk Score era because now you have a way to gauge risk and it can be titrated, so it was a big step forward. I also want to get into the idea that you can protect your heart disease risk naturallythat is Mother Nature. Previously you've talked about APOC3 and a startling finding about these homozygotes that you identified in Pakistan. Would you tell us that story?

Dr Kathiresan: You wrote many years ago about protective mutations. When we think about genetics, we think automatically about risk, but actually there is a big value of genetics in finding people who are naturally protected because of a mutation, and the main value is that you could hopefully develop a medicine that might mimic that mutation. If you can do that, then you can transfer the benefit that nature gave just to that one rare person to the entire population. That's the concept.

There's a very good example in the cardiovascular space with the gene PCSK9, where this held true. We set out a couple of years ago to ask whether there are other examples. The first that we found was the gene apolipoprotein C3. This is a gene that has been known about for 30 or more years. It's a gene that puts a break on your body's ability to handle dietary fat. When we eat a McDonald's burger, right after the meal, the triglyceride level goes up two- to threefold. The body has to clear that fat and the APOC3 protein actually dampens your ability, or puts a break on your body's ability, to clear it.

We found that about 1 in 150 people in the United States have a favorable mutation that gets rid of one of the two gene copies of APOC3. These individuals have lost a "bad guy" in their blood, and therefore they have lower lifelong triglyceride levels and about a 40% lower risk for heart attacks. That immediately suggested that if you could develop a medicine that got rid of APOC3, you might be able to reduce risk for heart attack.

One of the other key features of this paradigm is finding individuals who lack both copies of that gene. Sometimes you would call them "human knock-outs." Why do you want to know that? If there's a person walking around who naturally lacks both copies of that gene, and they are healthy, then that immediately says that you could pretty safely treat somebody with an inhibitor of that protein and not have a lot of adverse effects. It's not a complete predictor, but it's pretty close.

We set out to find these individuals. We looked at more than 100,000 people in the United Sates of European ancestry and did not find a single person who lacked both copies of APOC3. It turns out that there are people in whom both copies are gone, but that property tends to happen more when the parents of a child are closely related to each otherfor example, first-cousin marriage. In some parts of the world, it is actually fairly common. It's not taboo as it is in the United States. Pakistan is a country with the highest proportion of marriages that involve parents who are closely related. We went to an investigator in Pakistan, a collaborator who had recruited a large study of heart attacks there, and we did sequencing of APOC3 in more than 20,000 people. We found four individuals who completely lacked the gene.

Dr Topol: It was striking that these people, first with low triglycerides, also had no triglyceride elevation when they ate a fatty meal.

Dr Kathiresan: It's fascinating. This was a small fishing village. My collaborator, Danish Saleheen, had a mobile truck to do studies. They went out to the fishing village and recruited family members in whom gene copies were present and those with both copies gone. They gave both groups of individuals a fat challenge and then took blood samples every hour for 6 hours. In all of the people who had APOC3, the triglyceride levels went up (like they would in you and me), but in the people who didn't have the gene, the triglyceride levels did not budge at all after the fatty meal. This gives us some insight as to why people are protected from heart attack.

Dr Topol: It's interesting, because it flies in the face of so many studies where they lowered triglyceride levels and findings were very disappointingthere was little clinical effect. But this is a different target, of course.

Dr Kathiresan: That's the issue. There were lots of studies over the years (particularly with fibrates and fish oils, for example). In randomized controlled trials, those two medicines lowered triglycerides but they were unable to show that they lowered risk for heart attack. The challenge is that we don't really know what the molecular targets are for those two drugs, and triglyceride metabolism is complex. You can imagine waysand there are actually waysthat you can lower the triglyceride level, but counteract that with other bad things where the net effect might be no effect on disease risk. The way you lower the triglycerides will mattermaybe a little less so than for LDL. It looks like almost any way you lower LDL (although there are some exceptions there too) makes a difference in terms of heart disease risk. For triglycerides, it matters how you lower them.

We are seeing that there are several genes (APOC3 and a couple of others) in the pathway where there is naturally occurring genetic variation, pointing to these genes as being the way to lower triglycerides if you want to lower risk for heart attack.

Dr Topol: That's phenomenal. What we are seeing here is starting to really crack the big three: Lp(a), APOC3 (and other triglycerides), and LDL. We're going to see the lipid story become amplified. There is still going to be this other...

Dr Kathiresan: Residual risk.

Dr Topol: That's going to be an interesting enigma.

Dr Topol: Where are you going next? How are you going to keep building this? This foundation of knowledge has been extraordinary. You have been working on it for a decade. What can you do to expand this now?

Dr Kathiresan: The lab has worked on three elements during the past 10 years: discovery of new genes, understanding how they work, and then translating those findings to improve cardiac care. I see genomics and informed cardiac care going in two ways. One is identifying a subset of individuals who are at much higher risk, based on the genome. We are pretty good at that right now and I think there will be broad uptake over the next 10 years.

We'll then be able to find a subset of individuals early in life, based on their DNA sequence, who are at three-, four-, or 10-fold higher risk for heart attack. Then the question becomes, what do you do for those patients? We've already shown the value of lifestyle and probably a statin, but then the key question is, what else is there? Can we develop a medicine in the nonlipid space that can have dramatic benefit? That's what I see in the next 10 years.

Dr Topol: That would be exciting. We will ultimately get there as we learn more.

Now, you are big on Twitter.

Dr Kathiresan: No bigger than you.

Dr Topol: I enjoy following you. You are great to follow because you are one of my favorite educators. We can learn a lot from Twitter. What do you like about it? Sometimes, of course, you are tweeting about the Steelers, but when you are not tweeting about the Steelers or politics, what do you enjoy about Twitter?

Dr Kathiresan: I love what you just said. Every day I learn something new on Twitter. It's a little bit of a double-edged sword. We all know about social media; it's quite addictive. I could sometimes spend an inordinate amount of time on it. That aside, I learn a lot and it's mostly about science. It's things that I would not have seen. On your feed, you transfer an incredible amount of information daily, and there are lots of other opinions. Often now it is the place for immediate news, whether it's science news or other news.

A good example: A couple of weeks ago, the topline results from the randomized controlled trial of the PCSK9 antibody were announced. I knew they were going to be announced because it was a 4 PM release by Amgen at the close of the market, so I'm waiting.

Dr Topol: The first look is going to be on Twitter.

Dr Kathiresan: Exactly. A day later it will show up in The New York Times.

Dr Topol: The pulse of our field, as you say; the amount of information that you can get through Twitter in science and biomedicineour worldis quite extraordinary, and it's just as surprising that a lot more physicians and researchers don't use it.

Dr Kathiresan: Two of the healthiest areas are genomics and cardiovascular medicine. There's a tremendous amount of cardiology on Twitter, and of course, genomics is way ahead of a lot of other fields.

Dr Topol: It seems that way. It's some of my favorite stuff.

This has been really fun. I just cannot say enough about how much you have accomplished in such a short time to advance the field. [Heart disease is] still right there as the number-one cause of death and disability, and we still have a long way to go, although cancer is catching up and may soon overtake it in the United States.

Thanks so much for joining us. And thanks to all of you for joining us for this conversation. It got a little deep into the pathophysiology and genomics of coronary disease, but it's certainly an area that we are going to continue to build on.

Follow Dr Kathiresan on Twitter @skathire and Dr Topol @EricTopol

View original post here:

Kathiresan and Topol on Genomics of Heart Disease - Medscape

Joyce Harper The Conversation – The Conversation UK

Profile Articles Activity

Joyce Harper is Professor of Human Genetics and Embryology at University College London in the Institute for Womens Health where she is head of the Reproductive Health Department, Principal Investigator of the Embryology, IVF and Reproductive Genetics Group, Director of Education and Director of two MSc programmes - Prenatal Genetics and Fetal Medicine and Reproductive Science and Womens Health. She has been working in the fields of IVF and reproductive genetics since 1987 and written over 170 scientific papers and published two textbooks. Her research includes preimplantation genetic diagnosis, factors affecting preimplantation development, comparison of in vivo and in vitro development, differences in culture media, embryo selection methods, sperm DNA damage and social and ethical issues surrounding IVF and reproductive genetics including gamete donation, surrogacy, social egg freezing, religious views to ART and fertility education and awareness.

Joyce is passionate about public engagement to discuss all aspects of womens health, including wellbeing. She has established a public engagement group with daily posts http://www.globalwomenconnected.com. Joyce is writing a book covering womens health from birth to death. She is deputy chair of the UK Fertility Education Initiative, trying to improve fertility awareness in the UK and a member of the Fertility Arts Education Project Steering Group.

Joyce has had many senior roles in the European Society of Human Reproduction and Embryology (ESHRE), including establishing the ESHRE PGD Consortium. She is chair of the HFEA Horizon Scanning Group and an advisor to the HFEA Science and Clinical Advances Advisory Committee. She is on the Board of the British Fertility Society. She is a member of the Nuffield Council for Bioethics working group on genome editing.

For further information see http://www.joyceharper.com.

1987

Kings College London, PhD

1984

Queen Elizabeth College, BSc

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Joyce Harper The Conversation - The Conversation UK

The healthcare problems of 2009 have not been fixed – Washington Examiner

With the Republican Senate failing to repeal the Affordable Care Act last week, the administration and Congress should consider paying greater attention to the healthcare problems of 2009.

When I graduated medical school in 2009, as the nation debated healthcare reform and the future of our healthcare system, the main challenges impeding doctors and patients were obvious to me. They included a rigid and perverse physician reimbursement system, a labyrinth of increasingly complicated, costly, and sometimes contradictory mandates and priorities, and a runaway malpractice system.

Medicare and Medicaid have historically reimbursed physicians via price controls, and their main cost control mechanism is to pay physicians less. This reimbursement system creates a dangerous lack of time and resources in the trenches, which facilitate myriad unintended consequences that can jeopardize care and ironically increase costs.

The price controls limit access for these patients, particularly those on Medicaid, which can lead to harmful delays or produce a heavy reliance on costly and overcrowded emergency rooms. Ultimately, the poorest patients with the greatest needs are hurt the most and have the hardest time getting help. A recent review in the Journal of General Internal Medicine found an association between hospital strain and mortality. As such, this unnecessary strain this reimbursement system produces also has the potential to harm the care of all patients.

Studies have shown that primary care can improve quality and lower healthcare costs. But the physician reimbursement system is skewed against primary care. This contributes to enormous time pressures on primary care doctors. Research in the Journal of General Internal Medicine found that the average primary care physician addresses on average 7.1 clinical problems in an on average 20.9 minute visit, leaving just 3.8 minutes per item. This time crunch hinders the ability of patients to understand their disease, treatment course, and follow up. It also impedes prevention and counseling that could facilitate healthy lifestyles and detect serious diseases earlier. This compromises care.

Consequently, fewer medical students are pursuing primary care as a career. This limits the accessibility of patients to our healthcare system. When patients are sick and don't have a primary care doctor to turn to, they must either suffer and see their condition worsen or go to expensive emergency rooms. The primary care physician shortage also limits the availability of counseling, prevention, and other services that primary care physicians offer.

The physician reimbursement system has also historically not reimbursed physicians for non-face-to-face care. In addition to impeding innovation, this unintentionally pushes healthcare services to more intensive and costly sites than necessary. This too limits access to care and contributes to rising healthcare costs.

The regulatory climate of medical practice has become increasingly complex. One-size-fits-all regulations work well for inanimate cars moving down an assembly line. Yet they fail to capture the varied backgrounds, experiences and preferences of living human beings, as well as the possible different responses to different interventions. While a certain degree of oversight is needed to ensure quality and safety, doctors have been spending more and more time on charting, paperwork, and checking off boxes and less time with their patients. Over time, healthcare systems have been forced to devote more time and resources to the administration of medicine, which takes valuable resources away from the practice of medicine.

At the same time, the unpredictability of the malpractice system has led to a constant fear of costly lawsuits, encouraging doctors to order unnecessary tests, consults, and admissions to avoid being second-guessed later in court. This practice known as defensive medicine has been estimated to cost our healthcare system between $100 billion and $200 billion annually.

Years later, now as a practicing physician, I know that the problems of our 2009 healthcare system still exist today. Few, if any, are arguing that these challenges have been resolved. In fact, in many ways they have gotten worse. The problems of our 2009 healthcare system need to be addressed now more than ever, and would go a long toward lowering costs and producing a higher-quality, more accessible healthcare system.

Jason D. Fodeman, MD, MBA is a practicing physician. He specializes in delivery systems and health policy.

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The healthcare problems of 2009 have not been fixed - Washington Examiner

Hatch: ‘Health care, as far as I’m concerned, is over’ – The Weekly Standard

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The White House wants to keep pushing on health care. The Senate has other ideas.

5:46 PM, Aug 02, 2017 | By Andrew Egger

Andrew Egger Reporter The Weekly Standard

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Gage Skidmore

Finance Committee chairman Orrin Hatch has insisted repeatedly that the window for health care has closed, and that the Senates time is better spent on other issues for now.

Theres too much animosity and were too divided on health care, Hatch told Reuters on Monday. I think we ought to acknowledge that we can come back to health care afterwards, but we need to move ahead on tax reform.

Not every senator is convinced. Health Committee chairman Lamar Alexander announced Wednesday that his committee would hold bipartisan meetings looking at Obamacare repair, which would look at ways to prevent a collapse of the health insurance market.

Asked about these meetings Wednesday, Hatch was unimpressed.

Why are they having hearings on health care? he told reporters. Were onto taxation now. Health care, as far as Im concerned, is over.

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Hatch: 'Health care, as far as I'm concerned, is over' - The Weekly Standard

Health-Care Reform Can’t Die – National Review

Is legislative health-care reform really dead?

Most of Congress seems to think so, and President Trump agrees, if his irate tweets about taking executive action to fix health care on his own are any indication. But the fact remains that Obamacare exchanges are still struggling all across the country. While a GOP-led repeal bill might not be on the table again anytime in the near future, some lawmakers continue to float possible solutions.

In the House, a group of about 40 centrist lawmakers hopes to lead the effort to stabilize the Obamacare exchanges. Called the Problem Solvers caucus, the group includes some moderate congressmen from the New Democrat Coalition and the GOPs Tuesday Group.

Led by Democratic congressmen Tom Reed (N.Y.) and Josh Gottheimer (N.J.), the caucus is primarily focused on continuing to fund the Affordable Care Acts cost-sharing-reduction subsidies (CSR payments), which reduce the significant costs to insurers of covering low-income Americans under Obamacare.

The bipartisan group also wants to establish a federal stability fund that states could access to reduce premiums for citizens with high-cost medical needs. The moderate lawmakers hope to alter the employer mandate so that it applies only to companies with over 500 workers, which would relieve the tax burden on small businesses that choose not to provide insurance plans.

The Problem Solvers caucus has also rallied behind a few ideas that have gained bipartisan support in the past, including abolishing the ACAs medical-device tax and expanding states ability to seek waivers from some of the bills coverage rules.

On Wednesday, Republican congressman Mark Meadows, chair of the House Freedom Caucus, said health-care reform isnt over. He also said that he has met with the Trump administration to discuss the path forward, and hes confident they can develop a new plan. Meadows was one of the key GOP members to broker the deal for an amendment that enabled the American Health Care Act to pass the House in April.

Over in the Senate, a handful of moderate GOP senators have suggested providing block-grant health-care funding to the states. This proposal was put forth in an amendment last week by GOP senators Lindsey Graham and Bill Cassidy, but it has yet to receive a vote. It would need to be scored by the CBO before a floor vote could take place.

Graham and Cassidy, along with moderate GOP senator Dean Heller (Nev.), met with Trump on Friday to discuss their plan. The White House, eager to capitalize on any idea to advance reform after last weeks debacle, seems intent upon using this plan as a means of gathering momentum for further health-care negotiation.

Meanwhile, Republican senator Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.) announced Tuesday afternoon that the Senate Health, Education, Labor, and Pensions committee will hold bipartisan hearings throughout September to discuss possible ways to stabilize the ACA marketplaces.

For his part, Trump has threatened to stop doling out CSR payments, apparently with the goal of further exacerbating the problems that already exist on the Obamacare exchanges. Trump seems to believe that further devolution of the exchanges would force lawmakers to implement an immediate health-care solution, but ending CSR payments would almost certainly lead to utter chaos in the insurance markets, making a fix even more difficult.

These efforts, while uncertain and rather uncoordinated, reveal a basic fact: We simply cant afford to give up on health-care reform. The fact that bipartisan cooperation is emerging only now is shameful; Democrats should have cooperated to begin with. Obamacare reform was always going to be necessary, in one form or another. With earlier Democratic support, it mightve been feasible to develop legislation that could fix at least some of the problems with the exchanges and garner enough support to be passed into law.

Legislative efforts may be effectively dead for the near future, but as health-care policy expert Avik Roy wrote on the Corner just after the Senate vote failed early Friday:

The GOP cannot simply move on and give up on health care. Health care is the biggest driver of our debt and deficit, the biggest driver of growth in government, and one of the biggest drivers of economic insecurity for those in the middle class and below. Take some time to reflect, yes. Come up with a better strategy, yes. But to give up on health-care reform is to give up on everything conservatives stand for.

If nothing else, the evident failures of Obamacare premium costs constantly on the rise, more insurers fleeing the ACA exchanges across the country, leaving many states with just one or two insurance options on the exchanges preclude anyone in Washington from giving up on reform for good.

READ MORE: Editorial: The Republican Health-Care Fiasco Republicans Should Revisit Health Care after a Tax Reform Success Maybe Health Care Wasnt Possible

Alexandra DeSanctis is a National Review Institute William F. Buckley Fellow in Political Journalism.

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Health-Care Reform Can't Die - National Review

Americans Die Younger Despite Spending the Most on Health Care – Bloomberg

By Laurie Meisler

August 2, 2017

Typically, the more a developed country spends on health care, the longer its people live. The U.S., which spends the most on health care, bucks that trend. Compared to the 35 countries in the Organization for Economic Cooperation and Development, which promotes policies to improve social and economic well-being, the U.S. life expectancy of 78.8 years ranks 27th. It has the fourth highest infant mortality rate in the OECD, the sixth highest maternal mortality rate and the ninth highest likelihood of dying at a younger age from a host of ailments, including cardiovascular disease and cancer.

The U.S. is the most obese country in the OECD, leads in drug-related deaths and ranks 33rd in prevalence of diabetes. Yet 88 percent of Americans say they are in good or very good health, according to OECD statistics. Only 35 percent of Japanese, who have the highest life expectancy in the OECD, regard themselves as healthy or very healthy.

Unlike other countries in the OECD, the U.S. mostly relies on voluntary health insurance to fund health-care costs. Public health insurance, such as Medicare and Medicaid, accounts for 27 percent of coverage. By contrast, the 10 countries with the highest life expectancy depend on voluntary insurance for an average of less than 6 percent of their costs, and government spending for nearly half.

One big reason U.S. health care costs are so high: pharmaceutical spending. The U.S. spends more per capita on prescription medicines and over-the-counter products than any other country in the OECD.

Notes: *Included in per capita spending on health care

**Includes cardiovascular disease, cancer, diabetes and chronic respiratory disease

Methodology: Bloomberg ranked the OECD countries by total expenditure on health, which is the amount each country spends for both individual and collective services. Dollar figures for per capita spending use current prices and current purchasing power parities. (PPPs are the rates of currency conversion that eliminate the differences in price levels between countries.) Expenditure data include personal health care services and expenses, medical goods dispensed to outpatients; prevention and public health services; health administration and health insurance. Spending figures for 2016 are estimated or provisional. Data for related factors are for 2015 or the latest data available.

Infant mortality refers to the number of deaths of infants under one year old. Compulsory/contributory health plans include social health insurance, compulsory private insurance and compulsory medical savings accounts.

Source: OECD, The World Bank, World Health Organization, International Diabetes Federation and Diabetes Atlas

With assistance from Yvette Romero

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Americans Die Younger Despite Spending the Most on Health Care - Bloomberg

Capitol Shocker: Democrats and Republicans Start Working Together on Health Care – New York Times

Photo Credit Linda Huang

Something unusual and important is happening in Congress: Republicans and Democrats are working together to improve the health care system. And theyre doing so in defiance of President Trump, who appears determined to sabotage the Affordable Care Act and the health insurance of millions of people.

This surprising if modest burst of bipartisanship comes just days after the Senate failed to pass a Republican bill to repeal important provisions of the A.C.A., or Obamacare. On Monday 43 members of the House outlined a proposal to strengthen the insurance marketplaces created by the 2010 law. On Tuesday Lamar Alexander and Patty Murray, the Republican and Democratic leaders of the Senate Health, Education, Labor and Pensions Committee, said they would hold hearings and introduce a bill to cut premiums and encourage insurers to sell policies on the marketplaces for 2018.

It is, of course, impossible to know if such efforts will succeed. Even if they result in legislation, Republican leaders could refuse to bring it to the floor for a vote. Having treated Obamacare as a political piata for seven years, Republicans might find it hard to actually help the program. Another danger is that Mr. Trump and his health and human services secretary, Tom Price, could try to pre-emptively weaken the marketplaces through administrative measures. Still, its good to see politicians actually doing their jobs. The sight of members of both parties working together in the public interest is uplifting, especially after the long partisan campaign to take insurance away from so many Americans.

Contrary to Mr. Trumps tweets, Obamacare is not collapsing. But it needs work, and some insurance markets are in trouble. Insurers have said they will no longer sell policies in 20 counties in Indiana, Nevada and Ohio, and many are proposing to raise premiums because of the uncertainty created by Mr. Trumps threats. Experts say insurers could withdraw from even more counties, especially in rural and suburban areas, if the president sabotages the law.

The biggest fear, one shared by Mr. Alexander and Ms. Murray, is that Mr. Trump will stop subsidies authorized by the A.C.A. to make health care affordable to low-income people. The government pays these subsidies, about $7 billion this year, to insurance companies every month. In exchange, the companies reduce the deductibles and co-pays for people who earn between 100 percent and 250 percent of the federal poverty line, or $12,060 to $30,150 a year for a single person.

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Capitol Shocker: Democrats and Republicans Start Working Together on Health Care - New York Times