After a rather bleak year, there are a few rays of hope for the U.S. individual health insurance market.

The Senate shot down Affordable Care Act repeal bills last week, and now Senate Republicans and Democrats are talking about cooperating on improvements to the existing law.

Lamar Alexander, a Tennessee Senator who can hardly be accused of being a wild-eyed liberal, announced a bipartisan meeting in September to stabilize insurance markets in 2018.

Like other parts of the country, a lot of people in Tennessee have come to rely on ACA insurance policies. And Alexander, while a staunch opponent of Obamacare, has no intention of setting them adrift in a sea of uncertainty.

Also, credit Senator John McCain with nixing the most recent bid to strip away the real meat of the ACA, ditching the individual mandate and opening up an opportunity for insurers to squeeze customers with pre-existing conditions. He was one of three Republican senators to oppose the final bill and his dramatic thumbs-down vote became a viral video clip.

Some accused McCain of being hypocritical because he actually voted for the first repeal-and-replace bill considered by the Senate, the one drafted by Majority Leader Mitch McConnell behind closed doors.

But McCain’s positions were consistent. He returned to Washington to vote in favor of opening debate on a replacement bill, a measure that passed with a 51-50 margin with Vice President Pence casting a tie-breaker. That’s because McCain is a right-of-center politician, but he believes in the American system of government.

So he approved starting the debate, and supported the McConnell bill because senators had an opportunity to debate it in open session. He voted against the final “skinny” bill for two reasons. One, the bill was a sham because nobody in Congress — either in the House or the Senate — wanted it passed into law. So why would you vote for something that you don’t want passed into law?

At the same time, the no vote allowed McCain, a prisoner of war in Vietnam, to stick it to President Trump for the rather nasty comment during the campaign: “I like people who weren’t captured.”

McCain knew Trump would be watching the video of his vote, and if he could have done it, he probably would have liked to have looked directly into the camera when he pointed thumbs down.

His vote was really a twofer. It was principled, yet at the same time it carried an element of revenge for McCain.

The potential winners — more or less coincidentally, I suppose — are Americans who rely on the individual health insurance market. Because if Alexander and other Republicans can rally enough support for a fix-it bill, customers will be looking at a lot more options next year along with more moderate price increases.

There’s still a long way to go, but if enough bipartisan support comes together there won’t be any “holes” in the insurance exchange — counties where there are no insurance choices. That was a very real possibility that market analysts have been warning about.

It still could happen if insurance companies go into the enrollment period rattled by fear of the unknown.

Long-term solutions to the U.S. health care fiasco remain elusive, and the best we can hope for is a clearer picture for 2018. We’ll take what we can get.

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So the Russians get accused of hacking the U.S. election, and when the new U.S. president meets the Russian president he says: “Hey! I got an idea — let’s sign a cybersecurity agreement!”

And the Russian president says: “Da! You send cybersecurity protocols and information, and we send you ours later!”

And the U.S. president says: “OK! It’s a deal!”

And folks, that’s how a historic cyber-pact was born … or is it AN HISTORIC cyber-security pact, we’ll have to ask those beady-eyed intellectuals over at CNN.

“I’m sure that Vladimir Putin could be of enormous assistance in that effort since he is doing the hacking,” Sen. John McCain said on Face The Nation Sunday.

Sure, there might be some hand-wringing in the U.S. this week since it appears the country is getting the bum’s rush and may be more vulnerable than ever to hackers.

But there’s a bright side to all of this. Administration incompetence may have driven a silver spike into the Republican agenda on health care. We’re not out of the woods, but there are rumblings that Senate leaders may have to do something previously unthinkable on the health care issue: Work with Democrats!

There’s no question that the health care system has to be fixed. It may not exactly be in a death spiral, as critics suggest, but premiums for 2018 are poised to rocket upwards due in large part to all of the uncertainty.

Insurers currently have no idea what 2018 will look like — whether they will be required to provide coverage for the basic problems spelled out in the Affordable Care Act, or whether young, healthy people will drop health insurance without the ACA mandate.

Insurance companies don’t even know, from month-to-month, whether the federal government will continue to pay the subsidies offered in the 2017 plans.

So if it is imploding, guess whose hands are on the detonator?

Sen. Mitch McConnell has a 52-seat Senate majority along with a handy-dandy vice president ready to step in with a tie-breaker. But even within his own party, there are deep ideological differences and trying to pull them all together is like herding cats.

The Los Angeles Times said Monday: “Trump has further complicated McConnell’s task, giving mixed signals about how he wants to proceed.”

First the president wanted to repeal and replace. Then he switched gears and said maybe Obamacare should just be repealed. At one point he called the replacement bill passed by the House “mean” — a week or so after celebrating its passage in a Rose Garden high-five-fest.

Contrary to popular myth, the swamp has not been drained and there are more alligators than ever. But if they’re bickering among themselves maybe they won’t notice the folks who are trying to pick their way ever-so-carefully to the other side.

Image credit: Wikimedia Commons

A computer will soon be able to tell you how long you’ll live.

New technology is being developed to analyze images of your heart, lungs and other organs and then tell you what your chances are of dying in five years.

Researchers at the University of Adelaide’s School of Public Health in Australia have already used the system with a 69 percent success rate.

Red flags raised by the analysis can steer your physician toward the right kind of treatment to head off undesirable outcomes. Or, if you get the all-clear you can crack open a Fosters and throw another shrimp on the barbie.

“Our research has investigated the use of ‘deep learning’, a technique where computer systems can learn how to understand and analyze images,” said Dr. Luke Oakden-Rayner, a radiologist with the university and lead author of a study on the technique that appeared in the Nature journal Scientific Reports.

“Although for this study only a small sample of patients was used, our research suggests that the computer has learned to recognize the complex imaging appearances of diseases, something that requires extensive training for human experts.”

Patients who suffered from severe chronic diseases like emphysema and congestive heart failure were the easiest to call for the computer but it detects other, less obvious problems as well.

“Instead of focusing on diagnosing diseases, the automated systems can predict medical outcomes in a way that doctors are not trained to do, by incorporating large volumes of data and detecting subtle patterns,” Oakden-Rayner said.

“Our research opens new avenues for the application of artificial intelligence technology in medical image analysis, and could offer new hope for the early detection of serious illness, requiring specific medical interventions.”

-It_is_certain.-_-_The_Magic_Eight_Ball_(7246548230)Finally — something to replace the rather cryptic Magic 8-ball, which has been the go-to prognostication device since it was marketed for commercial use in 1950. (The concept was actually introduced by The Three Stooges in their 1940 film, You Nazty Spy!)

Using a computer is more scientific, but the analysis will undoubtedly cost a lot more than the $6.74 price tag for the 8-ball listed on Amazon.

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DANGEROUS DEFINITIONS: A marquee over a bar on Dixie Highway in West Palm Beach reads: “Your hangover is not a pre-existing condition.”

Which brings up a very serious topic that will get lots of attention in the years to come if the Republican health care plan is signed into law. That is, what constitutes a pre-existing condition?

The point of the Affordable Care Act was to take this issue off the table. Once you put it back on the table in any way, shape or form, it becomes a slippery slope.

If someone has lung cancer, that’s obviously a pre-existing condition. But what if a patient is diagnosed — and successfully treated for — basal cell carcinoma? The risk of it spreading is low, especially if it’s caught early.

But will insurers be able to make a case that cancer of any type represents a pre-existing condition for all other types? So that if you are treated for basal cell, and later develop a different form of the disease, you won’t be covered?

These details will likely not be addressed by legislation. They may be worked out later in regulations that govern the new laws.

But in a political environment that is aggressively anti-regulation, will anyone have a watchdog role over these kinds of issues? Or will the health care market be left to run its own chaotic course?

Image credit: Zaneology via Wikimedia Commons

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Higher premiums for younger, healthier people helped fuel opposition to the Affordable Care Act early on. (Credit: Repeal ObamaCare/ Wikimedia Commons)

Democrats are howling about the health care bill passed by the House of Representatives, but it’s likely to resonate with the GOP’s core supporters.

The Affordable Care Act changed the structure of health insurance, mandating that insurers couldn’t charge more for pre-existing conditions, and only three times more for older patients compared to younger ones. That artificially increased premiums for young, healthy people, including those who supported Donald Trump’s candidacy.

You might think, in order to create a better society, that people would be willing to pay for services even though they themselves don’t use them. Childless couples, for example, pay for public education. But somehow, the discussion on health care has become ask not what you can do for your country but ask what you can for me.

Men are complaining about having to purchase policies that include maternity care.

In December, the Kaiser Foundation conducted focus groups among Trump voters to find out what kind of health care plan they wanted. Members of the groups were “unmoved by the principle of risk sharing,” the New York Times reported on Jan. 5.

Although support for the ACA has edged up since the election, a sizeable minority continues to oppose it — a Real Clear Politics polling average puts opposition to the ACA at more than 42 percent, about the same level as President Trump’s approval ratings.

If the new American Health Care Act brings down premiums for younger and healthier Americans, don’t expect a great rush to oust Republicans who voted for it in 2018. They’re just giving their constituents what they want.

In the Kaiser focus groups, participants said they liked the pre-ACA days because they could purchase low-cost plans, “even if it meant that less healthy people had to pay more.”

This is exactly what the new Republican health care system may be about to deliver.

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TRUTH ABOUT DEDUCTIBLES: We keep hearing about how, with deductibles over $5,000 per person under the ACA, the health care plans are expensive and virtually useless. It’s seldom if ever mentioned that benefits kick in well before deductibles are met.

For one thing, plans include a wellness visit, so at least you can get a checkup to find out where you stand.

But let’s say your doctor decides that something needs to be checked out further, and orders an MRI. If you are uninsured, you will pay the full cash rate for that service — which could be up to $3,000. But if you are covered under a policy, even though you are paying for the procedure out-of-pocket, you’re paying much-reduced network negotiated rate.

Instead of the $3,000, you might owe $800. True, you haven’t satisfied your deductible, but you’ve saved $2,200.

The idea that a family of three has to pay a hefty premium of $1,000 a month — and gets no benefit until they fork out $15,000 out-of-pocket — is just dead-wrong.

But hey, if it fits into the anti-ACA argument, let’s keep using it!

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WATER WOES: There’s a lot of talk about how “poor lifestyle choices” contribute to chronic disease.

But there are many environmental risk factors that are clearly beyond our control.

A recent study by the Natural Resources Defense Council (NRDC) said contamination of community drinking water is widespread, and provisions of the Safe Drinking Water Act (SDWA) of 1974 have not been adequately enforced by the federal Environmental Protection Agency.

“Our research shows that in 2015 alone, nearly 77 million people were served by more than 18,000 community water systems that violated at least one SDWA rule, and there were more than 80,000 violations of SDWA rules that year,” the NRDC said in its May 2 report, Threats on Tap: Widespread Violations Highlight Need for Investment in Water Infrastructure and Protections.

“These violations included exceeding health-based standards, failing to properly test water for contaminants, and failing to report contamination to state authorities or the public.”

Predicting the future is a sticky but profitable business, as any stock trader can tell you. But people are eager for speculation, especially when things aren’t going well and there’s a lot of anxiety.

Hence the interest in the 1997 book by William Strauss and Neil Howe, The Fourth Turning. The book’s thesis — that America faces a major crisis every 80 years or so and one is now upon us — is on target for a lot of people, in particular at least some members of the Trump Administration and most notably White House Chief Strategist Stephen Bannon.

I picked it up from my library and had to be put on waiting list to get it. Normally a book becomes available in a week or two — The Fourth Turning took almost two months to cycle around to me, there were so many people waiting to read it.

It is intriguing that 20 years ago the authors wrote: “The next Fourth Turning is due to begin shortly after the new millennium, midway through the Oh-Oh decade. Around the year 2005, a sudden spark will catalyze a crisis mood. Remnants of the old social order will disintegrate.”

And: “Sometime before the year 2025, Americans will pass through a great gate in history, commensurate with the American Revolution, Civil War, and the twin emergencies of the Great Depression and World War II.

“The risk of catastrophe will be very high ….”

World_War_III_43240You could certainly argue that the economic melt-down of 2008 was the start of the crisis period. Despite assurances to the contrary, we haven’t found our way out of financial crisis, with vast under-employment (people holding down two service jobs at restaurants and bars don’t count as unemployed in government statistics), consumer credit scores in the tank and people still struggling to get past bankruptcies and foreclosures.

War seems more likely under the current administration, and it doesn’t appear that it would go down quick and dirty like some of our more recent conflicts.

The New York Times was interested enough to write “Bannon’s Worldview: Dissecting the Message of ‘The Fourth Turning'” on April 8.

Writer Jeremy Peters said the book is “central to the worldview” of Bannon, who has apparently been interested in its theories for almost a decade.

Harvard historian David Kaiser, who writes a blog every Friday called History Unfolding, wrote a piece that appeared on the Time Magazine website on Nov. 18 of last year headlined: “Donald Trump, Stephen Bannon and the Coming Crisis in American National Life.”

Kaiser was interviewed by Bannon in 2009 for his documentary film, Generation Zero, at least in part, Kaiser says, because he has embraced portions of The Fourth Turning theories.

Kaiser wrote: “Strauss and Howe’s major prediction has now obviously come true: Few would deny that the U.S. has been in a serious political crisis for some time, marked by intense partisan division, a very severe recession, war abroad and, above all, a breakdown in the ties between the country and its political establishment.”

But he was concerned, he said in the article, that Bannon “expected a new and even bigger war as part of the current crisis, and he did not seem at all fazed by the prospect.

“I did not agree, and said so. But, knowing that the history of international conflict was my own specialty, he repeatedly pressed me to say we could expect a conflict at least as big as the Second World War in the near or medium term. I refused.”

While Bannon’s influence in the White House may have slipped recently, The New York Times reports that Trump himself was “channeling their thesis” — referring to Strauss and Howe — when he said during the campaign that “The American Dream is dead.”

The idea that history is cyclical isn’t new, of course. Mark Twain said: “History doesn’t repeat itself, but it rhymes.”

However, events are more likely to unfold in new and unexpected ways with lots of twists and turns that nobody can predict.

Absent some sort of cyber-catastrophe, it seems far more likely that the future will fall into the grip of Extreme Automation — call it Hyper-Automation or Super-Automation, whatever you’d like — with enormous social and culture-changing consequences.

This is discussed in an equally intriguing 2015 book by Silicon Valley software developer Martin Ford, Rise of the Robots: Technology and the Threat of a Jobless Future.

Think of a society with everything from self-driving cars to robotic garbage pickup, lawn service, and all types of maintenance. Think of sports, business and political stories written for media outlets by artificial intelligence products.

Think of mechanized and computerized fruit and vegetable pickers, self-checkout lines at the supermarket, and web-based programs that assist you in writing wills and executing real estate deals.

What will anxious, thumb-twittling Americans do then? Maybe that’s the real Fourth Turning.

Image: Cover of World War III comic books via Wikimedia Commons

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Life in the U.S. goes by in a blur in this photo titled “Busy New York at Dusk.” (Credit: Angelo DeSantis via Wikimedia Commons)

Next time somebody tells you they’re overworked, give them sympathy, a pat on the back — and a gold star. Overwork, it turns out, is a new sign of social status.

In many other cultures, people who have lots of leisure time on their hands are looked at in high regard. But a new paper published in the Journal of Consumer Research says that’s not the case in the U.S., where folks hold the overworked and those who say they “have no life” as being at the top of the social pecking order.

Researchers call it “humblebrag.”

“We uncovered an alternative type of conspicuous consumption that operated by shifting the focus from the preciousness and scarcity of goods to the preciousness and scarcity of individuals,” write the authors, Silvia Bellezza of the Columbia Business School and Neeru Paharia and Anat Keinan of Harvard University.

“People’s social-mobility beliefs are psychologically driven by the perception that busy individuals possess desirable characteristics, leading them to be viewed as scarce and in demand.”

They studied groups of people from the U.S. and compared them to groups in Italy, where just the reverse is true. People there assign high prestige and status to those who lead a more leisurely life.

The paper notes a 2014 Super Bowl commercial by Cadillac that said:

“Other countries they work, they stroll home, they stop by the café, they take August off— off! Why aren’t you like that? Why aren’t we like that? Because we are crazy driven hard-working believers, that’s why!”

If you really want to impress someone tell them that you are “in desperate need of a vacation.”

So yeah … Americans respect work. But are their noses really held to the grindstone?

In the movie Office Space (1999), Peter Gibbons explains his job to a pair of efficiency consultants: “Well, I generally come in at least 15 minutes late. I use the side door, that way Lumbergh can’t see me. And after that I just sort of space out for about an hour.

“I just stare at my desk. But it looks like I’m working. I do that for an hour after lunch, too. I’d say in a given week I probably only do about 15 minutes of real, actual work.”

In 1974, Bachman Turner Overdrive said: “And if your train’s on time/ You can get to work by nine/ And start your slaving job to get your pay/ If you ever get annoyed/ Look at me I’m self-employed/ I love to work at nothing all day.”

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ALSO: Americans want their vending machine snacks and they want them now!

A study conducted by Rush University Medical Center in Chicago demonstrated that people choose healthier snacks if they have to wait 25 seconds for their greasy, salty chips to roll down the chute.

The delay had the same affect as charging people more money for unhealthy choices or discounting healthy options.

“Having to wait for something makes it less desirable,” said lead author Brad Appelhans, a clinical psychologist. “Research shows that humans strongly prefer immediate gratification, and this preference influences choices and behavior in daily life.”

So much for the old saw: Good things come to those who wait.

Finally — a way to get your exercise without actually exercising.

Instead of lacing up the Skechers and carving out an hour or two for a run or strenuous walk, or heading off to the gym for a time-consuming and expensive workout, soon you may be able to just sit back and let a machine do all the hard lifting.

Just as it should be in the 21st century.

A new study in the journal Endocrinology touts the benefits of something called whole-body vibration, or WBV. With this method, you can stretch out and relax on a vibrating platform. The process transmits energy to the body and causes the muscles to contract and relax multiple times each second, according to researchers at the Medical College of Georgia at Augusta University.

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Anyway, it worked in mice and hopefully it will work in people, too.

“It’s nice to know that there are potentially other options out there, like whole body vibration, that could have some of the same beneficial effects as exercise and yet be less strenuous or something that could accommodate different schedules or levels of physical activity,” said Meghan McGee-Lawrence, lead author of the study.

In a news release, researchers noted that you can already buy a whole body vibrating device for under $100, although some deluxe models are sold for $2,500. But you can get a vibrating belt for under $20.

Researchers studied two groups of male mice, one of normal weight and one programmed to be obese. They then further divided them up into sedentary, WBV or treadmill groups.

The treadmill group exercised for 45 minutes and had to miss some of their favorite shows like The Price Is Right (wow — Drew Carey has really lost a lot of weight, hey?) and Wheel of Fortune. The WBV group chilled while being vibrated and the third group did no exercising at all.

Obese/ diabetic mice showed similar metabolic benefits from both the WBV and the treadmill. They gained muscle mass and insulin sensitivity.

“These results are encouraging,” McGee-Lawrence said. “However, because our study was conducted in mice, this idea needs to be rigorously tested in humans to see if the results would be applicable to people.”

The idea of vibrating your way to good health is not entirely new. Exercising belts were used as a method of fat reduction back in the 1950s and 1960s, and the concept goes back even further than that.

Here’s a nice collection of some of the old “fat melting” machines.

 
Image credit: A mouse gets a workout in a laboratory tunnel. Via Wikimedia Commons