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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

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Komodo dragons are the are the king-sized cousins of Nile monitor lizards, an invasive species showing up in Florida. (Credit: Wikimedia Commons)

Florida attracts lots of quirky creatures of both the two-legged and four-legged variety.

But none of them are creepier than the Nile monitor lizard, which has been gaining a foothold on the peninsula thanks to exotic pet owners who gave up on their repugnant reptiles and released them into the wild.

In January, I wrote a story for the Palm Beach Daily News about invasive species in the Loxahatchee Wildlife Refuge, the sprawling last-remaining vestige of the northern Everglades in Palm Beach County. The subject was Melaleuca and the proliferation of Old World climbing fern, which is strangling native vegetation.

But in talking with people from the U.S. Fish & Wildlife Service, the subject of invasive animal species also came up. There is a well-known problem with pythons in the Everglades, but less discussed is the more recent issue of Nile monitor lizards, which have been harassing domestic pets from suburban West Palm Beach to Fort Myers.

While alligators — and even some species of crocodiles — have a certain majesty and are native to the state, sightings in residential neighborhoods are likely to prompt a call to authorities for removal. But spotting a monitor lizard in your backyard may raise the hair on the back of your neck.

“A typical adult Nile monitor can grow over 5 feet in length and weigh close to 15 pounds.” the Florida Fish and Wildlife Commission says on its website. “If encountered, they typically flee into the water.”

But not always.

This report which aired last fall on Channel 2 in Fort Myers, shows a lizard attacking someone’s dog. Through November, the City of Cape Coral received more than 30 calls about monitor lizards.

“If approached, a Nile monitor lizard will try to appear bigger, puffing out its lungs and standing on its back legs,” the reporter on the story says. It hunts during the day and sleeps at night.

Monitor lizards are the “baby cousins” of the larger and even more formidable Komodo Dragons, which can range up to 10 feet long and weigh as much as 200 pounds.

Found on the Indonesian islands of Komodo, Rinca, Flores, Gili Motang, and Padar, they hunt in packs and prey on large animals, including deer. “They will also ambush live prey with a stealthy approach,” says a description on Wikipedia. “When suitable prey arrives near a dragon’s ambush site, it will suddenly charge at the animal and go for the underside or the throat.”

They have never been reported in Florida.

But I just finished a 2010 book by Randy Wayne White — part of the very entertaining Doc Ford series — called Deep Shadow, in which the biologist protagonist and his buddies run into a Komodo on a remote Central Florida lake while hunting for lost treasure. Adventure and intrigue ensue amid a battle with the giant lizard, which had been culling beef cattle from the local rancher over several decades. (Komodos can live to the age of 30.)

Diving in the lake, Ford spots the creature and says: “I tried to convince myself that I was watching an over-sized gator, but I knew it wasn’t true. More than anything else, it looked like the tail of a Nile monitor lizard — but that couldn’t be. Monitors didn’t grow to be thirteen feet long, and the animal I was watching had to be at least as big as that.”

“A Komodo monitor? In Florida? Even as I thought the word impossible, I knew that I was wrong again. Florida was the perfect habitat for the world’s largest venomous lizard.”

Fiction is fiction and a novel is a novel. But some people will keep any kind of exotic pet, and exotic pet ownership inevitably leads to a chance of accidental — or intentional — release.

In Deep Shadow, White says: “In the remote pasturelands of Central Florida, a Komodo-sized lizard wouldn’t just survive, it would thrive. An animal with its habits could live unnoticed for years, feeding by night and sleeping underground by day.”

One thing is certain: Florida with its near-tropical climate is more attractive to exotics than most other states. Environmentalists can and do make progress against both plant and animal varieties, but the war never seems to be completely won.

The Everglades is remote and its fringes press up against residential neighborhoods as development pushes farther into the peninsula’s interior.

Be careful out there.

Automation is taking away U.S. manufacturing jobs much faster than NAFTA or low-wage competitors in countries like Mexico or China.

That’s a fact, but one that gets lost in all the rhetoric around immigration and trade agreements.

And now in the last few months there’s increasing evidence that automation is also rushing to fill a labor vacuum in the agricultural industry. There’s a heated debate over undocumented workers coming into the U.S. to take farm jobs, but this could soon be a moot point.

The cheap foreign labor U.S. farmers have come to rely on for harvesting their crops may no longer be needed as machinery and sophisticated robots move into fields and orchards. A crackdown on immigration may not have the devastating effect on U.S. agriculture that growers feared, and domestic produce prices seem likely to rise if NAFTA is reworked or scrapped.

The result would be higher profits for farmers while middle class consumers face higher prices at the supermarket and see no real increase in employment opportunities.

Technology is advancing so quickly that the “America first” strategy that attracted so much support during last year’s election is already starting to look quaint.

strawberriesIn Florida, a winter fruit and vegetable center, a Tampa company called Harvest CROO Robotics was awarded a patent last summer on a strawberry picker that can harvest 25 acres of strawberries in three days.

Bloomberg reported last month: “Robotic devices like lettuce thinners and grape-leaf pullers have replaced so many human hands on U.S. farms in recent years that many jobs now held by illegal workers may not exist by the time Donald Trump builds his promised wall.”

A Michigan apple grower bought a $138,000 machine that can pick three times as many apples as workers using ladders and buckets. The machines never have to take a break, don’t need visas to get into the U.S., and don’t have to worry about immigration raids.

A California vineyard owner cut his need for grape pickers by 95 percent by purchasing an automated harvester.

Dairy farmers are using robots that milk, feed and clean cows.

Bloomberg says that out of a U.S. agricultural workforce of 2.6 million in 2016, up to 1 million were undocumented foreign workers. But that percentage is falling fast, since fewer foreign workers are coming into the country and those who do enter are looking for non-agricultural jobs.

Economists believe a lack of farm workers could mean higher prices at the supermarket. But if NAFTA is scrapped or renegotiated, the door could be open to higher produce prices anyway, even if automation plays a bigger role, because of less international competition.

So what’s in it for consumers if there’s no expansion of domestic job opportunities and supermarket prices are actually higher?

Tax the robots, says Microsoft founder Bill Gates. You could use the revenue to fund services for the elderly and for working with kids in schools, he said in an interview with Quartz, a publication founded by former Wall Street Journal reporter Kevin Delaney. It would also generate funding for worker retraining and may even have the effect of slowing down automation.

“Right now, the human worker who does, say, $50,000 worth of work in a factory, that income is taxed and you get income tax, social security tax, all those things,” Gates said. “If a robot comes in to do the same thing, you’d think that we’d tax the robot at a similar level.”

And here’s one thing guaranteed: You won’t hear any complaints from the robots.

Image credit: Fresh-picked strawberries via Wikimedia Commons.

Here’s yet another example of the law of unintended consequences — one that could have a harmful impact on the already-struggling U.S. health care system.

About 260 foreign medical students could lose their medical residency assignments as a result of the Trump Administration’s order banning travel to the U.S. from seven countries.

The Association of American Medical Colleges says the order could have a far-reaching effect on medical research and may also ultimately cause problems for patients in the U.S.

The organization released a statement saying that it’s “deeply concerned” about the order, which has been challenged in the U.S. courts and has been suspended — for now.

“International graduates play an important role in U.S. health care, representing roughly 25 percent of the workforce,” the statement said. “Current immigration pathways —including student, exchange-visitor, and employment visas — provide a balanced solution that improves health care access across the country ….”
Atul Grover, executive vice president at the AAMC, told Kaiser Health News: “These are doctors. They could be exceptional practitioners and I don’t know if you want to stop them from coming here and serving their patients.”

The countries are Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen.

One medical student from Sudan described the turn of events as “very devastating. Because you are born in an unfortunate situation, you have to pay the price for that.”

In addition to the 260 applicants for a residency slot — the positions were set to be announced March 17 — others who are already involved in a residency program fear that they won’t be able to complete it.

About a quarter of doctors in the U.S. are foreign-born, according to KHN. AAMC projects that there will be a shortage of 94,700 physicians in the U.S. by 2025.

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CRACKING THE CANCER CODE: Certain kinds of hard-shelled nuts can help fight cancer, new research shows.

Macadamia nuts, hazelnuts, walnuts, almonds and pistachios help initiate “programmed cell death” in cancer cells, researchers found, although it’s unclear whether their anti-cancer power is reduced by roasting.

That will require further study, they said.

The studies were conducted by Friedrich Schiller University Jena in Germany.

Image: pistachios could help in the fight against colon cancer and other types of the disease. (Credit: Wikimedia commons)