Tag Archives: health

Americans Flee America For Overseas Health Care Just Like Canadians

Mother Jones

I’d forgotten all about this, but tonight was the date of the great Ted Cruz-Bernie Sanders debate. Apparently Cruz decided to haul out the old chestnut about Canadians fleeing en masse to the US for health care, which just proves how crappy government-run medicine is.

Lots of people are pointing out that this isn’t really true, but I want to point out something different: Americans flee the US in pretty similar numbers to Canadians fleeing Canada. The best numbers we have suggest that about 45,000 Canadians left the country for medical care in 2015. (That’s all destinations, not just the US.) Meanwhile, about 250,000 Americans left the US for medical care abroad. And these numbers don’t even count the number of Americans who get their prescription drugs from overseas.

Overall, then, that’s about 0.13 percent of Canadians and 0.08 percent of Americans who flee their countries for health care. Those are pretty similar numbers. The only real difference is the reason for leaving. Canadians mostly cite wait times for elective surgery. Americans mostly cite the high cost of medical treatment.

So you see, every kind of health care system has its own problems. Canada’s is bad for rich people who can afford to pay top dollar to get faster service. America’s is bad for poor people, who would go bankrupt if they paid American prices. Check your moral compass and take your pick.

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Americans Flee America For Overseas Health Care Just Like Canadians

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Chronic Marijuana Use Is Up In Colorado

Mother Jones

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A new report from the Colorado Retail Marijuana Public Health Advisory Committee tells us that among 18-25 years olds, 13 percent report using marijuana daily or near-daily. Mark Kleiman is taken aback that this has gotten hardly any attention:

We know from other studies by Beau Kilmer and his group at RAND that daily/near-daily smokers consume about three times as much cannabis per use-day as less frequent smokers, enough to be measurably impaired (even if not subjectively stoned) for most of their waking hours….The National Survey on Drug Use and Health finds that about one-half of daily or near-daily smokers meet the diagnostic criteria for Substance Use Disorder. That’s a frightening share of users, and of the total population, to be engaging in such worrisome behavior.

….More and more people using cannabis more and more often is a trend that pre-dates legalization and is not restricted to states that have legalized….What is clear is that lower prices…make it easier for users to slip into heavy daily use. Indeed, that’s the main — some of us would say the only significant — risk of legalization. That risk could be reduced by using taxes to prevent the price collapse. So a report on the effects of legalization that neglects heavy use is like a review of the last performance of “Our American Cousin” that doesn’t mention John Wilkes Booth.

That sounds like a lot. On the other hand, if half of daily marijuana users typically have substance use disorders, that about 6.5 percent in Colorado. Here are the national figures for the past decade:

The Colorado figure is higher than than the national figure, but not hugely higher. It’s probably not a reason to panic, but it does bear watching.

The kind of people who read this blog are probably in favor of marijuana legalization—as I am—largely because they’re the kind of people who use it occasionally and don’t see a lot of harm in it. But like alcohol, there’s a certain share of the population that will fall into addiction, and that share is likely to increase as marijuana prices come down. There’s never a free lunch.

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Chronic Marijuana Use Is Up In Colorado

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Here Are the Top Five Takeaways From Yesterday’s Trump Interview

Mother Jones

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ABC’s David Muir has gotten some flak for his performance interviewing President Trump yesterday, but I’m not sure it’s deserved. Maybe he could have done better, but if the guy won’t answer a question, he won’t answer a question. Most of the time, Trump barely let Muir get in a word edgewise. Every time half a question came out, Trump would barrel over it and deliver a rambling, unrelated screed. If Muir had asked him what 2+2 equaled, Trump would have blathered for five minutes about our terrible schools and the Chinese are killing us and nobody knows numbers anymore and we have to get rid of Common Core and blah blah blah. Muir tried four or five times to get a straight answer about Trump’s idiotic claim that 3-5 million noncitizens voted, and Trump just flatly wouldn’t engage.

Still, there were a few interesting tidbits. I count four altogether. First, what’s this business of sending in the feds to deal with Chicago’s crime problem?

DAVID MUIR: You will send in the feds? What do you mean by that?

PRESIDENT TRUMP: It’s carnage….It’s horrible carnage….Now if they want help, I would love to help them. I will send in what we have to send in. Maybe they’re not gonna have to be so politically correct. Maybe they’re being overly political correct. Maybe there’s something going on.

Chart above adapted from CNN chart. Next up: Does Trump endorse torture?

DAVID MUIR: The last president, President Obama, said the U.S. does not torture. Will you say that?

PRESIDENT TRUMP: I will say this, I will rely on Pompeo and Mattis and my group. And if they don’t wanna do, that’s fine. If they do wanna do, then I will work for that end….And I’m gonna rely on those two people and others. And if they don’t wanna do it, it’s 100 percent okay with me. Do I think it works? Absolutely.

How about the oil in Iraq? Are we going to go back in and take it?

DAVID MUIR: You brought up Iraq and something you said that could affect American troops in recent days. You said, “We should’ve kept the oil but okay maybe we’ll have another chance.” What did you mean by that?

PRESIDENT TRUMP: Well, we should’ve kept the oil when we got out….

DAVID MUIR: You’ve heard the critics who say that would break all international law, taking the oil.

PRESIDENT TRUMP: Wait, wait, can you believe that? Who are the critics who say that? Fools. I don’t call them critics. I call them fools….

DAVID MUIR: What got my attention, Mr. President, was when you said, “Maybe we’ll have another chance.”

PRESIDENT TRUMP: Well, don’t let it get your attention too much because we’ll see what happens. I mean, we’re gonna see what happens.

Finally, will Trump guarantee that folks currently covered by Obamacare will remain covered under his new plan?

DAVID MUIR: You’ve seen the estimate that 18 million Americans could lose their health insurance if Obamacare is repealed and there is no replacement. Can you assure those Americans watching this right now that they will not lose their health insurance or end up with anything less?

PRESIDENT TRUMP: …. Here’s what I can assure you, we are going to have a better plan, much better health care, much better service treatment, a plan where you can have access to the doctor that you want and the plan that you want. We’re gonna have a much better health care plan at much less money.

And remember Obamacare is ready to explode. And you interviewed me a couple of years ago. I said ’17 — right now, this year, “’17 is going to be a disaster.” I’m very good at this stuff….And why not? Obama’s a smart guy. So let it all come due because that’s what’s happening…..

DAVID MUIR: So, no one who has this health insurance through Obamacare will lose it or end up with anything less?

PRESIDENT TRUMP: You know, when you say no one I think no one. Ideally, in the real world, you’re talking about millions of people. Will no one. And then, you know, knowing ABC, you’ll have this one person on television saying how they were hurt. Okay. We want no one. We want the answer to be no one.

So there you have it:

Two weeks ago, the Justice Department released a “blistering” report about the Chicago Police Department that said “excessive force was rampant, rarely challenged and chiefly aimed at African-Americans and Latinos.” But Trump thinks maybe they’re being too soft and they need someone to come in and toughen them up.
Torture is a war crime, but Trump is explicitly fine with it if any of his guys recommend it.
He still wants to take Iraq’s oil, and refuses to rule out the possibility of going back in and doing it. Trump seems to still not realize that the oil is all in the ground and he can’t just “take it,” nor that taking it would also be a war crime.
He thinks President Obama deliberately designed Obamacare to implode in 2017 when he would no longer be in office.
His health care plan will cover everyone who currently has coverage under Obamacare. No one will end up with something worse. “We want the answer to be no one.”

I would have posted this last night, but I just couldn’t stand any more Trump. It took me all morning to work up the willingness to tackle it.

And we’re only partly through the first week. There are 208 to go.

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Here Are the Top Five Takeaways From Yesterday’s Trump Interview

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Congress Gutted Researchers’ Ability to Study Gun Violence. Now They’re Fighting Back.

Mother Jones

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On November 14, six days after Donald Trump won the presidential election, more than 80 researchers from 42 schools of public health gathered for a closed-door meeting at the Boston University School of Public Health. Their agenda: how to get around the federal government’s de facto ban on researching the health impact of gun violence and get it done anyway.

“The idea was to pull together a meeting to say, ‘We have had no change in the number of firearm deaths and firearm injuries since 2000. It’s become endemic,'” says Sandro Galea, a physician, epidemiologist, and the dean of the BU School of Public Health, who organized the hush-hush meeting. “There has been no action on this to speak of at the federal level, and there has been no clear statement from academic public health on this issue. We brought people together to ask, ‘What should academic public health be doing toward moving us collectively toward mitigating the consequences of gun violence?'”

Despite the more than 30,000 gun-related deaths that occur in America every year, firearms receive relatively little attention as a subject of public-health research. A recent research letter published in the Journal of the American Medical Association found that gun violence is the least-researched leading cause of death in the United States. This is largely because of a 1996 bill that prevented the the Centers for Disease Control and Prevention (CDC) and other agencies from using federal money to “advocate for or promote gun control.” The lack of funding combined with the toxic environment that surrounds the debate over gun rights has made most public-health researchers wary of touching the topic.

JAMA/Icahn School of Medicine at Mount Sinai

The group that met at BU in November hope to reverse that two-decade trend. They drafted a call to action, the final version of which was published yesterday in the American Journal of Public Health. It outlines a plan to beef up gun violence research and scholarship by seeking funding from the private sector, as well as seeking common ground between pro-gun advocates and gun safety advocates, and developing state-level initiatives.

“Federal funding is not going to happen with the National Rifle Association around,” says John Rosenthal, a Massachusetts-based businessman and gun owner who was a keynote speaker at the November meeting. In 1994, he started Stop Handgun Violence, which has advocated stricter gun laws in his home state. (Massachusetts has the third-lowest gun violence rate in the nation, and some of its toughest gun laws.) “In the absence of public funding, this call to action could lead to significant private funding,” he says. “If enough schools of public health really look at it—and this is a public health epidemic—then lives will be saved. I think there will be a critical mass with this group and more that will follow.”

Galea says gun researchers have a lot of catching up to do. “The fundamental, foundational work of documenting the full scale of the health consequences of firearms has not been done,” he says. “It’s the kind of project that we do all the time. It just hasn’t been done with firearms because there haven’t been resources.”

Even if the researchers overcome these financial obstacles, they must still contend with the political climate. “Trump was a clear supporter of gun rights throughout the campaign and has widely claimed support from the gun lobby as a core part of his appeal; the gun lobby spent more than $30 million on the campaign,” they write in their call to action. “This portends challenges to advancing gun policy at the federal level in the next four years, if not longer.”

The NRA has called out Galea for his “deeply flawed research,” likening his defense of a controversial recent study of gun laws to “the behavior of a mule.” “It is very charged when you have the NRA calling you out personally,” Galea says. “It has a chilling effect. It’s hard to encourage young people to make a career out of studying something which brings with it the threat of a public fight with a group as powerful as the NRA.” After 20 years of delay, Rosenthal says it’s time to stop ignoring one of the country’s leading causes of death. “We’ve reached a tipping point,” he says. “Enough is enough.”

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Congress Gutted Researchers’ Ability to Study Gun Violence. Now They’re Fighting Back.

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Health Care Is All About the Benjamins

Mother Jones

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Sherri Underwood, a Midwestern woman in her mid-50s, writes that she voted for Donald Trump but now regrets it:

Most of my decision came down to my poor experience with Obamacare. In the ’90s, I was diagnosed with fibromyalgia, a chronic illness that causes fatigue, memory loss, physical aches, and soreness….I eventually was unable to work at all. I lost employer-based health insurance when I left the workforce and had to pay my health care costs out of pocket.

When Obamacare first came into effect, I was excited to get what I thought would be financial help with my costly medicine and treatments. But my husband’s salary put me in an earning bracket too high to qualify for any financial assistance….I’m left with a premium of $893, so high that I can no longer afford the cost of my medicines and treatments on top of the monthly premiums.

….In the end, I voted for Trump because he promised to repeal and replace Obamacare, and that was the most important issue to my own life. Looking back, I realize what a mistake it was. I ignored the pundits who repeated over and over again that he would not follow through on his promises, thinking they were spewing hysterics for better ratings. Sitting on my couch, my mouth agape at the words coming out his mouth on the TV before me, I realized just how wrong I was.

This is so depressing. Underwood’s general problem is that she’s decided Trump is not a man who will carry out his promises, so now she doesn’t believe he’s going to improve Obamacare. Fine. But what Underwood never understood is that even if Trump did carry out his promises, she’d still be worse off. Although Underwood may not have qualified for a subsidy, she did benefit from the fact that Obamacare allows a maximum premium ratio of 3:1 between old people and young people. Trump and other Republicans think this ought to be 5:1. If it were, Underwood’s premium would be over $1,000. Obamacare probably saved her something in the neighborhood of $2,000 per year.

Plus Obamacare allowed her to get insurance in the first place. Until it took effect, no one would cover her.

Lots of people have benefited considerably from Obamacare, but not everyone. Underwood found herself in the worst possible position: old enough to have a high premium but well-off enough that she didn’t qualify for assistance. So she was gobsmacked when she discovered just how much health care costs in America. Most people have no real clue about this, but per-capita health care spending in the US for someone 55 years old is about $10,000 per year. That means insurance premiums are going to be $10,000+ per year too. There’s just no getting around this.

If Republicans want to cover people like Underwood, they’re going to have to spend more money than Obamacare. If they want to reduce deductibles, they’re going to have to spend more money than Obamacare. If they want to increase subsidies for the middle class, they’re going to have to spend more money than Obamacare. This is an iron law, and no amount of blather about state lines or tort reform or anything else changes it more than minutely. But Republicans want to spend less, not more. Even if Trump had been sincere, there was never any chance that Underwood would do better under his plan than under Obamacare.

It all comes down to money. Ignore the rest of the chaff. If you think national health care should be better, it means spending more money. Period.

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Health Care Is All About the Benjamins

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Trump’s Pick to Oversee Obamacare’s Destruction Faces a Senate Grilling

Mother Jones

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When Donald Trump’s nominee to oversee the country’s health care system appears before the Senate on Wednesday morning, he can expect to face a barrage of questions not only about Republican plans to replace Obamacare, but also about whether he broke the law by profiting off health stocks.

Rep. Tom Price (R-Ga.), Trump’s nominee for secretary of health and human services, is scheduled to testify Wednesday before the Senate Committee on Health, Education, Labor, and Pensions, before he later visits the Senate Finance Committee, which will vote on his confirmation. An orthopedic surgeon who has made it his political mission to reduce regulation of the medical industry, Price has led Republican attacks on President Barack Obama’s health care law, the Affordable Care Act. He’s one of the few members of Congress to lay out a detailed alternative, although his proposal has not been adopted by the president he hopes to work for. But Price’s ability to get confirmed in the Senate might depend less on policy than on a string of alleged ethical lapses that have come to light since his nomination was announced in November.

All of this portends a confrontational hearing and a less-than-warm reception from Senate Democrats. Here are the controversies that are most likely to emerge in the hearing.

Obamacare replacement

Republicans have stumbled toward a repeal of the Affordable Care Act since the new Congress convened at the beginning of the month. Both chambers have passed resolutions to preclude a Democratic filibuster of a repeal, but Republicans are still struggling to figure out what will take Obamacare’s place if they eradicate the law.

Price has introduced the same Affordable Care Act replacement bill in each session of Congress since the law was enacted in 2009. But Price’s plan would likely strip many poor people of insurance by ending the Affordable Care Act’s expansion of Medicaid coverage to millions of low-income Americans. Price would also change the formula for determining who gets government subsidies for private insurance so that it doesn’t take income into account—meaning far more of the tax benefits would go to the wealthy than under the current system.

Is Price’s plan Trump’s plan? No one knows. Over the weekend, Trump said his plan to replace Obamacare would offer “insurance for everybody”—something Price’s plan does not seem to offer. CNN reported that Price has been excluded from the Trump team’s deliberations on health care reform so that he can avoid answering questions about those plans in his Senate hearing.

Still, Price will have to offer some sort of vision for how the Trump White House will address the health system—and just promising to repeal Obamacare won’t be enough. On Tuesday, the Congressional Budget Office released a report finding that number of people without insurance would increase by 18 million under the first year of a repeal, with that number expanding to 32 million by 2026. Premiums for individually purchased insurance would also double beyond current projections over the next decade.

Conflicts of interest

Price has been the subject of ethics concerns since Trump announced his nomination. The Wall Street Journal reported in December that Price has made more than $300,000 in trades in health care stocks over the past four years, while he continued to introduce health care legislation. Democrats called foul, with one House member writing a letter to federal financial regulators requesting an investigation into whether Price’s trading broke the law. Senate Minority Leader Chuck Schumer has pushed the Office of Congressional Ethics to examine whether Price’s stock trades violated laws prohibiting members of Congress from profiting off non-public knowledge.

Over the weekend, CNN reported that Price had bought between $1,001 and $15,000 in stock in a medical device company right before he introduced a bill that would have directly helped the company. On Tuesday, Schumer said that stock purchase “could very well be a violation of the law.”

Reproductive rights

Price is a staunch opponent of abortion rights. He has voted several times for a federal 20-week abortion ban, which stands in contrast to Trump’s pledge to send the abortion debate “back to the states” when his Supreme Court picks try to overturn Roe v. Wade. But abortion isn’t the only area where Price has fought against reproductive rights. Mother Jones reported in December on the myriad ways Price has tried to restrict contraception, including defunding Planned Parenthood, gutting Obamacare’s mandate that employer-sponsored insurance plans cover contraception without a copay, and passing “personhood” bills that would make certain IUDs and the morning-after pill illegal.

Payments to doctors

In addition to expanding insurance coverage, the Affordable Care Act changed the way doctors and hospitals are compensated in order to slow the growth rate of health spending. Throughout his career, Price has complained that the government burdens doctors with too many regulations and attacked proposals that would pay doctors for results rather than for each test ordered or procedure performed. Although he can’t repeal Obamacare’s insurance expansion without congressional action, he can reverse many of the law’s medical payment reforms, since these policies are largely at the discretion of the secretary of health and human services. Even as the American Medical Association has lavished praise on Price’s nomination, a faction of doctors has rejected the AMA’s endorsement and called for more scrutiny into Price’s attacks on the Obamacare reforms.

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Trump’s Pick to Oversee Obamacare’s Destruction Faces a Senate Grilling

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The Most Popular Theory About What Causes Obesity May Be Very Wrong

Mother Jones

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You’ve heard it over and over again: The obesity crisis, which affects more than a third of US adults and costs the country hundreds of billions of dollars every year, is due to the fact that people eat more calories than they expend. In other words, one of the leading causes of preventable deaths is rooted in gluttony and sloth. If people jogged more and ate fewer Big Macs, they wouldn’t get obese.

What if that idea is just wrong? Gary Taubes thinks it is. Taubes joined us on the most recent episode of Bite to talk about the flaws in this popular idea of how we get fat.

As a journalist and author, Taubes has devoted his career to understanding how what we eat affects our weight. Taubes sees serious flaws in the “energy-balance theory”—that you just have to eat less and move more to stave off the pounds—and thinks that the idea is seriously undermining the fight against obesity. The more nutritionists and doctors promote that theory, he argues, the more they avoid talking about what Taubes sees as a more convincing cause of our public health woes: sugar.

Taubes traces the roots of the energy-balance theory in his new book, The Case Against Sugar. In the 1860s, German scientists invented a calorimeter which measured how many calories a person consumed and then used up. This innovation helped inform the “new” nutrition science of the early 1900s: “You could measure the energy in, you could measure the energy out,” Taubes explains. “Clearly if someone was getting fatter, they were taking in more energy than they expended. From this came this theory that obesity was an energy-balance disorder.”

But in the 1960s, researchers developed radioimmunoassay, allowing them to measure the circulation of hormones in the blood. Scientists could soon establish how hormones regulate the fat we accumulate, and how the food we eat influences those hormones. But at that point, notes Taubes: “The obesity and nutrition community continues to say, ‘look, we know why people get fat: It’s because they take in more calories than they expend.'”

That stubborn theory—Taubes sarcastically deems it “the gift that keeps on giving”—prevails even today. As my colleague Julia Lurie pointed out in this story, junk food companies use this idea in order to peddle sugary foods to kids. In one lesson of Energy Balance 101, a curriculum backed by companies like Hershey and PepsiCo and taught to 28 million students and counting, students learn that going for a bike ride can balance out munching on a chocolate bar.

The problem with this mentality, Taubes and numerous doctors and scientists argue, is that it ignores the way certain ingredients play a unique role in the way our bodies develop fat. Sugar is metabolized differently, and it doesn’t trigger the hormone that tells us when we’re full. Doctor Robert Lustig argues that too much sugar causes metabolic syndrome, a condition linked to heart disease, diabetes, and other chronic illnesses.

So if obesity isn’t an energy-balance disorder, but is rather a metabolic defect, says Taubes, “you have to fix the hormonal thing.” And “the way you start fixing it is you get rid of all the sugar in your diet.”

Taubes realizes all of this is such a bummer to swallow. He’s written a book that’s “the nutritional equivalent of stealing Christmas,” he writes. So I wanted to know, if not sugar, what’s his vice? You’ll have to listen to the episode to find out.

Bite is Mother Jones‘ podcast for people who think hard about their food. Listen to all our episodes here, or subscribe in iTunes, Stitcher, or via RSS.

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The Most Popular Theory About What Causes Obesity May Be Very Wrong

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Cancer Survivor and Former Republican Tells Paul Ryan Obamacare Saved His Life

Mother Jones

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A former Republican who once worked for the Reagan and Bush campaigns confronted House Speaker Paul Ryan on Thursday, asking why the GOP is seeking to repeal the Affordable Care Act without a serious replacement plan. The moment came during a CNN town hall event, where Jeff Jeans revealed that like Ryan, he too once opposed the health care law.

“When it was passed, I told my wife we would close our business before I complied with this law,” Jeans said. “Then at 49, I was given six weeks to live with a very curable type of cancer. We offered three times the cost of my treatment, which was rejected. They required an insurance card.”

“Thanks to the Affordable Care Act, I’m standing here today.”

As Ryan attempted to respond, insisting Republicans are working to replace Obamacare with “something better,” Jeans interjected to publicly express his gratitude to the president.

“I want to thank President Obama from the bottom of my heart because I would be dead if it weren’t for him.”

Hours before the televised event, Republicans took a major step at dismantling Obamacare. On Friday morning, President-elect Donald Trump tweeted in support of repeal efforts:

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Cancer Survivor and Former Republican Tells Paul Ryan Obamacare Saved His Life

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Donald Trump Is "an Existential Threat to Public Schools"

Mother Jones

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On the day President-elect Donald Trump announced Michigan billionaire philanthropist Betsy DeVos as his pick for education secretary, the heads of the country’s two largest teachers unions jumped to condemn the choice. American Federation of Teachers (AFT) president Randi Weingarten called DeVos “the most ideological, anti-public education nominee put forward since President Carter created a Cabinet-level Department of Education.” National Education Association (NEA) president Lily Eskelsen García noted the administration’s choice “demonstrated just how out of touch it is with what works best for students, parents, educators, and communities.”

Educators have worried that DeVos, a prominent Republican fundraiser, and her support for “school choice” and the use of vouchers would endanger public education. With the billionaire’s confirmation hearing slated for Wednesday, the nation’s two biggest teachers’ unions have gone on the offensive with grassroots campaigns to challenge DeVos’ nomination.

Neither group anticipated Donald Trump to win the election. “We did everything in our power to get Hillary Clinton elected. We didn’t have a plan B,” Weingarten says. “We always thought Donald Trump would be as dangerous as he’s showing he is.” But both unions say they were unsurprised by Trump’s selection of DeVos, whose past work in Michigan align with the president-elect’s proposals to direct federal dollars toward private and charter schools. “We have many, many years of experience with her and her undermining of the public education system in Michigan. We have frontline stories about what her agenda and the Trump agenda has meant to communities and to students,” says Mary Kusler, senior director of the NEA Center for Advocacy. “She was not somebody who was plucked out of thin air for us.”

Education historian Diane Ravitch, who founded the advocacy group Network for Public Education in 2013, described unions as “shocked and worried” by the DeVos selection in an email to Mother Jones. “The previous Republican administrations did not threaten the very existence of public education and teachers unions,” she added. “This coming four years is an existential threat to a basic Democratic institution: public schools. Trump has picked a Secretary who is hostile to public schools. This is unprecedented.”

In the weeks following the election, the unions at the national and local levels turned their attention to trying to disqualify DeVos by emphasizing her lack of experience in public education and her work in Michigan. Last month, the AFT, which has 1.6 million members, went on an education campaign, unveiling fact sheets on DeVos and other Cabinet picks like Labor Secretary-designee and fast-food executive Andrew Puzder and Health and Human Services Secretary-designee Rep. Tom Price (R-Ga.). At these agencies, Weingarten says, are “people who have been appointed whose ideology seems antithetical to the mission of these agencies.”

On December 6, the AFT and NEA released a joint open letter condemning Trump’s pick, stating that her “sole ‘qualification’ for the job is the two decades she has spent attempting to dismantle the American public school system.” The letter has amassed more than 130,000 signatures from parents, teachers, and other supporters. Representatives from both unions say that members have been arranging meetings with senators. Meanwhile, local affiliates for both unions have encouraged members to flood senators with calls, emails, and letters in opposition.

Though activity settled down leading up to the holidays, the NEA—the nation’s largest union with 3 million members—expects to ramp up calls from members to speak on behalf of students in the next week to senators on the Senate Committee on Health, Education, Labor, and Pensions, which will oversee DeVos’ hearing. When asked if current efforts to organize around the confirmation hearing was enough to oppose DeVos, Kusler said the union’s members were doing what they could. “At the end of the day, you’ve got to remember: Our members are teaching kids during the day,” she added, likening the current grassroots efforts to that of 2015, when both unions engaged in separate campaigns during the reauthorization of the Elementary and Secondary Education Act, now known as the Every Student Succeeds Act. “We’ve never been in this situation around the confirmation for a secretary of education that has looked like this,” Kusler says. “So engaging our members using the tactics we use anyway for a legislative fight around a confirmation of a secretary is unprecedented.”

Katharine Strunk, an associate professor of education at the University of Southern California who studies teachers’ unions, noted that unions would be able to activate their base of support, but that they may have less sway in lobbying efforts, given Republicans’ firm control of the Senate. “If you don’t have the majority,” the AFT’s Weingarten says, “it’s a pretty uphill battle.” Voters who sided with Trump may have wanted to shake up the system, Weingarten adds, but she doesn’t believe that they “voted to end public education as we know it.”

Carol Burris, executive director of Ravitch’s Network for Public Education, says she anticipates a difficult four years for teachers’ unions. The organization engaged in its own campaign, urging its supporters to send letters to senators over the holidays and to call and visit their offices. This week, the network called on members to make phone calls to senators in each state, particularly those on the committee overseeing DeVos’ hearing. “Betsy DeVos and the people who believe what she believes have no patience for unions in any form and certainly not teachers’ unions,” she says. “They see teachers’ unions not as partners in providing a good education for kids, but as adversaries.”

Future challenges from the unions will largely depend on the policies the Trump administration chooses to pursue. In a speech at the National Press Club on Monday, Weingarten warned that DeVos’ nomination threatened the bipartisan agreement around the federal government’s role in shaping education and could undermine the public education system DeVos would be charged with overseeing.

“Betsy DeVos lacks the qualifications and experience to serve as secretary of education,” Weingarten told the audience. “Her drive to privatize education is demonstrably destructive to public schools and to the educational success of all of our children.”

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Donald Trump Is "an Existential Threat to Public Schools"

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The Link Between Road Pollution and Dementia Just Got Stronger

Mother Jones

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Most of us associate car pollution with coughing and wheezing, but mounting evidence is linking air pollution to a less obvious health effect: Dementia.

People who live near a major road are up to 12 percent more likely to develop dementia—a group of memory-loss disorders including Alzheimer’s disease—than those who live further away, according to study published Wednesday in medical journal in The Lancet.

The study, led by scientists at Public Health Ontario, found that the risk of dementia increased the closer residents lived to a major road, and the longer they lived there. The authors tracked all the adults living in Ontario, Canada—about 6.6 million people—over the course of a decade from 2001 to 2012. Using postal codes and medical records, they determined how close a given resident lived to a major road—including freeways, highways, or congested roads with two or more lanes—and if they went on to develop dementia.

Residents living within 50 meters (55 yards) of a major road were between 7 and 12 percent more likely to develop dementia, depending on how long they had lived there and whether they lived in an urban or rural area. With distance from the road, the risk dissipated until, 200 meters away from a major road, residents were at no more risk than those who lived further away.

The numbers are particularly alarming considering how many people live close to traffic sources: Nearly half of adults in Ontario lived within 200 meters (219 yards) of a major roadway, and Copes estimates similar numbers for the United States.

This isn’t the first study to suggest that air pollution can change the brain. As journalist Aaron Reuben reported in a 2015 Mother Jones feature, several studies have found that people exposed to high pollution rates over time show more cognitive decline and pre-dementia symptoms than those who breathe cleaner air, even when controlling for things like income, ethnicity, and other environmental factors. Scientists are still pinpointing exactly how air pollution changes the brain, but as Reuben noted, fine particulate matter found in car exhaust is small enough to travel throughout our bodies—including to our brains. Once in the brain, pollution particles lead to inflammation that could contribute to cognitive decline over time.

Public health advocates have long recommended limiting exposure to major roads to the extent possible—whether that means living farther from major roads or choosing to exercise or commute on less congested streets. For now, this option isn’t available to all: Multiple studies have found that people of color and low-income populations are be exposed to air pollution at far higher rates than white people.

“The challenge is to look at different ways of laying out of communities so that we have a higher percentage of our population who are located or residing more than 200 meters away from major traffic arteries,” says Ray Copes, the director of environmental and occupational health at Public Health Ontario and a co-author on the Lancet study. That could mean building new homes, schools, and hospitals farther from major roads, or planning cities with more dispersed traffic.

The end goal, according to Copes: create “a greater degree of separation between traffic and noses.”

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The Link Between Road Pollution and Dementia Just Got Stronger

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